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The Vaccine Schedule Debate

Vaccines and their effects on small children have been one of the great medical debates of this decade. And today, the issues become a little muddier. In addition to releasing the latest vaccine recommendation schedule today, the American Academy of Pediatrics journal "Pediatrics" is running an article by Dr. Paul A. Offit, the director of the Vaccine Education Center at Children's Hospital of Philadelphia, that attacks a popular vaccine book by Dr. Bob Sears, the son of well-known pediatrician and "The Baby Book" author William Sears.

In "The Vaccine Book," Sears recommends two "common sense" delayed vaccination schedules for children. One is designed for parents who want to decline or delay vaccines. The other is designed for parents who want to minimize the number of shots per office visit to no more than 2, requiring 12 office visits by the age of 2. Sears is also a proponent of separating the measles, mumps and rubella (MMR) shot into three separate shots and not combining vaccinations with live cultures (MMR and chicken pox). Currently, MMR and Varicella, or chicken pox, are recommended for kids ages 12-15 months.

"Increasing the number of vaccines, the number of office visits, and the ages at which vaccines are administered will likely decrease immunization rates. In addition to the logistic problem of requiring so many office visits, Sears’ recommendation might have another negative consequence; recent outbreaks of measles showed that several children acquired the disease while waiting in their pediatricians’ offices," writes Offit.

"At the heart of the problem with Sears’ schedules is the fact that, at the very least, they will increase the time during which children are susceptible to vaccine-preventable diseases. If more parents insist on Sears’ vaccine schedules, then fewer children will be protected, with the inevitable consequence of continued or worsening outbreaks of vaccine-preventable diseases. In an effort to protect children from harm, Sears’ book will likely put more in harm’s way."

Offit is not one to shy away from controversy. In January, when the TV drama "Eli Stone" was about to air an episode in which the lawyer argued -- fictionally -- that a mercury-based preservative in a vaccine caused her son's autism, Offit spoke up, saying the show conveyed "a highly distorted and confusing message about the role of vaccines."

Not surprisingly, Sears disagrees with Offit's assessment of his book, writing on his Web site's blog: "While Dr. Offit and I share the same opinion on the importance of vaccines, at the end of the day we will have to continue to agree to disagree on one major point: He believes that offering parents the option of an alternative vaccine schedule that spreads out the shots and allows worried parents to vaccinate their babies in a manner they are more comfortable with will result in LOWER vaccination rates because it legitimizes these parents fears about vaccines. I, on the other hand, believe that providing parents (who otherwise would NOT vaccinate at all) with a schedule of vaccines that they feel right about for their baby will allow such parents to vaccinate, and we will achieve HIGHER vaccination rates."

What have your experiences been with the current vaccination schedules that most pediatricians use? Have you asked your pediatrician for vaccination changes? How'd that work out?

By Stacey Garfinkle |  December 29, 2008; 8:00 AM ET  | Category:  Health
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Comments


Even though the Gardisil vaccine is "required" for girls entering 6th grade in the District, our pediatrics practice does not recommend it until a couple years later. They want to wait a few years to see if it works and to understand the potential side effects. They advise their patients to exercise their opt out rights.

Posted by: dcmom | December 29, 2008 8:04 AM | Report abuse

According to information I found on the internet, Congressional investigators and federal health officials have secreted a report prepared by experts proving vaccine mercury is harming children far worse than previously known. The “Thimerosal VSD Study: Phase I” document was secreted in 2000, and subsequent congressional hearings and news reports neglected it.

The study, conducted by scientists commissioned by the Centers for Disease
Control (CDC), shows statistically significant links between vaccine-injected
mercury and “neurological developmental disorders” including misery, depression, and suicide. Additional links to autism were strongly suggested by the data that heavily discourages the use of the drug Thimerosal containing mercury used for vaccine sterility.

The official documents marked “CONFIDENTIAL . . . DO NOT COPY OR RELEASE” were obtained by class action attorneys through Freedom of Information petitions and posted this week on the Internet attached to a filmed commentary by public health expert, Dr. Leonard G. Horowitz. The iMovie is viewable on YouTube.

Posted by: Bitter_Bill | December 29, 2008 8:08 AM | Report abuse

Unfortunately, Dr. Sears may have a point. However, the only reason he has a point is due to the pseudoscientific misinformation put out there by the anti-vaccine wackos like Jenny McCarthy. They have done such a disservice to our society as well as to the concept of critical scientific thinking that they deserve to be banned to a deserted island somewhere.

