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December 10, 1997, Vol 278, No. 22 >
ARTICLE | December 10, 1997

Immunization FREE

W. Michael McDonnell, MD; Frederick K. Askari, MD, PhD
JAMA. 1997;278(22):2000-2007. doi:10.1001/jama.1997.03550220206026
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References

Immunization is undergoing important changes, with improved vaccines replacing less immunogenic or less safe vaccines, new vaccines for common diseases such as chickenpox and hepatitis A infection, and improved immunization schedules. Immunization is also being transformed by basic work in molecular medicine. Vaccines made of DNA are being developed as a form of gene therapy that use the patient's own cellular machinery to make foreign proteins that stimulate an immune response. Currently immunization is used to protect patients prior to exposure to an infectious agent or during the incubation phase after exposure, but before disease has occurred. New technologies are being investigated to induce the immune system to fight infections that have already produced chronic disease such as acquired immunodeficiency syndrome and chronic hepatitis B virus infection.

REFERENCES

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Peter G.  Childhood immunizations . N Engl J Med . 1992;;327:1794-1800.
2 +
Centers for Disease Control and Prevention.  Update: quarterly immunization table . MMWR Morb Mortal Wkly Rep . 1997;;46:36-37.
3 +
Hill HF.  Pax polio . Science . 1997;;275:40-41.
4 +
Centers for Disease Control and Prevention.  Certification of poliomyelitis eradication—the Americas, 1994 . MMWR Morb Mortal Wkly Rep . 1994;;43:720-722.
5 +
Dennehy PH, Jost EE, Peter G.  Active immunizing agents . In: Feigin RD, Cherry JD, eds. Textbook of Infectious Disease . 3rd ed. Philadelphia, Pa: WB Saunders Co; 1992;:2231-2260.
6 +
Stiehm RE.  Passive immunization . In: Feigin RD, Cherry JD, eds. Textbook of Infectious Disease . 3rd ed. Philadelphia, Pa: WB Saunders Co; 1992;: 2261-2288.
7 +
Centers for Disease Control and Prevention.  Update: vaccine side effects, adverse reactions, contraindications and precautions . MMWR Morb Mortal Wkly Rep . 1996;;45 ( (RR-12) ):1-35.
8 +
Peter G, Hall CB, Halsey NA, Marcy SM, Pickering LK, Orenstein WA, eds. 1997 Red Book: Report of the Committee on Infectious Diseases . 24th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 1997;.
9 +
American Academy of Pediatrics, Committee on Infectious Diseases.  Recommended childhood immunization schedule—United States, January-December 1997 . Pediatrics . 1997;;99:136.
10 +
Centers for Disease Control and Prevention.  Recommended childhood immunization schedule—United States 1997 . MMWR Morb Mortal Wkly Rep . 1997;;46:36-37.
11 +
Gardner P, Eickhoff T, Griffin M,et al.Guidefor Adult Immunization . 3rd ed. Philadelphia, Pa: American College of Physicians; 1994;.
12 +
