6. Risk when disease is virtually absent Risk during an epidemic Concepts difficult even for professionals e.g. “ temporal” vs.“causal” association, “ relative risk”, “ risk assessment” A communications challenge
7.
8.
9. 1940 1950 1970 1980 1990 Vaccine uptake DTP introduced 81% 31% 93% Cases per 100000 Year Source: Gangarosa. Lancet 351, 1998 1960 INCIDENCE OF PERTUSSIS IN COUNTRIES AFFECTED BY ACTIVE ANTI-VACCINE MOVEMENTS (United Kingdom) 0 100 200 300 400 500 I Active AVM