Some people will probably argue on here that, if we follow Dr. Sears' recommendations, then people will finally believe that vaccinations do not cause autism. However, I doubt that will be the case. The autism/vaccination crowd firmly believes in this link, regardless of evidence to the contrary. There is simply no way to disprove their beliefs because it is a BELIEF and no longer a matter of scientific disagreement. They are much like those people who believe UFOs landed at Roswell. There is simply no way to disprove this stuff because the people are not operating in a rational, scientific manner.

So, sure, we can do what Dr. Sears suggests, but I seriously doubt that anyone will stop believing in the autism/vaccination link as a result.

Posted by: rlalumiere | December 29, 2008 8:09 AM | Report abuse

I want to agree with Sears on the final point. If it's delayed vs. no vaccines, then he's doing a service. However, I would bet that it's people who would get vaccines regardless that are now opting to get on a delayed schedule. We'll probably see some studies on this popping up soon.

We haven't had any vaccine issues, and we're on the normal AAP schedule. I'm very clear on the risk and rewards, as I've been trained in the biomedical sciences.

I know I'm a broken record about This American Life, but they had a story on vaccines recently: http://thislife.org/Radio_Episode.aspx?sched=1275

Posted by: atb2 | December 29, 2008 8:17 AM | Report abuse

My son had all of his on schedule, and a couple of others besides, and we've had no problems.

My weak understanding of this is that Themerisol is no longer used as a vaccine preservative. Does anyone know if that is the case? Regardless, I'm still of two minds about this.

As someone who works in the nebulous field of environmental exposure risk reduction, I know there are people who have lower thresholds of tolerance to exposure to certain contaminants. If the vaccines carried more than miniscule doses of mercury, in all likelihood, they won't affect the majority of children given vaccines. But some people can be more sensitive to the effects of mercury, so perhaps that small population of children were impacted in some way by vaccines. Something like that is so incredibly hard to measure, though, because environmental factors come into play (home life, if people smoke in the home, outside influences, etc.) and the fact that no one knows excatly what causes autism to begin with.

I would hope, though, that the very, very remote chance that vaccines would "give" your child autism would be a risk you were willing to take to protect them from the very real risk of contracting a potentially fatal disease. Not only that, but by not vaccinating, you're weakening the "herd immunity" factor that does protect those that, for whatever reason, cannot be vaccinated. Personally, I foud that argument much more compelling and vaccinated on the schedule my doctor reccommended.

Posted by: Mazarin | December 29, 2008 8:47 AM | Report abuse

A few things to clear up.
1.) Since 2003, childhood vaccines have not contained mercury and yet the autism rate continues to rise.
2.) There have been numerous studies on mercury and vaccines. Even if one was "secreted", there are many more valid studies that examine the topic.
3.) Vaccine preventable diseases still exist and can cause harm to children. Fairfax County has seen measles cases in 2008. Measles and pertussis rates are at the highest since 1996 across the US.
4.) We live in an area in which many people travel throughout the world and vaccine preventable diseases still exist at high rates throughout the world. In many outbreaks that have occurred, it started with someone who had traveled overseas and spread to unvaccinated individuals here in the US.

There is a lot of misinformation in the media about vaccines and Dr. Offit is working at correcting this with facts. Parents need to make their decisions regarding vaccines by examining all information not just one side of the issue as presented by Jenny McCarthy or Dr. Sears. They need to also consider the risk of the diseases that these vaccines prevent.

Posted by: pediatricrn | December 29, 2008 9:09 AM | Report abuse

I think a delayed schedule is a fantastic idea -- for parents who have the means and ability to make sure the kids get vaccinated that way. But many don't. I suppose it would be a real hardship for almost everyone except in cases where there's a stay-at-home parent.

I truly cannot believe anyone listens to Jenny McCarthy on the issue of vaccines. Autism is not a curable disease. It eludes me why people think she knows more than the medical establishment on this topic.

Posted by: WorkingMomX | December 29, 2008 9:11 AM | Report abuse

It doesn't matter that there is no longer thimerosal in childhood vaccines. The anti-vaccine folks have moved on to aluminum and the immune reaction to the antigen itself as the causative agents of diseases X, Y, and Z. It's a moving target.

Posted by: atb2 | December 29, 2008 9:16 AM | Report abuse

"It eludes me why people think she knows more than the medical establishment on this topic."