Centers for Disease Control and Prevention.  Update: childhood vaccine-preventable diseases—United States 1994 . MMWR Morb Mortal Wkly Rep . 1994;;43:718-720.
13 +
Centers for Disease Control and Prevention.  Status Report on the Childhood Immunization Initiative: national, state and urban area vaccination coverage levels among children aged 19 to 35 months—United States, 1996 . MMWR Morb Mortal Wkly Rep . 1997;;46:657-664.
14 +
Centers for Disease Control and Prevention.  Status Report on the Childhood Immunization Initiative: reported cases of selected vaccine preventable diseases—United States, 1996 . MMWR Morb Mortal Wkly Rep . 1997;;46:665-671.
15 +
Centers for Disease Control and Prevention.  Impact of missed opportunities to vaccinate preschool-aged children on vaccination coverage levels—selected US sites, 1991-1992 . MMWR Morb Mortal Wkly Rep . 1994;;43:709-718.
16 +
Centers for Disease Control and Prevention.  Poliomyelitis prevention in the United States: introduction of a sequential vaccination schedule of a inactivated poliovirus vaccine followed by oral poliovirus vaccine . MMWR Morb Mortal Wkly Rep . 1997;;46( (RR-3) ):1-22.
17 +
American Academy of Pediatrics, Committee on Infectious Diseases.  Recommended use of acellular pertussis vaccine . Pediatrics . 1997;;99:282-288.
18 +
Centers for Disease Control and Prevention.  Prevention of varicella: recommendations of the ACIP . MMWR Morb Mortal Wkly Rep . 1996;;45 ( (RR-11) ):1-32.
19 +
Gardner P, Eickhoff T, Poland GA, et al.  Hepatitis A vaccine, varicella vaccine, purified typhoid Vi polysaccharide vaccine, pneumococcal and influenza vaccines . Ann Intern Med . 1996;;12( (1) , pt 1):35-40.
20 +
Lemon SM, Thomas DL.  Vaccines to prevent viral hepatitis . N Engl J Med . 1997;;336:196-204.
21 +
Hepatitis B virus: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Morb Mortal Wkly Rep . 1991;;40:1-25.
22 +
American Academy of Pediatrics, Committee on Infectious Diseases.  Universal hepatitis B immunization . Pediatrics . 1992;;89:795-800.
23 +
Centers for Disease Control and Prevention.  Influenza surveillance—United States, 1992-93 and 1993-94 . MMWR Morb Mortal Wkly Rep . 1997;;46 (SS-1):1-27.
24 +
Centers for Disease Control and Prevention.  Recommendations of the ACIP: use of vaccines and immune globulins in persons with altered immunocompetence . MMWR Morb Mortal Wkly Rep . 1993;;42( (RR-4) ):1-18.
25 +
McDonnell WM, Askari FK.  DNA vaccines . N Engl J Med . 1996;;334:42-45.
26 +
Gilsdorf JR.  Vaccines: moving into the molecular era . J Pediatr . 1994;;125:339-344.
27 +
Ulmer JB, Donnelly JJ, Parker SE, Rhodes GH, Feigner PL, Liu MA.  Heterologous protection against influenza by injection of DNA encoding a viral protein . Science . 1993;;259:1745-1749.
28 +
Vitiello A, Ishioka G, Grey HM, et al.  Development of a lipopeptide based therapeutic vaccine to treat chronic HBV infection, I: induction of a primary cytotoxic T lymphocyte response in humans . J Clin Invest . 1995;;95:341-349.

