Why Delay Vaccines For Your Child?
Oct 08, 2015

I hear this often.  

“I plan to vaccinate, but I’m going to wait until my child is a bit older and better able to handle the vaccines.”  

And this.

“I’ll vaccinate my child.  I just prefer to space them out for my child and only do one at a time.”

Parents who choose to delay vaccines, or design their own vaccination schedule, do so because they believe it will be safer for their baby.

They typically want their children to be protected from preventable diseases, but they’re not convinced they need to follow the CDC’s recommended schedule in order to do that.

Some parents find it hard to accept that one schedule can be suitable for all children and so they feel more comfortable with a schedule that they design themselves – one which gives them the freedom to administer their children’s vaccines one at a time, or maybe even when the child is older.  Some parents make these decisions because they’re concerned that the recommended schedule somehow puts their child at risk of suffering some adverse event or reaction.  Essentially, parents who delay vaccines, or space them out, believe they’re providing a safer option for their child.

Unfortunately, the opposite can be true.

Deviating from the well-tested and recommended schedule can actually put a child at greater risk of disease, without ever reducing their risk of adverse events.  Parents often fail to see the harm in spacing out vaccines, but they also fail to acknowledge the increased risk of disease and the data that supports the safety of the recommended schedule.

How can it be safe for such a small child to receive so many vaccines at a single visit?

Some parents worry that too many vaccines administered at such a young age may overwhelming a baby’s immune system.  Some might even believe that this could lead to injury or developmental delay.  It’s understandable that parents have these fears, but a good hard look at the science indicates that there is simply no evidence to support those fears.

Vaccines are designed to facilitate a baby’s own immune system, not overload it like the diseases have been known to do.  From the moment a baby is born they grow and thrive in a largely unsterile environment. Every day a baby’s immune system is bombarded with trillions of new threats in the air they breathe, on the hard surfaces they touch, and in everything they put in their mouths.

While children today receive more immunizations than their parents did, today’s vaccines are safer and contain less antigens.  Antigens are the elements of the vaccine that contain the weakened or killed versions of the germs that cause the disease.  They are the critical part of the vaccine that stimulate the immune response.  A child who receives all the recommended vaccines based on the 2014 childhood immunization schedule may be exposed to up to 315 antigens through vaccination by the age of 2However, in 1980, that figure was as high as 3,041 antigens.  So the argument that today’s schedule is more dangerous simply because there are more vaccines is simply not supported.

If we consider the number of antigens in four or five vaccines administered at one time, it pales in comparison to the extensive number of threats that a baby’s immune system encounters in their environment every day.  Therefore, if life outside the womb isn’t enough to overwhelm their immune system, how is it that a few vaccines are too much to handle?

While it may be difficult for parents to stand by while their child receives multiple needles in one visit, studies show that it is actually less stressful for the child to have multiple vaccines at one visit than it is to repeatedly experience the discomfort of a single needle time and time again.

Additionally, if multiple vaccines being administered in one visit were an overload to a child’s system, than we could expect to see scientific data that would support this theory.  Instead, what we’ve seen is an abundance of studies that have studied everything from the safety of individual vaccines, combined vaccines, multiple administration of several vaccines in one visit and the vaccination schedule.

In fact, one of the most comprehensive studies of the current vaccination schedule was conducted in 2013 by the Institute of Medicine.  In this study, professionals who represent all different disciplines of health and medicine, but who are unaffiliated with the vaccine industry, reviewed a compilation of evidence from a diverse collection of studies.  The conclusion was that the current vaccine schedule is safe and effective.

That wasn’t the only time the safety of the schedule was studied, and it certainly won’t be the last.  The recommended schedule is always being reviewed and revised, and there are plenty of other studies for parents to examine for evidence.   

Why is it necessary to vaccinate infants who are so young, and what harm is there in waiting until my child is older?

PertussisIf a parent is concerned that a baby may not be able to “handle” so many vaccines, shouldn’t they be equally anxious that their baby won’t be able to handle the dangerous and deadly infectious diseases that the vaccines are helping to prevent?

Most parents don’t believe their children will get sick, be hospitalized, or die from diseases that we vaccinate for.  I’ve come to know many parents whose children have died at the hands of a preventable disease and not one would say they had expected it.  Most people believe the incidence of vaccine preventable diseases is rather low (and it often is, thanks to the community immunity that help protects both vaccinated and unvaccinated individuals when the majority of the population is adequately immunized). However, as we see outbreaks of diseases we realize that these diseases are still a threat to those who are not already immune.

When a child becomes sick, their body makes infection-fighting antibodies.  If and when they recover, these antibodies remain prepared to fight off the disease should it reappear. But it can be especially difficult for some babies to fight off aggressive infections like pertussis, and that’s when the disease can overwhelm the child, resulting in severe symptoms, hospitalizations and even death.

