BOX 6-1
Leading Research Questions of Interest to Select Stakeholders

  1. How do child health outcomes compare between those who receive no vaccinations and those who receive the full currently recommended immunization schedule?
  2. How do child health outcomes compare between (a) those who receive the full currently recommended immunization schedule and (b) those who omit specific vaccines?
  3. For children who receive the currently recommended immunization schedule, do short- or long-term health outcomes differ for those who receive fewer immunizations per visit (e.g., when immunizations are spread out over multiple occasions), or for those who receive their immunizations at later ages but still within the recommended ranges?
  4. Do potentially susceptible subpopulations—for example, children from families with a history of allergies or autoimmune diseases— who may experience adverse health consequences in association with immunization with the currently recommended immunization schedule exist?

on patient barriers to obtaining vaccinations. Although the committee acknowledges that these subjects are of interest and indeed are merely two examples of a large number of potential questions about the system of delivery of the immunization schedule that research could evaluate (see Chapter 4), they are beyond the scope of this committee’s task. Therefore, the committee makes no recommendations regarding further research aimed at addressing such concerns; however, the committee encourages HHS to make continued efforts to identify populations facing barriers to immunization and consider stakeholder concerns on the safety, efficacy, and delivery of the immunization schedule and communication about the immunization schedule, as detailed in Recommendation 4-1.

This chapter focuses on potential health benefits or concerns about the recommended schedule at the individual level (e.g., the vaccinated child) and population-level considerations, including monitoring of community immunity (also called “herd immunity,” which is the indirect protection afforded to unimmunized individuals, e.g., infants too young to be vaccinated against pertussis when a sufficient fraction of the population is vaccinated), that are necessary for study of the recommended immunization schedule.

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