Vaccines & Autism

Internet Resources

According to this report there is no reliable scientific evidence to support a causal link between childhood immunizations and autism, diabetes, asthma or other chronic conditions. Failure to have their children immunized with recommended vaccinations can put them at risk for serious or fatal infections, including seemingly harmless diseases such as measles.
Neil Osterweil, Medpage Today
Unfortunately, the ABC's article treats pivotal issues using narrowly-selected details from an equally narrow range of resources, and which contains vague allusions, unfounded or false statements, and injudicious speculation.
Laura Ruede
Vaccines often contain preservatives, adjuvants, additives, or manufacturing residuals in addition to pathogen-specific immunogens. Some parents, alerted by stories in the news media or information contained on the World Wide Web, are concerned that some of the substances contained in vaccines might harm their children. We reviewed data on thimerosal, aluminum, gelatin, human serum albumin, formaldehyde, antibiotics, egg proteins, and yeast proteins. Both gelatin and egg proteins are contained in vaccines in quantities sufficient to induce rare instances of severe, immediate-type hypersensitivity reactions. However, quantities of mercury, aluminum, formaldehyde, human serum albumin, antibiotics, and yeast proteins in vaccines have not been found to be harmful in humans or experimental animals.
Paul A. Offit, Rita K. Jew
Dedicated to presenting valid scientific information about vaccines.
"...for something like a new vaccine there is too much information to simply send a fax. Professionals should be fully informed, ideally before something like this is made public. They should not have to give speculative advice to patients based on what they have heard and read in the media."
Peter Martell, Kevin Hurley, Scotland on Sunday
This site focuses SOLELY on the misuse of scientific articles by anti-immunization activists. Concurrently with this project, I am undertaking an online project to publish the significant findings in the autopsy reports of children of who have died as a result of immunizations.
Ed Friedlander
Despite belief in the importance of immunization by a vast majority of parents, the majority of parents had concerns regarding vaccine safety. Strategies to address important misperceptions about vaccine safety as well as additional research assessing vaccine safety are needed to ensure public confidence.
Barbara Bardenheier et al
This article addresses the basic information regarding immunizations that all nurses who care for infants and children should know. It presents a brief overview of immunology and the history of immunization science. Immunization standards, techniques of administration, and the handling of immunobiologics are discussed along with current vaccines, toxoids, and immune sera. Public laws and governmental support resources relating to immunizations are presented as well as are special circumstances, such as foreign adoptions, breastfeeding infants, and those who are immunocompromised. Finally, the pediatric immunization schedule is presented and selected vaccine-preventable diseases are discussed.
Elizabeth Farren
Effective immunization is one of the most cost-effective methods for decreasing mortality, morbidity, disability and the overall burden of disease, hence any intervention to make these programmes more effective is a public health priority.
World Health Organization
The father's experts were a consultant pediatrician with a special interest in immunology and a professor of pediatrics and infectious diseases. The mother's "expert," Jayne Donegan, is a general practitioner who practices homeopathy. One of the appeals judges said that the rival expert opinions had been of "unusually unequal force," and another characterized the antivaccination evidence that the mother had relied upon as "junk science."
Stephen Barrett, Quackwatch
Assessments of whether a given vaccine causes a particular adverse reaction vary from the casual observation to the carefully controlled study. The majority of individuals are not trained in interpreting such studies and are unlikely to understand the enormous difference in significance between these two extremes. Nonetheless, the public frequently forms a decision about a vaccineís safety based on the information available to them -- often a report based on unscientific observations or analyses that fail to stand the scrutiny of rigorous scientific investigation
World Health Organization Global Advisory Committee on Vaccine Safety
CBER is responsible for ensuring the safety and efficacy of blood and blood products, vaccines, allergenics, and biological therapeutics. CBER's regulation of biological products has expanded in recent years to include a wide variety of new products such as biotechnology products, somatic cell therapy and gene therapy, and banked human tissues.
U.S. Food and Drug Administration
The success of disease prevention through immunization, however, can lead some parents to mistakenly believe that diseases like measles, polio and whooping cough no longer exist. For instance, many parents have never seen anyone with measles and think of it as a mild childhood illness that might keep a child home from school for a few days. But the reality is that measles killed 3,000 children in the United States every year before the vaccine was available. The disease also caused 48,000 children to be hospitalized annually.
American Academy of Pediatrics
Contrary to some fears, childhood vaccines do not appear to overwhelm the immune system and make youngsters prone to other infections, according to the largest study to examine the issue. A Danish study found no increased risk for other infectious diseases among more than 800,000 children who received the standard set of vaccinations.
Rob Stein, Washington Post
In 1998, Program for Appropriate Technology in Health launched the Children's Vaccine Program with support from the Bill & Melinda Gates Foundation. The mission of CVP is to promote equal access to new and lifesaving vaccines worldwide. Our strategy is to link arms with the world's leading immunization experts and national partners to repair crumbling immunization programs, build human and financial capacity within countries, and introduce new vaccines and immunization technologies.
The parents included in this study had chosen not to immunize at least one of their children. Most parents felt they had made an informed decision, based on an assessment of the risks and benefits of immunization and an acceptance of responsibility for that decision. Health professionals were not perceived as providers of balanced information. It is therefore important that parents have easy access to accurate information concerning the pros and cons of treatment, and have the opportunity to discuss their concerns with health professionals.
