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Committee on the Assessment of Studies of Health Outcomes Related to the Recommended Childhood Immunization Schedule; Board on Population Health and Public Health Practice; Institute of Medicine. The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies. Washington (DC): National Academies Press (US); 2013 Mar 27.

The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies.

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1 Introduction

Vaccines have significantly contributed to worldwide reductions in morbidity and mortality by reducing the incidence of serious infectious diseases ( IOM, 2012 ). Today, people all over the world experience the benefits of immunizations, beginning in infancy. Most adults in the United States have not witnessed firsthand the devastating illnesses against which vaccines offer protection, for example, polio, diphtheria, and Haemophilus influenzae meningitis. However, as the incidence of vaccine-preventable disease has declined, many do not appreciate the potential of these diseases to reemerge, and the potential adverse effects of the vaccines themselves take on greater saliency among certain stakeholders. Indeed, vaccine safety concerns exist among a diverse range of individuals, institutions, and formal and informal networks worldwide.

Healthy individuals are immunized with immunogenic materials that induce immunity to serious pathogens. A “schedule” is a tool that is used to ensure that the recommended immunizations are provided to shield both children and adults from disease when they are the most vulnerable. In the United States, schedules recommended by the U.S. Advisory Committee on Immunization Practices (ACIP) (schedules for children from birth to age 6 years, children and adolescents ages 7 through 18 years, and adults) are based on the immunogenicity of vaccines and the burden and timing of disease ( CDC, 2011a ). Each schedule is designed and updated yearly on the basis of new evidence (see Appendix A ). This report focuses on the vaccines that protect young children under age 6 years against 14 different pathogens because that time period is when multiple inoculations are given (see Appendix A ).

Children may receive as many as 24 injections by 2 years of age and up to 5 injections in a single visit (see Appendix A ). Immunization schedules vary around the world, however, with the variability being due in part to the different patterns of disease that exist globally ( Lopalco et al., 2009 ; WHO, 2012 ). Additionally, levels of antigens and immunization timing and number differ. Some countries also have differing approaches to postmarketing surveillance systems, as will be described in Chapter 3 .

Although the number of vaccinations recommended is greater than ever before, the vaccines used in the current immunization schedule actually have fewer antigens (inactivated or dead viruses and bacteria, altered bacterial toxins, or altered bacterial toxins that cause disease and infection) because of developments in vaccine technology ( Offit et al., 2002 ). For example, the vaccines to prevent whooping cough used before 1991 contained 3,000 different potentially antigenic proteins ( IOM, 2002 ). From 1980 to 2000, the immunization schedule's total number of antigens decreased by approximately 96 percent (from 3,041 to 123–126) ( Offit et al., 2002 ).

Ever since vaccines were introduced in the 18th century, questions and concerns about their safety have been voiced. However, the protection against feared, deadly diseases that vaccines offer encourages the majority of health care professionals and laypeople to support immunization ( Stern and Markel, 2005 ). Although research on the adverse effects of individual vaccines is robust and a required part of the approval process by ACIP, questions about the safety of the entire recommended immunization schedule for children persist. Moreover, how safety is interpreted varies according to the severity of an adverse event and the benefit of the vaccine. For example, some might believe that one serious adverse event that occurs once in 1 million doses is “safe enough” compared with the benefit of prevention of serious disease, whereas others may consider that risk unacceptably high.

As the number of recommended vaccines has increased in recent years, some parents and advocacy groups have expressed the concern that the immunization schedule is too crowded and complex because of the increasing number of vaccines administered during the first 2 years of a child's life ( Offit et al., 2002 ). In addition to the complexity of vaccine delivery, some people have raised questions about the potential for adverse health outcomes as a consequence of the simultaneous or sequential administration of childhood vaccines ( Gregson and Edelman, 2003 ). Even though the current childhood immunization schedule offers flexibility for administration of recommended vaccines (see Appendix A ), some parents elect not to follow the recommended schedule ( Dempsey et al., 2011 ).

Analysis of current U.S. data shows that the vaccination rate among children entering kindergarten exceeds 90 percent for most recommended vaccines ( CDC, 2012b ). However, increases in the prevalence of delay or refusal of recommended vaccines have contributed to the emergence of vaccine-preventable illnesses across the country. For example, measles and pertussis outbreaks have occurred in recent years in geographic areas with higher concentrations of unimmunized children ( Felkin et al., 2000 ). States with easy procedures for granting exemptions were associated with a 90 percent higher incidence of pertussis in 2004 ( Omer et al., 2006 ). Some vaccine-preventable diseases can be fatal and have caused morbidity and mortality in infants and people with compromised immune systems. The impacts on disease prevention that vaccines have had in the United States are illustrated in Table 1-1 .

Comparison of Pre-Vaccine Annual Incidence and Current Morbidity for Vaccine-Preventable Diseases.

Vaccinations—like all medical procedures—are neither 100 percent free of risk nor 100 percent effective. Vaccines, in rare cases, can cause illness. Most children who experience an adverse reaction to immunization have a preexisting susceptibility. Some predispositions may be detectable prior to vaccination; others, at least with current technology and practice, are not ( IOM, 2012 , p. 82). The U.S. Department of Health and Human Services (HHS), through its agencies responsible for vaccine safety, supports such research and surveillance, including studies addressing concerns and fears over the current childhood immunization schedule. The system in the United States designed to ensure vaccine safety is detailed in Chapter 3 . While immunization may be one of the greatest achievements in public health, the complex interactions among populations, health care systems, families, children, and so forth that are affected by the immunization schedule cannot be ignored.

• STUDY BACKGROUND

On June 2, 2009, the National Vaccine Advisory Committee (NVAC) reviewed the nation's vaccine safety system and endorsed the recommendation of the NVAC Safety Working Group for an external expert committee, such as a committee convened by the Institute of Medicine (IOM), “with broad expertise in research methodologies, study design, and the ethical conduct of research to consider the strengths and weaknesses, ethical issues and feasibility including timelines and cost of various study designs to examine outcomes in unvaccinated, vaccine-delayed and vaccinated children and report back to the NVAC” ( CDC, 2011b , p. 72).

The recommendation by the NVAC Safety Working Group was based on a series of meetings and discussions on the U.S. childhood immunization schedule in which individuals raised concerns that the schedule could potentially harm children because of immunological or neurodevelopmental adverse effects. Furthermore, in the minds of some parents, concerns about potential harms outweigh the well-documented benefits of immunization for the prevention of morbidity and mortality, with the result being that their children are less than fully immunized ( NVAC, 2009 ).

After years of debate, some people continue to advocate for a study to compare health outcomes among vaccinated and unvaccinated children. The NVAC report stated that “the strongest study design, a randomized clinical trial that includes a study arm receiving no vaccine or vaccine not given in accord with the current recommended schedule, is not ethical, would not pass Institutional Review Board (IRB) review, and cannot be done” ( NVAC, 2009 , p. 38). ( Chapter 6 discusses some of the ethical considerations in detail.) Furthermore, it may be impossible to draw unbiased results from an observational study of this issue because of potential differences in baseline health and social characteristics of populations and subgroups.

• COMMITTEE ON THE ASSESSMENT OF STUDIES OF HEALTH OUTCOMES RELATED TO THE RECOMMENDED CHILDHOOD IMMUNIZATION SCHEDULE

The National Vaccine Program Office of HHS asked the IOM to convene a diverse committee of experts in pediatrics, neurology, medical ethics, immunology, statistics, epidemiology, and public health to identify study designs feasible to address questions about the safety of the United States' childhood immunization schedule. A 14-member committee was selected to complete a study addressing the statement of task (see Box 1-1 ). The committee's charge was independent of the charges for previous IOM studies of vaccines, and committee members were carefully selected to avoid real or perceived biases or conflicts of interest. Strict criteria for membership prevented any members from having financial ties to vaccine manufacturers or their parent companies, previous service on federal vaccine advisory committees, or delivered expert testimony or written publications on issues of vaccine safety.

Statement of Task. The Institute of Medicine will convene an expert committee to Review scientific findings and stakeholder concerns related to the safety of the recommended childhood immunization schedule.

Biographical sketches of the members of committee can be found in Appendix F . The committee's charge is detailed in Box 1-1 .

• COMMITTEE PROCESS

To complete its charge, the committee held three information-gathering meetings in two different locations. Before the first meeting and throughout the committee's deliberations, the committee gathered information on public perspectives and reviewed the scientific literature on the safety of the recommended childhood immunization schedule. At the public forums held in February, March, and May 2012, the committee heard presentations from clinicians, representatives of U.S. federal and state agencies and public health agencies in other countries, vaccine safety researchers, advocacy groups, vaccine manufacturers, and methodological experts. During the public forums, the committee invited comments (both written and oral) from the general public and representatives from numerous organizations with an interest in vaccine safety. Additionally, the committee received and reviewed written correspondence from the public throughout the duration of the study.

The committee held 5 deliberative meetings over 6 months between February and August 2012. To fully address its charge, the committee identified a consultant who prepared a commissioned paper on study designs that could be used to assess the safety of the immunization schedule (see Appendix D ). The paper, written by Martin Kulldorff, was intended to provide methodological input to the committee, but the paper does not necessarily reflect the committee's views or deliberations. To solicit stakeholders' interest and feedback, a draft version of the commissioned paper was posted on the committee's website on May 14, 2012, and comments on the paper were invited from the public. The comment period extended to May 31, 2012, and approximately 230 individuals provided written feedback. After a review of these comments and committee discussion, the committee requested revisions from the consultant. The commissioned paper was finalized on July 3, 2012, and again posted online for comment. The committee reviewed an additional 700 comments.

