At Risk: Truth About Vaccines, Lawsuits & Shortages

If you tell a lie big enough and keep repeating it, people will eventually come to believe it." - Joseph Goebbels (Jewish Virtual Library, American- Israeli Cooperative Enterprise).

"By the late 1970s fears of pertussis vaccine had spread to the United States. Before jurors persuaded more by emotional appeals than by science, lawyers successfully claimed that the pertussis vaccine caused sudden infant death syndrome (later found to be associated with sleep position), Reye's syndrome (later found to be associated with aspirin), unexplained coma, paralysis, mental retardation, and epilepsy. Seven companies stopped making the vaccine; within a few years only one, Lederle Laboratories, remained. Lederle was punished for its persistence. In 1986 a jury awarded $1.13 million to parents claiming that Lederle's pertussis vaccine had paralyzed their son -- an award that was more than half of the annual sales of the vaccine. Subsequent studies of hundreds of thousands of children showed that the risk of permanent brain damage was the same in children who had not received the vaccine as in those who had...... Unfortunately, the legacy of the pertussis litigation remains. Many pharmaceutical companies that abandoned vaccines never came back. At the beginning of the 1980s, 18 companies made vaccines; by the end of the decade, only four were left. The infrastructure to make vaccines became tenuous, and vaccine shortages became commonplace. For example, in 1998, the tetanus vaccine was in such short supply that its use was restricted to emergency rooms. Beginning in 2000, a pneumococcal vaccine for children -- designed to prevent bloodstream infections, meningitis, and a common cause of pneumonia -- was available only intermittently; parents could only hope that their children weren't among the thousands permanently harmed or killed every year by pneumococcus. Between 2003 and 2004 an influenza epidemic created a demand that dramatically exceeded supply; more than 150 children died that year from influenza. " - Paul Offit, Boston Globe

"The essay did note that Offit is co- inventor of the rotavirus vaccine currently licensed in the United States. The disclosure is helpful, but should have been more explicit. That vaccine is Merck's Rotateq, and Offit has served as a consultant to the drugmaker for many years. Merck has also been in the vaccine business for many years. In other words, Offit may be directly affected by any litigation that questions the worth of vaccines and, by extension, makes life more difficult for these companies. This is what he told UPI in 2003, before Rotateq was approved by the FDA: "I am a co-holder of a patent for a (rotavirus) vaccine. If this vaccine were to become a routinely recommended vaccine, I would make money off of that." - Ed Silverman, www.pharmalot.com

"Paul Offit attempts to rewrite history when he argues that the DPT vaccine does not cause brain inflammation and permanent brain injury in some children. Two large studies conducted in the United States and Britain, in which the children studied were enrolled prior to vaccination, demonstrated otherwise. The 1981 UCLA/FDA study published in Pediatrics compared DPT to DT vaccine and found that 1 in 875 DPT shots is followed within 48 hours by either a convulsion or collapse/shock episode. The case- controlled 1981 British National Childhood Encephalopathy Study found that the risk of brain inflammation within seven days of DPT vaccination is 1 in 110,000 DPT shots, with permanent brain damage occurring in 1 in 310,000 DPT shots. A re-analysis of the British study was validated in 1994 by the Institute of Medicine. Offit is entitled to his own opinion but not to his own facts. We have only ourselves to blame when we believe everything he says." - Barbara Loe Fisher, Boston Globe

Barbara Loe Fisher Commentary:

There are two reasons why people perpetuate a lie, even if they are not the original creators of it. Some do it out of ignorance or carelessness. Others do it deliberately with full knowledge. Sometimes it is difficult to determine whether facts are falsified deliberately or out of ignorance. Whatever the case, it is important to set the record straight when distortion of facts perpetuate a lie, especially when the lives of human beings are at stake.

A June 3 Boston Globe OpEd authored by Paul Offit, M.D. is littered with factual errors that perpetuate pharmaceutical industry-created myths, which have been used for two decades to persuade Congress to pass laws shielding vaccine makers from liability for vaccine injuries and deaths, while giving drug companies huge financial incentives to develop vaccines and lobby for vaccine mandates. Offit blames parents of DPT vaccine injured children seeking financial support for their children for driving drug companies out of the vaccine business. He does this even though he knows perfectly well there are more drug companies producing childhood vaccines today than in 1982.

Offit also blames parents of vaccine injured children for vaccine shortages even though he knows the main causes for vaccine shortages rest with the vaccine manufacturers themselves: production problems affecting distribution, incomplete compliance with FDA standards, and inaccurate predictions for public demand for a vaccine.

Offit further attempts to rewrite medical history by alleging that DPT vaccine does not cause brain damage. He does this even though he knows (1) the largest case controlled study ever conducted to investigate causes of brain damage in children, the 1981 British National Childhood Encephalopathy Study, concluded that the pertussis (whooping cough) portion of DPT vaccine causes acute brain inflammation and permanent brain damage; and (2) the Institute of Medicine agreed with that conclusion in 1994.

Although the federal vaccine injury compensation program (VICP) created by Congress in 1986 was not designed to function as the judge of whether a causal relationship between a particular vaccine and health outcome has been scientifically proven to exist - only to determine whether a child's injury could be reasonably presumed to be related to vaccination in the absence of a more plausible explanation - it is important to note that the vast majority of vaccine injury awards in the VICP have been for children suffering DPT vaccine brain injuries and deaths. Offit's attempt to exonerate DPT is part of a larger effort to convince the public - and drug company stockholders - that most vaccines, including his own, have no risks whatsoever.

A relatively small group of individuals worldwide personally profit from patents on childhood vaccines . However, a much larger group of individuals in the medical, research and public health professions in society benefit personally and professionally from government recommendations for universal use of many vaccines, recommendations that are subsequently turned into state vaccine mandates which generate millions, even billions, of dollars for vaccine manufacturers. Vaccine apologists and profiteers have a right to voice their opinions and legally make money in America's free enterprise system. However, their opinions should be put into proper perspective and the "facts" they use to aggressively promote widespread use of multiple vaccines and advocate one-size-fits-all vaccine policies should be verified before they become urban legend.

When the public trusts blindly, often what is most at risk is the truth.

The National Vaccine Information Center is committed to disseminating information about vaccines and infectious diseases in order to prevent vaccine injuries and deaths through public education and defend the informed consent ethic. Following is information about several myths being perpetuated by those who should know better, as well as a chronology of events between 1982 and 2007 that set the record straight.

