AAP: Delayed Vaccines Too Risky for Kids

re: AAP: Delayed Vaccines Too Risky for Kids

Cynthia again — Mon, 05 Jan 2009 21:33:02 GMT

Sorry, god forbid I sound judgmental on busy parents (you should see my house, and I only have one kid!) I simply meant that for instance, the Hep B vaccine given to newborns is an example of "let's get the shot in while we've got them there" (except of course in the cases where the mom's infected). I like the Sears book because it offers options -- if you are a paranoid parent, or suspect your kid is higher-risk, then the delayed schedule seems prudent and gets all the imp shots in. If you are an efficient, non-paranoid parent, then by all means follow the official schedule (and the book provides info to show you that the vaccines are valuable and worthwhile). While the environmental effects on autism are still so poorly understood (but we do know they exist), a little flexibility will keep everybody happy -- after all, EVERYONE is worried about the health of their children, we should all be on the same team.

I might add, in terms of adults being lazy -- how many adults around your children have gotten a pertussis or flu vax? That's also a nice way to protect the kids, but few bother...

re: AAP: Delayed Vaccines Too Risky for Kids

gpgirl — Wed, 31 Dec 2008 17:11:47 GMT

LogicalMama, I'm sure you have a lot of other reasons for deciding to delay your kids' vaccines, but saying that the schedule is set up for the convenience of the doctors and nurses puzzles me. The implication is that they care more about their own convenience than your child's health. Why would they go into this profession? Pediatricians make surprisingly little money, and that is after many years of schooling they have to pay off. Because of our current insurance system, their job includes a ton of paperwork they mostly have to do after-hours. Maybe I am lucky, because our pediatrician is wonderful. I have called him many times with questions that were not even directly health related (feeding, sleeping, etc.) and he always calls me back and takes his time to answer. (Usually during his lunch break or after-hours.) The same with our appointments. Why would having to deal with a toddler (which the parent has to hold down anyway and console after the shot) make a big difference compared to everything else they do?

I really would like a logical argument about vaccine schedules, but comments like yours make it look like people are not thinking things through very clearly.

re: AAP: Delayed Vaccines Too Risky for Kids

LogicalMama — Wed, 31 Dec 2008 04:56:17 GMT

Let's face it, isn't the vaccine schedule set up for the convenience of the doctors and nurses that administer the shots? Isn't it easier to give five shots to an infant that a parent can hold down than a squirmy, stronger, fighting toddler?!

I delayed with my son and seriously, the most unattractive thing about it was his ability to react at a later age! Had I done his shots at the suggested scheduling, not one instance of resistance would have happened! But I don't regret it and I'd do it that way again without a second thought! Afterall, it wasn't about me or the doctors or nurses, it was what I felt (after making a fully-informed decision) was best for my child!

re: AAP: Delayed Vaccines Too Risky for Kids

BettyWu — Wed, 31 Dec 2008 03:54:49 GMT

Cynthia, thank you for a reasoned and non-hysterical response. The other commentors are correct, we need more of that. But one sentence in your comment jumped out at me;

"The AAP seems so dogmatic on the vaccine issue, which doesn't help parents to feel their concerns are being respected"

My in-laws feel that the devil and Democrats are turning everyone gay. They are concerned that their grandchildren knowingly consort with the children of 'shudder' lesbians.

Sorry to be so dogmatic, but I do not respect their concerns. Ditto their concern about teaching creationism as science in public school.

Sure that's an overblown analogy, but I stand by the inference. If a concern is shown to be erroneous or, in this case, erroneous and potentially dangerous, it is owed no 'respect'. What it is owed is a clear and timely refutation.

re: AAP: Delayed Vaccines Too Risky for Kids

gpgirl — Tue, 30 Dec 2008 23:14:33 GMT

Manda, the reason the vaccine court was put into place was to assure the supply of vaccines. Usually, if something is perceived to go wrong with a drug, the drug company gets sued. However, civil courts are notorious for practicing junk science, and money is often rewarded even when there is no proof that the drug actually caused a problem. Since most vaccines have very low profit margins, drug companies would stop making them if they had to defend them in court in today's atmosphere. The government saw this as a major threat to public health, so they created the vaccine court. The vaccine court was NOT put in place because "it is known that a certain number of children will get sick or die from routine vaccines", as you say.

