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Immunization Safety Review Hepatitis B Vaccine and Demyelinating Neurological Disorders (2002) / Chapter Skim
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Appendix A: Committee Conclusions and Recommendations from Previous Reports
Pages 91-99

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From page 91...
... The committee concludes that further research on the possible occurrence of ASD in a small number of children subsequent to MMR vaccination is warranted, and it has identified targeted research opportunities that could lead to firmer understanding of the relationship. Recommendations Public Health Response The committee recommends that the relationship between the MMR vaccine and autistic spectrum disorders receive continued attention.
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From page 92...
... The committee recommends conducting further clinical and epidemiological studies of sufficient rigor to identify risk factors and biological markers of ASD in order to better understand genetic or environmental causes. Communications The committee recommends that goverurnent agencies and professional organizations, CDC and the Food and Drug Administration (FDA)
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From page 93...
... Policy Review and Analysis Public Health Response Recommendations The committee recommends the use of the thimerosal-free DTaP, Hib, and hepatitis B vaccines in the United States, despite the fact that there might be remaining supplies of thimerosal-containing vaccine available. The committee recommends that full consideration be given by appropriate professional societies and government agencies to removing thimerosal from vaccines administered to infants, children, or pregnant women in the United States.
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From page 94...
... The committee recommends continued research on theoretical modeling of ethylmercury exposures, including the incremental burden of thimerosal with background mercury exposure from other sources. The committee recommends careful, rigorous, and scientific investigations of chelation when used in children with neurodevelopmental disorders, especially autism.
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From page 95...
... APPENDIX A 95 Basic Science Research The committee recommends research to identify a safe, effective, and inexpensive alternative to thimerosal for countries that decide they need to switch from using thimerosal as a preservative. The committee recommends research in appropriate animal models on the neurodevelopmental effects of ethylmercury.
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From page 96...
... The committee concludes that the epidemiological evidence is inadequate to accept or reject a causal relationship between multiple immunizations and increased risk of allergic disease, particularly asthma. Biological Mechanisms Conclusions Autoimmune Disease In the absence of experimental or human evidence regarding molecular mimicry or mercury-induced modification of any vaccine component to create an antigenic epitope capable of cross-reaction with self epitopes as a mechanism by which multiple immunizations under the U.S.
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From page 97...
... infant immunization schedule could possibly influence an individual's risk for heterologous infections. Significance Assessment The committee concludes that concern about multiple immunizations has been, and could continue to be, of societal significance in terms of parental worries, potential health burdens, and future challenges for immunization policymaking.
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From page 98...
... Furthermore, the committee recommends that disease registries and research programs for autoimmune and allergic disorders routinely collect immunization histories as part of their study protocol. Basic Science and Clinical Research The committee recommends continued research on the development of the human infant immune system.
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From page 99...
... The committee recommends exploring surrogates for allergy and autoimmunity in existing cohort studies of variations in the vaccine schedule. Communication The committee recommends that an appropriate panel of multidisciplinary experts be convened by the Department of Health and Human Services.
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Key Terms

  • possibly influence
  • immunization schedule
  • infant immunization
  • neurodevelopmental disorders
  • recommends research

  • weak evidence
  • causal relationship
  • recommends exploring
  • allergic disorders
  • bystander activation

  • epidemiological evidence
  • mmr vaccine
  • autistic spectrum
  • increased risk
  • pregnant women

  • appropriate professional
  • continued research
  • molecular mimicry
  • spectrum disorders
  • recommends continued

  • epidemiological studies
  • recommends conducting
  • remaining supplies
  • particularly mercury
  • allergic disease

  • recommends studying
  • background exposure
  • continued attention
  • particularly asthma
  • vaccine available


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