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Study Finds Rotavirus Vaccine Reduces Some Hospitalization Costs

Vaccine News: Week In Review

A new study published in the Journal of the Pediatric Infectious Diseases Society provides additional evidence for the impact of the rotavirus vaccine, finding that more than 380,000 children avoided hospitalization for diarrhea from 2008 to 2013 due to vaccination. Preventive care resulted in an estimated $1.2 billion savings in direct medical costs.

Researchers analyzed data from community and academic hospitals in 26 states to estimate the nationwide impact of the vaccine. The periods before and after vaccination licensure, which occurred in 2006, were compared, excluding the first year when vaccination rates were low. Diarrhea hospitalizations dropped from 55 percent to 31 percent from 2008 to 2013, with greater reductions in the later years.

“Our findings confirm the sustained impact and effectiveness of the rotavirus vaccine program,” said author Eyal Leshem, MD, formerly of the Centers for Disease Control and Prevention (CDC) at the time of the study and currently an affiliate of the Sackler Faculty of Medicine at Tel-Aviv University in Israel.

The estimated $1.2 billion saved nationwide during the 2008-2013 period does not account for other costs saved, such as those associated with emergency room visits.

Study Finds Hepatitis A Virtually Eliminated in Alaska

Vaccine News: Week In Review

Researchers who presented at this year’s World Indigenous People’s Conference in Anchorage, Alaska announced that the state vaccination program has virtually eradicated the Hepatitis A virus.

In 1995, Alaska introduced a universal Hepatitis A vaccination program for children ages 2-14 and the vaccine became a requirement for school entry in 2001. By 2006, every child in Alaska between the ages of 1 to 19 was included in the universal vaccination program.

Before introducing the Hepatitis A vaccine, Alaska struggled with epidemics every 10-15 years. Between 1995 and 2007, hepatitis A incidence rates fell by 98 percent. From 2008-2016, only 23 cases were reported in Alaska.

“Dramatic declines in the incidence of hepatitis A occurred after HAV vaccine was recommended as a routine childhood vaccine and after it was required for school entry. Prior to routine vaccination, most the reported HAV cases were associated with outbreaks occurring within Alaska. Since 2008 however, 88% of reported hepatitis A cases have been imported, many of which were acquired during travel outside of the United States,” the authors wrote, including Stephanie Massay, Epidemiology Specialist with the Alaska Division of Public Health.

The CDC recommends that “the best way to prevent Hepatitis A is through vaccination with the Hepatitis A vaccine. Vaccination is recommended for all children, for travelers to certain countries, and for people at high risk for infection with the virus.”

Community Medical Panel Encourages HPV Vaccine

Vaccine News: Week In Review

Panelists at a medical forum held in Gainesville, Georgia on Thursday encouraged pre-teens and teenagers to receive the human papillomavirus (HPV) vaccine. The panel, hosted by the community organization WomenSource, focused on cancer prevention.

“This vaccine is not a sex vaccine; it is a cancer vaccine,” said Dr. Andrew Green, a gynecological oncologist who specializes in cancer of the cervix, uterus and ovary. “If you [end up] at my office, you’ve missed the boat and that’s a bad thing,” he added.

Dr. Cindy Fulenwider Greene, a board-certified dentist at BGW Dental Group who has advanced training related to detection and treatment of oral cancer; and Dr. Katie Herzog, a pediatrician with The Longstreet Clinic, rounded out the group of panelists.

The HPV vaccine has faced criticism over the years, including concerns about its safety and claims that it promotes sexuality promiscuity, despite continued confirmation of its safety and numerous studies disputing any link between the HPV vaccine and promiscuity.

“It is a safe vaccine; it has been proven over and over and over,” Dr. Andrew Green said at the panel. “It is an effective vaccine. We are already starting to see pap smear rates drop in women in late 20s and early 30s. There’s even some data saying the heart attack rate may be lower in people who got the vaccine.”

Hawaiian Inmates Confirmed with Mumps

Vaccine News: Week In Review

The Oahu Community Correctional Center has confirmed that eight inmates have mumps.

The total number of cases in the state of Hawaii has now risen to 209, including

the eight inmates, according to the Hawaii Department of Health. The facility is taking steps to ensure the disease does not spread.

“This includes vaccinations and isolation of positive cases until they are no longer contagious. Inmates who have come in contact with the infected inmates have been immunized per the DOH recommendation,” said a Department of Health spokesperson.

The situation is not being considered an outbreak, as eight confirmed cases among over 1,300 inmates remains small. However, precautions are being followed carefully.

