[balita-anda] MMR dan Autism
Rekan-rekan, dulu waktu Ella (19.5 bulan) mau di MMR, saya juga punya kekhawatiran yg. sama. Dan saya mengumpulkan beberapa artikel ttg. ini. Salah satunya yg. berikut ini. Saya akhirnya memutuskan utk. mem-vaksin Ella, sesudah konsultasi dgn. DSA-nya, cari2 referensi spt. ini, dan dengan pertimbangan spt. yg. dikatakan dsa-nya : jumlah kasus autism yg. dihubungkan dengan MMR vac. memang ada ; tapi dunia science itu 'kan tidak menyimpulkan hanya dari sejumlah kecil kasus dan ditarik generalisasinya. Bisa saja mereka yg. katanya autisme karena MMR itu sebenernya punya latar belakang yang lebih kompleks lagi, dan saat teridentifikasi dgn. autisme berdekatan waktunya dengan vaksin MMR. Jadi seolah-olah disebabkan vaksin MMR Meskipun demikian, tidak urung deg-deg-an juga... biarpun cuma 0.001% misalnya kejadian autism oleh vaksin, kalo yg.0.001% itu jatuh ke anak kita, yaa... sedih juga, kan ? Karena itu, waktu itu saya khusus berdoa, minta supaya Tuhan menjauhkan hal2 demikian itu dari Ella... Btw, saya juga baru divaksin MMR (sebenernya cuma cari utk. Rubella, tapi di Indo nggak ada yg. unsur Rubella saja), utk. menghindarkan kejadian Rubella saat hamil. Sekedar sharing, DSA saya menganjurkan ibu-ibu utk. imunisasi Rubella, daripada nanti pas hamil ketahuan ada Rubella-nya, atau pemeriksaan awal aman2 saja, tapi bulan berikutnya terinfeksi Rubella. Kasihan anaknya bisa cacat ganda. Lebih baik divaksin dulu supaya antibodinya terbentuk thp. Rubella. Begitu, katanya Ttg. ini juga ada di artikel berikutnya yg. akan saya postingkan juga. Semoga berguna. - satumed.com : Rabu, 19 April 2000 Anda mungkin pernah mendengar tentang vaksin MMR (Mumps, Measles, Rubella) yang berguna untuk meningkatkan kekebalan tubuh terhadap Parotitis (infeksi pada kelenjar ludah parotis atau sering dikenal sebagai gondongan), Campak dan Campak Jerman. Vaksin ini pernah dihubungkan dengan terjadinya autisme, tetapi para pakar menyatakan bahwa penelitian ini mengandung banyak kelemahan. Suatu penelitian yang dilakukan oleh Dr. Andy Wakefield sekitar dua tahun lalu mengatakan telah menemukan jejak virus tersebut dalam usus anak-anak penderita autisme, dimana risetnya ini menimbulkan ketakutan akan vaksin MMR untuk pertama kalinya. Tetapi The Royal Free and University College Medical School di London, dimana Dr. Wakefield bekerja, telah mengeluarkan pernyataan yang menunjukkan kelemahan riset ini. Riset terakhir disampaikan di depan Kongres Amerika Serikat minggu lalu oleh Dr. Wakefield dan Profesor John OLeary, direktur patologi di Coombe Womens Hospital di Dublin. Dia mengatakan bahwa pada 25 anak-anak pengidap autisme, 24 mempunyai jejak virus campak dalam ususnya. Profesor OLeary mengatakan kini terdapat "bukti yang menarik" tentang hubungan antara autisme dan MMR. Akan tetapi, hubungan ini sendiri tidak menjelaskan apakah virus tersebut menyebabkan autisme, atau bahkan sumber virus ditemukan dalam vaksin MMR, yang mengandung virus campak dan parotitis dalam bentuk "yang sudah mati". Tidak Bisa Dibuktikan Departemen Kesehatan mengatakan riset tersebut "tidak bisa dibuktikan dengan sarana ilmiah biasa. Hal itu tidak membuktikan apa-apa dan tetap belum ada bukti untuk mengatakan adanya kaitan antara suntikan vaksin MMR dan autisme," seorang juru bicaranya menambahkan. "Pasti merupakan bahaya besar kalau anak-anak harus meninggal karena penyakit yang dapat dicegah dengan vaksin karena ketakutan akan keamanan vaksin yang sesungguhnya belum dapat dipastikan." Seorang juru bicara Royal Free Hospital mengatakan bahwa tidak seorangpun ilmuwan lain sanggup menghasilkan atau membuktikan kebenaran pekerjaan Dr. Wakefield. Dia menunjukkan pada studi lain yang mengatakan bahwa tes kimia yang dilakukan oleh Dr. Wakefield untuk memastikan adanya virus campak mungkin saja telah dianggap positif oleh protein usus normal. "Dr. Wakefield dengan tegas mendesak untuk melakukan studi lanjutan termasuk blind test pada subyek, kontrol yang tepat dan tes independen oleh ahli laboratorium yang tidak mempunyai kepentingan di dalamnya." Riset awal skala kecil Dr. Wakefield mengatakan bahwa banyak anak-anak mengalami autisme tidak lama setelah menerima suntikan MMR, tetapi studi yang lebih besar oleh Medical Research Council (MRC) yang diterbitkan tahun lalu tidak menemukan satu pun bukti hubungan tersebut. MRC telah melakukan proyek riset yang jauh lebih besar untuk mencoba menentukan penyebab autisme. Meskipun anak-anak yang terinfeksi virus campak alami dapat meninggal dalam kasus yang jumlahnya sangat kecil, infeksi itu juga dapat memberi komplikasi yang serius, khususnya pada anak yang sangat muda. Komplikasinya dapat meliputi pnemonia (radang paru), bronkitis (infeksi pada bronkus) , kejang dan bahkan meningitis (infeksi selaput otak). Jumlah penggunaan vaksinasi MMR turun tajam setelah publikasi riset pertama Dr. Wakefield, yang menghubungkan antara MMR dengan autisme maupun penyakit Crohn. -- O _/)(\_
