Congressional Briefing Attempts to Discredit Vaccine Injury Compensation
Nov 08, 2013

On November 7th, a congressional briefing, entitled “The Injustice of the Vaccine Injury Compensation Program (VICP)” was sponsored by “The Canary Party” and billed as a precursor to a hearing scheduled on December 4th in the Committee of Government Oversight and Reform. 
Dorit Rubinstein Reiss, a passionate vaccine advocate with intimate knowledge of the legal system and  Professor at University of California Hastings College of the Law, attended the briefing and provided the following post as her personal response to comments she heard there.

 Doing Away With NVICP: Bad For Plaintiffs, Bad For Society

by Dorit Rubinstein Reiss

At a briefing in Congress about the National Vaccine Injury Compensation Program (NVICP), Ms. Mary Holland and Mr. Rolf Hazelhurst criticized the program’s operation. Ms. Holland, addressing several possible reform options, rejected improving the program (what she called “tinkering at the edges”) as a way to fix the problems she identified. Her solution was to have claims of vaccine injuries litigated in the regular courts, either through making NVICP optional, limiting it to the original 7 vaccines it covered in 1986, or repealing the act completely. Doing so would be an error. From plaintiffs’ perspective, adjudication through NVICP is either equivalent to the courts or better. For society, too, vaccine injuries are better handled by NVICP than by the regular courts.

What is NVICP?

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In 1986, Congress passed the National Childhood Vaccine Injury Compensation Act, creating NVICP as a no-fault alternative to the tort system.    NVICP provides an administrative scheme to compensate those who claimed they were injured by a vaccine. Parallel schemes exist in other countries. The initial determination is made by a special master, but petitioners can appeal to a judge of the U.S. Court of Federal Claims, which also appoints the special master. A decision of that judge can then be appealed to the relevant Federal Circuit.  The program was established to allow plaintiffs to sue the federal government rather than individual vaccine manufacturers in order to ensure the continued supply and development of new vaccines.

Since its creation the program has compensated 3412 claims to the tune of $2,777,620,433.90 (these numbers were accurate as of November 7, 2013). If those numbers look large to you, a reality check is in order: whether compared to the number of vaccine doses administered or to injuries from other sources, 3412 claims in 25 years is a tiny number.   And while close to $2.8 billion sounds like a lot, the costs of motor vehicle accidents in 2009 alone – one year v. NVICP’s 25 – was $244.7 billion.

The Plaintiffs’ Perspective:

Ms. Holland’s case focuses on the claim that NVICP is unjust and painful for plaintiffs. There is probably room for improving the program (or any other administrative program). But Ms. Holland is not interested in improving the program: she wants to abolish it and send plaintiffs to the courts. As pointed out by Neil Komesar in his book “Imperfect Alternatives”, when choosing between institutions, the question is not whether one of the choices is good or bad in abstract, but which one is better at handling the problem at hand. And on every aspect she raised, NVICP is equivalent to or better than the civil courts for any plaintiff with a valid claim.
Ms. Holland highlights that most petitioners lose. She said 80% of cases lose, which means only 20% of plaintiffs win. My calculations were slightly different – I calculated the rate of winning to be 26% (3412 claims compensated out of 13077 adjudicated). While that might seem low, again a comparison is in order: In 2005, the last year for which we have data, plaintiffs won only 20% of non-asbestos product liability claims.  Product liability claims are simply hard to win. In whatever forum. Sending plaintiffs to the regular courts would not make proving the claims easier for plaintiffs. One reason for that was mentioned by Ms. Holland herself: showing causation for product liability can be hard. NVICP actually gives plaintiffs a break on that: if they have a table injury (a table listing conditions likely to be caused by vaccines, if occurring within a set time) within the defined time, causation is assumed. While many plaintiffs bring injuries that are not on the table, requiring them to prove causation does not disadvantage them compared to the regular courts: there, too, plaintiffs would have to show that more likely than not the defect in question caused their injuries.
The real problem Ms. Holland and her colleagues face – a problem glossed over in the Canary Party video and her presentation, (as addressed in detail herehere and here) is that for the main injury they want to address, the claim that vaccines cause autism, they have no credible evidence for causation , and there is abundant evidence on the other side. Many, many studies examined that question finding no link. Claims that vaccines cause autism were also rejected in several lengthy decisions by NVICP as part of the Autism Omnibus Proceeding. Mr. Hazlehurst argued that the rejection was because of government corruption; but the lengthy, detailed, thoughtful decisions of the special masters show differently. The special masters carefully examined plaintiffs’ evidence. It simply did not support the alleged causal link. In fact in one opinion, Special Master George Hastings wrote,

“This case, however, is not a close case. The overall weight of the evidence is overwhelmingly contrary to the petitioners’ causation theories…In short, this is a case in which the evidence is so one-sided that any nuances in the interpretation of the causation case law would make no difference to the outcome of the case.”

