Finding the Silver Lining in Delayed Vaccination
Jun 26, 2012

A new study, released in Pediatrics last week, examined medical records for 97,711 children from Oregon and noted a concerning trend among parents there.  There has been an almost four-fold increase between 2006 and 2009 in the percentage of parents who delayed or skipped vaccinations, with the results showing that the number of babies on alternative schedules grew from 2.5% in 2006 to 9.5% in 2009.
The concern is that

 “By delaying certain vaccinations, parents may be putting their children — and those of others — at a far greater risk of contracting deadly diseases, such as pneumonia and pertussis….”

The study showed that

“despite going to the doctor’s office more, those babies got fewer shots overall compared with those whose parents stuck to the recommended schedule.”

And the long-term impact of an alternative schedule illustrates that the delayed vaccines are often too little, too late.

  While many people who limit shots or follow ‘alternative’ vaccine schedules plan to eventually get all the shots, many don’t follow through, according to the study. By 9 months, infants whose parents were ‘shot limiters’ had an average of 6.4 injections, compared to 10.4 injections for kids whose parents adhere to the schedule, the study found. Followed to 19 months, the children of ‘shot limiters’ still hadn’t caught up, and were less likely to be vaccinated against chicken pox, measles-mumps-rubella and hepatitis A.”

While there were several other articles that reported on the results of this survey, none of them were very encouraging.
But I’m typically a glass-half-full kind of person, so I got to thinking…
 Where is the silver lining here?  What hope is there?
And I realized something very important.
Despite the fact that we are seeing more parents utilizing alternative vaccination schedules, the fact of the matter is that these parents ARE still vaccinating. 
Thankfully, “shot-limiters”, as they are defined in this study, differ dramatically from those who completely reject vaccines.  These parents may have some concerns, but they recognize the benefits of vaccines and they are making the decision to immunize their children.
Too Many Shots Per Visit
Some parents prefer to administer one vaccine at a time so that they can monitor their child for potential reactions.  While this sounds reasonable, the survey results illustrate that parents often fail to return to the doctor in a timely manner to ensure their child receives missed immunizations, leaving their child unprotected at the exact time when these diseases are the most dangerous for their children.  The recommended schedule is not only designed to maximize the time spent at well visits, and limit the need for parents to make additional trips to the doctor, there are also special considerations given to the age at which children need protection, as well as how long it takes to complete each vaccination series in order to provide a child with their best chance at immunity.
Too Many Shots Too Soon vs. The Importance of Timing
Some parents delay vaccines because they worry that their child’s immune system is not prepared to handle the shots when they are yound and they want to wait until their child is older.  Again, this may sound logical, but experts assure us that the immune responses elicited by vaccines – even if there are multiple shots administered in one day – are miniscule in comparison to the  attacks on an infant’s immune system during the course of a normal day just playing at home.   The Vaccinate Your Baby website addresses this concern as follows:

“While children are receiving more immunizations by the age of two, they are actually receiving less antigens, or bits of the vaccine that would challenge the immune system. Overall numbers of antigens have fallen from about 3,041 in 1980 to approximately 153 today. Compare this number to the trillions of bacteria infants are exposed to, and form an immune response against, the moment they are born. Babies’ immune systems are well-equipped to handle not only those bacteria but many more additional, external threats.”

Alternative Schedules Chosen out of Fear, Not Fact
Parents often utilize alternative schedules in an effort to try to minimize perceived risks.  Perhaps parents feel this provides them with some kind of control over something they feel they otherwise would have no control over – their child’s immune response.  However, all too often, there are people (even sadly some doctors, like Dr. Bob Sears) who validate these parental concerns, suggest that alternative schedules are safe (though untested) and then neglect to properly educate parents about the additional risk they subject their children to.
We need to focus our efforts on identifying effective communication techniques that can help parents understand that  (1) the recommended schedule is safe for their children, (2) their actions are not providing any real benefit, and (3) their choice to delay is only adding to their child’s risk.
We would love to hear from parents, doctors, nurses and public health experts who have been successful in altering the perceptions of concerned parents so that they are comfortable adhering to the recommended schedule or catching up after once believing it was best to delay.  By sharing your comments, suggestions and insights you will not only help others who are tasked with these communication challenges, but you may also influence readers who are currently considering an alternative schedule.   Parents can also view the videos available on Vaccinate Your Baby that ask experts to address many of these parental concerns. 

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