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Mandatory childhood vaccination could cause “irreparable damage,” says expert panel

BMJ 2019; 367 doi: (Published 11 October 2019) Cite this as: BMJ 2019;367:l5995

Rapid Response:

Too much safety: vaccine mandates, hesitancy, and AFM


“We all strive for safety, prosperity, comfort, long life…but too much safety seems to yield only danger in the long run.” So said Aldo Leopold, an American wildlife ecologist writing about the control of predators more than 70 years ago. (A Sand County Almanac 1949) The principle applies to our zealous attempts to control microbial pathogens: excessive hygiene, overuse of antibiotics, and aggressive vaccination programs. It relates to the “irreparable damage” caused by vaccine mandates. (Mahase, BMJ 2019;367:l5995, October 11) It may also relate to acute flaccid myelitis/AFM.

On October 7 the CDC reported that the number of confirmed AFM cases in the US had climbed to 590 since recording first began in August 2014. (CDC, AFM Investigation) The actual number of cases is probably much higher. This devastating “mystery disease” is probably caused by non-polio enteroviruses, but based on what we know about poliomyelitis it is likely that IM injections—vaccines or antibiotics—are provoking co-factors. (Cunningham, BMJ rapid responses since January 2015) I have been in touch with CDC officials and AFM Task Force members, who acknowledge the possibility but so far have declined to test the hypothesis. Meanwhile, the popular press continues to report about confusion, mystery and menace as they write poignantly about AFM cases. (Jeffrey Kluger, TIME, 9 October 2019)

It is tragic when mandates and vaccine hesitancy lead to rejection of true lifesavers such as measles vaccine. It is also tragic when rigid mandates, such as those imposed in the US, lead to terrible adverse effects for the sake of the relatively small benefits of some of the other vaccines.

Too much safety seems to yield only danger in the long run….

ALLAN S. CUNNINGHAM 14 October 2019

Competing interests: No competing interests

14 October 2019
Allan S. Cunningham
Retired pediatrician
Cooperstown NY 13326, USA <>