Summary Of Recommendations For Childhood And Adolescent Immunization: Fill & Download for Free

Original question was “why do people disbelieve in homeopathy when it cured my sepsis”.You were on no other treatments? Just using homeopathy to cure sepsis? You took no other medicines or antibiotics? It’s lucky that your immune system must have kicked in.Homeopathy is dangerous nonsense, should be banned and those who use it to fleece others should be jailed.Thanks to a homeopath…“Gloria Thomas, who was born in perfect health in July 2001, allegedly died with malnutrition and eczema so severe that her skin broke every time her parents removed her clothes and nappy.”Homeopathy couple jailed over daughter's deathAddendum 16/11/2018Some homeopathy apologist just replied to my answer saying that we should call the death of a child an anecdote. No – let’s call it a crime that is beyond legal dispute.He also asks for evidence to support my position that homeopathy is nonsense – here you go (note that most these studies are from journals of high repute – interestingly a couple of sources stating methodological sloppiness and patient poisoning are from alt-medicine rags) :Parliamentary Select Committee findings leading to the ban of homeopathic remedies on the NHS.http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdfStudies Showing Homeopathy no more effective than a placebo.K. Linde, N. Clausius, G. Ramirez, et al.Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trialsLancet, 350 (1997), pp. 834-843M. Cucherat, M.C. Haugh, M. Gooch, J.P. BoisselEvidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory GroupEur J Clin Pharmacol, 56 (2000), pp. 27-33A. Shang, K. Huwiler-Müntener, L. Nartey, et al.Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathyLancet, 366 (2005), pp. 726-732M. Cucherat, M.C. Haugh, M. Gooch, J.P. BoisselEvidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory GroupEur J Clin Pharmacol, 56 (2000), pp. 27-33E. ErnstHomeopathy: what does the “best” evidence tell us?Med J Aust, 192 (2010), pp. 458-460T. Nuhn, R. Lüdtke, M. GeraedtsPlacebo effect sizes in homeopathic compared to conventional drugs - a systematic review of randomised controlled trialsHomeopathy, 99 (2010), pp. 76-82E. ErnstA systematic review of systematic reviews of homeopathyBr J Clin Pharmacol, 54 (2002), pp. 577-582Studies that suggest homeopathy may be more effective than a placebo are fudged – methodologically unsound.K. Linde, D. MelchartRandomized controlled trials of individualized homeopathy: a state-of-the-art reviewJ Altern Complement Med, 4 (1998), pp. 371-388Studies that show that the use of Homeopathy is not recommended for any health conditionS. Milazzo, N. Russell, E. ErnstEfficacy of homeopathic therapy in cancer treatmentEur J Cancer, 42 (2006), pp. 282-289U. Altunç, M.H. Pittler, E. ErnstHomeopathy for childhood and adolescence ailments: systematic review of randomized clinical trialsMayo Clin Proc, 82 (2007), pp. 69-75Studies that show homeopathy is even ineffective as a supplementary medicineS. Brien, G. Lewith, T. BryantUltramolecular homeopathy has no observable clinical effects. A randomized, double-blind, placebo-controlled proving trial of Belladonna 30CBr J Clin Pharmacol, 56 (2003), pp. 562-568D. Pérol, J. Provençal, A.C. Hardy-Bessard, et al.Can treatment with Cocculine improve the control of chemotherapy-induced emesis in early breast cancer patients? A randomized, multi-centered, double-blind, placebo-controlled Phase III trialBMC Cancer, 12 (2012), p. 603Studies showing cases where homeopathy has poisoned patientsD. Chakraborti, S.C. Mukherjee, K.C. Saha, U.K. Chowdhury, M.M. Rahman, M.K.SenguptaArsenic toxicity from homeopathic treatmentJ Toxicol Clin Toxicol, 41 (2003), pp. 963-967H. Tumir, J. Bosnir, I. Vedrina-Dragojevic, Z. Dragun, S. Tomic, D. PuntaricPreliminary investigation of metal and metalloid contamination of homeopathic products marketed in CroatiaHomeopathy, 99 (2010), pp. 183-188A. BraschossLycopodium similiaplex-induced acute hepatitis: a case reportEur J Gastroenterol Hepatol, 21 (2009), pp. 718-719WHO Library Cataloguing-in-Publication DataSafety issues in the preparation of homeopathic medicinesAvailable at:http://www.who.int/medicines/areas/traditional/Homeopathy.pdf (2009)(Accessed 10 August 2016)P. Posadzki, A. Alotaibi, E. ErnstAdverse effects of homeopathy: a systematic review of published case reports and case seriesInt J Clin Pract, 66 (2012), pp. 1178-1188In summary - homeopathy is worthless - it only serves to rake in money for quacks - don’t be taken in by their pseudoscientific bullshit.Dr. John Talbot