• PREVIOUS IOM VACCINE STUDIES

Since the late 1970s, the IOM has conducted 60 studies on vaccination (see Appendix G ). Each IOM study has relied on scientific evidence as the basis for its findings, conclusions, and recommendations. Committee members reviewed the summaries of 18 IOM studies that focused on vaccine safety. Reexaminations of safety are often prompted by new scientific findings and rising concerns usually in relationship to an individual vaccine and a possible adverse health outcome. However, the study of the present IOM committee is unique in that its focus is on the complete childhood immunization schedule.

This report follows a series of eight reports on vaccine safety that appeared between 2001 and 2004. The eighth report in this series examined the evidence about a possible link between autism and vaccines. That examination of the evidence found no association. A striking element described in each of these IOM reports is society's sustained interest in vaccines ( Fineberg, 2011 ).

The 2012 IOM committee report Adverse Effects of Vaccines: Evidence and Causality examined 158 pairs of vaccines and putative adverse effects and was the IOM's most recent study of vaccine safety ( IOM, 2012 ). No evidence to support a link between a vaccine and adverse events was found for the majority of adverse events, but this was often due to the rarity of the adverse event and the lack of evidence in general to support or reject a causal link. However, the committee concluded that very few health problems are caused by or are clearly associated with vaccines.

• ORGANIZATION OF THE REPORT

This report is organized into seven chapters and seven appendixes. Chapter 2 provides background on how vaccines are developed and recommended for U.S. children. Chapter 3 details existing surveillance and data systems for evaluating vaccine safety. Chapter 4 reports on the committee's review of stakeholder concerns. Chapter 5 describes the methods used to perform and the results of a literature review on the scientific findings of studies of selected health outcomes and the recommended immunization schedule. Chapter 6 presents several methodological approaches for future studies. Chapter 7 summarizes the committee's findings, conclusions, and recommendations. The appendixes include ACIP's 2012 recommended immunization schedule for children ( Appendix A ), a glossary ( Appendix B ), a list of acronyms used in this report ( Appendix C ), the commissioned paper by Martin Kulldorff ( Appendix D ), agendas from public meetings held by the committee ( Appendix E ), biographical sketches of the committee members ( Appendix F ), and a chronological list of the IOM's vaccine publications ( Appendix G ).

• CDC (Centers for Disease Control and Prevention). General recommendations on immunization—recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recommendations and Reports: Morbidity and Mortality Weekly Report. 2011a; 60 (2):1–64. [ PubMed : 21293327 ]
• CDC. Immunization Safety Office scientific agenda. Atlanta, GA: Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; 2011b.
• CDC. Final 2011 reports of nationally notifiable diseases. Morbidity and Mortality Weekly Report. 2012a; 61 (32):624–637.
• CDC. Vaccination coverage among children in kindergarten—United States, 2011–12 school year. Morbidity and Mortality Weekly Report. 2012b; 61 (33):647–652. [ PubMed : 22914226 ]
• Dempsey AF, Schaffer S, Singer D, Butchart A, Davis M, Freed GL. Alternative vaccination schedule preferences among parents of young children. Pediatrics. 2011; 128 (5):848–856. [ PubMed : 21969290 ]
• Felkin DR, Lezotte DC, Hamman RF, Salmon DA, Chen RT, Hoffman RE. Individual and community risks of measles and pertussis associated with personal exemptions to immunization. Journal of the American Medical Association. 2000; 284 (24):3145–3150. [ PubMed : 11135778 ]
• Fineberg HV. A perspective on vaccines: President's address; Washington, DC. 2011.
• Gregson AL, Edelman R. Does antigenic overload exist? The role of multiple immunizations in infants. Immunology and Allergy Clinics of North America. 2003; 23 (4):649–664. [ PubMed : 14753385 ]
• IOM (Institute of Medicine). Immunization safety review: Multiple immunizations and immune dysfunction. Washington, DC: National Academy Press; 2002. [ PubMed : 25057595 ]
• IOM. Adverse effects of vaccines. Washington, DC: The National Academies Press; 2012.
• Lopalco PL, de Carvalho HG, Kreidl P, Leitmeyer K, Giesecke J. Childhood vaccination schedules in Europe vary widely. Is this a problem. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2009; 52 (11):1095–1098. [ PubMed : 19756336 ]
• NVAC (National Vaccine Advisory Committee). Recommendations on the Centers for Disease Control and Prevention Immunization Safety Office draft 5-year scientific agenda. Washington, DC: National Vaccine Advisory Committee; 2009.
• Offit PA, Quarles J, Gerber MA, Hackett CJ, Marcuse EK, Kollman TR, Gellin BG, Landry S. Addressing parents' concerns: Do multiple vaccines overwhelm or weaken the infant's immune system. Pediatrics. 2002; 109 (1):124–129. [ PubMed : 11773551 ]
• Omer SB, Pan WK, Halsey NA, Stokley S, Moulton LH, Navar AM, Pierce M, Salmon DA. Nonmedical exemptions to school immunization requirements: Secular trends and association of state policies with pertussis incidence. Journal of the American Medical Association. 2006; 296 (14):1757–1763. [ PubMed : 17032989 ]
• Roush SW, Murphy TV, Disease Table Working Group Vaccine-Preventable. Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States. Journal of the American Medical Association. 2007; 298 (18):2155–2163. [ PubMed : 18000199 ]
• Stern AM, Markel H. The history of vaccines and immunization: Familiar patterns, new challenges. Health Affairs. 2005; 24 (3):611–621. [ PubMed : 15886151 ]
• WHO (World Health Organization). Immunization, vaccines and biologicals. Geneva, Switzerland: World Health Organization; 2012. [September 2012]. http://www ​.who.int/immunization ​/policy/immunization_tables ​/en/index.html .
• Cite this Page Committee on the Assessment of Studies of Health Outcomes Related to the Recommended Childhood Immunization Schedule; Board on Population Health and Public Health Practice; Institute of Medicine. The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies. Washington (DC): National Academies Press (US); 2013 Mar 27. 1, Introduction.
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Childhood Immunisation Ppt

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22 April 2022

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Powerpoint presentation on childhood immunisations (pre-Covid)

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Prevaccine and Vaccine-Era Disease Estimates

Hepatitis a, hepatitis b, haemophilus influenzae type b, measles, mumps, and rubella, streptococcus pneumoniae, conclusions, acknowledgments, impact of routine childhood immunization in reducing vaccine-preventable diseases in the united states.

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Sandra E. Talbird , Justin Carrico , Elizabeth M. La , Cristina Carias , Gary S. Marshall , Craig S. Roberts , Ya-Ting Chen , Mawuli K. Nyaku; Impact of Routine Childhood Immunization in Reducing Vaccine-Preventable Diseases in the United States. Pediatrics August 2022; 150 (3): e2021056013. 10.1542/peds.2021-056013

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Current routine immunizations for children aged ≤10 years in the United States in 2019 cover 14 vaccine-preventable diseases. We characterize the public-health impact of vaccination by providing updated estimates of disease incidence with and without universally recommended pediatric vaccines.

Prevaccine disease incidence was obtained from published data or calculated using annual case estimates from the prevaccine period and United States population estimates during the same period. Vaccine-era incidence was calculated as the average incidence over the most recent 5 years of available surveillance data or obtained from published estimates (if surveillance data were not available). We adjusted for underreporting and calculated the percent reduction in overall and age-specific incidence for each disease. We multiplied prevaccine and vaccine-era incidence rates by 2019 United States population estimates to calculate annual number of cases averted by vaccination.

Routine immunization reduced the incidence of all targeted diseases, leading to reductions in incidence ranging from 17% (influenza) to 100% (diphtheria, Haemophilus influenzae type b, measles, mumps, polio, and rubella). For the 2019 United States population of 328 million people, these reductions equate to >24 million cases of vaccine-preventable disease averted. Vaccine-era disease incidence estimates remained highest for influenza (13 412 per 100 000) and Streptococcus pneumoniae -related acute otitis media (2756 per 100 000).

Routine childhood immunization in the United States continues to yield considerable sustained reductions in incidence across all targeted diseases. Efforts to maintain and improve vaccination coverage are necessary to continue experiencing low incidence levels of vaccine-preventable diseases.

The United States childhood vaccination program has dramatically reduced morbidity, mortality, and disability for targeted diseases. Updated estimates of disease incidence and cases averted, reflecting changes in disease epidemiology, vaccine utilization, and vaccine recommendations (based on the 2017 to 2021 schedule), are needed.

The childhood vaccination program reduced the incidence of all targeted diseases—with reductions ranging from 17% (influenza) to 100% (diphtheria, Haemophilus influenzae type b, measles, mumps, polio, and rubella)—and averted >24 million disease cases for the 2019 United States population.

