Current vaccine schedule safe, says IOM report

Edwin Garcia, 5, reacts as he gets a flu vaccination at Carlin Springs Elementary School in Arlington, Va., Thursday, Jan. 7, 2010. H1N1 flu-shot drives for all ages are scheduled around the country for what's officially dubbed National Influenza Vaccination Week, in hopes of preventing a possible third wave of the epidemic later this winter. (AP Photo/Alex Brandon)

In light of recent concerns about vaccines, a review of scientific evidence supports the safety of the current vaccination schedule, according to an Institute of Medicine report released today.

The federal childhood immunization schedule covers children from birth through age 6 years and protects against 14 diseases, including the measles, mumps, and polio. Roughly 90 percent of American children receive most childhood vaccines advised by the federal immunization schedule by the time they enter kindergarten.

Children may receive up to 24 immunizations by the age of two and up to 5 injections in a single visit.  Some parents have said this may present unnecessary risks because of the timing and number of vaccinations. These parents have requested delays of one or more immunizations, or have had fewer vaccinations given at each visit. Some parents also refuse immunizations because of a vaccine’s potential side effects. The report points out these decisions may reflect the significant and sustained decline of vaccine-preventable diseases over the past several decades causing parents to believe that it’s not worth the risk of an extremely rare negative reaction to a vaccine.

A delay or refusal to immunize their children has already contributed to outbreaks of disease across the United States that pose a risk to the health of many people, particularly those with compromised immune systems, according to the report.

We asked blog contributor Gary A. Emmett, M.D., F.A.A.P., an attending pediatrician at Nemours Pediatrics, Philadelphia, and director of hospital pediatrics at Thomas Jefferson University Hospital to review the report and answer questions about the safety and effectiveness of vaccines:

What do I need to know about the IOM report?

It is a very objective view of the issue of immunization and their effects.  I am old enough to remember the devastation of even common “mild” childhood infections. The chicken pox could be fatal for a pregnant woman and cause blindness when it attacked the surface of the eyes. It was a fatal disease in all of my adolescents patients with cystic fibrosis.  None of the people who refuse immunization seem to remember that these diseases can cause tragic outcomes and some even fatal.

What did the IOM committee do to come to these findings?

The committee looked at every paper ever done for side effects and effects, and could find no collaboration of all the “rumors” on the internet about immunizations causing widespread problems.They could not find anything to suggest that the childhood immunization schedule is linked to autoimmune diseases, asthma, hypersensitivity, seizures, child developmental disorders, learning disorders or developmental disorders, or attention deficit or disruptive behavior disorders.

Are vaccines becoming more safe?

The number of vaccines has increased over the years to protect against a greater number of diseases, but children now receive fewer antigens because of technological advances. Antigens are the components of vaccines that stimulate the immune system. 

I have actually done vaccine safety studies on the human papillomavirus or HPV vaccine for males. The total lack of side effects even surprised me. There were not even many local soreness or swelling episodes. 

Having seen at least one teen with whooping cough early this week, we may have made the pertussis vaccine so safe that it does not last as long as the one with all the side effects that was given 30 years ago.

Why is it important to immunize my child?

Immunizations are not just for your child, they are for the community.  The German measles shot does not protect the child given it, so much as it protects hundreds of thousands of unborn babies from deafness and brain damage by protecting the mothers of those children.  Immunizations protect the whole “village,” not just the person who gets them.

What are some of the reactions a child can have to a vaccine? Are they common?

They are not common except for the pain and swelling after tetanus that occurs approximately  40 percent of the time about 4 to 8 hours after being given the immunization. Vaccines, in rare cases, can cause illness. Most children who experience a negative reaction to immunization have a preexisting susceptibility.

How will the government keep tracking the safety or current and new vaccines?

Philadelphia has one of the best immunization registries in the country.  Every vaccine given to every child in the city is easily accessible by any doctor’s office.  It really prevents accidentally giving too many shots or not enough.  It is wonderful and helps Philadelphia achieve one of the highest vaccination rates in the United States.