MYTH #1: DPT vaccine injury lawsuits in the 1970's and 1980's drove most drug companies making vaccines out of US market; or specifically, as Offit states in the June 3, 2007 Boston Globe Op Ed, " at the beginning of the 1980's, 18 companies made vaccines, by the end of the decade, only four were left."

FACT: In 1982, there were four drug companies making and selling vaccines for children in the U.S.: Merck, Wyeth, Lederle and Connaught. In 2007, after two decades of mergers and acquisitions, there are six drug companies making and selling vaccines for children in the U.S.: Merck, Wyeth, Sanofi Pasteur, GlaxoSmithKline, MedImmune and Novartis. Foreign companies, like Australia's CSL Biotherapies, are poised to enter the lucrative US vaccine market soon. There are more than 200 vaccine trials in various stages worldwide and most vaccines being developed will be targeted by CDC officials and drug company lobbyists for widespread use in order to guarantee stockholder profits for vaccine manufacturers.

MYTH #2: Because DPT vaccine injury lawsuits in the 1970's and 1980's drove drug companies out of the US market, vaccine shortages occurred and continue to occur; specifically, Offit blames "the legacy of pertussis litigation" for shortages of tetanus vaccine "in 1998," pneumococcal (Prevnar) vaccine "beginning in 2000" and influenza vaccine "between 2003- 2004."

FACT: In a 2002 Government Accounting Office (GAO) investigation and report,"Childhood Vaccines: Ensuring an Adequate Supply Poses Continuing Challenges," the threat of vaccine injury lawsuits was not listed among reasons for vaccine shortages in the U.S.. Instead, the GAO identified primary reasons as (1) manufacturing production problems; (2) calls by immunization policy-making bodies to remove a preservative from vaccines as a precautionary measure; (3) a manufacturer's decision to cease production of some vaccines; and (4) greater than- expected demand for a vaccine that had recently been added to the immunization schedule.

Almost all of the vaccine shortages that the U.S. has experienced have been due to vaccine manufacturer production and government regulation compliance problems. Dr Offit should be well aware of reasons for vaccine shortages in the past decade because he was publicly identified as a member of the CDC's Advisory Committee on Immunization Practices (ACIP) from 1998 to 2003.

The shortage of adult tetanus vaccine occurred in early 2001, not 1998, when Wyeth-Lederle abruptly announced it had stopped production of tetanus-toxoid containing products, as well as DTaP vaccine. The 2002 GAO report revealed Wyeth had been planning to leave the DTaP and tetanus vaccine market but accelerated its departure when it realized it would have problems responding to FDA requirements to make "significant upgrades to its facilities where tetanus toxoid was manufactured." In addition, in August 2001, Merck temporarily suspended operations in one of its facilities manufacturing MMR and Varicella (chicken pox) vaccines to address issues raised by FDA inspectors during a plant inspection and to make scheduled modifications to its facility. According to the 2002 GAO report, the time it took to make plant modifications and difficulties in meeting FDA manufacturing requirements contributed to shortages of MMR, varicella, DTaP, and Td vaccines between the end of 2001 and summer of 2002.

The shortage of pneumococcal vaccine in 2001- 2002, occurred when Wyeth-Lederle aggressively promoted its vaccine after FDA licensure in 2000 but failed to correctly predict public demand for the vaccine that made Prevnar the best selling new pharmaceutical product in 2001. Although failure of supply to meet demand was the main reason for the shortage, the 2002 GAO report added ""the company's production of the vaccine was also hampered by ongoing manufacturing problems" and "changes made in the company's quality assurance procedures" to comply with FDA standards.

The shortage of influenza vaccine in 2003-2004 and flu-related deaths resulted when a more severe type of influenza circulating that year (A/Fujian) was not contained in the flu vaccine. CDC officials, who knew it but didn't tell Americans, publicized the deaths of children attributed to the Fujian flu in the fall of 2003 and urged that everyone get vaccinated, which generated a huge demand for flu vaccine that exceeded supply.
http://www.nvic.org/History/Newsl etters/%203770Reaction.pdf

MYTH #3: DPT vaccine does not cause brain inflammation and permanent brain damage; specifically Offit states that "Subsequent studies of hundreds of thousands of children showed that the risk of permanent brain damage was the same in children who had not received the vaccine as in those who had."

FACT: Of all the vaccines which have been routinely used by children in the past century, the brain damaging effects of the pertussis (whooping cough) portion of DPT vaccine is among the most well documented in the scientific literature. Created in 1912, the crude pertussis vaccine basically consisted of B. pertussis bacteria killed with heat, preserved with formaldehyde, and injected into children. In the early 1940's, aluminum was added as an adjuvant and later the mercury preservative, thimerosal, was added when pertussis was combined with diphtheria and tetanus vaccines to create DPT. Pertussis vaccine was never studied in large clinical trials before being given to children in the first half of the 20th century or after it was combined into DPT and recommended for mass use by the American Academy of Pediatrics in 1947.

The pertussis vaccine's ability to kill was first signaled in 1933 when T. Madsen reported two babies died within minutes of vaccination. In 1947, Matthew Brody gave detailed descriptions of two cases involving brain damage and death after pertussis vaccination. But, it was the 1948 published case study by Byers and Moll that gave the strongest warning that children were suffering brain inflammation within 72 hours of pertussis vaccination and being left with various kinds of brain damage. Forty years later, the prospective UCLA/FDA study published in Pediatrics in 1981 comparing DT and DPT vaccines would find that 1 in 875 DPT shots is followed by either a convulsion or collapse shock episode within 48 hours of vaccination.

Biological mechanisms for pertussis vaccine induced brain damage center on pertussis toxin (PT), one of the most lethal toxins in nature. Pertussis toxin is a known neurotoxin, a reliable inducer of brain inflammation and brain damage, which is why it is used in lab animals to deliberately induce EAE (experimental autoimmune encephalomyelitis). Pertussis toxin is implicated in brain inflammation caused by pertussis (whooping cough) complications as well as pertussis vaccine complications. Unfortunately, pertussis toxin is also thought to be responsible for stimulating immunity which is why it remains in DPT, DTaP and Tdap vaccines.. Other ingredients in DPT vaccine, which have been associated with neuroimmune dysfunction and may interact synergistically with pertussis toxin to cause shock, brain damage or death are: endotoxin, aluminum, and mercury.