Similarly, the other conditions Ms. Holland wants to connect to vaccines – a large array of chronic conditions – lack evidence of a causal connection.
A causation problem also exists for the HPV cases in the video Ms. Holland ended her presentation with. In the video, multiple girls suffering from various conditions – or parents of deceased young girls – say to the camera that it is not a coincidence. Sincere as their belief in the causal connection to the HPV is, and painful as their conditions are, belief is not enough, and none of these cases has objective evidence of such a connection. Studies examining the HPV vaccine did not find that it caused the harms claimed – for example, a large study from the United States  and an even larger study from Sweden. With no credible evidence, these claims too face very high hurdles in the civil courts. In NVICP, the government – following Congress’ mandate to compensate even cases in doubt – settled a small number of HPV cases. A private litigant would not be operating under such a mandate.
Moving to the civil courts will not solve this problem. The same requirement of showing that the vaccine more likely than not caused the harm will apply. The same outcome should result.

Other problems raised by Ms. Holland are procedural. She says that the program forecloses access to other forums. That’s only partly accurate – while after Brusewitz v. Wyeth suits for design defect cannot be brought in state courts, a plaintiff can reject the special master’s determination and sue in state courts if her claim is based on a manufacturing defect or warning defect.  And at any rate, by itself, the lack of an alternative forum is not a problem if the proposed forum is good enough.

She complains the NVICP has become adversarial in a way that Congress did not intend. First, a quick glance at the cases published online shows that most cases – as with the civil courts – settle; and second, if a plaintiff is interested in a non-adversarial process, sending them to the civil courts is hardly the solution: our trial system is an adversarial one.
Ms. Holland complains about the length of the trials. Ideally, victims would be compensated swiftly, but product liability trials are complicated, and can easily take a long time in the courts: of the trials lasting more than 3 years in the federal courts in 2009-2011, about half are product liability cases.  (See examples here and here.) We just cannot assume trials will be quick in the civil courts. In one example, Mr. Tenuto contracted paralytic polio from his daughter’s Oral Polio Vaccine. He had the choice of suing through NVICP but chose to go through the regular federal courts. Mr. Tenuto was injured in 1979. The case ended thirty years later in 2010.  The NVICP has the infrastructure to more rapidly adjudicate cases – as Ms. Holland points out, the rules of procedure are relaxed, making the process easier on plaintiffs, and there is no discovery or jury trial, again streamlining the process. If even under those conditions the process takes a long time, imagine the length in the civil courts for these complicated cases.vaxcourt
Ms. Holland attacks the lack of judicial independence of the special masters; it’s true that neither the special masters nor the judges of the Court of Federal Claims are appointed for life, as federal judges are. But the judges who appoint the special masters are appointed by the President and confirmed by the Senate for 15 years; and the judges of the Circuit Courts to which the decision can be appealed do enjoy life tenure. In contrast, the state civil courts have judges who may be elected or appointed politically subject to retention election.
She complains about lawyer fees being slashed and delayed and expert fees delayed and reduced as well. I would like to see some evidence that fees are lower at NVICP than elsewhere. If they are, and it affects the ability of families to find representation, a modest reform might be in order – but Ms. Holland had not made that case. At any rate, this criticism ignores an important aspect of the process: NVICP covers lawyer fees and costs, even if you lose. This means that lawyers appearing before NVICP have guaranteed income, which may compensate for a lower return (it may also provide an incentive to lawyers to bring cases with lower chances of success to the program, thus increasing the number of unjustified claims. A reform addressing lawyer fees should probably examine the entire framework and its effect on cases). It also means plaintiffs receive the full award directly instead of paying the lawyer 30-50% as a contingency fee.
Ms. Holland also highlights the statute of limitations, with a period of three years (which Mr. Hazelhurst erroneously suggested starts on the date of vaccination. Actually, the clock of limitations starts “after the first symptom of the vaccine injury”. But statutes of limitation exist in civil courts too, and may even be shorter. One example is in California where the statute of limitations for personal injuries is “Two years from the injury. If the injury was not discovered right away, then it is 1 year from the date the injury was discovered.”
Finally, plaintiffs going through the civil courts would have to prove a design defect. Proving a design defect is done under principles of negligence, and is not easy. This would be an additional burden facing plaintiffs before they can recover.
In short, NVICP offers plaintiffs substantial advantages over the regular courts. Is the process perfect? Certainly not. But neither would a court process be, and it would impose substantial burdens on plaintiffs.

