
[[Image:Flu Vaccine.jpg|thumb|right|250px|A bottle and a syringe containing the influenza vaccine.]] A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or ameliorate the effects of infection by any natural or 'wild' strain of the organism. The term derives from vaccinia, the infectious viral agent of cowpox, which, when administered to humans, provided them protection against smallpox. The process of ditributing and administrating vaccines is referred to as vaccination. ==Origin of vaccines== In 1796, during the heyday of the smallpox virus in Europe, an English country doctor, Edward Jenner, observed that milkmaids would sometimes become infected with cowpox, through their interactions with dairy cows' udders. Cowpox is a mild relative of the deadly smallpox virus. Building on the foundational practice of innoculation, Jenner took infectious fluid from the hand of milkmaid Sarah Nelmes. He inserted this fluid, by scratching or injection, into the arm of a healthy local eight year old boy, James Phipps. Phipps then showed symptoms of cowpox infection. Forty-eight days later, after Phipps had fully recovered from cowpox, Jenner injected smallpox-infected matter into Phipps, but Phipps did not later show signs of smallpox infection. ==Types of vaccines== Vaccines may be living, weakened strains of viruses or bacteria which intentionally give rise to inapparent-to-trivial infections. Vaccines may also be killed or inactivated organisms or purified products derived from them. There are three types of traditional vaccines[http://www.immunecentral.com/infotemplate.cfm-1702-72-1]: * Inactivated - these are previously virulent micro-organisms that have been killed with chemicals or heat. Examples are vaccines against flu, cholera, plague, and hepatitis A. Most such vaccines may have incomplete or short-lived immune responses and are likely to require booster shots. * Live, attenuated - these are live micro-organisms that have been cultivated under conditions to disable their virulent properties. They typically provoke durable immunological responses. Examples include yellow fever, measles, rubella, and mumps. * Toxoids - these are inactivated toxic compounds from micro-organisms in cases where these (rather than the micro-organism itself) causes illness. Examples of toxoid-based vaccines include tetanus and diphtheria The live tuberculosis vaccine is not the contagious TB strain, but a related strain called "Bacillus Calmette-Guérin"; it is used in the United States very infrequently. A number of innovative vaccines are also in development and also in use: * Conjugate - certain bacteria have outer coats that inexperienced immune systems don't recognize. By linking these unknown outer coats to proteins and toxins that reliably provoke an immune response the body, the immune system can begin to recognize and destroy the coated bacteria * Subunit - rather than introducing a whole inactivated or attenuated micro-organism to an immune system, a fragment of it can create an immune response * Recombinant Vector - by combining the physiology of one micro-organism and the DNA of the other, immunity can be created against diseases that have complex infection processes In recent years a new type of vaccine, created from an infectious agent's DNA called ''DNA vaccination'', has been developed. It works by insertion (and expression, triggering immune system recognition) into human or animal cells, of viral or bacterial DNA. These cells then develop immunity against an infectious agent, without the effects other parts of a weakened agent's DNA might have. As of 2003, DNA vaccination is still experimental, but shows some promising results. ==Developing immunity== The immune system recognizes vaccine agents as foreign, destroys them, and 'remembers' them. When the virulent version of an agent comes along, the immune system is thus prepared to respond, by (1) neutralizing the target agent before it can enter cells, and (2) by recognizing and destroying infected cells before that agent can multiply to vast numbers. Vaccines have contributed to the eradication of Smallpox, one of the most contagious and deadly diseases known to man. Other diseases such as rubella, polio, measles, mumps, chickenpox, and typhoid are no where near as common as they were just a hundred years ago. As long as the vast majority of people are vaccinated it is much more difficult for an outbreak of disease to occur, let alone spread. This effect is called herd immunity. ==Controversy surrounding the use of vaccines== ''See article: Vaccine controversy'' Opposition to vaccination, from a wide array of vaccine critics, has existed since the earliest vaccination campaigns: [http://bmj.bmjjournals.com/cgi/reprint/325/7361/430?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=anti-vaccinationists&andorexactfulltext=and&searchid=1113046719196_3655&stored_search=&FIRSTINDEX=0&sortspec=relevance&resourcetype=1,2,3,4]. Prior to 1997, a number of vaccines, including those given to very young children, used thimerosal, a preservative that metabolizes into ethylmercury. It is used in some influenza, DTP (diphtheria, tetanus and pertussis) vaccine formulations. In the late 1990s, controversy over vaccines escalated in both the US and the United Kingdom when a study, published in the respected journal ''Lancet'', by Andrew Wakefield suggested a possible link between bowel disorders, autism and MMR vaccine, and urged further research [http://briandeer.com/mmr/lancet-paper.htm]. His report garnered significant media attention, leading to a drop in the uptake of the MMR vaccine in the UK and some other countries. The study garnered criticism for its small sample size, and for failing to use healthy controls. In response to the controversies, a number of studies with larger sample sizes were conducted, and failed to confirm the findings.[http://bmj.bmjjournals.com/cgi/reprint/325/7361/419?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=vaccines+history+&andorexactfulltext=and&searchid=1113045633124_3161&stored_search=&FIRSTINDEX=0&sortspec=relevance&resourcetype=1,2,3,4] [http://bmj.bmjjournals.com/cgi/reprint/324/7334/393?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&author1=taylor%2C+b&author2=miller%2C+e&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1113249908936_21240&stored_search=&FIRSTINDEX=0&sortspec=relevance&resourcetype=1,2,3,4]. In 2004, 10 of the 13 authors of the original Wakefield study retracted the paper's interpretation, without disputing the central finding of a consistent set of bowel disorders among the autistic study subjects, stating the data were insufficient to establish a causal link between MMR vaccine and autism.