Vaccines play a special role in the health and security of nations. The World Health Organization (WHO) cites "immunization and the provision of clean water as the two public health interventions that have had the greatest impact on the world's health", and the World Bank notes that "vaccines are among the most cost-effective health interventions available". Over the past century, the integration of immunization into routine health care services in many countries has provided caregivers with some degree of control over disease-related morbidity and mortality, especially among infants and children.
Despite these extraordinary successes, vaccines and their constituents (e.g., the mercury compound thimerosal, formerly used as a preservative) have come under attack in some countries as causes of neurodevelopmental disorders, such as autism and attention-deficit hyperactivity disorder; diabetes; and a variety of allergic and autoimmune diseases (Brown, p.181). Although millions of lives are saved by vaccines each year and countless cases of postinfection disability are averted, some segments of the public are increasingly unwilling to accept any risk whatsoever of vaccine-associated complications (severe or otherwise), and resistance to vaccination is growing (Jacobson, p. 3165)
No medical procedure is absolutely risk-free, and the risk to the individual must always be balanced with benefits to the individual and to the population at large. This dichotomy poses two essential challenges for the medical and public health communities with respect to vaccines: (1) to create more effective and ever-safer vaccines, and (2) to educate patients and the general public more fully about the benefits as well as the risks of vaccine use (Ada, p.1043). Because immunity to infectious diseases is acquired only by infection itself or by immunization, sustained vaccination programs for each birth cohort will continue to be necessary to control vaccine-preventable infectious diseases until and unless their etiologic agents can be eradicated from every region of the world.
An unwavering scientific and public health commitment to immunization is essential in countering public distrust and political pressure to legislate well-intentioned but ill-informed vaccine safety laws in response to the concerns of organized antivaccine advocacy groups. Ironically, it is the public health success of vaccines that has created a significant part of the problem: because the major fatal and disabling diseases of childhood are only rarely seen today in the United States, parents and young practitioners most likely will never have seen tetanus, diphtheria, Haemophilus influenzae disease, polio, or measles. Under these circumstances, the risks of immunization can easily (if erroneously) be perceived to outweigh the benefits, and this perception can be fueled by inaccurate information, poor science, and zealous advocacy. Caregivers must be prepared to educate parents about the importance of childhood immunization and to address their concerns effectively (Sears, pp.10)
Vaccination of children is begun at about 2 months of age. The recommended program of childhood immunizations in this country, updated in 2006 by the American Academy of Pediatrics includes the following vaccines:
Hepatitis B vaccine
Diphtheria-pertussis-tetanus (DPT) combined vaccine (a recently developed acellular pertussis vaccine is recommended to replace the whole