Book Review

Vaccines

N Engl J Med 1995; 332:476-477February 16, 1995

Article

Vaccines
Second edition. Edited by Stanley A. Plotkin and Edward A. Mortimer, Jr. 996 pp., illustrated. Philadelphia, W.B. Saunders, 1994. $159. ISBN: 0-7216-6584-5

This book is a unique collection of information about what some now call vaccinology. Its 35 chapters include the epidemiologic and clinical studies leading up to the licensure of vaccines currently in use and pay some attention to newer approaches to vaccine development and to vaccines on the horizon. Since the first edition, which appeared six years ago, there has been extensive addition and revision, reflecting the rapid movement in this area of medical research.

The authors were given a free hand in organizing their chapters, which include a great deal of primary data that span a number of years and are thus very difficult to retrieve from the literature. In many chapters, the editors have chosen an effective combination of investigators — those involved in the original development of the vaccine and those currently concerned with its regulation and implementation, such as physicians from the National Immunization Program at the Centers for Disease Control and Prevention.

Unfortunately, the chapters are arranged in no discernible order. Two different approaches to the prevention of influenza are discussed nine chapters apart. Differences of style and organization in the chapters are also evident. A clearer, more uniform template for the presentation of the data and a sterner editorial hand would have benefited the reader. The book is saved from these lapses of organization by the richness of the data and the experience and skills of the individual authors.

Too little attention is paid to international aspects of vaccine use, immunization against parasitic diseases, newer adjuvant therapies, and the immunologic basis of vaccine development. Nevertheless, for readers with a research interest in vaccines this book is an invaluable reference. It should be the first stop in investigations of the history of a vaccine, the potential for vaccine-associated illness, reports of vaccine failure, or indications for vaccine use. It contains information that extends well beyond what is available in the report of the Committee on Infectious Diseases of the American Academy of Pediatrics (Red Book; Elk Grove Village, Ill.: American Academy of Pediatrics) and the recommendations of the American Committee on Immunization Practices, which appear in the Morbidity and Mortality Weekly Report. For this reason, it should find a place in the library of any inquisitive primary care physician.

Peter F. Wright, M.D.
Vanderbilt Medical Center, Nashville, TN 37232