In Reply.—I appreciate Dr Roman's letter in response to my editorial concerning the pertussis vaccine encephalopathy myth. His comments are those of a concerned physician and should be taken seriously. To add further information to the topic he discusses, I refer Dr Roman to my earlier editorial on how standard practice in pediatrics is set.1
I do not believe that experts act capriciously. I addressed part of this in my previous editorial, but would like to take this opportunity to expand on those thoughts.
Most experts are dedicated professionals who strive to offer their best opinion in a discipline that does not have all the data it needs but must act on the data available to care for patients. My experience is mostly with recommendations for immunization and infectious diseases practice, so I will draw on that for my examples.
The Academy of Pediatrics Committee on Infectious Diseases (the "Red