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The Power of Words: A Commentary on the Delayed Vaccine Schedule

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

I recently read a post by Dr. Bob Sears on his website that listed several “Vaccine Friendly Doctors” in Colorado and across the nation. His article can be viewed here.

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 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. This nonprofit 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, bring their questions to their physician and makes fully informed decisions about their child’s health.

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Comments
  • comment avatar Rajean August 12, 2009

    Dr. Perry,
    This is helpful information. I would consider you a vaccine friendly doctor. I think it’s not only crucial but also ethical for physicians to listen to what concerns or questions their patients may have about their own health care or that of their children and then provide them with feedback and options so that an informed choice can be arrived at together.

    Just last week my son had four shots, actually six, I believe, immunizations at his two year exam. Two nurses tag-teamed to give him two injections in his arms and two again in his thighs to catch him up to the AAP & CDC’s vaccine schedule. I am pro immunizations, but that experience led me to a quesiton I thought you might be able to address.

    Can pharmaceutical companies work to develop the vaccines for infants and children in an oral form, rather than by injection? And if they are doing so or can do so, will physicians support this less-invasive means of administering the vaccines? I don’t think it’s healthy for children to be frightened about going to their doctor for well-child exams or any other visits for that matter. It is not a good ‘first impression,’ of the health care industry. It’s also not easy for parents to explain to their children how ‘we are helping you by hurting and scaring you.’

    I look forward to your feedback. Thank you.

  • comment avatar Amber August 12, 2009

    I had never heard of the delayed vaccination fad until last year. I am an advocate for vaccinations and I understand that some people refuse to vaccinate. However, the delayed vaccinations never made sense to me. Good to know there is little/no scientific backing.

    By the same token, moms everywhere should be sure to research any decision regarding their children’s health. I know too many who are quick to jump on the bandwagon.

  • comment avatar Kristina Reilly August 12, 2009

    Dr. Perry is part of a great team at Cherry Creek Pediatrics. Not only are they great at listening to parents concern about vaccination, they are also amazing at treat a child in a way that will best prerve their overall health. Antibiotics are only subscribed as neccesity, not as a requirment.

  • comment avatar Jess August 12, 2009

    While I appreciate the perspective in this article (Yay for not coming across as judgmental!), those of us who have chosen to delay vaccinations are not doing it based upon a sudden onset of “causing trouble syndrome”. I researched for nearly a year before deciding our vaccine schedule. I took into account the “little/no scientific backing”, along with my family’s physiological response to most vaccines, and what felt right to me.

    While I don’t believe, for one second, that following the CDC’s guidelines makes Dr. Perry an “unfriendly doctor”, I also don’t believe my choice to delay vaccinations makes me a crazy, nonsensical, trouble-maker who can’t think/research for herself.

    Please, feel sure in knowing most of us who are choosing to be on a delayed schedule know what we’re getting ourselves into. While it may make no sense to you, it does to us.

  • comment avatar isles August 12, 2009

    Thank goodness for pediatricians who know their stuff and can convey it clearly. (That’s you, Dr. Perry!) Anyone who cares for children should be worried about the fad of parents leaving their babies unprotected from dangerous diseases.

  • comment avatar Jennifer August 12, 2009

    I don’t follow the CDC recommendations, but I also don’t follow Dr. Sears’ guidelines, either.

    I don’t consider it a fad to be conservative in giving vaccinations, and I think it’s unfair to make such generalizations. Of course I care for children; it’s just insulting to imply otherwise. Parents often have exceptionally good reasons for being hesitant about vaccinations. For example:

    My oldest had reactions to his first 2 pertussis shots, leading me to decline the third and get only the Diptheria and Tetanus. Later I discovered that children who had a difficult delivery and potential head trauma (my son was delivered w/ forceps and had seizures following his birth–he’s great now, thankfully) should not receive the Pertussis vaccination because they may have an adverse reaction. My doctor obviously didn’t know this.

