|
Evidence-Based Medicine: MMR Vaccine Not Linked to Autism
-
JAMA: Association
Between Thimerosal-Containing Vaccines and Autism
"In a six-year Danish population-based cohort study, children given a
thimerosal-based vaccine were
compared with those receiving a thimerosal-free version of the same vaccine.
The risk of autism and autism-spectrum disorders did not differ
significantly between the two groups."
-
AAP: Study fails to show a connection between thimerosal and autism
"AAP provides the following information for clinicians who may be aware of recent press surrounding an article that claims to show a
correlation between thimerosal and autism. This paper uses data from the Vaccine Adverse Event Reporting System
(VAERS) inappropriately and contains numerous conceptual and scientific flaws, omissions of fact, inaccuracies, and misstatements."
AAP Press Release: http://www.aap.org/profed/thimaut-may03.htm
-
JAMA Editorial:
Congressional Autism Hearings Continue:
No Evidence MMR Vaccine Causes Disorder
-
AAP Press Release:
http://www.aap.org/advocacy/washing/23apr01.htm
-
Institute of Medicine Immunization Safety Review:
http://www.nap.edu/books/0309074479/html/
-
Journal of the American Medical Association -
Time Trends in Autism and in MMR Immunization Coverage in California (JAMA. 2001;285:1183-1185)
http://jama.ama-assn.org/issues/v285n9/abs/jbr00284.html
-
Pediatrics Electronic Article: Measles-Mumps-Rubella Vaccine and Autistic Spectrum Disorder:
Report From the New Challenges in Childhood Immunizations Conference Convened in Oak Brook, Illinois, June 12-13, 2000
Vol. 107 No. 5 May 2001, p. e84
http://www.pediatrics.org/cgi/content/abstract/107/5/e84
-
British Medical Journal 2001;322:460-463 (24JFebruary)
Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis
http://www.bmj.com/cgi/content/full/322/7284/460
-
WebMD: Autism Debate May End Up Harming Children
- There's No Evidence Vaccine Is Linked to the Disorder
http://webmd.lycos.com/content/article/1728.57049
-
Autism Research Must Continue - AAP to issue autism policy statement on diagnosis and treatment
http://www.aap.org/advocacy/washing/25apr01.htm
Mumps Outbreak at a Summer Camp --- New York, 2005
"...in the camp outbreak, mumps likely was introduced by an unvaccinated
counselor who traveled from the UK...the outbreak described in this report likely resulted from a combination of delay in diagnosis of mumps
and failure to report the cluster in a timely manner, in addition to close contact and social mixing..."
Varicella
Decline in Annual Incidence of Varicella -
Selected States, 1990--2001
"The findings in this report suggest that the steady decline
in reported varicella incidence during 1999-2001 resulted from the increased
use of varicella vaccine and not a decrease in reporting. These findings
are consistent with data from three active surveillance sites at which
individual cases are investigated (Antelope Valley, California; West
Philadelphia, Pennsylvania; and Travis County, Texas). During 1995-2000,
incidence of varicella for all age groups in these three sites declined
substantially (range: 76%-87%), corresponding with the high average
vaccination coverage of 80%."
MMWR September
19, 2003 / 52(37);884-885
AAP, Institute of Medicine: Vaccine Safety
Report
"A vaccine safety report issued by the Institute of Medicine (IOM) contains
findings and recommendations consistent with those of the AAP. No evidence
currently exists that proves a link between thimerosal-containing vaccines and
autism, ADHD and speech and language delay."
AAP Press
Release
IOM Online Report:
Immunization Safety Review: Thimerosal-Containing Vaccines and
Neurodevelopmental Disorders (2001)
Influenza
CDC
Influenza Home Page
Using
Live, Attenuated Influenza Vaccine for Prevention and Control of Influenza
"This report summarizes recommendations by ACIP for using intranasally
administered, trivalent, cold-adapted, live, attenuated influenza vaccine (LAIV), which was approved for use
in the US on June 17, 2003 (FluMist(R), MedImmune, Inc.). LAIV is currently approved for use among healthy
persons (i.e., those
not at high risk for complications from influenza infection) aged 5–49
years."
Carriers
Announce Coverage for Intranasal Flu Vaccine
"Administration of inactivated trivalent influenza vaccine to children aged
6 to 24 months did not reduce
their burden of AOM or their utilization of selected health care and related
resources."
