Concern over vaccine safety has been a major determinant of immunization policy—from passage of the Biologics Control Act in 1902 to the recent American Academy of Pediatrics (AAP) and Advisory Committee on Immunization Practices (ACIP) recommendations for expanded use of inactivated polio (IPV) and acellular pertussis vaccines.1-4  With the availability of new vaccines and vaccination options comes the challenge of how best to communicate these options to patients and their parents. Lessons from the field of risk communication on predictors of risk acceptability and vaccination decision heuristics provide insight into why some parents resist vaccination. This article provides a historical perspective on vaccine adverse events and applies lessons from risk communication research to help physicians improve their ability to discuss vaccine risks.

Immunizations have been described as the single most effective health intervention after clean water and sewage disposal, and have an extraordinary safety record. However, public policy...

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