A twisted advocacy threatens health gains for children

We are guided in our practice primarily by the Centers for Disease Control and Prevention and the American Academy of Pediatrics. By following the recommendations of those two bodies, we have been instrumental in reducing to zero, or to near zero, the incidence of Haemophilus influenzae meningitis, measles, polio, diphtheria, tetanus, and congenital rubella syndrome. And recently approved vaccines now recommended for children will likely lead to a significant reduction in the incidence of meningococcal infection in adolescents and young adults, of pertussis, and of rotavirus hospitalization in infants and young children.

But this past April 6, the motives and the methods of the CDC and the AAP were called into question in an aggressive full-page advertisement in USA Today. The Web-based organization that paid for the ad-perversely calling itself http://putchildrenfirst.org/-alleges there that the CDC's vaccine recommendations are responsible for a 6,000% increase in the incidence of autism and that the CDC, recognizing its culpability, is working to cover up its role. The most despicable and misleading statement in the advertisement? The allegation that ". . . mercury remains in children's vaccines and ... the CDC and American Academy of Pediatrics are fighting state laws banning mercury."

Preserving gains made through immunization policy requires persistence and near-universal application of those policies. We aren't yet able to claim worldwide eradication of polio, or of measles, and the recent report of an outbreak of mumps among young adults in Iowa reminds us that we are far from being rid of vaccine-preventable infections. As of the time I wrote this editorial, 19 influenza-related deaths of children have been reported in the US this year. Three previously healthy children died of complications of influenza in my hospital just in the past four weeks.

Vaccines, and policies advocated for administering them, will continue to be refined. New vaccines will enhance our ability to protect infants and children. Undoubtedly, there will be missteps along the way, and current vaccines will be improved. But a wholesale attack on vaccines, vaccine policy, and the agencies that apply science and an understanding of public health practice to develop them? Such a sprawling accusation has the potential to reverse a century of advances in child health.