Rachel K Sporton, Sally-Anne Francis
Are vaccines entirely risk-free? Nothing is. Failure to take action based on the existence of some risk is to rely on the dubious precautionary principle. The crucial question is whether the benefits of vaccines vastly outweigh the risks associated with a failure to use vaccines. Indeed they do. Already, we are seeing a resurgence of pertussis in the U.S., due in part to waning adult immunity and the transmission of the disease from infected adults to unvaccinated children. This is the message that must find its way back into headlines -- before vaccine-preventable diseases make a devastating comeback.
Aubrey Stimola
Combination vaccines have been in use for >50 years. Historical problems with vaccines, including intussusception after rotavirus vaccine, carrier suppression with tetanus toxoid conjugate vaccines, and decreased immunogenicity of some Haemophilus influenzae type b conjugate vaccines when mixed with acellular pertussis-diphtheria-tetanus, have contributed to some misperceptions about current vaccines. There is no evidence that adding additional vaccines through combination products increases the burden on the immune system, which has the capability of responding to many millions of antigens. Combining antigens usually does not increase adverse effectsmdashin fact, it can lead to an overall reduction in adverse events. Combination products simplify immunization and allow for the introduction of new vaccines without requiring the vaccinee to make additional visits to his or her health care provider. Licensed combination vaccines undergo extensive testing before approval by the United States Food and Drug Administration to assure that the new products are safe and effective.
Neil Halsey
The new law, moreover, would keep claims against ingredient producers in the vaccine compensation program, which was set up to handle these difficult issues. Even many trial lawyers who back changes to vaccine policy--including an extension of the statute of limitations--would rather deal with the vaccine court. For one thing, the awards can reach into the millions of dollars. In theory, many cases also have a better chance, since parents and their lawyers need not prove liability, says plaintiffs' lawyer Clifford J. Shoemaker. That's crucial in the case of alleged injury from thimerosal, because there's no proof it causes autism. To the contrary, autism rates have increased since 2000, when vaccine makers began reducing the amount of mercury used.
Business Week Online
More and more often, on various unrelated forums I read, it seems that anti-vaccination activism is becoming the trendy topic du jour. Decrying vaccinations as "dangerous" and "unproven" is hot these days; and worse yet, people are now advocating not immunizing children. I keep seeing the same claims posted again and again on all these different forums...sometimes, word-for-word the same, which suggests that people are copying the information from one place and pasting it into another, without actually doing any research to verify the authenticity of this information. This points, I think, to the same kind of credulity that lets people believe in the Loch Ness monster and the notion that human beings were created by space aliens from the tenth planet who used us as slaves to mine gold, but at the same time not believe that the world is round. Credulity pisses me off, as long-term readers of this journal will no doubt have noticed. So I did some legwork. I visited a bunch of anti-vaccination Web sites, and made a list of the claims I've seen posted on many of these sites, and then tracked down the truth. I've invested, at this point, about seven or eight hours into looking up each of these claims, reading very dry articles, doing Google searches, looking at links, and compiling an assessment of whether the claims are true or false. As it turns out, not all the claims are false. Some of them are true, though often not true in the way the activists campaigning against vaccination might think. And I found some surprises, too.
Environmental antigenic stimuli, such as pollen, cigarette smoke, dust mites, and pet dander, are presented to the infant at an early age and would be expected to contribute to the development of the infant's immune system. There is no shortage of antigen exposure for infants, regardless of vaccination status... There is no evidence that currently recommended vaccines overload or weaken the infant immune system. Infants have an enormous capacity to respond safely and effectively to multiple vaccines.
Aric Gregson, Robert Edelman
In the pharmaceutical realm, a litigation-happy public spells trouble for everyone, says Paul Offit, M.D., author of the new book The Cutter Incident: How America's First Polio Vaccine Led to the Growing Vaccine Crisis. Fear of being sued into oblivion is already causing drug makers to shelve remedies like Bendectin (a morning sickness drug that was blamed for birth defects despite a lack of supporting evidence) and the Lyme vaccine (which was blamed for causing chronic arthritis, despite serious biological implausibility). And who knows what life-saving drugs will never be developed? "If the litigious element of our society continues to discourage pharmaceutical companies from taking risks, we will all miss out on drugs that could greatly improve or even save our lives," says Offit. "Obviously, my book addresses vaccines in particular, but the same holds true for all sorts of critical drugs. It's hardly surprising that pharmaceutical companies focus on highly profitable, relatively 'safe' drugs like those for treating obesity, high cholesterol, impotency, and hair loss."
News Blaze
This paper examines the last three `epidemics' of measles in New Zealand and the way in which the campaigns to prevent these epidemics represented the disease and other agents. The paper explores the linkages between disease representations and the state.
Kevin Dew
Assessed the causal association of autism with measles, mumps, and rubella (MMR) vaccine versus that with monovalent measles, mumps, and rubella immunization. Results suggest a decreased risk of developing ASD with MMR compared to monovalent antigens.
H. Takahashi et al, Institute for International Cooperation, Japan International Cooperation Agency
This site presents news reports, features, and perspectives that address all aspects of vaccination, particularly topics with ethical dimensions. Sources highlighted include the mainstream press as well as medical and government publications.
University of Pennsylvania Center for Bioethics
The ownership of the site should be clear. The information provided should be based on sound scientific study. The site should carefully weigh the evidence and acknowledge the limitations of the work. Beware of "junk science" and suggestions of "conspiracies." The individuals or group providing the information should be qualified to address the subject matter. Arguments should be based on facts, not conjecture. The motives of the site should be clear. The information provided should make sense.One sign of a scientifically sound Internet site is that it contains references from and to recognized peer-reviewed publications. You should be able to obtain additional information if you need it.
