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Controversies in Vaccine Safety: A Critical Review covers the topic of the safety of vaccines, an area that is often assumed rather than demonstrated. Further, indications that any vaccine may have adverse effects tend to be downplayed in context to presumed vaccine effectiveness against infectious disease. In reality, some vaccines have much better safety profiles than others and the cumulative safety impact of multiple vaccinations may be different than a simple combination of individual vaccines. The latter point becomes more significant as western medicine adds more vaccines to the recommended schedule each year. Most of the existing mainstream literature tends to be both narrowly focused and dismissive of concerns about adverse effects. The latter is particularly problematic in cases where effectiveness has not been well established.