Vaksinasi dan Autisme

Saya termangu membaca tulisan pak Harry tentang autisme. Teringat kegelisahan seorang ibu yang menanyakan pada saya, hubungan antara imunisasi dan autisme.

Anaknya sebaya Daud dan (saat itu) masih punya jadwal beberapa kali imunisasi. Rupanya e-mail tentang imunisasi yang menyebabkan autisme sedang beredar di milis yang ia ikuti. Sebenarnya ini bukan berita baru. Semacam siklus saja, muncul periodik. Vaksinnya tak selalu sama, tapi intinya sama: bahaya autisme mengintai di balik imunisasi.

Pak Harry menulis tentang autisme dengan mencuplik dari wikipedia. Izinkan saya untuk mengambil sumber dari tulisan yang lain dan dari sisi pandang yang agak berbeda.

Dari dr. Sears:

There has been some recent press over a concern of some medical researchers that the MMR vaccine may be a contributing link to autism. There has been no conclusive medical evidence to date that supports this concern, and the potential severity of these three illnesses makes vaccinating against them very important.

Some parents who have a child with autism, or know someone who has a child with autism, and have a concern about it's relation to the MMR vaccine, can give their child each of the three components of this shot separately, one year apart. However, this is two extra injections.

Dari mayoclinic:

Some people believe autism is caused by vaccines — particularly the measles-mumps-rubella vaccine (MMR), as well as vaccines containing thimerosal, a preservative that contains a very small amount of mercury. But extensive studies have shown no link between vaccines and autism.

Sedangkan dari WHO:

Based on the extensive review presented, GACVS concluded that no evidence exists of a causal association between MMR vaccine and autism or autistic disorders. The committee believes the matter is likely to be clarified by a better understanding of the causes of autism.

GACVS also concluded that there is no evidence to support the routine use of monovalent measles, mumps and rubella vaccines over the combined vaccine, a strategy which would put children at increased risk of incomplete immunization. Thus, GACVS recommends that there should be no change in current vaccination practices with MMR.

Penelitian yang dijadikan rujukan bagi pemberitaan adanya korelasi antara vaksin MMR dan autisme dinyatakan memiliki cacat serius. Bertanggal 13 Juni 2003, artikel ini menuliskan:

Committee on Safety of Medicines (CSM) advice on methodology used in this paper

Previous research by Geier and Geier, using similar methodology, has been carefully reviewed by the CSM. The advice of the CSM was that this type of analysis (use of spontaneously reported adverse reaction data and numbers of vaccine doses distributed) cannot be used to determine and compare the incidence of adverse reactions associated with different vaccinations.

CSM will shortly be asked to review the current study by Geier and Geier. However, it is clear from CSM’s previous advice that this methodology is seriously flawed and the conclusions of the authors concerning the association between MMR and DTP vaccine and the outcomes studied cannot therefore be justified.

Sedangkan dari asosiasi dokter anak Amerika (AAP):

The most important weakness of the article is the reliance on VAERS (Vaccine Adverse Event Reporting System) data to draw conclusions about adverse event associations or causality. VAERS is a passive surveillance system for reporting possible vaccine adverse events that depends on health care professionals, patients, and others to file reports.

Health effects reported to VAERS as being associated with vaccines may represent true adverse events, coincidental occurrences, or mistakes in filing. Inherent limits of VAERS include incomplete reporting, lack of verification of diagnoses, and lack of data on people who were immunized and did not report problems.

Data from VAERS are useful for hypothesis generation (raising questions) but should not be used for research aimed at determining whether vaccines cause certain health problems (hypothesis proving), as was done in the article by Geier and Geier.

Dan dari Vaccine Safety, (format pdf):

Consistent evidence from ecologic, case-control, case-crossover, and cohort studies showing lack of an association between MMR vaccine and an increased risk for developing autism, either in the short time window following vaccination or at times distant from vaccination.


Group Health Cooperative Center for Health Studies
CDC Vaccine Safety Datalink Project

Sebagai pengingat: ini bukan pengganti nasihat/diskusi medis. Saya bukan peneliti, apalagi dokter. Namun jika anda bertanya tentang keputusan saya, saya tetap bergeming dengan jadwal imunisasi MMR untuk kedua anak saya.

Saya hanya berharap, para orangtua membuat keputusan tidak berdasarkan emosi dan paranoia semata. Pertimbangkan baik-baik, dan jika ragu dengan kondisi anak, konsultasikan pada dokter.

Walau demikian, keputusan ada di tangan orangtua. Milik orangtua. Dan dijalani anak kelak. Semoga tak ada kata menyesal.