    With all due respect to Dr. Perry (and I know Cherry Creek Peds is a great office), doctors are not perfect, and the medical community has made mistakes in the past: mercury in vaccines to name just one. I’d be much more comfortable with the medical community if they would acknowledge that they’re not perfect, that medicine is not an exact science, and that the recommendations could change tomorrow, based on new research and information.

    I agree that we need to eliminate things like measles, mumps, rubella, etc. They’re dangerous, no question. But I also think parents should be allowed to do as they see fit, and take responsibility for their decisions. When I heard that whooping cough was going around last year, you can bet I kept my kids in, since my oldest is not fully vaccinated. That’s me taking responsibility for my decisions. I’ve followed a conservative schedule with my younger two (e.g., no chicken pox vaccine unless they haven’t gotten it by kindergarten), and, again, keep them out of harm’s way if it looks like something is coming down the pike. I don’t expect to benefit from the “herd vaccination” notion, I just want to do what’s best for my kids.

  • comment avatar Apples August 12, 2009

    Dr. Perry is my kids’ ped, and he has in fact listened to our concerns and supported us in skipping flu vaccines. Whether you agree with him or not about the CDC protocols, you can trust his opinion here. Thanks Steve.

  • comment avatar Holly August 12, 2009

    I think that each parent needs to do what is best for their kids. Yay for researching and taking responsibility for whichever side you stand on regarding vaccines. I think we need to respect an educated decision and not bash others, including not calling CDC following doctors ‘non-vaccine friendly’. We do follow the CDC protocols and go to Cherry Creek Peds, but a lot of that decision was based on the fact that many parents aren’t giving their children vaccines and we were traveling with our kid at a super young age, so we wanted to protect him against what could be lurking out there.

  • comment avatar JoAnn August 12, 2009

    It’s great to get Dr. Perry’s perspective on this!

    I love our pediatrician, I am so thankful that we have access to such wonderful medical care AND the vaccines that are needed. It’s something that we take for granted.

  • comment avatar Dr. Steve Perry August 13, 2009

    Thank all of you with your insightful responses!

    As a pediatrician I have learned that the most important thing I can do is to listen to parents concerns and opinions. All parents want to do the best for their children and I never try and pass judgment, even when it comes to vaccinating. Vaccinations have become quite complex over the last 20 years and parents need to have trusted resources they can turn to to get the best advice they can.

    To answer Rajean’s question, unfortunately there are no oral vaccines being developed right now in the US. There is a nasal flu vaccine that is available for children over 2 and this is a very popular vaccine in our office! I tell 4 and 5 year olds every day that the shots are important to stay healthy and to go to school. Not too many kids (or adults) like shots, but you always want to consider the alternatives: serious diseases which are preventable.

    A short anecdote from today: I asked a mom if she would want her 5 year old’s vaccines split up today and come back in 2 weeks to get the second half: she laughed and I could not imagine putting the 5 year old through that either. Just some food for thought for when you are deciding to bring infants back for the altered vaccines schedule.

    — Dr. Perry

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  • comment avatar dt August 13, 2009

    So are any of you who follow the “delayed” schedule because you “considered your family’s responses” and “considered the alternatives” — are any of you actually trained in the science behind the vaccinations? Or, are you simply doing “warm and fuzzies” based on something that “sounds good” even though you don’t know the science behind it? And why are you paying for twice the number of doctor visits? Also, have you considered that by delaying YOUR child’s vaxxes, you are putting other children (young ones who haven’t yet been vaccinated) at risk for catching the diseases the vaccinations prevent? Also, will you take responsibility when your “delayed vax” child gives measles to a pregnant mother who didn’t know your child wasn’t vaxxed — thereby putting HER unborn child at risk?

    Please think through ALL the ramifications of your delayed actions — don’t just think of yourselves — but of the people with whom your child comes into contact. You don’t just harm them — you harm non family members as well.

  • comment avatar dragonet2 August 13, 2009

    I am not a parent*. But I am aghast at this new “trend” in public health.

