Like other childhood vaccinations, hepatitis B vaccination is sometimes refused because patients or parents of children have concerns about the safety of a vaccine (Allred et al., 2005; Gust et al., 2008; Smith et al., 2006a). The committee is unaware of credible evidence of serious harms caused by the hepatitis B vaccine in its many forms. In a 2002 scientific review by the Institute of Medicine, the hepatitis B vaccine was not found to be associated with adverse health outcomes (IOM, 2002). The committee believes that it is one of the safest vaccines available. The efforts of groups opposed to vaccination present a serious obstacle to comprehensive vaccination coverage, which is essential for the prevention and control of hepatitis B in the United States. Mistrust of vaccination (page 127-128)