The Social Perspective

From a social perspective, NVICP offers substantial advantages. The most obvious is that by protecting manufacturers from liability, NVICP reduces the risk of manufacturers leaving the market and of vaccine shortages. This is not a theoretical risk: vaccine shortages – and resultant diseases outbreaks, harming children – were behind the original act.
In addition, handling such cases by a specialized court allows for more expert determination, and the simplified procedures can guarantee quicker, more efficient compensation (the process may need reforming, and it is worth examining; but the potential for a more streamlined and efficient process than a regular court proceeding is there).
Ms. Holland suggests that an advantage of going through the courts will be to incentivize manufacturers to make vaccines safer. But vaccine safety is already regulated in other ways, with important safeguards in place to assure safety: vaccines have to go through three stages of clinical trials before they go on the market, the last stage involving tens of thousands of people and they are carefully monitored after market . A vaccine can be pulled off the market (as has happened in the past) if a serious safety problem arises. Ms. Holland does not explain why that’s not enough of a safeguard.
Two groups would benefit from abolishing NVICP: plaintiffs who cannot prove causation and lawyers who would like more control of the fee structure.
Plaintiffs who cannot prove causation may, in the regular court system, come across a judge who will let the claim go forward in spite of the lack of evidence. Judges should not: if plaintiff does not bring credible evidence that more likely than not defendants caused their harm, a claim should be dismissed. But even judges can make mistakes, so it is possible for a judge to wrongly accept flawed studies or let a case go forth with insufficient evidence, and a judge unfamiliar with the subject matter is more likely to do so than a judge in a forum that specializes in vaccine injury cases. And a jury may accept a claim with insufficient evidence, especially when faced with a child suffering a severe disability.
It’s easy to feel sympathy for a child with serious disabilities, and for the family having to support and help that child. And it may be appropriate for society to provide for such children, regardless of the cause of their problem. That’s a discussion worth having. But that’s not what the United States’ torts system is set up to do: the torts system is not a government insurance or assistance problem. It would, in fact, be very bad at it. It’s adversarial, it’s formalized and technical (leading to delays and costs), and because decisions are made by individual decision makers and not subject to any close centralized control, it’s inconsistent. It would be an expensive, inefficient, and probably unjust way to administer social assistance.
What the tort system is supposed to do is compensate plaintiffs who can show that a tort by the defendant caused their harm. As sad as their plight might be, plaintiffs who cannot show causation should not be compensated through the tort system. And the possibility that the system might err and compensate them anyway is not a reason to replace NVICP with a civil trial. If anything, it’s a reason not to.
The other group that may benefit from replacing NVICP with a court trial is lawyers who will be willing to take these cases on contingency fees and absent the program’s regulation will be have freedom to set costs (e.g. for expert reports). They will also collect 30-50% of whatever is awarded at trial.
I teach at a law school. I have friends, colleagues, and students who are lawyers. Most of the people I know in the legal field are highly ethical, bright, well-intentioned and professional. I would be the last person to attack lawyers’ desire to make a living. But the ability of lawyers to be able to get more money at the expense of the plaintiffs is not a good policy reason to want to move away from NVICP.

Every Child By Two is galvanizing support among their large base of vaccine advocates while also working with various national immunization organizations to address any concerns raised at the December 4th hearing,  They will be following these concerns, educating congressional leaders about the benefits of vaccines and keeping you informed via future posts.


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If you’ve forgone vaccines in the past and are now looking to vaccinate your child, the good news is that getting your child caught up on vaccines is totally doable. It may feel daunting,...


37 responses to “From Avoiding Vaccines to Getting A Child Caught Up: Where To Start?”

  1. Mark Sawyer, MD says:

    Prioritizing vaccines is always a challenge for physicians because we do think they are all important. Having said that, there is a spectrum of risk for exposure to the diseases we can prevent with vaccines so I’ll give my opinion about that. As you have probably heard measles and pertussis (whooping cough) are on a record breaking pace this year so I would consider those high priority now. Especially the pertussis vaccine given the new baby on the way. The diseases caused by Pneumococcus and Haemophilus can be very severe so the PCV13-Prevnar and HiB vaccines are always a top priority. Varicella (Chickenpox) is still around and is very contagious so that’s my next priority. I’m happy you’ve decided to vaccinate your children. Don’t wait too long in getting fully caught up!

  2. Lawrence says:

    My wife recently got here titers tested as part of her annual check-up & she discovered that she was not immune to Measles. With the recent rash of outbreaks (one is local to us), she felt it was important to get her MMR as quickly as possible.

    Even adults should be knowledgeable about their immunity status – so catching up isn’t just for kids – it behooves all of us to do our part to protect ourselves and others.