After decades of reports in the medical literature that the pertussis portion of DPT vaccine was causing brain damage in some children, the large, case controlled National Childhood Encephalopathy Study was conducted in Britain and published in 1981. It confirmed a statistically significant association between pertussis vaccine or pertussis-containing vaccines (DPT) and acute brain inflammation leading to permanent brain damage. An NCES reanalysis 10 years later re-confirmed the finding. In 1994, the Institute of Medicine, National Academy of Sciences, published a report validating the conclusions of NCES, stating that " "the balance of evidence is consistent with a causal relation between DPT and the forms of chronic nervous system dysfunction in the NCES in those children who experience a serious acute neurological illness within 7 days after receiving DPT vaccine."

1982- 2007: FACTS ABOUT VACCINES, LAWSUITS & SHORTAGES

In April 1982, before the NBC Emmy award winning documentary "DPT: Vaccine Roulette" was broadcast and alerted American parents that children were suffering brain damage after receiving DPT vaccine, there were four commercial vaccine manufacturers producing and marketing childhood vaccines: Merck, Wyeth, Lederle and Connaught. In 1982, children were given only three vaccines: live oral polio vaccine (Lederle, sole source); MMR vaccine (Merck, sole source); and DPT vaccine (Wyeth, owned by American Home Products; Lederle, owned by American Cyanamid; and the Canadian corporation, Connaught shared the DPT market).

1982-1984: A series of congressional hearings were held in the U.S. Senate Committee on Labor and Human Resources on DPT vaccine safety.

April 1984: A jury in Idaho found Lederle negligent in the manufacture of DPT vaccine on strict liability grounds. Between 1978 and 1984, DPT vaccine injury cases had been settled out of court or the manufacturer had prevailed but a jury had never returned a guilty verdict against a DPT vaccine manufacturer. In Toner v Lederle, the Idaho jury awarded Kevin Toner $1.4M for paralysis he suffered after reacting with transverse myelitis to his first DPT shot at two months of age. Lederle was found guilty on the grounds of strict liability. The jury agreed with plaintiff's lawyers that a drug company could produce a vaccine that was "unavoidably unsafe" and passed FDA standards, while still being negligent for not doing everything it could do to reduce the risk associated with the vaccine. [Lederle would eventually appeal the decision to the Ninth Circuit Court of Appeals, which would uphold the jury verdict in an opinion written by Judge Anthony Kennedy, now serving on the US Supreme Court. In 1988, Lederle appealed to the US Supreme Court, who turned the case down, and the jury verdict and Ninth Circuit Court of Appeals decisions held.]

June 1984: Wyeth announced it was no longer going to produce and sell DPT vaccine, leaving the market to Lederle and Connaught. Merck, Lederle and Connaught increased pressure on Congress to pass legislation shielding them from liability by suggesting that if they were not protected, they would leave the nation without a vaccine supply.

December 1984: The CDC announced an emergency shortage of DPT vaccine and blamed it on the fact Wyeth abruptly ceased production of DPT due to DPT vaccine injury lawsuits. However, in testimony before the U.S. House Energy and Commerce Subcommittee on Health and the Environment, the vice president of Wyeth testified that the company was producing more vaccine in 1984 than it had in 1983 and planned to produce still more in 1985 because it was selling all of its pertussis vaccine to Lederle for Lederle to distribute. When questioned, federal health officials claimed they didn't know Wyeth was doing that.

February 1985: The book DPT: A Shot in the Dark by Coulter & Fisher was published by Harcourt Brace Jovanovich, documenting scientific evidence for DPT vaccine-induced brain and immune system dysfunction and included more than 100 new original case histories. The book would eventually be used by the Institute of Medicine as a reference for its 1991 report "Adverse Effects of Pertussis and Rubella Vaccines," which confirmed a causal relationship between DPT vaccine and acute encephalopathy.

1985: The FDA gave a license to Praxis Biologicals for the first HIB vaccine for use in 24 month old children and, shortly after, Lederle and Connaught also were given licenses to manufacture HIB vaccine.

1985: More than 200 lawsuits were pending in US courts against DPT vaccine manufacturers and pediatricians for DPT vaccine injury but most lawsuits continued to be settled on the courthouse steps for modest sums, after which all records were sealed from public view. Under pressure from drug companies and pediatricians to ensure the vaccine supply, Congress continued to hold hearings on a proposed federal vaccine injury compensation program. The program would provide a no-fault, expedited, less adversarial alternative to a court trial for families of catastrophically injured vaccine victims.

July 1986: After justifying a 10,000 percent in DPT vaccine prices to Congress by blaming it on DPT vaccine injury lawsuits, a July 25 hearing of the House Subcommittee on Health and the Environment heard charges that Lederle told the Securities and Exchange Commission, Wall Street and prospective investors that DPT vaccine injury lawsuits pose no risk of "material adverse effect" on the company. A US House Subcommittee report revealed $16.2 million was paid in settlements by US vaccine manufacturers to 52 children injured by all childhood vaccines (DPT, MMR and polio) during the previous five years, which worked out to an average of $300,000 per case. Out of the 15 cases that went to jury trial, the manufacturers won four cases, lost six and five were on appeal.

November 1986: President Reagan signed the National Childhood Vaccine Injury Act creating the federal Vaccine Injury Compensation Program (VICP), the National Vaccine Program, and instituting safety provisions in the mass vaccination system which required doctors to give parents benefit and risk information before vaccination; to report serious health problems following vaccination to a centralized federal Vaccine Adverse Events Reporting System (VAERS); to write down serious health problems following vaccination in a child's permanent medical record; and to keep a permanent record of all vaccines and lot numbers administered. Under the law, the VICP would use a Table of Compensable Events to determine whether a child's injury would automatically be presumed to be vaccine-related in the absence of a more plausible explanation. A provision in the law required the National Academy of Sciences, Institute of Medicine, to assemble physician committees to review the medical literature for evidence that vaccines can cause injury and death.

1986: The FDA gave Merck a license for the first recombinant DNA vaccine, hepatitis B vaccine

1987: Wyeth and Ayerst merged into Wyeth- Ayerst.

December 1987: The FDA gave a license to Connaught for a conjugate HIB vaccine.

1988: The FDA gave Lederle a license for a conjugated HIB vaccine and the CDC recommended universal use of conjugate HIB vaccine for all children at 18 months.

1989: The British drug company, SmithKline Beecham (SKB), entered the lucrative US vaccine market and the FDA licensed SKB's genetically engineered hepatitis B vaccine.

