Childhood immunization is one of the major public health achievements of the 20th century and is receiving special attention from the Clinton Administration. At the same time, some parents and health professionals are questioning the safety of vaccines because of the occurrence of rare adverse events after immunization. This volume provides the most thorough literature review available about links between common childhood vaccines - tetanus, diphtheria, measles, mumps, polio, Haemophilus influenzae type b, and hepatitis B - and specific types of disorders or death. The panel presents its findings in helpful tables as well as in narrative form, discusses approaches to evidence and causality, and examines the possible adverse effects - neurologic and immunologic disorders and death - of immunization. Helpful background information on the development of the vaccines and details about the case reports, clinical trials, and other evidence associating each vaccine with specific disorders are included.

"Vaccine Safety Committee, Division of Health Promotion and Disease Prevention, Institute of Medicine." "The project was supported by funds coordinated through the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (contract no. NO-AI-15130)"--T.p. verso.

Executive summary -- Causality and evidence -- Causality -- Sources of evidence for causality -- Summarizing the evidence for causality -- Neurologic disorders -- Demyelinating disease -- Non-demyelinating disease -- Immunologic reactions -- Anaphylaxis -- Interaction of antibody with normal tissue antigens -- Arthus reaction -- Delayed-type hypersensitivity -- Effect of vaccines on the immune system -- Diphtheria and tetanus toxoids -- Background and history -- Biologic events following immunization -- Encephalopathy -- Residual seizure disorder -- Demyelinating diseases of the central nervous system -- Guillain-Barre syndrome -- Neuropathy -- Arthritis -- Erythema multiforme -- Anaphylaxis -- Death -- Measles and mumps vaccines -- Background and history -- Biologic events following immunization -- Encephalopathy and encephalitis -- Aseptic meningitis -- Subacute sclerosing panencephalitis -- Residual seizure disorder -- Sensorineural deafness -- Optic neuritis -- Transverse myelitis -- Guillain-Barre syndrome -- Insulin-dependent diabetes mellitus -- Sterility due to orchitis. (cont) Thrombocytopenia -- Anaphylaxis -- Death -- Polio vaccines -- Background and history -- Biologic events following immunization -- Poliomyelitis -- Transverse myelitis -- Guillain-Barre syndrome -- Anaphylaxis and thrombocytopenia -- Death -- Hepatitis B vaccines -- Background and history -- Biologic events following immunization -- Guillain-Barre syndrome -- Other demyelinating diseases -- Arthritis -- Anaphylaxis -- Death -- Haemophilus influenzae type B vaccines -- Background and history -- Biologic events following immunization -- Transverse myelitis -- Guillain-Barre syndrome -- Thrombocytopenia -- Early susceptibility to H. influenzae type b -- Anaphylaxis -- Death -- Examples -- Reports of death identified from VAERS -- Vaccine-specific data concerning death after immunization -- Need for research and surveillance -- Diphtheria and tetanus toxoids -- Measles and mumps vaccines -- Polio vaccines -- Hepatitis B vaccines -- Guillain-Barre syndrome -- Death -- Simultaneous administration of more than one vaccine -- Risk-modifying factors -- General surveillance and epidemiologic studies.