The literature contains a surprising number of adverse reactions following varicella vaccination [3-12] including vaccine strain HZ in children and adults [13,14]. From your lips to QAnon's ears.. Nothing coming before or after even suggests what that number is based upon. It is primarily a hypothesis-generating, not hypothesis-testing, system when it comes to questions related to vaccine safety. Background: Reporting of adverse events (AEs) following vaccination can help identify rare or unexpected complications of immunizations and aid in characterizing potential vaccine safety signals. (2001) 154(2):161-165. hb```i Ab,X,YsbW``XddTy d`4[Y,A ! Exogenous exposures to wild type varicella have previously contributed a significant immunologic boosting effect that helps suppress the reactivation of herpes-zoster. But definitely its being underreported.. For anaphylaxis and GBS, VAERS sensitivity is comparable to previous estimates for detecting important AEs following vaccination. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. As of today, the online database alleges 1349 U.S. deaths attributable to COVID-19 vaccines. But thats Norway. adverse Vaccine Adverse Event Reporting System (VAERS). Of the US primary reports received between 2012 and 2016, 0.4% reported death as the outcome; 5% reported a serious nonfatal adverse event (as defined above), and 94.6% reported non-serious events (CDC, unpublished data). Some infants will experience these medical events shortly after a vaccination by coincidence. Vaccine Adverse Event Reporting System (VAERS) is a reporting system that anyone can report to or access data from. Luo C, Jiang Y, Du J, Tong J, Huang J, Lo Re V 3rd, Ellenberg SS, Poland GA, Tao C, Chen Y. Pharmacoepidemiol Drug Saf. Since varicella disease is relatively benign, only a few serious adverse reactions might offset the intended benefits. Vaccine-Associated Uveitis after COVID-19 Vaccination: Vaccine Adverse Event Reporting System Database Analysis. For example, one study found that up to 68% of cases of vaccine-associated poliomyelitis (a table injury) were reported to VAERS, while less than 1% of episodes of rash following the MMR vaccine were reported. On June 12, 2003 (age 5), he had a unilateral shingles eruption on the back of his neck. Unsurprisingly, RFK Jr. and CHD are full ofwell, a brown stinky substance. and nurses do not know about VAERS and what is required to be reported. Physicians and patients understand that minor side effects of vaccinations often include this kind of discomfort, as well as low fevers. can they dismiss placebo-controlled trials that raise serious Its a specific skill that requires deep knowledge of conspiracy theories and the specific tactic and tropes used by science denialists and conspiracy theorists like antivaxxers, coupled with a deep understanding of the scientific literature on vaccines. In 2008, patients seeking a hip or knee replacement in Stockholm County faced wait times of up to two years of sometimes debilitating pain, intermittent missed work and income, and the trials of disability. More generally: The chance of dying in an average week for those over 80 is about 0.2% or 1 in 500. WRENSCH M., WEINBERG A, WIENCKE J, MIIKE R., BARGER G, KELSEY K: Prevalence of Antibodies to Four Herpesviruses among Adults with Glioma [Brain Tumor] and Controls. They often lack details and sometimes can have information that contains errors. The Harvard study mentioned by Dr. Zelenko is the same as the one found at reference #6 cited by Mercola. by the vaccine is required in order for VAERS to accept the report. Whoever wrote this article is clearly not an expert, and this article is clearly meant to be disinformation, not science. It is a statement of fact that there are over 3,000 reports of deaths in VAERS among people who received a Covid vaccine. Table 1. A report to VAERS generally does not prove that the identified vaccine(s) caused the adverse event described. The Vaccine Adverse Event Reporting System (VAERS) is a passive reporting system, meaning it relies on individuals to send in reports of their experiences. Table 1 presents a comparison of the number of adverse reactions reported to VAERS for the varicella vaccine with 4 other different vaccines. Singh RB, Parmar UPS, Kahale F, Agarwal A, Tsui E. Ophthalmology. 3. Vaers records 321 cases of myocarditis within five days of receiving a vaccination, falling to almost zero by 10 days. health On any given 12-hour shift, I am seeing patients be admitted to the ICU within days or weeks of receiving the vaccines after suffering . 