Childhood vaccination has dramatically reduced morbidity, mortality, and disability caused by vaccine-preventable diseases, with ∼21 million hospitalizations, 732 000 deaths, and 322 million cases of disease averted in the United States between 1994 and 2013. 1   Among diseases targeted by vaccines recommended before 1980, 3—polio, measles, and rubella—have achieved elimination status as defined by the World Health Organization 2   and 1—smallpox—has been eradicated. 3   Diphtheria and tetanus have declined markedly in incidence with routine immunization and are well controlled, 2   whereas the incidence of pertussis and mumps has declined when compared with prevaccine levels but still fluctuates given periodic outbreaks since vaccination was introduced. 3   The public health burden of diseases targeted in the childhood immunization program between 1980 and 2005, including hepatitis A, hepatitis B, invasive Haemophilus influenzae type b (Hib), varicella, and invasive pneumococcal disease (IPD), has decreased by more than 80% 3   ; reductions in related nontargeted diseases (eg, acute otitis media caused by Streptococcus pneumoniae ) have also been observed. 4   After 2005, the routine immunization schedule 5   for United States children ≤10 years of age targeted additional pathogens, such as rotavirus and further pneumococcal serotypes. 5  

This study updates estimates of the reduction in overall and age-specific disease incidence associated with the routine childhood immunization program in the United States (based on the 2017 to 2021 vaccination schedule). This update incorporates changes in vaccine utilization rates and observed incidence of the targeted vaccine-preventable diseases since previous evaluations. 3 , 6   The present analysis will be of interest to policy makers, public health decision makers, and modelers concerned with public health interventions to minimize the burden of vaccine-preventable diseases. A companion study evaluated the value of the childhood immunization program for the 2017 United States birth cohort. 7  

We estimated the epidemiologic impact of the United States routine childhood immunization program (ages ≤10 years) by calculating the percent reduction in overall and age-specific disease incidence rates for each disease targeted by the program. We multiplied the prevaccine and vaccine-era incidence rates (using age-specific data, where available) by 2019 United States population estimates, 8   accounting for underreporting where necessary, to calculate the 2019 clinical disease burden with and without childhood immunization and to estimate the cases averted by vaccination. As in previous studies, we assumed that the difference between incidence rates during these periods was entirely attributable to the childhood immunization program. 3 , 6  

For the prevaccine period, we estimated disease incidence using published incidence estimates or calculated incidence using published annual case estimates and United States population data from the same period. For the vaccine era, we calculated incidence as the average incidence over the most recent 5 years of available surveillance data; we used published incidence estimates if surveillance data were not available. For both periods, we accounted for underreporting where necessary.

Table 1 summarizes the prevaccine and vaccine-era disease incidence sources. Age-specific incidence data were used for all diseases except diphtheria, polio, tetanus, and rotavirus. Incidence of Hib and rotavirus was limited to ages <5 years and diphtheria to ages ≤10 years, given lack of data in older age groups in the prevaccine period and the fact that clinical burden was largely limited to those age groups in both periods. Incidence of measles, mumps, and rubella was included only up to age 40 years, as prevaccine incidence data in ages ≥40 years was unavailable. For pneumococcal pneumonia, pneumococcal acute otitis media (AOM), and rotavirus, resource use estimates (ie, hospitalizations, emergency department [ED] visits, and outpatient visits) are reported instead of incidence and disease cases because of limitations in the source data.

Summary of Prevaccine and Vaccine-Era Disease Incidence Sources

ABC, Active Bacterial Core; AOM, acute otitis media; CDC, Centers for Disease Control and Prevention; ED, emergency department; IPD, invasive pneumococcal disease; NNDSS, National Notifiable Diseases Surveillance System.

Dates of immunization program initiation correspond to dates of vaccine licensure and/or routine recommended use. 3 , 96   For additional details on vaccines with multiple dates listed, please see Roush and Murphy 3   and Widdowson et al. 76  

Prevaccine pertussis incidence estimates for ages >10 y were estimated from all cases reported by Roush and Murphy, 3   adjusted to account for the estimate from Cherry 95   that approximately 93% of pertussis infections in the first half of the 20th century were among ages <10 y.

An underreporting factor of 10 was taken from economic evaluations and burden-of-illness studies 53 – 55   and was multiplied by prevaccine pertussis incidence in ages >10 y and vaccine-era pertussis incidence for all ages; prevaccine incidence from birth to age 10 y (taken from Zhou et al) already accounted for underreporting. 9   This underreporting factor is conservative compared with previous studies that have tested underreporting of pertussis up to 100 to 200 times reported cases among adolescents and adults. 53 , 55 , 56  

A prevaccine underreporting factor was calculated based on an estimated 48% of notifiable polio cases being paralytic in 1954. 74   This implied underreporting factor (1 of 0.48 = 2.1 cases per reported case) was used to calculate the estimated total number of notifiable polio cases (both paralytic and nonparalytic) based on the incidence of paralytic polio reported by Baicus. 75  

The prevaccine underreporting factor (22.2) was calculated from the 1994 NNDSS report, 20   which reported that approximately 3.7 million cases of varicella occurred annually prevaccine, with 4% to 5% of cases reported. 11 – 15  

Because cases of varicella were not reported by age in 2014 and 2015, the total cases were distributed by age using the same age distribution of cases from 2016 when calculating the age-specific 5-year incidence rate. The vaccine-era underreporting factor (10.4) was calculated based on the underreporting factor used by Roush and Murphy 3   (12.7 = 612 768 cases estimated of 48 445 cases reported by 33 states in 2006), adjusted for 40 states reporting varicella cases in 2015 versus 33 states in 2006 (12.7 × 33/40 = 10.4).

We obtained prevaccine diphtheria disease incidence for children aged ≤10 years from an economic evaluation by Zhou et al, 9   which estimated incidence from a 1916 to 1919 survey of childhood vaccine-preventable diseases in 31 353 United States children and physician-reported data. 10   We assumed the incidence reported by Zhou et al 9   for ages 5 to 9 years uniformly applied to all children ≤10 years. We calculated vaccine-era incidence among children aged ≤10 years as the average value over the most recent 5 years (2014 to 2018) of available data from the Centers for Disease Control and Prevention (CDC) National Notifiable Disease Surveillance System (NNDSS) reports. 11 – 15  

We calculated prevaccine hepatitis A incidence using the average number of reported cases between 1990 and 1994 from the NNDSS 16 – 20   divided by the 1994 United States population for each respective age group. 21   We calculated vaccine-era incidence as the average value over the most recent 5 years (2014 to 2018) of available data from the NNDSS. 11 – 15   A systematic review and meta-analysis of underreporting of hepatitis A in nonendemic countries found that reported hepatitis A cases ranged from 4% to 97% of total estimated cases across 8 included studies, with a pooled proportion of 59%. 22   As a result, an underreporting factor of 1.7 (1/59% = 1.7) was applied for prevaccine and vaccine-era estimates, 22   which is similar to underreporting factors found in other studies. 23  

We estimated prevaccine hepatitis B incidence as the average number of reported cases between 1976 and 1980 from the NNDSS 24 – 28   and calculated vaccine-era incidence as the average value over the most recent 5 years (2014 to 2018) of available data from the NNDSS. 11 – 15   The underreporting factor for hepatitis B (6.5) was obtained from a probabilistic model estimating underreporting of hepatitis A, B, and C. 23  

We obtained prevaccine disease incidence for Hib for children aged <5 years for 1976 to 1984 from an economic analysis by Zhou et al. 29   We calculated overall incidence by summing the incidence values reported separately for Hib-related meningitis, epiglottitis, bacteremia, pneumonia, cellulitis, arthritis, and other invasive diseases reported in Zhou et al. 29   We calculated vaccine-era incidence among children aged <5 years as the average value over the most recent 5 years (2013–2017) of available data from CDC Active Bacterial Core (ABC) surveillance reports. 30 – 34  

For influenza, instead of using data from the period before influenza vaccines were routinely recommended, we estimated prevaccine incidence among children aged ≤10 years by using the number of cases and averted cases estimated by the CDC, assuming all averted cases would have occurred without vaccination. 35 – 42   Specifically, we summed the number of reported cases to the cases averted by vaccination among children <5 years and children aged 5 to 10 years for 5 recent influenza seasons (2014–2015 to 2018–2019) and then divided the total number of cases by the number of children in the United States in each respective age group for the same period. 8   An average incidence across the 5 years was then calculated for both age groups. For vaccine-era incidence, we used the same source and calculated the average incidence over the same 5 recent seasons (2014–2015 to 2018–2019). Our analyses did not account for the impact of adolescent and adult influenza vaccination or herd immunity in older age groups; therefore, incidence of influenza was restricted to ages ≤10 years, and we attributed all changes in incidence to vaccination in this age cohort.

For measles, mumps, and rubella, we obtained prevaccine disease incidence from Zhou et al. 43 – 47   For the vaccine era, we calculated incidence as the average value over the most recent 5 years (2014 to 2018) of available data from the NNDSS. 11 – 15  

We estimated prevaccine pertussis incidence for birth to 10 years from 2 economic evaluations of diphtheria, tetanus, and acellular pertussis vaccine, which derived age-specific risk of pertussis from United States data in the 1920s and from Sweden in the 1980s. 9 , 48   Prevaccine incidence for ages >10 years was calculated using the number of reported pertussis cases estimated by Roush and Murphy 3   for ages >10 years during 1934 to 1943 (before the start of routine pertussis vaccination in the late 1940s) divided by the size of the United States population >10 years old over the same period. 49 , 50   We calculated vaccine-era incidence as the average value over the most recent 5 years (2014 to 2018) of available data from the NNDSS. 11 – 15   An underreporting factor of 10 was applied in the prevaccine and vaccine eras ( Table 1 ). 51 – 56  

For IPD, we calculated prevaccine disease incidence as the average value from the 1997 to 1999 ABC surveillance reports 57 – 59   and calculated vaccine-era incidence as the average value from the 2013 to 2017 ABC surveillance reports. 60 – 64  

For pneumococcal pneumonia, we obtained prevaccine, age-specific, all-cause pneumonia hospitalization rates per 100 000 for the period 1997 to 1999 65   and all-cause outpatient visit rates per 100 000 for the period 1998 to 2000 66 , 67   ( Table 1 ). For the vaccine era, we used the incidence of all-cause pneumonia from 2014 based on an analysis of a large convenience insurance claims dataset (MarketScan) multiplied by the percentage hospitalized or treated in an outpatient or ED setting taken from the same study. 68   We multiplied the all-cause rates by the prevaccine 69 , 70   and postvaccine 71 , 72   percentage of all-cause pneumonia caused by pneumococcus ( Table 1 ).

