During the past century, the average life expectancy of US citizens
increased by 30 years, primarily due to improvements in sanitation and development
and use of vaccines and antimicrobial agents.1
Immunizations are one of the most cost-effective health intervention strategies
available, saving society more than $5 for each dollar spent on most of the
vaccines that are recommended routinely for children in the United States.2 At the end of the 20th century, the percentage of
children younger than 2 years who received all vaccines in the recommended
childhood immunization schedule was at a record high of about 90%.3 Immunization is one of the major public health achievements
of the 20th century.1 Despite this remarkable
success, the National Immunization Program has been subjected to increasing
attacks by a number of individuals and groups. We highlight the benefits of
the vaccines in the recommended childhood immunization schedule, discuss the
known risks of vaccinations, explore some of the current impediments to a
maximally effective national immunization program, and discuss challenges
that lie ahead.
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