It is imperative that the medical profession ensure the safety of vaccines, but it is equally important that the science behind studies is examined, Dr. Orenstein said. One study in his review that raised parental fears of the connection between thimerosol and autism was a California ecological study that showed an apparent connection between children with autism in special education classes with estimated mercury exposure from vaccines. "This was an ecological study," Dr. Orenstein commented. "This could have been due to a change in diagnostic codes as well as the number of available educational services for autism. This would be easily studied in a better epidemiological study."
Linda Little, Medscape
vaccines have been so successful that they have eradicated from the public memory the devastating effects of childhood illnesses: paralysis from polio, blindness caused by measles, deafness following mumps, and death that resulted from the overwhelming infection caused by Hemophilus influenza. "I've lost patients to things we immunize against now," said suburban Baltimore pediatrician Daniel J. Levy, who graduated from medical school in 1975.
Sandra Boodman, Washington Post
One of the major problems in the United States is that we rely on the motivation of vaccine manufacturers who are neither motivated nor altruistic. Our country could learn a great deal about vaccine production from the countries of Western Europe, where the government controls the production and distribution of vaccines. Relying on corporate good will and a large supply of vaccine with a small profit margin is a dangerous strategy where public health and safety are involved.
Marc Siegel
It is quite reasonable to assume that the Amish have different alleles (more precisely, different allele frequencies) than the general population because they are pretty much genetically isolated from the rest of us. The genetic work done on the Amish and Mennonites confirms this - the only stretch is assuming that this difference will have no effect on the prevalence of a certain disorder, namely autism.
Prometheus: A Photon in the Darkness
The Global Advisory Committee on Vaccine Safety was established in 1999 to respond promptly, efficiently, and with scientific rigour to vaccine safety issues of potential global importance.
World Health Organization
Measles continues to be a leading cause of childhood morbidity and mortality in developing countries and an outbreak threat in the majority of countries. In 2000, measles was considered the fifth leading cause of childhood mortality, and the World Health Organization estimated that approximately 777,000 measles-associated deaths occurred worldwide. In 2001, WHO and the United Nations Children's Fund developed a 5-year strategic plan, endorsed by the World Health Assembly in 2003, to reduce measles mortality by 50% by 2005 (relative to 1999 estimates) and to achieve and maintain interruption of indigenous measles transmission in large geographic areas with established measles elimination goals. This plan included strengthening routine vaccination coverage, providing a second opportunity for measles immunization to children, improving measles case management, and improving surveillance with laboratory confirmation of suspected measles cases
Morbidity and Mortality Weekly Report
GACVS agreed and concluded that there is no evidence for a causal association between MMR vaccine and autism or autistic spectrum disorders. It is the opinion of the committee that additional epidemiological studies are unlikely to add to the existing data but that there is a need for a better understanding of the causes of autism.
Global Advisory Committee, World Health Organization
Human beings have benefited from vaccines for more than two centuries. Yet the pathway to effective vaccines has been neither neat nor direct. This paper explores the history of vaccines and immunization, beginning with Edward Jenner's creation of the world's first vaccine for smallpox in the 1790s. We then demonstrate that many of the issues salient in Jenner's era such as the need for secure funding mechanisms, streamlined manufacturing and safety concerns, and deep-seated public fears of inoculating agents have frequently reappeared and have often dominated vaccine policies. We suggest that historical awareness can help inform viable long-term solutions to contemporary problems with vaccine research, production, and supply.
Alexandra Minna Stern, Howard Markel
Human beings have benefited from vaccines for more than two centuries. Yet the pathway to effective vaccines has been neither neat nor direct. This paper explores the history of vaccines and immunization, beginning with Edward Jenner's creation of the world's first vaccine for smallpox in the 1790s. We then demonstrate that many of the issues salient in Jenner's era -- such as the need for secure funding mechanisms, streamlined manufacturing and safety concerns, and deep-seated public fears of inoculating agents -- have frequently reappeared and have often dominated vaccine policies. We suggest that historical awareness can help inform viable long-term solutions to contemporary problems with vaccine research, production, and supply.
Alexandra Minna Stern and Howard Markel
An article of faith for the anti-vaccinators is that vaccination causes autism. The reality is that autism is usually detected at about the age when children are receiving certain shots, and several epidemiological studies involving millions of children (Finland, Denmark, California) have demonstrated no link.
Peter Bowditch
This study once again hammers home the inherent unreliability of the VAERS database as a tool for longitudinal studies of the rate of vaccine-related complications. Not only can anyone access it and enter reports without verification, but there is no denominator, which means testing for causality is not even possible with VAERS. Worse, as the authors point out, the rate of reporting of autism as a complication of vaccines is easily influenced by numerous external factors. For example, the authors pointed out that 75% of the autism reports in VAERS between 1990 and 2001 were received not long after the the publication of the the now utterly and completely discredited Wakefield study that claimed to find a link between the MMR vaccine and autism and that 2/3 were received after the American Academy of Pediatrics recommendation that thimerosal be removed from vaccines. And it's not just autism. For example, in 2002, half the reports to the VAERS database about mental retardation were related to litigation.
