Vaksin MMR

Dengan Hormat,

Jujur saya dipusingkan dengan dua pendapat yang bertentangan tentang vaksin MMR. Sebagian berpendapat bahwa MMR pemicu Authisme sedangkan yang sebagian berpendapat sebaliknya.

Dua minggu yang lalu saya memberikan vaksin kepada anak saya yang berumur 4.5 th. Ketika melihat catatan kesehatan di buku, dokter anak kami kaget mengapa anak saya belum di berikan MMR. Saya agak berat menjawab walaupun sepatah kata yang keluar belum lengkap dokter yang bersangkutan telah memberikan saya ceramah panjang lebar dan dari nada bicaranya dan pandangan matanya memberikan isyarat bahwa dia sangat kesal dengan saya. Padahal belum lengkap kata-kata saya keluar dari mulut.

Pak Dokter memanggil saya KAMU. "Apa alasan KAMU ?". Meskipun sedikit risih tapi saya berusaha untuk sabar. Jadi sepanjang 20 menit itu habislah saya diceramahin. Jawaban pendek saya yang mengatakan bahwa kita tidak bisa menutup mata bahwa antara para dokter juga ada perbedaan pendapat berbuntut kepada cerita ttg siapa saja yang tidak setuju dengan Vaksin MMR termasuk menyebut seorang professor.

Di ujung pembicaraan saya hanya berkata "baiklah Dok saya akan belajar lagi soal ini maklum kedokteran bukan bidang saya namun Common Sense Logic saya bisa menerima kalau MMR bisa saja berpengaruh kepada sebagian kecil pasien. Di forum ini saya butuh masukan yang banyak soal MMR.


Terima Kasih.


Rudy Firmanto

Pak Rudy,

Baru saja saya coba search di Google tentang MMR vaccine. Banyak publikasi yang bermutu (dikeluarkan oleh Depkesnya Amerika, jurnal2 kedokteran ternama, ikatan dokter anak Amerika/AAP, dan berbagai sekolah kedokteran yang baik) yang membahas mengenai MMR dan autisme. Salah satunya ada website tentang keamanan vaksin (www.vaccinesafety.edu). Berikut saya coba copy headlines dari website tsb. Text lengkap dapat diakses dengan link dari website tsb.

MMR/MEASLES VACCINE

MMR Vaccination and Pervasive Developmental Disorders: no association. Smeeth, et al report that MMR vaccination is not associated with an increased risk of pervasive developmental disorders (PDDs). The authors studied 1294 affected children and 4469 controls in the General Practioners Database in the United Kingdom and "We have found no convincing evidence that MMR vaccination increases the risk of autism or other PPDs". (09-15-04) PubMed Abstract Lancet Institute of Medicine reports that MMR and thimerosal do not cause autism. The IOM committee concluded that the body of epidemiological evidence favors rejection of a causal relationship between the MMR vaccine and autism and between thimerosal-containing vaccines and autism. [link] May 17, 2004 Authors Retract Controversial Interpretation of 1998 Lancet Paper Linking MMR Vaccine to A New Syndrome of Bowel Disease and Autism. Statements from the authors and the Lancet editor. March 6, 2004

Investigations Reveal an Unreported Conflict of Interest and Problems With Reporting in Wakefield's 1998 Autism-MMR Study. Information on the investigation by The Lancet into problems with Andrew Wakefield's study. February 27, 2004.