  3. Teresa says:

    Your child’s doctor honestly has your child’s best interests in mind, years of schooling, and tons of research behind his decision. Talk to him and get the shots on the schedule he recommends. Your child will face a stronger immunological threat from the lollypop they give him when he’s done (assuming your son is like mine, and the lolly will immediately be covered in dirt.)

  4. Mary says:

    I would find another doctor, perhaps a pediatrician, who can provide you more concrete advice. I would ask: can my 3 and 5 year olds receive all vaccinations (at least the 1st dose in those that have multiple doses…) right away? Basically what is the soonest you can “catch up.” I would also be aware of the vaccine rates in their daycare/playgroup/etc and take care to minimize exposure in the same way you will keep your unvaccinated newborn away from unnecessary risk. I don’t think you need to over-worry about this, you are on the right path. Just start and make sure you (and other adult family members) personally get your boosters too – whooping cough etc Basically I think your family physician should be more proactively helping you with this, so I would recommend to be direct with them and ask for more guidance ASAP, or find another doctor who is more responsive. Good luck 🙂

  5. nolocovore says:

    Maybe I misunderstood your doctor’s advice – my advice is get all the shots as SOON as you CAN.

  6. Anthony says:

    First of all, they need to get a new family physician.

  7. Melody RN says:

    Dear Mom of 2+1, Congratulations on your pregnancy! Such an exciting time for you and your family. I know I speak for many other mothers and nurses when I say, Thank you for taking the first initial steps in protecting your children from vaccine preventable diseases. By getting your older children up-to-date, you’re also creating a safer environment for your newborn. I agree with the suggestions of Dr. Sawyer, especially in light of the recent outbreaks we are seeing here in the United States.
    I would also like to mention that there are vaccines you and your husband should consider in the near future that will help to further protect your newborn. With almost half of pertussis/whooping cough cases in newborns originating from the parents and caregivers, we as healthcare providers highly recommend the Tdap for new parents and grandparents, especially If you cannot remember the date of your most recent booster. The best time for pregnant mothers to get the Tdap is ideally in the third trimester-that allows time for your body to pass antibodies to your baby before birth and has shown to provide protection in newborns! I strongly recommend that you also advocate for any adults who will be helping and visiting to verify their vaccination status as well.
    I’d also like to note that your delivery will take place during the beginning of Flu season. Once again, like the whooping cough vaccine, science has shown that by vaccinating a pregnant mother against flu protects the infant post-delivery. Especially since a newborn cannot receive an influenza vaccine till 6 months of age, your baby will be dependant on those around them to protect from viruses. Please inquire about these vaccines at your next ob appointment to learn about your healthcare providers recommendations for your area.
    Good luck with your growing family and the best wishes!

    Melody, Pediatric RN

  8. Catherina says:

    This is an excellent question – the CDC does have a catch up schedule, here http://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html but since you are have a lot to catch up on you can triage the “most important” vaccines (with a baby in the house that is hib, pertussis and PCV for the younger child), you have 5 months until baby, so some time, no need to rush – there are catch up schedules that would get your kids up to date really fast, however, I was never a great 5 pokes a visit fan (did it once, for DD, she did great with that, mom not so much) – what I would do (with no more than 2 shots per visit – you can combine more if you want fewer visits!):

    for the 5 year old – several vaccines are NOT needed: rota, hib, PCV, you could do:
    now DTaP/IPV/hepB (Pediarix is the US 5 in 1 vaccine)
    in July: MMR in one arm, Varicella in the other
    in August: DTaP/IPV/hepB 2 (so Pediarix again)
    in September: get MMRV

    The 3 year old doesn’t need rota, but one each of hib and PCV, so you could do:
    now DTaP/IPV/hepB (Pediarix is the US 5 in 1 vaccine)
    in July: MMR in one arm, Varicella in the other
    in August: DTaP/IPV/hepB 2 (so Pediarix again)
    in September: Hib in one arm, PCV in the other

    Both should get a third DTaP/IPV/hepB next spring, and 5 years after that.

    See how you feel then, still missing for “full coverage” are Meningitis (1 shot) and HepA (2 shots, 6 months apart). You could get them these (Men and the first of hepA) before the baby is born, but because of age, they would not be at the top of my list. You could, for example, also get those shots at a baby shot visit – that might motivate the older kids. I should mention that my suggestion contains one less DTaP than recommended on the US schedule. However, this is what is recommended on some European schedules and protection after two DTaPs is reasonable for about half a year and after the third DTaP in Spring, your kids will be as protected as if they had four shots. If you don’t want to veer off schedule, then you could get a DTaP in October and the DTaP/IPV/hepB 6 months after that.

