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PEDIATRICS Vol. 109 No. 1 January 2002, pp. 124-129

SPECIAL ARTICLE

Addressing Parents’ Concerns: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System?

Paul A. Offit, MD*, Jessica Quarles{ddagger}, Michael A. Gerber, MD§, Charles J. Hackett, PhD||, Edgar K. Marcuse, MD, Tobias R. Kollman, MD#, Bruce G. Gellin, MD** and Sarah Landry{ddagger}

* Section of Infectious Diseases, Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, and Wistar Institute of Anatomy and Biology, Philadelphia, Pennsylvania
{ddagger} Division of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
§ National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
|| Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
Section of Infectious Diseases, Children’s Hospital and Regional Medical Center, University of Washington School of Medicine, Seattle, Washington
# Department of Pediatrics, University of Washington School of Medicine, Department of Epidemiology, University of Washington School of Public Health and Community Medicine, and Children’s Hospital and Regional Medical Center, Seattle, Washington
** Department of Preventive Medicine, Vanderbilt Medical College, Nashville, Tennessee

--> Recent surveys found that an increasing number of parents are concerned that infants receive too many vaccines. Implicit in this concern is that the infant’s immune system is inadequately developed to handle vaccines safely or that multiple vaccines may overwhelm the immune system. In this review, we will examine the following: 1) the ontogeny of the active immune response and the ability of neonates and young infants to respond to vaccines; 2) the theoretic capacity of an infant’s immune system; 3) data that demonstrate that mild or moderate illness does not interfere with an infant’s ability to generate protective immune responses to vaccines; 4) how infants respond to vaccines given in combination compared with the same vaccines given separately; 5) data showing that vaccinated children are not more likely to develop infections with other pathogens than unvaccinated children; and 6) the fact that infants actually encounter fewer antigens in vaccines today than they did 40 or 100 years ago.

Key Words: multiple vaccines • immunity • parental concerns

Abbreviations: Ig, immunoglobulins • Th, helper T-cell • Hib, Haemophilus influenzae type b • OPV, oral polio vaccine • HIV, human immunodeficiency virus • MMR, measles-mumps-rubella • DTP, diphtheria-tetanus-pertussis

Received for publication Aug 7, 2001; Accepted Oct 4, 2001.


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