The elimination of infectious diseases in the United States during this century has been a truly remarkable achievement. Mortality from diphtheria, smallpox, pertussis, poliomyelitis, and tetanus have been reduced dramatically. Consequently, attention turned to the conquest of diseases such as measles, rubella, and even mumps. As the expertise which was acquired in these efforts is applied to elimination of infectious diseases that produce relatively less morbidity, the wisdom of pursuing these goals is critically evaluated.Skepticism stems not only from bureaucratic considerations of cost-benefit ratios, but also from the fear that vaccines are not themselves without risks. We have been sensitized, if you will excuse the pun, by a number of sobering experiences such as the use of killed measles vaccines.
展开▼
