The Pink Book: Free Vaccine Textbook From the CDC

What is the virus that causes measles? How many cases of polio occurred before vaccines? How do we know that vaccines are safe and effective? How should vaccines be stored? What are the symptoms of rubella? What are the complications from meningococcal disease? What are the clinical features pertussis? How is mumps spread? How is diphtheria diagnosed? What is the difference between hepatitis A and hepatitis B?

Why is it important to be vaccinated against tetanus? How does some HPV vaccines prevent anal and genital warts? How are vaccines administrated? What strategies do the CDC recommend for improving vaccine coverage for influenza? How long should you wait between two doses of the same vaccine? How do you report adverse events following vaccinations and why is it important to distinguish between correlation and causation?

These and many more questions are answered in a free and awesome textbook on vaccines and vaccine-preventable diseases called Epidemiology and Prevention of Vaccine-Preventable Diseases (also called the Pink Book) from the Center for Disease Control and Prevention (CDC). It works as a great go-to guide if you want to read up on the basic biology of the pathogens that cause vaccine-preventable disease, how they cause disease, signs and symptoms of the diseases, complications, how they are diagnosed and spread, historical incidence of the disease over time and in relationship to vaccination, the vaccines being used, contraindications and precautions for vaccines and adverse reactions.

The book is currently in its 13th edition and consists of over 500 pages with 22 chapters in total. The first six chapters are dedicated to general issues surrounding vaccines. This includes an introduction to the principles of vaccinations. This chapter explains basic facts about immunology and the human immune system, such as the difference between the innate and adaptive immune system and how they work. It also covers different types of vaccines and how vaccines are classified, such as live attenuated vaccines, inactivated vaccines, pure and conjugate polysaccharide vaccines and recombinant vaccines.

The chapter on general recommendations on immunizations (chapter 2) discusses the timing and spacing of vaccines, interactions between vaccines and antibodies, when vaccines can be given at the same time and which vaccines need to be separated, intervals between the administration of separate doses of the same vaccines, number of doses, adverse reactions to vaccines and how to report them, and different precautions and contraindications to vaccines (including immunosuppression and cell transplants). It also surveys things that are wrongly believed to be contraindications and how to screen for real contraindications or precautions. The chapter on immunization strategies goes into additional detail on different kinds of programs or approaches, from the Immunization Information Systems (IIS) to reduction of barriers to getting vaccinated.

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Vaccine safety (chapter five) is an important issue that deserves a lot of attention and this book fulfills that need. It looks at the amazing benefit of vaccines, the crucial nature of public confidence, and the different ways vaccines are tested and monitored. Before a vaccine gets licensed, it is subjected to testing on cell cultures, lab animals and humans. Human testing involve three steps (I, II and III) of studies that look at efficacy, safety and common reactions in thousands of people. The two major ways that vaccines can be monitored after being licensed is the Vaccine Adverse Event Reporting System (VAERS) and the Vaccine Safety Datalink (VSD). VAERS can aid in finding new or rare side effects or accurately estimate prevalence of specific side effects, but anyone can submit a report and reported side effects are not evidence of a cause and effect relationship. The VSD allows researchers to conduct planned vaccine safety studies and test hypotheses that are generated in the scientific literature or from reports. The Clinical Immunization Safety Assessment (CISA) Project reviews individual cases and Vaccine Injury Compensation Program (VICP) compensates putative victims of vaccine injury quickly and generously as long as there is more evidence than not for their vaccine injury claim.

After a chapter on vaccine storage and handling that discuss temperature monitoring and vaccine inventory reviews, the sixth chapter focuses on vaccine administration in itself. This includes information on how to staff should be trained, how vaccines are prepared, how a patient should be treated before a vaccine is given, where the different vaccines should be given, documentation and how to prevent administration errors.

The next chapters (chapter 7 though 22) covers each of the vaccine-preventable diseases for which there is a vaccine for on the U. S. vaccine schedule: diphtheria, Haemophilus influenzae type b, hepatitis A, hepatitis B, human papillomavirus, influenza, measles, meningococcal disease, mumps, pertussis, pneumococcal disease, polio, rotavirus, rubella, tetanus and varicella. Each chapter covers the basic biology of the virus, how the virus is spread and infects, what the clinical features of the diseases are, what kinds of laboratory testing, what the epidemiology, how common the disease has been in the past, what vaccines exists for the diseases, contraindications and precautions to immunizations, reported side effects, how the vaccine should be stored and handled and so on.

The book has six rich appendices. These include the vaccine schedule and recommendations, vaccine ingredients, vaccine information statements, vaccine injury tables and reporting systems, data and statistics over deaths and cases of vaccine-preventable diseases since the 1950s, the impact of vaccines during the 1800s and 1900s as well as vaccine coverage levels, and different immunization resources.

In summary, this is a fantastic textbook for people who want to learn a ton of crucial information about vaccines and vaccine-preventable diseases, but do not have enough time to read hundreds of research papers. It is also suitable to check up basic facts about each disease and the different vaccines and can easily be used as an authoritative and high-quality scientific source in discussions about vaccines online. It requires almost no prior knowledge, but it is good to have an interest in the topic before starting reading it.

The book can be read online or downloaded in PDF format. Unfortunately, there is no single file with all chapters, so each chapter has to be downloaded in PDF format separately.

Emil Karlsson

Debunker of pseudoscience.

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