For pneumococcal AOM, we used prevaccine, age-specific incidence from 1997 to 1999 and vaccine-era incidence from 2012 to 2014 from a retrospective analysis of the National Ambulatory Medical Care Survey comparing ambulatory visit rates before the introduction of 7-valent and following 13-valent pneumococcal conjugate vaccine. 4   We summed annual rates of physician office, hospital outpatient, and hospital ED visits to calculate a total annual ambulatory visit rate per 1000 children. To calculate pneumococcal AOM burden for each period, we multiplied all-cause rates by the percentage of AOM caused by pneumococcus in the prevaccine period (1995 to 2001) (44%) and vaccine era (2010 to 2016) (21%). 73  

For polio, we obtained the average number of paralytic poliomyelitis cases for the period 1951 to 1954 (before the introduction of the first polio vaccine in 1955) from Roush and Murphy 3   . We divided the total number of cases by the average United States population size from 1951 to 1954 to estimate an overall incidence rate. 49   Age-specific data were not available in the prevaccine period; therefore, the same incidence rate was used for all ages. A prevaccine underreporting factor of 2.1 was applied ( Table 1 ). 74 , 75   We calculated vaccine-era incidence as the average value over the most recent 5 years (2014 to 2018) of available data from the NNDSS. 11 – 15  

We calculated prevaccine estimates of rotavirus-related burden among children aged <5 years using 1993 to 2002 data on the cumulative individual risk of event by age 59 months for events including hospitalizations, ED visits, and hospital or ambulatory outpatient visits. 76   The median values were used to calculate annual probabilities of each type of rotavirus-related resource use. We further assumed rotavirus events were uniformly distributed from birth to age 5 years ( Supplemental Table 3 ). In the vaccine era, we calculated rotavirus-related burden by multiplying prevaccine event rates by the estimated reduction in hospitalizations 77   and reduction in ED and outpatient visits. 78  

We calculated prevaccine tetanus incidence based on the number of cases reported during 1947 to 1949 (before routine vaccination began in the late 1940s 3   ) divided by the average size of the United States population during that same period. 49   Data were not available by age in the prevaccine period; therefore, the same incidence rate was used across all ages in the model. We calculated vaccine-era incidence as the average value over the most recent 5 years (2014 to 2018) of available data from the NNDSS. 11 – 15  

We calculated prevaccine varicella incidence using the average number of reported varicella cases between 1990 and 1994 (before vaccine introduction in 1995) from the NNDSS 16 – 20   divided by the 1994 United States population for each respective age group. 20 , 21   We calculated vaccine-era incidence as the average value over the most recent 5 years (2014 to 2018) of available data from the NNDSS. 11 – 15   Underreporting factors of 22.2 and 10.4 were applied to prevaccine and vaccine-era incidence, respectively ( Table 1 ). 3 , 20  

We report calculated incidence overall and by age for both the prevaccine and 2019 vaccine-era periods. We calculated the percent reduction in incidence overall and by age group for each disease by comparing the 2 periods. Using 2019 United States population estimates from the United States Census Bureau, we calculated the number of cases of each disease that would be expected in 2019 without and with the routine childhood immunization program and the number of cases of disease averted.

For infants (<1 year), prevaccine annual incidence per 100 000 was highest for pneumococcal AOM (49 324), influenza (18 903), measles (9200), and pertussis (4720) ( Supplemental Tables 3 – 5 ). For young children (ages 1 to 4 years), as for infants, incidence in the prevaccine period was highest for pneumococcal AOM (15 004–49 324), influenza (18 903), measles (10 641–11 503), and pertussis (4720), as well as for varicella (4519). For school-aged children (ages 5–18 years), prevaccine incidence varied by age group but was highest for influenza (14 066), varicella (389–6480), pneumococcal AOM (4840), and pertussis (131–4720). For adults, prevaccine incidence was highest for pneumococcal pneumonia (29–1553), rubella (300), mumps (99–256), and pertussis (131).

After vaccines were introduced, incidence decreased for all diseases evaluated ( Fig 1 ; Table 2 ). Incidence was reduced to less than 1 per 100 000 for 6 of the diseases: diphtheria, Hib, measles, polio, rubella, and tetanus. The incidence of mumps was reduced by >99% and varicella by 98%. The incidence of rotavirus-related hospitalizations among children aged <5 years was reduced by 91%; a lower reduction was observed for rotavirus-related ED visits (61%) and outpatient visits (45%). The incidence of pertussis was reduced by 91%, hepatitis A by 87%, hepatitis B by 86%, and IPD by 60%. Pneumococcal pneumonia hospitalization rates and outpatient visit rates decreased by 84% and 69%, respectively, and incidence of pneumococcal AOM decreased by 75%. The incidence of influenza among people aged <11 years was reduced by 17%.

Percentage reduction in disease incidence in the vaccine era by disease. Percentage reduction for rotavirus is hospitalizations. IPD does not include pneumococcal pneumonia or acute otitis media. Percentage reductions in disease incidence round up to 100% for several diseases, although there are still some cases in the vaccine era ( Table 2 ). IPD, invasive pneumococcal disease.

Prevaccine and Vaccine-Era Disease Incidence Estimates, Annual Cases, and 2019 Cases Averted in the United States by Disease

Annual cases are rounded to the nearest thousand. AOM, acute otitis media; ED, emergency department; IPD, invasive pneumococcal disease.

Incidence estimates are adjusted by underreporting factors of 1.7 for hepatitis A, 6.5 for hepatitis B, 10.0 for pertussis (in ages 11 y and older prevaccine and all ages in the vaccine era), 2.1 for polio prevaccine (to capture paralytic and nonparalytic cases), 22.2 for varicella prevaccine, and 10.4 for varicella in the vaccine era (with all other diseases assumed fully reported and/or already adjusted to account for underreporting from the source data).

Prevaccine and vaccine-era case estimates are calculated using 2019 United States population estimates and are rounded to the nearest thousand. For Haemophilus influenzae type b and rotavirus, the population size for ages <5 y ( n = 19 576 683) was used to calculate annual cases. Annual cases for diphtheria and influenza were calculated using the population size for ages ≤10 y ( n = 43 833 518). The population size for ages <40 y ( n = 170 936 198) was used to calculate annual cases for measles, mumps, and rubella. For all other diseases, the total United States population size ( n = 328 239 523) was used to calculate annual prevaccine and vaccine-era cases.

Rotavirus and pneumococcal disease results are shown separately by healthcare resource use because of a lack of incidence data.

The calculated value for cases averted may not precisely equal the difference between the number of cases in the “with immunization” and “without immunization” period because of rounding.

For the 2019 United States population of 328 million people, the number of cases of each disease without and with the childhood immunization program and the estimated number of cases averted are shown in Table 2 . In the vaccine era with routine immunization, the annual number of cases of disease was 0 for polio, <10 cases per year for diphtheria and rubella, and <100 cases per year for Hib and tetanus. Pneumococcal AOM and influenza represented the largest clinical burden annually (>1 000 000 cases per year), followed by pertussis, pneumococcal pneumonia, outpatient rotavirus gastroenteritis, and outpatient varicella (between 100 000 and 1 million cases per year).

Routine immunization was estimated to avert over 24 million cases of vaccine-preventable disease in 2019 across all age groups, ranging from approximately 1000 cases of tetanus averted to more than 4.2 million varicella cases averted ( Table 2 ). Cases averted were greatest (>1 000 000) for influenza, measles, mumps, rubella, pertussis, varicella, and outpatient visits for pneumococcal AOM.

This analysis found that routine childhood immunization in the United States has continued to reduce the incidence of all targeted diseases. Landmark achievements have been the reduction in incidence of diphtheria, Hib, measles, polio, rubella, and tetanus to negligible levels (<1 case per 100 000 population annually); and >90% reduction in incidence for 10 diseases targeted by the routine childhood immunization program for children ≤10 years of age. These reductions equate to the prevention of over 24 million cases of disease for the 2019 US population.

Roush and Murphy 3   evaluated the impact of routine childhood immunization on vaccine-preventable diseases for which recommendations were in place before 2005, using 2006 disease data. Our estimates were generally consistent with the previous results and other published studies, 79   although we estimated a greater reduction in incidence of IPD (60% versus 34%) and of varicella (98% versus 85%). A potential explanation for these differences may be that our analysis used vaccine-era incidence from 2013 to 2017 for pneumococcal disease and from 2014 to 2018 for varicella, capturing the greater impact of the 13-valent pneumococcal conjugate vaccine (recommended in 2010 for infants) compared with the 7-valent pneumococcal conjugate vaccine and capturing the greater impact of 2-dose varicella vaccine compared with 1 dose (second dose added to recommendations in 2007). 80  

With sustained vaccine coverage at levels greater than 80% for most pediatric vaccines (with the exception of hepatitis A, rotavirus, and annual influenza vaccine), many vaccine-preventable diseases are now controlled as a public health problem or eliminated in the United States. However, despite significant impact of vaccines, continued risk from these vaccine-preventable diseases remains. When whole-cell pertussis vaccine was withdrawn in Sweden in 1979 because of concerns about safety and efficacy, incidence rates of pertussis similar to those observed in the prevaccine era returned in Sweden within a few years; after introduction of the diphtheria, tetanus, and acellular pertussis vaccine in 1996, incidence rates decreased markedly compared with the 1986 to 1995 10-year period. 81 , 82   Similarly, despite elimination status being declared for measles in 2000, under-vaccination has led to continued measles outbreaks in the United States, jeopardizing elimination status for the disease. 83 – 85   Diphtheria outbreaks continue to occur where vaccination rates are low, particularly in areas of social disruption, and are often associated with high rates of mortality. 86 , 87   The most recent large outbreak occurred in Russia from 1990 to 1997, resulting in ∼115 000 cases and 3000 deaths across the population. 88   These experiences underscore the importance of continued immunization in sustaining reductions in incidence of infectious diseases.

