“49 Doses” poster

49 doses 149 dose 2

This two-page document on NVIC’s site opens with a large picture of smiling children and mothers, and the title “49 Doses of 14 Vaccines Before Age 6? 69 Doses of 16 Vaccines By Age 18? Before you take the risk, find out what it is.”

The title is followed by ranges of ages with a list of the vaccines administered at each age. The bottom of the page claims that vaccines contain different ingredients, including “lab altered live or inactivated viruses and bacteria, chemicals, metals, proteins, antibiotics and human, animal and insect DNA and RNA.”

The second page of the document is split into two columns. The left side reads “If You Vaccinate Your Child, Learn How to Recognize the Signs and Symptoms of Vaccine Reactions” [capitalization and emphasis in the original] and lists several alleged vaccine reaction. For each “reaction,” there is a matching quote under the title “Mother’s Description.” This column ends by listing other reported reactions, including regressive autism, asthma, arthritis, diabetes, sudden death, and others.  It mentions the Vaccine Injury Compensation Program (VICP) and urges reporting of vaccine reactions.

The right-handed side of that asks “Is the Childhood Vaccine Schedule Safe?” It describes an increase in chronic disease in the United States and correlates it to the increase in the number of vaccines. This section includes a quote from an Institute of Medicine Report that “key elements of the entire [child vaccine] schedule – the number, frequency, timing, order and age of administration of vaccines – have not been systematically examined in research studies.”

The final paragraph discusses influenza and TDaP vaccination in pregnancy, asserting that the FDA determined there are no adequate controlled studies examining whether or not the vaccines are safe for the pregnant woman or her developing fetus.

 What is NVIC claiming?

NVIC’s claims are three-fold. First, they are claiming that we give children too many vaccines at too young an age. Second, they are claiming that vaccines carry substantial risks. Those risks include the reactions and the chronic diseases and disorders listed in the document. Finally, they claim that the current schedule, the administration of combinations of vaccines, and the practice of vaccinating women in pregnancy have not been properly studied or tested.

Are the claims accurate?

Too Many Vaccines:

We vaccinate young children against fourteen diseases, giving each vaccine in multiple doses, to provide the most effective immunity. Each of these diseases carries potential risks, up to and including death and hospitalization.

If we can prevent a dangerous disease in a safe manner, we should. So the question is whether vaccines are safe. NVIC implies that they are not–because there are too many doses, because the ingredients are unsafe, and because they carry substantial risks of adverse events.

Examining whether or not we give children too many doses, scientists have pointed out that babies face much more extensive challenges from their environment. We live in a world full of germs, and from the moment he is born, each day a baby’s immune system fights off literally thousands of them. In comparison, the challenge vaccines pose is minuscule, and far easier for a baby to handle, as scientists have calculated.

While the number of vaccines we give has increased, technological advances allow us to give vaccines that pose a much smaller challenge to a baby’s immune system,  vaccines that often include only one or a few single proteins from a bacteria or virus, and vaccines that are called subunit vaccines. The challenge today’s vaccines pose to the immune system is therefore smaller than the challenge the older vaccines posed.

Therefore, the claim that there are too many vaccines on the schedule can be dismissed as inaccurate.

As to vaccine ingredients, it is natural to be concerned about a list of scary-sounding chemical names. While vaccines contain the ingredients listed in the poster, each ingredient is serves an important purpose, and the amounts of each ingredient in vaccines are too small to cause any issue. See here and here for more information.

Do Vaccines Carry Substantial Risks?

Nothing in life is 100% safe. A child can choke on a Cheerio, get food poisoning from spinach, or hepatitis A from organic berries. Vaccines, too, can cause harm, but the evidence is that serious side effects from the vaccines on the schedule are extremely rare. They are much smaller than the risks of the diseases. The process for putting vaccines on the schedule, with its extensive testing and careful expert evaluation, is designed to make sure that vaccines are only on the schedule if their risks are minimal and far outweigh their benefits.

By listing a number of scary conditions – for example, regression or brain inflammation – and not mentioning that if vaccines cause them at all they are extremely rare, NVIC misleads its readers.

NVIC’s poster also makes claims about problems not caused by vaccines.

We addressed in our previous post the fact that vaccines do not cause autism. That fact is, however, worth repeating. Similarly, studies with tens of thousands of children examined whether vaccines cause asthma (1), diabetes (2), and allergies (3). The studies found no link. Again, the best science we have shows that vaccines are not connected to any of these chronic problems. Drawing a connection between these chronic diseases and vaccines, against the evidence, is inaccurate.

