Too Many, Too Soon

The increasing number of recommended vaccines for children is an understandable and growing concern of parents today. In the first 15 months of your child’s life there are 25 recommended vaccines. YIKES! No wonder parents are vaccine weary.

Of course the good news is that if your child receives all the recommended vaccines they are protected against 14 diseases. And 25 vaccines doesn’t mean 25 shots. Thanks to technological advances, many vaccines have been combined, and the rotavirus vaccine is oral.

Contrary to what you may hear, the recommended schedule was not just pulled out of a hat, it isn’t for the doctor’s convenience and it certainly isn’t to make Big Pharma richer. No, the schedule is the way it is because those are the times when infants and young children are most at risk for being hospitalized and dying from certain diseases. Another determining factor in the design of the schedule is the way an infant’s immune system matures; some vaccines are not effective until the child reaches a certain age.

Given the level of concern by parents regarding the immunization schedule, the Institute of Medicine (see box below) recently conducted a detailed analysis of the US childhood immunization schedule. This is the most comprehensive examination of the immunization schedule to date, and it looked specifically for evidence that vaccination was linked to “autoimmune diseases, asthma, hypersensitivity, seizures, child developmental disorders, learning or developmental disorders, or attention deficit or disruptive disorders,” including autism. It found no link between vaccines and any of these child health issues.

You can download the 2013 Childhood Immunization Schedule and Safety report.

What is an Antigen?

An antigen is any substance that causes your immune system to produce antibodies against it. An antigen may be found in a foreign substance from the environment such as chemicals, bacteria, viruses or pollen. An antigen may also be formed within the body, as with bacterial toxins or tissue cells.


Do vaccines overwhelm kids’ undeveloped immune systems?

Modern science has improved the design and development of vaccines. So, although our babies might be getting more shots for more diseases, the antigens being injected are actually fewer. Drastically fewer, in fact.

“The amount of antigens that children fight every day (2,000–6,000) is much more than the antigens in any combination of vaccines on the current schedule (150 for the whole schedule).”

American Academy of Pediatrics

We know that a newborn’s immune system is not fully developed at birth. However, it is very well equipped to handle a tremendous number of immunological challenges. How could they survive the very act of birth if it were not?

But, you say, that isn’t the same as injecting a healthy infant with infectious material into their body. Again we have to keep in mind the quantity of antigens, the type of vaccine or antigen, and the risk of not vaccinating. A baby’s immune system can handle multiple shots of a weakened or killed virus much better than it can fight off a serious disease. Remember, vaccines give babies a practice run. They teach your baby’s body to recognize disease antigens and raise a full immunologic response.

Perhaps you are more concerned about all the additives in vaccines rather than the antigens themselves. If so, visit our Vaccine Ingredients page. Package inserts of vaccines list all the items that were used in making a vaccine. People against vaccines frequently list off these ingredients as if vaccines were nothing but fluid from toxic waste dumps. The truth is that our bodies actually produce some of the chemicals found in vaccines, and nature has placed them in our food as well. Have you breastfed your baby today? You gave her aluminum. Ate an apple, banana or a grape? You ingested formaldehyde. The FDA requires the listing of any chemical or substance used in the production of a vaccine; it doesn’t mean those items remain in the finished vaccine product.

Did You Know?

The number of antigens in a vaccine is negligible compared to what an infant is exposed to from the environment starting immediately after birth. In contrast, babies are exposed to trillions of bacteria each day on their skin and in their mouth and digestive tract.

Kristen A. Feemster , MD, MPH


Why do we vaccinate against so many diseases?

Well, mostly because we can. And that is great news not just for us and our little ones, but for the whole world. If you vaccinate your child following the schedule recommended by the CDC and AAP, your child will have immunity to 14 diseases by age 2.

But many people lament the good old days when we had fewer vaccines and thus fewer shots. Let’s think that one through. Do we lament the days when cancer drugs weren’t available? When children died much more frequently from infectious disease? Smallpox, anyone? No, we are happy to accept advancements in medicine, science and technology when we know someone dear who needs them. The difficulty with vaccines is that we are injecting healthy kids with antigens to protect them against diseases we may seldom see, versus treating the tangible symptoms of an illness. And it is for this very reason that the FDA approval process for a vaccine is much greater and much more rigorous than that of a drug used to treat an illness.

Thanks to vaccines, most of us will never see cases of the diseases that once routinely caused death and severe illness, and in many places of the world still do. If we keep vaccinating our children, polio could be eradicated from the world just like smallpox. Our grandchildren (if your children are quite young now) may not get immunized against polio. And then measles. Hooray! Vaccinating isn’t just an individual or community issue. It’s a global one, too.

That’s something that frequently gets left out of a conversation about vaccines. When a vaccine is no longer needed, such as the case with smallpox which has been eradicated, we no longer receive it. However, some diseases like tetanus will never be eradicated because the germ lives in the soil and we don’t get it from other people.

Visit the Immunize for Good website to learn more about future vaccine research.

Why do we vaccinate such young babies? 

The most serious diseases attack the very young and elderly. We immunize very young children against diseases because infancy is the time when kids are the most vulnerable to life-threatening illnesses or are at risk to develop chronic forms of an illness such as hepatitis B. We vaccinate to save lives and prevent debilitating illness because diseases don’t play fair.

As loving and conscientious parents, we would like to think we can control every encounter and exposure our infant has in the first few months of life, but we really can’t. Since we can’t control, we should protect.

Finally, fear about the risks of vaccinations is often based on internet research done by parents, or from conversations with other parents. To be truly informed about vaccines, you should spend as much time looking up the risks of a disease, and the risk of our low herd immunity, as you do the risk of a particular vaccine.

Understanding how vaccines work and why the schedule is the way it is can take much of the fear out of immunization. So, the next time you hear these myths about vaccination you will be able to respond with a evidenced-based answer.

The Institute of Medicine

The Institute of Medicine is a non-profit, non-governmental, honorific membership organization.

Its purpose is to provide unbiased, evidenced-based advice on issues relating to biomedical science, medicine and health, and its mission to serve as adviser to the nation to improve health. It works outside the framework of the US federal government to provide independent guidance and analysis and relies on a volunteer workforce of scientists and other experts, operating under a rigorous, formal peer-review system. The Institute’s members, elected on the basis of their professional achievement and commitment to service, serve without compensation in the conduct of studies and other activities on matters of significance to health.

An unusual diversity of talent among Institute members is assured by the charter stipulation that at least one-quarter be selected from outside the health professions, from such fields as the natural, social and behavioral sciences, as well as law, administration, engineering and the humanities.

(OK, we did a no-no here. The above information about the IOM was taken from Wikipedia which is not always a reliable source, but in this case it provides an excellent overview. We’ll give credit where it’s due. The IOM was renamed in 2015 as the National Academy of Medicine.)



Children’s Hospital of Philadelphia

Are ‘alternative’ vaccine schedules safer? Kristen A. Feemster, MD, MPH