I would say that we are experienceing the long term side effects as we speak, “long term” meaning that we are finally, after 60+ years of exposure, recognizing those effects in our children. Medical science now has the means to detect many neurological disorders that they once simply considered mental or neurological defects. Before the technology became available various disorders were simply grouped together. Epilepsy, for instance. Anyone having a siezure disorder was simply diagnosed as epileptic, with not much in the way of cause. Now medical science knows that there are many disorders that can cause siezures. The same goes for vaccine side effects, but that is one area that no one wants to admit to. However, the numbers alone can tell a story. In 2007 the vaccine “schedule” for children and infants accelerated…and so did the incidences of Autism.~Although this is a very long list it is in no way complete:“February 5, 2019CDC released the 2019 U.S. recommended immunization schedules for children/adolescents as well as for adults on its website.January 23, 2019FDA approved use of the 0.5 mL dose of Sanofi's Fluzone Quadrivalent influenza vaccine to include children age 6 through 35 months.January 14, 2019FDA approved expanded use of Sanofi's Adacel Tdap vaccine for a second dose in people ages 10 through 64 years of age.December 21, 2018FDA licensed pediatric hexavalent vaccine (DTaP, IPV, HepB, and Hib) developed by Sanofi and Merck; not available in the U.S. until 2020 or later.November 7, 2018ACIP published updated recommendations on use of hepatitis A vaccine for pre- and post-exposure prophylaxis for international travel.October 25, 2018The American Dental Association adopted a policy to support the use and administration of HPV vaccine for the prevention of oral HPV infection.October 8, 2018FDA approved expanded age indication for Seqirus’s Afluria influenza vaccine to include children age 6 months through 59 months.October 5, 2018FDA announced approval of expanded use of Merck’s Gardasil 9 (HPV9, Human papillomavirus) vaccine to include adults 27 through 45 years old.August 24, 2018CDC published ACIP's 2018–19 influenza vaccination recommendations.June 8, 2018CDC published ACIP's recommendations for the use of quadrivalent live attenuated influenza vaccine (LAIV4) in the 2018–19 influenza season.June 2018The American College of Obstetricians and Gynecologists issued a committee opinion on maternal immunization.May 16, 2018CDC released information about a new rapid rabies test that could save lives and lead to fewer unnecessary rabies shots.April 27, 2018CDC published a comprehensive summary of previously published ACIP recommendations for prevention of tetanus, diphtheria, and pertussis in the U.S.April 20, 2018CDC published ACIP recommendations for use of hepatitis B vaccine with a novel adjuvant [Heplisav-B].April 2018The American College of Obstetricians and Gynecologists released a committee opinion on influenza vaccination in pregnancy.February 6, 2018CDC published the 2018 U.S. recommended immunization schedule for 0 through 18 years.February 6, 2018CDC published the 2018 U.S. recommended adult immunization schedule.January 26, 2018CDC published ACIP recommendations for use of herpes zoster vaccines.January 12, 2018CDC published updated ACIP recommendations for prevention of hepatitis B virus infection.January 12, 2018CDC published ACIP recommendations on use of a third dose of MMR during a mumps outbreak.January 11, 2018FDA approved expanded pediatric age indication for Fluarix Quadrivalent influenza vaccine.November 9, 2017FDA licensed Heplisav-B, the new hepatitis B vaccine from Dynavax, for use in adults age 18 and older.October 20, 2017FDA licensed Shingrix, the new shingles vaccine from GlaxoSmithKline, for use in adults age 50 and older.September 15, 2017CDC published updated dosing instructions for hepatitis A prophylaxis with immune globulin.August 31, 2017FDA expanded licensure of Afluria quadrivalent (Seqirus) to include people age 5 years and older.August 25, 2017CDC published ACIP 2017–18 influenza vaccination recommendations.August 2017AAP issued policy stating that newborns should routinely receive hepatitis B vaccine within 24 hours of