    For one big reason. I AM old enough to remember:

    People crippled by polio, AND we’ve now learned that once acquired, polio lays dormant in the nervous system and can pop back out in the 50-60-year-olds and make them crippled in new and different ways.

    People rendered blind or deaf by measles, or heart murmurs caused by rubella (mother in law has this, has a pacemaker, BUT she’s 95 now and perking along well). Mumps can cause sterility in both sexes.

    All the diseases that vaccination prevent can also just kill an infant dead. Whooping cough is horrible in an infant/toddler.

    The “herd” has to have enough immunity to prevent illness. Especially because there ARE a few infants that cannot be vaccinated for health reasons. If, say, no one is vaccinated for whooping cough and it blasts through your community, your fragile, sick infant would be likely more exposed because no other child has immunity.

    This whole trend leaves me stunned and stupified by people who want to leave their precious children exposed to really dangerous diseases.

    * There are a large number of children in my life, and some who consider me another parent because I’ve been involved with them pretty much before they were out of their mommas. I would not wish any of the illness that not vaccinating would cause on any of them. And I love them all beyond belief.

  • comment avatar Mike August 13, 2009

    A point of clarification on the use of mercury in vaccines. The mercury compound found in vaccines is ethyl mercury, which is easily confused with the better known methyl mercury. Methyl mercury is the kind we’re warned about when eating seafood; it accumulates in living tissue rather than being expelled, and can build up in the food chain until it reaches toxic levels. As for methyl mercury, it is known that it does not accumulate in organisms but is eliminated almost immediately. Although the toxicity of ethyl mercury has not been as thoroughly studied as that of methyl mercury, the amount that was used in vaccines was far below the known toxicity levels of other mercury compounds. Its safety can be assumed based on the actual amount of mercury, which is the toxic substance in the compound and for which toxicity levels are known.

    Similarly, vaccines do not contain anti-freeze, but a compound with, again, a similar sounding name.

  • comment avatar Soren August 14, 2009

    to Jennifer:

    Mercury in vaccines was, and is not a mistake. It is perfectly safe, and not harmful side effects of it has even been shown.

    No one claims that the medical, or pharmaceutical, industry is perfect. There are many mistakes. But vaccination is not one of them. We know some people have adverse effects when receiving a shot, but most people have no serious side effects, indeed the side effects are nothing compared to the terrible diseases the vaccines prevent.

  • comment avatar shawmutt August 14, 2009

    Thanks Dr. Steve Perry. We need more rational, educated voices like yours out there to counteract the anti-vax woo.

  • comment avatar Dawn August 14, 2009

    Very good comments to read. Dr Perry, I know many doctors like you and think you are all great.

    @Jennifer: as long as you are discussing the vaccines with your doctor and taking responsibility (as in keeping your not fully immunized child in during a pertussus outbreak), I think that is fine. If your oldest reacted to the first 2 DTaP shots, then it makes sense not to continue with them but to substiture the TD. That is what a responsible parent/doctor team does. They work together to safely immunize a child as close to schedule as possible.

    I had never heard that a traumatic delivery could lead to reactions to the DTaP. Where did you learn that? Sounds interesting.

    Chicken pox…I wish my kids could have had the vaccine instead of the disease or a milder case of the disease with the vaccine. My older child, who got it from younger sibling, was VERY ill, wouldn’t eat/drink due to pox in the mouth that made it painful, couldn’t sit because the entire perineal area was covered with pox, couldn’t lie down because the whole body was covered…it was a very miserable week. Child ended up with an IV to ward off dehydration and pain killers (at age 5!!!). Far more traumatic then a shot would have been. (My MIL said that child should be “immune forever” based on how much toxin she had in her body, but recent levels before college showed her as normally/low immune. At that time they didn’t recommend vaccination but said to check later on in life. The MD also warned…and I don’t know if this is true or not…that since the child was so ill, child may be more prone to shingles flare ups!!!!)