Possible connections between immunization and developmental disorders, most notably autistic disorders, have been the subject of a great deal of debate and have caused much concern for parents who want to make the safest choices for their children. Anxiety has risen steadily since the mid-1990s, when a medical investigative team led by A Wakefield postulated that the measles-mumps-rubella (MMR) vaccine may be a causative factor in the development of autism spectrum disorder. Further anxiety for parents has been caused by the suggested association between developmental disorders and mercury toxicity due to thimerosal, which is used as a preservative in some vaccines. Many Canadian parents, while continuing to seek chelation therapy in response to this suggestion, are not aware that, in Canada, thimerosal has never been added to MMR, and has not been present in diphtheria-pertussis-tetanus-poliomyelitis or pentavalent vaccines since 1992. It is found in only Hepatitis B vaccine in some provinces.
Wendy Roberts, Mary Harford
Like any other medical intervention, immunization has risks. No medical procedure is 100% effective or 100% safe for every person. This cannot, however, be validly used as an argument against immunization, just as the occasional tragic outcome from surgery is not a valid argument for abolishing surgery. Immunization remains the only proven way to protect against vaccine-preventable diseases.
Chanda Cooper Warren
High vaccine coverage rates today have almost eliminated diseases that used to kill thousands of people every year in the U.S. Before vaccines were introduced there were over 175,000 cases of diphtheria annually (1920-22), over 147,000 cases of Pertussis (1922-25), and over 503,000 cases of measles (1951-54). Very high vaccine coverage (>94%) is needed to prevent the spread of measles.
National Network for Immunization Information
The Immunization Safety Review Committee (ISR) was a project within the Institute of Medicine that addressed current and emerging vaccine-safety concerns. The committee provided independent, non-biased advice to vaccine policy-makers, as well as practitioners and the public.
Institute of Medicine
The body of epidemiological evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism... Potential biological mechanisms for vaccine-induced autism that have been generated to date are only theoretical. Recommends a public health response that fully supports an array of vaccine safety activities and recommends that available funding for autism research be channeled to the most promising areas.
Institute of Medicine, Immunization Safety Review Committee
Well-designed studies of more than 1200 children with severe allergic reactions to eggs have clearly shown that these children can safely receive MMR vaccine.Therefore, vaccine skin testing and desensitization are no longer recommended for children with a history of severe egg allergy, and there is no reason to delay immunization. However, the recommendations for influenza vaccine, which is also manufactured using egg products, are different. Children with previous anaphylactic reactions to chickens or egg protein can experience, on rare occasions, anaphylactic reactions to inactivated influenza vaccines. The Red Book recommends that egg-allergic children should not receive inactivated influenza vaccine. The alternative for these patients is chemoprophylaxis.
Russell W. Steele, Medscape
I'm a microbiologist and immunologist with an interest in the diseases that affect animals we farm, such as cattle, sheep and deer. For the moment I'm taking some time to start writing a book, working to save some money and then moving on to start a PhD towards the end of the year.
During the early stages of polio immunization, the Cutter Company followed the then-imperfect instructions regarding production of the vaccine to the letter, but those instructions -- together with the then-imperfect scientific knowledge regarding the vaccine -- proved inadequate to guarantee the vaccine's safety. As a result, the live polio virus survived in some of the company's vaccine, which was distributed to a large number of people. Seventy thousand of those immunized by the faulty vaccine experienced the transient flu-like symptoms of mild polio, 200 wound up being paralyzed by polio, and 10 died from the disease. Some of the victims then hired the most flamboyant plaintiffs' lawyer of the time, Melvin Belli, who proceeded to sue the Cutter Company for all that it was worth. Although the trial was essentially a draw, the outcome nevertheless established a principle that would be nearly fatal to the production of vaccines in America:
Obtains and disseminate objective information on the safety of recommended immunizations.
On the Vaccine Safety Datalink
Board on Health Promotion and Disease Prevention, The National Academies
Korean organization founded on the belief that health in developing countries can be dramatically improved by the development, introduction and use of new and improved vaccines.
One common concern that's surfaced in recent years is that there's some link between vaccines and disorders such as autism. But experts say there's no evidence to support that theory. "There have been five major studies done … and they found no link" between vaccines and autism, says Mary Dodig, Ulster County's supervising public health nurse for communicable diseases.
Tracy Dowd, Times Herald-Record
Discussion of the anti-vaccination bias of the American Association of Physicians and Surgeons.
Health Fraud Discussion List
In recent years, the most prevalent anti-vaccine rumor has held that Thimerosal, a mercury-containing preservative used in vaccines from the 1930s until just recently, is behind an "epidemic of autism." Once again, scientific studies have disproved the allegation, but hundreds of parents are filing suit, and trial lawyers continue to troll for clients.
William Tucker
Jared Hansen, Kathleen Seidel, Grace Baron, Susan Senator, Boston Globe
Immunizations should be part of routine health care obtained through one's personal physician (or in some instances, through one's local health department). Long-lasting protection is available against measles, mumps, German measles (rubella), poliomyelitis, tetanus (lockjaw), whooping cough (pertussis), diphtheria, chickenpox (varicella), Hemophilus influenzae b (Hib), and hepatitis B.
James Laidler, Autism Watch
Those who support the idea that mercury causes autism cite a wide range of researchers who've conducted research into the connection and found positive evidence to support the link. Particular favourites amongst believers in the link are Dr. Mark Geier, David Geier (who's not even a Doctor) and Dr Andrew Wakefield. Dr Mark Geier is in American parlance a 'professional witness', meaning one who will perform as an expert witness for you in court cases for money.
Kevin Leitch
Provides up-to-date, science-based information to healthcare professionals, the media, and the public: everyone who needs to know the facts about vaccines and immunization.
