Addressing Parents’ Concerns: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System?

Offit, Paul A.; Quarles, Jessica; Gerber, Michael A.; Hackett, Charles J.; Marcuse, Edgar K.; Kollman, Tobias R.; Gellin, Bruce G.; Landry, Sarah

doi:10.1542/peds.109.1.124

Cited by 268 publications

(147 citation statements)

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“…U skladu sa tim, simultano odvijanje imunskog odgovora na veliki broj različitih antigena je uobičajeno, te nije razložno očekivati da bi ovo moglo da predstavlja bilo kakav problem u kontekstu vakcinacije polivalentnim vakcinama. Pored toga, postoje i snažni empirijski dokazi da kombinovanje vakcina, osim u retkim slučajevima gde postoji specifičan osnov za neželjenu interakciju, tokom pomnog praćenja velikih grupa vakcinisanih osoba, nije dovelo do bilo kakvog znaka "preopterećenja" imunskog sistema [6]. Na kraju, valja dodati i to da postoji trend da vakcine novijeg dizajna, kao posledica napretka tehnologije, sadrže manji ukupan broj antigena od vakcina prethodnih generacija [6].…”

Section: Vakcine I Imunitet: "Velika Tri" Argumentaunclassified

Anti-vakcinalni pokreti i naučna medicina

Janković

2014

Биомедицинска Истраживања

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Kratak sadržajUprkos velikim uspesima u sprečavanju, suzbijanju, pa i iskorenjivanju zaraznih oboljenja, aktivna imunizacija kao profilaktička metoda je od samog početka bila žučno osporavana. Osporavanje vrednosti aktivne imunizacije je i danas u porastu, što predstavlja svojevrstan paradoks kada se uzme u obzir postojanje dugotrajnih (u nekim slučajevima viševekovnih) pozitivnih iskustava u primeni vakcinacije: postojani napredak naučne medicine i imunologije koji je doveo i vodi ka brojnim poboljšanjima u osmišljavanju, proizvodnji, primeni i kontroli kvaliteta vakcina; impresivna suma naučnih istraživanja i pažljivo zabeleženih činjenica koje svedoče o visokom stepenu delotvornosti i bezbednosti vakcina u širokoj upotrebi; i najzad, ukupan broj sprečenih slučajeva oboljevanja i sačuvanih ljudskih života koji se, čak i prema škrtim procenama, u svetskim okvirima uveliko meri milionima. Nasuprot svemu tome, sve snažniji i sve agresivniji anti-vakcinalni pokreti nastoje, različitim načinima, da argumentuju tezu da su ozbiljni neželjeni efekti vakcina toliko česti da čine aktivnu imunizaciju opasnijom od samih zaraznih bolesti od kojih je ona namenjena da nas zaštiti. Pristajanje velikog dela javnosti uz anti-vakcinalne stavove i opadanja broja redovno vakcinisanih osoba u mnogim sredinama može da izazove povratak nekih od najvećih pošasti čovečanstva. Ono što naročito zabrinjava, jeste veliki broj lekara i drugih zdravstvenih radnika koji antivakcinalnim pokretima pripadaju ili ih podstiču, uprkos tome što je (uz izvesne ograde) većina popularnih anti-vakcinalnih stavova ne samo suprotna usvojenim i utemeljenim saznanjima imunologije i nepotkrepljena naučnim istraživanjima, već uistinu i lišena racionalne osnove. Ključne riječi: vakcinacija, anti-vakcinalni pokret, naučna medicina UvodAktivna imunizacija (vakcinacija) je jedno od najdelotvornijih oruđa naučne medicine, čijom je primenom drastično suzbijeno (u slučaju velikih boginja do potpunog iskorenjivanja) mnoštvo zaraznih oboljenja koja su odnosila milione ljudskih života i/ ili često ostavljala trajne štetne posledice. Uvođenje redovne vakcinacije je, uz poboljšanje higijene i životnog standarda, u velikoj meri zaslužno za smanjenje stope smrtnosti dece sa preko 50%, koliko je tipično iznosila sve do poznog XIX veka, na manje od 0,1% koliko danas iznosi u zemljama Evrope [1]. Činjenica da je čovečanstvo kroz razvoj nauke i tehnologije, koji pre svega počiva na sve boljem razumevanju procesa koji se odigravaju u prirodi, steklo sposobnost da na opštu dobrobit iskoristi funkcionalne mehanizme imunskog sistema usavrša-vane milionima godina evolucije -imunsko pamćenje i moćni sekundarni imunski odgovor -rečito svedoči o pređenom putu i rasponu mogućnosti koje pruža naučna medicina. Na žalost, svaki korak na tom putu, još od pionirskih radova Edward Jenner-a i Louis Pasteur-a, bio je žučno osporavan, pogrešno shvatan i podvrgavan masovnom nepoverenju. To je čes-to rezultiralo oštrim otporima u sprovođenju aktivne imunizacije, prevashodno motivisanim iracional...

