Three quarters of pediatricians report being asked by parents to use “alternative” vaccination schedules, according to a recent study led by Aaron Wightman, MD, of the University of Washington in Seattle, and reported on by Reuters Health. And most pediatricians were willing to stray from national vaccination schedules for some infections to meet the parents’ wishes. The problem is that the more children in a community who go unvaccinated, the higher the chances that others will be infected-even those who’ve been vaccinated themselves.
For the study, researchers surveyed more than 200 Washington pediatricians about requests by parents to delay or skip vaccinations. Seventy-seven percent of respondents said that parents “sometimes” or “frequently” asked for changes to the vaccination schedule, and 6 out of 10 pediatricians said that they were comfortable doing so if asked. The pediatricians surveyed indicated that they’d be more likely to delay or skip a child’s vaccination for diseases that are considered to be less immediately dangerous, including hepatitis B.
“It’s kind of a slippery slope,” said Amanda Dempsey, MD, PhD, MPH, a researcher of pediatric infectious diseases at the University of Michigan in Ann Arbor who wasn’t involved in the study. Delaying any vaccine, she warned, “undermines the importance of the schedule in general.” Other studies indicate that when parents delay or skip vaccinations for their child, it’s because of safety concerns such as the now-disproved link between vaccination and autism.
Decreased immunization increases the likelihood of disease outbreak, said Dempsey, whose research indicates that up to 10 percent of parents use an alternate vaccination schedule, with 2 percent skipping vaccinations entirely. Furthermore, since vaccination is not a 100 percent guarantee against infection, even kids who receive vaccinations are at increased risk when their peers aren’t vaccinated. Dempsey warned that the Washington study “suggests to me that it’s possible that this may become more the norm in the future, as more and more pediatricians are being asked to do this.”
The Advisory Committee on Immunization Practices (ACIP) recommends that all infants receive three to four doses of hepatitis B vaccine, with the first dose administered before hospital discharge and the remaining doses spaced out over the following 4 to 12 months on a schedule determined by the child’s pediatrician. Children and adolescents who have not been vaccinated or whose vaccinations were incomplete should be vaccinated at the first opportunity.