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http://www.pediatrics.org/cgi/content/abstract/111/3/653
PEDIATRICS Vol. 111 No. 3 March 2003, pp. 653-659
SPECIAL ARTICLE
Addressing Parents Concerns:
Do Vaccines Cause Allergic or Autoimmune Diseases?
Paul A. Offit, MD* and Charles J. Hackett, PhD
Division of Infectious Diseases, Childrens Hospital of Philadelphia, University of Pennsylvania School of Medicine, and the Wistar Institute of Anatomy and Biology, Philadelphia, Pennsylvania
Division of Allergy, Immunology, and Transplantation, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
Anecdotal case reports and uncontrolled observational studies in the medical literature claim that vaccines cause chronic diseases such as asthma, multiple sclerosis, chronic arthritis, and diabetes. Several biological mechanisms have been proposed to explain how vaccines might cause allergic or autoimmune diseases. For example, allergic diseases might be caused by prevention of early childhood infections (the "hygiene hypothesis"), causing a prolongation of immunoglobulin E-promoting T-helper cell type 2-type responses. However, vaccines do not prevent most common childhood infections, and large well-controlled epidemiologic studies do not support the hypothesis that vaccines cause allergies. Autoimmune diseases might occur after immunization because proteins on microbial pathogens are similar to human proteins ("molecular mimicry") and could induce immune responses that damage human cells. However, wild-type viruses and bacteria are much better adapted to growth in humans than vaccines and much more likely to stimulate potentially damaging self-reactive lymphocytes. Consistent with critical differences between natural infection and immunization, well-controlled epidemiologic studies do not support the hypothesis that vaccines cause autoimmunity.
Flaws in proposed biological mechanisms that explain how vaccines might cause chronic diseases are consistent with the findings of many well-controlled large epidemiologic studies that fail to show a causal relationship.
Key Words: vaccines vaccine safety asthma allergies multiple sclerosis diabetes chronic arthritis
Abbreviations: IgE, immunoglobulin E Th2, T-helper cell type 2 Th1, T-helper cell type 1 HMO, health maintenance organization Hib, Haemophilus influenzae type b MBP, myelin basic protein HBsAg, hepatitis B surface antigen OspA, outer surface protein A LFA-1, lymphocyte function-associated antigen-1
Received for publication Jun 14, 2002; accepted Sep 10, 2002.
Pediatrics Online, 20 Mar 2003
Vaccine safety: causal or coincidental associations
Paul A Offit
Pediatrics Online, 20 Mar 2003 [Full text]
Copyright © 2003 by the American Academy of Pediatrics. [Disclaimer]
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