[http://briandeer.com/mmr/lancet-retraction.htm] In 2004 and 2005, England and Wales have seen an increase in the incidence of mumps infections among adolescents and young adults, which health authorities attribute to a decline in booster shots from 92% to 80%, which they believe is due to the alleged misinformation generated by Wakefield's study [http://www.nzherald.co.nz/index.cfm?c_id=2&ObjectID=10125382]. Also in 2004, the United States' IOM reported that evidence "favors rejection" of any a link between vaccines containing thiomerosal, or MMR, and the development of autism [http://www.iom.edu/report.asp?id=20155]. ===Potential for adverse side effects in general=== Some people refuse to immunize themselves or their children, because they believe vaccines' adverse side effects outweigh their benefits. A variation of this reasoning is that not enough is known of the adverse effects to determine whether the potential benefits make the risks worthwhile. Since most people are vaccinated against contagious and potentially fatal diseases, the chances of someone who is not vaccinated becoming ill is a good deal smaller than it might be if their opinion was held by more people. Thus it could be argued that they reap some of the benefits of vaccines, through herd immunity, without assuming the risks those who choose to vaccinate do. Advocates of routine vaccination argue that side effects of approved vaccines are either far less serious than actually catching the disease, or are very rare, and argue that the calculus of risk/benefit ratio should be based on benefit to humanity rather than simply on the benefit to the immunized individual. The main risk of rubella, for example, is to the fetuses of pregnancy women, but this risk can be effectively reduced by the immunization of children to prevent transmission to pregnant women. ===Efficacy of vaccines=== It's worthwhile to note that vaccines don't guarantee that you are protected from the disease. That is, even having been vaccinated, there is still a remote possibility that you may get the disease. The efficacy or performance of the vaccine is dependent on a number of factors: * the disease itself (for some diseases vaccination performs better than for other diseases) * the strain of vaccine (some vaccinations are for different strains of the disease) [http://bmj.bmjjournals.com/cgi/content/full/319/7206/352] * whether you kept to the timetable for the vaccinations * perhaps other factors such as ethnicity or genetic predisposition If you have been vaccinated and do catch the disease, it's likely that it will be much milder than if you had not been vaccinated. ==Economics of vaccine development== One challenge in vaccine development is economic: many of the diseases most demanding a vaccine, including HIV, Malaria and Tuberculosis, exist principally in poor countries. Pharmaceutical firms and biotech companies have little incentive to develop vaccines for these diseases because there is so little revenue potential. Most vaccine development to date has relied on "push" funding by government and non-profit organizations, of government agencies, universities and non-profit organizations. To date, there has been very little involvement of private industry on a commercial basis. Many researchers and policymakers are calling for a different approach, using "pull" mechanisms to motivate industry. Mechanisms such as prizes, tax credits, or advance market commitments could ensure a financial return to firms that successfully developed an HIV vaccine. If the policy were well-designed, it might also ensure that people have access to a vaccine if and when it is developed. ==See also== *AIDS vaccine *Edward Jenner *genetics *iatrogenesis *immunization *immunology *inoculation *medicine *Timeline of vaccines *vaccination *Vaccines and Fetal Tissue ==External links== * [http://pediatrics.aappublications.org/cgi/content/full/112/3/604 AAPPublications.org] - 'Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data' ''Pediatrics'', Vol 112, No 3, September 2003 (Danish study showing continued increase in autism after discontinuation of MMR vaccine thimerosal formulations) * [http://bmj.bmjjournals.com/cgi/content/full/319/7206/352 bmj.bmjjournals.com] - 'Comparative efficacy of three mumps vaccines', Matthias Schlegel, Joseph J. Osterwalder, Renato L. Galeazzi, Pietro J. Vernazza, ''British Medical Journal''' Vol 319, No 352, August 7, 1999 * [http://briandeer.com/mmr/lancet-paper.htm BrianDeer.com] - 'Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children' Andrew Wakefield, et al., The ''Lancet'', Vol 351, No 9103, February 28, 1998 * [http://blogs.cgdev.org/vaccine CGDev.org] - Center for Global Development: 'Vaccines for Development' (updated regularly) * [http://clearlyexplained.com/technology/health/vaccines.html ClearlyExplained.com] - 'Vaccines - ClearlyExplained.com', Richard Conan-Davies, BSc Dip Ed (October 22, 2001) * [http://www.iom.edu/Object.File/Master/19/029/0.pdf IOM.edu (pdf)] - 'Before the Institute of Medicine' (statement on link between thimerosol and autism), US Congressman Dave Weldon, M.D., (February 9, 2004) * [http://www.jpands.org/vol8no1/geier.pdf JPandS.org (pdf)] - 'Thimerosal in Childhood Vaccines, Neurodevelopment Disorders, and Heart Disease in the United States', Mark Geier, M.D., Ph.D., and David Geier, B.A., ''Journal of American Physicians and Surgeons'', Vol 8, No 1, Spring, 2003 * [http://www.imss.macrobiotic.net/vaccinehistory.html MacroBiotic.net] - 'A Short History of Vaccines' * [http://www.nlm.nih.gov/medlineplus/immunizationvaccination.html NIH.gov] - 'Immunization' ('conventional' opinion on vaccines from National Intitutes of Health) * [http://www.novaccine.com NoVaccine.com] - 'The American Vaccine Information Directory' (AVID), Dr. Dan Schultz * [http://www.truthcampaign.ukf.net/articles/health/vaccination.html TruthCampaign.ukf.net] - 'Vaccination Assault on the Human Species', Pat Rattigan, ND Virology Infectious diseases th:วัคซีน
What about use of the avian leukemia virus to manufacture vaccinations in chicken eggs and then the subsequent vaccine allergies associated with people who are allergic to eggs? ----- "Despite the lck of evidence". *Snort* What suddenly makes mercury utterly harmless just because "Thimerosal" has been written on a label? I do wish folx like the FDA would treat their pharmochemicals with as much skepticism as they try to instill in us about medicines they can't make money on. :I'm sorry, this is just silly. It's based on a common misunderstanding. Thimerosal contains mercury in the same way that table salt contains chlorine. Chlorine is a poisonous gas used during the First World War as a chemical agent to kill or disable enemy troops. :Evidence that chlorine is dangerous doesn't mean that table salt is dangerous. To discover the dangers of salt you need to study salt, not chlorine! To discover the dangers of thimerosal, study thimerosal, not mercury. Nothing 'suddenly makes mercury utterly harmless', but nobody has ''claimed'' mercury to be safe. It's poisonous by ingestion and by breathing its vapour. But Thimerosal is ''not'' mercury! (User:Chrisjj, 6th December 2003) ::So how come those who are looking at the the long-term effects of Thimerosal - ie "studying" it - and finding things you don't like, aren't looking at "evidence"? Why are they wrong, and not the politicised FDA (you think it's apolitical? Explain its tantrum about Canadian drugs)? I know perfectly well the difference between elements and their compounds - but we're not talking about an ionic compound essential to life as we know it. What's the proof this ''heavy metal'' has a bond in thimerosal strong enough to carry the Hg all the way through metabolism to excretion without side effects, esp and particularly in the several large per-body-mass doses given the developmentally sensitive very young? (I remind you that what little pharmochemical testing is done is in the main done in adults, not children, even in products targeted for children?) Your analogy with salt is as facile and misleading as that made by MSG lovers who say it's on the GRAS list, so are salt and vinegar so it must be safe (w/o regard for the scientifically dubious process by which the GRAS is maintained). ::Thimerosal ''may'' be safe. But there're enough historical failings and worse by things like the FDA that I, personally, no longer trust authoritarian pronouncements. I want empirical science. I don't ''know'' if the rise in asthma, autism, "hyperactivity", etc are caused by inoculants, or the preservatives, or the pollution, or food additives, or leachates from the containers, or growth hormones, or TV, or the combination. But I see no good evidence anointed "proper authorities" are bothering to look or even "want" to look. ::(And be careful writing (parroting?) phrases like "lack