It is not the case that people think Jenny McCarthy knows more than the medical establishment on this or any topic. What is the case is that people do not trust the medical establishment. Period. End of story.

Distrust of government, advocacy organizations, and the AMA are good things. Think Tuskegee. AIDS. Breastfeeding in the 50s and 60s.

Distrust keeps parents focused on science, their knowledge of their own children, and their instinct about whether the purveyors of certain information have an ax to grind. Let's not let the autism argument dominate from an otherwise highly valuable conversation about the pace and specifics of the Almighty Vaccination Schedule and whether it is serving our children.

Posted by: anonfornow | December 29, 2008 9:21 AM | Report abuse

Thanks, Dr. Sears. I wouldn't give my cats and dog more than one vaccine at a time. Why would I do that to my child? I decided it was worth the bother after seeing the stray cat I adopted get weak and tired after receiving more than one vaccine. He recovered and I made the decision not to do that again. For my daughter I delayed the MMR and also ordered each vaccine separately. It's not just about autism--your child's immune system should be protected. It's best for your system to process one vaccine at a time--putting them together is just a matter of convenience and the benefits are well worth the extra time and expense. If you follow the received wisdom re vaccination you will constantly be pumping vaccines into your kids and yourself. Every person responds differently to this and there's no way to definitively prove or disprove the health risks. I have a big no to gardasil and yearly flu shots (and I've the flu three times in my entire life). Think about it. As the antivaccine people say, the risk is 100% when it happens to you or your child.

Posted by: RAC4 | December 29, 2008 9:26 AM | Report abuse

RAC4, I'm with you on waiting on Gardisil. And I'm with you on the delayed vaccination schedule, because for me, I can and will manage it. But there's a risk to not vaccinating as well. A mom at my son's preschool felt the way you do about the flu shot - until her 4-year old son died of the flu two years ago. So let's not pretend risk is accepted only by those who vaccinate.

Posted by: WorkingMomX | December 29, 2008 9:31 AM | Report abuse

Your initial statement is wrong: there is NO debate or disagreement among the medical community about vaccines or the vaccine schedule. The debate and disagreement comes from people without medical degrees, people who have been disciplined or had their licenses revoked, and quacks who are taking money from parents who are desperate to find a way to improve their child's situation.

To the extent that you can prove a negative, science has proven that there is no link between thimerosol and autism. Do not expect that to have any impact whatsoever on the debate, or on what the antivax community will believe and vociferously defend.

The public misinformation on this topic is horrifying. It is clear to me that people in this country have no exposure to what pertussis looks and sounds like, or to children dying from measles encephalitis. Or to polio. Or to what rubella does to a developing fetus. If those people want to take that risk for their own children, they are foolish. If they want to take it for our entire "herd," they should be branded criminals.

Posted by: badmommy | December 29, 2008 9:48 AM | Report abuse

Badmommy, speaking of doing it for the herd:

Researchers followed more than 12,000 students at the University of Minnesota and St. Olaf's College over four flu seasons. They found that for every two people vaccinated against flu, there was one fewer day of flu or flu-like illness. (The researchers could not determine which illnesses were caused by flu viruses versus other viral infections.)

Meanwhile, moved by his new data, Ehlinger is gung-ho on promoting flu shots among the nation's 18 million college and university students. This fall, he challenged the University of Minnesota's 50,000 students to break into Guinness World Records in the category of most flu shots on a single day.

"We immunized 11,810 students, faculty and staff at the University of Minnesota in one big push," Ehlinger says. "We smashed the previous record of about 3,200 in a day."

He used a sales pitch that was partly altruistic. "Our slogan is: 'Do it for the herd.' Do it for yourself, but also get the herd immunity so that you keep it from spreading in your community," Ehlinger says.

If enough of a herd (whether humans or animals) is immunized, the spread of infections can be slowed or halted, protecting even those who weren't vaccinated.

Ehlinger figures this fall's University of Minnesota flu vaccination campaign will prevent something like 5,000 days of illness on campus this flu season. That's nearly 14 years' worth of sick days.

Posted by: WorkingMomX | December 29, 2008 10:02 AM | Report abuse

I'm not picking on RAC4 specifically, since this is a common delayer sentiment, but where does this line of thinking come from: "your child's immune system should be protected. It's best for your system to process one vaccine at a time."? Is it from the Sears book? It doesn't make a whole lot of sense to me, since we continuously process antigens every day from the day we're born.