1989: The FDA gave Merck a license for conjugated HIB vaccine.

1989: Praxis Biologicals was acquired by American Cyanamid to create Lederle- Praxis.

1989: The French Merieux Institute acquired Connaught Lab of Canada and became Pasteur Merieux.

January 1991: The CDC recommended the universal use of HIB vaccine and hepatitis B vaccine for all infants.

December 1991: The FDA gave Lederle a license for acellular DTaP vaccine for the fourth and fifth booster doses for children 18 months and older and, in 1992, Connaught received a license for acellular DTaP vaccine for booster doses.

January 1993: A unanimous US 4th Circuit Court of Appeals decision affirmed the right of seven adults and children who contracted polio from the oral polio vaccine between 1979 and 1987 to recover damages from the federal government because the FDA permitted vaccine manufactured by Lederle Labs to be released to the public even though the vaccine failed to meet FDA safety standards.

1993: The Vaccines for Children Program was established by Congress, which allocated federal funds to provide CDC recommended vaccinations for all children, without regard for ability to pay. Vaccine tracking systems were created.

1994: Wyeth-Ayerst acquired American Cyanamid and its subsidiary Lederle-Praxis to form Wyeth- Lederle.

1994: The Institute of Medicine published two congressionally mandated reviews of the medical literature, "Adverse Events Associated with Childhood Vaccines," which confirmed that vaccines can cause chronic brain and immune system dysfunction and death; and "DPT Vaccine and Chronic Nervous System Dysfunction," which confirmed a reanalysis of the findings of the 1981 landmark British National Childhood Encephalopathy Study (NCES). IOM concluded that "the balance of evidence is consistent with a causal relation between DPT and the forms of chronic nervous system dysfunction in the NCES in those children who experience a serious acute neurological illness within 7 days after receiving DPT vaccine."

March 1995: The FDA gave Merck a license for live varicella zoster (chicken pox) vaccine.

1995: The FDA gave SmithKline Beecham a license for the first hepatitis A vaccine.

1995: Public health officials at the Department of Health and Human Services, with the assistance of the Department of Justice officials, change the Table of Compensable Events in the VICP to reduce the numbers of children automatically awarded compensation under the Table; from this point on, almost all vaccine victims would be required to meet a higher causation standard for presumption in order to obtain an award in the VICP.

1996: The FDA gave Wyeth-Lederle and Pasteur Merieux licenses for their acellular DTaP vaccines for use in infants two months and older.

July 1996: The CDC recommended all 12-18 month old children receive varicella zoster (chicken pox) vaccine.

1997: The FDA gave a license to a new vaccine manufacturer to enter the US market, North American Vaccine, for DTaP vaccine and gave SmithKline Beecham a license for DTaP.

1998: Andrew Wakefield, M.D. and colleagues in Britain published a study presenting clinical evidence for an association between MMR vaccine, intestinal bowel dysfunction and autism.

1998: The CDC recommended acellular DTaP vaccine for all five doses to replace whole cell DPT.

August 1998: The FDA gave a license to Wyeth- Lederle for the first live rotavirus vaccine (monkey- human hybrid virus) and the CDC recommended it for universal use in all infants in early 1999.

1999: Pasteur Merieux merged with Aventis to become Aventis Pasteur.

May 1999: U.S. House Committee on Criminal Justice, Drug Policy and Human Resources of the Government Reform Committee helds a hearing on hepatitis B vaccine immune and brain dysfunction.

June 1999: The CDC recommended exclusive use of inactivated polio vaccine (IPV) for infants and children, to replace the live oral polio vaccine (OPV) that can cause vaccine strain polio in a vaccinated person or someone who comes into close contact with a recently vaccinated person's body fluids.

July 1999: The FDA and EPA jointly advised the vaccine manufacturers to remove thimerosal (mercury) preservatives from childhood vaccines as a precautionary measure after a congressionally mandated review of mercury in products revealed cumulative exposures from childhood vaccines that exceeded EPA guidelines.

July 1999: The CDC announced recommendations for use of rotavirus vaccine in infants was suspended due to reports of bowel obstruction in infants. Wyeth- Lederle withdraws the vaccine from the market in the fall.

August 1999: The U.S. House Government Reform Committee, chaired by Congressman Dan Burton, held the first of a several year series of investigative hearings on vaccine safety issues, including vaccines and autism.

August 1999: The FDA gave a license to Merck for thimerosal-free hepatitis B vaccine and thimerosal-free HIB vaccine and gave SmithKlineBeecham a license for a trace thimerosal hepatitis B vaccine in March 2000.

2000: SmithKline Beecham merged with Glaxo Wellcome to become GlaxoSmithKline.

February 2000: The FDA gave Wyeth- Lederle a license for the first 7-valent pneumococcal vaccine (Prevnar) and in June 2000 the CDC recommended it for universal use in all infants.

January 2001: Wyeth-Lederle abruptly announced it had stopped production of tetanus-toxoid containing products, as well as DTaP vaccine, leaving the market to Aventis Pasteur and GlaxoSmithKline. As a result, adult tetanus vaccine lagged behind demand between 2001-2002, temporarily resulting in Td shortages. The 2002 GAO report revealed the reasons behind Wyeth- Lederle's action: the company had been planning to leave the DTaP and Td market but accelerated its departure when it realized it would be difficult "to respond to requirements set forth in a consent decree with the federal government. To comply with these requirements, the company faced making significant upgrades to its facilities where tetanus-toxoid was manufactured."

2001: An hypothesis entitled Autism: A novel form of mercury poisoning by Sallie Bernard and others is published in Medical Hypothesis.

2001: Wyeth-Lederle's Prevnar vaccine became the number one best selling new pharmaceutical on the US market. However, Prevnar supply shortages occurred because Wyeth-Lederle had aggressively promoted the vaccine before and after licensure while failing to gauge public demand so supply fell far short of demand and caused temporary shortages (http://www.cdc.gov/mmwr/preview/mmwr html/mm5219a6.htm. In addition, there were significant manufacturing problems that reduced Prevnar production and release of vaccine in 2001 and 2002. A 2002 GAO report "Childhood Vaccines: Ensuring an Adequate Supply Poses Continuing Challenges" confirmed that "CDC estimates the monthly national need for this vaccine to be 1.3 million doses, but the manufacturer was only able to provide about half the needed doses during the first 5 months of 2002. Company officials said an extensive pre-education campaign resulted in record-breaking adoption of the vaccine. The company's production of the vaccine was also hampered by ongoing manufacturing problems. Changes made in the company's quality assurance procedures, partly to comply with the terms of a consent decree with the federal government, resulted in delays in the release of the vaccine. Manufacturing equipment problems also affected the manufacturer's ability to meet demand."