    Gardisil vaccine has been discussed in our house for eligible children. We are letting them decide the pros and cons, but so far the eligible ones had decided to have the series. My husband and I stayed out of the decision making entirely.

  • comment avatar Erika August 14, 2009

    I personally think any delayed vaccination schedule is a reasonable compromise for parents who wish to have their children fully vaccinated but are uncomfortable with filling a child’s body with so many different things before age 2.

    My questions about vaccinations started on day one. I wondered out loud … If Hep B is transmitted sexually or through blood, why would my brand new baby need to have such a vaccine?

    The Sears book was *one* source I turned for answers to such questions.

    I chose to delay many of my daughter’s vaccinations. Not because I don’t believe in vaccinating her, but because I do believe in having a general understanding of the contents of an injection before allowing it to go into such a small person! I am a first-time parent who wants to be armed with knowledge so I can have an educated discussion with my daughter’s pediatrician about her care. I continue to be *overwhelmed* by the number of vaccines recommended for our kids before the age of 2 … And, after talking to her pediatrician, learned that yes, some of them can be deferred until the child is a little older and has a more mature immune system. I don’t (by any means) claim to be a doctor … just a parent who chooses to make informed choices based on information from several different sources.

    The pediatrician we use is Dr. Noah Makovsky — and although he is (also) not on Dr. Sears’ list, he’s always been very open, honest and caring in regard to our choice to delay certain vaccines. He also takes the time to discuss benefits and risks of each vaccine before administering the shots. Through my own research and dialog with Dr. Noah, many of my own fears have been eased in regards to certain vaccines— especially MMR, which I now believe has a lot of misinformation swirling around it.

    I intend to have my daughter fully vaccinated before she starts school but this delayed schedule has allowed her little body more time to grow before getting all of them. After all of the conversations and research, it felt like the right thing to do.

    I applaud any doctor who can be compassionate with confused, overwhelmed parents to help ease their fears when it comes to their children. I also applaud those who willingly work with the parents of their tiny patients to provide the best care possible — whether he/she is listed as “vaccine friendly” or not.

  • comment avatar Erika August 14, 2009

    And Dr. Perry — for what it’s worth, you sound like you *are* a Vaccine Friendly Doctor … just … maybe not a “Sears-endorsed” doctor. I took the Sears book with a grain of salt and used it as a conversation starter with my daughter’s doctor. I never saw the book or their proposed vaccine schedule as a biblical source.

    I understand your point about using words that may potentially confuse people — all the more reason to maintain an open dialog with your patient’s parents. I know your practice is highly recommended by doctors and parents around the metro area and there is no greater praise than the word-of-mouth endorsement of a happy parent … who has a happy, healthy child.

  • comment avatar Hawk August 14, 2009

    Re: Erika – You said, “My questions about vaccinations started on day one. I wondered out loud … If Hep B is transmitted sexually or through blood, why would my brand new baby need to have such a vaccine?”, – Does anyone, other than you and your spouse, ever hold your new baby? A relative? A friend? Have you ever seen someone get a sudden nosebleed? Are you 100% positive that everyone who comes into contact with your baby has washed their hands after possibly handiling bodily fluids? (a bit of a gross thought – but having been in the military, and having worked in nursing homes and hospitals, I have seen some things that would surprise you). Granted, it is fairly unlikely that your baby will be exposed to Hep B, but is that a bet you really want to make?

  • comment avatar Erika August 14, 2009

    Hawk,

    You made an assumption that we did not vaccinate against Hep B. We did. I stated only that I had *questions* that started on day one and that all of the possibilities were overwhelming. Weighing the risks and benefits is part of the process. No vaccination decision is taken lightly.

  • comment avatar Brad Feaker August 16, 2009

    A voice of sanity. Bravo Dr. Perry.