of evidence." I snicker every time i hear pronouncements about "lack of evidence" because a second look usually reveals there's no evidence because nobody's bothered to look for evidence. "Lack of evidence" is not equivalent to "null results.") ::What I'm asking for, of course, is long-term blind large-sample science. It's unfortunate that the only way to get that for pharmochemicals like Thimerosal is to dump them on the market and watch what happens. Unfortunate, because it's treating people as guinea pigs instead of informed-consent patients, and because when contraindications do turn up the entities in charge of approving the release in the first place have every practical motive run ''contrary'' to telling the truth. :I stand by what I wrote, 'To discover the dangers of thimerosal, study thimerosal'; and most of your comment above agrees with that. Whether I (or you) 'like' the findings is not relevant - if studies of thimerosal show it to be unsafe then we all need to know. But to write, as you did, 'What suddenly makes mercury utterly harmless just because "Thimerosal" has been written on a label?', is silly. I don't believe anyone has claimed mercury to be safe because the word 'thimerosal' is written on a label! Please try to be more rational and people may take you more seriously. (User:Chrisjj, 11th December 2003) ===Autism=== The MMR vacine has never contained thimerosal. It would not work if it did. While you could claim that thimerosal contains ethly mercury you can see from it's structure[http://www.hc-sc.gc.ca/pphb-dgspsp/publicat/ccdr-rmtc/02vol28/images/2809fg1.gif] that it contains a phenyl ring and a carboxcilic acid salt. It's like claiming polystyrene contians benzene. *smacks forehead* Yeah, I meant the DTP (Diphtheria Pertussis) vaccine, which DID contain thimerasol until the FDA revised their Mercury Containing Products act sometime in the late 1997. The MMR vaccine is supposedly immune-regulated. This is what happens when I "be bold" like they say in the help texts. *grins sheepishly* All of the largest studies (which contain over 10,000 patients each) shows no statistical evidence supporting any vaccines causing autism. The supporting studies for the vaccines and autism have fewer than 1,000 (and in most cases, only a dozen or so) patients, and even then the link is tenuous at best. The real issue, I feel, and this is in no way related to the article, is the changing relationships between doctor and patient, especially when it deals with consent. In many ways, this controversy is similar to the circumcision debate: Should we, as parents, allow doctors to do these things to our kids just because they say so? The answer, of course, is that measles, mumps, diphtheria and a whole host of other diseases used to be the most common cause of death among those in developed nations. Now it's heart disease and cancer. It's a calculated risk, to be sure, but it's one that should be provided by informed choice, with doctors as counselors and information providers, rather than as authority figures. Of course, with multiple sources of information (the media, anti-vaccination groups, family magazines) other than the medical community, parenting decisions certainly ain't easy anymore. == Cleanup == I have gone through and removed the following from this article because it was either not npov, to specific for a general article on vaccines. User:*Kat* 08:04, Mar 30, 2005 (UTC) :Intro :Vaccines may also help the immune system to fight against degenerative cells (cancer). :Developing Immunity :More recent vaccine technologies have provided vaccines made of highly purified antigen components derived from the pathogens themselves (e.g., pertussis) or through recombinant DNA technology producing such antigens in yeast or mammalian cell cultures (e.g., hepatitis B), as well as conjugate vaccines that chemically bond "weak" antigens such as bacterial polysaccharides (complex sugars found in a "capsule" that surrounds a bacterium; they are usually specific to a bacterial serotype) to carrier proteins that yield a better, longer lasting immune response than is seen with the polysaccharide antigens alone (e.g., meningococcal and pneumococcal vaccines). I removed this because I thought that it was too technical as well as too convoluted. There was also another paragraph that said almost exactly the same thing (in simpler language). After doing some research (to translate the above paragraph) I more or less combined the two. The second, \"simple\" paragraph was left almost intact with a few things from the above paragraph included. Smallpox, for example, appears to have been completely eliminated in the wild. This had already been stated earlier in the article :==Smallpox== :Vaccination against smallpox is an especially contentious issue. Dissenters suggest modern vaccines might result in developmental disorders, and suggest that infections in the past (as in the small vaccinia outbreak in England in 1961) were more lethal and/or were spread in greater proportion, among those who were vaccinated. They contend that improved sanitation and nutrition, not vaccine, account for most of the reduction in smallpox. Inoculation proponents dispute these allegations, while still recognizing the fact that the current vaccine has risks. As the current risk of the disease (barring germ warfare) is effectively zero, routine smallpox vaccination has not been recommended for many years. '''I removed this because it veer's off topic. The article is about vaccines in general, not the small pox vaccine in particular. ::The threat from smallpox as a biological weapon has, however, caused a reconsideration, though not a reversal, of this position. A 2003 US vaccination effort was unpopular. There was poor turnout among hospital staff who were designated to be the first to receive the vaccine. In addition to the known risks of the vaccine, several deaths were reported from cardiac causes among the immunized, suggesting that people with coronary artery disease might be at risk. Development of newer formulations that might avoid the newly discovered risks is underway. Illinois and New York suspended the program pending investigation of the apparent vaccine deaths of two healthcare workers (the main focus of the program). The California Nurses Association opposed the effort from the start.[http://rense.com/general36/poxx.htm][http://www.usatoday.com/news/health/2003-10-15-smallpox_x.htm] Again, I think this is too specific for a general article on vaccines. There is an article on the Smallpox vaccine, perhaps it could be incorporated there. :Vaccination against smallpox is an especially contentious issue. Dissenters suggest modern vaccines might result in developmental disorders, and suggest that infections in the past (as in the small vaccinia outbreak in England in 1961) were more lethal and/or were spread in greater proportion, among those who were vaccinated. They contend that improved sanitation and nutrition, not vaccine, account for most of the reduction in smallpox. Inoculation proponents dispute these allegations, while still recognizing the fact that the current vaccine has risks. As the current risk of the disease (barring germ warfare) is effectively zero, routine smallpox vaccination has not been recommended for many years. The possibility of smallpox being used as a biological weapon in the United States prompted the U.S. government to authorize the manufacture and injection of smallpox vaccine. Due to the number of deaths that resulted, the project has been discontinued. With the exception of the last sentence (which I wrote trying to make the paragraph relevant) this paragraph is about ''vaccinations'' :The threat from smallpox as a biological weapon has, however, caused a reconsideration, though not a reversal, of this position. A 2003 US vaccination effort was unpopular. There was poor turnout among hospital staff who were designated to be the first to receive the vaccine. In addition to the known risks of the vaccine, several deaths were reported from cardiac causes among the immunized, suggesting that people with coronary artery disease might be at risk. Development of newer formulations that might avoid the newly discovered risks is underway. Illinois and New York suspended the program pending investigation of the apparent vaccine deaths of two healthcare workers (the main focus of the program). The California Nurses Association opposed the effort from the start.