This analysis includes some limitations. First, consistent with previous studies, 3 , 6   the analysis does not directly account for other public health measures (eg, better sanitation, healthcare access, and improved standards of care) that have been introduced over the past 70 years and likely contributed to the reduction in vaccine-preventable diseases. Furthermore, this analysis did not account for random error in the parameter estimates or account for the proportion of disease incidence reduction that may be attributed to adolescent and adult vaccines or to booster doses. As a result, the analysis may overestimate reductions in burden directly attributable to childhood immunization. Future analyses could address these methodological limitations using time-series analysis to identify and adjust for trends to explore the extent to which adolescent and adult vaccination programs, which have expanded since 2005, 80 , 89 , 90   contribute to reduction in disease incidence.

Second, owing to limited data on differences among racial and ethnic groups, this analysis did not account for racial or ethnic disparities in vaccine coverage and incidence of vaccine-preventable diseases. Evaluating the public health impact of routine immunization among racial and ethnic groups is an important direction for future research. Moreover, this analysis was limited in scope to vaccine-preventable disease for vaccines included in the United States routine childhood immunization program for children ages ≤10 years. Expansion of this analysis to include vaccine-preventable diseases, such as meningococcus and human papillomavirus targeted by routine adolescent vaccines, is another potential area of future research.

Third, because annual incidence varies substantially from year to year for many vaccine-preventable diseases, we have calculated prevaccine and vaccine-era incidence as averages across multiple years, where data allowed. Despite our efforts to estimate average incidence values in both periods, significant epidemics or outbreaks occurred for some diseases that may not be reflected in the annual averages used in this analysis. 91   For the vaccine era, data used to derive disease incidence were for years preceding the coronavirus disease 2019 (COVID-19) pandemic. There are multiple factors that may influence the impact of COVID-19 on the incidence of vaccine-preventable diseases. For example, behavior changes caused by nonpharmaceutical interventions, including lockdowns, face-covering use, and other social distancing measures may reduce the transmission of some diseases, while simultaneously causing disruptions to vaccine uptake and coverage for the pediatric population that may adversely impact the prevention of vaccine-preventable diseases. 92 – 94   Future surveillance and survey data will help to understand the impact of the COVID-19 pandemic and other potential “shocks” to the immunization program on the transmission of other vaccine-preventable diseases.

Routine childhood immunization in the United States has continued to reduce the incidence of all targeted vaccine-preventable diseases. In the vaccine era, the incidence of diphtheria, Hib, measles, polio, rubella, and tetanus has been reduced to <1 per 100 000; across all targeted diseases, ∼24 million cases have been averted because of vaccination for the 2019 United States population. Routine immunization remains an effective public health intervention to avert disease; maintenance of high rates of vaccination coverage is necessary for sustained impact.

We thank Kate Lothman of RTI Health Solutions, who provided medical writing support for the development of this manuscript and whose services were funded by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co, Inc, Rahway, NJ, USA.

Ms Talbird, Mr Carrico, and Dr La conceptualized and designed the study, reviewed the literature, interpreted the results, and drafted the initial manuscript; Drs Chen, Nyaku, Carias, and Roberts conceptualized the study and provided input on the study design, secured funding, and interpreted the results; Dr Marshall interpreted the results; and all authors reviewed and revised the manuscript, approved the final manuscript as submitted, and agree to be accountable for all aspects of the work.

COMPANION PAPERS: companions to this article can be found online at http://www.pediatrics.org/cgi/doi/10.1542/peds.2021-056007 and http://www.pediatrics.org/cgi/doi/10.1542/peds.2022-057831 .

Dr La’s current affiliation is GSK, Philadelphia, Pennsylvania.

FUNDING: This study was funded by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co, Inc, Rahway, NJ, USA.

CONFLICT OF INTEREST DISCLOSURES: Ms Talbird and Mr Carrico are employed by RTI Health Solutions, which received funding for the conduct of this study. Dr La was an employee of RTI Health Solutions when this study was conducted and is now an employee and shareholder in the GSK group of companies. Drs Chen, Carias, and Roberts are employees of Merck Sharp and Dohme LLC, a subsidiary of Merck & Co, Inc, Rahway, NJ, and are shareholders in Merck & Co, Inc. Rahway, NJ. Dr Nyaku was an employee of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co, Inc, Rahway, NJ and a shareholder in Merck & Co, Inc, Rahway, NJ when this study was conducted. Dr Marshall has been an investigator on clinical trials funded by GlaxoSmithKline, Merck, Pfizer, Sanofi Pasteur, and Seqirus, and he has received honoraria from these companies for service on advisory boards and/or nonbranded presentations.

active bacterial core

acute otitis media

Centers for Disease Control and Prevention

coronavirus disease 2019

emergency department

Haemophilus influenzae type b

invasive pneumococcal disease

National Notifiable Disease Surveillance System

Supplementary data

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Jagannath Chatterjee

The eternal problem....

Childhood Illnesses – Road to Health

• Standard childhood illnesses, such as measles, mumps, and even whooping cough, may be of key benefit to a child's developing immune system and it may be inadvisable to suppress these illnesses with immunisations. – Dr Phillip Incao, MD
• Childhood illnesses are a standard feature of childhood because the young body needs them. - Rudolf Steiner, Austrian Scientist
• All acute inflammatory childhood illness--measles, mumps, rubella, chicken pox, scarlatina, or whooping cough--develops the cell-mediated immune system – the deeper immunity
• Childhood illnesses create immunity for life. Vaccines can push diseases to an age where it is dangerous.

Childhood Illnesses Can Prevent Serious Conditions Later in Life

• In early 1997, a team of British physicians writing in Science noted : "Childhood infections may, therefore,�paradoxically protect against asthma.“ These infections�have a purpose in building general immunity.
• Danish physician Tove Ronne in The Lancet in 1985:�"Measles virus infection in childhood can prevent disease in adult life." Among these, Dr. Ronne listed skin disease, immune dysfunctions, degenerative diseases of bone and cartilage, and certain cancers.
• Measles can cure eczema. Induced measles can cause cancer to reduce (remission). Having measles, mumps, rubella in early childhood can prevent against allergies, eczema, asthma , cardiovascular disease mortality and cancer. Polio virus used for cancer remission
• Association of measles and mumps with cardiovascular disease: The Japan Collaborative Cohort (JACC) study.

Kubota Y, et al. Atherosclerosis. 2015. http://www.ncbi.nlm.nih.gov/m/pubmed/26122188/

Childhood Illnesses Protect Against Cancer

• Albonico et al found that adults are significantly protected against non-breast cancers -- genital, prostate, gastrointestinal, skin, lung, ear-nose-throat, and others -- if they contracted measles (odds ratio, OR = 0.45), rubella (OR = 0.38) or chickenpox (OR = 0.62) earlier in life. [ Med Hypotheses 1998; 51(4): 315-20].
• Montella et al found that contracting measles in childhood reduces the risk of developing lymphatic cancer in adulthood [ Leuk Res 2006; 30(8): 917-22].
• Alexander et al found that infection with measles during childhood is significantly protective -- it cuts the risk in half -- against developing Hodgkin's disease (OR = 0.53) [ Br J Cancer 2000; 82(5): 1117-21].
• Glaser et al also found that lymph cancer is significantly more likely in adults who were not infected with measles, mumps or rubella in childhood [ In J Cancer 2005; 115(4): 599-605].
• Gilham et al found that infants with the least exposure to common infections have the greatest risk of developing childhood leukemia [ BMJ 2005; 330: 1294].
• Urayama et al also found that early exposure to infections is protective against leukemia [ Int J Cancer 2011; 128(7): 1632-43].
• In the world of science, it is quite well known that having infections in early life protects against various cancers in later life

Disease Mortality Declined Before Vaccines Introduced – Australian Data . Data from USA, UK, New Zealand & Canada also reflect the same.

Disease Mortality Decline In US (1900-1980) Due to Better Living Conditions, Sanitation, Medical care – JAMA 1999. Vaccines not mentioned. 30 diseases studied. No widespread vaccinations in that period.

US – Major diseases

USA – Diphtheria, Measles

UK & France

Safety of Vaccines Questioned

• A steep rise in cases of Autism (moderate to very severe and mostly permanent disability in children) after more vaccines introduced in 1990’s raised questions over vaccine safety. Parents could know deterioration in children after receiving vaccine shots.
• Doubts raised over use of mercury in vaccines (Thiomersal) and links to Autism. Mercury contamination had led to similar symptoms in Japan and Iraq.
• It became known that Aluminum, Formalin, Polysorbate 80, Phenol, MSG, Neomycin, Squalene, human and animal matter was contained in vaccines.
• More and more parents started reporting vaccination injury and Autism (a severe disorder) after vaccines.