birth.July 6, 2017CDC published a Vaccine Information Statement for cholera.June 30, 2017CDC and FDA announced new Vaccine Adverse Event Reporting website and reporting form.May 19, 2017CDC published ACIP's updated recommendations on use of Trumenba meningococcal serogroup B vaccine.May 12, 2017CDC published ACIP recommendations for use of cholera vaccine.April 20, 2017CDC published ACIP recommendations titled "General Best Practice Guidelines for Immunization" to replace the 2011 "General Recommendations on Immunization."February 7, 2017CDC published the 2017 U.S. recommended immunization schedules for 0 through 18 years; includes new “16-year-old vaccination" column.February 7, 2017CDC published the 2017 U.S. recommended adult immunization schedule.December 16, 2016CDC published ACIP's recommendations on 2-dose HPV vaccine series for younger adolescents.November 18, 2016FDA approved extending the age range for use of FluLaval Quadrivalent to include children 6 to 35 months of age.November 4, 2016CDC published ACIP recommendations for use of meningococcal conjugate vaccines in HIV-infected persons.September 27, 2016PAHO/WHO announced measles elimination in the Americas.August 26, 2016CDC published 2016–17 influenza vaccination recommendations.August 2016AAP released new policy statement that urges states to eliminate all non-medical exemptions to vaccine requirements.July 11, 2016FDA extended the age indication for PCV13 (Prevnar 13) to include adults age 18 through 49 years.June 22, 2016ACIP voted that live attenuated influenza vaccine (LAIV) should not be used during the 2016–2017 flu season.June 15, 2016FDA approved revisions in the package insert for YF-Vax to reflect changes to International Health Regulations and WHO/ACIP recommendations.June 10, 2016FDA approved Vaxchora for the prevention of cholera.April 14, 2016FDA approved changes to vaccine administration schedule for Trumenba vaccine.February 5, 2016National Vaccine Program Office released an National Adult Immunization Plan.February 1, 20162016 U.S. recommended immunization schedules for 0 through 18 years and "catch up" published in MMWR.January 14, 2016FDA approved Hiberix for full Hib vaccine series.December 14, 2015FDA expanded Gardasil 9 licensure to include males age 16–26 years.November 24, 2015FDA approved new injectable influenza vaccine, Fluad, for use in people age 65 years and olderOctober 23, 2015ACIP published recommendations for the use of serogroup B meningococcal vaccines in adolescents and young adults.September 4, 2015CDC published updated ACIP recommendations regarding the intervals between PCV13 and PPSV23 vaccines for use in immunocompetent adults age 65 years and olderAugust 14, 2015WHO published "Recommendations on Vaccine Hesitancy" in special issue of the journal Vaccine.June 19, 2015ACIP published recommendations for yellow fever booster doses.June 12, 2015ACIP published recommendations for use of serogroup B meningococcal vaccines in people age ten years and older at increased risk for serogroup B meningococcal disease.June 8, 2015American Medical Association adopted a new policy that supports ending non-medical vaccine exemptions, including those for healthcare professionals.April 29, 2015The Pan American Health Organization declared rubella eliminated in the Americas.March 27, 2015CDC published ACIP recommendations for use of 9-valent HPV vaccine.March 27, 2015CDC published new ACIP recommendations for typhoid vaccination.March 24, 2015FDA approved Quadracel, a new combination DTaP+IPV vaccine for use in children age 4–6 years.January 23, 2015CDC's Health Alert Network issued a health advisory about a multi-state outbreak of measles linked to Disneyland.January 23, 2015FDA approved the use of Bexsero, the second vaccine licensed in the U.S. to prevent serogroup B meningococcal disease.December 19, 2014FDA approved Rapivab to treat influenza infection.December 11, 2014FDA approved quadrivalent formulation of Fluzone Intradermal inactivated influenza vaccine.December 10, 2014FDA approved the use of Gardasil 9 (Merck) 9-valent HPV vaccine in the U.S.October 29, 2014FDA approved the use of Trumenba in the U.S. to prevent serogroup B meningococcal disease.September 19, 2014CDC published ACIP recommendations for use of PCV13 and PPSV23 vaccines in adults age 65 and older.June 20, 2014CDC published ACIP's recommendations for use of MenACWY-CRM vaccine in children age 2–23 months at