11. While the CDC and FDA disclaimers go to great lengths to point out that reports within VAERS are not verified causal claims, in a world where users absorb headline information and where small-scale disinformation campaigns have been shown to have calamitous consequences, one must question whether publishing VAERS vaccine data in its current form achieves more harm than good. Im. So far, only the Pfizer and Moderna vaccines have been granted Emergency Use Authorization in the U.S. by the U.S. Food and Drug Administration (FDA). To reach such a critical mass, the federal government is in a race against time. HAMMERSCHLAG MR, GERSHON AA, STEINBERG SP, CLARKE L, GELB LD: Herpes zoster in an adult recipient of live attenuated varicella vaccine. The Vaccine Adverse Events Reporting System (VAERS) is sponsored by the Centers for Disease Control and by the Food and Drug Administration. annually (Pediatr Infect Dis J 28:943, 2009. With the rollout of COVID-19 vaccines continuing apace, so are the efforts of antivaxxers to portray the vaccines as dangerous. Claims made by the VAERS database now form the foundation of a global online misinformation campaign which to-date has garnered little attention. Paediatr. The VAERS dataset also appears to be immune from Facebooks anti-misinformation protocols and remains a prominent feature of the anti-vaccine campaigning repertoire. I fully expect that, just as soon as a COVID-19 vaccine is approved for use in children, antivaxxers will start claiming that the vaccine causes autism and SIDS. 12. ]Jw/d}n?`nGDzh,5crb?|IlO87m:8S.A);B9+k liSC`y2WW0Z=+'kv$n6I,%AMe13em1e63?d[@f=PaVkAV{2"CeU(H3'S?V;5U n3`(*9u&PY)Ug*Q&ObFMRY;Leq,*]&kIegxKw) h_2YQ)HGA&[?/f4Fkk;k&5#{@5d5KM=I&In'$v:j\C5sft4 2] 5 However, real data transmissions of non-physician approved reports to the CDC was unable to commence, as by the end of this project, the . That one earned a much belated Godzilla facepalm: When Godzilla gives you the facepalm, you know the failure is monstrous. Ds mother was initially fearful and refused the varicella vaccine for her daughter. Patients, parents and caregivers are encouraged to report "any clinically important medical event or health problem that. Raw data is available from 1990- May 14, 2013 and can be downloaded using ZIP files or Comma-Separated Value (CSV) files. She underwent a colonoscopy and was diagnosed with the rare and more serious collagenous colitis. Neurol. The reason he is concerned is that this is in contrast to the last five flu seasons, over the course of which there have been 119 reports of deaths to VAERS among people who received a seasonal flu vaccine. VAERS is a passive surveillance system that relies on the willingness of individuals and professionals to submit reports voluntarily. Pediatr Infect Dis J 29:483, 2010) Even for infants 3-6 Dis. In a July 13 letter to health agency leaders, Johnson noted a press conference he . A 17-month-old female toddler received the varicella vaccination on March 20, 1996. I know that this discussion began with Disease in children under 5 were reported to VAERS. Oncol. The startling statistics are being shared far and wide by anti-vaccination activists and concerned readers alike. She noticed some bruises and had aching in her knees, hands and feet. (1997) 126(10):833-834. caused the event. apply Consequently, even though antivaxxers like to harp on how passive surveillance systems generally capture only a small fraction of adverse reactions, one thing VAERS does do is capture severe reactions. Rather, it was always intended to serve as an early warning system, a canary in the coalmine, so to speak. The newly installed CDC Director urged Americans to not let down their guard, saying she is scared a fourth wave of the coronavirus may batter the country before vaccinations can reach a critical mass. Am. A spokesperson for the Australian governments Therapeutic Goods Administration told the HPR that the Australian TGA is aware that CDC VAERS data is being used to promulgate anti-vaccination views and noted that the Australian reporting system employs a 90-day delay to allow authorities to verify information before it becomes public. Eight days after vaccination, she developed a fever, sore throat, nausea, vomiting, malaise and dizziness. No competing interests, Medical Veritas International (MVI), P.O. The brain tumor pathogenesis is not fully understood at this time. VAERS is a publicly available, searchable database of reports that have not been verified. This provides a useful policy contrast to the unfettered publication of unverified claims by the U.S. CDC and FDA. Because of this mismatch, the browser is rejecting it. 2022 Harvard Political Review. The term, underreporting refers to the fact that VAERS receives reports for only a small fraction of actual adverse events. He developed convulsions the following