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EU Court Weakens Requirements for Vaccine Injury Claims

Vaccine News: Week In Review

Earlier this week, the highest court in the European Union ruled that “courts can consider whether a vaccination led to someone developing an illness even when there is no scientific proof.”

The Court of Justice ruled in favor of a French claimant who initiated legal action against Sanofi Pasteur in 2006 for an alleged vaccine injury. The plaintiff claimed that a 1988 hepatitis B immunization resulted in his multiple sclerosis diagnosis the following year.

Numerous studies have disproven the link between the hepatitis B vaccine and multiple sclerosis, a key argument that led to the case’s dismissal in France’s Court of Appeals. After the case was heard at France’s Court of Cassation, it reached the Court of Justice.

This landmark ruling significantly reduces the burden of proof for claimants by requiring the following evidence for cases: “the time between a vaccine’s administration and the onset of a disease, an individual’s previous state of health, the lack of any family history of the disease and a significant number of reported cases of the disease occurring following vaccination.”

Vaccine experts have criticized the ruling for lowering the threshold of proof for adverse events following vaccination. Most notably, Dr. Paul Offit is quoted as saying, “Using those criteria, you could reasonably make the case that someone should be compensated for developing leukemia after eating a peanut butter sandwich.”

Given the increasing visibility that vaccine skeptics have received, the ruling could be used to validate their controversial arguments. Recent disease outbreaks, specifically the devastating measles outbreak in Minnesota, have demonstrated that anti-vaccine rhetoric has real-world implications.

ACIP Retains Core Influenza Recommendations, Considers New Herpes Zoster Vaccine

Vaccine News: Week In Review

The Advisory Committee on Immunization Practices (ACIP) convened in Atlanta this week for the second of three meetings scheduled for 2017.

The committee voted to retain many of its influenza recommendations from the previous year, including a provision to expand approved influenza vaccine options for pregnant women. The group also advised against using FluMist for the 2017-2018 flu season, consistent with its recommendation against administering the nasal spray for the 2016-2017 season.

Committee members heard presentations on Shingrix, GSK’s herpes zoster vaccine that could potentially replace Merck’s Zostavax in national vaccine guidelines.

Influenza Vaccine Ineffective for Seniors During 2016-2017 Season

Vaccine News: Week In Review

Recently released data revealed that the influenza vaccine had a lower level of effectiveness in adults 65 and older during the 2016-2017 season.

While the vaccine had an overall moderate rate of effectiveness (42%), it was essentially ineffective for seniors. Studies suggest that the flu vaccine has been ineffective for seniors “in four of the last seven flu seasons.” The group suffered the highest rate of influenza-related hospitalizations and deaths during the past flu season.

Despite low effectiveness, health officials are still encouraging seniors to get the influenza vaccine next season, as there are still “important benefits of vaccination with currently available vaccines.”

Growing Numbers of Pregnant Women Getting the Whooping Cough Vaccine

Vaccine News: Week In Review

A recent study from the U.S. Centers for Disease Control and Prevention (CDC) found that a growing number of pregnant women are getting vaccinated against whooping cough, or Pertussis.

Whooping cough is a potentially fatal respiratory infection, and the CDC recommends pregnant women get a Tdap vaccine against tetnanus, diphtheria and pertussis during the third trimester of every pregnancy to help protect their baby from whooping cough in the first few months of life.

“Getting Tdap vaccination while pregnant helps protect babies during the critical time between birth and 2 months old, the age when they are old enough to begin getting their own whooping cough vaccines,” said Carla Black, a researcher with the CDC’s Immunization Services Division who worked on the study.

About 49 percent of pregnant women in the U.S. got the Tdap vaccine last year, up from just 27 percent in 2014.

The study also found that women were most likely to get the Tdap vaccine when a doctor or nurse recommended it and offered to immunize them. About 70 percent of women were immunized under these circumstances, compared with just 1.4 percent of women who were not recommended the vaccine by a health care provider.

Fever During Pregnancy May Increase Autism Risk in Offspring

Vaccine News: Week In Review

A study published this week found that a mother’s fever during pregnancy is associated with a higher risk that her child will be diagnosed with autism spectrum disorder.

This research, conducted by researchers at Columbia University’s Mailman School of Public Health and published in the journal “Molecular Psychiatry”, lends support to the theory that infectious agents may disrupt a fetus’s brain development.

The study examined over 90,000 Norwegian children born between 1999 and 2009, and identified over 15,000 whose mothers had said they had fevers at some point during their pregnancy. Of that group, 583 had children later diagnosed with autism.

This publication coincides with recent attention on the scientifically discredited theory that childhood vaccines cause autism. President Trump has energized some anti-vaccine activists with his request for a vaccine safety commission.

Some parents believe see a link between their child developing autism and vaccinations. The timing of these two events is coincidental, as symptoms of autism typically become clear around age two, the same age when children begin to be vaccinated.