Posted by: atb2 | December 29, 2008 10:41 AM | Report abuse

It is a common misconception that the only thing vaccine delayers are concerned about is autism and/or thimerosal.

Posted by: DCResident00 | December 29, 2008 11:01 AM | Report abuse

I think this is a tough issue. Both my kids were vaccinated (possibly twice). They were born in China and supposedly received all the vaccinations on schedule. For my older daughter, who was less than one year old at adoption, the pediatrician recommended she simply repeat all the vaccines. The alternative was to do a blood test to check for immunity. His experience was that most children adopted from China didn't have immunity, and she was already having blood drawn for several other tests, so I went with his suggestion. She also supposedly had the BCG vaccine, which is used in Asian countries (and perhaps others) to prevent TB. The US doesn't use it because it is not considered effective, but it does usually result in a positive TB test. The AAP also recommends a TB test for newly adopted children, and the doctor did this on her first visit. It was negative. Subsequently another mom from our adoptive group reported that she'd had the titers done for her child to check for immunity, and they showed no immunity to the diseases. So I always felt I did the right thing by revaccinating. With my second daughter, who was three and had (supposedly) nearly finished the whole vaccine routine, the pediatrician recommended running the titers first. They showed no immunity, so she also started over again.

In both cases, they were on a catch up vaccine schedule, which was more compacted. They may have been given some that were outdated or improperly stored, thus losing the immunity giving properties. So they potentially had much more exposure to risk than most children. Or perhaps they were never vaccinated and the records fudged--though they still had a compressed vaccination schedule.

I believe in vaccinating children, but if I knew then (when I was making decisions about vaccinating my kids) what the risks are (and there are some) I would have opted to slow the process down a bit. I am a working mom, but I think we could have made it in to the doctor for vaccines.

Anyway, the doctor's offices aren't going to be offering these alternative schedules to parents, asking them to choose. They will continue to vaccinate and then, as an afterthought, make you sign permission to vaccinate. The alternative schedules will only be used by families who seek them out and request that their pediatricians use them.

Posted by: janedoe5 | December 29, 2008 11:09 AM | Report abuse

To clarify: my kids were on a compacted, catchup vaccine schedule once they arrived in the US. The comment about perhaps never having received vaccines or having received ineffective vaccines was referring to when they were in China. And then I switched back to talking about the compressed vaccination schedule once they got here.

Posted by: janedoe5 | December 29, 2008 11:12 AM | Report abuse

...and also, why is it only Dr. Offit who responds to every vaccine debate issue? Every single vaccine article quotes Dr. Offit as the number one source. You'd think the pro-vaccine people would try to find someone else to substantiate their claims - perhaps someone who doesn't have as large a conflict of interest. I'm more than willing to listen to debates from both sides, but when the major claim of the anti-vaccine people is that money is doing all the talking for the pro-vaccine side, why would you have someone with a direct financial interest in vaccines being the main spokesperson?

Posted by: DCResident00 | December 29, 2008 11:14 AM | Report abuse

DCResident00:

You can't set this particular disagreement up that way. Sears doesn't advocate NOT giving vaccines (e.g. he's not one of the "anti-vaccine people")---so Offit disagreeing with Sears has nothing to do with conflicts of interest. Whether you go with Sears or Offit---your kids get vaccinated, and the pharm. companies profit (IF that's one's belief in why we do vaccines, not mine).

The issue is whether it does more harm than good to alter the current schedule. Unfortunately, Dr. Sears has to live in the real world, where many parents choose not to give vaccinations at all. So he's trying to compromise.

FWIW, both our sons have received the standard schedule, with no issues. I tend to agree with Offit that unless there's a COMPELLING reason to delay or schedule differently, then getting them done as per the current recs is the way to go. But, if it's a choice between no vaccine and vaccines on an alternate schedule, then Sears' suggestion is a no-brainer.

Posted by: MeinDC2 | December 29, 2008 12:15 PM | Report abuse

“To the extent that you can prove a negative, science has proven that there is no link between thimerosol and autism.”

Science has not proven a link between thimerosol and autism. Science has not proven a link between genetics and autism. Science has not proven a link between other environmental stimulus and autism. Science has not studied the combination of all of these and autism. That is all science HAS done. To date, nothing has been proven.

“If those people want to take that risk for their own children, they are foolish. If they want to take it for our entire "herd," they should be branded criminals.”

