Tag: research

How Do Anti-Vaccine Folks Think?

Does it sometimes seem like anti-vaccine folks are speaking a foreign language?

It definitely seems like they misunderstand and misuse a lot of scientific terms, like evidence, research, and toxin, doesn’t it?

Anti-Vaccine Glossary

The first step to understanding someone who is truly anti-vaccine and unnecessarily puts their kids at risk for vaccine-preventable diseases, might be to understand how they misunderstand most things about vaccines…

Measles is highly contagious, which is likely why all of the Brady kids got sick.
Anti-vax folks get the message of the Brady Bunch measles episode all wrong…

For example, many of them believe that anecdotes and case studies are strong evidence and on par with the preponderance of evidence that has shown that vaccines are safe, effective, and necessary.

What other terms do they get wrong?

When you say… Anti-Vaccine folks think…
research I googled it and found something on an anti-vaccine website that confirms what I already thought
peer review I had my anti-vaccine friends, some of whom are actually in charge of the journal, take a look at it
personal stories can only be anecdotal vaccine injury scare stories, but never about regretting a skipped vaccine or personal stories about vaccine-preventable diseases
aluminum mercury
consensus my anti-vaccine friends on Facebook
shills anyone who supports vaccines
pediatrician a vaccine pusher
science pseudoscience
learn the risk learn the exaggerated risks of vaccines that I’m going to scare you about
expert anyone who agrees with me
unavoidably unsafe vaccines can’t ever be safe to anyone in any circumstance ever
toxin anything and everything that sounds sciency
placebo pure saline
chemical anything that isn’t natural, not understanding that everything is a chemical
scientist anyone who took a science class in high school or college
doctor typically a chiropractor
medicine non-evidence based therapies that don’t involve Big Pharma, aren’t covered by insurance, and are likely very expensive
risk can only come from a vaccine, never from skipping or delaying a vaccine or from a vaccine-preventable disease
shedding what happens when someone gets a vaccine
vaccine injury anything and everything bad that happens to you in the days, weeks, months, and years after you get vaccinated or in the days, weeks, months, and years before you were born because of the vaccines your parents or grandparents received
religious vaccine exemption I just don’t want to vaccinate and protect my kids, so will lie and say it is about religion
vaccine preventable disease since many anti-vaccine folks don’t really think that vaccines work, they might act more confused if you use this term
informed consent when I tell you all of the bad stuff about vaccines, most of which isn’t true, and leave out any talk of benefits
leaky gut explains every major problem kids have after getting vaccinated
MAPS doctors the new DAN doctors
VAERS a list of vaccine-injuries
herd immunity doesn’t exist, but can only happen from natural immunity
hiding in the herd what used to protect unvaccinated kids, until more and more folks started listening to us to our anti-vaccine propaganda
package inserts can be used to scare parents about SIDS and autism
do your research go to an anti-vaccine forum or website
cherry picking what does picking cherries have to do with vaccines???
natural immunity easy life-long immunity without any consequences
vaccine choice I want to do it my way, no matter how many choices I have
germ theory germs don’t cause disease and if they did, vaccines didn’t stop them, it was better nutrition and sanitation
homeopathy vaccines don’t work, weekly chiropractic adjustments can keep you healthy, and natural immunity is best, but buy some homeopathic vaccines anyway
essential oils definitely not being sold as part of a multi-level marketing scheme
monkey pox just smallpox renamed
Guillain-Barré Syndrome just polio renamed
roseola just measles renamed
SIDS a vaccine injury
vitamin K a vaccine to be avoided
cognitive dissonance how we sleep at night after skipping or delaying vaccines and leave our kids unnecessarily unprotected from life-threatening diseases
Andrew Wakefield “…Nelson Mandela and Jesus Christ rolled up into one.”

Get it?

It’s why many people have a hard time talking to friends and family members who are anti-vaccine. And even visits to the pediatrician to talk about vaccines don’t always go so well.

More on the Anti-Vaccine to Science Translator

Which Vaccines Do You Get When You Join the Military?

The oral adenovirus vaccine is approved to prevent adenovirus infections in military populations.

Believe it or not, many vaccines are available that we don’t routinely get.

Some we only get if we travel, like vaccines for yellow fever and typhoid. Others we only get in high risk situations, like if you get exposed to a bat with rabies.

And one, the adenovirus vaccine, you can only get if you join the military.

Which Vaccines Do You Get When You Join the Military?