[http://rense.com/general36/poxx.htm][http://www.usatoday.com/news/health/2003-10-15-smallpox_x.htm] This is about the smallpox vaccine''' :''Controversy''' :Some groups in the United States claimed a link due to a preservative called thimerosal. Thimerosal is a preservative that contains Mercury (element). It was (and in some cases still is) used in some DTP (diphtheria, tetanus and pertussis) vaccine formulations. http://www.truthout.org/issues_05/032305EA.shtml| :under the 1997 FDA Modernization Act. In its report of October 1, 2001, the IOM (IOM) Immunization Safety Review Committee concluded that the evidence is inadequate to either accept or reject a causal relationship between thimerosal exposure from childhood vaccines and autism. In a further report, of May 2004 [http://www.iom.edu/report.asp?id=20155] The reason why I removed this is because the 2004 report (mentioned in article) rendered this 2001 report moot. :A second, parallel, controversy arose in the United Kingdom over the vaccine for measles, mumps, and rubella (MMR), another vaccine that is routinely administered to children under the age of 2 in developed nations, but which contains no preservative. A possible link to autism came to the forefront when in 1998, [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9500320 Wakefield and colleagues] reviewed reports of children with bowel symptoms and regressive developmental disorders, mostly autism, in a small sample of 12 children. The study was criticized for its small sample size, and for failing to use healthy controls. In 2004, 10 of the 13 authors of the original Wakefield study retracted the paper's interpretation, stating that the data were insufficient to establish a causal link between MMR vaccine and autism. This followed an investigation by Brian Deer for the London Sunday Times, who reported that Wakefield had links to lawyers hoping to sue the vaccines' manufacturers [http://briandeer.com/mmr-lancet.htm]. Further allegations were made by Deer in a UK television documentary, MMR: What They Didn't Tell You, first broadcast in November 2004 [http://briandeer.com/wakefield-deer.htm]. '''Since this said almost the same thing as the paragraph on the US's vaccine related controversy I more or less combined the two and did my best to make the end result more readable without changing the intent of either paragraph. :In response to the US and UK controversies, which closely mirror the framing of litigation in the two countries, a number of studies with large sample sizes were researched in many developed nations. These studies have sparked criticism over conflicts of interest, which has even been expressed by at least two Republican congressmen in the US, Dan Burton [http://www.house.gov/burton/autism.htm] and Dave Weldon[http://www.autisminfo.com/WeldonAutismOne2004.htm]. The majority of those studies, funded primarily by pharmaceutical interests, showed no correlation between the use of vaccines (including the MMR vaccine) and increased autism: - * [http://pediatrics.aappublications.org/cgi/content/full/114/3/584 \"Thimerosal Exposure in Infants and Developmental Disorders: A Retrospective Cohort Study in the United Kingdom Does Not Support a Causal Association\" PEDIATRICS Vol. 114 No. 3 September 2004] * [http://pediatrics.aappublications.org/cgi/content/full/113/2/259 \"Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta\" PEDIATRICS Vol. 113 No. 2 February 2004] * [http://pediatrics.aappublications.org/cgi/content/full/112/3/604 \"Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data\" PEDIATRICS Vol. 112 No. 3 September 2003] - This study shows an increase in autism after the discontinuation of the thimerosal formulations of the MMR vaccine in the Danish population. * [http://www.nih.go.jp/JJID/56/114.html \"An Epidemiological Study on Japanese Autism concerning Routine Childhood Immunization History\" Jpn. J. Infect. Dis., 56, 114-117, 2003] reincorporated in a [more] neutral form and as a result, I removed this line: ''The study also garnered criticism for its small sample size, and for failing to use healthy controls.'' A couple of the links have been placed in the External links section as well. :The autism controversy highlights several issues pertaining to public health, biology science, medical ethics standards, and the medical community. First, it beckons greater attention to the value of large-scale, case-controlled scientific studies in proving or disproving a hypothesis (in this case, a link between autism and vaccines). Secondly, it demonstrates both the importance of medical professionals having the most solid and up-to-date information and the importance of communicating this information in a clear and unbiased fashion to patients. Thirdly, it suggests a possible need to change the role of the medical community, from authoritarian wardens to counselors who provide informed choices, which might influence evolution of the doctor-patient relationship to become more of a partnership. Lastly, it emphasizes how medical issues involve all aspects of modern culture and society, including the media, the affected families, and the scientific community at large. Seriously POV, but I'm not enough of an expert to make it NPOV :External links''' :* [http://briandeer.com/mmr-lancet.htm BrianDeer.com] - Brian Deer's denunciation of MMR study by Dr. Andrew Wakefield :- * [http://www.nationalautismassociation.org/library.php NationalAutismAssociation.org] - NAA library of pdf files :- * [http://www.nlm.nih.gov/medlineplus/immunizationvaccination.html NIH.gov] - National Intitutes of Health :- * [http://www.ratbags.com/rsoles/vaxliars1.htm RatBags.com] - Anti-vaccination Liars :- * :- * [http://www.whale.to/vaccines.html whale.to] - an Anti-vaccination website == Durability of inactivated vaccines == On Immune Central[http://www.immunecentral.com/infotemplate.cfm-1702-72-1], the entry on inactivated vaccines states that: :However, most inactivated vaccines stimulate a relatively weak immune response and must be given more than once. A vaccine that requires several doses (boosters) has a limited usefulness, especially in areas where people have less access to regular health care. So why did Geni see fit to take that caveat out? I'm putting it back in. --User:Leifern 18:13, 2005 Apr 15 (UTC) :The word "most"? You made an absolute statement. I know there are exceptions.User:Geni 18:17, 15 Apr 2005 (UTC) ::a) Most does not mean "all." B) Then edit the statement rather than take it out. --User:Leifern 18:20, 2005 Apr 15 (UTC) ::Now I get it - "may" means "not necessarily" or "not always" which makes a statement such as "You may experience dizziness" equivalent to "some people will experience dizziness." Strictly speaking, "most people may experience dizziness" is a meaningless statement, since it implies that a minority of people definitely will not experience dizziness. But it's a common way to hedge, so I don't have any objections to the way it is now. --User:Leifern 18:48, 2005 Apr 15 (UTC)
