To the Editor: Dr Halsell and colleagues1 reported that myopericarditis occurred at a rate of 1 per 12 819 primary vaccinees in the US military. Similarly, Drs Grabenstein and Winkenwerder2 found that between 0.5% and 3.0% of military vaccine recipients needed short-term sick leave. Both groups of authors concluded that adverse events occurred at rates below historical rates, and that a mass vaccination program could be carried out safely. In both reports, however, vaccine complications were derived using passive rather than active surveillance. Therefore, the very favorable comparison of military adverse effect rates to historical rates is misleading.
Furthermore, claims that no deaths were associated with the military vaccination program and that no women developed myopericarditis are incorrect. Two military deaths have in fact been reported to be associated with smallpox vaccination.3 - 4 One occurred in a previously healthy 22-year-old female reservist who died 1 month after receiving both anthrax and smallpox vaccines. According to the autopsy report, this was associated with pericarditis.
Similarly, the rate of myopericarditis found by the US Centers for Disease Control and Prevention (CDC) in civilians under active surveillance was more than 7 times higher than the military rate: 1 in 1725 vaccinees, of whom 71% were women.5 Furthermore, the CDC reports that 2 women are now known to have developed dilated cardiomyopathy following smallpox vaccination.6 The total number of serious adverse events among civilians from January 24 through June 20, 2003, is 71, or a rate of 1 in 500 smallpox vaccinations.6 These events included 5 myocardial infarctions and 1 stroke.
The letter by Dr Nass, as originally submitted to THE JOURNAL, was previously posted at http://www.cbsnews.com/htdocs/pdf/nassletter.pdf.—ED.
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
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