•    The mission will continue to creep, away from mere overemphasis on infectious disease prevention and management to a pursuit of disease eradication, a far more radical and quixotic goal;

•    The strategy will continue to overreach, from a step-wise expansion of the U.S. vaccine program expansion to a global escalation of vaccine interventions across diseases and geographies;
•    The communication approach will grow increasingly strident, shifting from the mere hyping of infectious disease risk to promoting an ambience of fear, hijacking the threat of terrorism to lend legitimacy to the creeping mission;

•    The style of engagement with families will become more coercive, moving from an emphasis on herding the public with public relations to imposing forced vaccination with all the necessary suppression of dissent and infringement on civil liberties that would be required to institute such coercive measures;

•    The operational oversight of vaccine safety will degenerate, from the current utilitarian stance, which merely devalues adverse reactions, to a more Orwellian posture in which adverse event denial becomes the prevailing mode of management;

•    The program governance standards will decline further, from a half-hearted attempt to manage conflict of interest to a full embrace of governance by and for the vaccine development complex, as continued engagement with increasingly restive (and non-compliant) parent groups becomes less and less appealing.

We believe you have an historic opportunity to signal a new day in childhood public health management. To do this, we suggest you take the following ten simple steps.

1.    Declare autism a national emergency. It is the proverbial "canary in a coal mine" for a host of chronic neurological and immune system disorders.

2.    Launch a full-scale investigation into all potential environmental causes of autism and related disorders, including mercury and vaccines.

3.    Extend the investigation to address the broader increases in immune and neurological dysfunction in children, including learning disabilities, attention deficit disorders, asthma and diabetes.

4.    Design and launch a comprehensive surveillance system aimed at quantifying the incidence rates, trends and costs to society for chronic diseases and disabilities in American children.

5.    Re-structure CDC vaccine program funding priorities to commit funds for independent research into the biological mechanisms of vaccine injury and death, including research into genetic and other biological factors which put some individuals at greater risk than others for suffering vaccine adverse events.

6.    Launch a comprehensive audit of the safety of the newly expanded vaccine program, comparing the incidence of chronic disease and disability in high, low and zero vaccine exposure populations.

7.    Maintain and expand independent researcher access to government vaccine risk assessment data resources such as the Vaccine Safety Datalink and the Vaccine Adverse Event Reporting System.

8.    Remove vaccine risk assessment and vaccine safety oversight responsibilities from CDC and FDA and place them in a separate federal agency, with accountability to the general public, including parent groups.

9.    Charge the new federal agency with responsibility to investigate vaccine adverse reactions and provide necessary resources for a comprehensive re-assessment of long-term health outcomes of alternative childhood vaccination strategies.

10.    Reconstitute the current leadership of the NIP to include outside scientists with no previous involvement in vaccine development, regulation, policy-making or promotion.

We appreciate the opportunity to submit this report and hope that we will have an occasion to review it with you in person in the near future.
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(Editor's note: To date -- more than three years later -- there has been no response from Gerberding or anyone else at the CDC.)

Mark Blaxill is Editor at Large for Age of Autism. Barbara Loe Fisher is co-founder of the National Vaccine Information Center.