March 2001: The FDA gave Aventis Pasteur a license for thimerosal free DTaP vaccine.

April 2001: The Institute of Medicine issued a report on MMR vaccine and autism concluding that " the evidence favors rejection of the causal relationship at the population level between MMR vaccine and autistic spectrum disorders" but also stated that "the proposed biological models linking MMR vaccination to autism spectrum disorders, although far from established, are nevertheless not disproved" and urged further research be conducted.

August 2001: Merck temporarily suspended operations in one of its facilities manufacturing MMR and Varicella (chicken pox) vaccines to address issues raised by FDA inspectors during a plant inspection and to make scheduled modifications to its facility. According to the 2002 GAO report, the time it took to make plant modifications and difficulties in meeting FDA manufacturing requirements contributed to shortages of MMR, varicella, DTaP, and Td vaccines between the end of 2001 and summer of 2002.

September 2001: The FDA gave Chiron/Evans a license to manufacture flu vaccine with trace amounts of thimerosal.

September 11, 2001: Terrorists destroyed the World Trade Center in New York City. Within weeks, DOD officials suggested terrorists had weaponized smallpox and anthrax that could be used to attack and infect large numbers of Americans. In the name of national security, eventually drug company and government officials persuaded Congress to pass legislation (Homeland Security, MSEHPA, Bioshield, BARDA) giving sweeping new emergency powers to federal and state public health officials while appropriating billions of dollars to develop experimental bioterrorism and pandemic flu vaccines. At the same time, Congress yielded to drug company lobbyists and public health officials seeking liability shields for drug companies and vaccine administrators to absolve them from legal responsibility for vaccine injuries and deaths that occur in the future when the Secretary of Health declares a public health "emergency" and orders mass use of experimental vaccines.

October 2001: The Institute of Medicine issued a report on thimerosal-containing vaccines and neurodevelopmental disorders which concluded that the hypothesis, while not proven, is "biologically plausible" and called for further research.

February 2002: GlaxoSmithKline ceased manufacture and distribution of Lyme disease vaccine, citing insufficient market, after adults and children injured by Osp-A Lyme vaccine speak out about their reactions.

2002: American Home Products changed its name to Wyeth.

September 2002: The FDA gave Aventis Pasteur a license to manufacture a thimerosal-free influenza vaccine.

June 2003: The FDA gave a license to MedImmune for the first live virus nasally administered influenza vaccine (FluMist).

October 2003: The CDC recommended that children 6 to 23 months of age receive an annual flu vaccination.

2003-2004: A mini-epidemic of a more severe type of influenza caused by the A/Fujian strain occurred around the world, including the U.S. In spring of 2003, federal health agencies and the pharmaceutical industry knew the genetically mutated type A flu was emerging out of Asia and causing significant complications, including death, but chose not to include it in the 2003/2004 flu vaccine formula after the WHO voted to stay with strains that had been included in the previous year's formulation (A/Panama, A/Caledonia and B/Hong Kong). Without informing the public that the flu vaccine did not contain the strain of flu causing severe flu that season, the CDC heavily publicized child flu deaths in the fall of 2003 and Americans stood in long lines that fall and winter to get flu vaccine, which caused a vaccine shortage and subsequent CDC-recommended rationing of flu vaccine supplies. (http://www.nvic.org/History/Newsl etters/%203770Reaction.pdf). The FDA stated that "between October 2003 and early January 2004, the deaths of 93 children younger than 18 had been reported to the CDC, according to preliminary data" and eventually the CDC would state that 152 flu related deaths occurred in children younger than 18 that year.

May 2004: The Institute of Medicine published a report rejecting a causal relationship between thimerosal containing vaccines and autism, concluding that hypotheses generated to date concerning biological mechanisms for vaccine induced autism are theoretical only. The IOM Committee discouraged further scientific research into the vaccine-autism association.

Summer 2004: Influenza vaccine manufactured by the British Chiron Corporation, which provides about half the inactivated influenza vaccine for the U.S., was found to be contaminated with bacteria. There was a flu vaccine shortage in the US during the 2004-2005 season as a result.

2004: Aventis Pasteur merged with Sanofi to become Sanofi-Pasteur and one of the world's largest pharmaceutical companies.

October 2004: Two professors from the Harvard School of Public Health published an article in the Journal of the American Medical Association, stating "We independently searched reported jury verdicts and judicial decisions for cases involving flu vaccine and found only 10 reported cases in the last 20 years.....overall there is little evidence of significant litigation involving the flu vaccine....by all appearances the situation is not one in which a rational observer would conclude that litigation is a substantial burden on manufacturers."

October 2004: US District Court Judge Emmet Sullivan issued an injunction blocking DOD from ordering US soldiers receive anthrax vaccine without their informed consent, citing the reactive anthrax vaccine's "experimental" status because the FDA had never licensed it as effective for use against weaponized inhalation anthrax. [DOD would subsequently get around the injunction by requesting the Secretary of Health and Human Services utilize recently acquired Project Bioshield powers and issue an "Emergency Use" authorization].

December 2004: FDA gave Sanofi Pasteur a license for thimerosal-free influenza vaccine.

January 2005: The FDA gave Sanofi- Pasteur a license for a new meningococcal and diphtheria toxoid conjugate vaccine (Menactra) and in May 2005, the CDC recommended it for all 11-12 year old children.

April 2005: Evidence of Harm by David Kirby was published by St. Martin's Press, presenting documentation for an association between mercury containing vaccines and autism.

May 2005: The FDA gave GlaxoSmithKline a license for Tdap for use in children 10 to 18 years old and in June gave Sanofi Pasteur a license for Tdap for persons 11 to 64 years old, after which the CDC immediately recommended Tdap be given to all 11-12 year old children.

October 2005: The CDC recommended that all 12 month old infants routinely receive hepatitis A vaccine.

February 2006: The FDA gave Merck a license for a new live rotavirus vaccine (human-cow hybrid virus) and in March 2006 the CDC recommended it for all infants;

March 2006: The FDA gave Merck a license for the first HPV vaccine (GARDASIL) and in June 2006 the CDC recommended it for all 11 year old girls.