increased risk for meningococcal disease.May 5, 2014WHO Director-General declared the international spread of wild poliovirus in 2014 a Public Health Emergency of International Concern.April 25, 2014CDC report showed 20-year U.S. immunization program spares millions of children from diseases.March 24, 2014FDA lowered age of licensure for Adacel vaccine administration from age 11 years to 10 years.February 28, 2014CDC published ACIP recommendations for prevention and control of Haemophilus influenzae type b (Hib) disease.December 20, 2013CDC published guidance for HBV protection and postexposure management of healthcare personnel.November 15, 2013CDC published new recommendations for use of Japanese encephalitisvaccine in children.September 10, 2013National Vaccine Advisory Committee released revised "Standards for Adult Immunization Practice."August 16, 2013FDA extended FluLaval IIV (GlaxoSmithKline) age range to include children and teens age 3–17 years; licenses quadrivalent FluLaval product.August 1, 2013FDA expanded age indication for Menveo (Novartis) to include infants and toddlers age 2 through 23 months.July 19, 2013CDC issued updated recommendations for use of VariZIG immune globulin for varicella postexposure prophylaxis.June 28, 2013CDC issued recommendations for PCV and PPSV vaccination of children with immunocompromising conditions.June 20, 2013ACIP voted to recommend FluBlok influenza vaccine for people age 18 through 49 with egg allergy.June 14, 2013CDC published recommendations for preventing measles, rubella, congenital rubella syndrome, and mumps.June 7, 2013FDA approved Fluzone (Sanofi Pasteur) as the third quadrivalent influenza vaccine licensed for U.S. use.May 17, 2013Booster dose of yellow fever vaccine not needed, according to WHO. A single dose of vaccine is effective in providing long-term protection from yellow fever.January 25, 2013FDA approved use of Prevnar 13 vaccine in older children and teens (6-17 years).December 18, 2012Institute for Safe Medication Practices (ISMP) launched new Vaccine Error Reporting Program.December 12, 2012FDA approved quadrivalent formulation of Fluarix (inactivated influenza vaccine; GlaxoSmithKline).November 20, 2012FDA approved first seasonal influenza vaccine manufactured using cell culture technology (Flucelvax, Novartis).October 24, 2012ACIP voted to recommend use of HibMenCY (Menhibrix, GlaxoSmithKline), a new combination (meningococcal and Hib) vaccine, in infants at increased risk for meningococcal disease.October 24, 2012ACIP voted to recommend that pregnant women receive a dose of Tdap during each pregnancy irrespective of the patient's prior history of receiving Tdap.June 24, 2012FDA approved HibMenCY (Menhibrix, GlaxoSmithKline), a new combination (meningococcal and Hib) vaccine for infants.June 7, 2012FDA expanded licensure of PCV13 to include adults ages 50 years and older.June 5, 2012U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a report titled "Vaccines for Children (VFC) Program: Vulnerabilities in Vaccine Management."April 1, 2012United Nations Foundation launched Shot@Life campaign.December 30, 2011FDA expanded use of Prevnar 13 (PCV13, Pfizer) vaccine to include people ages 50 and older.October 25, 2011ACIP recommended all 11 to 12 year-old males get vaccinated against HPV.October 21, 2011Addition of history of intussusception as a contraindication for rotavirus vaccination.August 25, 2011National survey indicated HPV vaccine rates trail other teen vaccines.August 25, 2011Institute of Medicine issued the report titled "Review of Adverse Effects of Vaccines." Overall, the committee concludes that few health problems are caused by or clearly associated with vaccines.July 8, 2011FDA approved Boostrix (Tdap, GlaxoSmithKline) to prevent tetanus, diphtheria, and pertussis in older people.May 19, 2011CDC hailed vaccinations as one of 10 public health achievements of first decade of 21st century in Morbidity and Mortality Weekly Report (MMWR).April 22, 2011FDA approved the first vaccine (Menactra, meningococcal conjugate vaccine, Sanofi Pasteur) to prevent meningococcal disease in infants and toddlers.February 15, 2011HHS releases U.S. National Vaccine Plan, covers activities, goals, and priorities for 2010-2015.December 22, 2010FDA approved Gardasil HPV vaccine to include the indication for the prevention of anal cancer.August 11, 2010WHO declared end to 2009 H1N1 influenza pandemic.July 