I do agree that there should be a dialogue about vaccine schedules. My problem is that people often present false information. Then people make decisions based on bad info. The media is notorious for doing this, since sensationalistic headlines sell.

I actually thought Cynthia's argument was a pretty good one - until she labeled parents who could not make all the extra vaccine appointments as "lazy". What I have seen happen is that people decide to vaccinate per Dr. Sears schedule, then reality sets in. (They go back to work, etc.) They can't make the extra appointments, then more and more vaccines get delayed for a prolonged period. These people are not lazy, but it is difficult to justify the extra time off of work (especially for those paid by the hour).

I do have one question that I am not clear about. I have read that the toxins in vaccines are similar to, but much lower than, the toxins that we are exposed to everyday. Does anyone have any more information on this, of if this is exaggerated? Thanks.

re: AAP: Delayed Vaccines Too Risky for Kids

Manda — Tue, 30 Dec 2008 21:58:09 GMT

Thank you Cynthia for your intelligent commentary. I appreciate your response quite a bit. I think that it is unfortunate the dialogue around vaccines, how and when and if, has become a debate and a debate that is often seen to have two sides : 1) All vaccines, all on-schedule and 2) NO vaccines.

My doctor who has done significant research on vaccines strongly encourages a delayed schedule. His comment and I have found this to be true in some of the research I have done, was that most vaccine studies look at low-income or populations considered at-risk in some way. Usually, at-risk for poor wellness care. Thus, the question that many of the studies answers is: is it better to vaccinate a child with many vaccines, all at once, or to not vaccinate them at all. This isn't necessarily the question that a parent is (or even should be) asking. For instance, if your child has certain sensitivities (keep in mind that the vaccine courts did just rule for the first time in a case where autism was shown to have been caused by a vaccine and exists at all because it is known that a certain number of children will get sick or die from routine vaccines), you might wonder if the benefits to your child outweighs the risks.

Even if your child has no sensitivities, it is a case of cost benefit analysis. Vaccines have risks. Not vaccinating has risks. It is not just as simple as one side being right. For many, vaccinating on schedule has fewer risks than not. For some, vaccinating, but delaying those vaccinations actually decreases the risks. And, for others, not vaccinating at all is the least risky answer.

The question, however, is usually far more complex than we make it out to be.

re: AAP: Delayed Vaccines Too Risky for Kids

Michelle — Tue, 30 Dec 2008 21:45:52 GMT

I am using Dr. Sears vaccine book as well. It explains what is in each vaccine, what it prevents and I've found it to be very helpful.

re: AAP: Delayed Vaccines Too Risky for Kids

Cynthia — Tue, 30 Dec 2008 21:20:34 GMT

Personally, I really appreciate Dr. Sears' vaccine book. I should note that I am a working research biologist -- I am used to the process of trying to make an intelligent guess of reality based on incomplete, sometimes confusing and conflicting information, and a dose of common sense -- that is all science is, I'm afraid, and medicine too. Clinical trials do not always provide clear answers even when available -- particularly for highly variable, small effects. Dr. Sears' book is the first source to take a cost-benefit analysis approach to the vaccine question -- it doesn't have to be all or nothing. How to maximize the benefits to the child while minimizing the costs (possible dangers)of vaccinating? There are two common sense reasons to spread out the vaccines a little -- to allow the body to process and remove the aluminum added as an adjuvant, and to minimize the side-effects of the immune response itself. As long as the parents are willing to go to the extra hassle of keeping track of the alternative schedule and more visits, why not allow it? The AAP seems so dogmatic on the vaccine issue, which doesn't help parents to feel their concerns are being respected. I recommend reading the book before snarking off on Dr. Sears -- it is well-written and very reasonable, and not at all "anti-vaccine". I might add, obviously even the AAP wouldn't recommend doing, say, all several-dozen vaccinations at once on one day -- intelligent people can reasonably disagree about what is the ideal schedule. The official one is skewed towards making vaccinations fit efficiently into the typical ped visits, so lazy parents don't flake -- good from a public health perspective, not nec ideal for my child.