The most comprehensive, up-to-date and accurate of information on vaccines, disease and immunisation in the UK. The most frequently asked questions submitted to this website are compiled into list which is updated weekly.
The reviewed epidemiological evidence indicates that, although possibly not contributing to optimal stimulation of the immune system in infancy, current infant vaccines do not cause allergic diseases.
S. Koppen et al
Comparison of 20th Century Annual Morbidity and Current Morbidity Vaccine-Preventable Diseases; Compulsory Immunization Laws; School Immunization Laws; Incidence of Measles According to Evidence of Mandatory School Entry Requirements; Incidence of Reported Measles in States Enforcing School Immunization Laws; Reported Incidence Of Mumps For 5-19 Year Olds By Type Of State Immunization Requirement; School Immunization Laws; Estimated Varicella Vaccination Coverage Among Children 19-35 Months of Age by State; Growth of State Laws Requiring Vaccination; Exemptions To School Immunization Laws; State Implementation of Exemptions; Easy Exemption Process Associated with High Rates; State Implementation of Exemptions; Relative Risk of Measles and Pertussis in Exemptors from School Laws; School Exemption Rates in Counties With and Without Pertussis Outbreaks; Religious and Medical Exemptions Among Massachusetts Kindergarten Students 1986-1999; School Exemption Rates (%) Colorado: 1987-1998; Non-Medical Exemptions and Legal; Arkansas; US District Court; US District Court Ruling; Arkansas Reaction; Model Legislation for Non-Medical Exemption; Arkansas Non-Medical Exemption; Non-Medical Exemption.
Daniel Salmon, Institute for Vaccine Safety, Johns Hopkins University
If mercury in vaccines didn't cause autism, then why did more than 10,000 autistic children this year receive the same chelation therapy that caused Abubakar's death? One answer is the media concentration on scare stories linking thimerosal to autism.
Fredericksburg Free Lance-Star
An independent scientific panel weighing a possible link between autism and the mercury preservative in childhood vaccines heard suggestions on Monday that the source of the heavy metal could be fish.
"Pertussis is really the new emerging disease — and it is out there again because of waning immunity," said Dr. Baren, adding that the disease is predominant among teens and infants who have not been fully immunized, with the peak age period now 10 to 19 years. "We're seeing quite a bit in teenagers now." While the disease had all but disappeared in 1980, 19,000 cases were diagnosed in the United States in 2004, up from approximately 7000 three years earlier. Michael Gerardi, MD, director of pediatric emergency medicine for Atlantic Health in New Jersey, attributes the peak in part to the "immunization scare" that linked DTaP vaccination with autism, which has not been substantiated by research. "That scare has reduced immunization rates, and we're seeing the consequences now," he said. Dr. Gerardi, who practices at Morristown Memorial Hospital, urged emergency physicians and other "front-line" healthcare workers to ensure that they are immunized against pertussis.
Bonnie Darves, Medscape
The majority of recent cases of tetanus among children in the United States were in unvaccinated children whose parents objected to vaccination. Parents who choose not to vaccinate their children should be advised of the seriousness of the disease and be informed that tetanus is not preventable by means other than vaccination.
Elizabeth Fair et al
A graphic novella.
James Weldon
For any parent, there are few more traumatic diagnoses than that a child suffers from autism. But the increasing political attention to that affliction is having the unintended and dangerous consequence of limiting vaccines for all children.
Wall Street Journal
The results suggest an urgent need to compare the health levels and incidence of chronic disorders in vaccinated and non-vaccinated children.
Trevor Wilson
Research, scientific advancements and medical developments over the decades has led to new vaccines being produced and studied so that people can be protected from disease. Some of the key research papers and reports are included for your information.
Immunisation for Life
In this Assessment report, we explain the historical and modern debates through an examination of the historical and contemporary aspects of immunization requirements as a condition of school attendance. Part II provides a brief history of vaccination as a medical and public health practice, using smallpox disease as the primary case study, and subsequently addresses corresponding societal and individual objections to the proliferation of vaccination programs. We discuss the chronology and social milieu leading to these policies through an historical description of legal and social factors underlying school vaccination laws and requirements. Part III reviews the subsequent legislative and judicial reactions to these policies. Did state and local lawmakers second guess the need for school vaccination laws, and, if so, for what reasons? How did courts construe these laws? Our judicial examination includes a review of the various legal and constitutional objections to school vaccination policies, including those based on religious beliefs under the First Amendment, equal protection theories, and due process concerns. The historical and modern legal and social contexts supports a contemporary discussion of views about school vaccination requirements in Part IV. We examine the modern debate through a scholarly discussion of available evidence of the public health effectiveness of school vaccination programs. We compare (1) childhood immunization rates and (2) rates of vaccine-preventable childhood diseases before and after the introduction of school vaccination requirements. Without devaluing the importance of the health and safety of each individual, these data suggest that school vaccination requirements have succeeded in increasing vaccination rates and reducing the incidence of childhood disease. Finally, we discuss modern antivaccination arguments. Like arguments from the past, modern antivaccination sentiment is fueled by general distrust of governmental programs, a rugged sense of individualism, and concerns about the efficacy and safety of vaccines. Although these latter views are often grounded in myths about the correlation of vaccine requirements with increases in childhood diseases (like autism) or other dangers, some vaccines can harm a statistically small number of children and perpetuate fears. In these cases, the public health objective of controlling communicable disease spread in the population is weighed against potential harms to children. Especially for diseases like smallpox that no longer infect the population, the potential to use any vaccine that could harm any individual is deemed an unacceptable risk (unless smallpox was reintroduced into the general population through bioterrorism or other means). A brief conclusion follows.
