between their polypeptides and human myelin and for complimentarity of their antigens with other viruses or bacterial cell wall substances that might be present in vaccine recipients (Westall and Root-Bernstein, 1983).

In summary, a number of questions remain unanswered regarding risks for adverse events following vaccination and ways to lower such risks. Several speakers suggested research avenues that might prove fruitful in this regard, including studies that assess the risk of adverse events after vaccination in specific genetic populations; on a molecular biology level, the impact over time of multiple vaccination; whether there is a link between learning disabilities and vaccination; whether autistic children have different immune responses than nonautistic children; whether health care workers vaccinated with the hepatitis B virus vaccine (HBV) experience more autoimmune disorders; and whether the antigens in vaccines are likely to cause demyelinating disorders. Several forum members and other workshop participants voiced concern that some of these studies would be difficult to design or impractical to conduct because of a lack of standard definitions or reactions, rarity, and lack of clear diagnostic tests for risk states such as autism. Others felt that information that they would provide, if the studies are successfully carried out, would be valuable in determining risk for adverse events following vaccination.



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