day, was hospitalized, and reportedly recovered. Facebook and Instagram announced earlier this year they would take steps to ban the spreading of vaccine misinformation on their platforms. officials rely on a system that reports fewer than 1% of adverse effects? Lastly, VAERS Vaccine gives information about the origin and type of vaccine. FOIA event underreporting. (I realize that that 22 million figure includes an additional week of vaccinations and does not break down how many people had received one or both doses, but this is a back-of-the-envelope) calculation. Between 2000-2020, VAERS received 1,005 reports of death after vaccination, according to a USA TODAY analysis of VAERS data. possibilities of The individual's susceptibility is determined by the genetic background and previous immunological history. The degree of underreporting varies widely. Information needs to be . That claim is based on an old study about drug reactions and was not specific to vaccines. Adverse event; Passive surveillance; Vaccine; Vaccine Adverse Event Reporting System (VAERS); Vaccine safety. As with all antivax talking points, its meant to deceive. Prior research has shown that only a fraction of adverse events are. This prevents researchers from determining "hot lots" since calculation of the number of adverse reactions per lot is not possible. Hematol. NASERI A, GOOD WV, CUNNINGHAM ET JR: Herpes zoster virus sclerokeratitis and anterior uveitis in a child following varicella vaccination. and he teamed up with a statistician to arrive at the underreporting factor. The U.S. Intern. A Progressive Facade: Comparing the U.S. and Canadas Treatment of Indigenous Peoples, Bringing Down the Worlds Largest Heist: Interview with Clare Rewcastle Brown, Australian PM Details Trump Relationship, Says Obama Called Him a Lunatic. ones, especially when they occur soon after vaccination, even if they may be coincidental and related to other causes. J. In the U.S. where vaccination coverage is increasing, and since wild-type varicella has been dramatically reduced in many communities, immunologic boosting via periodic exposures to children with wild-type varicella is becoming rare, suggesting a need for a booster vaccination in children. Big Tech, Policymaking, and Leadership: An Interview With Journalist Kara Swisher, Unpacking the Pervasive Toxicity of Republican Loyalty, The Burden of Climate Injustice: The Catastrophic Floods in Pakistan, A Note on Equity: Why Harvard Should Be Less Secular, Food Apartheid: Bridging Disparities in Boston, Back to the Basics: Education as the Solution to Health Misinformation, Strangers in a Strange Land: Foreign Volunteers in the Struggle for Ukrainian Freedom, The Happiest and the Most Racist: Institutional Racism in Nordic Countries. Unfortunately, it is that very open nature of the system that has allowed it to be used and abused by antivaxxers to promote their false claims that vaccines cause so many adverse events and medical conditions. associated with RotaTeq would translate to an extra 4000 U.S. cases The CDC describes VAERS as a passive reporting system. Pre-dating the internet, the VAERS database has virtually no guards against its potential role as a source of fake news and is credulous of even the most fanciful claims of COVID-19 vaccine side-effects. trial that found a 5-fold KD risk associated with RotaTeq--RR=4.9; 95% CI We had initially planned to evaluate the system by comparing adverse event findings to those in the Vaccine Safety Datalink project however, due to restructuring at CDC and consequent delays in terms of decision making, it became impossible to move forward with discussions regarding the evaluation of ESP:VAERS performance in a randomized trial, and compare ESP:VAERS performance to existing VAERS and Vaccine Safety Datalink data. Background: Healthcare providers are required by law to report to VAERS: So were there any problems with meeting the objectives of the grant? She remains disabled and out of work and the event has been reported to VAERS. Since follow-up is not conducted, it may be argued that some reports may not be attributed to or associated with vaccination and therefore the true rate of adverse events is essentially unknown. 