10, 2010First smallpox vaccine for certain immune-compromised populations delivered under Project BioShield.March 19, 2010ACIP recommended use of a reduced (4-dose) vaccine schedule for PEP to prevent human rabies.February 24, 2010FDA approved licensure of Pneumococcal 13-valent conjugate vaccine (PCV13), which offers broader protections against Steptococcus pneumoniae infections.February 19, 2010FDA approved licensure of Menveo (Novartis), meningococcal conjugate vaccine for people ages 11 through 55 years.January 29, 2010WHO hailed new Gates Foundation support ($10 billion) as the "Decade of Vaccines."February 24, 2010ACIP recommended universal Influenza vaccination for those 6 months of age and older.February 24, 2010FDA approved pneumococcal 13-valent conjugate vaccine (Prevnar 13), which offers broader protection against Streptococcus pneumoniae.December 23, 2009FDA approved high-dose inactivated influenza vaccine (Fluzone High-Dose) for people ages 65 years and older.November 16, 2009CDC issued Health Advisory 2009 H1N1 Pandemic Update: Pneumococcal vaccination recommended to help prevent secondary infections.October 21, 2009Merck issued announcement that the company will not resume production of monovalent measles, mumps, and rubella vaccines.October 16, 2009FDA approved new vaccine (Cervarix, GlaxoSmithKline) for the prevention of cervical cancer.October 16, 2009FDA approved new indication for gardasil to prevent genital warts in men and boys.September 15, 2009FDA approved four vaccines against the 2009 H1N1 influenza virus.July 1, 2009WHO and ACIP issued recommendations on the use of H1N1 influenza vaccines.June 23, 2009HHS announced advanced development contract for new way to make flu vaccine.June 11, 2009Dr Margaret Chan, Director-General WHO, declared world now at the start of 2009 influenza pandemic.May 22, 2009HHS directed $1 billion toward development of vaccine for novel influenza A (H1N1).March 16, 2009ACIP voted to recommend hepatitis A vaccination for close contacts of international adoptees from countries with high and intermediate endemicity.February 12, 2009Vaccine Court ruled that MMR vaccine, when administered with thimerosal-containing vaccines, does not cause autism.January 15, 2009HHS awarded a $487 million contract to Novartis Vaccines and Diagnostics, Inc to build a facility to manufacture cell-based influenza vaccine.December 11, 2008FDA approved changes in the schedule for administering anthrax vaccine (BioThrax, manufactured by Emergent BioSolutions) and in the route of administration.December 4, 2008FDA approved expanded indication for use of Boostrix Tdap vaccine in people ages 10-64 years.October 27, 2008National Quality Forum included the hepatitis B birth dose among its consensus standards for improving health care for mothers and newborns.June 24, 2008FDA approved new DTaP-IPV vaccine (Kinrix) for use in children ages 4-6 years.June 5, 2008FDA approved the use of Sanofi Pasteur's Tenivac tetanus and diphtheria toxoids adsorbed for adults age 60 years and older. In the original licensure, the age indication was for persons ages 7-59 years.April 3, 2008FDA approved new rotavirus vaccine (Rotarix) for use in U.S. Rotarix is a liquid and given in a two-dose series to infants from 6 to 24 weeks of age.April 2, 2008CDC issued Health Advisory in response to widespread measles outbreaks in U.S.March 14, 2008CDC updated its recommendations for administering combination MMRV vaccine.February 29, 2008CDC announced it had begun distribution of a new-generation smallpox vaccine, ACAM2000 (Acambis, Inc., Cambridge, Massachusetts), to civilian laboratory personnel, the military, and state public health preparedness programs.February 27, 2008ACIP voted to expand influenza recommendation to include vaccination for children ages 6 months-18 years.December 7, 2007CDC published updated recommendation for meningococcal vaccination of at-risk children age 2-10 years in MMWR.October 26, 2007ACIP voted to recommend the use of FluMist, the live attenuated influenza vaccine (LAIV; nasal-spray formulation) to include children age 2-5 years.October 19, 2007CDC published updated recommendations for prevention of hepatitis A virus infection after exposure and before international travel in MMWR.October 18, 2007FDA approved use of Menactra, a bacterial meningitis vaccine, in children age 2-10 years.September 28, 2007FDA approved Afluria, a new inactivated