We disagree with Dr Sepkowitz that examining the Vaccine Adverse Event Reporting System for rare serious events casts doubt on the safety of vaccines. Demonstrating that reported adverse events after the the administration of the acellular pertussis vaccine are (1) rare after millions of doses have been used (vs only thousands used in prelicensure clinical trials) and (2) less common than similar events reported after the administration of the whole-cell pertussis vaccine should help instill public confidence in a vaccine that historically has been the most feared.
While controversy remains about whether the whole-cell pertussis vaccine has been proven to be a cause of permanent neurologic damage,1-3 a consensus exists that the evidence is consistent with a causal relationship between the whole-cell pertussis vaccine and acute encephalopathy, with an attributable risk between 0 and 10.5 cases per million doses of whole-cell pertussis vaccine.4 As Dr Sepkowitz
Rosenthal S, Chen RT, Hadler S. Reputed Brain Damage and 'Serious' Reactions From DTP Vaccines-Reply. Arch Pediatr Adolesc Med. 1997;151(1):108. doi:10.1001/archpedi.1997.02170380111027