title: Immunizations in the United States: success, structure, and stress.
abstract: Immunization is a great success of preventive medicine. In the United States, most vaccine-preventable diseases of childhood are at or near record lows while the number of diseases preventable by vaccination has increased. These successes result from a comprehensive system that includes basic research; developing and testing vaccine candidates; a manufacturing base; a regulatory authority; development of immunization policies; implementation of immunization recommendations; and a compensation system for the few people unavoidably injured by vaccines. Despite the successes, the system faces numerous challenges, including vaccine supply, cost, and safety; adult immunization; vaccine research and development; and biopreparedness.
authors.affiliation: Emory University, Atlanta, Georgia, USA. worenst@emory.edu
authors.forename: Walter A
authors.initials: WA
authors.lastname: Orenstein
authors.forename: R Gordon
authors.initials: RG
authors.lastname: Douglas
authors.forename: Lance E
authors.initials: LE
authors.lastname: Rodewald
authors.forename: Alan R
authors.initials: AR
authors.lastname: Hinman
mesh_terms: D000328:Adult; D003140:Communicable Disease Control / Q000379:methods*; D003141:Communicable Diseases / Q000453:epidemiology; D003299:Cooperative Behavior; D006801:Humans; D017589:Immunization Programs; D011315:Preventive Medicine; D012449:Safety; D014481:United States / Q000453:epidemiology; D014612:Vaccines / Q000191:economics / Q000600:supply & distribution*
chemical_list: D014612:Vaccines