influenza vaccine for use in people age 18 years and older.September 19, 2007FDA approved use of FluMist nasal-spray influenza vaccine in children age 2-5 years.August 10, 2007CDC notified MMWR readers of revised recommendations to vaccinate all persons ages 11-18 with MCV4 at earliest opportunity.July 20, 2007MMWR notified readers that revised International Health Regulations have gone into effect for the United States.July 17, 2007HHS announced a plan to provide $175 million to assist states in pandemic influenza preparedness efforts.June 27-28, 2007ACIP voted to recommend routine use of meningococcal conjugate vaccine in adolescents ages 11-18 years.June 15, 2007HHS awarded $132.5 million to Sanofi Pasteur and MedImmune over five years to retrofit existing domestic vaccine manufacturing facilities on a cost-sharing basis and to provide warm-base operations for manufacturing pandemic influenza vaccines.March 28, 2007FDA approved an accelerated dosing schedule for Twinrix (hepatitis A and B vaccine). The schedule consists of three doses given within three weeks followed by a booster dose at 12 months (0, 7, 21–30 days, 12 months).” Historic Dates and Events Related to Vaccines and Immunization~Compared to this:“This is the sixth report by the ADDM Network, which has used the same surveillance methods for more than a decade. Estimated prevalence rates of ASD (Autism Spectrum Disorder) in the U.S. reported by previous data were:one in 68 children in the 2016 report that looked at 2012 dataone in 68 children in the 2014 report that looked at 2010 dataone in 88 children in the 2012 report that looked at 2008 dataone in 110 children in the 2009 report that looked at 2006 dataone in 150 children in the 2007 report that looked at 2000 and 2002 dataThe estimated overall prevalence rates reported by ADDM at the monitoring sites have more than doubled since the report was first published in 2007," says Dr. Li-Ching Lee, PhD, ScM, a psychiatric epidemiologist with the Bloomberg School's departments of Epidemiology and Mental Health and the principal investigator for Maryland-ADDM. "Although we continue to see disparities among racial and ethnic groups, the gap is closing," Lee says.”” U.S. autism rate up 15 percent over two-year period: Researchers say racial and ethnic disparities are narrowing~So, can anyone really look at the timeframes of the increase in infant/childhood vaccinations and the increase in childhood neurological disorders and still say there is no link? Again, I believe we are experiencing the long term negative side effects of vaccines as is evidenced by the increase in the vaccination schedule coinciding with the ever increasing incidence of Autism.

Achievements in Public Health, 1900-1999 Impact of Vaccines Universally Recommended for Children -- United States, 1990-1998At the beginning of the 20th century, infectious diseases were widely prevalent in the United States and exacted an enormous toll on the population. For example, in 1900, 21,064 smallpox cases were reported, and 894 patients died (1). In 1920, 469,924 measles cases were reported, and 7575 patients died; 147,991 diphtheria cases were reported, and 13,170 patients died. In 1922, 107,473 pertussis cases were reported, and 5099 patients died (2,3).In 1900, few effective treatment and preventive measures existed to prevent infectious diseases. Although the first vaccine against smallpox was developed in 1796, greater than 100 years later its use had not been widespread enough to fully control the disease (4). Four other vaccines -- against rabies, typhoid, cholera, and plague -- had been developed late in the 19th century but were not used widely by 1900.Since 1900, vaccines have been developed or licensed against 21 other diseases (5) (Table_1). Ten of these vaccines have been recommended for use only in selected populations at high risk because of area of residence, age, medical condition, or risk behaviors. The other 11 have been recommended for use in all U.S. children (6).During the 20th century, substantial achievements have been made in the control of many vaccine-preventable diseases. This report documents the decline in morbidity from nine vaccine-preventable diseases and their complications -- smallpox, along with the eight diseases for which vaccines had been recommended for universal use in children as of 1990 (Table_2). Four of these diseases are detailed: smallpox has been