But don’t folks get a lot of vaccines when they join the military?

It depends…

Whether you join the Army, Navy, Air Force, Marine Corps, or Coast Guard, health personnel will evaluate your immunity status by checking your titers to routine vaccine-preventable diseases. So no, if you were wondering, it doesn’t seem like they just check the vaccine records that you might bring from your pediatrician.

And then once they assess your immunization or immunity status, you will get vaccinated:

  • upon accession – adenovirus, influenza, meningococcal, MMR, Tdap, and chicken pox
  • during the first or second half of collective training – hep A, hep B, and polio (if needed) and other vaccines based on risk

So, in addition to getting caught up on all routine vaccines that they might be missing, there are other “military vaccines” that they might need, including:

  • Adenovirus vaccine – given to enlisted soldiers during basic training
  • Anthrax vaccine – only military personnel with extra risk, although some civilians can get this vaccine too
  • Smallpox vaccine – only military personnel who are high risk and smallpox epidemic response team members, although some civilians can get this vaccine too
Which vaccines you get in the military might be determined by where you are getting deployed to.
Which vaccines you get in the military will likely be determined by where you get deployed.

Like the recommendations for civilians, other vaccines are mainly given to military personal if they have extra risk based on where they are being deployed.

  • Cholera – only military personnel with extra risk based on deployment or travel to endemic areas
  • Japanese encephalitis – only military personnel with extra risk based on deployment or travel to endemic area in Eastern Asia and certain western Pacific Islands
  • Rabies vaccine – pre-exposure vaccination is only for military personnel with animal control duties or with extra risk based on deployment, including special operations personnel
  • Typhoid vaccine – only military personnel with extra risk based on deployment or travel to typhoid-endemic areas and other areas with poor sanitation.
  • Yellow fever vaccine – only military personnel with extra risk based on deployment or travel to yellow-fever-endemic areas in sub-Saharan Africa and tropical South America.

These are the same vaccines that we would get if we traveled to high risk areas.

 

Military Vaccines in Development

It shouldn’t be a surprise that the military does research on infectious diseases and vaccines.

Members of the military are often put at great risk for known and emerging diseases, like Ebola, Zika, and malaria.

That’s why some vaccines might have been given as an investigational new drug in special situations, typically when “individuals who have a high occupational risk – laboratory workers, facilities inspectors, vaccine manufacturers and certain military response teams.”

These vaccines, which were initially developed at US Army labs, are no longer being produced, but have included:

  • Argentine hemorrhagic fever (Junin virus) vaccine
  • Chikungunya fever vaccine
  • Eastern equine encephalitis vaccine
  • Q fever vaccine
  • Rift Valley fever vaccine
  • Tularemia vaccine
  • Venezuelan equine encephalitis vaccine
  • Western equine encephalitis vaccine

Today, the Walter Reed Army Institute of Research (WRAIR) “is a leader in global efforts against the world’s most pervasive and high impact infectious diseases.”

WRAIR is working on vaccines for HIV, Ebola, MERS, and Zika.

What to Know About Military Vaccines

You will need some extra vaccines when you enlist in the military, but how many will depend on if you are up-to-date when you join and your area of responsibility. So there is no one-size-fits-all military immunization schedule.

More on Military Vaccines

 

How To Counter Vaccine Hesitancy

There is nothing wrong with having questions about vaccines. And there is certainly nothing wrong with doing a little, or even a lot of research about vaccines.

“We are not against vaccines. Just because we have hesitancies and valid concerns about injecting our baby with specific chemicals and toxins does not mean we are anti anything…

As a soon-to-be-parent [and especially as a first-time-mom] I do feel it my responsibility to have questions, and to listen to my motherly instinct to question things, and do my research.”

Kat Von D

The problem comes when the answers folks get come from misinformation, and it leads them to skip or delay their child’s vaccines, leaving them unprotected.

What is Vaccine Hesitancy?

To counter vaccine hesitancy, you likely first need to understand what it means.

“Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite availability of vaccination services. Vaccine hesitancy is complex and context specific varying across time, place and vaccines. It includes factors such as complacency, convenience and confidence.”

SAGE Vaccine Hesitancy Working Group

So it means someone who is anti-vaccine, right?

Not exactly.

“Although many may characterize all individuals who eschew vaccines as “anti-vaccine” or “vaccine deniers,” in reality there is a broad spectrum of individuals who choose not to have themselves or their children vaccinated.”

