This is the transcript from the 2001 closed-door meeting of the Immunization Safety Review Committee of the Institute of Medicine (IOM). Recently renamed the National Academy of Medicine, the IOM is a branch of the National Academy of Sciences. Importantly, it helps us understand how the IOM process worked when the committee was looking at the issue of vaccine injury and autism. The process itself, the thinking of the members, their discussion of methodology are critical pieces of information for those evaluating the IOM process. Furthermore, the transcript was apparently leaked by an IOM insider who felt it important enough make the public aware of these internal discussions, after the IOM’s findings were made. This meeting took place one day after the first public forum.