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[[Image:Flu Vaccine.jpg|thumb|right|250px|A bottle and a syringe containing the influenza vaccine.]] A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or ameliorate the effects of infection by any natural or 'wild' strain of the organism. The term derives from vaccinia, the infectious viral agent of cowpox, which, when administered to humans, provided them protection against smallpox. The process of ditributing and administrating vaccines is referred to as vaccination. ==Origin of vaccines== In 1796, during the heyday of the smallpox virus in Europe, an English country doctor, Edward Jenner, observed that milkmaids would sometimes become infected with cowpox, through their interactions with dairy cows' udders. Cowpox is a mild relative of the deadly smallpox virus. Building on the foundational practice of innoculation, Jenner took infectious fluid from the hand of milkmaid Sarah Nelmes. He inserted this fluid, by scratching or injection, into the arm of a healthy local eight year old boy, James Phipps. Phipps then showed symptoms of cowpox infection. Forty-eight days later, after Phipps had fully recovered from cowpox, Jenner injected smallpox-infected matter into Phipps, but Phipps did not later show signs of smallpox infection. ==Types of vaccines== Vaccines may be living, weakened strains of viruses or bacteria which intentionally give rise to inapparent-to-trivial infections. Vaccines may also be killed or inactivated organisms or purified products derived from them. There are three types of traditional vaccines[http://www.immunecentral.com/infotemplate.cfm-1702-72-1]: * Inactivated - these are previously virulent micro-organisms that have been killed with chemicals or heat. Examples are vaccines against flu, cholera, plague, and hepatitis A. Most such vaccines may have incomplete or short-lived immune responses and are likely to require booster shots. * Live, attenuated - these are live micro-organisms that have been cultivated under conditions to disable their virulent properties. They typically provoke durable immunological responses. Examples include yellow fever, measles, rubella, and mumps. * Toxoids - these are inactivated toxic compounds from micro-organisms in cases where these (rather than the micro-organism itself) causes illness. Examples of toxoid-based vaccines include tetanus and diphtheria The live tuberculosis vaccine is not the contagious TB strain, but a related strain called "Bacillus Calmette-Guérin"; it is used in the United States very infrequently. A number of innovative vaccines are also in development and also in use: * Conjugate - certain bacteria have outer coats that inexperienced immune systems don't recognize. By linking these unknown outer coats to proteins and toxins that reliably provoke an immune response the body, the immune system can begin to recognize and destroy the coated bacteria * Subunit - rather than introducing a whole inactivated or attenuated micro-organism to an immune system, a fragment of it can create an immune response * Recombinant Vector - by combining the physiology of one micro-organism and the DNA of the other, immunity can be created against diseases that have complex infection processes In recent years a new type of vaccine, created from an infectious agent's DNA called ''DNA vaccination'', has been developed. It works by insertion (and expression, triggering immune system recognition) into human or animal cells, of viral or bacterial DNA. These cells then develop immunity against an infectious agent, without the effects other parts of a weakened agent's DNA might have. As of 2003, DNA vaccination is still experimental, but shows some promising results. ==Developing immunity== The immune system recognizes vaccine agents as foreign, destroys them, and 'remembers' them. When the virulent version of an agent comes along, the immune system is thus prepared to respond, by (1) neutralizing the target agent before it can enter cells, and (2) by recognizing and destroying infected cells before that agent can multiply to vast numbers. Vaccines have contributed to the eradication of Smallpox, one of the most contagious and deadly diseases known to man. Other diseases such as rubella, polio, measles, mumps, chickenpox, and typhoid are no where near as common as they were just a hundred years ago. As long as the vast majority of people are vaccinated it is much more difficult for an outbreak of disease to occur, let alone spread. This effect is called herd immunity. ==Controversy surrounding the use of vaccines== ''See article: Vaccine controversy'' Opposition to vaccination, from a wide array of vaccine critics, has existed since the earliest vaccination campaigns: [http://bmj.bmjjournals.com/cgi/reprint/325/7361/430?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=anti-vaccinationists&andorexactfulltext=and&searchid=1113046719196_3655&stored_search=&FIRSTINDEX=0&sortspec=relevance&resourcetype=1,2,3,4]. Prior to 1997, a number of vaccines, including those given to very young children, used thimerosal, a preservative that metabolizes into ethylmercury. It is used in some influenza, DTP (diphtheria, tetanus and pertussis) vaccine formulations. In the late 1990s, controversy over vaccines escalated in both the US and the United Kingdom when a study, published in the respected journal ''Lancet'', by Andrew Wakefield suggested a possible link between bowel disorders, autism and MMR vaccine, and urged further research [http://briandeer.com/mmr/lancet-paper.htm]. His report garnered significant media attention, leading to a drop in the uptake of the MMR vaccine in the UK and some other countries. The study garnered criticism for its small sample size, and for failing to use healthy controls. In response to the controversies, a number of studies with larger sample sizes were conducted, and failed to confirm the findings.[http://bmj.bmjjournals.com/cgi/reprint/325/7361/419?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=vaccines+history+&andorexactfulltext=and&searchid=1113045633124_3161&stored_search=&FIRSTINDEX=0&sortspec=relevance&resourcetype=1,2,3,4] [http://bmj.bmjjournals.com/cgi/reprint/324/7334/393?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&author1=taylor%2C+b&author2=miller%2C+e&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1113249908936_21240&stored_search=&FIRSTINDEX=0&sortspec=relevance&resourcetype=1,2,3,4]. In 2004, 10 of the 13 authors of the original Wakefield study retracted the paper's interpretation, without disputing the central finding of a consistent set of bowel disorders among the autistic study subjects, stating the data were insufficient to establish a causal link between MMR vaccine and autism.