According to a July article in the WSJ, only 2.1% of all citizens ages 18-45 are immune to diphtheria, tetanus, and pertussis. Only 30% of the total population was vaccinated for influenza last season. That same year the vaccine was only 40% effective, so only 12% of the population was actually covered by the vaccine. You have just made 97% of all citizens aged 18-45 and 70% of all other age groups (totaling 248 million US citizens) criminals. Do you think we have enough jails for all of them?

“He used a sales pitch that was partly altruistic. "Our slogan is: 'Do it for the herd.' Do it for yourself, but also get the herd immunity so that you keep it from spreading in your community," Ehlinger says.”

Tell Ehlinger that he is clueless. Herd immunity has never been achieved for influenza, EVER! Given current efficiencies like last years, even if every single US citizen was given the vaccine, “herd” immunity would not have been achieved.

“Ehlinger figures this fall's University of Minnesota flu vaccination campaign will prevent something like 5,000 days of illness on campus this flu season. That's nearly 14 years' worth of sick days.”

Ehlinger is digging where only a proctologist would go for those numbers.

Posted by: cakkallen@rstarmail.com | December 29, 2008 12:47 PM | Report abuse

MeinDC2 - You're right, I made it too "black and white." I would say, however, that most if not all anti-vaccine and vaccine-wary people (delayers for example) would say that they have a high distrust of pharma companies and other money-makers because of the conflicts of interest. And yet, every single article that is takes a pro-vaccine stance (like all of the ones that have been in the WP recently) have quoted Dr. Offit. It seems like every single one relies solely on quotes from Dr. Offit. The Dr. Offit who is yes, the Director of Vaccine education, but also the same Dr. Offit who holds a patent for the rotovirus vaccine, if I'm not mistaken. That part is rarely mentioned, incidentally. What I'm saying is that it just fuels the fire to repeatedly use Dr. Offit and to repeatedly NOT discuss his potential conflicts of interest. Isn't there anyone else that wants to stand up and speak out against people who don't vaccinate? Surely there must be someone who doesn't have conflicts of interest, and then I think that would make for a better argument.

Posted by: DCResident00 | December 29, 2008 1:11 PM | Report abuse

Just saw on the Dr. Offit article linked to in this blog post that Dr. Offit is "the coinventor of and co-patent holder for RotaTeq." I'm glad it at least says that in the article.

Posted by: DCResident00 | December 29, 2008 1:35 PM | Report abuse

My daughter had pertussis last spring (even though she was completely up to date on all of her vaccines). Nearly 20 children in her elementary school caught it and had confirmed cases. There were most likely more cases but many children were not tested. It was a public health nightmare, starting with the unvaccinated child who first had it (with a religious exemption, the only kind allowed in NY, but the family is Catholic, as are we, and I'm hopping mad about their selfishness).

The pediatrician refused TWICE to test for pertussis, despite the outbreak and despite the repeated calls from the County health nurse's office. I finally took my daughter to the ER, and was told there, that most likely she did NOT have pertussis. (She did after all, and my insurance picked up the $2000 tab).

Many people are living in a state of denial. Pertussis in an otherwise healthy 10 year old is not that horrible, although it sounds horrible and scares the parents. The problem is, that a friend of ours had a newborn baby at this time, and my daughter visited with her briefly. That was very scary, but thankfully, the baby was fine.

Posted by: readerny | December 29, 2008 1:46 PM | Report abuse

DCResident00--

A valid point. However, it's pretty hard to find well-qualified experts in any field who don't have SOME link to pharmaceutical companies. That's because research relies on dollars, and when funding is tight (like it is now), researchers will go elsewhere for those resources. Even when funding is plentiful, researchers will pad their coffers (you can always buy that extra piece of equipment, hire another technician, etc.) The exception is govt. scientists, who are restricted in terms of collaborative ties with industry. [Full disclaimer: I am a govt. scientist, so I have some expertise here, though not in vaccine research.]

In the end, you have to evaluate the quality of the research data. It can't just be assumed that because one has their research funded, in whole or in part, by Big Pharma, then all of the research is suspect. Just because Offit has profited from the roto vaccine doesn't make his motives less scientifically/clinically driven. Ask any parent who's kid has had rotovirus---a vaccine is a godsend.