Figures

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Peter G.  Childhood immunizations . N Engl J Med . 1992;;327:1794-1800.
2 +
Centers for Disease Control and Prevention.  Update: quarterly immunization table . MMWR Morb Mortal Wkly Rep . 1997;;46:36-37.
3 +
Hill HF.  Pax polio . Science . 1997;;275:40-41.
4 +
Centers for Disease Control and Prevention.  Certification of poliomyelitis eradication—the Americas, 1994 . MMWR Morb Mortal Wkly Rep . 1994;;43:720-722.
5 +
Dennehy PH, Jost EE, Peter G.  Active immunizing agents . In: Feigin RD, Cherry JD, eds. Textbook of Infectious Disease . 3rd ed. Philadelphia, Pa: WB Saunders Co; 1992;:2231-2260.
6 +
Stiehm RE.  Passive immunization . In: Feigin RD, Cherry JD, eds. Textbook of Infectious Disease . 3rd ed. Philadelphia, Pa: WB Saunders Co; 1992;: 2261-2288.
7 +
Centers for Disease Control and Prevention.  Update: vaccine side effects, adverse reactions, contraindications and precautions . MMWR Morb Mortal Wkly Rep . 1996;;45 ( (RR-12) ):1-35.
8 +
Peter G, Hall CB, Halsey NA, Marcy SM, Pickering LK, Orenstein WA, eds. 1997 Red Book: Report of the Committee on Infectious Diseases . 24th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 1997;.
9 +
American Academy of Pediatrics, Committee on Infectious Diseases.  Recommended childhood immunization schedule—United States, January-December 1997 . Pediatrics . 1997;;99:136.
10 +
Centers for Disease Control and Prevention.  Recommended childhood immunization schedule—United States 1997 . MMWR Morb Mortal Wkly Rep . 1997;;46:36-37.
11 +
Gardner P, Eickhoff T, Griffin M,et al.Guidefor Adult Immunization . 3rd ed. Philadelphia, Pa: American College of Physicians; 1994;.
12 +
Centers for Disease Control and Prevention.  Update: childhood vaccine-preventable diseases—United States 1994 . MMWR Morb Mortal Wkly Rep . 1994;;43:718-720.
13 +
Centers for Disease Control and Prevention.  Status Report on the Childhood Immunization Initiative: national, state and urban area vaccination coverage levels among children aged 19 to 35 months—United States, 1996 . MMWR Morb Mortal Wkly Rep . 1997;;46:657-664.
14 +
Centers for Disease Control and Prevention.  Status Report on the Childhood Immunization Initiative: reported cases of selected vaccine preventable diseases—United States, 1996 . MMWR Morb Mortal Wkly Rep . 1997;;46:665-671.
15 +
Centers for Disease Control and Prevention.  Impact of missed opportunities to vaccinate preschool-aged children on vaccination coverage levels—selected US sites, 1991-1992 . MMWR Morb Mortal Wkly Rep . 1994;;43:709-718.
16 +
Centers for Disease Control and Prevention.  Poliomyelitis prevention in the United States: introduction of a sequential vaccination schedule of a inactivated poliovirus vaccine followed by oral poliovirus vaccine . MMWR Morb Mortal Wkly Rep . 1997;;46( (RR-3) ):1-22.
17 +
American Academy of Pediatrics, Committee on Infectious Diseases.  Recommended use of acellular pertussis vaccine . Pediatrics . 1997;;99:282-288.
18 +
Centers for Disease Control and Prevention.  Prevention of varicella: recommendations of the ACIP . MMWR Morb Mortal Wkly Rep . 1996;;45 ( (RR-11) ):1-32.
19 +
Gardner P, Eickhoff T, Poland GA, et al.  Hepatitis A vaccine, varicella vaccine, purified typhoid Vi polysaccharide vaccine, pneumococcal and influenza vaccines . Ann Intern Med . 1996;;12( (1) , pt 1):35-40.
20 +
Lemon SM, Thomas DL.  Vaccines to prevent viral hepatitis . N Engl J Med . 1997;;336:196-204.
21 +
Hepatitis B virus: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Morb Mortal Wkly Rep . 1991;;40:1-25.
22 +
American Academy of Pediatrics, Committee on Infectious Diseases.  Universal hepatitis B immunization . Pediatrics . 1992;;89:795-800.
23 +
Centers for Disease Control and Prevention.  Influenza surveillance—United States, 1992-93 and 1993-94 . MMWR Morb Mortal Wkly Rep . 1997;;46 (SS-1):1-27.
24 +
Centers for Disease Control and Prevention.  Recommendations of the ACIP: use of vaccines and immune globulins in persons with altered immunocompetence . MMWR Morb Mortal Wkly Rep . 1993;;42( (RR-4) ):1-18.
25 +
McDonnell WM, Askari FK.  DNA vaccines . N Engl J Med . 1996;;334:42-45.
26 +
Gilsdorf JR.  Vaccines: moving into the molecular era . J Pediatr . 1994;;125:339-344.
27 +
Ulmer JB, Donnelly JJ, Parker SE, Rhodes GH, Feigner PL, Liu MA.  Heterologous protection against influenza by injection of DNA encoding a viral protein . Science . 1993;;259:1745-1749.
28 +
Vitiello A, Ishioka G, Grey HM, et al.  Development of a lipopeptide based therapeutic vaccine to treat chronic HBV infection, I: induction of a primary cytotoxic T lymphocyte response in humans . J Clin Invest . 1995;;95:341-349.

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