Tara C Smith on Vaccine Rejection and Hesitancy: A Review and Call to Action

Many of the folks who are vaccine hesitant aren’t truly anti-vaccine. They are likely being misled by anti-vaccine myths and propaganda, but at least they aren’t the ones spreading it across Facebook or on their own blogs and anti-vaccine websites.

How To Counter Vaccine Hesitancy

How do you counter vaccine hesitancy?

“It’s unfair for anyone to expect me [or any parent] to take the word of the pharmaceutical companies who have much to gain from and industry worth billions without question – and then have to dismiss any concerns of my own.”

Kat Von D

You learn to answer all of the questions and concerns that these parents might have about vaccines and vaccine-preventable diseases, including the risks and benefits of vaccines and the risks of being unvaccinated.

“Well, if you’re going to inform yourself about vaccines, I think anybody who’s truly informed will realize that getting a vaccine is much better than not getting one. If you’re choosing not to vaccinate your child, it’s because you’re getting, frankly, bad information about vaccines.”

Paul Offit, MD

You also make sure that parents, teachers, nurses, doctors, pharmacists, reporters, and everyone else gets good information about vaccines.

And you call out the misinformation and out-right lies of the anti-vaccine movement, especially when they say that vaccines never work, are always dangerous and full of toxins, or aren’t necessary.

You don’t let parents get manipulated by the anti-vaccine industry, which has gotten very good at selling fear – literally.

Like the card trick in My Cousin Vinny, anti-vaccine talking points are easy to explain because they are all an illusion.
Like the card trick in My Cousin Vinny, anti-vaccine talking points are easy to explain away, because they are all an illusion.

Remember, there is not one anti-vaccine argument or talking point that ever holds water.

Why not?

Because unless you go cherry picking, the evidence overwhelmingly shows that vaccines work, vaccines are safe, and vaccines are necessary.

What to Know About Countering Vaccine Hesitancy

If you are on the fence or scared to vaccinate your kids, let us help you learn why vaccines are safe and necessary and arguments against vaccines never hold water.

More on Countering Vaccine Hesitancy

Are Anti-Vaccine Folks Smarter Than the Rest of Us?

For the overwhelming majority of us, it seems like a simple decision – get your kids vaccinated and protected and avoid all of the risks of vaccine-preventable diseases.

After all, we understand that vaccines are safe and necessary.

But folks who choose to skip or delay vaccines want to do what is best for their kids too, even as they come to the exact opposite decision, so who is making the smarter choice?

Are Anti-Vaccine Folks Smarter Than the Rest of Us?

Not surprisingly, anti-vaccine folks think they are smarter.

Why?

“In the end we are left with a powerful sense of knowledge – false knowledge. Confirmation bias leads to a high level of confidence, we feel we are right in our gut. And when confronted with someone saying we are wrong, or promoting an alternate view, some people become hostile.

The Dunning-Kruger effect is not just a curiosity of psychology, it touches on a critical aspect of the default mode of human thought, and a major flaw in our thinking. It also applies to everyone – we are all at various places on that curve with respect to different areas of knowledge. You may be an expert in some things, and competent in others, but will also be toward the bottom of the curve in some areas of knowledge.”

Steven Novella on Lessons from Dunning-Kruger

While it is easy to blame it on the Dunning-Kruger effect, a study that appeared in the July 2004 issue of Pediatrics, Children who have received no vaccines: who are they and where do they live?, is often used by anti-vaccine folks to reinforce the idea that they are smarter.

“Undervaccinated children tended to be black, to have a younger mother who was not married and did not have a college degree, to live in a household near the poverty level, and to live in a central city. Unvaccinated children tended to be white, to have a mother who was married and had a college degree, to live in a household with an annual income exceeding 75,000 dollars, and to have parents who expressed concerns regarding the safety of vaccines and indicated that medical doctors have little influence over vaccination decisions for their children”

Children who have received no vaccines: who are they and where do they live?

But the part of the study that is often quoted is comparing unvaccinated vs undervaccinated.

In the same study, the education level of unvaccinated vs vaccinated is virtually the same.

And the differences for the unvaccinated vs undervaccinated kids was about their living near the poverty level. If these families grew up with less money, they likely had less opportunities to go to school, and unfortunately, had less opportunities to keep their kids up-to-date on their vaccines.

One study, Maternal characteristics and hospital policies as risk factors for nonreceipt of hepatitis B vaccine in the newborn nursery, did seem to associate a higher education level with refusing the newborn hepatitis B vaccine, but an even bigger factor was being born in a facility that actually had a policy that offered the vaccine.