But I do agree---Offit's own interests should be part of any mention of his work. In point of fact, most scientific journals now require financial conflict-of-interest statements. I also agree that others in the field should speak up---and I think many do. Just that the media tend to place one or two people on their speed dial, and Offit is one of the more outspoken of the experts.

Posted by: MeinDC2 | December 29, 2008 1:47 PM | Report abuse

We follow a schedule where my children receive only one vaccine at a time. This means that, if listening to Dr. Offitt, their immunization is delayed by, at the most, 4 weeks. Some people don't even get their kids to the doctors on time, so is my kid really that much more at risk? I don't think so, and the result of our schedule of vaccinations is that my kids do not fear the doctor, they don't have to deal with leg pain and cramping from up to 5 sticks at a time and we can tell exactly which vaccine caused a reaction if one occurs.

yes, it means that I have to spend more time at the office than I would like, but I think it is worth it. If it helps them no get autism, then all the better, but that is not the reason that we are doing it. I've had 5 vaccinations at once before a trip and it hurt like hell and made my adult body feel awful. I can't imagine doing that to my poor infant who has no way to communicate his pain or discomfort. I also had a reaction and we didn't know which vaccine caused it. I'd rather be safe than sorry.

Posted by: mdsails | December 29, 2008 3:13 PM | Report abuse

It's my understanding that Thimerosal is still used in multi-dose vaccine vials, such as the flu shot. And while it's true that none of the flu vaccines used for kids under 2 contain thimerosal, it is possible for kids 2-5 to get vaccines containing it.

My 2-year-old daughter was vaccinated according to the regular recommended schedule, but honestly, I'm reconsidering that for the new baby. At the very least, I'd like to delay her chicken pox vaccine (the state won't allow me to skip it altogether, which I'd rather do).

It just seems silly to me that we're now requiring vaccines for illnesses that are mostly harmless in childhood. I was speaking to my pediatrician about it, and he admitted that (a) the chicken pox vaccine does not confer permanent immunity the way that actually having the disease as a child does, and (b) that chicken pox is a much more serious illness in adults than it is in children. So, basically, all the kids who are getting the vaccine now will have to receive boosters for the rest of their lives or risk becoming seriously ill as adults, when they could have just gotten it over with as kids.

Yes, I know that some infinitismal percentage of children died each year of chicken pox before the vaccine. Yes, it would be beyond horrible if it happened to my child or to anyone else's child as a result of my child infecting them. But I don't happen to think preventing that infinitismal risk is worth requiring vaccines that could result in a much greater risk to adults in a few decades.

Posted by: newsahm | December 29, 2008 3:33 PM | Report abuse

I think 12 visits to the Doctor for shots is excessive. Given that little kids often have colds and other minor illnesses that preclude getting shots it seems like a schedule that would almost insure noncompliance.

I agree with readerinny -- these diseases are around and you do not want your child to get them! Not only will they get very sick, but you'll have trouble getting treatment for them because everyone thinks they're not around any more.

Parents who refuse to vaccinate are sucking off the good will of parents who do vaccinate.

Posted by: RedBird27 | December 29, 2008 3:58 PM | Report abuse

The parents that do vaccinate don’t really help anyone other than, maybe, their children. This statement doesn’t apply to chicken-pox, influenza, diphtheria, tetanus, or pertussis, or cervical cancer (Gardasil), so what exactly are you referring to?

According to CDC estimate there are 39 million people who are not immune to measles, mumps, or rubella due to not being vaccinated or being vaccinated with an ineffective vaccine. How can you tell the difference between the un-vaccinated and the un-covered?

Posted by: cakkallen@rstarmail.com | December 29, 2008 4:27 PM | Report abuse

I have vaccinated all of my children on schedule and will continue to do so. I have several friends who have asked the pediatrician for an alternate schedule and not one has had a problem with the office accomodating their requests. I think that if a parent is opposed to the recomended course of shots I would rather offer them a schedule they are willing to follow than have them skip the shots all together.

Posted by: thosewilsongirls | December 29, 2008 4:38 PM | Report abuse

Good point Mdsails, about vaccine reaction. A friend of mine chose in the 90's to separate the vaccines because her pediatrician said that if the child got multiple immunizations at the same visit, and got a reaction to one of them, they would not do any further boosters of any of the vaccines given on the day of the reaction, since there would be no way of knowing which one caused the reaction. For a child who may have a reaction to any one vaccine, separating them actually means that the child gets more vaccines than the same child would if the vaccines had been given on the current schedule.

