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ONE of the most important medical developments in the 20th century has been the control of once common childhood infectious diseases by the administration of highly effective vaccines. In the United States, the reported number of cases of diphtheria, measles, mumps, pertussis, poliomyelitis, rubella, and tetanus has declined by 97 percent or more (Table 1).1 In the past five years, the introduction in the United States of vaccines against Haemophilus influenzae type b has had a substantial impact on such infections.1 The eradication of smallpox in 1977 and the current near-eradication of poliomyelitis in the Western Hemisphere, as a result . . .
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