Dáil Éireann debate -
Thursday, 21 Nov 2002

Vol. 557 No. 6

Written Answers. - Autism Incidence.

Tony Killeen

Question:

77 Mr. Killeen asked the Minister for Health and Children the number of children with autism in each health board area; the number of new cases presenting annually; if the rate is increasing dramatically; the research being undertaken relating to the effects of various vaccines; and if he will make a statement on the matter. [23014/02]

Minister of State at the Department of Health and Children (Mr. T. O'Malley)

Extensive research continues to be conducted worldwide in relation to the MMR vaccine. The World Health Organisation has indicated that MMR vaccine does not cause autism and that there has been no new scientific evidence that would suggest impaired safety of MMR. The WHO strongly endorses the use of MMR vaccine on the grounds of its convincing record of safety and efficacy. The international consensus from professional bodies and international organisations is that MMR is a safe and effective vaccine and that the existing research and medical evidence does not support a causal link between MMR vaccine and autism or inflammatory bowel disease. The institutions include the Medical Research Council Expert Committee UK, the UK Committee on Safety of Medicines, the Centres for Disease Control and Prevention, CDC USA and the American Academy of Paediatrics.

Recent studies by the United States Institute of Medicine concluded that there is no link between the vaccine and autism or inflammatory bowel disease. This consensus is based on large-scale epidemiological studies and more specific studies done in the laboratory setting. A large Finnish study involving 1.8 million individuals demonstrated that no case of inflammatory bowel disease or autism was linked to the MMR vaccine. A similar Swedish study found no increase in cases of autism in the ten years during which MMR vaccine was introduced. A recent UK study where researchers analysed some 2,000 studies from 180 countries found no evidence of a causal link between MMR vaccine and autism or inflammatory bowel disease. In recent weeks, the New England Journal of Medicine published details of a study of more than 500,000 children born in Denmark between January 1991 and December 1998 which indicated that the risk of autism was the same for children regardless of whether or not they were vaccinated with MMR.

The primary concern of my Department in relation to immunisation is that the vaccines in use are safe and effective. The Irish Medicines Board and the Royal College of Physicians of Ireland support the use of MMR on the grounds that it has been demonstrated to be a safe and effective vaccine. There is a sound evidence basis for the use of MMR in the national programme.

There has been an increase in recent years in the numbers of children being diagnosed with autism. Similar increases have also been experienced in other European countries and in the USA. The diagnosis of autism is a clinical one, that is, it is based on a variety of observations rather than a defined laboratory investigation. Hence the evolving concept of an "autistic spectrum" which stretches from those severely affected to those with only a mild disability. There is increasing recognition of autism in Ireland and in other countries. What is not clear, however, is whether the increase is due to a greater awareness leading to better ascertain ment, or whether there is actually a true increase in the prevalence of autism.

In recent years, as part of the overall planning and development of services for persons with autism, the health boards have been obtaining additional information on the needs of this group in their regions, and in particular in relation to those who require or will require specialist services. My Department is working with the health boards and the Eastern Regional Health Authority to establish an information system which will provide accurate data in relation to the numbers of persons with autism and their service needs. My Department has asked the health boards and the Eastern Regional Health Authority for information in relation to the numbers of children with autism known to them in their regions and the number of new cases presenting annually. This information will be forwarded to the Deputy as soon as it becomes available.