Myers Appointed Director of National Vaccine Program Office

U.S. Surgeon General David Satcher announced yesterday the appointment of Dr. Martin Myers to the position of director of the National Vaccine Program Office. Myers, a "highly respected" herpes virologist and teacher, had served as NVPO's acting director from February 2000 to October 2000 (Office of the U.S. Surgeon General release, 12/4). As head of the NVPO, Myers is positioned at the heart of an issue that has sparked an "intense" battle between health officials and consumer "activists" -- vaccination. Both groups are engaged in a tug-of-war for parents' attention, with the government and the pediatrics community promoting childhood vaccination and activists warning about its dangers. One of the most prominent of the activist groups is the National Vaccine Information Center, a group founded by parents who say their children were harmed by an older version of the diphtheria/tetanus/pertussis vaccine no longer used by doctors. The NVIC has countered many of the government's arguments in favor of childhood vaccination, citing data that points to side effects and other risks involved with some vaccines. An article in today's Washington Post profiles the arguments and positions adopted by the government and the NVIC regarding various vaccines:

• Diphtheria/tetanus/pertussis vaccine: The NVIC points to "anecdotal evidence" to bolster its claim that DTaP causes "rare cases" of death, brain damage and illness. However, the group "concedes" that the current version of the vaccine causes "far fewer" side effects than the old version, which was replaced in 1996. The CDC counters that "no studies have proved a link" between either the old or new vaccine and death or permanent brain damage.
  
• Chickenpox vaccine: NVIC notes a study published this year in the
  Journal of the American Medical Association that revealed a 4% rate of "serious side effects" to the vaccine which ranged from severe allergic shock to death. The FDA researchers who wrote the study, however, stated that "most side effects were minor" and the serious risks "appear to be rare." The added that they "could not confirm [a] causal link" between the vaccine and these effects.
  
• Measles/Mumps/Rubella: NVIC highlights a 1998 Lancet study which found that eight out of 12 "previously healthy" children developed stomach problems and autistic behavior after receiving the vaccine. Five of those eight children had prior "adverse reactions" to other vaccines. The CDC points to a "larger" 1999 Lancet study which found no correlation between the introduction of the MMR vaccine in 1988 and the increase of autism spectrum disorders in London children.
  
• Vaccine-Diabetes Link: NVIC points to a 1997 study in Infectious Diseases in Clinical Practice which links the introduction of three new vaccines in Finland to a 147% increase in diabetes in children ages four and under. In children between the ages of five and nine, the vaccine was linked to a 40% increase in diabetes. However, two separate 1998 gatherings of infectious disease experts found "no evidence behind increased risk of diabetes" from childhood vaccines. The health officials cited genetics, environment and "certain infections" as "more likely factors" for the increase in diabetes incidence.
  
• Hepatitis B: An NVIC review of the U.S. Vaccine Adverse Events Reporting System database shows that the vaccine covered 2,424 side effects between 1990 and 1998. The group's review of the data also found that the vaccine resulted in 73 deaths in children under 14. The group cites a Duke University researcher who says that the side effects of the vaccine are "underreported" because drug studies monitored children for only four to five days, "insufficient time" to detect autoimmune diseases that can be a side effect. The CDC, however, finds "no association between serious side effects and [the] vaccine" following the inoculation of more than 20 million people in the United States and more than 500 million people worldwide. The agency says that death from the vaccine "is extremely rare," and an Institute of Medicine analysis of early data found "insufficient evidence" that the vaccine is linked to death. A recent study "suggested" that people developing rheumatoid arthritis after hepatitis B vaccination "were genetically at risk for the disease."
  
• Illness in Children: The NVIC states that since most vaccine trials do not include sick children, "no evidence exists that it is safe to vaccinate even mildly ill children." The CDC counters that "mild childhood illness" does not make the vaccine any less safe or effective. The agency urges parents not to let mild illness deter them from taking their childhood to be vaccinated on schedule, since missed or delayed vaccinations could result in "serious disease" (Kritz, Washington Post, 12/5).