ASHINGTON, Feb. 20 Amid growing fears
that vaccines may harm babies' immune systems, an independent panel of
experts said today that childhood shots did not increase the risk of juvenile
diabetes, a disease associated with immune system dysfunction, or certain
serious infections like meningitis.
But the evidence is inconclusive, the study said, on whether immunization
increases the risk of asthma, another immune-related disorder.
The panel, an independent committee of the Institute of Medicine, has been
examining the highly politicized issue of vaccine safety for the federal
government. The new report, the third in a series of nine, said there was no
reason for federal health officials to change the current immunization
schedule, which calls for infants to receive as many as 15 shots in the first
six months of life.
But the panel did call for further study, particularly research intended
to show whether certain children had genetic predispositions for adverse
reactions to vaccines. That pleased critics of vaccination, who have
complained that their concerns are being ignored.
"For 20 years, we have been calling for studies of how and why some
children are unable to handle the process of immunization like other
children," said Barbara Loe Fisher, president of the National Vaccine
Information Center, a group that represents parents who say vaccines have
harmed their children.
The report, Ms. Fisher said, "is a major step forward."
In 1980, infants were vaccinated against just four diseases, diphtheria,
tetanus, pertussis and polio. But today American children are vaccinated
against a much broader variety of conditions, like chickenpox, hepatitis,
measles and mumps. As the vaccination schedule has grown, so have parents'
fears.
According to the new report, a survey found that 25 percent of parents
agreed with the statement that administering too many vaccines was not good
for babies and could weaken immune systems.
In London, parents are so concerned about reports that the vaccine for
measles, mumps and rubella, or MMR, causes autism that one- fourth of
eligible toddlers are not being vaccinated. The Institute of Medicine panel
has already tackled that question, finding no link between the vaccine and
the disorder.
In its report today, the panel did call for the Department of Health and
Human Services to convene a group of experts to examine parents' perceptions
and said doctors needed to learn how to discuss such fears with anxious
mothers and fathers.
"People are just wondering if all of this is necessary," said
Dr. Marie McCormick, chairwoman of the panel and a professor of maternal and
child health at the Harvard School of Public Health. "We really need to
have a much better, more comprehensive approach to understanding what
people's concerns are."
Although it is true that infants receive more shots today than in the
past, the study noted that children were now exposed to fewer antigens, the
substances that vaccines use to initiate immune responses. A streamlined form
of the pertussis vaccine has reduced the number of antigens, to fewer than 5
from 3,000, the report said. The smallpox vaccine, which contained 200
potential antigens, is no longer in use, and vaccines that have been added to
the immunization schedule have relatively few antigens.
"When you look at the infant immune system," Dr. McCormick said,
"it is quite competent and quite capable of handling larger antigen
loads."
In examining a potential link to autoimmune disorders, the panel
concentrated on Type 1 diabetes, an autoimmune form of the disease in which
the body produces antibodies against its own insulin-secreting cells. A
review of eight studies found that multiple vaccinations had no effect on the
incidence of the disease.
A review of seven studies found that repeat vaccinations did not increase
the risk of developing infections like colds, ear infections, meningitis and
pneumonia.
A review of five studies on the potential link between vaccines and
allergic diseases, including asthma, found some suggestion that certain shots
increased the risk. But there were methodological weaknesses in those
studies, the report said, and the panel urged further research.
Asked about asthma, Dr. McCormick said, "The evidence is not
sufficient to say either yes or no." But, she added, asthma is a potential
risk that has to be compared to "the very real risk of the disease for
which children are being immunized."