This is not the real world, as I knew it when I started pediatric practice in 1966.

Then, the diseases against which vaccination was recommended had been common at one time or, in the case of tetanus, had a high mortality rate.

Now, according to a page 1article in the December 2005 AAP News by Robert W. Frenck, M.D.,FAAP, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) is recommending universal vaccination against hepatitis A, even though: a) the current incidence of hepatitis A in this country is only 2/100,000, and b) $6,700,000 spent on the vaccine will save only one life. (Morbidity of course is negligible since hepatitis A does not cause chronic hepatitis.)

From the evidence printed in AAP News, it appears that targeting high-risk states for hepatitis A vaccination has been successful, but that universal vaccination would not...

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