“Likewise, vaccine refusal now appears to be less a function of socioeconomic status than it once was. Previously, maternal education was strongly associated with vaccine refusal, but now mothers without a high school diploma are even more likely than college graduates to have unvaccinated children . Also, unvaccinated children are no longer found primarily in the highest income households (perhaps a function of income data being top-coded at $50,000), but now are equally likely to live in households with more moderate (or even below poverty) incomes.”

Laura Blakeslee on Trends and Characteristics of Unvaccinated Children in the United States : The National Immunization Survey, 2002 − 2010

Other studies have either showed a higher level of college graduates for those who vaccinated their kids or no difference.

What about all of the experts in the anti-vaccine movement? Remember that the heroes and so called experts of the the anti-vaccine movement mostly includes celebrities, some doctors and scientists who are practicing way out of their field of expertise when they talk about vaccines, and others whose work is not supported by the great majority of experts in their field.

That’s not necessarily the end of the story though.

Yet another study (a small survey), Parental Delay or Refusal of Vaccine Doses, Childhood Vaccination Coverage at 24 Months of Age, and the Health Belief Model, found that as compared to parents who vaccinated their kids, those who delayed or refused vaccines:

  • were less likely to think that vaccines were necessary
  • were less likely to think that their kids would get a disease if they weren’t vaccinated
  • were less likely to believe that vaccines are safe
  • were more likely to believe that vaccines caused serious side effects
  • were more likely to believe that children get too many vaccines

And surprisingly, considering that the above things are basically anti-vaccine talking points that are easily disproven, they were actually more likely to have gone to college and to be a college graduate. It is not a surprise that they were less likely to have a good relationship with their doctor and were less likely to believe that their doctor had their child’s best interest at heart.

Parents unknowingly gave their infants teething powder made with mercury, causing pink disease or mercury poisoning.
Parents unknowingly gave their infants teething powder made with mercury, causing pink disease or mercury poisoning. Ironically, a decrease in illiteracy levels might have been the cause.

So maybe some anti-vaccine parents are indeed well-educated about some things, but that just gets us back to the Dunning-Kruger effect, as they certainly aren’t making smart decisions about vaccines.

Fortunately, this is still a very small, although very vocal, minority of people, as most parents vaccinate and protect their kids.

What to Know About Anti-Vaccine Intelligence and Education

Parents who choose to skip or delay their child’s vaccines are not making smart decisions about vaccines.

More on Anti-Vaccine Intelligence and Education

Using Pubmed to Do Research About Vaccines

A lot of the vaccine research that folks do is on PubMed.

Using PubMed to Do Research About Vaccines

And that’s not necessarily a bad thing.

“PubMed comprises more than 27 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.”

All of the studies that say that vaccines are safe, that vaccines work, and that vaccines are necessary are in PubMed.

So are the studies that show that vaccines are not associated with autism, SIDS, and other so-called vaccine induced diseases, like ASIA.

Unfortunately, there are also poorly done studies in PubMed that do purport that vaccines are associated with autism and that ASIA is a real thing.

Can You Use PubMed to Do Research About Vaccines?

Kelly Brogan didn't make history in getting a case report published in a low impact journal who's editorial board includes a Reiki Master, chiropractors, and naturopaths.
Kelly Brogan didn’t make history in getting a case report published in a low impact journal who’s editorial board includes a Reiki Master, chiropractors, and naturopaths.

Just like anyone can put up a website or Facebook page and say whatever they want, almost anyone can get a study or article published in a journal and get it indexed in PubMed.

While PubMed is an index with over 27 million citations, it doesn’t do anything to evaluate those citations to see if they include studies with design flaws, conflicts of interest, or are simply fraudulent.

That means that you need to know that a study does not get a badge of legitimacy for simply being in PubMed!

And it does not automatically mean that the evidence and conclusions from the article are of high quality just because it is listed in PubMed.

So use PubMed to find articles to help you do research about vaccines, but then read the article from beginning to end, not just the abstract, and make sure it is an article you can trust:

  • Was it published in a legitimate journal, like Vaccine or Pediatrics, and some of these high-impact journals? (good)
  • Was it published in a predatory journals?  (bad)
  • Does it involve simply looking at VAERS data?  (usually bad)
  • Is it written by folks with a conflict of interest that makes the article biased?  (bad)
  • Has it already been refuted by other people because it wasn’t designed properly or had other major flaws?  (bad)
  • Is it written by people who have expertise on the topic they are writing about? (good)
  • Has it been retracted?  (very bad)
  • Is it a case report (a glorified anecdote), case series, or animal study (lowest quality evidence) or a systemic review or meta analyses (highest quality evidence)?
  • Is it a case control study, cohort study, and randomized controlled trial, which lie somewhere in between case reports and reviews on the hierarchy of evidence scale?