Posted by: janedoe5 | December 29, 2008 5:02 PM | Report abuse

Hopefully most good citizens realize that public policy is not a science. The fact that Hepatitis B vaccine is given on day 1 of life is a testament to this. The impact of aluminum adjuvants on day one of life has never been studied as to the potential effect on the developing brain, the great irony of those purporting how safe the CDC schedule is that its never been tested against any other vaccine protocol for safety. Never have there been any massive protocol comparisons for safety as we require of US oncologist to even think of changing a chemotherapy regimen. When the CDC says make it so, a herd of pediatricians stands at the ready unquestioning and those that differ such as Dr. Sears are not appreciated for questioning the governing handlers of medicine. Epidemiological studies produced by conflicted authors are clouding so much of the issues here, the Simpsonwood discussion clearly is an example of top flight but conflicted medical professionals seeing a signal between neurodevelopmental delays and vaccine number, age stratification also came out of some of the data present such that the earlier an exposure the greater the risk of a neurodevelopmenat delay (its not just the thimerosal). The real crime here is that we have completely lost transparnecy in medicine (you think Wall Street is bad?). When the average US MD is not informed of such a secretive discussion and it requires a FOIA filing 5 years after the fact it is quite obvious someone is trying to hide something. Lastly, the sloppiest immunotherapy in medicine is an vaccine schedule that is never titer checked in an individual for efficacy, nice to see some talk about titers above. Someday it will be unheard of to give a vaccine without evidence of need for it by a negative titer level, where is the evidence based medicine for the individual?

Posted by: TedFogartyMD | December 29, 2008 10:57 PM | Report abuse

Vaccines save lives? Which part of the vaccine does that? The aluminum? The formaldehyde? The mercury? The diseased animal tissue it’s grown on? Or is it the live or half dead virus? Or is it some magical, mystical ingredient they don't list on the package insert? What part of this satanic ritual is life saving injected into an immune system NO ONE on the planet understands? Please Dr Offit share with us your vast knowledge of just how injecting some of the most toxic substances on the earth inside little bodies can confer immunity. Waiting patiently...

Posted by: lovthatlea | December 29, 2008 11:53 PM | Report abuse

Dr. Offit throwing mud at a colleague is disgusting. Dr. Sears also believes in the great benefit of vaccines but refuses to lie to parents about the dark side of adverse events. As a doctor, I am amazed that vaccines have this 'sacred cow' status that they can do no harm.

Dark side:
1. A recent large study from Manitoba has demonstrated that delaying DTP by 2 months can cut the childhood asthma rate by 50%.

2. A study by Gallagher et al from SUNY finds that, by analyzing NHANES data, if your child received the Hep B vaccine series they have a 9x increase risk of requiring special ed

3. A recent publication in Neurology shows that the GSK brand of HepB, Engerix, increases the risk of developing multiple sclerosis 3x in children.

4. Vaccines can, and always have, been able to cause brain injury (just look up the recent botched Alzheimer's vaccine AN1792). The brain damage can be diagnosed as Autism.

I don't think the AAP or Dr. Offit will mention these studies or put out press releases on this science. Good work Dr. Sears to break from the lies of the AAP and Pharma funded salesman like Offit. Injecting the mercury containing flu shot to babies should be criminal.

Posted by: hoyadoc97 | December 30, 2008 12:35 AM | Report abuse

We were fine with the standard vaccine schedule until my son's 5-year-old checkup, which required four or five vaccinations, a finger-stick blood drawing and an optional flu shot.

My son already had learned to dread shots (and therefore doctor's appointments) by that age. The nurse gave me the option of doing all the shots in one appointment or doing some that day and coming back a few weeks later to do the rest.

I chose the second option (dividing up the shots), since my son became progressively more and more upset with each injection, and I thought he needed a break. He was especially upset after the finger-stick, which for some reason was scheduled after the injections even though it took the longest and looked the most painful.

In retrospect, I probably should have gotten all the shots over with in one appointment because the day we were scheduled to come back for the rest of the 5-year-old vaccinations my son became hysterical even before we even got to the doctor's office, refused to go into the examination room (clinging to the doorframe) and made a number of escape attempts. I have never seen him look so miserable.

My son is scheduled for his 6-year-old checkup in a few weeks. I hope he doesn't have to get any vaccinations this time, though I expect he will. Poor little guy!

Posted by: pegysus | January 1, 2009 9:56 PM | Report abuse

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