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The Immunization Safety Review Committee was established by the Institute
of Medicine (IOM) to evaluate the evidence of possible causal associations between immunizations and certain
adverse outcomes. This year they focused on sudden infant death syndrome (SIDS) and sudden unexpected death in
infancy (SUDI).
The issue of association between immunization and SIDS is based on the fact that vaccines are routinely given during
the period of the highest incidence of sudden infant death syndrome, which is between 2 and 4 months of age. In
this situation it is necessary to answer the question if the use of vaccines contribute to an increased risk of
SIDS, or if it is just a coincidence. Although the rate of SIDS is declining dramatically, about 2,500 infants
still die each year from SIDS in the United States. And there are those who believe that vaccinations are responsible
for some of these deaths.
The experts from the Institute of Medicine reviewed the recent research on the relationship between immunizations
and SIDS. The American Academy of Pediatrics currently recommends multiple doses
of seven different vaccines during the first year of life. These vaccines include the combination Diphtheria-Tetanus-acellular
Pertussis (DTaP) vaccine, Haemophilus influenzae type b (Hib) vaccine, Hepatitis B (HepB) vaccine, Inacticated
Polio vaccine (IPV), and Pneumococus vaccine (PCV).
The Committee concluded that there is no evidence of a causal relationship between these vaccines and sudden infant
death syndrome, sudden unexpected death in infancy, or neonatal death. For some vaccines there was a strong evidence
of no causal relationship; for others, the evidence was inadequate to accept or reject causal relationship, which
was due to a small number or no epidemiologic studies evaluating the relationship between vaccination and SIDS.
For example, the Committee concluded that "the evidence is inadequate to accept or reject a causal relationship
between DTaP vaccine and SIDS." That was due to the fact that the epidemiologic "evidence" consists
of only one uncontrolled observational study. The American SIDS Institute with the American
Association of SIDS Prevention Physicians (AASPP) is addressing this issue by designing and sponsoring the
controlled multi-center clinical trial on Prolonged Apnea
and Prolonged Bradycardia Following DTaP Immunization in Preterm Infants. We expect to complete the study within
a year.
Timely immunizations protect infants from many potentially dangerous infectious diseases. The report of the Institute
of Medicine once again confirmed that there is no reason to believe that vaccines routinely given to infants during
their first year of life contribute to an increased risk of sudden infant death syndrome, sudden unexpected death
in infancy, or neonatal death.
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