re: AAP: Delayed Vaccines Too Risky for Kids

patricia — Tue, 30 Dec 2008 21:13:40 GMT

Poppet and gpgirl and others here, thanks for the useful information. I am not and never have been anti-vax, but my first daughter is susceptible to febrile seizures, two of which have happened the day of a regularly scheduled shots visit (she's had 4 in 2.25 years). I can't say for sure if the shots caused or exacerbated the fever that caused the seizure (in one case she was ill with pneumonia and an ear infection at the time, both of which had been undiagnosed until we were in the hospital for her seizure), but I'd rather minimize that risk if I can. I don't know if breaking them up slightly (as Poppet suggests) might help with that potential issue with my second baby, but I have the time to make extra doctor visits and it sounds like there isn't much risk with spreading the schedule out slightly. I plan to discuss with my pediatrician, of course, but I'd like to have some thoughts formulated before we discuss it, and you guys have given me some stuff to think about.

re: AAP: Delayed Vaccines Too Risky for Kids

Laura — Tue, 30 Dec 2008 19:54:14 GMT

Is Dr. Sears an actual doctor, or is he a "doctor" in the Dr. Phil vein?

At least Dr. Sears admits that his opinion is crap.

re: AAP: Delayed Vaccines Too Risky for Kids

gpgirl — Tue, 30 Dec 2008 19:16:56 GMT

Poppet, you are talking about splitting up the shots by a week, which would mean the baby would still get the vaccinations according to schedule. (Not everyone goes to the 2 month visit on exactly the 2 month birthday. It can even be a few weeks later and still considered on time. Therefore, you are still giving your baby all the shots on time.) You just have to make extra doctor visits, which as you say is not feasible for everyone.

I think what the AAP is concerned about is someone who would delay a vaccine by a much longer time.

btw, HepB is not only an STD. There are many other ways to get HepB. (It is much easier to catch and lives longer in the air than HIV.)

re: AAP: Delayed Vaccines Too Risky for Kids

ticktock — Tue, 30 Dec 2008 19:03:46 GMT

I spaced out my daughter's vaccines because I was scared of all the hype. Now I'm a vaccine advocate.

Spacing out vaccines and separating them only means more shots and more doctor visits. Dr. Sears has no good excuse for his alternative plan. The only justification he can give is that it gives parents who wouldn't normally vaccinate permission to immunize their children. It's all smoke and mirrors.

re: AAP: Delayed Vaccines Too Risky for Kids

Poppet — Tue, 30 Dec 2008 19:02:12 GMT

I'm not a believer in the theory that vaccines cause autism, but I do see the sense in splitting up vaccines for my baby. At his 2-month-old visit, he was slated for SEVEN immunizations...SEVEN. My husband has Type I hypersensitivities and I have autoimmune problems, so I'd rather not set the kidlet's immune system on fire if there's a gentler option. He gets half his shots on one visit, half a week later. I've had some training in immunology (science degree, worked in clinical drug trials for a number of years), so if there's a good reason NOT to split them up, I haven't heard about it.

My feeling is that the AAP wants to make sure that children get all their immunizations while parents are heavily invested in taking children to the doctor...hence the recent push to immunize babies against HepB, an STD. It's far easier to have parent immunize infants when they are seeing a doctor for the lengthy series of shots rather than the somewhat spotty track record of a busy young adult who may not have time or money to keep up with immunizations.

re: AAP: Delayed Vaccines Too Risky for Kids

Donald — Tue, 30 Dec 2008 18:52:03 GMT

In response to km: No doctors practice medicine and a large part of that includes the practice of science there is no right or wrong answer, it's only what the evidence shows. As it stands now vaccines have saved millions of lives and their has been no evidence put forth showing any benefit of delayed schedule.

So doctors get tired of answering the same questions that they get from parents who get these ideas from misinformed media outlets and completely wrong celebrities, so they want to make a loud a clear statement about what the evidence shows is best for your children.

It may seem cruel to be so direct, but if someone was endangering your child you would be to. Every doctor out there wants to make sure you know that delayed schedules are a sham and a danger to your child.

If you would like some science and numbers behind it

here you are: www.sciencebasedmedicine.org

if you want the to long to read version, here you are.

"What vaccinations offer is small, controlled, harmless amounts of antigens and neutered pathogens, rather than the prodigious free-for-all of morbidity and mortality from natural disease.

