Immunization Safety Review Vaccinations and Sudden Unexpected Death in Infancy (2003) / Chapter Skim
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Appendix A: Committee Recommendations and Conclusions from Previous Reports
Appendix A: Committee Recommendations and Conclusions from Previous Reports
Pages 85-95
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From page 85... ...
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 86... ...
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 government agencies and professional organizations, CDC and the Food and Drug Administration (FDA)
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From page 87... ...
Public Health Response Recommendations Policy Review and Analysis 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 88... ...
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 89... ...
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 90... ...
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. Public Health Response Recommendations Policy Review The committee recommends that state and federal vaccine policymakers consider a broader and more explicit strategy for developing recommendations for the use of vaccines.
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From page 91... ...
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 92... ...
Biological Mechanisms Conclusions The committee concludes that there is weak evidence for biological mechanisms by which hepatitis B vaccination could possibly influence an individual's risk of the central or peripheral nervous system disorders of MS, first episode of CDD, ADEM, or optic neuritis, transverse myelitis, GBS, or brachial neuritis. SIGNIFICANCE ASSESSMENT The committee concludes that concerns about the hepatitis B vaccine remain significant in the minds of some parents and workers who are required to take the vaccine because of occupational risk.
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From page 93... ...
Basic and Clinical Science The committee recommends continued research in animal and in vitro models, as well as in humans, on the mechanisms of immune-mediated neurological disease possibly associated with exposure to vaccines. Communication The committee again recommends that government agencies and professional organizations responsible for immunizations critically evaluate their communication services with increased understanding of, and input from, the intended user.
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From page 94... ...
SIGNIFICANCE ASSESSMENT The committee concludes that concerns about exposure to SV40 through inadvertent contamination of polio vaccines are significant because of the seriousness of cancers as the possible adverse health outcomes and because of the continuing need to ensure and protect public trust in the nation's immunization program. PUBLIC HEALTH RESPONSE RECOMMENDATIONS Policy Review The committee does not recommend a policy review of polio vaccine by any of the national or federal vaccine advisory bodies, on the basis of concerns about cancer risks that might be associated with exposure to SV40, because the vaccine in current use is free of SV40.
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From page 95... ...
The committee recommends that once there is agreement in the scientific community as to the best detection methods and protocols, pre-1955 samples of human tissues should be assayed for presence or absence of SV40 in rigorous, multi-center studies. The committee recommends further study of the transmissibility of SV40 in humans.
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