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Childhood immunization is one of the major public health measures
of the 20th century and is now receiving special attention from the
Clinton administration. At the same time, some parents and health
professionals are questioning the safety of vaccines because of the
occurrence of rare adverse events after immunization. This volume
provides the most thorough literature review available about links
between common childhood vaccines?tetanus, diphtheria, measles,
mumps, polio, Haemophilus influenzae b, and hepatitis B?and
specific types of disorders or death. The authors discuss
approaches to evidence and causality and examine the
consequences?neurologic and immunologic disorders and death?linked
with immunization. Discussion also includes background information
on the development of the vaccines and details about the case
reports, clinical trials, and other evidence associating each
vaccine with specific disorders. This comprehensive volume will be
an important resource to anyone concerned about the immunization
controversy: public health officials, pediatricians, attorneys,
researchers, and parents. Table of Contents Front Matter 1
Executive Summary 2 Causality and Evidence 3 Neurologic Disorders 4
Immunologic Reactions 5 Diphtheria and Tetanus Toxoids 6 Measles
and Mumps Vaccines 7 Polio Vaccines 8 Hepatitis B Vaccines 9
Haemophilus influenzae Type b Vaccines 10 Death 11 Need for
Research and Surveillance APPENDIX A Executive Summary from Adverse
Effects of Pertussis and Rubella Vaccines APPENDIX B Strategies for
Gathering Information APPENDIX C Glossary APPENDIX D Committee and
Staff Biographies Bibliography Index
Vaccines have made it possible to eradicate the scourge of
smallpox, promise the same for polio, and have profoundly reduced
the threat posed by other diseases such as whooping cough, measles,
and meningitis. What is next? There are many pathogens, autoimmune
diseases, and cancers that may be promising targets for vaccine
research and development. This volume provides an analytic
framework and quantitative model for evaluating disease conditions
that can be applied by those setting priorities for vaccine
development over the coming decades. The committee describes an
approach for comparing potential new vaccines based on their impact
on morbidity and mortality and on the costs of both health care and
vaccine development. The book examines: Lessons to be learned from
the polio experience. Scientific advances that set the stage for
new vaccines. Factors that affect how vaccines are used in the
population. Value judgments and ethical questions raised by
comparison of health needs and benefits. The committee provides a
way to compare different forms of illness and set vaccine
priorities without assigning a monetary value to lives. Their
recommendations will be important to anyone involved in science
policy and public health planning: policymakers, regulators, health
care providers, vaccine manufacturers, and researchers. Table of
Contents Front Matter Executive Summary Introduction Progress in
Vaccine Development Considerations of Candidate Vaccines Overview
of Analytic Approach and Results Review of the Analytical Model
Ethical Considerations and Caveats Observations References Appendix
1: Borrelia burgdorferi Appendix 2: Chlamydia Appendix 3:
Coccidioides Immitis Appendix 4: Cytomegalovirus Appendix 5:
Enterotoxigenic E. coli Appendix 6: Epstein-Barr Virus Appendix 7:
Helicobacter pylori Appendix 8: Hepatitis C Appendix 9: Herpes
Simplex Virus Appendix 10: Histoplasma capsulatum Appendix 11:
Human Paillomavirus Appendix 12: Influenza A and B Appendix 13:
Insulin-Dependent Diabetes Mellitus Appendix 14: Melanoma Appendix
15: Multiple Sclerosis Appendix 16: Mycobacterium tuberculosis
Appendix 17: Neisseria gonnorrhea Appendix 18: Neisseria
meningitidis Appendix 19: Parainfluenza Virus Appendix 20:
Respiratory Syncytial Virus Appendix 21: Rheumatoid Arthritis
Appendix 22: Rotavirus Appendix 23: Shigella Appendix 24:
Streptococcus, Group A Appendix 25: Streptococcus, Group B Appendix
26: Streptococcus pneumoniae Appendix 27: Information on accessing
Electronic Spreadsheets Appendix 28: Summary of Workshops Appendix
29: Questions Posed to Outside Experts and List of Responders Index
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