The Vaccine Schedule Generally, Multiple Vaccines, or Vaccines in Pregnancy are not tested:

NVIC implies that the vaccine schedule has not been properly studied,using, without context, a quote from an Institute of Medicine report from 2013. But the same report concluded: “Upon reviewing stakeholder concerns and scientific literature regarding the entire childhood immunization schedule, the IOM committee finds no evidence that the schedule is unsafe.”

Highlighting an isolated quote and ignoring the conclusion of the report is not an accurate representation of the committee’s conclusions.

There are, in fact, multiple studies of different combinations of vaccines. Some examples are here, here and here. And see this article. Before getting a vaccine on the market, manufacturers must do concomitant studies showing it’s safe with the schedule. Recently, such a study was done for the not yet licensed meningococcal B vaccine.

Finally, NVIC suggests that the influenza and TDaP vaccines, now recommended in pregnancy, have not been adequately studied for safety in pregnancy. But there are many studies of the flu vaccine during pregnancy. There is also a growing body of studies of the safety of TDaP in pregnancy, including at least one large scale study.


This poster included a number of misleading claims and inaccuracies. We urge readers, again, to reject the unsupported or invalid claims and to keep the problems in mind when they read other materials by NVIC.



[1] Balicer, R D., Grotto, I., Mimouni, M., Mimouni, D. Is Childhood Vaccination Associated With Asthma? A Meta-analysis of Observational Studies. Pediatrics. Vol. 120 No. 5 November 1, 2007.  http://pediatrics.aappublications.org/content/120/5/e1269.full; DeStefano F, Gu D, et. al. Childhood vaccinations and risk of asthma. Pediatr Infect Dis J. 2002 Jun;21(6):498-504. http://www.ncbi.nlm.nih.gov/pubmed/12182372; Hviid A, Melbye M. Measles-mumps-rubella vaccination and asthma-like disease in early childhood. Am J Epidemiol. 2008 Dec 1;168(11):1277-83. doi: 10.1093/aje/kwn253. Epub 2008 Oct 8. http://aje.oxfordjournals.org/content/168/11/1277.long.

[2] Grimaldi-Bensouda L, Guillemot D, et. al; the PGRx-AID Study Group. Autoimmune disorders and quadrivalent human papillomavirus vaccination of young female subjects. J Intern Med. 2013 Nov 8. http://www.ncbi.nlm.nih.gov/pubmed/24206418; DeStefano F, Mullooly JP  et. al. Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus. Pediatrics. 2001 Dec;108(6):E112.  http://pediatrics.aappublications.org/content/108/6/e112.long; D. Elliman. (1999). Vaccination and type 1 diabetes mellitus: Currently no evidence of a link, but more studies are needed as vaccines change. British Medical Journal, 318(7192), 1159-1160. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115570/; T. Jefferson & V. Demicheli. (1998). No evidence that vaccines cause insulin dependent diabetes mellitus. Journal of Epidemiology and Community Health, 52(10), 674-675. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1756616/.

[3] McKeever TM, Lewis SA, Smith C, Hubbard R., Vaccination and allergic disease: a birth cohort study, Am. J. Public Health. 2004 Jun; 94(6): 985-9; H. P. Roost et al. (2004). Influence of MMR-vaccinations and diseases on atopic sensitization and allergic symptoms in Swiss schoolchildren, Pediatric Allergy and Immunology, 15(5), 401-407. doi:10.1111/j.1399-3038.2004.00192.x.  http://www.ncbi.nlm.nih.gov/pubmed/15482514; P. A. Offit & C. J. Hackett. (2003). Addressing parents’ concerns: Do vaccines cause allergic or autoimmune diseases? Pediatrics, 111(3), 653-660. doi:10.1542/peds.111.3.653. http://pediatrics.aappublications.org/content/111/3/653.full.pdf; H. R. Anderson, J. D. Poloniecki, D. P. Strachan, R. Beasley, B. Bjorksten, & M. I. Asher, Immunization and symptoms of atopic disease in children: Results from the international study of asthma and allergies in childhood, Am. J. Public Health, 91(7), 1126-1129 (2001) http://www.ncbi.nlm.nih.gov/pubmed/11441744.


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