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11 Need for Research and Surveillance
Pages 305-308

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From page 305...
... A1though the committee was not charged with proposing specific research investigations, in the course of its reviews additional obvious needs for research and surveillance were identified, and those are briefly described here. DIPHTHERIA AND TETANUS TOXOIDS Recent advances in molecular analysis of diphtheria and tetanus toxins make it possible to construct mutant toxins that would be potentially safer, more immunogenic, and more readily purified for use as vaccines.
From page 306...
... HEPATITIS B VACCINES Evidence is inadequate to accept or reject a causal relation between hepatitis B vaccine and Guillain-Barre syndrome, transverse myelitis, optic neuritis, multiple sclerosis, or other demyelinating syndromes. The absence of reports of such outcomes in large-scale field trials suggests that if hepatitis B vaccine causes these adverse events, it does so at a very low frequency.
From page 307...
... SIMULTANEOUS ADMINISTRATION OF MORE THAN ONE VACCINE The committee was able to identify little information pertaining to the risk of serious adverse events following administration of multiple vaccines simultaneously. This is an issue of increasing concern as more vaccines and vaccine combinations are developed for routine use.
From page 308...
... Regional or national disease registries could be established for those rare but serious conditions suspected of sometimes being caused by one or more licensed vaccines, for example, GBS, transverse myelitis, optic neuritis, and Stevens-Johnson syndrome. Such disease registries, if reasonably complete, would provide information about the descriptive epidemiology of these conditions, including age-, sex-, and race-specific background incidence rates.

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