Why following a delayed vaccine schedule may be dangerous

by Steve Perry, MD

I recently read a post by Dr. Bob Sears which listed several “Vaccine Friendly Doctors” in Colorado and across the nation.

As a pediatrician and vaccine advocate, I thought I’d be on this list. I am “vaccine-friendly doctor” who works with moms and dads to find the best health care plan for their babies. I read the information on both sides of the issue and weighed the science against the emotional worry that so many parents feel about vaccines. While I always recommend vaccination by the CDC schedule, I always listen to parents concerns.

But, much to my surprise, I was not on this list. After a looking closer, I found that those on the list are a small population of physicians that are “friendly” to the “alternative” or delayed vaccine schedule outlined in Dr. Sears’ The Vaccine Book. The delayed vaccine schedule calls for a drawn-out vaccine plan based on Dr. Sears’ beliefs on calming parental vaccine fears. This delayed schedule has no research or science backing it, it is simply one pediatrician’s opinion.

The biggest medical problem with the delayed schedule is that it leaves babies open to disease for a longer period of time. If a baby is vaccinated by the CDC’s tried, tested and true vaccine schedule, that baby will have immunity to over 14 diseases by the age of two! With the CDC recommended schedule, babies visit their doctor five times in the first 15 months and receive protection against up to 14 diseases in as little as 18 shots if using combination vaccines, or as many as 26 shots if using individual antigens.

We immunize children so young against these diseases because infancy is the time period that kids are MOST vulnerable to life-threatening diseases. The people at greatest risk of dying from vaccine-preventable disease are the very young and the very old. We vaccinate to save lives.

On the delayed schedule, by 15 months of age children will have only received immunity against eight diseases. They miss out on measles, rubella, chickenpox, Hep A, and Hep B. By 15 months, children on this delayed schedule are given 17 shots and visit the doctor’s office 9 times – almost twice as many visits to the doctor as the CDC schedule.

Beyond Dr. Sears advocating for a medically untested vaccine schedule, I was dismayed at his classification of physicians like myself who vaccinate according to the CDC schedule. Because we follow the American Academy of Pediatrics and the CDC’s vaccine guidelines we are “unfriendly” doctors? Because I am following the science of my colleagues I am an “unfriendly” doctor?

This type of misinformation is damaging to families and physicians. It is the power of words that plant seeds of doubt in the minds of parents to fear vaccines. It’s this misleading information that manipulates parents into feeling that they are bad parents if they don’t question the safety and validity of vaccines.

As a pediatrician, I know it can be confusing for parents who get so much information about vaccines every day online and on TV. We all want to be informed advocates for our children’s health. Reading a balance of both sides allows parents to make an informed choice.

The best place to start the conversation about vaccines is with your pediatrician or by reading reputable sites like the Colorado Children’s Immunization Coalition at www.childrensimmunization.org. This non-profit does not accept donations from pharmaceutical companies and works to improve childhood vaccination rates across Colorado.

The reason I became a pediatrician was to protect children from illness and disease. Dr. Bob may only define “vaccine-friendly doctors” as those who promote his book, but the overwhelming data on the effectiveness and safety of vaccination makes it easy for us all to become a vaccine-friendly community. I hope that parents take time to read information on both sides of the issue, brings their questions to their physician and makes fully informed decisions about their child’s health.

Steve Perry is a pediatrician at Cherry Creek Pediatrics in Denver, Colorado and co-chair of the Colorado Children’s Immunization Coalition’s Policy Committee.

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  • Kristine

    If the parents of one of your patients felt they had looked at both sides of this issue and made an informed decision not to follow the traditional vaccine schedule, would you honor their wishes?

  • http://33charts.com DrV

    Great post, Steve. If all 60,000 members of the AAP made an annual post just like this, we would rule the search engines. Hope to see more.

  • http://www.BookstoreMD.com BookstoreMD

    Kristine: If a kid gets Polio because of a delayed vaccine schedule, whose fault is that – parents?? Doctors?? Who is willing to take moral responsibility for crippling that child?

