Skip to main content

Alternative Schedules: Why Not?

  • Chapter
  • First Online:
  • 3702 Accesses

Abstract

Vaccines are one of the most successful public health interventions of all time. Sixteen diseases that afflicted generations of American children are now vaccine preventable. However, as the number of vaccines in the routine childhood immunization schedule has increased, parents have become more concerned about the safety and necessity of these vaccines than they are about the diseases themselves. Alternative vaccination schedules, which differ substantially from the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommended schedule, have become increasingly popular. In this chapter we review the science behind the official immunization schedule and explore parental concerns about the recommended immunization schedule. We review the problems inherent to alternative vaccine schedules; namely, they are not evidence based, prolong susceptibility to vaccine-preventable diseases, and result in unnecessary office visits and infant stress. We also provide evidence-based talking points and practical suggestions to help primary care providers work with families who request alternative schedules.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Gellin BG et al. Do parents understand immunizations? A national telephone survey. Pediatrics. 2000;106(5):1097–102.

    Article  PubMed  CAS  Google Scholar 

  2. Centers for Disease Control and Prevention (CDC). Recommended childhood immunization schedule—United States, 1999. MMWR Morb Mortal Wkly Rep. 1999;48(1):12–6.

    Google Scholar 

  3. Offit PA et al. Addressing parents’ concerns: do multiple vaccines overwhelm or weaken the infant’s immune system? Pediatrics. 2002;109(1):124–9.

    Article  PubMed  Google Scholar 

  4. Centers for Disease Control and Prevention (CDC). Recommendation of the Advisory Committee on Immunization Practices (ACIP) for use of quadrivalent meningococcal conjugate vaccine (MenACWY-D) among children aged 9 through 23 months at increased risk for invasive meningococcal disease. MMWR Morb Mortal Wkly Rep. 2011;60(40):1391–2.

    Google Scholar 

  5. Fiore AE, Wasley A, Bell BP. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2006;55(RR-7):1–23.

    Google Scholar 

  6. Merriam Webster Dictionary. http://www.merriam-webster.com/dictionary/alternative.

  7. Sears R. The vaccine book: making the right decision for your child. New York, NY: Little, Brown; 2007.

    Google Scholar 

  8. A user-friendly vaccination schedule. http://www.lewrockwell.com/miller/miller15.html (2012). Accessed 5 Feb 2012.

  9. ChildrensHealthChoices.org. Alternative vaccination schedules. http://toomanytoosoon.org/ (2012). Accessed 5 Feb 2012.

  10. Dempsey AF et al. Alternative vaccination schedule preferences among parents of young children. Pediatrics. 2011;128(5):848–56.

    Article  PubMed  Google Scholar 

  11. Smith PJ et al. The association between intentional delay of vaccine administration and timely childhood vaccination coverage. Public Health Rep. 2010;125(4):534–41.

    PubMed  Google Scholar 

  12. Diekema DS, Comm B. Responding to parental refusals of immunization of children. Pediatrics. 2005;115(5):1428–31.

    Article  PubMed  Google Scholar 

  13. American Academy of Pediatrics. Parental refusal of immunization. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, editors. Red Book: 2009 Report of the committee on infectious diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009. p. 8–9.

    Google Scholar 

  14. Traveler may have spread measles in 5 US airports. http://www.aolnews.com/2011/02/27/traveler-may-have-spread-measles-in-5-us-airports/ (2012). Accessed 5 Mar 2012.

  15. D’Arcy J. Measles outbreak after Super Bowl ignites vaccine debate. http://www.washingtonpost.com/blogs/on-parenting/post/measles-outbreak-after-super-bowl-ignites-vaccine-debate/2012/02/22/gIQAWNqPWR_blog.html(2012). Accessed 5 Mar 2012.

  16. Feikin DR et al. Individual and community risks of measles and pertussis associated with personal exemptions to immunization. JAMA. 2000;284(24):3145–50.

    Article  PubMed  CAS  Google Scholar 

  17. Glanz JM et al. Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children. Pediatrics. 2009;123(6):1446–51.

    Article  PubMed  Google Scholar 

  18. Glanz JM et al. Parental decline of pneumococcal vaccination and risk of pneumococcal related disease in children. Vaccine. 2011;29(5):994–9.

    Article  PubMed  Google Scholar 

  19. Glanz JM et al. Parental refusal of varicella vaccination and the associated risk of varicella infection in children. Arch Pediatr Adolesc Med. 2010;164(1):66–70.