Are you ready to get educated about vaccines?

That’s great, but PubMed shouldn’t be your first stop, or your only stop.

As you do your research or get bombarded with a list of links or abstracts from PubMed, remember that there is a hierarchy of evidence to consider before deciding if a paper or study is really evidence of anything. And finding a case report, study on rats, or an invitro study won’t win you an argument about vaccines when there are randomized control trials and systemic reviews on the other side.

What to Know About Using PubMed to Do Research About Vaccines

PubMed is a giant index of journal articles, but simply being in PubMed doesn’t mean that an article or study is reliable or of high quality, whether it is about vaccines, a vaccine-preventable disease, or any other medical topic.

More on Using PubMed to Do Research About Vaccines

How Are Vaccines Really Made?

Do you know how vaccines are made?

A lab worker injects flu virus into an egg, one of many steps in making our flu vaccines.
A lab worker injects flu virus into an egg, one of many steps in making our flu vaccines. Photo courtesy of the FDA

When we say that chickens are used to make flu vaccine, do you think that means that live chickens are actually infected with the flu to make the vaccine?

They aren’t.

Just like live monkeys aren’t injected with the polio virus to make the polio vaccine.

Those are just myths you see in vaccine scare videos on anti-vaccine websites.

How Are Vaccines Really Made?

So how are vaccines really made?

It depends, after all, there are a lot of different types of vaccines.

But instead of monkey cages and chicken coops in the labs of today’s vaccine manufacturers, you will find clean rooms with large scale, stainless steel bioreactors, master cell banks, seed fermenters, microcarriers, centrifuges, filtration and chromatography equipment, and filling and lyophilization equipment.

Do you picture a series of these large scale, stainless steel bioreactors when you think about how vaccines are made?
Do you picture a series of these large scale, stainless steel bioreactors when you think about how vaccines are made?

That doesn’t sound so scary or shocking, does it?

What’s shocking about the whole process of making a vaccine?

It takes a long time. Often one to three years! And that’s after all of the time that went into the research, testing, and licensing of the vaccine.

“Viruses are grown in cells, which can be either primary cells, such as chicken fbroblasts (e.g., yellow fever vaccine), or continuous cell lines, such as MRC-5 (e.g., hepatitis A vaccine). Bacterial pathogens are grown in bioreactors using medium developed to optimize the yield of the antigen while maintaining its integrity. Recombinant proteins can be manufactured in bacteria, yeast, or cell culture. ”

Plotkin’s Vaccines (Seventh Edition)

The only other shocking thing about making vaccines is how boring it all is, at least if you aren’t into biology, with most vaccines using the same basic steps:

  • decide on the type of antigen – vaccines can be made of attenuated live viruses, inactivated viruses or bacteria,  or just part of the virus or bacteria (subunit and conjugate vaccines)
  • generate an antigen – this is the thing in the vaccine that will stimulate an immune response and protect your child. It used to be what anti-vaccine folks were concerned about until we explained that kids today are exposed to far fewer antigens, even though they get more vaccines and more protection.
  • release and isolate the antigen – the antigen was either growing in cells or other medium and in this step, as much of the antigen is collected as possible.
  • purify the antigen – multiple steps are involved in removing many of the vaccine ingredients or excipients that were used up to this step by precipitation, ultrafiltration, and column chromatography, etc. That’s why many are said to remain only in residual amounts, like formaldehyde.
  • strengthen the antigen – in this step, an adjuvant might be added.
  • combine all of the ingredientsstabilizers and preservatives might also be added in this step.
  • last steps – finished vaccine is put in vials and syringes and then packaged
  • lot release and distribution – each lot is tested before it is released to make sure it meets FDA standards for potency, safety, and sterility.

None of that sounds as scary as injecting monkeys with smallpox, watching them die, and then harvesting their infected kidney cells though, does it? If you have watched any of the anti-vaccine scare videos, hopefully the first thing that came to mind is that the smallpox vaccine isn’t actually made with the smallpox virus! It is, of course, made with vaccinia virus and wouldn’t cause anyone, whether a monkey, cow, or person to actually get smallpox. And if you haven’t figured it out by now, monkeys aren’t used to make smallpox vaccines.