James G. Hodge, Jr., Lawrence O. Gostin
What was causing the immune system to turn against itself? The research was pointing to bombardment by multiple vaccines that overwhelmed the immature immune systems of infants and toddlers.
Lesli Mitchell
People today think they have some inalienable right to compensation if things go wrong. That's new. It wasn't my parents' attitude. And it's not how medicine works. You learn things the hard way in medicine, when things do go wrong. And medicine evolves, and you fix them. But people no longer accept that... I'll tell you what's in my heart. I'm a pediatrician. I have kids myself. If a rotavirus vaccine ever gets approved, it can save 2,000 lives a year. That's why I do this.
Josh Fischman, Paul Offitt, US News
The childhood diseases measles, mumps, and rubella can now be prevented with a safe and effective vaccine. More frightening than the diseases themselves in a way is the fact that some parents aren't having their kids vaccinated, thinking that children are more likely to die from vaccines than from diseases. That isn't true, and last week brought the further good news that the largest-ever study seeking a link between the MMR vaccine and autism found no connection.
Todd Seavey
Specifically, members of Immunization Safety Review Committee had no ties to vaccine manufacturers, had not made policy statements regarding vaccines; had not served as expert witnesses--paid or unpaid--in any vaccine-related litigation; and had not worked for nor received recent funding for research on vaccine safety from the agencies that sponsored the study. As is the case with all IOM projects, their service was entirely voluntary; they received no compensation.
Harvey Fineberg, Institute of Medicine
"Many children with autism start to develop autistic symptoms around the same time as they receive immunizations," said Judith Miles, professor of pediatrics, Thompson Endowed Chair of Child Health and Pathology, and director of the Medical Genetics Division at MU. "Obviously, it is worrisome to families and it seems reasonable to conclude that a relationship exists. However, if you look at the data there is simply no relationship between them. There has been no thimerosal in Denmark's vaccines since 1991 and yet diagnosed cases of autism there rose at the same rate as it did worldwide."
Rocky Mountain News
New research from Canada may not end the debate about childhood vaccines and autism, but it offers more evidence that vaccines are not to blame for the dramatic rise in reported cases of the developmental disorder. The study examined outcomes among 28,000 children in Quebec, exposed to different dosages of the measles, mumps, rubella (MMR) vaccine and vaccines containing the mercury-based preservative thimerosal. Researchers found no relationship between MMR vaccine exposure, thimerosal exposure and autism rates. In fact, a higher incidence of autism was seen in Canadian children vaccinated after thimerosal was eliminated from vaccines than among children who received thimerosal-containing immunizations.
Salynn Boyles, Medscape
Contrary to the fears of some parents, a 10-year study by Danish researchers found no evidence that combination vaccines, such as the measles, mumps and rubella shot, weakened children's immune systems. The study, published today in the Journal of the American Medical Association, tracked 805,206 children born in Denmark.
Alex Raksin, Los Angeles Times
Why are vaccines under fire? Some experts say it's due to their success. "It's the natural evolution of a vaccine program," says Paul Offit, M.D., chief of infectious diseases and director of the Vaccine Education Center at the Children's Hospital of Philadelphia. "As you eliminate the diseases, people are not as compelled to get vaccines." Adds Kathryn Edwards, M.D., spokesperson for the National Network for Immunization Information, "Many diseases are out of sight and then out of mind. So people don't see the value of vaccines." Yet high immunization rates are necessary to keep diseases like measles and even polio from making a dangerous comeback. Here are ten myths about vaccines -- and the truth behind them.
Beth Howard, Parenting
The National Partnership for Immunization (NPI) hosted a media conference call on December 10, 2003, in which leading experts discussed new science on the safety and benefits of vaccines. The call was led by David Neumann, PhD, Executive Director of NPI. Dr. Neumann was joined by both Paul Offit, MD, Chief of Infectious Diseases at the Children's Hospital of Philadelphia and Professor of Pediatrics at the University of Pennsylvania School of Medicine, and by Polly Sager, PhD, Assistant Director for Research in Infectious Diseases, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases.
National Partnership for Immunization
Includes Pediatric Vaccines and Autism: Despite the consensus of the overwhelming majority of scientists to the contrary, public concern persists that vaccines may be causally linked to autism, a situation worsened by the popular press's failure to let sleeping dogs lie. Although the possibility of a vaccine/autism link has been soundly and repeatedly debunked by professional analyses of numerous studies, the press continues to capitalize on parents' fears about the link by ignoring the science, and by presenting mixed messages.
Ruth Kava, American Council on Science and Health
The provision didn't take away anyone's right to sue. Instead, it allows people injured by vaccines and their ingredients the chance to quickly recover damages for their injuries from a compensation fund paid for by manufacturers. "Most people agree to a settlement through this fund, but if they are not satisfied with their award, they can then choose to file a civil lawsuit," Mr. Schwartz says.
Washington Times
CDC is actively involved in detecting and investigating vaccine safety concerns and supporting a wide range of vaccine safety research to address safety questions.
Melinda Wharton
Attitudes, beliefs, and behaviors indicative of vaccine safety concerns contribute substantially to underimmunization in the United States. Although concerns were significantly more common among parents of underimmunized children, many parents of fully immunized children demonstrated similar attitudes, beliefs, and behaviors, suggesting a risk to the currently high vaccination levels.