National Vaccines Advisory Committee Conference

Vaccine News: Week In Review

Earlier this week, the National Vaccine Advisory Committee (NVAC) held a meeting at the Department of Health and Human Services (HHS) in Washington, D.C.

The meeting focused on three subject areas: Immunization Information Systems (IIS); vaccine confidence; and vaccine technologies and adult immunizations. The committee listened to numerous presentations on the three subject areas, each of which was followed by a panel discussion featuring the speakers.

The research presented illustrated the need for effective, well-funded Immunization Information Systems, in order to properly track vaccinations among populations. Kristen Ehresmann from the Association of Immunization Managers (AIM) described how an effective IIS in Minnesota has proved extremely useful in determining how best to target Minnesota’s resources, during the current measles outbreak.

The presentations on vaccine confidence emphasized how these efforts to boost vaccine confidence and reduce vaccine hesitancy need to be both multi-faceted and localized. Additionally, the research illustrated a number of the most frequently cited parental concerns around vaccines: vaccine safety, necessity of vaccines, the vaccine schedule and freedom of choice.

Additionally, the research on adult vaccinations found considerable racial and ethnic disparities among adults in all of the vaccines assessed, particularly among the pneumococcal and herpes vaccines.

Change in Vaccination Policy in Germany

Vaccine News: Week In Review

New legislation will go into effect next month requiring kindergartens to notify the German health authority if parents have not submitted proof of vaccination counseling for their children.

This change will strengthen current vaccination policy. Current law requires parents to submit proof that they have attended vaccination counseling before enrolling their child in kindergarten, but childcare centers do not currently have to report this information.

Childcare centers are not allowed to refuse a child a place without this proof from parents, an aspect of the existing regulation that will remain in place.

From January to May 2017, Germany has reported 634 cases of measles, compared with just 62 cases during the same period in 2016. Other nations including the United States, Italy, Thailand and Ukraine are reporting either outbreaks or higher cases of measles than the previous year, according to a European Centre for Disease Prevention and Control report.

Immigrant Parents in South Carolina Opting Out of Vaccinations for their Children

Vaccine News: Week In Review

Some immigrant parents in South Carolina are opting out of some health services for their children, including vaccinations, because of fear that they will be deported and separated from their families, a South Carolina public health advocate said this week.

Julie Smithwick is executive director of PASOs, a group founded in 2005 which helps the Latino community and service providers work together for strong and healthy families through education, support and grassroots leadership development.

“We’ve gotten calls from the health department of mothers not coming to…appointments, not showing up for immunizations,” said Smithwick.

Many of these children qualify for government-sponsored health care benefits and immunizations.

Recently, Kaiser Health News reported that some foreign-born Californians are similarly reluctant to sign their children up for Medicaid policies “out of concern that personal information may be used to deport families.”

Mumps Outbreak at Pennsylvania State University

Vaccine News: Week In Review

Pennsylvania State University confirmed this week that the case count of mumps has now reached 86.

The outbreak started in late January 2017, and by April the number of confirmed cases was 77.

The majority of those infected during the original outbreak have recovered, but new cases continue to appear on the Penn State campus.

Most students, including those living on and off campus, are expected to receive two doses of the Measles Mumps Rubella (MMR) vaccine, or to submit results from a blood test proving immunity, as recommended by the Centers for Disease Control and Prevention (CDC).

“Mumps outbreaks can still occur in highly vaccinated U.S. communities, particularly in close-contact settings such as schools, colleges, and camps. However, high vaccination coverage helps to limit the size, duration, and spread of mumps outbreaks,” states the CDC.

According to the CDC, there has been more than a 99 percent decrease in mumps cases in the United States since vaccinations for the disease began in 1967.

Seasonal Trivalent Influenza Vaccination During Pregnancy and the Incidence of Stillbirth: Population-Based Retrospective Cohort Study

Regan et. al Clinical Infectious Diseases

Mothers who received seasonal TIV during pregnancy were significantly less likely to experience stillbirth compared with unvaccinated mothers. These results support the safety of seasonal influenza immunization during pregnancy and suggest a protective effect.

Link to abstract and full paper.

The Benefit of Early Influenza Treatment of Pregnant Women Hospitalized with Laboratory Confirmed Influenza

Oboho et al. The Journal of Infectious Diseases

Pregnant women are at higher risk for serious illness and complications, including death, from influenza. For expectant mothers hospitalized with flu, early treatment with the influenza antiviral drug oseltamivir may shorten their time in the hospital, especially in severe cases, suggests a new study published in The Journal of Infectious Diseases and available online. The findings also underscore the importance of flu vaccination for this risk group.

View the full article published in The Journal of Infectious Diseases.

Autism Occurrence by MMR Vaccine Status Among US Children With Older Siblings With and Without Autism

Jain et al. JAMA

To report ASD occurrence by MMR vaccine status in a large sample of US children who have older siblings with and without ASD the authors did a retrospective cohort study using an administrative claims database associated with a large commercial health plan. Participants included children continuously enrolled in the health plan from birth to at least 5 years of age during 2001-2012 who also had an older sibling continuously enrolled for at least 6 months between 1997 and 2012.