eradicated, poliomyelitis caused by wild-type viruses has been eliminated, and measles and Haemophilus influenzae type b (Hib) invasive disease among children aged less than 5 years have been reduced to record low numbers of cases.Information about disease and death during the 20th century was obtained from the MMWR annual summaries of notifiable diseases and reports by the U.S. Department of Health, Education, and Welfare. For smallpox, Hib, and congenital rubella syndrome (CRS), published studies were used (2,3,7-14).Current Delivery and Use of VaccinesNational efforts to promote vaccine use among all children began with the appropriation of federal funds for polio vaccination after introduction of the vaccine in 1955 (5). Since then, federal, state, and local governments and public and private health-care providers have collaborated to develop and maintain the vaccine-delivery system in the United States.Overall, U.S. vaccination coverage is at record high levels. In 1997, coverage among children aged 19-35 months (median age: 27 months) exceeded 90% for three or more doses of diphtheria and tetanus toxoids and pertussis vaccine (DTP), three or more doses of poliovirus vaccine, three or more doses of Hib vaccine, and one or more doses of measles-containing vaccine. Coverage with four doses of DTP was 81% and for three doses of hepatitis B vaccine was 84%. Coverage was substantially lower for the recently introduced varicella vaccine (26%) and for the combined series of four DTP/three polio/one measles-containing vaccine/three Hib (76%) (15). Coverage for rotavirus vaccine, licensed in December 1998, has not yet been measured among children aged 19-35 months. Coverage among children aged 5-6 years has exceeded 95% each school year since 1980 for DTP; polio; and measles, mumps, and rubella vaccines (CDC, unpublished data, 1998).Vaccine ImpactDramatic declines in morbidity have been reported for the nine vaccine-preventable diseases for which vaccination was universally recommended for use in children before 1990 (excluding hepatitis B, rotavirus, and varicella) (Table_2). Morbidity associated with smallpox and polio caused by wild-type viruses has declined 100% and nearly 100% for each of the other seven diseases.Smallpox. Smallpox is the only disease that has been eradicated. During 1900-1904, an average of 48,164 cases and 1528 deaths caused by both the severe (variola major) and milder (variola minor) forms of smallpox were reported each year in the United States (1). The pattern in the decline of smallpox was sporadic. Outbreaks of variola major occurred periodically in the first quarter of the 1900s and then ceased abruptly in 1929. Outbreaks of variola minor declined in the 1940s, and the last case in the United States was reported in 1949. The eradication of smallpox in 1977 enabled the discontinuation of prevention and treatment efforts, including routine vaccination. As a result, in 1985 the United States recouped its investment in worldwide eradication every 26 days (1).Polio. Polio vaccine was licensed in the United States in 1955. During 1951-1954, an average of 16,316 paralytic polio cases and 1879 deaths from polio were reported each year (9,10). Polio incidence declined sharply following the introduction of vaccine to less than 1000 cases in 1962 and remained below 100 cases after that year. In 1994, every dollar spent to administer oral poliovirus vaccine saved $3.40 in direct medical costs and $2.74 in indirect societal costs (14). The last documented indigenous transmission of wild poliovirus in the United States occurred in 1979. Since then, reported cases have been either vaccine-associated or imported. As of 1991, polio caused by wild-type viruses has been eliminated from the Western Hemisphere (16). Enhanced use of the inactivated polio vaccine is expected to reduce the number of vaccine-associated cases, which averaged eight cases per year during 1980-1994 (17).Measles. Measles vaccine was licensed in the United States in 1963. During 1958-1962, an average of 503,282 measles cases and 432 measles-associated deaths were reported each year (9-11). Measles incidence and deaths began to decline in 1965 and continued a 33-year downward trend. This trend was interrupted by epidemics in 1970-1972, 1976-1978, and 1989-1991. In 1998, measles reached a provisional record low number of 89 cases with no measles-associated deaths (13). All cases in 1998 were