Deborah Gust et al
Public confidence in vaccines and high rates of vaccine uptake are critical to the continued effectiveness of immunization programs. Even when risks are purely theoretical, experience has shown that unaddressed public concerns can drastically decrease immunization coverage, to the detriment of public health. Thus the call to remove thimerosal from vaccines seeks to maintain public confidence by avoiding even theoretical risk. NACI makes recommendations based on the best available scientific evidence. Vaccine safety is an essential consideration in any recommendation made by NACI. Concerns regarding thimerosal, as reviewed in the 2003 statement, were purely theoretical. Nevertheless, NACI identified them as important issues for further consideration and study. The weight of evidence now available, however, refutes any link between thimerosal and autism. As such, NACI concludes that there is no reason for vaccine providers or other health care professionals who may counsel individuals regarding immunization to raise any concerns regarding exposure to thimerosal.
National Advisory Committee on Immunization
Summary of the evidence on both the benefits and the potential risks of vaccines, with an emphasis on the vaccines used in routine childhood immunization. The report addresses some of the common myths about vaccines and discusses some vaccine safety issues that have recently been in the news.
Kathleen Meister
The Vaccine Adverse Event Reporting System is a cooperative program for vaccine safety of the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS is a post-marketing safety surveillance program, collecting information about adverse events (possible side effects) that occur after the administration of US licensed vaccines.
Centers for Disease Control
The US Vaccine Adverse Event Reporting System (VAERS) is a passive reporting system to which anyone can report an event. Publicity related to potential adverse events may change reporting patterns. The objective of this paper is to show how litigation-related reports have influenced the trends in possible adverse event reports to VAERS. The VAERS public-use data files were downloaded in July 2004 and translated into identical SAS data sets for analysis. Cases that were related to litigation were identified using a word search algorithm. All cases for the most frequently reported symptoms in litigation (overdose, neuropathy, autism, "mental retardation," arthralgia, and "speech disorder") were reviewed. In recent years, most case reports to VAERS that were related to overdose, neuropathy, and thimerosal were related to litigation. Many cases that were related to autism and mental retardation were as well. This review shows a previously undisclosed rise in the number of reports to the VAERS related to pending litigation for vaccine injury. The implications of this for understanding longitudinal reporting patterns are discussed.
Michael J. Goodman, James Nordin
In the US, the government has gone some way to easing the risk assumed by vaccine developers via the Vaccine Injury Compensation Programme, a national fund that compensates families whose children are injured by vaccines. But Offit maintains that flaws in this program limit its effectiveness. Families can choose to opt out of the programme and proceed to a jury trial, the program does not cover all vaccines, and it does not cover effects on an unborn child when the mother is vaccinated.
In-Pharma Technologist
This section on vaccine safety offers a PDF file containing the educational tear sheet titled The Facts about Childhood Vaccines. This file is easily downloaded from the site. The section also contains detailed answers to many questions about vaccine safety and an overview of timely vaccine topics.
Children's Hospital of Philadelphia
Sen. Judd Gregg (R-N.H.), the Senate's chief advocate for strict liability protections, asserted that the companies need to be thoroughly indemnified against suits to provide enough of an incentive for them to make vaccines, which tend to be low-profit products... "You're not going to get vaccine production in the U.S. unless you have liability protection," Gregg said in a telephone interview. "The risk of a major liability suit far outweighs the potential rate of return that you'd get on the investment."
Jeffrey Birnbaum, Washington Post
You can't practice medicine without a license. But you can set up your own website on medical topics without consulting with anyone at all. The Net makes it easier to find information, but it also makes it easier for bad information to parade as fact.
Stacy Mintzer Herlihy, Esther Aronson
Comprehensive information about a specific disease and the vaccine that prevents it. Each page includes a Q & A section, photos and/or video footage, true stories of individuals who have suffered or died from the disease, descriptions of public policies, and references to other resources.
If the interpretation of burden of proof allows the reported links between Autism and vaccinations to be submitted as evidence, then it is possible that it could have a major impact in the way of compensation for those injured by vaccines.
Floyd Tilton
Keeping in mind the dual objectives of promoting a robust vaccine industry and encouraging public confidence in vaccines, Congress should take the steps needed to bring about a second “golden age” of vaccines that will benefit all Americans. Of the solutions available, a retooled and expanded VICP, or some similar program, is the best opportunity to protect vaccine makers from lawsuits while quickly and fairly compensating injured parties. While the vaccine provision currently pending before Congress would be a good first step towards offering the vaccine industry the liability protection it needs, Congress will have to revisit the issues of extending the number of vaccines protected and providing fair and just compensation to those injured by vaccines.
Randolph Pate, Heritage Foundation
Views of parents who believe vaccines injured their children differ significantly from those of the general population regarding the benefits of immunization. Understanding the factors that shape this perspective can improve communication among vaccine providers, policymakers, and parents/patients.
Emily Jane Woo et al
Offering bibliographies of journal articles and popular articles on various vaccine-related issues.
Immunization Action Coalition
Vaccination has greatly diminished death, illness and suffering in the world. But no other medical technology has been so dogged with controversy. The book chronicles the development of the key lifesaving vaccines since the 18th century. It tells the stories of great scientists and their discoveries, of the protests and pain along the stumbling path of progress. This is the first book to tell the whole story of vaccination for a general audience. In light of controversies about flu vaccine and autism, it will be of particular interest to parents, pediatricians, public health workers and anyone fascinated by medical history.
Arthur Allen
Welcome to our Vaccine Page. Please read through this very important information carefully and don't forget to consult with your doctor.
