A case-control study of measles vaccination and inflammatory bowel disease

Background The cause of inflammatory bowel disease (IBD) remains to be established. Evidence has linked measles infection in early childhood with the subsequent risk of developing IBD, particularly Crohnʹs disease. A cohort study raised the possibility that immunisation with live attenuated measles vaccine, which induces active immunity to measles infection, might also predispose to the later development of IBD, provoking concerns about the safety of the vaccine. Method We report a case-control study of 140 patients with IBD (including 83 with Crohnʹs disease) born in or after 1968, and 280 controls matched for age, sex and general practitioner (GP) area, designed to assess the influence of measles vaccination on later development of IBD. Documentary evidence of childhood vaccination history was sought from GP and community health records. Findings Crude measles vaccination rates were 56·4% in patients with IBD and 57·1% among controls. Matched odds ratios for measles vaccination were 1·08 (95% CI 0·62–1·88) in patients with Crohnʹs disease, 0·84 (0·44–1·58) in patients with ulcerative colitis, and 0·97 (0·64–1·47) in all patients with IBD. Interpretation These findings provide no support for the hypothesis that measles vaccination in childhood predisposes to the later development of either IBD overall or Crohnʹs disease in particular.