Chapter 116. Immunization Principles and Vaccine Use (Part 6)

Risk Assessment Vaccines are considered safe when the risk of use is judged to be acceptable in relation to the benefits. For vaccines given to healthy individuals for diseases that are no longer common, acceptable risks are set at very low levels—indeed, far lower than for most medical products. However, "safety" does not and cannot ever mean "zero risk." The determination of safety is thus based on a scientific assessment of the data and a considered judgment of all the issues involved, including benefits and risks. Communities and individuals may differ, both among themselves and from health care professionals,...
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Chapter 116. Immunization Principles and Vaccine Use (Part 6) Chapter 116. Immunization Principles and Vaccine Use (Part 6) Risk Assessment Vaccines are considered safe when the risk of use is judged to be acceptablein relation to the benefits. For vaccines given to healthy individuals for diseasesthat are no longer common, acceptable risks are set at very low levels—indeed, farlower than for most medical products. However, safety does not and cannot evermean zero risk. The determination of safety is thus based on a scientificassessment of the data and a considered judgment of all the issues involved,including benefits and risks. Communities and individuals may differ, both amongthemselves and from health care professionals, in how they perceive the risks,benefits, and acceptability of vaccines and in how they judge the amount ofuncertainty that is tolerable. Some parent advocacy groups, such as those thatoppose mandatory vaccination, feel that no amount of risk is acceptable, especiallyfor childhood vaccines. Sources of Immunization Recommendations Harmonized recommendations for vaccine use in the United States aredeveloped by several professional groups. Schedules for immunization of childrenand adolescents and of adults are shown in Figs. 116-1 and 116-2, respectively.Vaccines recommended for special use are shown in Table 116-2. Table 116-2 Special Vaccines for Infants, Children, and Adults Vacci Vacc Rou Indic Effi Adversene ine Type te of ations cacy Events Administr ation Anthra Inact SC For 90 No seriousx ivated (6 doses high risk of % adverse effects avirulent primary exposure antibody known plus annual (e.g., persons response; bacteria booster) in contact efficacy with or uncertain involved in manufacture of animal hides, furs, bone meal, wool, goat hair) and military risk of biowarfare exposure Tuber Live ID Not Var Regionalculosis bacteria generally iable for adenitis,(BCG) (attenuated recommende adult disseminated Mycobacter d in U.S. pulmonary BCG infection in ium bovis) because of TB; best immunocompromi low risk of used to sed hosts TB and preventinterference childhoodwith PPD TB,test meningitis , and Consi miliaryder for PPD- diseasenegativechildren inprolongedcontact withineffectivelytreated adultTB patientsor those withdrug-resistant TBand forhealth careworkers inhigh-risksettings. Not for immunosupp ressed individuals Choler Kille Oral Travel 60– Frequenta d whole ers to 85%, short fever and local bacteria endemic duration reactions, pain, areas; swelling however, not recommende d for use by U.S. citizens because of extremely low risk. Not available in the U.S.Plague ...