The Childhood Immunization Schedule and Safety

Vaccines are among the most safe and effective public health interventions to prevent serious disease and death. Because of the success of vaccines, most Americans today have no firsthand experience with such devastating illnesses as polio or diphtheria. Health care providers who vaccinate young children follow a schedule prepared by the U.S. Advisory Committee on Immunization Practices. Under the current schedule, children younger than six may receive as many as 24 immunizations by their second birthday. New vaccines undergo rigorous testing prior to receiving FDA approval; however, like all medicines and medical interventions, vaccines carry some risk.


Driven largely by concerns about potential side effects, there has been a shift in some parents' attitudes toward the child immunization schedule. The Childhood Immunization Schedule and Safety identifies research approaches, methodologies, and study designs that could address questions about the safety of the current schedule.


This report is the most comprehensive examination of the immunization schedule to date. The IOM authoring committee uncovered no evidence of major safety concerns associated with adherence to the childhood immunization schedule. Should signals arise that there may be need for investigation, however, the report offers a framework for conducting safety research using existing or new data collection systems.

Table of Contents


Front Matter
Summary
1 Introduction
2 Determination of the Immunization Schedule
3 Existing Data Sources and Systems
4 Stakeholder Concerns Related to the Safety of the Immunization Schedule
5 Review of Scientific Findings
6 Methodological Approaches to Studying Health Outcomes Associated with the Current Immunization Schedule: Options, Feasibility, Ethical Issues, and Priorities
7 Conclusions and Recommendations
Appendix A: 2012 Advisory Committee on Immunization Practices' Recommended Immunization Schedule for Children
Appendix B: Glossary
Appendix C: Acronyms
Appendix D: Study Designs for the Safety Evaluation of Different Childhood Immunization Schedules--Martin Kulldorff
Appendix E: Agendas of Public Meetings Held by the Committee
Appendix F: Biographical Sketches of Committee Members
Appendix G: Institute of Medicine Publications on Vaccines