Abstract with link to Full paper.

Association of Tdap Vaccination With Acute Events and Adverse Birth Outcomes Among Pregnant Women With Prior Tetanus-Containing Immunizations

Sukumaran et al. JAMA

Pertussis is poorly controlled, with the highest rates of morbidity and mortality among infants. Although the source of infant pertussis is often unknown, when identified, mothers have historically been the most common reservoir of transmission. Despite high vaccination coverage, disease incidence has been increasing. The authors examined whether infant source of infection (SOI) has changed in the United States in light of the changing epidemiology.

Abstract with link to Full paper.

Association Between Hospitalization With Community-Acquired Laboratory-Confirmed Influenza Pneumonia and Prior Receipt of Influenza Vaccination

Grijalva et al. JAMA

The Etiology of Pneumonia in the Community (EPIC) study was a prospective observational multicenter study of hospitalizations for community-acquired pneumonia conducted from January 2010 through June 2012 at 4 US sites. In this case-control study, the authors used EPIC data from patients 6 months or older with laboratory-confirmed influenza infection and verified vaccination status during the influenza seasons and excluded patients with recent hospitalization, from chronic care residential facilities, and with severe immunosuppression. Logistic regression was used to calculate odds ratios, comparing the odds of vaccination between influenza-positive (case) and influenza-negative (control) patients with pneumonia, controlling for demographics, comorbidities, season, study site, and timing of disease onset. Vaccine effectiveness was estimated as (1 - adjusted odds ratio)×100%.

Abstract with link to Full Paper.

Administration of thimerosal-containing vaccines to infant rhesus macaques does not result in autism-like behavior or neuropathology

Gdad et al. PNAS

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder. Some anecdotal reports suggest that ASD is related to exposure to ethyl mercury, in the form of the vaccine preservative, thimerosal, and/or receiving the measles, mumps, rubella (MMR) vaccine. Using infant rhesus macaques receiving thimerosalcontaining vaccines (TCVs) following the recommended pediatric vaccine schedules from the 1990s and 2008, we examined behavior, and neuropathology in three brain regions found to exhibit neuropathology in postmortem ASD brains. No neuronal cellular or protein changes in the cerebellum, hippocampus, or amygdala were observed in animals following the 1990s or 2008 vaccine schedules. Analysis of social behavior in juvenile animals indicated that there were no significant differences in negative behaviors between animals in the control and experimental groups. These data indicate that administration of TCVs and/or the MMR vaccine to rhesus macaques does not result in neuropathological abnormalities, or aberrant behaviors, like those observed in ASD.

Abstract with link to Full paper.

Sources of Infant Pertussis Infection in the United States

Skoff et al. Pediatrics

Pertussis is poorly controlled, with the highest rates of morbidity and mortality among infants. Although the source of infant pertussis is often unknown, when identified, mothers have historically been the most common reservoir of transmission. Despite high vaccination coverage, disease incidence has been increasing. The authors examined whether infant source of infection (SOI) has changed in the United States in light of the changing epidemiology.

Abstract with link to Full paper.

Demographic characteristics of members of the Vaccine Safety Datalink (VSD): A comparison with the United States population.

Sukumaran et al. Vaccine

The Vaccine Safety Datalink (VSD) is a collaboration between CDC and nine integrated health care systems that serves as a cornerstone of US post-licensure vaccine safety monitoring. Given concerns that potential differences between the insured VSD population and the US population could limit the generalizability of VSD study findings, this paper performed a comparison of the demographic characteristics between the two populations.

Abstract with link to Full paper

Safety of Vaccines Used for Routine Immunization of US Children: A Systematic Review.

Maglione et al. Pediatrics

Concerns about vaccine safety have led some parents to decline recommended vaccination of their children, leading to the resurgence of diseases. Reassurance of vaccine safety remains critical for population health. This study systematically reviewed the literature on the safety of routine vaccines recommended for children in the United States.

Abstract with link to Full paper.

Safety of Vaccines Used for Routine Immunization of US Children: A Systematic Review.

Maglione et al. Pediatrics

Concerns about vaccine safety have led some parents to decline recommended vaccination of their children, leading to the resurgence of diseases. Reassurance of vaccine safety remains critical for population health. This study systematically reviewed the literature on the safety of routine vaccines recommended for children in the United States.

Full paper

U.S. Hospitalizations for Pneumonia after a Decade of Pneumococcal Vaccination

Griffin et al. The New England Journal of Medicine

The introduction of 7-valent pneumococcal conjugate vaccine (PCV7) into the U.S. childhood immunization schedule in 2000 has substantially reduced the incidence of vaccine-serotype invasive pneumococcal disease in young children and in unvaccinated older children and adults. By 2004, hospitalizations associated with pneumonia from any cause had also declined markedly among young children. Because of concerns about increases in disease caused by nonvaccine serotypes, we wanted to determine whether the reduction in pneumonia-related hospitalizations among young children had been sustained through 2009 and whether such hospitalizations in older age groups had also declined.