    Article  PubMed  Google Scholar 

  20. Janssen AP, Tardiff R, Herring RM, Smith MJ. Physician’s perceptions of current vaccine issues. Washington, DC: US Department of Health and Human Services; 2008.

    Google Scholar 

  21. Strine TW et al. Predictors of age-appropriate receipt of DTaP dose 4. Am J Prev Med. 2003;25(1):45–9.

    Article  PubMed  Google Scholar 

  22. Smith PJ et al. Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the Health Belief Model. Public Health Rep. 2011;126:135–46.

    PubMed  Google Scholar 

  23. Marshall GS. Addressing concerns about vaccines. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, editors. The Vaccine Handbook: a practical guide for clinicians. West Islip, NY: Professional Publications, Inc; 2010. p. 211.

    Google Scholar 

  24. Fairchok MP et al. Epidemiology of viral respiratory tract infections in a prospective cohort of infants and toddlers attending daycare. J Clin Virol. 2010;49(1):16–20.

    Article  PubMed  Google Scholar 

  25. Offit PA, Moser CA. The problem with Dr. Bob’s Alternative Vaccine Schedule. Pediatrics. 2009;123(1):e164–9.

    Article  PubMed  Google Scholar 

  26. Draft NVAC vaccine safety working group report. http://www.hhs.gov/nvpo/nvac/documents/NVACVaccineSafetyWGReport041409.pdf (2009). Accessed 31 July 2009.

  27. Chen RT et al. Vaccine safety datalink project: a new tool for improving vaccine safety monitoring in the United States. Pediatrics. 1997;99(6):765–73.

    Article  PubMed  CAS  Google Scholar 

  28. Thompson WW et al. Early thimerosal exposure and neuropsychological outcomes at 7 to 10 years. N Engl J Med. 2007;357(13):1281–92.

    Article  PubMed  CAS  Google Scholar 

  29. Smith MJ, Woods CR. On-time vaccine receipt in the first year does not adversely affect neuropsychological outcomes. Pediatrics. 2010;125(6):1134–41.

    Article  PubMed  Google Scholar 

  30. Meyerhoff AS, Jacobs RJ. Do too many shots due lead to missed vaccination opportunities? Does it matter? Prev Med. 2005;41(2):540–4.

    Article  PubMed  CAS  Google Scholar 

  31. Merck and Sanofi Pasteur Initiate Phase III study in the United States of pediatric combination vaccine to help prevent six infectious diseases. http://www.merck.com/newsroom/news-release-archive/research-and-development/2011_0421.html (2012). Accessed 5 Mar 2012.

  32. Ramsay DS, Lewis M. Developmental change in infant cortisol and behavioral response to inoculation. Child Dev. 1994;65(5):1491–502.

    Article  PubMed  CAS  Google Scholar 

  33. Hanson D et al. Comparison of distress and pain in infants randomized to groups receiving standard versus multiple immunizations. Infant Behav Dev. 2010;33(3):289–96.

    Article  PubMed  Google Scholar 

  34. American Academy of Pediatrics. Managing injection pain. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, editors. Red Book: 2009 Report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009. p. 20–1.

    Google Scholar 

  35. Salmon DA et al. Factors associated with refusal of childhood vaccines among parents of school-aged children: a case–control study. Arch Pediatr Adolesc Med. 2005;159(5):470–6.

    Article  PubMed  Google Scholar 

  36. Smith PJ et al. Association between health care providers' influence on parents who have concerns about vaccine safety and vaccination coverage. Pediatrics. 2006;118(5):e1287–92.

    Article  PubMed  Google Scholar 

  37. Wightman A et al. Washington state pediatricians’ attitudes toward alternative childhood immunization schedules. Pediatrics. 2011;128(6):1094–9.

    Article  PubMed  Google Scholar 

  38. Centers for Disease Control and Prevention (CDC). Invasive Haemophilus influenzae Type b disease in five young children – Minnesota, 2008. MMWR Morb Mortal Wkly Rep. 2009;58(3):58–60.

    Google Scholar 

  39. Centers for Disease Control and Prevention (CDC). Outbreak of measles – San Diego, California, January – February 2008. MMWR Morb Mortal Wkly Rep. 2008;57(8):203–6.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael J. Smith M.D., M.S.C.E. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Smith, M.J. (2013). Alternative Schedules: Why Not?. In: Chatterjee, A. (eds) Vaccinophobia and Vaccine Controversies of the 21st Century. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7438-8_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-7438-8_16

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7437-1

  • Online ISBN: 978-1-4614-7438-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics