{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:37:17Z","timestamp":1792521437629,"version":"4.5.0"},"reference-count":97,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,8,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Concerns about vaccine safety have led some parents to decline recommended vaccination of their children, leading to the resurgence of diseases. Reassurance of vaccine safety remains critical for population health. This study systematically reviewed the literature on the safety of routine vaccines recommended for children in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Data sources included PubMed, Advisory Committee on Immunization Practices statements, package inserts, existing reviews, manufacturer information packets, and the 2011 Institute of Medicine consensus report on vaccine safety. We augmented the Institute of Medicine report with more recent studies and increased the scope to include more vaccines. Only studies that used active surveillance and had a control mechanism were included. Formulations not used in the United States were excluded. Adverse events and patient and vaccine characteristics were abstracted. Adverse event collection and reporting was evaluated by using the McHarm scale. We were unable to pool results. Strength of evidence was rated as high, moderate, low, or insufficient.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Of 20\u2009478 titles identified, 67 were included. Strength of evidence was high for measles\/mumps\/rubella (MMR) vaccine and febrile seizures; the varicella vaccine was associated with complications in immunodeficient individuals. There is strong evidence that MMR vaccine is not associated with autism. There is moderate evidence that rotavirus vaccines are associated with intussusception. Limitations of the study include that the majority of studies did not investigate or identify risk factors for AEs; and the severity of AEs was inconsistently reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>We found evidence that some vaccines are associated with serious AEs; however, these events are extremely rare and must be weighed against the protective benefits that vaccines provide.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2014-1079","type":"journal-article","created":{"date-parts":[[2014,7,2]],"date-time":"2014-07-02T09:54:30Z","timestamp":1404294870000},"page":"325-337","source":"Crossref","is-referenced-by-count":175,"title":["Safety of Vaccines Used for Routine Immunization of US Children: A Systematic Review"],"prefix":"10.1542","volume":"134","author":[{"given":"Margaret A.","family":"Maglione","sequence":"first","affiliation":[{"name":"RAND Corporation, Santa Monica, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lopamudra","family":"Das","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Raaen","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria","family":"Smith","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramya","family":"Chari","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydne","family":"Newberry","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Shanman","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Perry","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew Bidwell","family":"Goetz","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles Healthcare System and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Gidengil","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, California;"},{"name":"Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2014,8,1]]},"reference":[{"issue":"12","key":"2021120906531039600_B1","first-page":"241","article-title":"Ten great public health achievements\u2014United States, 1900\u20131999.","volume":"48","author":"Centers for Disease Control and Prevention (CDC)","year":"1999","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"4","key":"2021120906531039600_B2","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1542\/peds.2009-1653","article-title":"Measles outbreak in a highly vaccinated population, San Diego, 2008: role of the intentionally undervaccinated.","volume":"125","author":"Sugerman","year":"2010","journal-title":"Pediatrics"},{"issue":"4","key":"2021120906531039600_B3","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1542\/peds.2013-0878","article-title":"Nonmedical vaccine exemptions and pertussis in California, 2010.","volume":"132","author":"Atwell","year":"2013","journal-title":"Pediatrics"},{"key":"2021120906531039600_B4","volume-title":"Adverse Effects of Vaccines: Evidence and Causality","author":"Institute of Medicine","year":"2011"},{"issue":"21","key":"2021120906531039600_B5","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1056\/NEJMoa011961","article-title":"The safety of inactivated influenza vaccine in adults and children with asthma.","volume":"345","author":"Castro","year":"2001","journal-title":"N Engl J Med"},{"key":"2021120906531039600_B6"},{"key":"2021120906531039600_B7","unstructured":"Santaguida PL, Raina P. 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