    Several things to watch out for: on days where your kids do NOT get the same shot, have a look at the vial/syringe, so the right kid gets the right shot. Make sure to keep your own records on which shots your kids got when, since they are not on a “traditional” schedule, you might need to refer back to this. Also: older kids have their own minds whether they want to be vaccinated – calculate bribes into your budget 😉

    Finally: consider a DTaP for yourself at around 32 weeks pregnant (you could get one with your kids), so you’ll give your new baby maternal immunity against pertussis.

    I hope this helps: congrats on your decision!

  9. Mary Beth Koslap-Petraco DNP, PNP-BC, CPNP, FAANP says:

    First of all I am so happy that you have decided to protect your children against vaccine preventable disease! I know this has been a long and difficult decision for you and your family. I have 2 infant grandsons myself so I know how much thought you and your family have put into your decision. I have done a lot of research on how to vaccinate and what is the best way to do it so that I can offer the very best possible advice to families like yours. The schedules we use are based on the best available science to give individuals the optimum response to the vaccines so the vaccines provide the greatest amount of protection.

    Let’s start with your 5 year old. If he was my grandson I would suggest to my children that they do follow the ACIP schedule because there is no evidence that spacing out the vaccines decreases any chance for side effects. And the longer it takes to vaccinate the longer my grand babies would go without protection. For a reasonable first visit for your 5 year old I would suggest DTaP, IPV, Hep b, MMR and Varicella vaccines. That might sound like a lot but your son’s immune system is very capable of setting up an immune response provided by all of the vaccines. In fact one cold exposes your child to more antigens than all of the vaccines we give put together! I would suggest you request that your provider use the combination vaccines. If combinations are used then your child will only receive 2 shots on the first visit. The combinations he would receive are DTaP-IPV-Hep b vaccine and MMR/V vaccine. There is a chance your child could develop a fever following the vaccines but the fever does not usually last long and fevers of 101 degrees or higher can be controlled with acetomenophen or ibuprophen. You can also expect some redness and swelling at the site of the injections. If that happens cool water on a wash cloth applied to the injection sites usually helps. Yes you are correct that your 5 year old is too old for some vaccines and those are Hib, PCV13, and Rotavirus vaccine. Your 5 year old should return in 1 month for DTaP, IPV, Hep b, and MMR vaccine. Again he should get the combination DTaP-IPV-Hep b and MMR. He has to wait 3 months after the first dose to get the second VAR (varicella) vaccine. One month after the second set of shots your 5 year old would return for another DTaP-IPV-Hep b. This combination would give him an extra dose of Hep b which is perfectly fine for him and he would only need one needle rather than 2 if the DTaP and IPV were given seperately. Then he would wait 6 months after the 3rd DTaP-IPV-Hep b to get a booster dose of DTaP and IPV. While he could get a 4th dose of Hep b 2 months after the 3rd dose it could be given with the booster doses of DTaP and IPV. After those 6 month booster doses your 5 year old would be caught up with his immunizations. If it is influenza season then you would want to get the Flu vaccine. I prefer the inhaled flu mist vaccine over the shot for healthy children for 2 reasons. It is not a needle and it works better than the shot in children. Of course you can discuss this with your provider. I would also suggest that your children receive all of their shots in their legs. As a Nurse Practitioner comfort measures are very important to me and the data showes that children up through 5 years of age develop less redness and swelling when they get their vaccines in their legs rather than their arms. The reason for this is that the muscles in the legs are much larger than arms and walking helps the vaccines to be absorbed better. Another comfort measure is letting your child blow bubbles while he is receiveing the vaccines.

    Now for your 3 year old. Again what I am suggesting is exactly what I would suggest for my grandchildren. I would also ask for some combination vaccines for your 3 year old. On the first visit I would advise DTaP, IPV, Hep b, Hib, PCV13, MMR, and VAR. There are 2 different combinations among DTaP, IPV, Heb b, Hib, that could be used for your 3 year old as well as the combination MMR/V. There is a higher chance of developing a fever if your 3 year old receives the MMR/V and with that higher chance of fever a higher chance of developing febrile seizures. While children usually outgrow febrile seizures and they are not harmful to the child but they can be frightening for parents. The 3 year old would receive 4-5 shots at this visit depending on which combinations are used. For your 3 year olds’s second visit one month later DTaP, IPV, and Hep b would be needed and that can be given in one combination shot. For the third visit one month after the second you would have the same option as for your 5 year old. A seperate DTaP and IPV or the combination DTaP-IPV-Hep b where he will receive an extra Hep b. The next visit would be the same as for your 5 year old DTaP, IPV, and Hep B six months after the 3rd set of vaccines. Your 3 year old would then be caugh up. Influenza vaccine would also be needed if it is flu season. You should also consider adding Hep a vaccine at some point for both children.