No matter how you slice it, the vaccine schedule represents a minuscule exposure to antigens and organisms compared to what people encounter as part of life. Worrying about the exposure from the vaccine schedule is like worrying about a thimble of water getting you wet when you are swimming in an ocean".

re: AAP: Delayed Vaccines Too Risky for Kids

gpgirl — Tue, 30 Dec 2008 18:39:12 GMT

km, where did you get the idea that the AAP fights clinical trials for alternative schedules? They have no power against someone who would propose such a clinical trial. Are you saying they will not let someone perform a trial, or that there are trials out there they are trying to hide?

Please let us know where you got this info. Otherwise, this sounds like another anti-vac scare tactic.

By the way, of course there is nothing wrong with investigating risks. That is why there are so many studies that have been performed that show vaccines are safe and effective.

The reason the AAP screams "blue murder" when someone talks about risks is because these risks that people talk about have no scientific basis. Without scientific data, I could say anything is a risk. For example, people smoke less now, and there is a higher rate of autism, so why not say smoking prevents autism. This may sound ridiculous, but this is the same kind of logic that allows people to justify saying vaccines cause autism.

re: AAP: Delayed Vaccines Too Risky for Kids

km — Tue, 30 Dec 2008 18:18:26 GMT

There are no clinical trials on alternative vaccination schedules because the AAP fights them tooth and nail. I understand that the AAP want parents to perceive vaccines as safe, but they think that the way to do this is to scream blue murder any time someone talks about risks.

Vaccines, like any medical procedure, carry risks as well as benefits. There is nothing wrong with investigating possible ways to mitigate the risks.

re: AAP: Delayed Vaccines Too Risky for Kids

Knitty — Tue, 30 Dec 2008 17:36:44 GMT

"What kind of doctor writes a book giving a recommendation based on nothing but some kind of feeling he has?"

The kind who should be ignored, but he's got a whole cult going.

re: AAP: Delayed Vaccines Too Risky for Kids

DrV — Tue, 30 Dec 2008 17:26:46 GMT

"A book based on a feeling" Kind of sums up the antivax movement. Read this beautifully written article and tell me how anyone can justify Sears' blue sky rationale.

re: AAP: Delayed Vaccines Too Risky for Kids

gpgirl — Tue, 30 Dec 2008 17:26:34 GMT

Clara - I'm sorry but I don't really understand. Are you saying that, instead of getting a series of shots of a particular vaccine spaced out, kids should get them all at once? If that is what you are asking, that will not work. The vaccines are designed to be given as indicated. That is, if you are supposed to get 3 doses, 2 months apart, you cannot combine them all at once, or else the vaccine will not be effective.

Maybe I completely misunderstood?

re: AAP: Delayed Vaccines Too Risky for Kids

clara — Tue, 30 Dec 2008 17:13:23 GMT

Correct me if I'm wrong, but an infant, with an immature immune system has to get about 3 or 4 doses of a shot by the time he is 1. He is not considered protected until he is 1. So, why not just wait until he is 1 and then give 1 shot instead of a bunch of doses? Even if its more than one shot at 1 yr old, he would be stronger and less likely to have a reaction. A child under 1 has no protection until he has the full series, so why bother immunizing an infant?

re: AAP: Delayed Vaccines Too Risky for Kids

gpgirl — Tue, 30 Dec 2008 17:03:39 GMT

What kind of doctor writes a book giving a recommendation based on nothing but some kind of feeling he has?

On the other hand, if it is a choice between not getting the vaccinations and delaying them, I guess delaying is better. However, since all of the evidence points toward getting the vaccines per the recommended schedule, I don't see why anyone would want their young child to be susceptible to a disease when there is a safe, effective alternative.

re: AAP: Delayed Vaccines Too Risky for Kids

Kelly — Tue, 30 Dec 2008 14:30:00 GMT

I have a 17month old so we are almost done with all the vaccines. However I did read Dr. Sears' book and I decided to just ask my pediatrcian what she thought of breaking them up. Logically it does not seem like a good idea to me to shoot a baby full of five shots in five minutes. I am not a Doctor, but the advice given to me by ours was to take three of them and come back for the other two. I was late in the game with Sears' book.

All that to say, I would rather see them spaced out than not to have them at all. I think it poses a greater health risk to the masses to have a measels outbreak.