April 2006: Novartis acquired Chiron, entering the US flu vaccine market (FluViron)

May 2006: The FDA gave a license to Merck for herpes zoster (shingles) vaccine and in October 2006 the CDC recommended it for use by all Americans aged 60 and older.

By 2007 American children were being told by government health officials and pediatricians to get 48 doses of 14 vaccines by age six and 53-56 doses of 15 or 16 vaccines by age 12. In May 2007, CNN Money reported predictions that vaccine industry sales will more than double by 2010.

MMR Vaccine Victim in U.S. Claims Court

" In excruciating detail, an Arizona mother on Monday described severe autism and devastating health problems that plague her 12-year-old daughter and asked a court to find common childhood vaccines were the cause. The test case is being closely watched by nearly 5,000 families of autistic children who have lodged similar claims for compensation from a federal fund. The case of Michelle Cedillo, of Yuma, Ariz., is the first alleging a vaccine-autism link to be heard in the U.S. Court of Federal Claims. It and eight other test cases are important because they will guide the handling of the other pending claims......Theresa Cedillo said her daughter suffered five days of fever, her temperature often spiking to 105 degrees, after receiving a measles, mumps and rubella vaccination at age 15 months. Michelle was a happy, robust, responsive and loving child - in short, normal - but hasn't been the same since, her mother told the court. Wearing noise-canceling headphones, Michelle was brought into the courtroom in a wheelchair at the start of the proceedings. She stayed only a short time, moaning audibly several times. Besides autism, Michelle suffers from inflammatory bowel disease, glaucoma and epilepsy. In addition, her bones, weakened by years of malnourishment, are prone to breaks, Theresa Cedillo said. Everything she eats is pumped in through a feeding tube, except for crackers and water." - Andrew Bridges, Associated Press June 11,2007

"The court is being asked to decide whether there is a link between autism and childhood vaccines. If it finds one exists, the families could be eligible for compensation under the Vaccine Injury Compensation Fund, a program established by Congress to ensure an adequate supply of vaccines by safeguarding manufacturers from lawsuits. Under the program, people injured by vaccines receive compensation through a special trust fund. Autism is characterized by impaired social interaction. Those affected often have trouble communicating, and they exhibit unusual or severely limited activities and interests. Classic symptoms of mercury poisoning include anxiety, fatigue and abnormal irritation, as well as cognitive and motor dysfunction. Monday's case addresses the theory that the cause of autism is the measles, mumps and rubella vaccine in combination with other vaccines containing thimerosal. The preservative, about 50 percent mercury by weight, is no longer found in routine childhood vaccines but is used in some flu shots. In July 1999, the U.S. government asked vaccine manufacturers to eliminate or reduce, as expeditiously as possible, the mercury content of their vaccines to avoid any possibility of infants who receive vaccines being exposed to more mercury than is recommended by federal guidelines. " - CBS Evening News

" Concerns about thimerosal's possible link to autism have gained publicity in recent years as the occurrence of autism in children has climbed steadily in the United States. Doctors have struggled to find a clinical reason for the increase. Because vaccinations are mandatory for all children at a certain age, some parents and doctors believe the vaccines indicate a common link that cannot be ignored. However, current research weighs heavily against the premise of a thimerosal-autism link, as thus far a number of large scientific studies have shown no association between the two........The bottom line is that vaccines prevent life-threatening and life-risking diseases," AAP's McMillan said. "It is about the most effective public health measure we have. It is very important that we do not allow misinformation to affect that. "In the case of the MMR [measles-mumps- rubella] vaccine, we know that it prevents diseases that can injure and kill children," said Dr. Gary Freed, director of general pediatrics for the University of Michigan Health System." - ABC Evening News

Barbara Loe Fisher Commentary:

This week, special masters in the U.S. Court of Federal Claims began hearing the case of Theresa Cedillo and Michael Cedillo, as parents and natural guardians of Michelle Cedillo v. Secretary of Health and Human Services. The parents are bringing a vaccine injury claim on behalf of their 12 year old daughter, Michelle, who developed normally until she received an MMR vaccination at 15 months and, within 7 days, suffered a high fever, rash and symptoms of brain inflammation that was followed by mental and physical regression. Michelle, now 12, suffers from brain and immune system dysfunction, including autism.

The federal Vaccine Injury Compensation Program (VICP) was created under the National Childhood Vaccine Injury Act of 1986 as a no fault, non- adversarial alternative to suing a vaccine manufacturer or pediatrician, who negligently administers a vaccine, for vaccine-related injuries and deaths. The VCIP was created 1986 after drug companies making vaccines threatened to leave the nation without a vaccine supply unless they were shielded from liability. Nearly two billion dollars has been awarded to vaccine victims since then, with money for awards being obtained from a surcharge on vaccines that is placed in a national trust fund. The trust fund currently has a several billion dollar surplus in it because the Department of Health and Human Services and the Department of Justice, which defend the government in vaccine injury claims, fight almost every claim.

The majority of the VICP awards that have been awarded after years of legal proceedings, have been made for brain inflammation and encephalopathy caused by the pertussis (whooping cough) vaccine in the DPT or DTaP shot but awards for MMR, polio and several other vaccines have also been made.

Pertussis vaccine-induced brain inflammation and measles vaccine induced brain inflammation has been documented in the medical literature:

The large case controlled National Childhood Encephalopathy Study (NCES) conducted in Britain in 1981 found that "there were statistically significant associations between the onset of various neurological disorders notified and immunization with DTP vaccine within the previous 7 days and with measles vaccine within the 7 to 14 days, before onset.....it is estimate that the attributable risk of a serious neurological disorder within seven days after DTP vaccine in previously normal children irrespective or eventual clinical outcome is 1 in 110,000 immunizations.....the corresponding rate for previously normal children with evidence of persistent neurological damage one year later is 1 in 310,000 immunizations." The NCES study also found that "the risk of a serious neurological disorder within 14 days after measles vaccine in previously normal children irrespective of eventual clinical outcome is 1 in 87,000 immunizations."

No large case controlled studies comparable to the methodology employed by NCES investigating potential causes of brain dysfunction in children, including the receipt of one or more vaccines in early childhood, has been conducted since NCES was published in 1981.

The VICP was not originally designed to be a federal imitation of bringing a product liability or malpractice lawsuit in civil court. Compensation was to be awarded based on "presumption" in the absence of a more plausible explanation for a child's health deterioration after vaccination, not "scientific proof" the vaccine or vaccines caused the child's injury. A Table of Compensable Events included in the 1986 law listed clinical symptoms and time periods within which symptoms occur following DPT, MMR and polio vaccination to serve as a guide for presumption of causation.