    The latest recommendations from ACIP also recommends that you recieve a Tdap vaccine in your 3rd trimester to protect your new baby from whopping cough. The optimal time to give the Tdap vaccine is at this time because it gives the baby the best antibody protection. ACIP recommends a Tdap vaccine in the 3rd trimester with every subsequent pregnancy. I would also suggest your husband and other family members who will have contact with the new baby recieve a Tdap vaccine at least 2 weeks before the baby is born because it takes 2 weeks for the vaccine to work.

    I have reviewed what I would do for your family following the ACIP guidelines but of course you should discuss your children’s immunization schedules with your provider. I wish you the very best for your family and a beautiful healthy baby and an easy labor. And thank you again for making such an important decision to protect your family and community from vaccine preventable diseases.

  10. Ohio Pediatrician says:

    Congratulations on your new addition and on making the decision to vaccinate your children! As a pediatrician, I have run across almost this exact situation with some of my patients. I can tell you that as medical providers we are very excited to be able to provide the life-saving protection of vaccinations for previously unvaccinated children. While your children have aged out of some of the recommended vaccinations, they are eligible for the majority of them, although they may not receive as many doses due to their age.
    For the families I’ve worked with, I usually ask first if there are any restrictions on what vaccinations and the number of vaccinations that they are willing to receive and why; while I would prefer to provide complete catch up as fast as possible and healthy children are capable of tolerating and responding well to far more vaccines than I would probably give in one sitting (I have an arbitrary and personal 6 shot limit just from a kindness standpoint), I am willing to work with parents’ requests (I’d prefer your children to be vaccinated against something rather than nothing). I address any concerns they have regarding specific vaccines. From there, I tend to prioritize the most fatal and contagious diseases first. Given the current measles and pertussis outbreaks, I would make these the among the first that are provided, especially with a pregnant woman in the household and a newborn on the way. If the number of shots is the concern, there are many combination vaccines that reduce the number of injections your children receive, while still providing a very comprehensive update – you can ask your pediatrician what is available at the office. If spacing is desired, vaccinations can usually be updated monthly until catch up is complete, although this will vary with the type of vaccines. Be aware that this can be more distressing for your child than receiving shots at the same time.
    Ideally I would at the very least start with DTaP, PCV -13, Hib, and MMR. Thankfully, these are available in combinations that would also provide protection against varicella, Hepatitis B, and polio and I would certainly argue in favor of giving those combination vaccinations. Also of paramount importance, I would recommend that all family members get their seasonal flu vaccine this fall and that all adult caregivers (including mom) get their Tdap. It is safe and recommended for pregnant women to be vaccinated with flu vaccine at any point in the pregnancy (the killed injection, not the live intranasal) and the Tdap in their 3rd trimester, which has the added benefit of providing some passed down protection to baby.
    Again, my congratulations on your new baby and my commendations on your decision to vaccinate your children! Your doctor should be willing to discuss your concerns and to answer your questions about vaccinations. For additional reliable information you can consult the resources at http://www.immunize.org/catg.d/p4012.pdf.

  11. I concur that you should get a new family physician. You need a physician you can trust and believe in, not one who is going to give you snark. First of all, is this the same physician who accepted your decision to not vaccinate your children for five years? Then I wouldn’t trust that doctor’s judgment and commitment to an appropriate vaccination schedule. The only downside of catching up is the time and expense of multiple doctor visits until all the shots are received. That is the reason combination shots exist. And that is one reason the shots are all administered in the first two years, Wellbaby visits are convenient. Once the children are older and reach school age when many mothers return to the workforce, it is harder to take time off from work and school for doctors appointments. That is why it is not really a conspiracy to over-vaccinate. It is just more convenient for everyone involved.

    Good luck and thank you for helping the herd. People with underdeveloped or compromised immune systems such as infants, those with allergies to vaccines, the elderly, and the medically fragile all thank you.

  12. Rich says:

    Just a quick note regarding Catherina’s recommendations…No “Meningitis” vaccine for kids of this age and the last line should be recommending a Tdap not a DTaP for a pregnant Mom.

  13. Alet RN says:

    Congratulations on your new baby! And on your decision to protect your newborn, as well as your older children. A good pediatrician will certainly be your most important start on this journey. I have nothing more to add to the excellent advice of the pediatricians on this thread. Good luck on your journey and enjoy your new baby!

  14. Congratulations on all accounts! I’m sure that your family has not taken this decision lightly and it truly is gratifying on our end to see.

    My 2 cents: tetanus is very important as there is no herd immunity and it’s often fatal. There is no natural immunity to tetanus because the amount needed to kill is less than a nanogram. Even a wasp sting carries a risk, so get that one done.

