Vaccines: Past and Present

The incredible success of vaccination worldwide has not been without its share of setbacks, challenges, and controversies. While the fear of vaccine-preventable diseases has greatly diminished, new concerns about vaccine safety and the increasing number of required immunizations has led to public skepticism and parental refusal of vaccines.

The articles in this special issue offer guidance on how to reduce these increasingly common negative attitudes toward vaccination and reassert the safety, efficacy, and necessity of routine vaccinations.

Vaccines-an amazing history.
In his historical vingettes, Dov Boros, PhD, illustrates the progress of global vaccination, such as the eradication smallpox, and the challenges still faced, such as the need for an effective antituberculosis vaccine. He also summarizes a few controversies that have hindered parental acceptance of immunizations-most notably, the refuted study linking the measles, mumps, and rubella vaccine to autism.

How great is the risk of disease when parents refuse vaccination?
Children of parents who refuse immunizations are at increased risk for vaccine-preventable diseases compared with children of parents who accept immunizations. In his article "Importance of Immunization: A Serious Disease Is Just a Plane Ride Away," Chokechai Rongkavilit, MD, reviews the reasons for parental delay and refusal of vaccination. He also summarizes the findings of recent outbreaks of vaccine-preventable diseases and the lessons learned from them. He concludes his article with suggestions on how to stengthen public trust in vaccination.

Current vaccine issues: arguments for and against.
Would you dismiss a patient because of parental refusal of vaccination? Do you think promoting the fact that childhood vaccines are thimerosal-free helps reinforce the message that they are safe or does it validate the alleged thimerosal–neurodevelopmental disorders link? The pros and cons of these and other topics are debated by several pediatric practitioners from West Virginia University in Morgantown.

There is always room for improvement.
Larissa Hirsch, MD, and Charles A. Pohl, MD, describe the findings of 2 recent studies. One found improved immunization rates when patients held vaccination records. Another noted reduced pain during immunizations with administration of sweet oral solutions.