However, in 1995 federal health officials and Justice Department lawyers gutted the Table of Events by re-writing the definition of encephalopathy and removing symptoms and health conditions, such as residual seizures, that would automatically presume causation so that very few children would quality for automatic compensation under the Table guidelines. New vaccines, including HIB, hepatitis B, varicella zoster, pneumococcal, rotavirus, influenza, meningococcal, hepatitis A, were added to the VICP to protect the vaccine manufacturers and physicians from liability for injuries and deaths related to those vaccines but presumption guidelines were not added to the Table of Compensable Events.

Therefore, today almost all vaccine injured claims are argued off-Table and the process for obtaining compensation has become highly adversarial, traumatic, and time consuming, with two out of three vaccine victims turned away for compensation. The special masters have become judge and jury presiding over combatants on an uneven playing field, not facilitators of administration of vaccine injury claims. A federal vaccine injury compensation program that was supposed to re-instill public faith in the mass vaccination system has become a source of mistrust of the system.

To listen live or to listen to audio tapes of U.S. Court of Claims proceedings, click here:


Daily transcripts can also be viewed at:
Day 1, June 11, 2007 transcripts
Day 2, June 12, 2007 transcripts
Day 3, June 13 transcripts
Day 4, June 14, 2007 and upcoming trancripts
Soon will be available on-line.










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Pap Clears HPV; Majority Reject Vaccine Mandate

"The act of performing a Papanicolaou smear produces an inflammatory cytokine response, which may initiate immunologic clearance of human papillomavirus (HPV) and reduce the risk of cervical cancer, South African investigators propose in the April 24th online issue of the Journal of Inflammation.....Women who had even a single Pap smear in their history had a lower incidence of cancer. Dr. Passmore's team also observed that "a statistically significant decline in the HPV positivity rate correlated with the lifetime number of Pap smears received"........"This is the first study to our knowledge to investigate the effect of a Pap smear on cervical inflammation," the Cape Town researchers say. The findings, they conclude, are "an important step towards understanding whether these local Pap smear- associated responses are one of the factors initiating more long-term protection from HPV infection and clearance." - Reuters News Service, Pap Smears Cause Cytokine Response That May Help Clear HPV, MEDSCAPE , May 14, 2007

"The National Poll on Children's Health also asked parents if they felt, in general, that newly available vaccines were safe for their children..... less than one-half of parents (43%) agreed or strongly agreed that new vaccines are safe for their children. The majority either disagreed that new vaccines are safe for their children (8%) or were neutral (49%). There was a strong relationship between parents' perception of the safety of new vaccines and their views on vaccine mandates. Most parents (75%) who disagreed that new vaccines are generally safe opposed HPV school mandates, and 26% of parents who were neutral on vaccine safety opposed HPV mandates." - C.S. Mott Children's Hospital National Poll on Children's Health

Barbara Loe Fisher Commentary:

Too often in the past quarter century, the push to mandate newly licensed vaccines is based more on ideology, money and politics than on evidence based science. Although public health officials have convinced pediatricians to believe that vaccine injuries and deaths are either a myth or do not matter because the good of "the herd" trumps the value of individual life, parents aren't buying it anymore. Case in point: the rush to put policy before science did not work with the newly licensed HPV vaccine, GARDASIL, marketed by Merck.

HPV infection is a viral infection experienced by most people after they become sexually active with one or more partners, who have also been sexually active with one or more partners. It is an infection which is naturally and asymptomatically cleared from the body by more than 90 percent of girls and women who contract it. In the tiny minority of women, who do not naturally clear the HPV virus from the body and go on to develop chronic infection, the majority can prevent cervical cancer with regular pap smears that can detect pre-cancerous cervical lesions so they can be treated.

But now, there is even more evidence that regular pap smears are a powerful and cost effective weapon in the effort to end cervical cancer. The performing of a pap smear, according to a study published in the April 24 Journal of Inflammation, may help to produce an inflammatory response which initiates immunologic clearance of the HPV virus from a women's body. This would help explain why, in addition to early detection of pre-cancerous cervical lesions, the aggressive pap smear campaign in the US since the 1950's has been so successful in generating a 70 percent drop in cervical cancer cases in the US. It would also help explain why cervical cancer is the number one cancer killer of women in underdeveloped countries, where women living in poverty do not get routine physical exams and pap smears.

In the past six months, public opposition to proposed HPV vaccine mandates for 11 year old girls in America has reflected the fact that Americans are starting to understand what NVIC has been saying for more than two decades: when it comes to vaccines, policy often precedes science. HPV vaccine mandates for sixth grade girls pushed by Merck lobbyists seeking to capture the lucrative US market and endorsed by "public health" proponents who have never seen a vaccine they didn't want everyone to take, have been rejected in almost every state legislature in the US. Elected representatives in the states chose to listen to the voters who elected them rather than do the bidding of Merck.

And now, there is quantifiable evidence that public opposition to HPV vaccine mandates is not primarily focused on concern that kids will have sex too soon. A National Poll on Children's Health, conducted through C.S. Mott Children's Hospital and published by the University of Michigan, found that only 44 pecent of American parents support HPV vaccine mandates for young girls. They also found that only 43 percent of American parents agree that new vaccines are safe for their children and that "there was a strong relationship between parents' perception of the safety of new vaccines and their views on vaccine mandates. Most parents (75%) who disagreed that new vaccines are generally safe opposed HPV school mandates."

Public opposition to HPV vaccine mandates, then, is based on public opposition to being forced to use a vaccine for which policy has preceded science.

Before there is any more talk about HPV vaccine mandates and universal use by all pre-adolescent girls of this new vaccine, there needs to be more basic science research into the biological mechanisms as well as environmental and genetic factors involved in HPV infection, clearance, persistence, and resistance; and research into the biological mechanisms as well as environmental and genetic factors involved in HPV vaccine induced brain and immune system dysfunction, infertility, miscarriage, development of pre- cancerous lesions in girls vaccinated while actively infected with HPV vaccine types contained in the vaccine, and long term effectiveness.

