Are we asking the right questions about vaccination and children’s health?

5/9/17 UPDATE: This groundbreaking study was immediately retracted for political reasons. Read our update here.

Vaccines, considered by many as one of the top-ten public health achievements of the 20th century, are “powerful medical interventions.”1 Vaccines are thought to work by priming the immune system to recognize and defend itself against the specific diseases targeted by the vaccines.2 However, immunologists admit that they have little understanding of exactly how vaccines activate the immune system.3

Many vital aspects of vaccination have either been poorly studied or never studied at all, particularly in regards to longer-term effects of individual vaccines or of the vaccine program as a whole. The systems currently in place in the United States to monitor what happens after a vaccine is administered are primarily designed to detect acute, short-term adverse events arising from a single vaccine. These monitoring systems are ill-suited to discern chronic or subtle effects that manifest more than a few weeks post-vaccination.4

Some recent studies in lower-income countries have indicated that vaccines can have complex repercussions that are not specific to the disease in question, including cross-reactions to allergens and more severe consequences, including death.5,6 These “nonspecific” effects may plausibly arise as a result of interactions between vaccine antigens and adjuvants or other ingredients, through different combinations and sequencing of vaccines, or through cumulative effects of the vaccine schedule over time.7

In the U.S., careful consideration of the longer-term impact of vaccination on children’s health—including both disease-specific and nonspecific effects—has immense public health relevance. This is because the pediatric vaccination schedule has become significantly more crowded over the past two decades, at the same time that the prevalence of chronic illness and neurodevelopmental disorders (NDDs) in children has exploded.4,8,9 In their first six years, the U.S. vaccine schedule expects children to receive 48 doses of 10 vaccines covering 14 diseases,10 compared with just three vaccines for seven diseases in the 1970s.

The expanded vaccine schedule also has broadened its scope beyond a handful of classic infectious diseases to encompass vaccines addressing less virulent pathogens and non-infectious or chronic conditions.4 Some of the newer vaccines primarily seek to minimize societal and economic costs (e.g., missed time from school or work, physician visits) rather than prevent morbidity or premature deaths.4,11 ….

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