[http://briandeer.com/mmr/lancet-retraction.htm] In 2004 and 2005, England and Wales have seen an increase in the incidence of mumps infections among adolescents and young adults, which health authorities attribute to a decline in booster shots from 92% to 80%, which they believe is due to the alleged misinformation generated by Wakefield's study [http://www.nzherald.co.nz/index.cfm?c_id=2&ObjectID=10125382]. Also in 2004, the United States' IOM reported that evidence "favors rejection" of any a link between vaccines containing thiomerosal, or MMR, and the development of autism [http://www.iom.edu/report.asp?id=20155]. ===Potential for adverse side effects in general=== Some people refuse to immunize themselves or their children, because they believe vaccines' adverse side effects outweigh their benefits. A variation of this reasoning is that not enough is known of the adverse effects to determine whether the potential benefits make the risks worthwhile. Since most people are vaccinated against contagious and potentially fatal diseases, the chances of someone who is not vaccinated becoming ill is a good deal smaller than it might be if their opinion was held by more people. Thus it could be argued that they reap some of the benefits of vaccines, through herd immunity, without assuming the risks those who choose to vaccinate do. Advocates of routine vaccination argue that side effects of approved vaccines are either far less serious than actually catching the disease, or are very rare, and argue that the calculus of risk/benefit ratio should be based on benefit to humanity rather than simply on the benefit to the immunized individual. The main risk of rubella, for example, is to the fetuses of pregnancy women, but this risk can be effectively reduced by the immunization of children to prevent transmission to pregnant women. ===Efficacy of vaccines=== It's worthwhile to note that vaccines don't guarantee that you are protected from the disease. That is, even having been vaccinated, there is still a remote possibility that you may get the disease. The efficacy or performance of the vaccine is dependent on a number of factors: * the disease itself (for some diseases vaccination performs better than for other diseases) * the strain of vaccine (some vaccinations are for different strains of the disease) [http://bmj.bmjjournals.com/cgi/content/full/319/7206/352] * whether you kept to the timetable for the vaccinations * perhaps other factors such as ethnicity or genetic predisposition If you have been vaccinated and do catch the disease, it's likely that it will be much milder than if you had not been vaccinated. ==Economics of vaccine development== One challenge in vaccine development is economic: many of the diseases most demanding a vaccine, including HIV, Malaria and Tuberculosis, exist principally in poor countries. Pharmaceutical firms and biotech companies have little incentive to develop vaccines for these diseases because there is so little revenue potential. Most vaccine development to date has relied on "push" funding by government and non-profit organizations, of government agencies, universities and non-profit organizations. To date, there has been very little involvement of private industry on a commercial basis. Many researchers and policymakers are calling for a different approach, using "pull" mechanisms to motivate industry. Mechanisms such as prizes, tax credits, or advance market commitments could ensure a financial return to firms that successfully developed an HIV vaccine. If the policy were well-designed, it might also ensure that people have access to a vaccine if and when it is developed. ==See also== *AIDS vaccine *Edward Jenner *genetics *iatrogenesis *immunization *immunology *inoculation *medicine *Timeline of vaccines *vaccination *Vaccines and Fetal Tissue ==External links== * [http://pediatrics.aappublications.org/cgi/content/full/112/3/604 AAPPublications.org] - 'Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data' ''Pediatrics'', Vol 112, No 3, September 2003 (Danish study showing continued increase in autism after discontinuation of MMR vaccine thimerosal formulations) * [http://bmj.bmjjournals.com/cgi/content/full/319/7206/352 bmj.bmjjournals.com] - 'Comparative efficacy of three mumps vaccines', Matthias Schlegel, Joseph J. Osterwalder, Renato L. Galeazzi, Pietro J. Vernazza, ''British Medical Journal''' Vol 319, No 352, August 7, 1999 * [http://briandeer.com/mmr/lancet-paper.htm BrianDeer.com] - 'Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children' Andrew Wakefield, et al., The ''Lancet'', Vol 351, No 9103, February 28, 1998 * [http://blogs.cgdev.org/vaccine CGDev.org] - Center for Global Development: 'Vaccines for Development' (updated regularly) * [http://clearlyexplained.com/technology/health/vaccines.html ClearlyExplained.com] - 'Vaccines - ClearlyExplained.com', Richard Conan-Davies, BSc Dip Ed (October 22, 2001) * [http://www.iom.edu/Object.File/Master/19/029/0.pdf IOM.edu (pdf)] - 'Before the Institute of Medicine' (statement on link between thimerosol and autism), US Congressman Dave Weldon, M.D., (February 9, 2004) * [http://www.jpands.org/vol8no1/geier.pdf JPandS.org (pdf)] - 'Thimerosal in Childhood Vaccines, Neurodevelopment Disorders, and Heart Disease in the United States', Mark Geier, M.D., Ph.D., and David Geier, B.A., ''Journal of American Physicians and Surgeons'', Vol 8, No 1, Spring, 2003 * [http://www.imss.macrobiotic.net/vaccinehistory.html MacroBiotic.net] - 'A Short History of Vaccines' * [http://www.nlm.nih.gov/medlineplus/immunizationvaccination.html NIH.gov] - 'Immunization' ('conventional' opinion on vaccines from National Intitutes of Health) * [http://www.novaccine.com NoVaccine.com] - 'The American Vaccine Information Directory' (AVID), Dr. Dan Schultz * [http://www.truthcampaign.ukf.net/articles/health/vaccination.html TruthCampaign.ukf.net] - 'Vaccination Assault on the Human Species', Pat Rattigan, ND Virology Infectious diseases th:วัคซีน
Vaccine
What about use of the avian leukemia virus to manufacture vaccinations in chicken eggs and then the subsequent vaccine allergies associated with people who are allergic to eggs? ----- "Despite the lck of evidence". *Snort* What suddenly makes mercury utterly harmless just because "Thimerosal" has been written on a label? I do wish folx like the FDA would treat their pharmochemicals with as much skepticism as they try to instill in us about medicines they can't make money on. :I'm sorry, this is just silly. It's based on a common misunderstanding. Thimerosal contains mercury in the same way that table salt contains chlorine. Chlorine is a poisonous gas used during the First World War as a chemical agent to kill or disable enemy troops. :Evidence that chlorine is dangerous doesn't mean that table salt is dangerous. To discover the dangers of salt you need to study salt, not chlorine! To discover the dangers of thimerosal, study thimerosal, not mercury. Nothing 'suddenly makes mercury utterly harmless', but nobody has ''claimed'' mercury to be safe. It's poisonous by ingestion and by breathing its vapour. But Thimerosal is ''not'' mercury! (User:Chrisjj, 6th December 2003) ::So how come those who are looking at the the long-term effects of Thimerosal - ie "studying" it - and finding things you don't like, aren't looking at "evidence"? Why are they wrong, and not the politicised FDA (you think it's apolitical? Explain its tantrum about Canadian drugs)? I know perfectly well the difference between elements and their compounds - but we're not talking about an ionic compound essential to life as we know it. What's the proof this ''heavy metal'' has a bond in thimerosal strong enough to carry the Hg all the way through metabolism to excretion without side effects, esp and particularly in the several large per-body-mass doses given the developmentally sensitive very young? (I remind you that what little pharmochemical testing is done is in the main done in adults, not children, even in products targeted for children?) Your analogy with salt is as facile and misleading as that made by MSG lovers who say it's on the GRAS list, so are salt and vinegar so it must be safe (w/o regard for the scientifically dubious process by which the GRAS is maintained). ::Thimerosal ''may'' be safe. But there're enough historical failings and worse by things like the FDA that I, personally, no longer trust authoritarian pronouncements. I want empirical science. I don't ''know'' if the rise in asthma, autism, "hyperactivity", etc are caused by inoculants, or the preservatives, or the pollution, or food additives, or leachates from the containers, or growth hormones, or TV, or the combination. But I see no good evidence anointed "proper authorities" are bothering to look or even "want" to look. ::(And be careful writing (parroting?) phrases like "lack of evidence." I snicker every time i hear pronouncements about "lack of evidence" because a second look usually reveals there's no evidence because nobody's bothered to look for evidence. "Lack of evidence" is not equivalent to "null results.") ::What I'm asking for, of course, is long-term blind large-sample science. It's unfortunate that the only way to get that for pharmochemicals like Thimerosal is to dump them on the market and watch what happens. Unfortunate, because it's treating people as guinea pigs instead of informed-consent patients, and because when contraindications do turn up the entities in charge of approving the release in the first place have every practical motive run ''contrary'' to telling the truth. :I stand by what I wrote, 'To discover the dangers of thimerosal, study thimerosal'; and most of your comment above agrees with that. Whether I (or you) 'like' the findings is not relevant - if studies of thimerosal show it to be unsafe then we all need to know. But to write, as you did, 'What suddenly makes mercury utterly harmless just because "Thimerosal" has been written on a label?', is silly. I don't believe anyone has claimed mercury to be safe because the word 'thimerosal' is written on a label! Please try to be more rational and people may take you more seriously. (User:Chrisjj, 11th December 2003) ===Autism=== The MMR vacine has never contained thimerosal. It would not work if it did. While you could claim that thimerosal contains ethly mercury you can see from it's structure[http://www.hc-sc.gc.ca/pphb-dgspsp/publicat/ccdr-rmtc/02vol28/images/2809fg1.gif] that it contains a phenyl ring and a carboxcilic acid salt. It's like claiming polystyrene contians benzene. *smacks forehead* Yeah, I meant the DTP (Diphtheria Pertussis) vaccine, which DID contain thimerasol until the FDA revised their Mercury Containing Products act sometime in the late 1997. The MMR vaccine is supposedly immune-regulated. This is what happens when I "be bold" like they say in the help texts. *grins sheepishly* All of the largest studies (which contain over 10,000 patients each) shows no statistical evidence supporting any vaccines causing autism. The supporting studies for the vaccines and autism have fewer than 1,000 (and in most cases, only a dozen or so) patients, and even then the link is tenuous at best. The real issue, I feel, and this is in no way related to the article, is the changing relationships between doctor and patient, especially when it deals with consent. In many ways, this controversy is similar to the circumcision debate: Should we, as parents, allow doctors to do these things to our kids just because they say so? The answer, of course, is that measles, mumps, diphtheria and a whole host of other diseases used to be the most common cause of death among those in developed nations. Now it's heart disease and cancer. It's a calculated risk, to be sure, but it's one that should be provided by informed choice, with doctors as counselors and information providers, rather than as authority figures. Of course, with multiple sources of information (the media, anti-vaccination groups, family magazines) other than the medical community, parenting decisions certainly ain't easy anymore. == Cleanup == I have gone through and removed the following from this article because it was either not npov, to specific for a general article on vaccines. User:*Kat* 08:04, Mar 30, 2005 (UTC) :Intro :Vaccines may also help the immune system to fight against degenerative cells (cancer). :Developing Immunity :More recent vaccine technologies have provided vaccines made of highly purified antigen components derived from the pathogens themselves (e.g., pertussis) or through recombinant DNA technology producing such antigens in yeast or mammalian cell cultures (e.g., hepatitis B), as well as conjugate vaccines that chemically bond "weak" antigens such as bacterial polysaccharides (complex sugars found in a "capsule" that surrounds a bacterium; they are usually specific to a bacterial serotype) to carrier proteins that yield a better, longer lasting immune response than is seen with the polysaccharide antigens alone (e.g., meningococcal and pneumococcal vaccines). I removed this because I thought that it was too technical as well as too convoluted. There was also another paragraph that said almost exactly the same thing (in simpler language). After doing some research (to translate the above paragraph) I more or less combined the two. The second, \"simple\" paragraph was left almost intact with a few things from the above paragraph included. Smallpox, for example, appears to have been completely eliminated in the wild. This had already been stated earlier in the article :==Smallpox== :Vaccination against smallpox is an especially contentious issue. Dissenters suggest modern vaccines might result in developmental disorders, and suggest that infections in the past (as in the small vaccinia outbreak in England in 1961) were more lethal and/or were spread in greater proportion, among those who were vaccinated. They contend that improved sanitation and nutrition, not vaccine, account for most of the reduction in smallpox. Inoculation proponents dispute these allegations, while still recognizing the fact that the current vaccine has risks. As the current risk of the disease (barring germ warfare) is effectively zero, routine smallpox vaccination has not been recommended for many years. '''I removed this because it veer's off topic. The article is about vaccines in general, not the small pox vaccine in particular. ::The threat from smallpox as a biological weapon has, however, caused a reconsideration, though not a reversal, of this position. A 2003 US vaccination effort was unpopular. There was poor turnout among hospital staff who were designated to be the first to receive the vaccine. In addition to the known risks of the vaccine, several deaths were reported from cardiac causes among the immunized, suggesting that people with coronary artery disease might be at risk. Development of newer formulations that might avoid the newly discovered risks is underway. Illinois and New York suspended the program pending investigation of the apparent vaccine deaths of two healthcare workers (the main focus of the program). The California Nurses Association opposed the effort from the start.[http://rense.com/general36/poxx.htm][http://www.usatoday.com/news/health/2003-10-15-smallpox_x.htm] Again, I think this is too specific for a general article on vaccines. There is an article on the Smallpox vaccine, perhaps it could be incorporated there. :Vaccination against smallpox is an especially contentious issue. Dissenters suggest modern vaccines might result in developmental disorders, and suggest that infections in the past (as in the small vaccinia outbreak in England in 1961) were more lethal and/or were spread in greater proportion, among those who were vaccinated. They contend that improved sanitation and nutrition, not vaccine, account for most of the reduction in smallpox. Inoculation proponents dispute these allegations, while still recognizing the fact that the current vaccine has risks. As the current risk of the disease (barring germ warfare) is effectively zero, routine smallpox vaccination has not been recommended for many years. The possibility of smallpox being used as a biological weapon in the United States prompted the U.S. government to authorize the manufacture and injection of smallpox vaccine. Due to the number of deaths that resulted, the project has been discontinued. With the exception of the last sentence (which I wrote trying to make the paragraph relevant) this paragraph is about ''vaccinations'' :The threat from smallpox as a biological weapon has, however, caused a reconsideration, though not a reversal, of this position. A 2003 US vaccination effort was unpopular. There was poor turnout among hospital staff who were designated to be the first to receive the vaccine. In addition to the known risks of the vaccine, several deaths were reported from cardiac causes among the immunized, suggesting that people with coronary artery disease might be at risk. Development of newer formulations that might avoid the newly discovered risks is underway. Illinois and New York suspended the program pending investigation of the apparent vaccine deaths of two healthcare workers (the main focus of the program). The California Nurses Association opposed the effort from the start.