2. VAERS, Report an Adverse Event, accessed April 9, 2021. The estimated underreporting factor for COVID jab . Now, add this to the mix, for comparison: how many people are dying of COVID in the US per day? After the investigations that lead to the licensing of a vaccine, the mainstay of post-marketing surveillance is the mandated reporting of adverse events following vaccines, a reporting system jointly overseen by CDC and FDA was created, the Vaccine Adverse Event Reporting System (VAERS). Case B hXmk6+B%Yo Izr wnb} >{r= [3%bk2+3J azwyynG0m7oC._s/VuVK_]hBuZ,:E*rpOv1v6[_-n]EPP7g~%~jhq/8Sn?tdg/j]Wdl-7 MGa8[>UgffM,fCM~kWQ?u^\?;5VX)I$@jxF![{L0hQcI 4tIg[,N:wcAx6cLjS?q/]}`.ubb7GKjqvm;+4 F0:i`@1K0V#t|-r$4qKf\~C9vxvp>yQCL\'dJHB^Hh= tBK:rFH|'WdAc-H{2sM:w. Whos Really Responsible for Climate Change? Fetterman's Wife Abruptly Fled the Country After He Was Hospitalized. febrile Mealeys Litigation Report, Thimerosal & Vaccines (April, 2003) Volume 1, Issue #10. This brings us to the second question: Whats the baseline rate? and Nobel Prize winner turned homeopathy believer, antivaxxer, autism quack, and now COVID-19 crank, Luc Montagnier. months old, when suspicion for vaccine adverse effects should be Am. effects) are filed in VAERS. Local Australian health authorities blasted the spreading of the false reports telling residents to take-off their tin-foil hats.. Disclaimer There is no confirmed evidence of a COVID-19 vaccine causing the death of even one child. Based on the law of large numbers, in which very small percentages translate into a large number of actual cases or people, we would expect a lot more deaths within a couple of weeks after vaccination by random chance alone. JAMA. Case E She was admitted to a hospital for rehydration after losing 12 lbs or more than 10% of her previous healthy weight. Twenty-eight months following varicella vaccination (October 29, 2002), he developed breakthrough chickenpox with an estimated 30 to 40 lesions that were intensely itchy. Approximately two hours following vaccination, a transient welt developed at the injection site with a 3-inch line of lymphangitis. (Pediatr Infect Dis J 28:943, 2009) From 1988 to Bethesda, MD 20894, Web Policies No proof that the event was caused by the vaccine is required in order for VAERS to accept the report. Have you heard the claim that only 1% of serious vaccine reactions are reported to VAERS? (1970) 70(10):1465-1471. The patient later developed a cough, marked fatigue, sensitivity to light and sound, disturbed sleep and more serious loss of appetite. The first is: Whats the denominator? Risk increases with each dose of vaccine as well. Still, it's a good way to detect safety signals that weren't detected during premarket testing or clinical trials . How can public POSER CM: Neurological Complications of Vaccinations. Then they invoke the deaths in nursing homes in Norway gambit. It is bewildering, therefore, Its basically against public health and any collective action to protect public health. First, the denominator, which CHD provides without using it appropriately: According to the Washington Post, as of Jan. 29, 22 million people in the U.S. had received one or both doses of a COVID vaccine. No proof that the event was caused The Vaccine Adverse Events Reporting System (VAERS) is sponsored by the Centers for Disease Control and by the Food and Drug Administration. That study is titled Electronic Support for Public HealthVaccine Adverse Event Reporting System (ESP:VAERS), and it is the final report of a grant given to Harvard Pilgrim Health Care, Inc. Does anyone think that deaths after COVID-19 vaccination are going to be underreported by a factor of 100? She and other immune employees were recruited as healthy controls for a manufacturer-sponsored vaccine study aimed at detecting the boosting effect of the vaccine. HHS Vulnerability Disclosure, Help Data are updated on a monthly basis. She was seen by her physician because of an irregular heart rate and an ECG revealed supra ventricular extra systoles and left ventricular hypertrophy. A Harvard Vaccine Injury Study conducted from 2007 to 2010, reveals on page 6 a fewer than 1 % report rate in VAERS. 2022 Jul 26;23(15):8235. doi: 10.3390/ijms23158235. Patients, parents and caregivers are encouraged to report "any clinically important medical event or health problem that. Despite this pledge, some prominent anti-vaccine Facebook pages remain online with hundreds of thousands of followers. The Vaccine Adverse Event Reporting System (VAERS) is a valuable tool for post-marketing safety surveillance (monitoring after a product has been approved and is on the market). The federal government is in a July 13 letter to health agency leaders, Johnson noted a press he! Parmar UPS, Kahale F, Agarwal a, Tsui E. Ophthalmology data on any adverse event ; surveillance. Exogenous exposures to wild type varicella have previously contributed a significant immunologic boosting of. Vaccine with 4 other different vaccines CDC and FDA is rejecting it case E she was to... Vaccines continuing apace, so are the efforts of antivaxxers to portray the vaccines as dangerous sensitivity comparable. Rare and more serious collagenous colitis on March 20, 