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  • comment avatar Albert August 17, 2009

    @Erika

    Although I applaud you for vaccinating your child and researching, I think that some of your logical conclusions are faulty. You are not “filling a child’s body with so many different things before age 2.” A common cold would expose the child to far more virus particles as well as number of antigens compared to the entire immunization schedule for a child. We (I’m over 40) had more antigen exposure from a single smallpox vaccine than compared to all the current childhood vaccines combined. Please see the following at Science Based Medicine for more information.
    http://www.sciencebasedmedicine.org/?p=289#more-289

  • comment avatar Mother of two September 10, 2009

    I’m not sure if all of you are really understanding a concerned parents point of view. It’s not that I don’t understand the importance of immunizations because I fully believe in them. However, I feel that the child’s system is not always able to handle all of these shots at once. I read the side effects for some of these immunizations such as DTap and they can be life changing. I will not play Russian Rulet with my child. Go to the web site http://www.thinktwice.com. These are real parents dealing with the loss of their child/ children because of the side of effects from different immunizations. Also some Dr’s are linking SIDS and Autism to immunizations. In the 1950’s Autism was 1 to 10,000 after a particular immunization was released that number is now 1 to 150. Until there is evidence to support the fact that none of this is related I will continue on a delayed schedule.

  • comment avatar Audra October 9, 2009

    @Albert

    We actually are “filling a child’s body with so many different things before age 2.” It’s not just viral particles and antigens. Here’s a list of other ingredients found in vaccines including known neurotoxins:

    Aluminum Hydroxide, Aluminum Phosphate, Bovine Protein, Lactalbumin Hydrolysate, Formaldehyde or Formalin, Glutaraldyde, Monkey Kidney Tissue, Neomycin, 2-Phenoxyethanol, Polymyxin B, Polysorbate 80 Yeast Protein, Thimerosal [a vaccine preservative that is approximately 50% mercury by weight], gelatin, ammonium sulfate, aluminum potassium sulfate, Bovine Extract, sodium phosphate.

    @Everyone

    Here’s a newsletter from Dr. Jay Gordon:

    2/16/09
    “This past week three decisions were handed down denying that vaccines caused autism in three children. The cases are known as “Cedillo,” Hazlehurst,” and “Snyder” and were decided by three separate “Special Masters.”
    The simplest analogy involves the countless dozens of court decisions about cigarettes and cancer over the past fifty years. There was no “proof” which satisfied courts, judges and juries for decades. Common sense and eventually the scientific community and the government finally acknowledged that the tobacco industry was at fault. The same will be found true of the vaccine manufacturers, but I hope it doesn’t take fifty more years.
    The pharmaceutical industry controls which research gets into journals and which does not. This creates public perception of vaccine risks and benefits which may be at odds with what is actually observed in the medical community.
    The “Vaccine Court” has already awarded over two billion dollars in compensation to families who successfully showed that they or their children had suffered harm from routine vaccination.
    I have worked with hundreds of parents who are completely certain that their children were “normal” prior to receiving certain vaccines and then developed autism and other problems within a short period of time after getting the shots.
    This is most definitely not scientific proof, but I cannot ignore thirty years of my own personal observations and experience.
    I’ve received a lot of email this week about the rulings of the Special Masters of the U.S. Court of Federal Claims. The complete decisions can be found here:
    http://www.uscfc.uscourts.gov/node/5026
    “It’s a great day for science and I’d like to think it’s also a great day for children with autism,” said Dr. Paul Offit, chief of infectious diseases at Children’s Hospital of Philadelphia and co-inventor of the rotavirus vaccine (a standard childhood immunization that does not contain thimerosal).
    The latest estimate is that Dr. Offit’s share of the Rotateq revenues is $29,000,000 to $55,000,000. I think he has a conflict of interest here.
    Selectively and slowly vaccinating our kids is the safest course of action.”

    http://drjaygordon.com/development/index.asp

    I just hope that parents do their own research before they start vaccinating their children and do not blindly trust their doctors. Doctors mean well, but they are like everyone else, human. There are 100 medical mistakes a day, 100,000 people die each year, and 1,000,000 people have excess injuries each year from medical error.

    http://en.wikipedia.org/wiki/Medical_error