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Doody's Review ServiceReviewer: Archana NMI Chatterjee, MD PhD(Creighton University)
Description: This is a report of the safety committee of the Board on Health Promotion and Disease Prevention from the Institute of Medicine (IOM) of the National Academies. The IOM convened a panel of 15 members from diverse backgrounds including pediatrics, neurology, immunology, internal medicine, infectious diseases, genetics, epidemiology, biostatistics, risk perception and communication, decision analysis, public health, nursing and ethics to review the data on influenza vaccine and neurological conditions.
Purpose: The purpose of this book is to address concerns of possible association of influenza vaccines with a nervous system condition called Guillain-Barre syndrome (GBS) or other similar conditions. This is an important contribution to the literature on the subject. The objectives are appropriate and the book meets them well.
Audience: According to the authors, this book is written primarily for public health officials and primary care practitioners who provide influenza vaccines, in order to help address concerns that the public may have regarding influenza vaccines and GBS or similar neurological syndromes. The authors are eminent authorities in their fields.
Features: Infection with the influenza virus can have serious consequences for people of all ages, but it is particularly worrisome for infants, the elderly, and people with underlying heart or lung conditions. The mainstay of influenza prevention for decades has been annual vaccination of at-risk populations, with a vaccine that is reformulated each year to adjust to the changes in the circulating influenza viruses. In 1976, an association was noted between influenza vaccination against the expected "Swine Flu" and cases of GBS. Ever since then, the controversy has raged over whether influenza vaccines are causally related to GBS or other similar conditions. This report of an independent panel of experts that reviewed the existing data regarding this issue concludes that the evidence favored acceptance of a causal relationship between the 1976 swine influenza vaccine and GBS in adults. The committee concluded that the evidence favored rejection of a causal relationship between influenza vaccines and exacerbation of multiple sclerosis. For other years' influenza vaccines and GBS, and for other neurological conditions studied, the evidence was deemed to be inadequate to accept or reject a causal relationship. The executive summary was particularly useful in encapsulating the detailed information provided in the rest of the book. Readers may find the tables in the book useful, because they provide synopses of the various studies reviewed. The references are a little outdated, but that is to be expected with a book of this type.
Assessment: This is a useful book for those interested in the topic of influenza vaccines and GBS or other similar neurological syndromes. There are no comparable, comprehensive reviews of the literature available.