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Different vaccinations are set up for children getting their checkups in the Immunization Lab at the Children's Hospital Primary Care Clinic in Oakland, Calif., on Wednesday, Jan. 16, 2013. The Institute of Medicine released a report Wednesday declaring the recommended childhood immunization schedule to be safe. (Laura A. Oda/Staff)

The typical American child receives 24 immunizations by age 2, with some getting as many as five shots during a single doctor's visit.

Is this the best way to protect young children from deadly diseases, or does it overload the immune system of these tiny bodies making some vulnerable to a vaccine-induced reaction?

On Wednesday, after reviewing existing research, the influential Institute of Medicine declared the recommended vaccine schedule safe.

"We conducted an extensive (scientific) literature review," said Alfred Berg, a family medicine professor at the University of Washington in Seattle. "Our committee found no evidence that the childhood immunization schedule is not safe."

The institute, an independent body that advises the federal government on health matters, noted that the vaccine schedule is meant to protect children against serious diseases such as Hepatitis B, measles and rubella when they are most vulnerable to illness.

Advances have reduced the inactivated or dead viruses and bacteria that children are exposed to in vaccines, the committee said.

And it noted that new vaccines undergo rigorous testing by the Food and Drug Administration.

But the findings are unlikely to ease the concerns of some parents of autistic children and other critics who believe vaccines had serious side effects and may have led to their children's disorders.

"It doesn't sound like this report is going to get to the bottom of anything," said Rebecca Estepp, a spokeswoman for the Elizabeth Birt Center for Autism, Law and Advocacy.

Such concerns prompted the U.S. Department of Health and Human Services to ask the institute to investigate, especially since some parents are delaying or avoiding having their children vaccinated.

San Jose resident Rebecca Makarova is among the 90 percent of American families that follow the recommended schedule. She has a 5-year-old boy, a 3-year-old girl, and a 17-month-old boy.

"I'm trusting my health care provider," Makarova said. "For me, that's one way of helping protect them."

But Alameda resident Tammy Tsao decided to space out shots for her 2-year-old son to avoid his getting four at once.

"Even for an adult, that's shocking for the body," Tsao said.

The committee found no studies of whether it is better or worse to space out vaccinations within the recommended time frame.

But it noted that outbreaks of diseases such as measles and whooping cough have occurred when parents delayed vaccinations past the recommended period or declined immunizations.

After January 2014, California will require parents who want their children exempted from immunizations to sign a form stating that a health professional has informed them of vaccines' risks and benefits.

Estepp, a San Diego resident and a spokeswoman for the Elizabeth Birt Center, is among those seeking more research. She said her then 9-month-old son, who had been developing normally, reacted severely to a Hepatitis B shot.

"It started with fever and high-pitched screaming and incredible diarrhea," she said. "It lasted for 10 days and then he recovered, but he was sick constantly and he had mystery fevers." Estepp said her son's development stalled and he was diagnosed with autism. He is now 15.

Autism's cause is unknown and most in the medical community argue that no evidence links it to vaccines.

Some critics have urged studies comparing immunized children to those in communities who are not vaccinated. But with less than 1 percent of Americans declining all immunizations, the committee concluded it would be difficult to recruit enough willing participants and unethical to ask them to forego immunization.

Scott Laster, a board member of the advocacy group SafeMinds, said researchers could compare vaccinated and unvaccinated children by looking at home-schooled children. "They're not doing the study because they don't want to find the answer," he said.

Alameda resident Elizabeth Tran Wong believes vaccination pros outweigh the cons, especially since her 3-year-old daughter is in preschool where she is exposed to other children.

"When it comes to modern medicine, I trust them as much as I can," Tran Wong said. "Stuff like chickenpox and smallpox, that was a huge threat back in the day. It's crazy to think people would die from that. No one even knows what it is anymore."

Protecting children
Federal guidelines recommend vaccinating children against these diseases. Some require several doses, with the first occurring within the first two months.
Hepatitis B
Rotavirus
Diphtheria, tetanus, pertussis
Haemophilus influenzae type b
Pneumococcal
Inactivated poliovirus
Influenza
Measles, mumps, rubella
Varicella
Hepatitis A
Meningococcal