“Both vaccines are derived from the New York City Board of Health strain of vaccinia, but Dryvax was grown on the skin of calves and then essentially freeze-dried for storage. It was licensed by FDA in 1931 but is no longer manufactured. ACAM2000, a “second generation” smallpox vaccine, is derived from a clone of Dryvax, purified, and produced using modern cell culture technology.”

FDA on ACAM2000 (Smallpox Vaccine) Questions and Answers

In fact, most of today’s vaccines are made in bioreactors, not in cows or monkeys.

Flu vaccine is mostly still made using chicken eggs, specifically 11-day-old embryonated chicken eggs. The flu viruses are passed into the eggs, incubated for a time to allow them to grow, and then harvested, inactivated, and purified.

How purified do they get? So purified that even people with egg allergies can get a flu vaccine these days.

Vaccines are safe. Vaccines are made safely.

What to Know About How Vaccines Are Really Made

Vaccines are made using a very safe and scientific process that is heavily regulated that will neither scare nor shock you.

More on How Vaccines Are Really Made

Expert Statements on Vaccines

The AAP published their first recommendations on vaccines in 1938.
The AAP published their first recommendations on vaccines in 1938.

Some parents are still confused about who they should listen to for advice about vaccines.

Is there really a controversy or a real debate going on about whether or not getting vaccinated is a good decision?

What do the experts say?

They say that:

And no, it’s not just one or two of them…

“Vaccines protect the health of children and adults and save lives. They prevent life – threatening diseases, including forms of cancer. Vaccines have been part of the fabric of our society for decades and are one of the most significant medical innovations of our time.”

More than 350 medical, professional and advocacy organizations in a 2017 letter to President Trump

It is the hundreds of thousands of experts at every major health organization around the world!

American Academy of Pediatrics

The American Academy of Pediatrics, an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists, has long advocated for the health and safety of our children.

“Vaccines are safe. Vaccines are effective. Vaccines save lives.

Claims that vaccines are linked to autism, or are unsafe when administered according to the recommended schedule, have been disproven by a robust body of medical literature. Delaying vaccines only leaves a child at risk of disease. Vaccines keep communities healthy, and protect some of the most vulnerable in our society, including the elderly, and children who are too young to be vaccinated or have compromised immune systems.”

Fernando Stein, MD, FAAP, President and Karen Remley, MD, MBA, MPH, FAAP, CEO/Executive Vice President, American Academy of Pediatrics

Vaccine friendly pediatricians who are pushing non-standard, parent-selected, delayed protection vaccine schedules are leaving kids at risk for vaccine-preventable diseases.

“Pediatricians who routinely recommend limiting the numbers of vaccines administered at a single visit such that vaccines are administered late are providing care that deviates from the standard evidence-based schedule recommended by these bodies.”

AAP on Countering Vaccine Hesitancy

Vaccines are necessary.

“Because rare medically recognized contraindications for specific individuals to receive specific vaccines exist, legitimate medical exemptions to immunization requirements are important to observe. However, nonmedical exemptions to immunization requirements are problematic because of medical, public health, and ethical reasons and create unnecessary risk to both individual people and communities.”

AAP on Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance

Society of Pediatric Nurses

“Immunizations are safe and effective in promoting health and preventing disease.”

SPN Position Statement on Immunizations

National Association of Pediatric Nurse Practitioners

Established in 1973, with more than 8,500 members, the National Association of Pediatric Nurse Practitioners (NAPNAP) is the professional association for pediatric nurse practitioners (PNPs) and all pediatric-focused advanced practice registered nurses (APRNs).

“NAPNAP supports the prioritization of immunization education for parents, guardians and other caregivers of infants, children, and adolescents. This education must include the most current scientific evidence related to vaccine safety, risk, benefits and current resources available to ensure that parents and caregivers receive adequate information about immunizations. This includes, when necessary, relaying the risk of not immunizing their child and potential devastation that can occur when a child is infected with a vaccine-preventable disease. It is incumbent that a PNP also be aware of misinformation in the public domain and provides the correct information to the public as well as the health care community.”