The introduction of effective conjugate vaccines is changing the landscape of pediatric infectious disease, and pediatricians need to be current on the scope of these changes. The purpose of the special report is to update the pediatric community on current issues in the prevention and treatment of infections due to Streptococcus pneumoniae. Specifically, the experts whose comments are reported here will discuss the effectiveness of pneumococcal conjugate vaccine (PCV7) for the prevention of invasive pneumococcal disease(IPD), highlight strategies for further reduction on IPD, illustrate how changes in antimicrobial management affect the course of respiratory illness in children, and identify what the FDA, AAP, industry, and community can do to prevent future shortages of vaccine supply.
Jerome O. Klein et al
Thimerosal does not cause autism; nor does the MMR vaccine. This is the conclusion reached by The Institute of Medicine's Immunization Safety Review Committee in its report, Vaccines and Autism. The report states that "the body of epidemiological evidence favors rejection of a causal relationship between the MMR vaccine and autism" as well as a "rejection of a causal relationship between thimerosal-containing vaccines and autism."
National Network for Immunization Information
The weight of currently available scientific evidence does not support the hypothesis that vaccines cause autism. We recognize there is considerable public interest in this issue, and therefore support additional research regarding this hypothesis. CDC is committed to maintaining the safest, most effective vaccine supply in history.
Centers for Disease Control
Scientific evidence does not support the hypothesis that vaccines cause autism. One of the most effective ways that parents can protect the health of their children is to ensure that the children receive all of their recommended immunizations on time.
Centers for Disease Control, Prevention
Neither vaccines containing thimerosal or MMR vaccine are associated with autism.
Centers for Disease Control
But the youngest Americans who can remember diphtheria and whooping cough are on Medicare. The youngest who can remember polio and measles are in their 50s and 40s, respectively. Most parents making immunization decisions today are in their 20s and 30s.
Consumer Reports
In this edition of our weekly Please Explain feature, we'll tackle the subject of viruses and vaccines. With avian bird flu an important issue in the news, we decided to find out how viruses work, and how vaccines combat them. We'll also look at how vaccines are manufactured and distributed. We'll hear from Paul Offit from the Department of Pediatrics at the Children's Hospital of Philadelphia, and Ian Lipkin, a neurologist and microbiologist from the Mailman School of Public Health at Columbia.
Leonard Lopate, Paul Offit, Ian Lipkin
We need a variety of incentives to revitalize the portion of the private sector that has been battered by policymakers and regulators -- both to push forward good scientific ideas and to pull big drug makers into the field. Public policy must reward inputs on vaccine R&D (via grants, tax credits and the waiver of regulatory registration fees) and outputs of products (with guaranteed purchases, milestone payments when regulatory approval of new vaccines are granted, indemnification from liability claims, waiver of FDA user fees for vaccine reviews, and reciprocity between U.S. regulatory approvals and those in certain foreign countries). Part of this effort should be aggressive funding of "proof of concept" R&D on various new technologies and approaches to making flu vaccine, to boosting the immune response, and to creating greater reserve capacity for the commercial production of vaccines. Finally, instead of being a major cause of the problem, regulators must become part of the solution.
Henry I. Miller, TCS Daily
As the fear of such diseases has receded from public memory, new fears have arisen about the vaccines themselves. For this reason, the Institute of Medicine (IOM) has regularly reviewed evidence of any possible associations between vaccines and adverse medical outcomes. Recently, the IOM issued 8 reports examining suggested risks and societal benefits associated with different vaccines. These reports reemphasized the enormous positive benefit-to-risk ratios provided by current vaccines, and concluded that there was no convincing evidence to support proposed links between vaccines and the diseases of autism, multiple sclerosis, or sudden infant death syndrome.
Harvey Fineberg
Teaching or preaching that vaccinations are bad without looking at their benefits, and then telling them that adjustments are good without stating their risks, is dishonest and again violates our nonmaleficience duty. It harms people by scaring them away from preventive treatments - vaccinations - that have been shown to be effective, with real but small risks comparable to chiropractic care itself.
Stephen Perle
During the past fifty years, the number of pharmaceutical companies making vaccines has decreased dramatically, and those that still make vaccines have reduced resources to make new ones. Pharmaceutical companies are gradually abandoning vaccines because the research, development, testing, and manufacture of vaccines are expensive and because the market to sell vaccines is much smaller than the market for other drug products. Congressional action could assure both a steady supply of existing vaccines and the promise of vaccines for the future.
Paul Offit
The trial established beyond reasonable doubt that Cutter had not been negligent. But the judge stated—as a matter of law, so that the jury was powerless to disagree—that the company was liable for damages, even if it had done nothing wrong, simply because its product had harmed its recipients. This principle of absolute liability soon found itself defended in legal journals on the grounds that a large company was best able, via its insurance, to distribute the costs of risks among all the relevant parties, and society as a whole would benefit from the arrangement. Quite apart from its repugnance to natural justice, this principle has been disastrous to the manufacture of vaccines. It opened the way for huge claims against the manufacturers. Since the courts are often cavalier in their complete disregard of scientific evidence, awarding huge damages against companies not only innocent of any negligence but whose products have done no objectively demonstrable harm, it is not surprising that pharmaceutical companies have largely withdrawn from the vaccine market. For them, the potential profits are small, and the risks great.
Theodore Dalrymple
The IOM committee that wrote the report concluded that hypotheses regarding how the MMR vaccine and thimerosal could trigger autism lack supporting evidence and are theoretical only.
Mark Moran, Psychiatric News

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