[http://rense.com/general36/poxx.htm][http://www.usatoday.com/news/health/2003-10-15-smallpox_x.htm] This is about the smallpox vaccine''' :''Controversy''' :Some groups in the United States claimed a link due to a preservative called thimerosal. Thimerosal is a preservative that contains Mercury (element). It was (and in some cases still is) used in some DTP (diphtheria, tetanus and pertussis) vaccine formulations. http://www.truthout.org/issues_05/032305EA.shtml| :under the 1997 FDA Modernization Act. In its report of October 1, 2001, the IOM (IOM) Immunization Safety Review Committee concluded that the evidence is inadequate to either accept or reject a causal relationship between thimerosal exposure from childhood vaccines and autism. In a further report, of May 2004 [http://www.iom.edu/report.asp?id=20155] The reason why I removed this is because the 2004 report (mentioned in article) rendered this 2001 report moot. :A second, parallel, controversy arose in the United Kingdom over the vaccine for measles, mumps, and rubella (MMR), another vaccine that is routinely administered to children under the age of 2 in developed nations, but which contains no preservative. A possible link to autism came to the forefront when in 1998, [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9500320 Wakefield and colleagues] reviewed reports of children with bowel symptoms and regressive developmental disorders, mostly autism, in a small sample of 12 children. The study was criticized for its small sample size, and for failing to use healthy controls. In 2004, 10 of the 13 authors of the original Wakefield study retracted the paper's interpretation, stating that the data were insufficient to establish a causal link between MMR vaccine and autism. This followed an investigation by Brian Deer for the London Sunday Times, who reported that Wakefield had links to lawyers hoping to sue the vaccines' manufacturers [http://briandeer.com/mmr-lancet.htm]. Further allegations were made by Deer in a UK television documentary, MMR: What They Didn't Tell You, first broadcast in November 2004 [http://briandeer.com/wakefield-deer.htm]. '''Since this said almost the same thing as the paragraph on the US's vaccine related controversy I more or less combined the two and did my best to make the end result more readable without changing the intent of either paragraph. :In response to the US and UK controversies, which closely mirror the framing of litigation in the two countries, a number of studies with large sample sizes were researched in many developed nations. These studies have sparked criticism over conflicts of interest, which has even been expressed by at least two Republican congressmen in the US, Dan Burton [http://www.house.gov/burton/autism.htm] and Dave Weldon[http://www.autisminfo.com/WeldonAutismOne2004.htm]. The majority of those studies, funded primarily by pharmaceutical interests, showed no correlation between the use of vaccines (including the MMR vaccine) and increased autism: - * [http://pediatrics.aappublications.org/cgi/content/full/114/3/584 \"Thimerosal Exposure in Infants and Developmental Disorders: A Retrospective Cohort Study in the United Kingdom Does Not Support a Causal Association\" PEDIATRICS Vol. 114 No. 3 September 2004] * [http://pediatrics.aappublications.org/cgi/content/full/113/2/259 \"Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta\" PEDIATRICS Vol. 113 No. 2 February 2004] * [http://pediatrics.aappublications.org/cgi/content/full/112/3/604 \"Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data\" PEDIATRICS Vol. 112 No. 3 September 2003] - This study shows an increase in autism after the discontinuation of the thimerosal formulations of the MMR vaccine in the Danish population. * [http://www.nih.go.jp/JJID/56/114.html \"An Epidemiological Study on Japanese Autism concerning Routine Childhood Immunization History\" Jpn. J. Infect. Dis., 56, 114-117, 2003] reincorporated in a [more] neutral form and as a result, I removed this line: ''The study also garnered criticism for its small sample size, and for failing to use healthy controls.'' A couple of the links have been placed in the External links section as well. :The autism controversy highlights several issues pertaining to public health, biology science, medical ethics standards, and the medical community. First, it beckons greater attention to the value of large-scale, case-controlled scientific studies in proving or disproving a hypothesis (in this case, a link between autism and vaccines). Secondly, it demonstrates both the importance of medical professionals having the most solid and up-to-date information and the importance of communicating this information in a clear and unbiased fashion to patients. Thirdly, it suggests a possible need to change the role of the medical community, from authoritarian wardens to counselors who provide informed choices, which might influence evolution of the doctor-patient relationship to become more of a partnership. Lastly, it emphasizes how medical issues involve all aspects of modern culture and society, including the media, the affected families, and the scientific community at large. Seriously POV, but I'm not enough of an expert to make it NPOV :External links''' :* [http://briandeer.com/mmr-lancet.htm BrianDeer.com] - Brian Deer's denunciation of MMR study by Dr. Andrew Wakefield :- * [http://www.nationalautismassociation.org/library.php NationalAutismAssociation.org] - NAA library of pdf files :- * [http://www.nlm.nih.gov/medlineplus/immunizationvaccination.html NIH.gov] - National Intitutes of Health :- * [http://www.ratbags.com/rsoles/vaxliars1.htm RatBags.com] - Anti-vaccination Liars :- * :- * [http://www.whale.to/vaccines.html whale.to] - an Anti-vaccination website == Durability of inactivated vaccines == On Immune Central[http://www.immunecentral.com/infotemplate.cfm-1702-72-1], the entry on inactivated vaccines states that: :However, most inactivated vaccines stimulate a relatively weak immune response and must be given more than once. A vaccine that requires several doses (boosters) has a limited usefulness, especially in areas where people have less access to regular health care. So why did Geni see fit to take that caveat out? I'm putting it back in. --User:Leifern 18:13, 2005 Apr 15 (UTC) :The word "most"? You made an absolute statement. I know there are exceptions.User:Geni 18:17, 15 Apr 2005 (UTC) ::a) Most does not mean "all." B) Then edit the statement rather than take it out. --User:Leifern 18:20, 2005 Apr 15 (UTC) ::Now I get it - "may" means "not necessarily" or "not always" which makes a statement such as "You may experience dizziness" equivalent to "some people will experience dizziness." Strictly speaking, "most people may experience dizziness" is a meaningless statement, since it implies that a minority of people definitely will not experience dizziness. But it's a common way to hedge, so I don't have any objections to the way it is now. --User:Leifern 18:48, 2005 Apr 15 (UTC)
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