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?
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…
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
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?
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:
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
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
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.
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?
“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.”
“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.
Are Anti-Vaccine Folks Smarter Than the Rest of Us?
Not surprisingly, anti-vaccine folks think they are smarter.
“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
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.
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.
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.”
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)
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
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.
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.
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 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.”
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.