Re: [balita-anda] MMR dan Autism
sumber : www.cdc.gov [Centers for Disease Control and Prevention] 1. Does the MMR vaccine cause autism? CDC believes that the current scientific evidence does not support the hypothesis that MMR, or any combination of vaccines, cause the development of autism, including regressive forms of autism. A suspected link between MMR vaccine and autism has been suggested by researchers and some parents of children with autism. Often symptoms of autism are first noted by parents as their child begins to have difficulty with delays in speaking after age one. MMR vaccine is first given to children at 12 to 15 months of age. Therefore, children an apparent onset of autism within a few weeks after MMR vaccination may simply be an unrelated chance occurrence. An extensive study of the evidence was recently conducted in the United Kingdom. The British Committee on Safety of Medicines convened a "Working Party on MMR Vaccine" to conduct a systematic review of reports of autism, gastrointestinal disease, and similar disorders after receipt of MMR or measles/rubella vaccine. The National Childhood Encephalopathy Study (NCES) was examined to see if there was any link between measles vaccine and neurological events. The researchers in England found no indication that measles vaccine contributes to the development including educational and behavioral deficits (Miller et al 1997). A more recent epidemiological study also found no association between MMR vaccine and autism (Taylor et al. 1999). This study compared rates of autism between children who received the MMR vaccine and children who did not. The results found no difference in rates of autism between the two groups. 2. What about the study by Dr. Andrew Wakefield, of the Royal Free Hospital in the United Kingdom? Current scientific evidence does not support the hypothesis that the MMR vaccine, or any combination of vaccines, causes the development of autism, including regressive forms of autism. This includes the research conducted by Dr. Wakefield. The Wakefield Study This study was conducted in 1998 and looked at whether the existence of the measles virus from the MMR vaccine could cause bowel disease and, in turn, cause autism. The authors reviewed reports of 12 children with bowel disease and regressive developmental disorders, mostly autism. In 9 of the cases, the child's parents or pediatrician speculated that the MMR vaccine had contributed to the behavioral problems of the children in the study. This study was reviewed by an expert committee from the UK Medical Research Council (MRC). The Council concluded there is no evidence to link the MMR vaccine with autism. On April 3, 2000 the MRC issued a new report confirming its earlier conclusion; MMR has not been linked with inflammatory bowel disease in autism. A copy of this research report can be found in the appendix and is also available at the MRC web site, http://www.mrc.ac.uk Limitations of Dr. Wakefield's Study 1. The study used too few cases to make any generalizations about the causes of autism; only 12 children were included in the study. Further, the cases were selected by researchers and may not be representative of many cases of autism. 2. There were inadequate groups of control children. As a result, it is difficult to determine whether the bowel changes were similar to changes in normal children, or to determine if the rate of vaccination in autistic children was higher than in the general population. 3. The study did not identify the time period during which the cases were identified. 4. In at least 4 of the 12 cases behavioral problems appeared before the onset of symptoms of bowel disease; that is, the effect preceded the proposed cause. It is unlikely, therefore, that bowel disease or the MMR vaccine triggered the autism. 3. Would it be safer to separate the MMR vaccine into its individual components--in other words, give children three separate shots, at different times (e.g., six months or one year apart), instead of one combined shot? Why do we have to use the combined vaccine? There is no scientific research or data to indicate that there is any benefit to separating the MMR vaccine into its individual components. This idea is not based on any published evaluation of the effect(s) it may have on children. In fact, splitting the MMR vaccine into three separate doses may be harmful because it would expose children unnecessarily to potentially serious diseases. For instance, if rubella vaccine were delayed, 4 million children would be susceptible to rubella for an additional six to 12 months. This would potentially allow otherwise preventable cases of congenital rubella syndrome (CRS) to occur. Infection of pregnant woman with "wild" rubella virus is one of the few known causes of autism. Thus, by preventing infection of pregnant women, rubella vaccine also prevents autism. 4. Should a younger sibling, or a child of someone who suffered autism be vaccinated with MMR or other
