Vaccinations research paper
Aluminum salts have safely been used to adjuvant vaccines since the s and are currently used in vaccines such as hepatitis A, hepatitis B, diphtheria-tetanus-containing vaccines, Hib, and pneumococcal vaccines, but they are not used in the live, viral vaccines, such as measles, mumps, rubella, varicella, and rotavirus.
Studies have shown that children who receive aluminum-containing vaccines have serum levels of aluminum that are well below the toxic range [ 29 ]. The authors found no correlation between infant blood or hair aluminum concentrations and vaccine history or between blood aluminum and overall developmental status [ 30 ]. A specific concern that has been raised about aluminum adjuvants is their possible relationship to macrophagic myofasciitis, a condition consisting of a variety of systemic complaints along with findings in muscle biopsies of minute lesions that contain aluminum salts [ 31 ].
Associated systemic symptoms related to finding aluminum salts in cells at an injection site of an aluminum-containing vaccine, however, have never been established [ 32 ]. Shoenfeld and coworkers have proposed the existence of a condition that they term autoimmune autoinflammatory syndrome induced by adjuvants [ 33 ]. The syndrome, however, is poorly defined and includes many nonspecific and relatively common symptoms eg, fatigue, insomnia, and fever [ 34 ].
A study that evaluated the incidence of autoimmune disease in more than 18 patients who received subcutaneous allergen-specific immunotherapy containing large quantities of injected aluminum adjuvants found that patients receiving injected aluminum had a lower incidence of autoimmune disease compared with controls [ 35 ].
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Some parents are concerned that too many vaccines given so early in life might overwhelm the immune system. Given the number of antibody-generating B cells in the circulation, the number of vaccine-specific antigens to which infants are exposed during the first few years of life, and the quantity of antibodies necessary to react to each antigen, it has been estimated that infants have the theoretical capacity to respond to at least 10 vaccines at 1 time [ 36 ].
A study of the immune response to general, nonvaccine specific stimuli in fully vaccinated and entirely unvaccinated children between 3 and 5 years of age found that childhood vaccines do not cause long-lasting, gross alterations of the immune system [ 37 ]. No epidemiologic study has found an increased risk of disease according to the number of vaccines or vaccine antigens received in childhood. A recent US study found no relationship between either the cumulative number of antigens or the number of antigens received in a single day and subsequent nonvaccine-targeted infections [ 38 ].
The History Of Vaccines And Immunization: Familiar Patterns, New Challenges | Health Affairs
A study that compared long-term neuropsychological outcomes in more than children found no correlation between the number of vaccine-specific antigens received in infancy and adverse neuropsychological outcomes by age 7 to 10 years [ 39 ]. Finally, a large US case-control study that evaluated total cumulative vaccine-specific antigen exposure or maximum exposure on a single day found no association between antigen exposure from vaccines during the first 2 years of life and the risk of developing autism or different subtypes of autism [ 40 ].
The immune system of infants is perfectly capable of handling the number of antigens in vaccines, and studies have not found increased risks of adverse health outcomes related to the number of vaccines or vaccine antigens received early in life. In this brief article, a focused summary is provided on the most pertinent evidence related to some of the more common vaccine safety controversies discussed with primary care providers in the United States. As this article is not intended to be a comprehensive systematic review of vaccine safety, we have not addressed all vaccine controversies, including those in other parts of the world, or included discussion of known vaccine adverse reactions that are not presently particularly controversial eg, anaphylaxis following vaccination or intussusception following rotavirus vaccines.
We hope that the concise format will be useful to busy healthcare providers and others with an interest in immunization safety. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Potential conflicts of interest. All authors: No reported conflicts of interest.
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Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents. Editor's Choice.
Correspondence: F. Oxford Academic. Google Scholar. Heather Monk Bodenstab. Paul A Offit. Cite Citation. Permissions Icon Permissions. Abstract Concerns about vaccine safety can lead to decreased acceptance of vaccines and resurgence of vaccine-preventable diseases. Table 1. Open in new tab. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Search ADS. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. A population-based study of measles, mumps, and rubella vaccination and autism. MMR vaccination and pervasive developmental disorders: a case-control study.
Autism occurrence by MMR vaccine status among US children with older siblings with and without autism. Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies. Prenatal and infant exposure to thimerosal from vaccines and immunoglobulins and risk of autism. Thimerosal exposure in infants and developmental disorders: a prospective cohort study in the United Kingdom does not support a causal association. Early thimerosal exposure and neuropsychological outcomes at 7 to 10 years. Neuropsychological performance 10 years after immunization in infancy with thimerosal-containing vaccines.
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Vaccinations and risk of central nervous system demyelinating diseases in adults. Vaccinations and the risk of relapse in multiple sclerosis. Vaccines in Multiple Sclerosis Study Group. Autoimmune, neurological, and venous thromboembolic adverse events after immunisation of adolescent girls with quadrivalent human papillomavirus vaccine in Denmark and Sweden: cohort study.
Risk of autoimmune diseases and human papillomavirus HPV vaccines: six years of case-referent surveillance. Quadrivalent HPV vaccination and risk of multiple sclerosis and other demyelinating diseases of the central nervous system. European Medicines Agency Assessment Report. Updated aluminum pharmacokinetics following infant exposures through diet and vaccination.
Blood and hair aluminum levels, vaccine history, and early infant development: a cross-sectional study. Macrophagic myofasciitis lesions assess long-term persistence of vaccine-derived aluminium hydroxide in muscle. Association of subcutaneous allergen-specific immunotherapy with incidence of autoimmune disease, ischemic heart disease, and mortality.
Lack of broad functional differences in immunity in fully vaccinated vs. Association between estimated cumulative vaccine antigen exposure through the first 23 months of life and non-vaccine-targeted infections from 24 through 47 months of age.
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Increasing exposure to antibody-stimulating proteins and polysaccharides in vaccines is not associated with risk of autism. Issue Section:. Download all figures. Comments 0. Add comment Close comment form modal. I agree to the terms and conditions. You must accept the terms and conditions. Add comment Cancel. Submit a comment. Comment title.
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