This is where vaccines can help.  Vaccines work by preparing the immune system for the possibility of exposure ahead of time.  They can trigger the same immune response without causing illness.  This allows children to benefit from the immunity that comes with infection, without having to suffer the severe, and occasionally fatal, consequences of infection.

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Why does it matter when my child is vaccinated, as long as they’re eventually vaccinated?

The vaccination schedule is not arbitrary, but rather it is based upon an abundance of data and research. Each vaccine is individually tested before it is added to the schedule, and all new vaccines must be tested in conjunction with existing ones to ensure there are no negative interactions. Regulatory agencies such as the Food and Drug Administration (FDA) are careful to look for any side effects associated with concomitant use before approving a new vaccine.  Even after the public begins using a vaccine, it is continually monitored by the FDA, the CDC, and other healthcare organizations, through the Vaccine Adverse Events Reporting System and the Vaccine Safety Datalink.

After determining the safety and efficacy of a vaccine, a decision must be reached as to when it would be best to be administered.  Disease statistics are analyzed to identify which age groups are most susceptible to which diseases and when.  Then the recommendation accounts for when a child is most at risk for disease and when their immune system is able to mount an appropriate immune response to the vaccine.

For example:

Hepatitis B Vaccine

HepBWhen it comes to the hepatitis B virus, the age of infection can influence the likelihood of chronic issues.  That’s one reason it’s recommended that babies get a birth dose of HepB vaccine. About 90% of infants who become infected will develop liver cancer and chronic liver disease later in life.  However, when the illness is contracted at an older age, the chronic effects are less prominent.  So the earlier a child is protected, the less likely it is that they will suffer chronic infection.

The virus is transmitted in the blood of infected individuals and while some think this is restricted to things like intravenous drug use, tattooing, or sex with people who are infected, it’s also possible to catch hepatitis B virus through more casual contact, such as sharing washcloths or toothbrushes.  The blood is quite infectious – 100 times more infectious than HIV.   Even unseen amounts of blood can contain enough viral particles to cause infection, and the virus remains viable and infectious in the environment for at least 7 days.

Of the estimated 1.25 million people hronically infected with the hepatitis B virus in the U.S., 30%-40% of them acquired the infection during childhood.  Since many of those infected don’t show any signs or symptoms and often don’t even know they’re infected, they are often unknowingly transmitting the disease to others.  By administering a birth dose of the vaccine, we minimize the risk of infection from a mother or other close contact.  If an infant is born to an infected mother, administering the vaccine soon after birth can avoid a positive HepB infection for the child.

Pertussis (DTaP)/ Rotavirus, Pnuemococcal and Hib Vaccine

PertussisHib (also known as whooping cough) is most deadly when it is contracted by a young child, as is rotavirus, pneumococcus, and Haemophilus Influenzae Type B (Hib). To achieve the greatest immunity from these diseases, babies need multiple doses of these vaccines starting at two months of age, and continuing at 4, 6, and 12-15 months of age.  (A 5th dose of DTaP is also recommended between 4-6 years of age).  With each vaccine in the series a child’s immunity is expected to increase, with the most complete protection expected once the full series of vaccines are complete.   Since only partial immunity is expected after a single dose, any vaccination delay leaves the child at a greater risk of infection and simply prolongs complete coverage.

Measles Containing Vaccines

The reason the MMR (measles, mumps, rubella) vaccine isn’t usually administered until babies are 12 months old is because there is evidence that the baby still has some passive immunity from the mom. This can prevent the baby from mounting a robust immune response to the vaccine. Once the baby is 6 months old that immune response does start to wane, and by 12 months old we can be more certain that the passive immunity from the mother is gone.

Research has also suggested that delaying measles containing vaccination is not necessarily a safer choice since a more robust immune response in older children, versus younger children, may result in a higher risk of fever and a lower threshold for seizure.  For example, a study published in JAMA Pediatrics looked at the vaccine safety surveillance data of 850,000 children 12-23 months of age after receipt of measles containing vaccines.  The study revealed that the risk of fever and seizure significantly increased in 16-23 month old children, as compared to 12-16 month old children.

If you’re a parent that is willing to vaccinate your child, why wait?

Consider the fact that in delaying vaccines you’re simply extending the chances that your child will catch the disease before they’ve been adequately protected.  You may also be causing them more stress and greater risk of adverse events.

Before you delay, take a moment to review the scientific evidence that supports the recommended vaccination schedule and the safety of administering multiple vaccines in one visit.  For links to more safety studies check out the  Vaccinate Your Baby website and listen to what a few immunization experts had to say on the subject.  

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For more video interviews with immunization experts addressing frequently asked questions about the vaccine schedule, click here.

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