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Based on the Tools for Practice article, “The autism-vaccine story: fiction and deception?” by G. Michael Allan and Noah Ivers. An earlier version of this article appeared in the Canadian Family Physician.

Autism and vaccine

Clinical question

Is there any link between the measles-mumps-rubella (MMR) vaccine and autism?



The truth about the Wakefield study is as follows:

The legacy of this unfortunate publication includes decreased immunization rates with increased measles rates and continued parental immunization fear.

Bottom line

Convincing evidence from multiple countries shows no association between MMR vaccine (or thimerosal) and autistic disorders. The origins of this controversy incorporate unethical conduct and misleading research.


A gap exists between ideal and actual pediatric immunization rates. Meta-analysis of 47 randomized controlled trials showed that patient reminders can increase immunization rates. Adding new babies to a register at first visits and using patient reminders when immunizations are due are effective, feasible, office-based approaches to improving immunization rates. Patient leaflets are available to help address concerns about long-term side effects.


Dr. Mike Allan is an expert advisor with EvidenceNetwork.ca, an Associate Professor in the Department of Family Medicine at the University of Alberta in Edmonton and the Director of Evidence and CPD with Alberta College of Family Physicians. Dr. Noah Ivers is a family physician at Women’s College Hospital in Toronto, Ont.

Experts available for interview 

Mike Allan, MD
University of Alberta
Evidence-based Primary Care Practice
780-248-2057 | 780-342-4038 (clinic) | 780-720-4093 (c) | michael.allan@ualberta.ca

Stephen Hwang, MD, MPH
St. Michael’s Hospital
Vaccine Safety & Public Health
416-864-5991 | hwangs@smh.ca | @StephenHwang

John Millar, MD, FRCP(C), MHSc
University of British Columbia
Public Health & Health Policy
604-922-0995 or (c) 604-785-9058 | john.millar10@gmail.com | @JohnMillar10

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