The American public is smarter than public health officials, doctors and drug company lobbyists give them credit for being. People do not want to use or have their children be required to use vaccines which have not been proven safe, effective or necessary.
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Majority of U.S. Parents Not in Favor of State HPV Vaccine Mandates

C.S. Mott Children's Hospital National Poll on Children's Health

A publication from the University of Michigan Department of Pediatrics and Communicable Diseases and the University of Michigan Child Health Evaluation and Research (CHEAR) Unit.

Vol. 1, Issue 3; May 22, 2007

Report Highlights


*Only 44% of parents support a school mandate for the HPV vaccine for girls entering 9th grade.
*Parent support is stronger (68%) for a mandate for another new teen vaccine that prevents tetanus, diphtheria, and whooping cough (Tdap).
*Parents of older children are less likely to favor a mandate for the HPV vaccine.
*Parents concerned about safety of new childhood vaccines are less likely to support an HPV vaccine mandate.


In 2006, vaccination against human papillomavirus (HPV) was recommended by the Centers for Disease Control and Prevention (CDC) for all girls aged 11-12 years old. The currently available vaccine prevents infections by 4 different types of HPV, transmitted through sexual contact, that cause cervical cancer and genital warts.

States' legislative action regarding HPV vaccine has generated considerable attention. Virginia has enacted a law requiring HPV vaccination for entry into 9th grade, and 24 other states (including D.C.) have introduced bills to mandate that girls receive the 3- dose HPV vaccine series.

Advocates say that mandates that require children receive certain vaccines before they can enter daycare or school are known to boost immunization rates and protect children's health. Opponents say that vaccination mandates take health decisions out of the hands of parents. The debate is amplified for the HPV vaccine, because the vaccine prevents a major disease-cancer- but HPV infections would not be expected to affect school attendance like other infections for which vaccine mandates exist. Critics also cite concern about the HPV vaccine's cost and safety, and others express moral objections to a vaccine mandate for a sexually transmitted infection.

The C.S. Mott Children's Hospital National Poll on Children's Health asked parents if they would support a state law that requires girls to receive HPV vaccine before entering 9th grade. As a comparison, parents were also asked if they would support a state law requiring boys and girls to get a new booster vaccine that protects against tetanus, diphtheria and whooping cough (Tdap), also before entering 9th grade.

As shown in Figure 1, parents were far more likely to support a state school entry mandate for the Tdap vaccine (68%) than for the HPV vaccine (44%). Moreover, 26% of parents strongly disagree or disagree with a HPV vaccine mandate - nearly three times the proportion who disagree with the Tdap mandate.

Women (48%) were more likely than men (38%) to support a state mandate for HPV vaccine. Of note, parents of teens (ages 13-17) were less likely to support an HPV vaccine mandate (40%) than were parents of children 6-12 years old (44%) and parents of children younger than 6 years old (53%).

Parents with public insurance (Medicaid and Medicare) were more likely to support HPV vaccine mandates than parents with private insurance or no coverage.

There were no differences in support for mandates for HPV or Tdap vaccine by region or race/ethnicity, and there was no consistent pattern by parent education, household income or parent age. As shown in Figure 2, the rank order of the top 3 health problems for children differed by the race/ethnicity of the person surveyed. While the list was similar for Hispanics and other race/ethnicity groups to the overall rankings, among whites alcohol abuse nudged above childhood obesity as the third biggest concern.

Attitudes About Vaccine Safety and Mandates

The National Poll on Children's Health also asked parents if they felt, in general, that newly available vaccines were safe for their children. As shown in Figure 2, less than one-half of parents (43%) agreed or strongly agreed that new vaccines are safe for their children. The majority either disagreed that new vaccines are safe for their children (8%) or were neutral (49%).

There was a strong relationship between parents' perception of the safety of new vaccines and their views on vaccine mandates. Most parents (75%) who disagreed that new vaccines are generally safe opposed HPV school mandates, and 26% of parents who were neutral on vaccine safety opposed HPV mandates. Among parents who agreed that vaccines are generally safe, only 16% opposed an HPV mandate. In contrast, among parents who agreed that vaccines are generally safe, 61% supported an HPV mandate.

State Legislation and Parent Opinion on Mandates

The National Poll on Children's Health included responses from parents in 48 states and the District of Columbia. Responses of parents in Virginia and 24 states (including D.C.) considering legislation about HPV school mandates were compared with responses of parents in the remainder of states, to see whether their attitudes about mandates differ.

Overall, there were no significant differences in parent opinions on a state mandate for HPV vaccination for girls when comparing responses from states with an existing mandate or pending legislation (45% in favor of mandates) to states that have not introduced HPV mandate legislation (42% in favor of mandates). In addition, there were no significant differences in opinions between these two groups regarding school mandates for Tdap vaccine.

Implications

State mandates regarding vaccination upon school entry have long been effective ways to help safeguard children's health, but they have become increasingly controversial. In the case of HPV vaccine, mandate proponents argue that states should encourage parents to prevent their daughters from getting cervical cancer caused by HPV infection. Mandate opponents say that HPV vaccination should not be required because the infection is not communicated through respiratory contact and therefore does not pose the same danger to health of school communities as other illnesses prevented by mandated vaccines. Of note, the CDC and the American Academy of Pediatrics support universal HPV vaccination for girls but do not support mandates for HPV vaccine.

In this National Poll on Children's Health, we found that less than one-half of US parents favor an HPV vaccine mandate for school entry. Moreover, one- quarter of parents unequivocally disagree with HPV vaccine mandates. In contrast, more than two-thirds of parents favor a mandate regarding the new Tdap vaccine - although such a mandate has not been considered by states so widely as HPV mandates.

These findings indicate that the American public is able to distinguish between new vaccines, and that legislative action on HPV may be somewhat disconnected from public sentiment. Ultimately, HPV vaccination efforts may lack the boost given by school entry mandates to other broadly recommended vaccines.

Datasource

This report presents findings from a nationally representative household survey conducted exclusively by Knowledge Networks, Inc, for C.S. Mott Children's Hospital. The survey was administered from March 14- 26, 2007, to a randomly selected, stratified group of adults aged 18 and older with and without children from the Knowledge Networks standing panel that closely resembles the U.S. population. The sample was subsequently weighted to reflect the U.S. population figures from the Census Bureau. The response rate was 73% among Knowledge Networks panel members contacted to participate. This report reflects responses from a subsample of 1342 parents.

C.S. Mott Children's Hospital National Poll on Children's Health

Director: Matthew M. Davis, MD, MAPP Associate Professor of Pediatrics, Internal Medicine and Public Policy

Editor: Dianne C. Singer, MPH Research Associate