Is There an Alternative Vaccine Schedule?

From the WebMD Archives

Laura Dye was all for childhood vaccinations until she had her first child. Then she got cold feet after reading what she now calls “scare mongering” online.

"I was super scared about vaccines," says Dye, who lives in southern Delaware. "It was my new little baby. He was so perfect."

She wanted to limit vaccines out of concern they might harm her newborn son. Her husband, Jared, wanted their new son fully vaccinated. “He had a great aunt who had polio and said that is never happening to our kid,” Dye says.

It was the vaccine debate in a nutshell, with each parent pushing for what they thought was best for their baby.

They compromised. They would space apart their baby’s shots so he got no more than 2 per checkup. It would take much longer to get him vaccinated than the CDC recommends.

At the time, Dye was on board. But in less than 3 years, she had completely changed her mind. What happened?

Timing Is Everything

Kids get up to 27 vaccines by their second birthday. They can get as many as 5 shots at some visits.

It’s all part of the CDC’s official vaccination schedule, which targets 14 serious diseases including whooping cough, diphtheria, tetanus, mumps, measles, rubella, rotavirus, polio, hepatitis B, and meningitis.

Why so many shots, so close together?

"The reason is that this is when people are most vulnerable” to these dangerous diseases, says Gail Shust, MD, a childhood infectious diseases expert at the Icahn School of Medicine at Mount Sinai. For instance, whooping cough and meningitis can be life-threatening without vaccine protection. In short, it just can’t wait.

Research backs it up, based on clinical trials and decades of experience with patients. The schedule is very specific to keep children as safe as possible until they are fully protected.

“We have the most knowledge and understanding of how the immune system responds in that time frame,” says Kari Simonsen, MD, a specialist in children’s infectious diseases at the University of Nebraska.

According to the Institute of Medicine, the vaccine schedule works, with vaccines preventing many cases of measles and other infectious diseases.

Continued

Are There Alternative Schedules?

There are no official alternative vaccine schedules. No major medical group approves of them. And there is no research to show that they are safe, Simonsen says.

Still, some parents space vaccinations apart, as Dye did with her son. Others skip some. Parents or doctors invent some of these plans.

In The Vaccine Book: Making the Right Decision for Your Child, Robert Sears, MD, writes that the schedules he put together “follow proper dosing intervals and age ranges that each vaccine is approved for.”

Most other pediatricians, the American Academy of Pediatrics (AAP), and the CDC do not support any plan that steps outside of the official schedule.

Like Dye, parents who take this approach worry that too many shots too early will overwhelm their child's immune system or that specific ingredients in the vaccine will harm them.

But actually, alternative schedules may raise -- not lower -- the risk.

They have no benefit, "only a downside," for the child and the larger community, says Paul Offit, MD. He’s an infectious diseases expert at the Children's Hospital of Philadelphia who has written several books on vaccines.

Alternative schedules have not been formally studied, but there is some evidence that they may contribute to disease outbreaks.

"States where a high number of parents opt out [of vaccines] show an increased risk of infectious diseases," says Doug Opel, MD, a pediatrician at Seattle Children's Hospital. "It's significant and it's profound."

These are unvaccinated children. But from there, he says, it not a big leap to think kids who have some but not all shots will also fall short on protection.

What Does Your Doctor Say?

It’s not mainstream, but some doctors may be OK with adjusting the schedule a bit. Opel, for one, believes that some vaccination is better than none -- but that it’s best to stick with the official plan.

Stephanie Cave, MD, a family medicine doctor in Baton Rouge, LA, does not follow the official childhood vaccination schedule. Instead, she says she tailors it for each patient. 

"I have a problem that the [official schedule] is supposed to cover everybody and treat everybody the same way," says Cave, who wrote a book called What Your Doctor May Not Tell You About Children's Vaccinations, which questions vaccine safety. "In my practice, we don't treat everyone the same way." 

Continued

The AAP says there’s no sure way to adjust the schedule and know that your child will be safe from potentially life-threatening infections, since all kids are at risk. And it might actually mean more shots in the long run.

Dye’s son, who’s now 3, had no problems with the vaccine schedule his parents came up with. Dye says her doctor went along with it because her son would eventually get all his shots. But Dye admits that it was a “pain” to schedule all the extra doctor visits to get his shots, bit by bit.

In hindsight, she says that she had had an “emotional reaction” based on “crazy conspiracy theory articles.” She says she decided to look into it further and learned that the alleged link between autism and vaccines “had been disproven.”

The only real science-based evidence she could find supported vaccines’ safety and effectiveness. So her daughter, now 7 months old, is getting all her shots on time.

"I absolutely feel reassured about my kids, that I am preventing them from getting diseases that there's no need for there to be," Dye says.

Other parents still aren’t so sure.

If you wonder if your child really needs all those shots -- even if you know that the science overwhelmingly supports vaccine safety -- talk it over with your doctor. Chances are, you both want to do the right thing.

You may be surprised to find that there is some built-in flexibility in the regular schedule without going outside the recommendations.

For instance, babies can get the third dose of hepatitis B vaccine any time between 6 and 18 months of age. And they can get the rotavirus vaccine in two or three doses, depending on the specific vaccine product used. These are all things you can ask your doctor about.

"Parents are entitled to have information and to voice their concerns," Shust says. "Absolutely, we want to hear them."

WebMD Feature Reviewed by Hansa D. Bhargava, MD on 5/, 015

Sources

SOURCES:

Laura Dye, 34, mother of two, southern Delaware.

Offit, P. Pediatrics, January 2009.

Sears, R. The Vaccine Book: Making the Right Decision for Your Child, Little, Brown and Company, 2007, revised 2011.

Dempsey, A. Pediatrics, November 2011.

Stephanie Cave, MD, family medicine doctor, Baton Rouge, LA; author, What Your Doctor May Not Tell You About Children's Vaccinations.

Wightman, A. Pediatrics, published online Nov. 28, 2011.

Gail Shust, MD, assistant professor of pediatric infectious diseases, Icahn School of Medicine at Mount Sinai.

Paul Offit, MD, division of infectious diseases, Children's Hospital Philadelphia.

paul-offit.com: "Books by Paul A. Offit, MD."

American Academy of Pediatrics Policy Statement: "Recommended Childhood and Adolescent Immunization Schedule - United States, 2014."

American Academy of Pediatrics: "The Problem with Dr Bob’s Alternative Vaccine Schedule."

Institute of Medicine: "The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies."

Kari Simonsen, MD, pediatric infectious disease doctor, University of Nebraska Medical Center.

Doug Opel, MD, pediatrician, Seattle Children's Hospital.

Robison, S. Pediatrics, published online June 18, 2012.

Seattle Children's Hospital blog: Seattle Mama Doc: "Pediatricians' Conditional Comfort With Alternative Vaccine Schedules."

CDC: "Recommended Immunization Schedules for Persons Aged 0 Through 18 Years, United States, 2015."

© 2015 WebMD, LLC. All rights reserved.

Pagination