Abstract with link to Full paper.

Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies

The Institute of Medicine (IOM) of the National Academies

This report is the most comprehensive examination of the immunization schedule to date. The IOM committee uncovered no evidence of major safety concerns associated with adherence to the childhood immunization schedule. Should signals arise that there may be need for investigation, however, the report offers a framework for conducting safety research using existing or new data collection systems.

Abstract with link to Full paper.

Adverse Effects of Vaccines: Evidence and Causality

The Institute of Medicine (IOM) of the National Academies

Using epidemiologic and mechanistic evidence, the committee developed 158 causality conclusions and assigned each relationship between a vaccine and an adverse health problem to one of four categories of causation:

  • Evidence convincingly supports a causal relationship
  • Evidence favors acceptance of a causal relationship
  • Evidence favors rejection of a causal relationship
  • Evidence is inadequate to accept or reject a causal relationship

The committee finds that evidence convincingly supports a causal relationship between some vaccines and some adverse events—such as MMR, varicella zoster, influenza, hepatitis B, meningococcal, and tetanus-containing vaccines linked to anaphylaxis. Additionally, evidence favors rejection of five vaccine-adverse event relationships, including MMR vaccine and autism and inactivated influenza vaccine and asthma episodes. However, for the majority of cases (135 vaccine-adverse event pairs), the evidence was inadequate to accept or reject a causal relationship. Overall, the committee concludes that few health problems are caused by or clearly associated with vaccines.

Abstract with link to Full paper.

Prenatal and Infant Exposure to Thimerosal From Vaccines and Immunoglobulins and Risk of Autism

Price et al. Pediatrics

Exposure to thimerosal, a mercury-containing preservative that is used in vaccines and immunoglobulin preparations, has been hypothesized to be associated with increased risk of autism spectrum disorder (ASD). This study was designed to examine relationships between prenatal and infant ethylmercury exposure from thimerosal-containing vaccines and/or immunoglobulin preparations and ASD and 2 ASD subcategories: autistic disorder (AD) and ASD with regression.

Abstract with link to Full paper.

Lack of Association Between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study

Hornig M et al. PLoS One

The presence of measles virus (MV) RNA in bowel tissue from children with autism spectrum disorders (ASD) and gastrointestinal (GI) disturbances was reported in 1998. Subsequent investigations found no associations between MV exposure and ASD but did not test for the presence of MV RNA in bowel or focus on children with ASD and GI disturbances. Failure to replicate the original study design may contribute to continued public concern with respect to the safety of the measles, mumps, and rubella (MMR) vaccine. The objective of this case-control study was to determine whether children with GI disturbances and autism are more likely than children with GI disturbances alone to have MV RNA and/or inflammation in bowel tissues and if autism and/or GI episode onset relate temporally to receipt of MMR.

Abstract with link to Full paper.

Measles Vaccination and Antibody Response in Autism Spectrum Disorders

Baird et al. Archives of Disease in Childhood

The objective of this study was to test the hypothesis that measles vaccination was involved in the pathogenesis of ASD as evidenced by signs of a persistent measles infection or abnormally persistent immune response shown by circulating measles virus or raised antibody titres in MMR vaccinated children with ASD compared with controls .

Abstract with link to Full paper.

Continuing Increases in Autism Reported to California’s Developmental Services System

Schechter and Grether. Archives of General Psychiatry

Previous analyses of autism client data reported to the California Department of Developmental Services (DDS) have been interpreted as supporting the hypothesis that autism is caused by exposure to the preservative thimerosal, which contains ethylmercury. The exclusion of thimerosal from childhood vaccines in the United States was accelerated from 1999 to 2001. The Immunization Safety Review Committee of the Institute of Medicine has recommended surveillance of trends in autism as exposure to thimerosal during early childhood has decreased. The authors look to determine whether trends in DDS autism client data support the hypothesis that thimerosal exposure is a primary cause of autism.

Abstract with link to Full paper.

Historical Comparisons of Morbidity and Mortality for Vaccine-Preventable Disease in the United States

Roush and Murphy. JAMA

To compare morbidity and mortality before and after widespread implementation of national vaccine recommendations for 13 vaccine-preventable diseases for which recommendations were in place prior to 2005 the authors assed.prevaccine baselines based on representative historical data from primary sources and compared them to the most recent morbidity (2006) and mortality (2004) data for diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella (including congenital rubella syndrome), invasive Haemophilus influenzae type b (Hib), acute hepatitis B, hepatitis A, varicella, Streptococcus pneumoniae, and smallpox.

Abstract with link to Full paper.

Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years

Thompson et al. New England Journal of Medicine

It has been hypothesized that early exposure to thimerosal, a mercury-containing preservative used in vaccines and immune globulin preparations, is associated with neuropsychological deficits in children. The authors enrolled 1047 children between the ages of 7 and 10 years and administered standardized tests assessing 42 neuropsychological outcomes. (They did not assess autism-spectrum disorders.) Exposure to mercury from thimerosal was determined from computerized immunization records, medical records, personal immunization records, and parent interviews. Information on potential confounding factors was obtained from the interviews and medical charts. They assessed the association between current neuropsychological performance and exposure to mercury during the prenatal period, the neonatal period (birth to 28 days), and the first 7 months of life.

Abstract with link to Full paper.

Lack of Association Between Rh Status, Rh Immune Globulin in Pregnancy and Autism

Miles and Takahashi. American Journal of Medical Genetics

Though causes of autism are considered largely genetic, considerable concern remains that exposure to Rh immune globulin (RhIg), which until 2001 in the United States contained the preservative thimerosal, can cause autism. To determine whether mothers of children with autism are more likely to be Rh negative (Rh?) or to have received RhIg preserved with thimerosal, which is 49.6% ethyl mercury, the authors surveyed families of children with an autism spectrum disorder (ASD) ascertained through a University-based autism clinic considered free of ascertainment biases related to type of autism or severity. Analysis of complete records including the blood group status and RhIg exposure of 214 families showed that Rh? status is no higher in mothers of children with autism than in the general population, exposure to antepartum RhIg, preserved with thimerosal is no higher for children with autism and pregnancies are no more likely to be Rh incompatible.

Abstract with link to Full paper.

Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links With Immunizations

Fombonne et al. Pediatrics

The purpose of this work was to estimate the pervasive developmental disorder prevalence in Montreal, Canada, in cohorts born from 1987 to 1998 and evaluate the relationship of trends in pervasive developmental disorder rates with: (1) changes in cumulative exposure to ethylmercury (thimerosal) occurring through modifications in the immunization schedule of young children and (2) trends in measles-mumps-rubella vaccination use rates and the introduction of a 2-measles-mumps-rubella dosing schedule during the study period.

Abstract with link to Full paper.

Comparison of Blood and Brain Mercury Levels in Infant Monkeys Exposed to Methylmercury or Vaccines Containing Thimerosal

Burbacher et al. Environmental Health Perspectives

Thimerosal is a preservative that has been used in manufacturing vaccines since the 1930s. Reports have indicated that infants can receive ethylmercury (in the form of thimerosal) at or above the U.S. Environmental Protection Agency guidelines for methylmercury exposure, depending on the exact vaccinations, schedule, and size of the infant. In this study the authors compared the systemic disposition and brain distribution of total and inorganic mercury in infant monkeys after thimerosal exposure with those exposed to MeHg.

Abstract with link to Full paper.

MMR Vaccination and Pervasive Developmental Disorders: A Case-Control Study

Smeeth et al. Lancet

Concern that measles-mumps-rubella (MMR) vaccination might cause autism has led to a fall in vaccine coverage. We investigated whether MMR vaccination is associated with an increased risk of autism or other pervasive developmental disorders. The authors did a matched case-control study using the UK General Practice Research Database. Cases were people born in 1973 or later who had first recorded diagnosis of pervasive developmental disorder while registered with a contributing general practice between 1987 and 2001. Controls were matched on age, sex, and general practice.

Abstract with link to Full paper.

Neurotoxic Effects of Postnatal Thimerosal Are Mouse Strain Dependent

Hornig et al. Molecular Psychiatry

Mercuric compounds are nephrotoxic and neurotoxic at high doses. Thimerosal, a preservative used widely in vaccine formulations, contains ethylmercury. Thus it has been suggested that childhood vaccination with thimerosal-containing vaccine could be causally related to neurodevelopmental disorders such as autism. This study was designed to determine whether vaccination with a thimerosal-containing vaccine is associated with development of autism.

Abstract with link to Full paper.

Thimerosal Exposure in Infants and Developmental Disorders: A Prospective Cohort Study in the United Kingdom Does Not Support a Causal Association

Heron et al. Pediatrics

There is an established link between exposure to mercury and impaired childhood cognitive development and early motor skills. Thimerosal (also known as thiomersal), a preservative used in a number of children’s vaccines, contains ethylmercury (an organic compound of mercury), and there has been concern that this exposure to mercury may be of some detriment to young children. The aim of this research was to test in a large United Kingdom population-based cohort whether there is any evidence to justify such concerns.

Abstract with link to Full paper.

Immunization Safety Review: Vaccines and Autism

The Institute of Medicine (IOM) of the National Academies

This eighth and final report of the Immunization Safety Review Committee examines the hypothesis that vaccines, specifically the measles-mumps-rubella (MMR) vaccine and thimerosal-containing vaccines, are causally associated with autism. The committee reviewed the extant published and unpublished epidemiological studies regarding causality and studies of potential biologic mechanisms by which these immunizations might cause autism.

Abstract with link to Full paper.

