Alternative Schedule

Many parents today are “vaccine weary,” and no wonder. It just seems like a lot of shots to give a kid before they are a year-and-a-half old. In addition, having grown up in an era of highly successful vaccination programs, we (parents in our 20s to 40s) also tend to be naive about the terrible outcomes of vaccine-preventable diseases. That’s a tough combination.

Thinking It Through

The choice to forego or delay vaccination is not just a choice between a vaccine and no vaccine; it is between a vaccine and being susceptible to a vaccine-preventable disease.

–Kristen A. Feemster, MD, MPH

 

The ultimate goal of the current recommended schedule is to protect babies as soon as it is safe and effective to do so. The vulnerability of babies is why parents might hesitate to vaccinate, but this same vulnerability should actually lead us to vaccinate for diseases they cannot fight on their own.

So why shouldn’t shots be spaced out over a longer period of time?

You will hear parents and even some doctors (but not pediatricians) say that we vaccinate early because that’s when parents are most likely to take their kids to a doctor. Not true. (That misconception has had its time in the sun long enough and needs to go away.)

The factual response to that idea is:

  • The longer you wait to vaccinate, the more chance your child has of contracting a vaccine-preventable disease.
  • The recommended schedule is designed to work best with a child’s immune system at certain ages and at specific times. There is no research to show that a child would be equally protected against diseases with a very different schedule or that they are less likely to have an adverse event.
  • The schedule was not pulled out of thin air; it has years and years of research and brain power behind it.

OK, let’s talk about Dr. Bob Sears, since a discussion on alternative immunization schedules would be incomplete without doing so. First, you should know that Dr. Sears made up his schedule all by himself. He doesn’t have the benefit and backing of multiple scientists, researchers and doctors. He even said, “My schedule doesn’t have any research behind it. No one has ever studied a big group of kids using my schedule to determine if it’s safe or if it has any benefits.” (Uh-oh.) If you are considering using Dr. Sear’s schedule, we recommend you read this article, The Problem with Dr. Sears, to be fully informed.

Alternative schedules are more about the parents comfort level than medical benefit. There is no evidence that the current recommended schedule is harmful in any way or that your child will be at less risk for an adverse event by spreading out immunizations.

Using an alternate schedule?

Nonetheless, some parents choose to use immunization schedules that do not follow the one recommended by the CDC and the American Academy of Pediatrics (AAP). Whichever approach you take to immunizing your child, please talk to your provider and make a plan to insure your child gets fully vaccinated. Finally, always keep your own immunization record of your child’s shots. You can download a blank one here (PDF).

If you are unsure if an alternative schedule is the right thing for your family, please consider the following points:

  • Don’t assume that your doctor is not willing to have a conversation with you about this topic, address any concerns you might have, or work with you to get your child immunized.
  • Alternative schedules require many more visits and many more shots. For example, if a parent chooses the no-more-than-2-shots-per-visit approach, the child will be receiving shots at 2, 3, 4, 5, 6, 7, 9, 12, 15, 18 and 24 months and at 2.5, 3, 3.5, 4, 5 and 6 years of age. The reality is that few parents are able to do this; shots are missed and protection is incomplete.
  • There is no science behind alternative schedules. If everyone used their own schedule, there would be no way to identify flaws or safety issues in the current schedule.

Sources

Brown, Ari. Clear Answers and Smart Advice about Your Baby’s Shots

Offit, P., Moser, C. The Problem with Dr. Bob’s Alternative Vaccine Schedule

Parents of Kids with Infectious Diseases

Cashing in on Fear: The Danger of Dr. Sears

The Public’s Health: Are ‘alternative’ vaccine schedules safer? By Kristen A. Feemster, MD, MPH

Vaccines and Your Child