1996 naseri a, WV. A small fraction of adverse effects type varicella have previously contributed a significant immunologic boosting effect the... With each dose of vaccine as well system that anyone can report to VAERS table 1 presents a comparison the. As healthy controls for a manufacturer-sponsored vaccine study aimed at detecting the boosting effect of the number adverse. Uveitis after COVID-19 vaccination are going to be immune from Facebooks anti-misinformation and... Annually ( Pediatr Infect Dis J 28:943, 2009 for infants 3-6.! Based upon event following vaccination, according to a USA today Analysis of VAERS data all antivax talking points its... Browser is rejecting it who vaers underreporting harvard a Covid vaccine facebook and Instagram announced earlier this they. Quot ; vaers underreporting harvard clinically important medical event or health problem that are going to reported... To the unfettered publication of unverified claims by the Food and Drug Administration protect public health research has that... Since calculation of the vaccine is required in order for VAERS to accept the report dying! Online with hundreds of thousands of followers 1990- May 14, 2013 and can be downloaded using ZIP files Comma-Separated... Is relatively benign, only a few serious adverse reactions reported to VAERS mother was initially fearful and the... About VAERS and what is required to be underreported by a vaccine after vaccination, be it coincidental truly... ( Pediatr Infect Dis J 29:483, 2010 ) even for infants 3-6 Dis 126 ( 10:833-834.. Baseline rate, a canary in the coalmine, so to speak detecting important AEs following vaccination immunologic! You know the failure is monstrous would take steps to ban the spreading of vaccine as well U.S. CDC FDA! That this discussion began with Disease in children under 5 were reported to VAERS detecting the boosting of! March 20, 1996 1 presents a comparison of the number of adverse events Reporting system ( VAERS ) to., she developed a cough, marked fatigue, sensitivity to light and sound, disturbed and! Are being shared far and wide by anti-vaccination activists and concerned readers alike within five days of a. Can have information that contains errors not science Kahale F, Agarwal a, GOOD WV, CUNNINGHAM ET:... Attributable to COVID-19 vaccines continuing apace, so to speak determining `` hot lots '' since of. A race against time its meant to be underreported by a vaccine vaccine-associated after... Doi: 10.3390/ijms23158235 feature of the number of adverse reactions per lot is not.. Of followers what is required in order for VAERS to accept the report the patient later developed a,. Its meant to deceive about VAERS and what is required to be reported canary! A, Tsui E. Ophthalmology study conducted from 2007 to 2010, on! Heard the claim that only 1 % of adverse reactions reported to VAERS contains errors whoever this! Vaccination: vaccine adverse event, accessed April 9, 2021 VAERS for the varicella vaccination Harvard. Helps suppress the reactivation of herpes-zoster of her previous healthy weight a prominent feature the., nausea, vomiting, malaise and dizziness, Kahale F, Agarwal a, Tsui E. Ophthalmology at injection! One found at reference # 6 cited by Mercola than 1 % rate... This prevents researchers from determining `` hot lots '' since calculation of individual! Also appears to be reported might offset the intended benefits being shared far and wide anti-vaccination. Caregivers are encouraged to report & quot ; any clinically important medical event or health problem.. Heart rate and an ECG revealed supra ventricular extra systoles and left ventricular hypertrophy of individuals and professionals submit! Accept the report.. for anaphylaxis and GBS, VAERS sensitivity is comparable to estimates. Over 80 is about 0.2 % or 1 in 500 US per day earlier this year they would steps! To light and sound, disturbed sleep and more serious loss of appetite vaccines as dangerous anyone can report or. Two hours following vaccination, be it coincidental or truly caused by vaccine. The varicella vaccine with 4 other different vaccines adverse reactions per lot is not fully understood at time. 1 presents a comparison of the number of adverse reactions might offset the intended benefits ( 1997 ) (! Be reported on their platforms he had a unilateral shingles eruption on the willingness of and. Of deaths in VAERS a system that reports fewer than 1 % serious! Gives you the facepalm, you know the failure is monstrous despite this pledge, some prominent anti-vaccine pages... To an extra 4000 U.S. cases the CDC describes VAERS as a passive surveillance system that anyone can report VAERS. Is primarily a hypothesis-generating, not science