  • http://confutata.wordpress.com Squillo

    Nice post. It’s no surprise that what Sears means by “vaccine-friendly pediatrician” is, of course, one who is willing to abdicate his/her responsibility to advise patients based on the best medical information available in order to avoid conflict or appeal to a particular group of families–just as he has done in pursuit of either adulation, profit, or both.

    I would define it as you seem to: a pediatrician who is willing to listen to, and consider individual families’ concerns while still providing evidence-based advice, and respecting a family’s decision without necessarily agreeing with it (or pretending to.)

  • Kristine

    I’m not here to debate the importance of vaccines. I agree that they are important.

    My issue is with the leap that Dr. Perry makes from “vaccine friendly doctor” to “unfriendly” doctor and the implication he makes in doing so.

    I agree with Squillo that “a pediatrician who is willing to listen to, and consider individual families’ concerns while still providing evidence-based advice, and respecting a family’s decision without necessarily agreeing with it (or pretending to.)” I’m not clear that this is what Dr. Perry is saying however, which is why I asked the question “what would he do if parents of a patient of his chose not to vaccinate or to follow a non-traditional schedule.”

    BookstoreMd, to answer your question I do think that the moral responsibility lies with the parents if they make the decision to delay vaccinations and their child gets sick. I find it very interesting that you would use polio as your example however, considering there has not been a non-vaccine related case of paralytic polio in the US since 1993.

  • http://google.com anon

    Why would an infant need protection from Hep. B? They are not sexually active, health care workers, or drug abusers. There ARE documented risks from vaccines, perhaps it is more correct to think about the risks to each individual child before haphazardly giving medication they may not need.

  • Anonymous

    With so many other parents not vaccinating their children these days (in some wealthy communities, vaccination rates are under 90% — clearly not a question of people being too poor to vaccinate their children), it may be more important for parents to ensure that their children (and perhaps themselves) are vaccinated, since unvaccinated children in schools, playgrounds, churches, etc. are just that many more additional vectors of serious disease.

    Regarding Hepatitis B vaccine for newborns, the intent is to try to immunize newborns against Hepatitis B that they may acquire from mothers with unknown or undetected Hepatitis B infection.

  • tpetrusick

    I am an “old Fart”. HiB vaccine has probably had the biggest impact on daily general peds practice. In the old days EVERY infant two and under with a fever made you stop and look them in the eye to think do I need to tap this one? Of course you did not tap every one but think about how many times a day you see a child under two with a fever for evaluation and remember that the most frequent ped law suit was delayed dignosis of menigitis. I tell my vaccine refusal parents that it is their responsibility to inform me and every provider that sees their child that immunizations have not been done or are incomplete so that the MD can consider all possibilities.

  • Anonymous

    I agree that delaying vaccines may place infants at risk, but I think this post misconstrues the purpose of Dr. Sears’ “vaccine-friendly” list. I looked up the list, and all a doctor need do to be on the list is email Bob Sears to ask to be included. Dr. Perry, if you take time to address parents’ concerns regarding vaccines AND you would still keep them in your practice if they decline or delay certain vaccines, you could be on that list. My sense from reading your post is that you would not want to, but your post made out that you were being excluded. The tone of victimization that many pediatricians have regarding parents deciding not to vaccinate is not helpful to the issue of improving vaccination rates.

  • http://confutata.wordpress.com Squillo

    Anonymous (#9)

    I took a look at the list, too, and you appear to be correct: all one need do is request to be included. That said, I’m not sure I agree that the poster misconstrues the true purpose of the list.

    I doubt most responsible peds would want to be included, for a number of reasons. First, given the disclaimer Sears placed at the start, any ped on the list might expect to be inundated with inquisitions regarding his/her vaccination philosophy, and, potentially, with patients who are not really looking for a pediatrician to advice them. Many will be parents not open to a rational discussion–only looking for a ped who will do what they have already decided is best.

    Moreover, if you look at the websites of many of the docs included on the list, it appears that many are dangerously close to what many of us would consider quacks. There are quite a few “naturopathic physicians” who, in many jusisdictions, cannot practice even any basic form of medicine. Many also don’t bill insurance, and/or offer only “concierge service”–not unethical per se, but, in my opinion, somewhat suspect in this context; it implies to me that they may be more interested in making a buck than in providing real medical care. (My bias, I realize.)