NAPNAP Position Statement on Immunizations

American College of Preventive Medicine

“Vaccine-preventable diseases were a major cause of mortality and morbidity in the United States in the 20th century. With the advent of immunizations, there have been dramatic rates of decline in these diseases. Clinical studies have shown vaccines to be efficacious and cost effective.  ”

ACPM on Childhood Immunizations

American College of Obstetricians and Gynecologists

Founded in 1951, the American College of Obstetricians and Gynecologists (The College) represents more than 58,000 members.

“Health care providers and patients should be aware that the reassuring safety data for use of the aforementioned vaccines in pregnancy are compelling, and there is no link to vaccine administration and miscarriage. An added benefit to immunizing during pregnancy is the potential for disease prevention in newborns by way of passive antibody transfer to the fetus. Hence, offering pregnant patients influenza and Tdap vaccines is an avenue to protect newborn infants at a critically vulnerable time and before neonates can be vaccinated.”

ACOG on Immunization for Pregnant Women

American Public Health Association

The American Public Health Association was founded in 1872, the APHA represents over 25,000 public health professionals.

“And further noting that the Institute of Medicine has recently released a report10 describing the U.S. immunization system as “a national treasure that is too often taken for granted” and calling for substantial increases in federal and state allocation of funds to support immunization infrastructure; therefore

Reaffirms its support for immunization as one of the most cost-effective means of preventing infectious diseases;”

APHA on The Need for Continued and Strengthened Support for Immunization Programs

American Medical Association

The American Medical Association, which was founded in 1847, has just over 240,000 members.

“The AMA fully supports the overwhelming body of evidence and rigorous scientific process used by the Advisory Committee on Immunization Practices which demonstrate vaccines are among the most effective and safest interventions to both prevent individual illness and protect the health of the public.”

William E. Kobler, MD, member of the AMA Board of Trustees.

Immune Deficiency Foundation

“The development of immunizations for common bacterial and viral infections has represented a major advance in the battle against microbial organisms that constantly threaten the welfare of humankind and particularly the pediatric population. However, the alarming increase in nonimmunized persons could lead to a return of the epidemics seen in the past.

…critical need for maintenance of herd immunity in the population at large. It is particularly important for family members of patients with defective T and B lymphocyte–mediated immunity to receive all of the available standard immunizations (excluding live poliovirus).”

Medical Advisory Committee of the Immune Deficiency Foundation on Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts

American Nurses Association

The American Nurses Association (ANA), founded in 1896, represents “the interests of the nation’s 3.6 million registered nurses.”

“To protect the health of the public, all individuals should be immunized against vaccine-preventable diseases according to the best and most current evidence outlined by the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP). All health care personnel (HCP), including registered nurses (RNs), should be vaccinated according to current recommendations for immunization of HCP by the CDC and Association for Professionals in Infection Control and Epidemiology (APIC).

As stated in the Code of Ethics for Nurses (ANA, 2015, p. 19), RNs have an ethical responsibility to “model the same health maintenance and health promotion measures that they teach and research…,” which includes immunization against vaccine-preventable diseases.”

ANA Position Statement on Immunizations

Autism Science Foundation

“Multiple studies have been completed which investigated the measles, mumps and rubella vaccination in relation to autism. Researchers have also studied thimerosal, a mercury-based preservative, to see if it had any relation to autism. The results of studies are very clear; the data show no relationship between vaccines and autism.”

Autism Science Foundation on Vaccines and Autism

The American Association of Immunologists

The American Association of Immunologists (AAI) is the largest professional association of immunologists in the world, representing more than 7,600 basic and clinical immunologists.

“Recent outbreaks have brought increased attention to vaccine- preventable diseases and have highlighted the need for robust and timely immunization to reduce preventable sicknesses and deaths. AAI strongly urges full adherence to recommended vaccination schedules and views vaccines as efficacious for individuals and crucial to public health.

Research has repeatedly confirmed that vaccinations are safe and highly effective for all healthy children and adults, and any suggestions to the contrary have been discredited. Ongoing vaccine research continually reaffirms its safety and efficacy, including the number of vaccines administered at any one time and the recommended vaccination schedule.”

The American Association of Immunologists Statement on Vaccines

American Osteopathic Association

“The American Osteopathic Association supports the Centers for Disease Control and Prevention in its efforts to achieve a high compliance rate among infants, children and adults by encouraging osteopathic physicians to immunize patients of all ages when appropriate ; supports the HHS National Vaccine Implementation Plan; and encourages third- party payers to reimburse for vaccines and their administration.”