    Agree with above that measles, pertussis and varicella are very important and timely to protect this new baby!

    Also, consider that some vaccines can only be given after a certain delay if other vaccines have already been administered. For example, after you get the varicella shot, you must wait 4 weeks to give the measles shot. Ditto influenza. So you might want to give those together and schedule a few others a week or two later and then you’re clear for influenza season this Fall.

    I know it’s going to seem like a lot of poking in a short period of time but hang in there!

  15. katie says:

    First of all, congrats on your pregnancy!!! And for coming to terms with vaccinations. This makes my heart smile.
    As you get you children up to date, dont forget to update yourself and your husband!!!!! To protect that new baby, youll want a recent Tdap booster for the both of you, plus anyone who plans to be your new baby!!!!!!! Just something to check into as you venture,into the wonderful workd of vaccines!!!!

  16. Georges Peter, M.D. says:

    We hope you are not overwhelmed by the volume of responses! They do emphasize that you and your husband, after considerable review and thought, have made a very important decision for the benefit of your children. We hope others will see the light and follow your lead. Those who don’t have their children vaccinated create a risk to other children, even those who are vaccinated because vaccines while highly effective are not 100% effective.

    By the way, the ACIP schedules are also approved each year by the Am. Academy of Pediatrics and the Am.Acad. of Family Physicians. Your doctor is probably a member of the latter. So the schedules reflect broad consensus among doctors.

  17. michelle says:

    I can’t tell you what is most important but the least important is Polio. The pediatric doctor I worked for always said that was the last one to catch up on.

  18. Lawrence says:

    @michelle – granted, I would also believe that is correct. There hasn’t been a Polio case here in a while…but I’m sure the anti-vax crowd would like nothing better than a return of “polio summers.”

  19. Gabs says:

    Why would you do this to your child. Getting him caugh up with not only traumatize him but could also be super dangerous. what made your change your mind? MMR vaccines is the worst

  20. Lawrence says:

    Why are you commenting on an article from three years ago?

  21. Chris says:

    Gabs: “MMR vaccines is the worst”

    Why should we care about what you say, necromancer?

  22. Leila says:

    My daughter is 17 and missing 69 vaccines. Where to start? She has natural immunity to pertussis and mumps. She has never been on antibiotics, has no allergies, and has never been sick except for pertussis and mumps. She had a few days worth of tylenol once for a sinus headache. No one will believe this, but it is the story of every unvaccinated child we know. Wake up to true, unmanufactured health. Say goodbye to chronic conditions. Don’t bow to pharmaceutical profits.

  23. Lawrence says:

    I bet Pertussis was fun….could have killed her.

    And natural immunity doesn’t last either.

  24. Chris says:

    “Natural immunity” doesn’t last for mumps either. I had it twice as a kid.

    Also, there is absolutely no “natural immunity” for tetanus, diphtheria, strep, rotavirus and a few other diseases.

    “No one will believe this, but it is the story of every unvaccinated child we know.”

    And we are supposed to believe you, a random anonymous person commenting on a three year old article? Gather up the data of those children, then a thousand more… then with their permission get their full verified medical records. Compile them, do some statistics and write it up in a paper. Submit it to a peer reviewed journal, and then you might have something worth our consideration.

  25. bmx Bicycles originated

    From Avoiding Vaccines to Getting A Child Caught Up: Where To Start? | Shot of Prevention

  26. B buckman says:

    How crazy. Even your meds say that if you miss dose do not double up. What the hell is wrong with your logic

    Vaccine store all the toxins In your child’s body. They do not go away

    Once you fill them up with aluminum mercury and the other toxic chemicals animal DNA and the rest. They go to work destroying their health.
    Have any of you actually real how much of this crap stays in there bodies and is responsible for hundreds of health problems and autism. How stupid can you be.
    Children are not at risk for diseases they are at risk for being piosonsed.
    Parents are brain dead

  27. Lawrence says:

    #1 – vaccines don’t “store” anything in the human body.

    #2 – Thimerosal isn’t contained in a single US Pediatric Vaccine anymore (hasn’t been for more than 15 years).

    #3 – Care to provide any real citations for your little rant?

  28. Nadia says:

    I have three kids 6, 5 and 3 years old. My oldest one had all of his immunizations but my other two haven’t had even one. Let me tell you this, this year my oldest one was sick with a flu 2 times, strep throat 4 times, has seasonal allergies, he is constantly sick. My other two without any immunizations haven’t been sick even once this year although they all sleep in the same room, they share toys or they will even drink from one cup. Their immune system is sooo much stronger. I will immunize them before they have to go to school since it is a requirement but I am holding off as much as possible.

  29. Chris says:

    Why should we believe your story?