The Safety of Inactivated Influenza Vaccine in Adults and Children with Asthma
"In a multicenter, randomized, double-blind, placebo-controlled, crossover
trial in 2032 patients with asthma (age range, 3 to 64 years), patients were
given injections of vaccine and placebo assigned randomly, with a mean of 22
days between the injections. Each day during the two weeks after each
injection, the patients recorded peak expiratory flow rates, symptoms thought to
be related to the injection, use of asthma medications, unscheduled health care
visits for asthma, and asthma-related absences from school or work. In the
two weeks after the injections. The frequency of exacerbations of asthma
was similar in the two weeks after the influenza vaccination and after placebo
injection. Among symptoms thought to be associated with the injection,
only body aches were more frequent after the vaccine injection than after
placebo injection. Conclusion was: the inactivated influenza vaccine is
safe to administer to adults and children with asthma, including those with
severe asthma."
NEJM: Volume
345:1529-1536
ACIP Recommends Expanded Influenza Vaccinations for Children
MMWR:
Simultaneous Administration of Varicella Vaccine and Other Recommended Childhood
Vaccines --- United States, 1995--1999
"Do Parents Understand Immunizations? A National Telephone Survey"
A survey of 1,600 parents reveals that the majority of parents understand the clear benefits of childhood immunization, yet many still
have misconceptions that may undermine their confidence in vaccines.
AAP Press
Release
Pediatrics Vol. 106 No. 5 November 2000, pp.
1097-1102
Study indicates thimerosal may
not be linked to illnesses in children
ABC World News (9/26, story 6, 2:45,
Gibson) reported, "The Centers for Disease Control is out
with a major study, tonight, about the safety of a controversial
preservative once used in child vaccines, thimerosal. Many parents
have become convinced, as we've reported, that thimerosal is
linked to their children's autism. However, the CDC, which has
always maintained that thimerosal was safe, says parents should
find its new study very reassuring." ABC (Donvan) continued,
"Thimerosal was the smoking gun. A suspicion confirmed for
many furious and heartbroken parents, when the CDC finally asked
drugmakers to pull it from childhood vaccines, which they
eventually did for most of them. But today, an opinion piece in
the New England Journal of Medicine says that decision was a
mistake."
The New
York Times (9/27, A31, Harris) reports, "Yet another
study has found that a controversial vaccine preservative appears
to be harmless. But the study is unlikely to end the increasingly
charged debate about vaccine safety." The Times continues,
"Some parents' groups and prominent legislators contend that
thimerosal, [a mercury-containing vaccine preservative], has
caused an epidemic of childhood autism. Several studies have
examined this question and found no evidence that thimerosal is
associated with autism." This particular study "examined
whether thimerosal...is associated with neurological or certain
psychological problems in children ages 7 to 10."
The AP
(9/27, Chang) adds that this "study did not examine autism --
the developmental disorder that some critics blame on vaccines. A
separate study due out in a year will look at that issue,"
said scientists at the CDC who conducted the study. "Thimerosal...has
not been used in childhood vaccines since 2001, although it is
still in some flu shots." The study focused on data regarding
childhood immunizations which occurred before then, and on
children who were "exposed to the preservative through shots
their mothers received while pregnant." The preservative was
used to prevent bacterial contamination of vaccines.
According to Bloomberg
(9/27, Cortez, Jinks), "The Public Health Service and the
American Academy of Pediatrics eight years ago asked manufacturers
to stop using the preservative thimerosal, which contained mercury
since the 1930s." The request followed an FDA "analysis
in 1999 [which] found [that] shots recommended for infants could
expose them to excess levels of mercury, though no clear damage
was detected."
Meanwhile, the Wall
Street Journal (9/27, D7, Sataline) notes, "The study of
1,107 children by the...[CDC] explored whether a correlation
existed between the amount of thimerosal exposure before birth or
in the first seven months of life and performance on 42 tests
measuring verbal, motor and intellectual acuity." The
researchers "didn't find that those exposed to thimerosal
consistently suffered in tests measuring word recall,
hyperactivity, stuttering, intelligence or other areas."
USA
Today (9/27, Manning) points out that "[f]ive percent, or
19 of 378 statistical test scores analyzed, showed results
considered significant." However, Anne Schuchat, director of
the National Center for Immunization and Respiratory Diseases at
the CDC, argued that "5% is the number that can be predicted
to result from chance alone in" a sample of this size.
Furthermore, "The significant links went in both directions.
Twelve indicated thimerosal exposure improved test performance,
while seven showed it resulted in poorer performance." USA
Today continues, "Only one finding raised a question that
researchers say needs further evaluation: a twofold greater risk
of verbal and motor tics seen in boys who had the highest
thimerosal exposure between birth and 7 months, compared with boys
with the lowest exposure."
