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An Educational Module

Arturo Casadevall
Professor and Chair
W. Harry Feinstone Department of Molecular Microbiology and Immunology
Johns Hopkins University Bloomberg School of Public Health


This module engages students in learning about association and causation in the context of vaccines, their side effects, and legal issues that could arise as a result of side effects associated with vaccinations.

The module employs five case studies. In the first two case studies, a child receives a vaccination, and students must determine whether an event (vaccination) causes a side effect in the child.  In the third case study, a child who has not been vaccinated transmits a disease to another child whose vaccination likely “has not taken.”  The fourth case study involves a vaccine-related death and considers whether more should have been done to screen the patient.  The final case presents a hypothetical situation wherein an expanded use of a vaccine may be the causal factor in an increased prevalence of a certain disease. 

The module discusses side effects associated with vaccines and conditions which have been associated with the administration of vaccines, but which are not supported by scientific evidence.  The module illustrates the fact that association is not causation and explores how causation is established in the scientific realm. 

Discussion points are provided for the teacher and the student.  Some of the discussion points raise questions that do not have clear answers and are reflective of the type of decisions that patients and physicians must make when considering vaccines.  Thematically, the five cases are linked in that they seek to demonstrate causative links among a temporal series of events.

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