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Section: Vakcine I Imunitet: "Velika Tri" Argumentaunclassified

Anti-vakcinalni pokreti i naučna medicina

Janković

2014

Биомедицинска Истраживања

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“…Increases in the number of vaccines recommended for routine use and required for school attendance have contributed to parental concerns about vaccines. 16 This study was designed to 1) characterize the knowledge, attitudes, and beliefs (KABs) of school personnel who work with parents on immunization issues, 2) determine whether the KABs of school personnel are associated with the decision of parents to claim an exemption, and 3) identify the sources used by school personnel to obtain information about vaccines and the sources they consider credible for vaccine information.…”

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confidence: 99%

Knowledge, Attitudes, and Beliefs of School Nurses and Personnel and Associations With Nonmedical Immunization Exemptions

Salmon¹,

Moulton²,

Omer³

et al. 2004

Pediatrics

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ABSTRACT. Objectives. We studied school personnel involved in the review of student's immunization status to determine whether personnel training, immunizationrelated knowledge, attitudes, and beliefs, use of alternative medicine, and sources of vaccine information were associated with the vaccination status of school children.Methods. Surveys were mailed to a stratified and random sample of 1000 schools in Colorado, Massachusetts, Missouri, and Washington. School personnel reported their training and perceptions of disease susceptibility/ severity, vaccine efficacy/safety, key immunization beliefs, use of alternative medicine, confidence in organizations, sources, and credibility of vaccine information, and the rates of vaccine exemptors in their schools. Logistic regression analysis was used to explore associations between personnel factors and beliefs (independent variables) with the likelihood of a child having an exemption (dependent variable). Regression models were adjusted for clustering of children in schools, type of school (public versus private), and state.Results. Surveys were returned by 69.6% of eligible participants. A child attending a school with a respondent who was a nurse was significantly less likely to be have an exemption than a child attending a school with a respondent who was not a nurse (odds ratio There were significant associations between sources used and perception of reliability for vaccine information with the likelihood of a child in the school having an exemption. Use of professional organizations, government resources, vaccine companies, and pharmacists for vaccine information were associated with a decreased likelihood of a child in the school having an exemption. Perceiving health departments and the CDC as a good or excellent source for vaccine information was associated with a decreased likelihood of a child in the school having an exemption.[Conclusions. The training, knowledge, attitudes, and beliefs of school personnel who work with parents on immunization issues were associated with the likelihood of a child in the school having an exemption. Although respondents generally believed in vaccinations, misconceptions were common. Many school personnel seem to be unaware of the seriousness of some vaccine-preventable diseases and that unimmunized children are highly susceptible to diseases. These misperceptions were associated with an increased likelihood of a child having an exemption.This study of associations cannot determine causal associations. Nonetheless, the frequency of vaccine misconceptions among school personnel warrants vaccine communication programs for school employees who work with parents on immunization issues. An intervention study could determine whether such programs have an impact on parental decisions to claim exemptions for their children.Personnel without formal health care training who advice parents on immunization issues could be passing on misinformation to parents. Nurses or properly trained

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“…• decrease in the content of adjuvants, preservatives and stabilizers while using a combined vaccine comparing to application of several monovaccines; it reduces the risk of immunization reactions and complications [13]; • cost savings (the cost of one vaccine in the composition of a combined vaccine is less than the cost of a monovaccine); • reduction of the number of visits to a doctor, saving of the parents' time; • decrease of the emotional stress of the child; • more timely and complete fulfillment of the prophylactic immunization chart [17]; • reduction of the number of injections during the vaccination according to the National vaccination calendar. Thus, the use of combined vaccines allows to immunize a child in the first 18 months of life with 9-11 vaccinations while using monovaccines involves 14-17 vaccinations [7, 12, 18].…”

Section: Resultsmentioning

confidence: 99%