And, WebMD
(9/27, DeNoon) adds that the observation of tics, "repetitive
physical motions or vocalizations," may have been
"simply chance" since it was observed among boys only
once, and was a case of "transient tics, which experts do not
consider a problem." WebMD notes that the CDC "asked
more than a dozen outside consultants to comment on the study
prior to publication of the final manuscript," including
"Sallie Bernard, the parent of a child with autism and
executive director of Safe Minds," an organization which
seeks "to convince parents that medical use of mercury causes
autism and other child health problems." Sallie Bernard
"formally dissents with the CDC's" findings from this
study. She cites "flaws in the study -- such as the inclusion
of a relatively small number of children exposed to very high or
very low amounts of thimerosal." However, Dr. Schuchat
disagrees. She concluded, "While definitive proof of
thimerosal safety remains elusive, so is definitive proof that
thimerosal-containing vaccines caused harm. ... The findings are
very reassuring that exposure to vaccines during the 1990s was not
associated with significant problems in children 7-10 years
old."
The Chicago
Tribune (9/27, Graham), HealthDay
(9/27, Gordon) and MedPage
Today (9/27, Groch) also cover the story.
Use of DT-Tetanus Toxoid-Acellular Pertussis Vaccine
as a Five-Dose Series
This report supplements the ACIP statement regarding use and
summarizes data regarding reactogenicity of acellular pertussis vaccines when administered as the 4th and 5th consecutive doses.
Because data are insufficient regarding the safety, immunogenicity, and efficacy of using DTaP vaccines from different manufacturers in
a mixed sequence, ACIP continues to recommend, whenever feasible, the same brand of DTaP vaccine be used for all doses in the vaccination
series. When the vaccine provider does not know or does not have available the type of DTaP vaccine previously administered, any of the
licensed DTaP vaccines can be used to complete the vaccine series.
MMWR: FDA
Approval of Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine
Adsorbed, (INFANRIX®) for Fifth Consecutive DTaP Vaccine Dose (July 8,
2003).
Acellular Pertussis Vaccine Proves Effective in Adults, Adolescents:
ACIP Recommends Adult Vaccination: New Tetanus, Diphtheria Pertussis
Vaccine (Tdap)
"...voted to recommend that adults from 19 to 64 years of age be
vaccinated with a newly licensed adult booster tetanus, diphtheria and
pertussis (whooping cough) vaccine (Tdap)..."
The Risk of Seizures after Receipt of Whole-Cell Pertussis or
Measles, Mumps, and Rubella Vaccine
"In a cohort study at four large
HMOs, relative risks of febrile and non-febrile seizures among 679,942 children after 340,386 DTP vaccinations,
137,457 MMR vaccinations and no recent vaccination were calculated. Receipt of DTP vaccine was associated with an increased risk of febrile seizures only
on the day of vaccination (adjusted relative risk, 5.70). Receipt of MMR
vaccine was associated with an increased risk of febrile seizures 8 to 14 days after vaccination (relative risk, 2.83). Neither was associated with an
increased risk of non-febrile seizures. The number of febrile seizures attributable to the administration of DTP and MMR vaccines was estimated to
be 6-9 and 25-34 per 100,000 children, respectively. As compared with other
children with febrile seizures that were not associated with vaccination, the children who had febrile seizures after vaccination were not found to be
at higher risk for subsequent seizures or neuro-developmental disabilities."
The Changing Epidemiology of Rubella in the 1990's: On the Verge of
Elimination and New Challenges for Control and Prevention
"The epidemiology of rubella and CRS has changed significantly in the last
decade. These changes and molecular typing suggest that the United States
is on the verge of elimination of the disease. To prevent future rubella
outbreaks and CRS, current strategies must be enhanced and new strategies
developed."
JAMA.
2002;287:464-472
FDA Approval for a Combined
Hepatitis A and B Vaccine
"FDA has licensed a combined hepatitis A and B vaccine (Twinrix.)
for use in persons aged >18 years. Twinrix is manufactured
and distributed by GlaxoSmithKline Biologicals (Rixensart,
Belgium), and is made of the antigenic components used in Havrix
and Engerix-B (GlaxoSmithKline)."
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5037a4.htm
ACIP Expands Hepatitis A Vaccination for Children
"The recommendation for vaccination of children, between 1
and 2 years of age will be integrated into the routine childhood vaccination
schedule"
ACIP Recommends New Vaccine to Prevent Rotavirus
|
