HJNO Jul/Aug 2025

HEALTHCARE JOURNAL OF NEW ORLEANS I  JUL / AUG 2025 43 353 Falchi, F., et al. (2016). The new world atlas of artificial night sky brightness. Science Advances, 2(6), e1600377. https://doi.org/10.1126/sciadv.1600377. 354 Versteeg, R. I., Stenvers, D. J., Kalsbeek, A., Bisschop, P. H., Serlie, M. J., & la Fleur, S. E. (2016). Nutrition in the spotlight: Metabolic effects of environmental light. Proceedings of the Nutrition Society, 75(4), 451–463. 355 Centers for Disease Control and Prevention. (2023). Youth Risk Behavior Survey Data Summary & Trends Report: 2011–2021. U.S. Department of Health and Human Services. https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf. https://stacks.cdc.gov/view/cdc/124928. 356 Centers for Disease Control and Prevention. (2010). Youth Risk Behavior Surveillance—United States, 2009. 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C., & Ardern, C. I. (2022). Inflammation, oxidative stress, and antioxidant micronutrients as mediators of the relationship between sleep, insulin sensitivity, and glycosylated hemoglobin. Frontiers in Endocrinology, 13, 897784 Public Health, 10, Article 888331 . 362 Figueiro, M. G., Wood, B., Plitnick, B., & Rea, M. S. (2015). The impact of light from computer monitors on melatonin levels in college students and children. Pediatrics, 136(4), e916–e923. Lund, L., Sølvhøj, I. N., Danielsen, D., & Andersen, S. (2021). Electronic media use and sleep in children and adolescents in western countries: a systematic review. BMC public health, 21, 1-14. 363 National Sleep Foundation. (2014). 2014 Sleep in America Poll: Sleep in the Modern Family. https://www.thensf.org/wpcontent/uploads/2021/03/2014-Sleep-in- America-poll-summary-of-findings-FINAL-updapdf. Twenge, J. M., Hisler, G. C., & Krizan, Z. (2019). 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Youth Risk Behavior Surveillance System (YRBSS) overview. https://www.cdc.gov [([ (https://www.cdc.gov/ children-mental-health/data-research/index.html). • Acid suppressants (PPIs, H2 antagonists) in their first year of life are more likely later in childhood to develop food and drug allergies, anaphylaxis, allergic rhinitis, and asthma, 452 findings that again require careful long-term investigation. Compounding the crisis of known and potential long-term harms of pediatric overtreatment is a lack of pediatric-specific trials cre- ating a critical knowledge gap. In many settings of pediatric care authorities, guidelines, and healthcare providers rely largely on dosing and safety profiles from adult studies. 453 Growth of the Childhood Vaccine Schedule The Executive Order establishing the MAHA Commission directed the study of any potential contributing causes to the childhood chronic disease crisis, including medical treatments, and to “assess the threat that potential over-utilization of medication… pose[s] to children with respect to chronic inflammation or other established mechanisms of disease, using rigorous and transparent data, includ- ing international comparisons.” Vaccines benefit children by protecting them from infectious diseases. But, as with any medicine, vaccines can have side effects that must be balanced against their benefits. Parents should be fully informed of the benefits and risks of vaccines. Many of them have concerns about the appropriate use of vaccines and their possible role in the growing childhood chronic disease crisis. • Since 1986, for the average child, by one year of age, the number of recommended vaccines on the CDC childhood schedule has increased from 3 injections to 29 injections (including in utero exposures from vaccines administered to the mother). Of course, par- ents may choose to delay to a later age or forego one or more of these vaccines. 454 455 • The number of vaccinations on the American vaccine schedule exceeds the number of vaccinations on many European schedules, including Denmark, which has nearly half as many as the U.S. 456 457 458 Yet, no trials have compared the advisability and safety of the U.S. vaccine schedule as compared to other nations. 459 • Unlike other pharmaceutical products, vaccines are unique in that all 50 states enforce some form of vaccine mandate for public school enrollment although almost all states allow exemptions for religious and/or personal reasons. 460 In contrast, over half of European countries—including the UK—do not require childhood vaccination. 461 Despite the growth of the childhood vaccine schedule, there has been limited scientific inquiry into the links between vaccines and chronic disease, the impacts of vaccine injury, and conflicts of interest in the development of the vaccine schedule. These areas warrant future inquiry: Clinical trials: Our understanding of vaccine safety and any links to chronic disease would benefit from more rigorous clinical trial designs, 462463 including the use of true placebos, larger sample sizes, and longer follow-up periods. Many vaccines on the CDC’s childhood schedule involved small participant groups, had no inert placebo-controlled trials, and had limited safety monitoring, some lasting six months or less—raising concerns about the ability to detect rare or long-term adverse effects. Complications and the Vaccine Safety Surveillance System: Vaccines can have a wide range of adverse effects. Manufacturers are only required by Federal law to list these adverse events in their package insert if they have a basis to believe there is a causal relationship between the drug and the occurrence of the adverse event. 464 There are, however, many possible adverse events for which there is inad- equate evidence to accept or reject a causal relationship. 465 466 Vaccine reactions are supposed to be evaluated in the United States through a range of federal agencies. 467 The Vaccine Adverse Event Reporting System (VAERS) relies on passive reporting by physicians and others, but provides incomplete “early warning” observational data. Many health care professionals do not report to VAERS because they are not mandated to do so or they may not connect the adverse