In Reply.—Dr Sepkowitz primarily proposes
that a large fraction of our case reports of postvaccinal hair loss might
have been received after April 1994, when the index patient's experience was
publicized in California. If so, he implies, the apparently large number of
case reports would more likely reflect only "background" coincidental events,
rather than a pathophysiologic linkage between vaccination and subsequent
loss of hair.
In the first 6 weeks after publication of our article, we were interviewed
by a half-dozen journalists, and secondary publicity appeared. Concomitant
with and presumably on account of the fanfare, we have learned of an additional
6 patients with hair loss after vaccinations. This high reporting rate, averaging
1 new case per week, displays the publicity effect precisely as we related
with respect to our index case and illustrates the problem that concerns Sepkowitz.
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