Search

To the Editor.— In "Vaccination and Disease Prevention for Adults" (1982; 248:1607), Goodman et al note in the Table thatinactivatedpoliovirus vaccine (IPV) is contraindicated during pregnancy on theoretical grounds. I question use of that rather standard phraseology with regard to either IPV or the oral live-virus vaccine (OPV). During the mid-1950s, when IPV first became available, among those with highest priority for immunization were pregnant women. They were not noted to suffer untoward effects nor did their offspring suffer birth defects. In the case of OPV, it is well known that the vaccine virus often spreads to other family members after being given to children within the family. Consequently, many susceptible pregnant mothers have been "immunized" along with their children. There is no evidence that they or their pregnancy outcomes have been adversely affected as a result. In short, I see no reason to withhold either IPV or

To the Editor.— The recommendations for vaccine injury compensation published in the Dec 7 issue ofThe Journal 1 are both necessary and generally sound. All claims of injury should first be funneled through a no-fault federal compensation program. However, when the claimant finds the disposition of his claim by the program to be unsatisfactory, there probably deserves to be a limited appeals process involving petition for a rehearing or appeal to a federal court, where a contention as to fact could be heard by a judge without jury. This is most apt to be needed when a claim is turned down. In addition, health insurers should not be permitted to exclude these injuries from medical care coverage, and compensation should be limited to cases of serious injury only to the extent that a family's health insurance does not provide such coverage. Pain and suffering compensation should be excluded. In

To the Editor.— In their COMMENTARY "Facilitating the Transitions of Adolescence," Hamburg et al 1 state "one in ten girls becomes pregnant during adolescence, and most of the pregnancies are not intended." Although one in ten is bad enough, that figure is in fact much too low. When abortions are considered along with childbirths, the true figure comes closer to 25% to 30%. Only about half of all teenage pregnancies go to term, and these number about 500 000 newborns annually.