The state DOH recommends that “all adults born in or after 1957, without evidence of immunity to mumps, who cannot verify previous MMR vaccination, should receive one MMR dose.”

American Academy of Pediatrics Urges Parents Not to Stretch the Immunization Schedule

Vaccine News: Week In Review

The American Academy of Pediatrics (AAP) released a statement this week addressing the dangers of alternative vaccine schedules.

“Only one vaccine schedule has been shown to be safe and effective. Any deviation from the recommended schedule may jeopardize benefit and increase the risk of harm,” the AAP statement noted.

Alternative vaccine schedules are often promoted by vaccine skeptics as a substitute for parents wary of the immunization schedule recommended by the Centers for Disease Control and Prevention (CDC). In 2007, Dr. Bob Sears published a book suggesting two alternative immunization schedules for vaccine hesitant parents; both theories have been widely denounced by public health experts.

“Infants and young children who follow immunization schedules that spread out shots-or leave out shots-are at risk of getting sick,” said Amanda Cohn, a pediatrician, senior advisor for vaccines at the CDC and executive secretary of the Advisory Committee on Immunization Practices (ACIP). “Several vaccine-preventable diseases remain common in the United States, and children may be exposed to these diseases during the time they are not protected by vaccines. This places them at risk for serious illness that might
cause hospitalization or death.”

New Report Shows Countries Aren’t Meeting a Basic Vaccination Target

Vaccine News: Week In Review

A press release issued by the World Health Organization (WHO) and UNICEF announced that 64 of 194 countries are not meeting a basic vaccination target for the diphtheria-tetanus-pertussis (DTP) containing vaccine.

The WHO’s goal is to vaccinate 90% of the world’s children against DTP, and according to the new data, only 130 of the 194 WHO Member States have achieved and sustained at least 90% coverage for DTaP at the national level.

“Worldwide, 12.9 million infants, nearly 1 in 10, did not receive any vaccinations in 2016, according to the most recent WHO and UNICEF immunization estimates. This means, critically, that these infants missed the first dose of diphtheria-tetanus-pertussis (DTP)-containing vaccine, putting them at serious risk of these potentially fatal diseases,” noted the WHO press release.

DTaP vaccine uptake is also a good indicator of how well countries are doing with other vaccinations, as it is typically the first immunization children receive and is considered one of the most basic vaccinations recommended by WHO.

CDC Issues Statement for Travelers Regarding Measles

Vaccine News: Week In Review

On July 19, the Centers for Disease Control and Prevention (CDC) issued a statement reminding travelers to Europe and other global destinations to protect themselves against measles, amid outbreaks of the disease.

Since 2016, travel notices have been issued in five European countries: Belgium, France, Germany, Italy and Romania, the most recent of which was issued for France on July 7.

“Most measles cases in the United States are the result of international travel,” Gary Brunette, MD, MPH, chief of the CDC’s travelers’ health program, said in the release. “Travelers get infected while abroad and bring the disease home. This can cause outbreaks here in the U.S.”

According to the European Centre for Disease Prevention and Control, more than 14,000 cases of measles have been reported in Europe since January 2016. Measles cases have been reported in 15 European countries in 2017: Austria, Belgium, Bulgaria, the Czech Republic, Denmark, France, Germany, Hungary, Iceland, Italy, Portugal, Slovakia, Spain, Sweden, and the United Kingdom.

The CDC recommends that anyone who isn’t protected against measles, either through vaccination or past infection, should get vaccinated with the measles, mumps, and rubella vaccine (MMR) vaccine, including before international travel, in order to protect both travelers and people back home.

Two doses of MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective.

University of Texas Students Diagnosed with Mumps

Vaccine News: Week In Review

Last week, Texas officials announced that seven University of Texas students have been diagnosed with mumps.

University of Texas health officials sent an email to students explaining the outbreak and the symptoms to look out for.

“I’m not nervous because I know I have gotten all my vaccinations, but I guess it is a big thing especially with school starting in the fall that if people are sick and it’s contagious, that’s bad,” said Christina Severson, a student of the University of Texas.

A student was also diagnosed with mumps at the university last year, and in 2015 there was another outbreak with several cases reported.

The Centers for Disease Control and Prevention (CDC) recommends the measles, mumps, and rubella vaccine (MMR) vaccine to protect against currently circulating mumps strains.

“Outbreaks can still occur in highly vaccinated U.S. communities, particularly in close-contact settings. In recent years, outbreaks have occurred in schools, colleges, and camps. However, high vaccination coverage helps limit the size, duration, and spread of mumps outbreaks,” states the CDC website.

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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