BOX 1 Committee Conclusions and Recommendations

SCIENTIFIC ASSESSMENT

Causality Conclusions

The committee concludes that the epidemiological and clinical evidence favors rejection of a causal relationship between multiple immunizations and an increased risk of heterologous infections.

The committee concludes that the epidemiological and clinical evidence favors rejection of a causal relationship between multiple immunizations and an increased risk of type 1 diabetes.

The committee concludes that the epidemiological and clinical evidence is inadequate to accept or reject a causal relationship between multiple immunizations and an increased risk of allergic disease, particularly asthma.

Biological Mechanisms Conclusions

Autoimmune Disease

In the absence of experimental or human evidence regarding molecular mimicry or mercury-induced modification of any vaccine component to create an antigenic epitope capable of cross-reaction with self epitopes as a mechanism by which multiple immunizations under the U.S. infant immunization schedule could possibly influence an individual’s risk of autoimmunity, the committee concludes that these mechanisms are only theoretical.

The committee concludes that there is weak evidence for bystander activation, alone or in concert with molecular mimicry, as a mechanism by which multiple immunizations under the U.S. infant immunization schedule could possibly influence an individual’s risk of autoimmunity.

In the absence of experimental or human evidence regarding loss of protection against a homologous infection as a mechanism by which multiple immunizations under the U.S. infant immunization schedule could possibly influence an individual’s risk of autoimmunity, the committee concludes that this mechanism is only theoretical.

In the absence of experimental or human evidence regarding mechanisms related to the hygiene hypothesis as a means by which multiple immunizations under the U.S. infant immunization schedule could possibly influence an individual’s risk of autoimmunity, the committee concludes that this mechanism is only theoretical.

Considering molecular mimicry, bystander activation, and impaired immunoregulation collectively rather than individually, the committee concludes that there is weak evidence for these mechanisms as means by which multiple immunizations under the U.S. infant immunization schedule could possibly influence an individual’s risk of autoimmunity.



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