Vaccine Ingredients – a secret well kept

Vaccines and Autism

• Vehemently denied, yet link impossible to hide
• CDC studies trying to disprove link have run into controversies for hiding the link. Scandals during reign of Julie Gerberding
• Scientists openly discussed vaccine autism link – and more dangers – at Simpsonwood (2000) while trying to hide autism link in CDC studies but minutes of meeting were exposed
• Two CDC studies called Verstraeten studies showed very high vaccine autism link. One study was manipulated to show no link and published. The other showing considerable link still lies unpublished
• Another group of CDC studies called Danish studies came crashing down after its Principal Coordinator Dr Poul Thorsen was figured in most wanted list of US Police for having misappropriated the research funds
• Recently the De-Stefano study of CDC came under a storm as its co-author Dr William Thompson revealed data manipulation to hide huge vaccine autism link (340%). Scientists tried to destroy data in 2002.
• CDC now faces Congress investigation. It’s research division “paralyzed with fear”. Congressman Bill Posey submitted on 29 th July 2015

How do vaccines cause Autism?

• As per original CDC study findings, mercury in vaccines is responsible for causing Autism in children. Studies have now shown that mercury even in trace amounts can be responsible
• Independent researchers have also pointed out the clear causative role played by Aluminum present in vaccines
• As per award winning journalist Janine Roberts, the aluminum in vaccines is in form of nano particles so that vaccine ingredients can permeate each cell of the body. Obviously this has a devastating impact on the body.
• Both mercury and aluminum have the ability to cross both blood brain barrier as well as placenta barrier. Thus vaccines given to pregnant women can kick start autism in the infants
• Researchers have also pointed out that the use of animal and human matter in vaccines can cause severe autoimmune reactions and lead to autism
• Vaccines like DPT, DTaP, MMR, Chicken Pox, Hep-B are implicated. Graphs show increase in autism after these vaccines were introduced

Japan – MMR Vac & Autism

Japan – Autism drops as MMR temporarily suspended 1993

AAP Fellow Quits in Protest....

How are vaccines tested for safety?

• Vaccines are tested by manufacturers or persons or agencies under their control. No other agency usually tests them. Phase I to Phase III. Phase IV after release.
• Vaccines are tested on extremely healthy subjects for a very short time (7 to 14) days or till the time adverse events start appearing
• Often serious adverse events are explained away or not reported
• Vaccines are not tested against any genuine placebo. They are tested against the same vaccine without the antigen or some other equally toxic substance
• In India, the Supreme Court and even Parliament has questioned trials but vaccines continue.
• Official vaccinated vs un-vaccinated study never conducted

Vaccines can NEVER be safe for children!

What tests are needed?

• Tests by independent agencies lacking conflict of interest
• Testing against genuine inert placebo and not another vaccine or toxic substance.
• Multiple vaccines given at one visit; never tested!
• Effects of entire vaccine schedule never studied!
• Long term effects never studied! Never studied for causing cancer, infertility, admitted in literature!
• No official studies of vaccinated vs non vaccinated
• Studies required on three generations of mice. Research shows toxicity carried down across generations through breast milk, sperm, epigenetic change
• What is the impact on the human gene? Has it been already altered by vaccines?

1967 study – Trauma of vaccination

Epigenetic Study - 2013

2008: Genes Activated

Independent Vaccinated Vs Non Vaccinated

UK Data – Vaccine Reactions

Adverse reactions – US Data (published MedAlert)

Adverse effects Encountered (MedAlert)

USA, for the year 2013

HPV Vaccines: Deaths now 232 (June 2015)

HPV Vaccine – Reactions Reported

Baby Ian – Allergic Reaction to Hep-B Vaccine

Mercury in Vaccines – Reduced in Developed Nations

• Thiomersal (mercury compound) used in vaccines since 1930. Never tested by FDA. One human study on 21 meningitis patients (1929); all died in short period, attributed to meningitis.
• "As it turns out, we are injecting our children with 400 times the amount of mercury that FDA or EPA considers safe.” - Robert F. Kennedy, Jr. on vaccine-autism-mercury link, 6/22/05
• In June 22, 2000 FDA formally declared that mercury should be removed from vaccines in USA. However mercury still remains as trace amount. Some vaccines still contain mercury in high amounts
• In India and other developing countries full dose mercury remains in all non live virus vaccines �

Mercury – Neurotoxin & Genotoxin

• Mercury -second most poisonous element (second only to uranium). Brain neurons rapidly and permanently disintegrate in the presence of mercury within 30 minutes of exposure. Mercury is known to change a body’s chromosomes. Used as decontaminant in vaccines. Can cross blood brain and placenta barrier
• “Symptoms of high exposure to this class of mercury based compounds include: long term neurological disorders, liver disorders, injuries to the cardiovascular system and hematopoietic system, deafness and ataxia, death.” As genotoxin, mercury is more dangerous in smaller doses.
• Acute poisoning may cause gastrointestinal irritation and renal failure, coordination problems, tremors, mental disorders among many others. Mercury vapour can cause damage.
• Causes Autism as per CDC unpublished study (Relative Risk – 7.6!)

Rat Study – Thiomersal (Mercury Compound in vaccines)

Folia Neuropathol.  2010;48(4):258-69.

Lasting neuropathological changes in rat brain after intermittent neonatal administration of thimerosal.

Olczak M 1 ,  Duszczyk M ,  Mierzejewski P ,  Wierzba-Bobrowicz T ,  Majewska MD .

Thimerosal, an organomercurial added as a preservative to some vaccines, is a suspected iatrogenic factor, possibly contributing to paediatric neurodevelopmental disorders including autism . We examined the effects of early postnatal administration of thimerosal (four i.m. injections, 12 or 240 μg THIM-Hg/kg, on postnatal days 7, 9, 11 and 15) on brain pathology in Wistar rats. Numerous neuropathological changes were observed in young adult rats which were treated postnatally with thimerosal. They included: ischaemic degeneration of neurons and "dark" neurons in the prefrontal and temporal cortex, the hippocampus and the cerebellum, pathological changes of the blood vessels in the temporal cortex, diminished synaptophysin reaction in the hippocampus, atrophy of astroglia in the hippocampus and cerebellum, and positive caspase-3 reaction in Bergmann astroglia. These findings document neurotoxic effects of thimerosal, at doses equivalent to those used in infant vaccines or higher, in developing rat brain, suggesting likely involvement of this mercurial in neurodevelopmental disorders.

PMID: 21225508 [PubMed - indexed for MEDLINE]

• http://www.ncbi.nlm.nih.gov/pubmed/21225508

“Since excessive accumulation of extracellular glutamate is linked with excitotoxicity, our data imply that neonatal exposure to thimerosal-containing vaccines might induce excitotoxic brain injuries, leading to neurodevelopmental disorders..” – Quoted in subsequent study. (2012) http://www.ncbi.nlm.nih.gov/pubmed/22015977

Thiomersal Bottle – Notice the skull & bones warning

In the USA incidence of autism started to dip as mercury in vaccines were reduced by Order but the flu vaccine with mercury was introduced, and aluminum uptake increased in other vaccines

Aluminum – Cause of brain damage

• Aluminum is a suspected carcinogen. It is a cardiovascular or blood toxicant, neurotoxicant, and respiratory toxicant. It has been implicated as a cause of brain damage, and is a suspected factor in Alzheimer’s Disease, dementia, convulsions, and comas. Aluminum can cross the blood brain barrier .
• It suffers synergistic toxicity with mercury and can increase the toxicity of mercury 100 times. Aluminum and mercury are both present in vaccines.
• In humans, there have been reports of a chronic inflammation syndrome called macrophagic myofascitis (MMF) being induced by alum-based vaccines. Symptoms included myalgias, arthralgias, marked asthenia, muscle weakness, and fever. In cats, this vaccine ingredient causes cancers.�

Aluminum in Vaccines & Autism

Formaldehyde - Carcinogen

• Formaldehyde (Formalin in vaccines) is ranked as one of the most hazardous compounds on ecosystems and human health - Environmental Defense Fund. These findings are for environmental exposure, and therefore, the dangers are much greater for the formaldehyde included in vaccines, since it is injected directly into the blood (should not be). Declared carcinogen-Twelfth Report on Carcinogens (2011).
• Toxic symptoms are more than a hundred. Can cause cancer, asthma, eczema, attention and memory problems, damage to reproductive organs, jaundice, kidney pain, menstrual irregularities, schizophrenia like symptoms, sterility, blood vomiting etc
• Formaldehyde, when present with mercury and aluminum, increases toxicity of mercury 1000 times .

Beats logic..

Package Insert - MMR

Package Insert – Hep B Vaccine

Package Insert – Chicken Pox Vaccine

Some other issues with vaccines

• According to medical texts, infants should not be given anything else except breast milk; not even water. Then how do they allow the extremely toxic vaccine injections? – Dr Suzanne Humphries
• Vaccinated mothers no longer have natural antibodies that they can pass on to children via breast milk. Therefore infants have become more vulnerable creating a vicious cycle
• Vaccines are an industrial product, manufactured for profits. Vaccine markets are created to generate more revenue. Effects on children are overlooked.
• Vaccines are now being mandated in the USA and Australia. This is in gross violation of parental rights and also of the Nuremburg Code and AMA’s own guidelines. The Senators pushing these mandates were exposed,paid by pharma as part of their lobbying
• The CDC of USA which recommends vaccines has a for-profit wing which receives generous funds from vaccine industry. Even WHO depends on industry funding. They cannot be trusted.

Are vaccines effective?

• Vaccines are supposed to produce humoral (blood related antibodies) that theoretically protect us against infections? Is this theory correct?
• It is known that, in many instances, antigen-specific antibody titers do not correlate with protection. In addition, very little is known on parameters of cell-mediated immunity which could be considered as surrogates of protection. (Del Giudice G et al, 2001)
• In a study published in Neurology it was demonstrated that titers (the measurement of the levels of antibodies in the bloodstream) were poor indicators of immunity. (Nathan E Crone et al, 1992)
• A titer test does not and cannot measure immunity, because immunity to specific viruses is reliant not on antibodies, but on memory cells – Expert testimony before European Court of Human Rights, 2006

Vaccine Failures!

