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Vaccine Safety Controversies and the Future of Vaccination Programs

François, Guido MSc, PhD*; Duclos, Philippe DVM, PhD†; Margolis, Harold MD‡; Lavanchy, Daniel MD§; Siegrist, Claire-Anne MD, PD∥; Meheus, André MD, PhD*; Lambert, Paul-Henri MD∥; Emiroğlu, Nedret MD, PhD¶; Badur, Selim MPharm, PhD#; Van Damme, Pierre MD, PhD*

Pediatric Infectious Disease Journal: November 2005 - Volume 24 - Issue 11 - pp 953-961
doi: 10.1097/01.inf.0000183853.16113.a6
Review Article

In the years following the hepatitis B vaccination/multiple sclerosis controversy, a number of new issues regarding vaccine safety have been raised, in some cases leading to more debate and confusion. Against this background, an international group of experts was convened to review the current points of view concerning the use of thimerosal as a preservative and its potential risks; the suggested link between thimerosal-containing vaccines and acute lymphoblastic leukemia; the alleged association between aluminum-containing vaccines/macrophagic myofasciitis and general systemic complaints; a possible link between vaccination and autoimmune pathology; and a hypothetical link between measles-mumps-rubella vaccination and autism. At present, there are no data to conclude that childhood vaccines, and in particular hepatitis B vaccine, pose a serious health risk or justify a change in current immunization practice. However, vaccine “scares” continue to have an international impact on immunization coverage. Creating a positive environment for immunization can be achieved by repositioning the value of vaccines and vaccination, supported by evidence-based information. The role of international organizations, the media, and the industry in the implementation of communication strategies was discussed and the impact of litigation issues on vaccination was evaluated. The Viral Hepatitis Prevention Board confirms its commitment to current recommendations for universal and risk group hepatitis B vaccination and further encourages the conduct of vaccine safety studies and the dissemination of their results.

From the *Viral Hepatitis Prevention Board, WHO Collaborating Centre for Prevention and Control of Viral Hepatitis, Department of Epidemiology and Social Medicine, University of Antwerpen, Antwerpen, Belgium; the †Immunization Safety Priority Project, VAM/V&B/HTP, World Health Organization, Geneva, Switzerland; the ‡Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta GA 30333; §Global Alert and Response, Department of Communicable Diseases Surveillance and Response, World Health Organization, Geneva, Switzerland; the ∥Center for Vaccinology and Neonatal Immunology, University of Geneva, CMU, Geneva, Switzerland; ¶Communicable Diseases Control, Prevention and Eradication, Regional Office for Europe, World Health Organization, Copenhagen, Denmark; and the #Department of Microbiology, University of Istanbul, Istanbul, Turkey.

Accepted for publication May 5, 2005.

Supported by unrestricted educational grants from GlaxoSmithKline Biologicals, Sanofi Pasteur MSD, several European universities and other institutions.

E-mail guido.francois@ua.ac.be. Reprints not available.

© 2005 Lippincott Williams & Wilkins, Inc.