Re: [balita-anda] MMR dan Autism
sorry, sumbernya waktu itu lupa saya catat... Kayaknya sih dari CDC juga. - Frequently Asked Questions about Measles, Mumps, and Rubella, and MMR Vaccine [Q.]Are measles, mumps, and rubella still a problem in the United States? All three diseases are currently at or near their lowest point ever reported in the United States. In 1995, a provisional total of 288 measles cases (lowest ever), 840 cases of mumps (lowest ever), and 200 cases of rubella (third lowest) were reported. [Q.]If the chance of the diseases is so low, why do we still give the vaccine? Measles, mumps, and rubella are all still very common in other parts of the world, and can be easily imported into the United States. A reduction in our vaccination efforts would lead to a rapid increase in the number of susceptible children, which could lead to an outbreak. [Q.]What kind of vaccine is MMR? MMR is a attenuated live virus vaccine. After injection, the viruses replicate (grow), and cause a subclinical or asymptomatic infection in the vaccinated person. The person's immune system fights the infection caused by these weakened viruses, and immunity develops. [Q.]How effective is MMR vaccine? From 95 percent to 98 percent of persons who receive a single dose of MMR will develop immunity to all three viruses. [Q.]Why is MMR vaccine given after the first birthday? Most infants born in the United States will receive passive protection against measles, mumps, and rubella in the form of maternal antibody. These antibodies can destroy the vaccine virus if they are present when the vaccine is administered. By 12 months of age, almost all infants have lost this passive protection, so the vaccine viruses can replicate and produce infection with interference. [Q.]If a single dose of MMR vaccine is so effective, why do we give a second dose? The second dose is to provide another chance to develop measles immunity for persons who did not respond to the first dose. About 2 percent to 5 percent of persons do not develop measles immunity after the first dose of vaccine. [Q.]What is the best age to give the second dose of MMR vaccine? The second dose of MMR can be given anytime, as long as the child is at least 12 months old and it has been at least a month since the first dose. However, the second dose is usually administered before the child begins kindergarten or first grade (4-5 years of age) or before entry to middle school (11-12 years of age). The age at which the second dose is required is generally mandated by state school entry requirements. [Q.]Can I give a PPD (tuberculin skin test) on the same day as a dose of MMR vaccine? Live measles vaccine can reduce the reactivity of a PPD because of mild suppression of the immune system. A PPD can be done before or at the same time as measles vaccine is given. However, if measles vaccine is given first, the PPD should be delayed for at least one month. [Q.]What is the most common adverse event following MMR vaccine? Low grade fever and a mild rash, which occur in 5 percent to 10 percent of recipients. [Q.]For years our clinic has given MMR intramuscularly (IM) rather than subcutaneously (SC). Is it less effective IM? If MMR has been given IM instead of SC should it be repeated? All live injected vaccines (MMR, varicella, and yellow fever) are recommended to be given subcutaneously. Intramuscular administration is not likely to decrease immunogenicity, and doses given IM do not need to be repeated. [Q.]Why are people born before 1957 exempt to receiving MMR vaccine? Persons born in 1957 and before lived through several years of epidemic measles before the first measles vaccine was licensed. As a result, these people are very likely to have had measles disease. Serologic surveys suggest that 95%-98% of persons born before 1957 are immune to measles. The "1957 rule" applies only to measles and mumps, and does NOT apply to rubella. [Q.]How long after a blood transfusion can a person be given MMR vaccine? MMR should not be given for 6 months following a transfusion of whole blood. Different blood products require different waiting periods before giving measles vaccine. Table 8 in the General Recommendations on Immunization gives a complete listing of these intervals. [Q.]Rubella is a very mild disease. Why do we even bother to vaccinate against it? Rubella disease in childhood is usually a mild illness. The major public health importance of rubella is the impact the virus may have on a developing fetus. If a woman is infected with rubella virus during the first trimester of pregnancy, the fetus may be stillborn, or may be born with severe birth defects, such as blindness, deafness, or mental retardation. These defects in a newborn of a woman who has rubella during pregnancy are collectively known as congenital rubella syndrome. [Q.]How common is arthritis following rubella vaccine? Joint pain is reported by 25
