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Adverse Events Associated with Childhood Vaccines: Evidence Bearing on Casuality (1994)
Institute of Medicine (IOM)

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Adverse Events Associated with Childhood Vaccines: Evidence Bearing on Causality

d The evidence that establishes a causal relation for anaphylaxis derives from MMR. The evidence regarding monovalent measles vaccine favors acceptance of a causal relation, but are less convincing, mostly because of incomplete documentation of symptoms or the possible attenuation of symptoms by medical intervention.

e The evidence derives from studies of diphtheria-tetanus toxoid for pediatric use (DT). If the evidence favors rejection of a causal relation between DT and encephalopathy, then in the committee's judgment the evidence favors rejection of a causal relation between Td and tetanus toxoid and encephalopathy.

f Infantile spasms and SIDS occur only in an age group that receives DT but not Td or tetanus toxoid.

g The evidence derives mostly from DPT. Because there are supportive data favoring rejection of a causal relation between DT and SIDS as well, if the evidence favors rejection of a causal relation between DPT and SIDS, then in the committee's judgment the evidence favors rejection of a causal relation between DT and SIDS.

h The evidence derives from tetanus toxoid. If the evidence favors acceptance of (or establishes) a causal relation between tetanus toxoid and an adverse event, then in the committee's judgment the evidence favors acceptance of (or establishes) a causal relation between DT and Td and the adverse event as well.

i The data come primarily from individuals proven to be immunocompromised.

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