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Report Confirms Safety of Childhood Immunization Schedule

UMDNJ professor and pediatrician invited to serve on Institute of Medicine's report committee.

Dr. Pauline Thomas, pediatrician and professor at UMDNJ, a member of the team that produced the report on childhood immunization.
Dr. Pauline Thomas, pediatrician and professor at UMDNJ, a member of the team that produced the report on childhood immunization.

For some parents, childhood immunizations are seen as a hazard to their kids' health -- a fear that may be augmented by the vaccination schedule itself, which can call for as many as five shots during a single visit to the pediatrician.

Some of those fears may be allayed by a new report from the Institute of Medicine, described as the most comprehensive examination of the entire schedule of childhood immunizations.

It confirms the safety of both the vaccinations and the schedule.

The report was prompted by concerns raised by some parents, who have expressed an increased opposition to the recommended timeframe for vaccines.

Under the current schedule, children under 2 receive up to 24 immunizations protecting them against 14 pathogens.

According to The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies, however, there is ample evidence that not vaccinating children increases their risk of contracting diseases, while it found no evidence that the current schedule is unsafe.

The amount of global travel is increasing the risk of spreading diseases, according to Dr. Pauline A. Thomas, a pediatrician and professor at UMDNJ's New Jersey Medical School and a member of the committee that produced the study.

“We feel that the existing system in place for monitoring vaccine safety is very good and very well attended to by the federal government and vaccine researchers,” Thomas said of the committee.

New Jersey has a mixed record in vaccinations. In a series of vaccinations tracked by the U.S. Centers for Disease Control and Prevention, New Jersey was slightly ahead of the national average in 2011, with 73.9 percent of children receiving the complete series compared with 73.6 nationally.

However, New Jersey trailed other higher-income northeastern states like Connecticut (79 percent), Maryland (78 percent), and Massachusetts (76.9 percent)

Thomas said the report filled a void. While each individual vaccine has been studied for its safety, the overall schedule hadn’t been assessed. However, she noted that each new vaccination has been studied in the context of the existing schedule.

While the report found that a randomized study would be the best way to conclusively compare the health of children who have had immunizations with those who haven’t, it also recommended against performing such as a study. That is because it would raise ethical concerns.

The committee instead recommended further examining data from an existing project, the Vaccine Safety Datalink.

Thomas said she is used to answering concerns about immunizations. A pediatrician with Summit Medical Group, she was invited to join the committee by the Institute of Medicine. The U.S. Department of Health and Human Services’ National Vaccine Program Office funded the report.

“Pediatricians have a lot of experience explaining immunizations and explaining the risks of not getting the immunizations,” she said. “And the evidence shows us that the vaccine schedule is safe, and pediatricians know that.”

The report may not win over parents who are skeptical of the current immunization schedule.

“I don’t see that it really gives us anything new,” said Sue Collins, cofounder of the Alliance for Informed Choice in Vaccination. “If you’re looking at flawed studies to start with and combing through them, then you still come out with a flawed outcome.”

Collins said that parents are asking for a choice in determining which vaccines their children receive.

“I think the problem is that parents are realizing that the vaccines that we have in the current schedule is not safe for every child,” Collins said. “I think the flaw is that we continue to have a one-size-fits-all philosophy.”

Immunizations have been the focus of debate in New Jersey in recent months, with the state Senate passing a measure that would reduce the number of exemptions for children receiving vaccines.

Report committee members warned against this approach, saying that there is increasing evidence linking a delay in immunizations with a higher risk of hospitalization.

Thomas emphasized that pediatric and family practice doctors agree annually on the immunization schedule, which is developed by the CDC's Advisory Committee on Immunization Practices.

Thomas also noted that vaccines have been changed to take out preservatives that were the subject of objections by parents, even when there was no research showing adverse outcomes.

Report committee chairwoman Ada Sue Hinshaw of the Uniformed Services University of the Health Sciences said more work should be done to improve how healthcare professionals inform the public about immunizations.

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