AOA on Immunizations

National Association of School Nurses

#TodaysSchoolNurse is “grounded in ethical and evidence-based practice, are the leaders who bridge health care and education, provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potential.”

“It is the position of the National Association of School Nurses (NASN) that immunizations are essential to primary prevention of disease from infancy through adulthood.

The school nurse is well-poised to create awareness and influence action to increase the uptake of mandated and recommended immunizations. The school nurse should use evidence-based immunization strategies, such as school-located vaccination clinics, reminders about vaccine schedules, state immunization information systems (IIS), strong vaccination recommendations, and vaccine education for students, staff, and families.”

NASN Immunizations Policy Statement

American Academy of Family Practice

“With the exception of policies which allow for refusal due to a documented allergy or medical contraindication, the AAFP does not support immunization exemption policies.”

AAFP Immunization Policy Statement

American Academy of Allergy, Asthma & Immunology

The American Academy of Allergy, Asthma & Immunology (AAAAI) is a professional organization with over 7,000 members, including allergists/ immunologists, in the United States and 73 other countries.

“Immunization is perhaps the greatest public health achievement of all time, having significantly reduced the morbidity and mortality of many infectious diseases. Routine immunization of children, adolescents, and adults provides substantial protection from a large number of infectious diseases…

Patients who have experienced adverse reactions to vaccines might unnecessarily be advised to avoid subsequent immunization, which could have important adverse personal and population health consequences. Although there are some adverse reactions to vaccines that constitute absolute contraindications to administration of future doses, most such reactions do not preclude subsequent immunization. Patients who have experienced an apparent allergic or other serious adverse reaction after receiving a vaccine warrant evaluation by an allergist/immunologist. Also, patients with preexisting health conditions that might predispose to adverse reactions to vaccines could benefit from such an evaluation. In most cases, a risk-benefit analysis will favor subsequent immunization.”

AAAAI Practice Paramater on Adverse Reactions to Vaccines

CJ First Candle

“There seems to be a common misconception that vaccines are somehow associated with SIDS deaths. This is not true! Experts warn that the risk of leaving your baby unprotected is 1,000 times greater than any increased risk for SIDS. Because infants receive many immunizations during the critical development period from two to six months of age, and 90 percent of SIDS deaths occur within this time frame, it is only logical that many SIDS victims have recently received vaccines. This does not mean that the immunization had anything to do with the infant’s subsequent sudden and unexpected death. The cause and effect of immunizations and SIDS has been comprehensively studied for more than two decades. In fact, in countries where immunization schedules are different from those in the United States, the peak incidence of SIDS is still between two to four months.”

CJ First Candle on Immunizations

Infectious Disease Society of America

Founded in 1963, the Infectious Diseases Society of America (IDSA), with over 9,000 members, represents physicians, scientists and other health care professionals who specialize in infectious diseases.

“The Infectious Diseases Society of America (IDSA) recognizes the great benefits that vaccines provide for the public health. Substantial scientific evidence demonstrates vaccines’ enormous value in protecting individuals and populations from serious and life-threatening infections. Scientific evidence also demonstrates the overall safety of vaccines. Communities are most effectively protected when all are immunized.

Studies demonstrate that the easier it is to receive an exemption, the higher the rate of exemptions in a particular state. As the number of exemptions increases, the risk of vaccine – preventable disease increases. Therefore, states must make every effort to minimize the number of its citizens exempted from immunization mandates. Such exemptions make the state legislatures who grant them, as well as the individuals who receive them, responsible for placing the remaining state population at greater risk of acquiring potentially fatal infections.”

IDSA Policy Statement on State Immunization Mandates

The Arc of the United States

“Prior to widespread immunization in the United States, infectious diseases killed or disabled thousands of children each year. The near elimination of intellectual disability due to measles encephalitis, congenital rubella syndrome, and Haemophilus influenzae type b meningitis or Hib can be contributed to vaccines.”

The Arc Facts About Childhood Immunizations

American College Health Association

“The American College Health Association (ACHA) strongly supports the use of vaccines to protect the health of our individual students and our campus communities. In recognition of the vital role that vaccine coverage plays in community immunity (herd immunity), ACHA discourages use of nonmedical exemptions to required vaccines.”

ACHA on Immunization Recommendations for College Students

What to Know About Expert Statements on Vaccines

Over the years, hundreds of organizations representing millions of families, health care providers, researchers, patients, and consumers,  have repeatedly expressed their unequivocal support for vaccines, because they understand that vaccines work and that they are safe and necessary.

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