Safety of measles and pertussis-containing vaccines in children with autism spectrum disorders.

Objectives: To determine whether children aged 4-7 years with a diagnosis of autism spectrum disorders (ASD) were at increased risk of fever, febrile seizures, or emergency department (ED) visits following measles- or pertussis-containing vaccines compared with children without ASD.
Methods: The study included children born between 1995-2012, aged 4-7 years at vaccination, and members of six healthcare delivery systems within Vaccine Safety Datalink. We conducted self-controlled risk interval analyses comparing rates of outcomes in risk and control intervals within each group defined by ASD status, and then compared outcome rates between children with and without ASD, in risk and control intervals, by estimating difference-in-differences using logistic regressions.
Results: The study included 14,947 children with ASD and 1,650,041 children without ASD. After measles- or pertussis-containing vaccination, there were no differences in association between children with and without ASD for fever (ratio of rate ratio for measles-containing vaccine = 1.07, 95% CI 0.58-1.96; for pertussis-containing vaccine = 1.16, 95% CI 0.63-2.15) or ED visits (ratio of rate ratio for measles-containing vaccine = 1.11, 95% CI 0.80-1.54; for pertussis-containing vaccine = 0.87, 95% CI 0.59-1.28). Febrile seizures were rare. Pertussis-containing vaccines were associated with small increased risk of febrile seizures in children without ASD.
Conclusion: Children with ASD were not at increased risk for fever or ED visits compared with children without ASD following measles- or pertussis-containing vaccines. These results may provide further reassurance that these vaccines are safe for all children, including those with ASD.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Klein has received research support from Sanofi Pasteur, GSK, Merck, Pfizer, and Protein Sciences (now Sanofi Pasteur) for unrelated studies. Dr. Getahun has received research grant support from NIH/NICHD and Bayer for unrelated studies. Dr. Donahue reports grants from Janssen Global Services, LLC, outside the submitted work. Dr. Qian received research support from GSK and Amgen for studies unrelated to this publication. Ms. Irving has received research grant support from MedImmune for unrelated studies. Dr. Donahue reports grants from Janssen Global Services, LLC, outside the submitted work. All other co-authors have no conflict of interest. Acknowledgements Funding/Support: The study was funded in part by a contract from the Centers for Disease Control and Prevention (CDC). Dr. Zerbo is also supported by career development Grant # K01AI139275 from the National Institute of Allergy and Infectious Diseases. The other authors received no additional funding. Role of Funder: The CDC provided technical assistance Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.
(Copyright © 2022. Published by Elsevier Ltd.)