• Diseases vaccinations are supposed to prevent regularly occur in fully vaccinated populations.
• A measles outbreak in early 1989 among approximately 4200 vaccinated students at a high school and two intermediate schools in suburban Houston, TX, was investigated to evaluate reasons for vaccine failure. (Pubmed)
• Mumps Outbreaks in Vaccinated Populations: Are Available Mumps Vaccines Effective Enough to Prevent Outbreaks? (Pubmed)
• Disease outbreaks are concentrated in highest-vaccinated population – Council on Foreign Relations Graph
• Whooping cough outbreaks are HIGHER among vaccinated children compared with unvaccinated children- Dr. David Witt, infectious disease specialist at the Kaiser Permanente Medical Center in California.
• In India measles vaccine is failing to prevent measles - Report �

Vaccines increase susceptibility!

• Vaccinated individuals are often made more susceptible to the diseases they are vaccinated against and are more likely to die from it.
• Dr R P Garrow reports in the British Medical Journal, Jan 14, 1928, that a person vaccinated against Small Pox was five times more likely to die of the disease than the unvaccinated.
• He also reported, the vaccination was causing a great surge in cases of Small Pox in areas where it was widely given
• Using RTI data doctors in India reported that children given the Oral Polio Vaccine are 6.26 times more likely to suffer paralysis than the unvaccinated.
• Measles after vaccination is more deadly.

Vaccines Cause Serious Side Effects

• The DaPT vaccine Tripedia has listed Autism and ADHD as a side effect. The DPT vaccine is linked to asthma, provocative polio, hyperactivity and learning disorders in children. A 1948 study by Dr Byers et al linked it to deaths, blindness, deafness, spasticity, convulsions, and other severe neurological disorders.
• The Hepatitis B vaccine has been linked to serious adverse effects including cancer of liver. Combination vaccines have more adverse effects; MMR, DPT, Pentavalent etc
• Vaccines are known to cause- Allergies * Asthma * Attention Deficit Disorder *Autism * Auto-immune Diseases * Blindness * Brain Cell Loss *Cancer * Central Nervous System Damage* Deafness * Developmental Damage *DEATH * Diabetes * Epilepsy * Learning Disabilities * Leukemia * Multiple Sclerosis * Neurological Disease * Organ Disease * Psoriasis * Seizures * Shaken Baby Syndrome * SIDS * Total Paralysis * All Diseases in Internal Medicine
• All vaccines can do harm – Dr Andrew Moulden, MD. Vaccines can never be safe – Dr Suzanne Humphries, MD

200 adverse effects compiled from published research papers � http://www.greenmedinfo.com/blog/200-evidence-based-reasons-not-vaccinate-free-research-pdf-download

Vaccine victims are mocked..

Vaccines being opposed by Dr’s and Medical Scientists in India

• BCG – Tested in 15 year trial in India. 0% effective!
• Hep-B vaccine – Meant for promiscuous adults in developed nations, now given to children in developing countries because they refused
• Oral Polio Vaccine – Known to cause polio; both individual cases and epidemics. Court case filed (CCF).
• Pentavalent vaccine – Very high death rate & hospitalization in all countries introduced. CCF
• HPV vaccine – Trial in India conducted unethically killing 7 (9?) tribal adolescent girls. Supreme Court
• Rota Vaccine – Rota diarrhea can be controlled by ORS. The vaccine has serious adverse effect. Recent Indian vaccine to be launched hiding trial data. CCF

How vaccines ‘eradicate disease’

• Disease rates are inflated 100 to 1000 times before vaccines are introduced
• Disease definition is changed when vaccines are introduced making it difficult to report the disease
• Doctors are advised that, ‘vaccinated children cannot come down with the disease vaccinated against’. So they change disease names when such cases come up
• Symptoms (for the same disease) are bifurcated to create new disease names and show drop in cases
• Pathology samples can be checked in only pre-selected laboratories so that positive cases can be suppressed
• Low level health workers or officials cannot report disease, they have to go through ‘experts’ who can then suppress cases

How Polio Was “Eradicated”

• 32,419 cases of the disease were inflated to 3,50,000. In India the figure was 12,000
• Definition of polio was changed three times to bring down number of cases
• A disease name called “Non Polio Acute Flaccid Paralysis” was created to bifurcate polio figures. Polio is traditionally infantile paralysis. It was changed to viral polio. Earlier 20 days duration was required to identify polio, it was increased to 60 days.
• Pathological tests could be carried out only in select WHO certified laboratories
• Cases of polio caused due the vaccine were suppressed
• Paralysis in children increased from 1005 in 1996 to 60,992 in 2012 after India was declared polio free!

Polio Vac – Controversial since 1955!

Oral Polio Vac and Cancer!

Polio Incidence & Pesticide (DDT)

Change in Polio Definition

• Traditionally infantile paralysis of any kind lasting more than 24 hours was recorded as polio
• After vaccine introduced only polio caused by 3 enteroviruses were considered polio. Other paralysis was given different names
• Later paralysis had to last more than 20 days
• This was increased to 60 days
• In addition, stools had to confirm presence of PV
• Only WHO accredited laboratories can confirm
• Polio caused by vaccine or vaccine strain virus turned virulent cannot be called polio
• Polio recorded as “Non Polio Acute Flaccid Paralysis”
• “Clinically indistinguishable and twice as deadly” –Dr’s

Polio – Controlled by vaccine?

You think Small Pox Was Eradicated by Vaccines?

• The practice of inoculation (against small pox) manifestly tends to spread the contagion, for a contagious disease is produced by innoculation where it would not otherwise have produced. The Gentleman’s Magazine and Historical Chronicle, vol.34, 1764,p.333
• In the 38 years after the start of innoculation, deaths from small pox relative to the number born increased to 127 per 1,000 (a 41 % increase) and relative to the number of burials (deaths) 81 per 1,000 (a 27% increase). The Great Small Pox Epidemic of 1775-82, History Today, July 20, 2003, p.12
• Since the late 1700s, the medical profession has supported vaccination without comparing vaccinated and unvaccinated. MMWR, vol.50, CDC, June 22, 2001, pp1-25
• ...the level of antibody that protects against small pox is unknown. ibid

Why did Gandhi revolt against vaccines?

• Gandhiji revolted against vaccines and declared it a ‘filthy process’. Why?
• “When we recall that vaccine lymph is derived, in the first place, either from a small pox corpse, the ulcerated udder of a cow, or the running sores of a sick horse’s heels...it has far reaching ill effects on the human constitution”. Studies in Vaccinia, The Lancet, vol. 1999, no.5150, May 13, 1922
• No practitioner knows whether the lymph he employs is derived from small pox, rabbit pox, ass-pox or mule pox. Ibid. (What viruses were in the vaccines? Even CDC does not know! Admitted after genetic assay of Dryvax)
• Some of the animals that have been used to passage today’s vaccine virus include rabbits, mice, goats, cows, pigs, horses, sheep, dogs, birds and humans.�

Small Pox Vaccine & Cancer

What else did the vaccine cause?

• “In these cases it is highly likely that acute infectious hepatitis was a result of contamination of human lymph derived vaccine. Other infectious diseases attributed to vaccination includes tuberculosis & syphillis” New York Times, Sept 26, 1869
• In the year 1981, a WHO consultant released to the media, that his investigation into the AIDS epidemic under the instruction of WHO, clearly revealed that HIV spread to humans from primates due to the small pox vaccine. WHO suppressed the report.
• The vaccine was linked to eczema vaccinatum with a fatality rate of 4-40%. Also linked to erisypelus epidemics which had high mortality rates. CNS damage.
• Huge epidemics of small pox in 1872-73 (Boston) started AFTER introduction of vaccine.

Leicester Small Pox Spike After Mandatory Vaccination. This UK state eliminated small pox with isolation, sanitation and nutrition

Testimonial of a Nobel Prize Winner

Blind Belief in Doctors – Not Recommended!

Educate before you vaccinate!

• Neither government or doctors will inform you about vaccine dangers
• If your child dies, becomes disabled or diseased it will be denied by authorities and marked ‘coincidence’
• You will not receive any free treatment, compensation or any rehabilitation help for your child
• The very doctor who vaccinated your child will become your enemy
• Doctors receive commissions, political parties receive funds, bureaucrats receive perks and promotions. You gain a dead, sick or disabled child!
• As per a law signed into effect in the USA in 1986 vaccine manufacturers and even individual vaccines are protected from law suits
• Vaccine industry & doctors protected, not your child!

Profitable industrial product

To Protect Your Child

• Ensure adequate age for marriage
• Provide proper nutrition and care for pregnant mother
• Homeopathic treatment during pregnancy will ensure a healthy child. Search for senior homeopath.
• Avoid drugs and vaccines during pregnancy. The tetanus vaccine being given during pregnancy is also used to sterilize girls and women in developing nations (used in India, Kenya). It can cause abortions and premature birth.
• Go in for natural child birth. Delay cord clamping. Do not clean child immediately after birth. Learn from natural birth movement. Aisharwaya Rai Bachhan did this!
• Give the first yellow milk – colostrum- to your child. You can breastfeed up to 2 years & beyond for benefits and emotional bonding
• Give baby homeopathic treatment during illnesses

What do other systems recommend?

