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Alternative Vaccination Schedules Preferred by Some Parents; Some Doctors Refuse to Go along

Syringe

There are various reasons why a parent might be interested in an alternative vaccination schedule.  Some are concerned about their small child being injected with several antigens at once.  Others may have heard of a celebrity who touts it and want to try it for their children.

Dr. Robert Steele is a pediatrician with Mercy-Springfield.  He says it’s fairly uncommon for parents who bring their children to him to ask for alternative vaccination schedules, but he does have requests occasionally.

According to Dr. Steele, some parents might have incomplete information and want to know more so they can feel comfortable with the decision they make.  Others feel more strongly about the way they feel their child’s vaccination schedule should be and they want confirmation that that’s the way to go.  Still others already know that’s what they want to do and just want to find out if their pediatrician is willing to work with them on it.

He says his approach towards vaccinations has evolved over time.  His approach ten years ago was to work with parents and give them more information…

"Now, I still give them as much information as I always have, and actually even more, but ultimately, if they choose not to vaccinate their children or do it in a manner that delays their child's vaccines,  then I ask them to seek care elsewhere."

Steele doesn’t deviate from the vaccination schedule recommended by the American Academy of Pediatrics.  He says there’s some leeway within that schedule, but if parents want to deviate from that, he’s not comfortable going along…

"Since the vaccination schedule is set forth with the idea in mind that you want to vaccinate the child as early as early as possible, that protects the child  at the earliest possible time from those diseases that  you're vaccinating against.  The second part is a more community-wide thought, and that is that the vaccines that the child gets not just protect that child but protects all the children that are around that child."

Steele says parents who simply refuse to vaccinate their children at all are relying on all the other parents who do vaccinate their kids to keep their children safe.

Dr. Louis Krenn, a pediatrician with CoxHealth, says only about a half dozen kids of the several hundred to 1000 children he cares for, are on alternative vaccination schedules.  And he says, while many of his colleagues refuse to deviate from the AAP schedule, he’s willing to work with parents who wish to do so.

Dr. Krenn says if parents want to spread the vaccine out over a longer period of time or delay shots until six to nine months, he’ll do that.  But he warns them that delaying vaccines can cause problems down the road…

"Many of our vaccine programs have specific time intervals that the vaccines need to be given within, and there are some risks if you give them too quickly.  You also get to a point where certain vaccines are only indicated to be given during specific periods in a child's life so that you get to a point where you simply cannot give the vaccine.  And that can create some trouble when the child gets to school age and the school nurse is trying to verify that they've been  properly immunized."

Krenn’s concern with delaying vaccines, even with electronic medical records that are widely used today, is error…

"My concern is that opens up a lot of opportunity for the vaccine to be given too soon,  for it to be missed, for the wrong vaccine to be given."

Despite his concerns, however, Dr. Krenn says he’s willing to look at what a parent wants for his or her child…

"We try to spend the time to go line by line with them and either say, 'ok, that's acceptable' or say, 'no, that's not acceptable and here's why that's not acceptable' and explain, you know, whether it's a limitation from the manufacturer or from the vaccine itself or whether the schedule that they've come up with is just overly complicated and I'm concerned that either myself or my staff will not be able to follow it and maintain the safety that I hold for my patients."

He says, while he’s willing to work with parents who would like to have their children on alternative vaccination schedules, he’s not willing to compromise the safety of his patients.

Both Dr. Krenn and Dr. Steele say there’s been an increase in vaccine-preventable diseases such as pertussis or whooping cough, mumps and measles, especially in states that have philosophical exemptions for school vaccinations.  Missouri doesn’t have such an exemption.

According to Dr. Steele, when a parent at his practice asks for an alternative vaccination schedule for his or her child or doesn’t want to vaccinate at all, he tries to explain in a compassionate and complete way why the AAP recommends the vaccination schedule it does.  He says he wants parents to make informed decisions…

"Ultimately, of course, it is the parents' decision whether to vaccinate or not.  You know, I feel very strongly that vaccinating children fully and on time is one of the most important things that you can do for your child with regard to their healthcare."

Vaccines work by tricking the body into thinking it’s injected with a disease and, in turn, the body produces antibodies to fight it.

Dr. Steele says the idea that multiple vaccines overwhelm the immune system doesn’t make sense…

"The thing that you're introducing into the body are called antigens.  Those are things that their body recognizes are foreign.  For a child that is vaccinated, by the time they are two years of age, they have been exposed to  somewhere in the neighborhood of 250 antigens, depending on which vaccination you're talking about.  As of 1992, so this is going to be for the vast majority of the parents that are now having children, they were vaccinated against fewer things and yet the number of antigens they were exposed to was over 3000."

And he says kids are constantly coming into contact with antigens every day.

Dr. Krenn is concerned that many young parents haven’t had any experience with the diseases that vaccines are designed to prevent, so he says it’s easy to look at the potential concerns for the vaccine and not see the potential concerns for what the diseases themselves can do.

For KSMU News, I’m Michele Skalicky.