The committee also acknowledges that the low rate of many infectious diseases may encourage parents to focus on the risks of immunizations rather than the risk of vaccine-preventable diseases. These low rates of infectious diseases may reinforce parents’ reliance on community immunity to protect their child rather than choose immunizations.

The vaccine safety activities of the federal government are prioritizing the engagement of stakeholders in multiple activities, detailed in the 2010 National Vaccine Plan and implementation efforts, as well as the Scientific Agenda of the Centers for Disease Control and Prevention’s Immunization Safety Office. However, an effective national vaccine program will require better-quality information on stakeholder concerns about the safety of vaccines, the severity of vaccine-preventable diseases, individual and population-level immunization, vaccine efficacy, and the delivery and supply of vaccines recommended in the childhood immunization schedule. To effectively implement immunization programs, a state-of-the-art communication plan is needed.

Recommendation 4-1: The committee recommends that the National Vaccine Program Office systematically collect and assess evidence regarding public confidence in and concerns about the entire childhood immunization schedule, with the goal to improve communication with health care professionals, and between health care professionals and the public regarding the safety of the schedule.


Brown, K.F., S.J. Long, M. Ramsay, M.J. Hudson, J. Green, C.A. Vincent, J.S. Kroll, G. Fraser, and N. Sevdalis. 2012. U.K. parents’ decision-making about measles-mumps-rubella (MMR) vaccine 10 years after the MMR-autism controversy: A qualitative analysis. Vaccine 30(10):1855-1864.

CDC (Centers for Disease Control and Prevention). 2012. National, state, and local area vaccination coverage among children aged 19-35 months—United States, 2011. MMWR Morbidity and Mortality Weekly Reports 61(35):689-696.

Chen, R.T., R.L. Davis, and P.H. Rhodes. 2005. Special methodological issues in pharmacoepidemiology studies of vaccine safety. In Pharmacoepidemiology, vol. 4, edited by B.L. Strom. West Sussex, England: John Wiley & Sons, Ltd. Pp. 455-485.

Dempsey, A.F., S. Schaffer, D. Singer, A. Butchart, M. Davis, and G.L. Freed. 2011. Alternative vaccination schedule preferences among parents of young children. Pediatrics 128(5):848-856.

Diekema, D.S. 2012. Issues leading to vaccine hesitancy. Presentation to Meeting 2 of the Institute of Medicine Committee on the Assessment of Studies of Health Outcomes Related to the Recommended Childhood Immunization Schedule, Seattle, WA, March 8.

Diekema, D.S., and the AAP Committee on Bioethics. 2005. Responding to parental refusals of immunization of children. Pediatrics 115(5):1428-1431.

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