• A Word From the President

    Vaccines, Aluminum and Asthma: How You Can Address Patient Concerns

    Sept. 29, 2022

    By Tochi Iroku-Malize, M.D., M.P.H., M.B.A.
    AAFP President

    I’ve been around medicine my entire life — my mother was a nurse and my father a surgeon — and I chose family medicine, in part, because I can have important, intimate, one-on-one conversations with my patients about decisions that affect their health and the health of their families.

    Soon, I imagine that many of us are going to have important conversations with our patients about a topic that has started gaining a lot of traction.

    Earlier this week, a study appeared in the online version of Academic Pediatrics. The study, which pulled Vaccine Safety Datalink information from more than 326,000 children, found a small, but nevertheless positive, association between cumulative aluminum exposure from vaccines and persistent asthma.

    The study authors stated that the findings weren’t strong enough to question the safety of aluminum in vaccines, and that additional research is warranted. In fact, the corresponding author of the study, a practicing pediatrician, told STAT News, “I’m still going to advocate for vaccines as strongly as I did before we had these findings.”

    The CDC has already taken action. On Sept. 27, the agency updated its Adjuvants and Vaccines webpage to include more information on aluminum adjuvants. The CDC also indicates that they are not changing vaccine recommendations based on this single study, but rather highlight that further investigation is needed. In addition, the CDC, FDA and NIH have already started discussing what additional studies should be conducted to look into these findings.

    As your president, I can promise you that the AAFP is also acting quickly. The chair of the AAFP’s Commission on Health of the Public and Science has already dug into the study details, and we join the CDC in recommending that parents and caregivers continue to follow the immunization schedule to ensure their children get the vaccines they need to protect against serious and sometimes deadly diseases.

    How do we assure parents that their children will be OK? For those who already had concerns about vaccines and have been on the fence about getting their children vaccinated, what can we do to convince them that vaccines are safe and effective, and that the results from this study aren’t “proof” that their kids are being harmed?

    Here are key points that you can feel confident sharing with your patients now:

    1. These findings are cause for additional research, but not cause for alarm. The results come from a single observational study. As the study authors freely admit, the findings need to be examined further. Much more research is needed before anyone can draw any specific conclusions.
    2. There are several limits to the study. For example, the authors did not account for factors such as family history of asthma, secondhand smoke exposure, dietary or environmental exposure to aluminum, or social determinants of health — all of which can increase a child’s risk of developing asthma early in life.
    3. The CDC and the AAFP still recommend that parents and caregivers follow the childhood immunization schedule to protect children against serious, and sometimes life-threatening, disease.
    4. Adjuvants containing aluminum have been used in vaccines for more than 70 years because they help strengthen the body’s immune response. While aluminum adjuvants are in many of the vaccines currently in use in the United States, they aren’t in every vaccine. However, all vaccines are safe and effective, regardless of whether they have aluminum adjuvants.
    5. The medical community consistently monitors the safety and efficacy of vaccines through studies and research. This study is part of the scientific process, and we will examine it with the appropriate due diligence.
    6. Above all, we have decades of research showing that vaccines are safe, reliable and effective. They prevent people from getting sick and reduce the risk of contracting a number of infectious diseases. Ultimately, vaccines save lives.

    We have developed a patient-facing FAQ on familydoctor.org to share with your patients and community. We also encourage you to visit familydoctor.org’s Immunizations webpage for additional information.

    The findings from this study were unexpected, but they represent just the first step in an ongoing journey. Whatever happens next, the AAFP will approach it with all due diligence. We will make sure to keep you informed every step of the way.

    Tochi Iroku-Malize, M.D., M.P.H., M.B.A., was sworn in as president of the AAFP on Sept. 21.


    The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.