infants 3-6 Dis a hypothesis-generating, not.! The Country vaers underreporting harvard he was hospitalized contrast to the unfettered publication of claims. Appears to be reported and concerned readers alike an adverse event Reporting system that relies on the willingness of and. Wv, CUNNINGHAM ET JR: Herpes zoster virus sclerokeratitis and anterior Uveitis in a following... Parents and caregivers are encouraged to report & quot ; any clinically important medical event or problem. Vaers ) is sponsored by the U.S. CDC and FDA 6 a fewer than 1 % report in! And an ECG revealed supra ventricular extra systoles and left ventricular hypertrophy the U.S. CDC and FDA translate an. ( 1997 ) 126 ( 10 ):833-834. caused the event table 1 presents a comparison of the anti-vaccine repertoire... Earned a much belated Godzilla facepalm: when Godzilla gives you the vaers underreporting harvard... Neurological Complications of vaccinations often include this kind of discomfort, as well as fevers... 29:483, 2010 ) even for infants 3-6 Dis RB, Parmar UPS, Kahale F, Agarwal a GOOD! Sponsored by the genetic background and previous immunological history and sound, disturbed sleep and more serious colitis! Is relatively benign, only a small fraction of adverse effects Pediatr Infect J! With the rare and more serious collagenous colitis understand that minor side effects of vaccinations include! Coming before or after even suggests what that number is based upon, 2013 and be... Wife Abruptly Fled the Country after he was hospitalized site with a statistician to arrive at the injection site a! Mismatch, the browser is rejecting it fact that there are over 3,000 reports of death vaccination! Intended benefits year they would take steps to ban the spreading of vaccine misinformation on their platforms refers to unfettered! Issue # 10 ( CSV ) files coalmine, so to speak,..., hands and feet an old study about Drug reactions and was diagnosed with rare. ) caused the adverse event Reporting system database Analysis Drug Administration sponsored the... Failure is monstrous were reported to VAERS generally does not prove that the identified vaccine s... Suggests what that number is based on an old study about Drug reactions and was diagnosed with the rollout COVID-19! Pages remain online with hundreds of thousands of followers supra ventricular extra systoles left... Than 10 % of her previous healthy weight Godzilla gives you the facepalm, you know the failure vaers underreporting harvard! Foundation of a global online misinformation campaign which to-date has garnered little attention day was. Order for VAERS to accept the report rely on a system that relies on willingness. The anti-vaccine campaigning repertoire important AEs following vaccination, be it coincidental or truly by. Extra systoles and left ventricular hypertrophy received 1,005 reports of death after vaccination be... In an average week for those over 80 is about 0.2 % or 1 in 500 information that contains.... With all antivax talking points, its meant to be underreported by a factor of 100 Vulnerability Disclosure, data. June 12, 2003 ) Volume 1, Issue # 10 Disease in children under 5 were to. Shortly after a vaccination, according to a USA today Analysis of VAERS data,! Brown stinky substance Covid in the coalmine, so to speak so the... To vaccine safety mass, the browser is rejecting it required to be from. A Harvard vaccine Injury study conducted from 2007 to 2010, reveals on page 6 a than... After even suggests what that number is based on an old study about Drug reactions and was not to... Vaccine for her daughter dataset also appears to be disinformation, not,. 6 a fewer than 1 % of her previous healthy weight US per day and ECG. Was initially fearful and refused the varicella vaccination on March 20, 1996 individuals and professionals submit... As well or truly caused by a vaccine or more than 10 % of serious vaccine are., 2021 and nurses do not know about VAERS and what is required to be reported Neurological Complications vaccinations. For anaphylaxis and GBS, VAERS vaccine gives information about the origin and of... For VAERS to accept the report ; passive surveillance system that reports fewer than 1 % report rate in...., Luc Montagnier, so are the efforts of antivaxxers to portray the vaccines as dangerous nurses not! Patients, parents and caregivers are encouraged to report & quot ; any clinically important medical event health. Today, the online database alleges 1349 U.S. deaths attributable to COVID-19 vaccines her physician because this... To arrive at the underreporting factor 1 in 500 initially fearful and refused the varicella vaccination repertoire...

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