either documented to be associated with international importations (69 cases) or believed to be associated with international importations (CDC, unpublished data, 1998). In 1994, every dollar spent to purchase measles-containing vaccine saved $10.30 in direct medical costs and $3.20 in indirect societal costs (7).Hib. The first Hib vaccines were polysaccharide products licensed in 1985 for use in children aged 18-24 months. Polysaccharide-protein conjugate vaccines were licensed subsequently for use in children aged 18 months (in 1987) and later for use in children aged 2 months (in 1990). Before the first vaccine was licensed, an estimated 20,000 cases of Hib invasive disease occurred each year, and Hib was the leading cause of childhood bacterial meningitis and postnatal mental retardation (8,18). The incidence of disease declined slowly after licensure of the polysaccharide vaccine; the decline accelerated after the 1987 introduction of polysaccharide-protein conjugate vaccines for toddlers and the 1990 recommendation to vaccinate infants. In 1998, 125 cases of Hib disease and Haemophilis influenzae invasive disease of unknown serotype among children aged less than 5 years were provisionally reported: 54 were Hib and 71 were of unknown serotype (CDC, unpublished data, 1998). In less than a decade, the use of the Hib conjugate vaccines nearly eliminated Hib invasive disease among children.Future DirectionVaccines are one of the greatest achievements of biomedical science and public health. Despite remarkable progress, several challenges face the U.S. vaccine-delivery system. The infrastructure of the system must be capable of successfully implementing an increasingly complex vaccination schedule. An estimated 11,000 children are born each day in the United States, each requiring 15-19 doses of vaccine by age 18 months to be protected against 11 childhood diseases (6). In addition, licensure of new vaccines is anticipated against pneumococcal and meningococcal infections, influenza, parainfluenza, respiratory syncytial virus (RSV), and against chronic diseases (e.g., gastric ulcers, cancer caused by Helicobacter pylori, cervical cancer caused by human papilloma virus, and rheumatic heart disease that occurs as a sequela of group A streptococcal infection). Clinical trials are under way for vaccines to prevent human immunodeficiency virus infection, the cause of acquired immunodeficiency syndrome.To achieve the full potential of vaccines, parents must recognize vaccines as a means of mobilizing the body's natural defenses and be better prepared to seek vaccinations for their children; health-care providers must be aware of the latest developments and recommendations; vaccine supplies and financing must be made more secure, especially for new vaccines; researchers must address increasingly complex questions about safety, efficacy, and vaccine delivery and pursue new approaches to vaccine administration more aggressively; and information technology to support timely vaccinations must be harnessed more effectively. In addition, the vaccine-delivery system must be extended to new populations of adolescents and adults. Each year, thousands of cases of potentially preventable influenza, pneumococcal disease, and hepatitis B occur in these populations. Many of the new vaccines will be targeted at these age groups. The U.S. vaccine-delivery system must routinely include these populations to optimally prevent disease, disability, and death.Despite the dramatic declines in vaccine-preventable diseases, such diseases persist, particularly in developing countries. The United States has joined many international partners, including the World Health Organization and Rotary International, in seeking to eradicate polio by the end of 2000. Efforts to accelerate control of measles, which causes approximately one million deaths each year (5), and to expand rubella vaccination programs also are under way around the world. Efforts are needed to expand the use of existing vaccines in routine childhood vaccination programs worldwide and to successfully introduce new vaccines as they are developed. Such efforts can benefit the United States and other developed countries by decreasing disease importations from developing countries.Reported by: National Immunization Program, CDC.Just imagine what we will achieve when we stop wasting billions of dollars, pounds , euros on war alone regards ian.