• Ayurveds flay village practice of giving even a drop of honey to infants
• Homeopathic texts talk about giving medicines to mothers so that children get it through breast milk
• Pregnancy, infancy and childhood are to be respected
• General practitioners (GP’s) were wary about medicating these groups. Vaccination was selective based upon child’s health. Many also conducted skin tests before administration. Seniors were more cautious and even skipped them if they perceived no threat
• Things changed after paediatricians arrived on the scene. They are reckless about vaccination and prescribing antibiotics etc for resultant conditions

Role of civil society

• Medicine is too important to be left at the hands of doctors. Civil society should not forget its watchdog role
• Civil society representatives should be a part of the National Technical Advisory Group on Immunizations that advises GoI on vaccinations
• The civil society should sensitize doctors on vaccine dangers. The industry keeps them in the dark
• Awareness about the murky world of vaccines ought to be created among the general populations
• Should demand a vaccine adverse event reporting system with compulsory reporting and monitor the same and seek compensation and rehabilitation for victims
• Vaccines crimes need to be referred to civil and criminal courts. Protecting vaccines is the goal of medical boards.

Be scientific...

Vaccine Information Websites

• www.nvic.org
• www.sanevax.org
• www.mercola.com
• www.greenmedinfo.com
• www.vaccineresearchlibrary.com
• www.vactruth.com
• www.vaccinetruth.org
• www.currenthealthscenario.blogspot.in
• www.vaccinationinformationnetwork.org
• www.naturalnews.com

ACIP Presentation Slides: November 2-3, 2021 Meeting

Coronavirus disease 2019 (covid-19) vaccines, hepatitis vaccines.

• Immunization Schedules

Orthopoxviruses Vaccines

Ebola vaccine.

Note: These files are not yet 508

Slides will be added as they become available.

November 2, 2021

Welcome & introductions.

• Introduction Dr. G Lee Dr. M Wharton
• Introduction pdf icon [9 pages] Dr. M Daley
• Pfizer-BNT162b2 use in children aged 5-11 years pdf icon [31 pages] Dr. A Gurtman
• SARS-CoV-2 Epidemiology in children pdf icon [29 pages] Dr. J Jones
• Myocarditis in adolescents and young adults pdf icon [23 pages] Dr. M Oster
• Vaccine safety surveillance in children pdf icon [25 pages] Dr. T Shimabukuro
• Implementation of COVID-19 vaccine pediatric program pdf icon [10 pages] Dr. K Chatham-Stevens
• Clinical considerations for COVID-19 vaccination in children pdf icon [33 pages] Dr. K Woodworth
• Evidence to Recommendations Framework: Pfizer-BioNTech COVID-19 vaccine in children aged 5-11 years pdf icon [80 pages] Dr. S Oliver

November 3, 2021

• Introduction pdf icon [11pages] Dr. K Ault
• Considerations for a Universal Adult HepB Recommendation pdf icon [24 pages] Dr. M Weng
• Introduction to Combined Immunization Schedule Work Group; Proposed Changes to 2022 Child and Adolescent Schedule; Proposed Changes to 2022 Adult Schedule pdf icon [145 pages] Dr. K Ault; Dr. P Wodi; Dr. A Hause
• Introduction pdf icon [7 pages] Dr. P Sanchez
• Clinical guidance for use of JYNNEOS pdf icon [23 pages] Dr. B Petersen
• Summary of work group considerations and proposed policy options pdf icon [110 pages] Dr. A Rao
• Introduction pdf icon [10 pages] Dr. W Chen
• Review of State Designated Ebola Treatment Centers and Laboratory Response Network Facilities pdf icon [48 pages] Dr. A Whitesell
• Evidence to Recommendations Framework pdf icon [65 pages] Dr. J Malenfant
• Proposed Policy Questions pdf icon [7 pages] Dr. C Cossaboom
• Vaccines & Immunizations
• VFC Resolutions
• Vaccine Information Statements (VISs)

1600 Clifton Road, N.E., Mailstop A27 Atlanta, GA 30329-4027 [email protected]

Exit Notification / Disclaimer Policy

• The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
• Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
• You will be subject to the destination website's privacy policy when you follow the link.
• CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

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91 Best Immunization-Themed Templates for PowerPoint & Google Slides

With over 6 million presentation templates available for you to choose from, crystalgraphics is the award-winning provider of the world’s largest collection of templates for powerpoint and google slides. so, take your time and look around. you’ll like what you see whether you want 1 great template or an ongoing subscription, we've got affordable purchasing options and 24/7 download access to fit your needs. thanks to our unbeatable combination of quality, selection and unique customization options, crystalgraphics is the company you can count on for your presentation enhancement needs. just ask any of our thousands of satisfied customers from virtually every leading company around the world. they love our products. we think you will, too" id="category_description">crystalgraphics creates templates designed to make even average presentations look incredible. below you’ll see thumbnail sized previews of the title slides of a few of our 91 best immunization templates for powerpoint and google slides. the text you’ll see in in those slides is just example text. the immunization-related image or video you’ll see in the background of each title slide is designed to help you set the stage for your immunization-related topics and it is included with that template. in addition to the title slides, each of our templates comes with 17 additional slide layouts that you can use to create an unlimited number of presentation slides with your own added text and images. and every template is available in both widescreen and standard formats. with over 6 million presentation templates available for you to choose from, crystalgraphics is the award-winning provider of the world’s largest collection of templates for powerpoint and google slides. so, take your time and look around. you’ll like what you see whether you want 1 great template or an ongoing subscription, we've got affordable purchasing options and 24/7 download access to fit your needs. thanks to our unbeatable combination of quality, selection and unique customization options, crystalgraphics is the company you can count on for your presentation enhancement needs. just ask any of our thousands of satisfied customers from virtually every leading company around the world. they love our products. we think you will, too.

Widescreen (16:9) Presentation Templates. Change size...

PPT layouts having children vaccinating immunization concept doctor injecting vaccination in arm of a little girl with face mask

Slides with vaccine and syringe injection for prevention immunization and treatment of coronavirus infection covid-19 ncov 2019

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Presentation design having vaccinated person using immunization certificate on smartphone at the restaurant or terrace

Theme enhanced with children vaccinating immunization concept doctor injecting vaccination in arm of a little girl with face mask backdrop

Presentation enhanced with children vaccinating immunization concept doctor injecting vaccination in arm of a little girl with face mask

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Slide set having family cut out and covid 19 vaccines lay on the table concept of family immunization coronavirus vaccine for children and parents

Presentation theme featuring family cut out and covid 19 vaccines lay on the table concept of family immunization coronavirus vaccine for children and parents

Theme enhanced with close-up shot of pediatrician ready to give a three month baby girl intramuscular injection of a vaccine in arm

PPT theme consisting of little boy with red pimples on blue background chicken pox concept

PPT layouts consisting of close-up shot of pediatrician giving a three month baby girl intramuscular injection in leg backdrop

Presentation with cute serious boy holding a syringe like a doctor different occupations healthcare

Slides having child's immunization record for school admittance

Slide set featuring vaccine and syringe injection for prevention immunization and treatment of coronavirus infection covid-19 ncov 2019 background

Presentation consisting of vaccine and syringe injection for prevention immunization and treatment of coronavirus infection covid-19 ncov 2019

PPT layouts with children vaccinating immunization concept doctor injecting vaccination in arm of a little girl with face mask

PPT theme having children vaccinating immunization concept doctor injecting vaccination in arm of a little girl with face mask backdrop

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Presentation design consisting of vaccine bottles vials medicine and syringe injection isolated on white vaccination immunization treatment to infection covid-19 coronavirus 2019-ncov background

Presentation theme consisting of vaccine bottles vials medicine and syringe injection isolated on white vaccination immunization treatment to infection covid-19 coronavirus 2019-ncov backdrop

Presentation design with vaccine bottles vials medicine and syringe injection isolated on white vaccination immunization treatment to infection covid-19 coronavirus 2019-ncov backdrop

Slide set with vaccine bottles vials medicine and syringe injection isolated on white vaccination immunization treatment to infection covid-19 coronavirus 2019-ncov

PPT theme enhanced with vaccine bottles vials medicine and syringe injection isolated on white vaccination immunization treatment to infection covid-19 coronavirus 2019-ncov

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Slide set with family cut out and covid 19 vaccines lay on the table concept of family immunization coronavirus vaccine for children and parents

Theme featuring little girl with red pimples at home chicken pox concept

Slide set consisting of pediatrician giving a three month baby girl intramuscular injection in arm child looking at a doctor cheerfully

Presentation theme with doctor giving child injection in doctor's office

PPT theme having doctor doing vaccine injection to a child background

PPT layouts consisting of composition of world immunization week text and syringe with needle world immunization week and health awareness concept digitally generated image

Theme with composition of world immunization week text and syringe with needle world immunization week and health awareness concept digitally generated image

Slide set enhanced with composition of world immunization week text and syringe with needle world immunization week and health awareness concept digitally generated image background

Slide deck featuring composition of world immunization week text and syringe with needle world immunization week and health awareness concept digitally generated image

More immunization templates for powerpoint and google slides:.

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Vaccine Research

Vaccine research presentation, free google slides theme and powerpoint template.

To combat certain diseases, vaccines are one of the most effective (and sometimes, durable) solutions. Here's a new template where you can give a speech on vaccine research. To surprise your audience, we've opted for an abstract design, but don't worry: there are also photos and some blue tones, which are always closely tied to health and safety.

Features of this template

• 100% editable and easy to modify
• 34 different slides to impress your audience
• Contains easy-to-edit graphics such as graphs, maps, tables, timelines and mockups
• Includes 500+ icons and Flaticon’s extension for customizing your slides
• Designed to be used in Google Slides and Microsoft PowerPoint
• 16:9 widescreen format suitable for all types of screens
• Includes information about fonts, colors, and credits of the free resources used

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