Measles, Mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. This paper by Taylor et al in the [Feb 16 2003] BMJ adds to the growing body of evidence that show no involvement of MMR vaccine in the development of autism. The authors report on their investigation of 473 and conclude that their data shows neither a "new variant' form of MMR-associated autism nor evidence of MMR contributing to the onset of autism. BMJ 2003;324:393-6. PubMed Abstract BMJ MMR and autistic enterocolitis: consistent epidemiological failure to find an association. In a News & Commentary in Molecular Psychiatry [Feb 2003], Fombonne and Cook review a recent paper by Taylor et al on MMR and Autistic Enterocolitis. Fombonne and Cook review Taylor's paper as well as the hypothesis by Wakefield et al that speculated about a connection between MMR and autism and ask, "How many more well-powered epidemiological investigations ... will be necessary for this hypothesis to be completely discarded?". Molecular Psychiatry 2003;8:133-4

A Population-based study of Measles, Mumps and Rubella Vaccination and Autism. A Danish study provides strong evidence against a causal relationship between MMR vaccination and autism. Madsen et al. NEJM 2002;347(19):1477-82. PubMed Abstract NEJM

The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. Barlow WE et al find no long-term adverse consequences from febrile seizures following administration of DTP and MMR vaccines. NEJM 2001;345(9):656-61. PubMed Abstract NEJM

Measles-Mumps-Rubella Vaccine and Autistic Spectrum Disorder: Report From the New Challenges in Childhood Immunizations Conference Convened in Oak Brook, Illinois, June 12-13, 2000. Pediatrics 2001;107(5). Halsey, Neal A.; Hyman, Susan L. The writers of this report reviewed over 1,000 references in the medical literature and determined that the available research does not support the hypothesis that MMR vaccine causes autism, autism spectrum disorders or inflammatory bowel disease. A complete copy of this report is available in the online version of Pediatrics at http://pediatrics.aappublications.org/cgi/content/abstract/107/5/e84.

PubMed Abstract Institute of Medicine (IOM) Committee Rejects Causal Relationship Between Measles-Mumps-Rubella Vaccine and Autism Spectrum Disorder At a public briefing on April 23, 2001 the Institute of Medicine's (IOM) Committee on Immunization Safety Review released a report in which they conclude that the evidence favors rejection of a causal relationship between the measles-mumps-rubella (MMR) vaccine and autism spectrum disorder, commonly known as autism.

The full text of the report is available at http://www.iom.edu/report.asp?id=4715

Evidence shows genetics, not MMR vaccine, determines autism (AAP News December 1999) by Charles G. Prober, MD, FAAP.

No evidence for measles, mumps, and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study. (Lancet 1998;351:1327-8) (5-02-98) This Finnish study shows details of the 31 children who developed gastrointestinal symptoms after approximately three million were vaccinated. Dr. Peltola et al, after more than 10 years following adverse events associated with MMR vaccine, found no data showing an association between MMR vaccine and developmental disorders or inflammatory bowel disease.


Mungkin sebelum mempercayai suatu pendapat, ada baiknya kita belajar banyak terlebih dahulu. Jangan percaya publikasi yang tidak jelas atau kurang dapat dipertanggungjawabkan. Pilihan imunisasi ada di tangan orangtua, dokter hanya mengarahkan. Bagaimana pun juga, imunisasi itu perlu persetujuan orangtua (informed consent), termasuk menyetujui risiko2 (bila ada) yang mungkin terjadi akibat imunisasi. Kedokteran memang mungkin bukan bidang anda, tapi sebagai konsumen yang baik, tentu anda punya rasa ingin tahu agar bisa berdiskusi dengan efektif dengan dokter anda sehingga hasil pengobatan dapat optimal.

Semoga membantu.


Endah


Pak Rudy, sebenarnya dukun anak dikau nggak perlu gitu sewotnya sama dikau selaku ortu anak, soal jadwal imunisasi on schedule itu kan masalah hasil study epidemiologis semata. Kalo anak dikau belon di vaksin, kan tinggal diusulkan untuk dilakukan semata. Mengajak konflik dengan ortu anak nggak ada manfaatnya :).

eddyJP
Personal ID: eddyjp@cbn.net.id

Ya begitulah Pak...

Kalau sebagian dokter "professor S " yang disebut dokter saya juga berpendapat bahwa ada pengaruhnya,...apalagi saya yang gak punya background kedokteran.

Anyway saya akan banyak belajar masalah ini..

RF