patient or parents and provider. Some other participants suggested that the brochures are a form of advocacy for vaccine use, in addition to providing such information.

A number of nonprofit organizations communicate vaccine benefits and risks to the public. Organizations that promote immunization include the Children's Defense Fund, the Children's Action Network, Kiwanis International, and the American Academy of Pediatrics. A consumer advocate indicated that most of these organization are funded by corporations or by the U.S. government and most do not discuss the risks associated with immunizations in their promotional materials. Organizations whose goal is to inform consumers about vaccine risks include the National Vaccine Information Center, Parents for Freedom of Choice, and Vaccine Information and Awareness. Many of these organizations are funded by individual donations and put their emphasis on the risk side of the equation.

Communication between health care providers and parents or patients is often limited, noted a practicing pediatrician, because the time that doctors have to spend with patients during an office visit is restricted. When communicating vaccine risks and benefits, consequently, practitioners often rely on materials such as the VISs, educational videos, or information provided by ancillary personnel. The speaker said he often gives parents the VISs at the first well-child visit, before the child is scheduled to receive any immunizations. This allows parents time to review the information in the statements and generate any questions before their next visit, during which the immunizations are administered. Although he does discuss some potential adverse events, the speaker acknowledged that he tends to emphasize the decreased risk of disease provided by the vaccine, often giving examples of the morbidity and mortality associated with the diseases against which the vaccines are protective.