Safety of Thimerosal-Containing Vaccines: A Two-Phased Study of Computerized Health Maintenance Organization Database

Verstraeten et al. Pediatrics

This study attempts to assess the possible toxicity of thimerosal-containing vaccines (TCVs) among infants. A 2-phased retrospective cohort study was conducted using computerized health maintenance organization (HMO) databases. Phase I screened for associations between neurodevelopmental disorders and thimerosal exposure among 124 170 infants who were born during 1992 to 1999 at 2 HMOs (A and B). In phase II, the most common disorders associated with exposure in phase I were reevaluated among 16 717 children who were born during 1991 to 1997 in another HMO (C).

Abstract with link to Full paper.

Immunization Safety Review: Influenza Vaccines and Neurological Complications

The Institute of Medicine (IOM) of the National Academies

The Immunization Safety Review committee reviewed the data on influenza vaccine and neurological conditions and concluded that the evidence favored acceptance of a causal relationship between the 1976 Swine Influenza vaccine and GBS in adults. The evidence about GBS for influenza vaccines of other years is not clear one way or the other (that is, the evidence is inadequate to accept or reject a causal relationship).

Abstract with link to Full paper.

Association Between Thimerosal-Containing Vaccine and Autism

Hviid et al. Journal of the American Medical Association

Mercuric compounds are nephrotoxic and neurotoxic at high doses. Thimerosal, a preservative used widely in vaccine formulations, contains ethylmercury. Thus it has been suggested that childhood vaccination with thimerosal-containing vaccine could be causally related to neurodevelopmental disorders such as autism. This study attempts to determine whether vaccination with a thimerosal-containing vaccine is associated with development of autism.

Abstract with link to Full paper.

Thimerosal and the Occurrence of Autism: Negative Ecological Evidence from Danish Population-Based Data

Madsen et al. Pediatrics

It has been suggested that thimerosal, a mercury-containing preservative in vaccines, is a risk factor for the development of autism. The authors examined whether discontinuing the use of thimerosal-containing vaccines in Denmark led to a decrease in the incidence of autism.

Abstract with link to Full paper.

Autism and Thimerosal-Containing Vaccines: Lack of Consistent Evidence for an Association

Stehr-Green et al. American Journal of Preventive Medicine

Between the mid-1980s through the late-1990s, the authors compared the prevalence/incidence of autism in California, Sweden, and Denmark with average exposures to Thimerosal-containing vaccines. Graphic ecologic analyses were used to examine population-based data from the United States (national immunization coverage surveys and counts of children diagnosed with autism-like disorders seeking special education services in California); Sweden (national inpatient data on autism cases, national vaccination coverage levels, and information on use of all vaccines and vaccine-specific amounts of Thimerosal); and Denmark (national registry of inpatient/outpatient-diagnosed autism cases, national vaccination coverage levels, and information on use of all vaccines and vaccine-specific amounts of Thimerosal).

Abstract with link to Full paper.

Association of Autistic Spectrum Disorder and the Measles, Mumps, and Rubella Vaccine

Wilson et al. Archives of Pediatrics & Adolescent Medicine

The objective of this study was to systematically review the evidence for and against the existence of an association between autistic spectrum disorder (ASD) and the measles, mumps, and rubella (MMR) vaccine.

Abstract with link to Full paper.

Thimerosal and Autism?

Nelson and Bauman. Pediatrics

Concern has been expressed over the possibility that the mercury-containing compound thimerosal in vaccines may cause autism. It is reasonable to ask whether thimerosal in childhood vaccine increases risk of chronic childhood neurologic disability and specifically of autism. Most of the information we have about mercury toxicity is related to exposure to methyl rather than ethyl mercury.Bernard et al offered an hypothesis that autism is an expression of mercury toxicity resulting from thimerosal in vaccines. This review will examine these issues and others to ask whether, according to evidence now available, thimerosal is a probable cause of autism.

Abstract with link to Full paper.

Neurologic Disorders After Measles-Mumps-Rubella Vaccination

Makela et al. Pediatrics

The possibility of adverse neurologic events has fueled much concern about the safety of measles-mumps-rubella (MMR) vaccinations. The available evidence concerning several of the postulated complications is controversial. The aim of this study was to assess whether an association prevails between MMR vaccination and encephalitis, aseptic meningitis, and autism.

Abstract with link to Full paper.

Mercury concentrations and metabolism in infants receiving vaccines containing thiomersal: A descriptive study

Pichichero et al. The Lancet

Thiomersal is a preservative containing small amounts of ethylmercury that is used in routine vaccines for infants and children. The effect of vaccines containing thiomersal on concentrations of mercury in infants’ blood has not been extensively assessed, and the metabolism of ethylmercury in infants is unknown. The authors aimed to measure concentrations of mercury in blood, urine, and stools of infants who received such vaccines.

Abstract with link to Full paper.