  30. Joyce Cooper says:

    My two-year-old is just beginning his immunizations and now he is actually suffering from PTSD he will not even let me change his diaper he’s so traumatized what should I do

  31. Jessica says:

    Please help me for this my son age 4 need a shot be late i try to explain to you because I’m deaf

  32. apatuh says:

    I pay a visit everyday a few blogs and blogs to read articles,
    however this web site presents quality based writing.

  33. anxious april says:

    Please don’t insult me or write mean comments or questions for me. Thirteen years ago when I was pregnant with my son, I would check the daily progress of pregnancy on a website that detailed the stages of fetal growth, what to expect, what to avoid, what to add, etc… This website warned against eating lunch meat during pregnancy, and this is when it all started. An internet search about the dangers of lunch meat during pregnancy led to the origins and dangers of fluoride. This led to the dangers of vaccines. Over the next few months, the internet convinced me that the dangers far exceeded the benefits. My childhood best friend has an autistic son, and she was my hair dresser at the time. One day while getting my hair done, I told her what I’d been reading online and I asked her about her sweet son and his onset of symptoms. She told me that she knew without a doubt that his vaccines caused his autism. She said she thought he had a predisposition to it and the multi-pack of shots he got in one day triggered it. He went from being a fun-loving, talking, walking toddler who would make eye contact and tell his mommy I wuv oo, to not walking, not making eye contact, not being able to say words, and being constantly upset, irritated, angry, and in fits. By the time I had this conversation with her, he was eight-years-old and had the cognitive development of a three-year-old. I asked her if she immunized her two children that were younger, and she told me that she did because she couldn’t live with the possibility of them contracting a deadly disease that could have been prevented by a simple and free shot. I had the equal and opposite conviction: I couldn’t live with the possibility of triggering/causing my perfect baby to become autistic. That conversation sealed the deal. My eleven and twelve-year-old sons have never had an injection in their entire lives. They are very healthy, and we live in a state that allows immunization exemptions based on philosophical reasons. However, we may be moving to California where such exemptions are not allowed. It is beyond terrifying for a person like me to face the fact that my children will have to all at once get several shots that I have for so long considered poison. I know that most vaccine recipients do not become autistic or have any allergic response at all. I know that herd immunity only works when the majority of people are immunized. I know that some precious children have truly serious conditions that force them to rely on herd immunity. I know that California is a sanctuary state and with that the likelihood of exposure to a myriad of diseases not native to America increases. None of this eases my mind. Those of us who are struggling with these conflicted feelings need gentle guidance. We want to do the very best thing for our children, and we want them to remain as healthy as they have been their entire lives. I liken this feeling to betrayal. I feel like something I have firmly believed in for so long, a conviction I’ve held so tightly, is being ripped from my core. I know that many of you reading this are rolling your eyes and typing a critical response, thinking I am being overly dramatic. But this is truly a difficult decision. Please try to put yourselves in our shoes. Please try to be understanding and compassionate. Please help us make this transition by guiding us in a kind and informative way. Is there a way to prepare an adolescent body for the onslaught of vaccines? I fear that the onslaught of hormones at this age is wreaking enough havoc on their bodies. What will adding these concoctions do? If you have valid, kind advice, please respond. If you are going to attack me, sarcastically question me, or insult me, please don’t. I am truly reaching out for help; not hate.

    • wpengine says:

      Hi, April. I appreciate how difficult it can be to make these decisions. Please know that the entire childhood vaccination schedule has less than 160 antigens. That is like a drop in a bucket full of thousands of exposures an infant will encounter in his or her first days of life. As an adolescent, your child is very well prepared to handle the vaccines that his or her health care provider may recommend. Please check out our website with answers to common questions about vaccines that I hope will ease your mind: https://www.vaccinateyourfamily.org/questions-about-vaccines/

  34. Jennifer Morris says:

    The original family’s post sounds like my own story so far. I have a almost two year old daughter, an almost three year old son, and currently pregnant and due November 29th. We started vaccines with my oldest but stopped at around his first birthday due to mainly anti vaccination warriors scaring me to death that my child would develop long term disabilities or even could die from vaccines. My youngest (almost two years old) has never received a vaccine. On top of all that, my family went through a very emotional and heartbreaking experience with my mother in law battling cancer and losing her fight just about a month ago, due to that my kids (both healthy ) have not been to the doctor at all in a year. I recently have decided to give my babies the protection they need and get their vaccines but I am o overwhelmed that it seems impossible. Love that this page offers insights not only from moms like me but also from real Heath professionals. Hopefully I can overcome the thought of giving up and get myself in the right head space to get myself motivated again..,

  35. Mrs. Jones says:

    If my child gets hurt as a direct result of the vaccine, can I sue the manufacturer ?

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