  • J

    By including HepB and HepA and chicken pox in your argument, you lessen it’s forcefulness. Some of us aren’t sheep of Dr. Sears, but have our own well-researched thoughts. My kids get vaccinated, just not on the schedule the AAP (or sears) suggest. Can anyone demonstrate that the AAP schedule isn’t simply convienent (getting them in early and often) as opposed to immunologically sound? Is there a reason some shots should be administered every two months? Because none of my peds have known.

  • Dr. Steve Perry

    I appreciate all of the comments. There are many reasons that vaccines should be given at the intervals and ages recommended by every scientific organization out there, immune response, safety, protection early in life from serious disease. There is absolutely no biological/rational reason for separating the vaccines. The only reason I see is an emotional one. Parents who come to a pediatrician should be coming to them because the pediatrician has the best advise on when to vaccinate/how to vaccinate/ and use the latest scientific and clinically proven safesty way to protect their infant and child.

    I often warn parents that these diseases are rapidly spread and are not 100% protective and if the rate of immunizations declines it puts even the fully immunized children at risk. This is not just a personal issue, it is a public health issue which makes the argument to toy with the vaccine schedule even that more serious.

  • Lisa S

    Regarding Hepatitis B vaccine for newborns, the intent is to try to immunize newborns against Hepatitis B that they may acquire from mothers with unknown or undetected Hepatitis B infection. — Anon

    I disagree.Pregnant women are tested for Hep B. If you are negative, they still want you to vaccinate your infant. It is because the group of people at risk for hep B were not easily pulled in for vaccination that the powers that be figured it was easier to fix the herd at birth. The prob with this (other than some of the side effects this vaccine has is not great for newborns) is that the vaccine protection is going to wane by the time the kids get sexually active and are sharing IV drug needles.

    Kristine I was reading on the CDC site that the last wild polio in the US was 1979. They stoped the oral polio vaccine b/c it was giving kids polio. So Bookstore, if you are a parent and you give your kid a vaccine that gives them polio whose resposibility is it? Who pays for vaccine damaged kids? The American taxpayer does b/c vaccine companies are protected by the government.

    I’m for more research. There are enough families out there that are refusing vaccines – track them for 20 years and find out what the rate of autoimmune disorders, autisim, neuro problems are and if it proves vaccines are safe there’s the end of the argument.

  • Cyndi

    As a parent who did not follow the “standard” schedule with the result that my children’s pediatrician chose to not treat them, a list of doctors who are willing to accept that they are partners in the care of my children rather than dictators of their care would have been helpful to me.
    I found a wonderful pediatrician by referral from the PICU intensivist who treated my youngest a few days after her birth (DiGeorge Syndrome), and we reached an understanding that has held for 14 years thus far. We have a partnership. She gives me her advice and recommendations, clearly explains all the options and potential concerns related to each option, and I make the final decision. The end result is that I remain fully engaged in the care of my children, and I am more likely to follow her recommendations than not.
    We eventually reached a compromise on the vaccine issue as well, and my daughter is almost “up-to-date” for her age group with the exception of a medical exemption for live virus vaccines. There is no way this would have been the outcome had I remained with a care provider who felt that their job was to tell me what to do and my job was to do it.

  • Cyndi

    In my previous comment:
    “She gives me her advice and recommendations, clearly explains all the options and potential concerns related to each option, and I make the final decision. The end result is that I remain fully engaged in the care of my children, and I am more likely to follow her recommendations than not.”

    I forgot to mention the trade-off benefits to the care provider. I don’t always choose to follow her recommendations, but I’m never non-compliant because whatever I do agree to is followed through as planned. As well, because I am an active participant in all decisions, in fact rather than in theory, she will never have to worry about a lawsuit from me regardless of the outcome. By taking an active role, I also take responsibility for the decisions made. That is a benefit worth pursuing for all care providers, in my opinion.

  • http://www.doctorkate.net drkateatkinson

    i just cant understand why one person can state these claims and a nation of parents is following him. there is no evidence in favor of delayed vaccines and my experience is that no parents who elect to do this ‘schedule’ actually stick with it as it requires such frequent visits that it isnt feasible for working parents to stick to it.

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