Immunization Safety Review: Multiple Immunizations and Immune Dysfunction

The Institute of Medicine (IOM) of the National Academies

The Immunization Safety Review committee reviewed the evidence regarding the hypothesis that multiple immunizations increase the risk for immune dysfunction, with a focus on evidence related to risk for infections, the autoimmune disease type I diabetes, and allergic disorders.

The committee found that evidence favors rejection of a causal relationship between multiple immunizations and increased risk for infections and for type I diabetes. They also found that epidemiological evidence regarding risk for allergic disease, particularly asthma, was inadequate to accept or reject a causal relationship. The committee recommended continued attention in the form of policy analysis, research, and communication strategy development to inform those concerned about these issues and to encourage parents to vaccinate their children.

Abstract with link to Full paper.

No Evidence for a New Variant of Measles-Mumps-Rubella-Induced Autism

Fombonne and Chakrabarti. Pediatrics

A link has been postulated between measles-mumps-rubella (MMR) vaccine and a form of autism that is a combination of developmental regression and gastrointestinal symptoms that occur shortly after immunization. This hypothesis has involved 3 separate claims: 1) that there is new phenotype of autism involving regression and gastrointestinal symptoms, 2) that this new variant is responsible for the alleged rise of autism rates, and 3) that this phenotype is associated with biological findings suggestive of the persistence of measles infection. We tested the first of these claims. If this new “autistic enterocolitis” syndrome had some validity, then 1 or several of the following 6 predictions should be supported by empirical data: 1) childhood disintegrative disorder has become more frequent, 2) the mean age of first parental concern for autistic children who are exposed to MMR is closer to the mean immunization age than in children who are not exposed to MMR, 3) regression in the development of children with autism has become more common in MMR-vaccinated children, 4) the age of onset for autistic children with regression clusters around the MMR immunization date and is different from that of autistic children without regression, 5) children with regressive autism have distinct symptom and severity profiles, and 6) regressive autism is associated with gastrointestinal symptoms and/or inflammatory bowel disorder.

Abstract with link to Full paper.

Immunization Safety Review: Thimerosal - Containing Vaccines and Neurodevelopmental Disorders

The Institute of Medicine (IOM) of the National Academies

At the request of the Centers for Disease Control and Prevention and the National Institutes of Health, a committee was convened by the Institute of Medicine (IOM) of the National Academy of Sciences to examine whether or not the use of vaccines containing the preservative thimerosal can cause neurodevelopmental disorders. In Immunization Safety Review: Thimerosal Containing Vaccines and Neurodevelopmental Disorders, the IOM committee carefully examines this issue.

Abstract with link to Full paper.

Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism

The Institute of Medicine (IOM) of the National Academies

The Centers for Disease Control and Prevention and the National Institutes of Health recognized the need for an independent group to carefully examine the hypothesized MMR-autism link and address other vaccine-safety issues as well, in order to give some guidance to themselves, health care providers, researchers, and a concerned public. These agencies engaged the Institute of Medicine, which in turn appointed the Immunization Safety Review Committee, a 15-member body of health professionals with wide-ranging expertise in areas relevant to the problem. The results of the committee’s assessment of the issue are described in this report titled Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism.

Abstract with link to Full paper.

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Amy Pisani @ EveryChildBy2
Tamara's daughter nearly died from pertussis. Yrs later she discover her sister's role in saving her daughter's life https://t.co/MC8VnH0hXK
Amy Pisani @ EveryChildBy2
Tamara's daughter nearly died from pertussis. Yrs later she discover her sister's role in saving her daughter's lif… https://t.co/02tsLQIYtn
Amy Pisani @ EveryChildBy2
Before you send your kids off to #camp consider several diff #vaccines that can protect them from dangerous illness. https://t.co/K2hNxIGqL1
Amy Pisani @ EveryChildBy2
Yrs ago whooping cough nearly took the life of Tamara's daughter. Today maternal #vaccines help prevent infant case… https://t.co/kAdWLE1qi4
Amy Pisani @ EveryChildBy2
Outbreaks help change minds. Prior to MN #measles outbreak administered appr 500 MMR #vaccines/week since outbreak about 3,000/week #ACIP
Amy Pisani @ EveryChildBy2
Update on MN #measles cases at #ACIP: 78 cases (of which 71 unvaccinated), mostly 1-4 yrs old, 21 hospital admissio… https://t.co/acZUS7rlr2
Amy Pisani @ EveryChildBy2
Travelers be aware- shortages in yellow fever #vaccine thru mid 2018 resulting in Stamaril being imported to address shortage. #ACIP
Amy Pisani @ EveryChildBy2
Thorough discussion of #mumps epi & studies of 3rd MMR dose at #ACIP. Despite increase in cases overall decline si… https://t.co/DR3iYD86l7
Amy Pisani @ EveryChildBy2
#Meningitis often strikes young adults but Dell tells a different story. At 31 he walked in ER but never walked out. https://t.co/gS3I2NXKus
Amy Pisani @ EveryChildBy2
99% of adults 40+ have varicella zoster virus in their bodies which can result in shingles. Today's #ACIP discussio… https://t.co/jMmAUJXCco
Amy Pisani @ EveryChildBy2
#ACIP review of PhaseIV study of Zostavax (for herpes zoster). Avg vax effectiveness 5 yrs following vax 45-50% in… https://t.co/l6RTi0qp7Q
Amy Pisani @ EveryChildBy2
#ACIP reviewing shingles vax to ensure adults are protected from this very painful disease afflicting adults not va… https://t.co/CwIWYidN0Z
Amy Pisani @ EveryChildBy2
Summary of prelim #flu vax effectiveness from #ACIP, reduced outpatient visits by 34-42%, reduced hospitalizations… https://t.co/flBb0MYBZF
Amy Pisani @ EveryChildBy2
#ACIP presentation provides overview of #flu surveillance from 2016-2017 season. Influenza A (H3N2) most prominent.… https://t.co/XRygUh5rTD
Amy Pisani @ EveryChildBy2
RT @famfightflu: There were more than 18,000 lab confirmed #flu hospitalizations this season w/ those 65+ in age representing the largest g…
Amy Pisani @ EveryChildBy2
Hepatitis A vaccine is only #vaccine on child schedule without a catch up recommendation. This is purpose of discussion today at #ACIP.
Amy Pisani @ EveryChildBy2
#ACIP We need to do better vax at risk adults at w/ 2-doses of HepA. Food contamination continues to sicken people.… https://t.co/e08CRusp6g
Amy Pisani @ EveryChildBy2
HepA vaccination coverage is the lowest of all vaccines for children. Also very low among teens & adults. #ACIP https://t.co/auEpQozsgT
Amy Pisani @ EveryChildBy2
#ACIP discussing hepatitis A - 2015 saw 1,390 cases. 1996, before vax approved over 31,000 cases in US.… https://t.co/4QZo0vqKxq
Amy Pisani @ EveryChildBy2
Good news! Hepatitis A vaccination provides long term protection. #GetVaxxed #ACIP https://t.co/ZpWwleArGV
Amy Pisani @ EveryChildBy2
#ACIP discussion on Hepatitis A; Antibody to HepA virus has increased in children (due to vaccination) but reduced… https://t.co/LssJPkNWFc
Amy Pisani @ EveryChildBy2
Happy to be at CDC's Advisory Cmte on Iz Practices mtg today. Watch live https://t.co/URMzuGN8Ek #ACIP
Amy Pisani @ EveryChildBy2
The June #ACIP meeting is about to start. Join the live feed to follow along https://t.co/rtpwdgmDfR or follow us for updates.
Amy Pisani @ EveryChildBy2
11,000 men in U.S. get HPV related #cancer each yr. With no screening tests for these cancers #HPV #vaccines matter! https://t.co/cRaI5GbpUm
Amy Pisani @ EveryChildBy2
Germany responds to measles outbreak by fining parents ($2,800) for failing to #vaccinate their kids. Interesting. https://t.co/4phqKE77hS
Amy Pisani @ EveryChildBy2
Thank the Dads in your life for protecting their loved ones from #vaccine preventable diseases. #VaccinesSaveLiveshttps://t.co/2n97bEqB7v
Amy Pisani @ EveryChildBy2
Real men vaccinate at every age to keep themselves & their families healthy! #TalkAboutVaccines #VaccinesAtEveryAgehttps://t.co/tcfEfy0uB0
Amy Pisani @ EveryChildBy2
Adult #vaccines can help keep fathers & grandfathers enjoying precious memories with family. #TalkAboutVaccineshttps://t.co/3ljapOE4Uu
Amy Pisani @ EveryChildBy2
Reduce spending by investing in prevention- preserve immunization funding https://t.co/Ko997B9hks @SteveDaines @SenatorCollins @marcorubio
Amy Pisani @ EveryChildBy2
Reduce spending by investing in prevention- preserve immunization funding https://t.co/Ko997B9hks @RoyBlunthttps://t.co/zCdegmwQuY
Amy Pisani @ EveryChildBy2
Best way to reduce spending? #ProtectPrevention Contact Senators today to preserve critical #vaccine funding.… https://t.co/W8QlPL7kPs
Amy Pisani @ EveryChildBy2
June 15th is Virtual Advocacy Day on 6/15! Tell members of Congress to #ProtectPrevention to save lives & money.… https://t.co/4MmZklwsBd
Amy Pisani @ EveryChildBy2
Reduce spending by investing in prevention- preserve immunization funding https://t.co/Ko997B9hks @SenThadCochran@Shttps://t.co/ZBjWZezSTS
Amy Pisani @ EveryChildBy2
Reduce spending by investing in prevention! Preserve immunization funding! @SenJohnHoeven @JohnBoozmanhttps://t.co/psvQXWbWXd
Amy Pisani @ EveryChildBy2
The PPHF helps prevent deadly disease outbreaks; tell Senate not to eliminate critical funds… https://t.co/4mkAPm1O0W