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Report Details Strategy for Monitoring Safety of Childhood Immunization Schedule

Christy Potter

Wednesday, January 16, 2013 • 2:32pm

BERKELEY HEIGHTS, NJ – While some parents and advocacy groups have been questioning the safety of the federal childhood immunization schedule, a new report says the schedule is safe.

Pauline Thomas, MD, a pediatrician with Summit Medical Group, was one of 14 medical professionals who served on a committee organized by the Institute of Medicine to examine evidence about the immunization schedule and recommend the best way to conduct any needed investigations.

Thomas spoke with The Alternative Press today about the report, entitled “The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies.”

“We looked into three things: what studies are out there on the vaccine schedule, the concerns of the stakeholders, and how the safety of the childhood immunization schedule can be studied going forward,” Thomas said. Stakeholders include not only parents but advocacy groups, pediatricians, public health officials, vaccine developers and the FDA, she said.

“Healthcare providers and public health officials are concerned that children receive vaccines,” Thomas said. When vaccines are not given on schedule, or not given at all, outbreaks of disease have been recorded, including recent cases of whooping cough, measles, Haemophilus influenza, and polio.

“Many parent share that same concern,” she said. “There is a smaller group that’s concerned about the number of vaccines. We looked at that and found evidence from 2002 that multiple vaccines are safe. We did a literature search on a number of articles that have come out since 2002, and reports that looked at the schedule as a whole.” She said the committee was satisfied, after considerable research, that the schedule is safe and there is no connection between vaccines and conditions that some have said are vaccine-related, such as autism.

Nevertheless, she said, the report offers a framework for conducting safety research using existing or new data collection systems. 

“We have several recommendations,” Thomas said. “We believe the federal government can more systematically keep track of everybody’s concerns, and help pediatricians and parents communicate with each other. Pediatricians are good at explaining individual vaccines but may need help understanding the schedule as a whole. They could better get out the message that it’s not safe to not receive your vaccines.”

Thomas added that as a parent and grandparent herself, she understands that it’s often frightening for young mothers to see their perfect babies get stuck with a needle.

“So many of these diseases we didn’t see for so long, like polio and whooping cough, so people tend to not realize what a threat they can be,” she said. “Then you look down at your perfect little baby and don’t want to think about him or her getting stuck with needles. But children can die from these preventable diseases.”

According to the report, roughly 90 percent of American children receive most childhood vaccines advised by the federal immunization schedule by the time they enter kindergarten. However, some parents choose to spread out their children's immunizations over a different time frame than recommended by the schedule and a small fraction object to having their children immunized at all. Their concerns arise in part from the number of doses that children receive; the schedule entails 24 immunizations by age two given in amounts ranging from one to five injections during a pediatric visit. Some critics of immunization policies have called for studies comparing health outcomes among vaccinated and unvaccinated children and for research to determine if subgroups exist that are predisposed to experiencing harmful health effects from the vaccines.

Studies have repeatedly shown the health benefits associated with the recommended schedule, including fewer illnesses, deaths, and hospital stays, the report notes. Every new vaccine is tested for safety and evaluated in the context of the entire schedule before it is added. The systems designed to detect possible harmful effects of immunization have worked well at discovering occasional problems with individual vaccines, such as a rare intestinal disorder linked to a now-discontinued rotavirus vaccine. However, the elements of the schedule – the number, frequency, timing, order, and age at which vaccines are given – are not well-defined in existing research and should be improved, according to the report.

The report was sponsored by the U.S. Department of Health and Human Services. For more information, visit http://national-academies.org or http://iom.edu.

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