Feature Article: No Payoff in Vaccine Delay, Only Risk

A recent survey found that during any given month, more than 9 out of 10 pediatricians report being asked to delay or space out vaccinations by parents of children ages 2 years or younger.

Published in the journal Pediatrics, the survey also showed that more than 7 out of 10 pediatricians reported sometimes or always agreeing to the delay even though the overwhelming majority of them believe doing so puts children at risk. They agree against their own best judgment because they want parents to feel as though they are listening and working with them. Unfortunately, while parents may be more satisfied with the provider, the children are left at increased risk of illness or harm if exposed to one of the diseases for which they have not been vaccinated.

The Centers for Disease Control and Prevention (CDC) advises that children be vaccinated for 14 diseases before 6 years of age on a specific schedule, which entails roughly 29 shots, sometimes several at once. Parents’ desire to separate, space out or skip some vaccines can be understood as that schedule can be intimidating. However, the recommended childhood immunization schedule — licensed by the Food and Drug Administration and endorsed by the CDC’s Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AFP) — is based upon the best scientific information available and is more rigorously and better tested for safety than any alternative schedule.

Those expert organizations determine when a child should receive a vaccine by balancing factors such as when the recipient is at highest risk of contracting the disease and when the vaccine will generate the best immune response. By spacing out, delaying or withholding certain vaccines, the amount of time a child is vulnerable to diseases like chickenpox, whooping cough (pertussis), influenza and pneumococcus is increased with no scientifically proven safety benefit.

Choosing to alter the recommended vaccine schedule also means extra visits to the doctor and more shots. Individual changes also increase the chance for administrative errors and additional out-of-pocket costs. Studies have also shown those who delay or space out vaccines are less likely to receive all of the recommended immunizations than those who follow the schedule.

So what should concerned parents do? The best course of action is to speak to and trust in your child’s pediatrician. Not only ask the doctor your questions, but also ask about reliable sources of information, and what your doctor does for his family with regard to vaccination. Once you’ve consulted your child’s doctor and the information he provided you, it is likely that you will feel much more comfortable with the choice to vaccinate according to the recommended schedule.

For more information on the recommended childhood immunization schedule and common vaccine-related questions, consult the following resources:

• Recommended Immunization Schedule: What You Should Know [PDF, 338KB]
• Too Many Vaccines: What You Should Know [PDF, 319KB]
• The Facts About Childhood Vaccines [PDF, 346KB]
• “The Problem with Dr. Bob’s Alternative Schedule” (paper)
• Vaccines and Your Child: Separating Fact from Fiction [PDF, 1.5MB] (book)
• Vaccines and Your Baby [PDF, 4MB] (booklet)

If you have additional vaccine-related questions, please email the Vaccine Education Center at contact PACK@email.chop.edu. However, please remember that we cannot answer specific health questions for an individual patient. Questions related to your child’s particular situation should be discussed with your child’s doctor directly.