Many parents request delays in vaccine schedule

NEW YORK Mon Nov 28, 2011 5:49pm EST

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NEW YORK (Reuters Health) - More than three quarters of pediatricians said they sometimes or often get asked by parents to use an "alternative" vaccination schedule that strays from national recommendations, according to a new survey of Washington State doctors.

And while almost all of them agreed with the current vaccination schedule for babies and young kids, and would follow it for their own child, most pediatricians were willing to give in to parents' wishes to delay vaccines for infections like chicken pox, hepatitis B and measles.

"I was a little surprised at the high level of pediatricians who reported having parental requests for (alternative schedules)," said Dr. Amanda Dempsey, who studies immunization and infectious diseases in kids at the University of Michigan in Ann Arbor, but wasn't involved in the new study.

"This seems to indicate that this is an ever-increasing problem."

Recent studies have shown that more parents are delaying or skipping certain vaccines, typically citing safety concerns, such as a link between vaccines and autism -- a theory which scientists now agree holds no water.

Researchers worry that with an increasing number of kids unvaccinated or under-vaccinated, diseases like measles or whooping cough could spread through schools and communities, putting at risk even those who do get recommended vaccines on time.

For youngsters under six, the Centers for Disease Control and Prevention's recommended vaccination schedule includes MMR (measles, mumps and rubella) shots, and vaccines to protect against whooping cough, chicken pox, hepatitis and seasonal flu, among others. (The full schedule is on the CDC website here: 1.usa.gov/k23A6d).

For the current study, researchers led by Dr. Aaron Wightman from the University of Washington in Seattle surveyed more than 200 pediatricians in their state about how often parents ask them for an alternative vaccination schedule -- and how likely they are to agree to one.

In the online questionnaires, 77 percent of the doctors said parents "frequently" or "sometimes" asked to skip or delay certain vaccines. And six out of ten said they were comfortable using an alternative schedule if parents asked for it.

Pediatricians were more likely to budge from the recommended schedule for certain vaccines over others -- for example, most said they would feel comfortable delaying hepatitis B or chicken pox vaccines, whereas fewer would consider straying from the diphtheria, tetanus and pertussis vaccine (DTap) recommendations.

That suggests doctors are more adamant about going through with vaccines that prevent potentially dangerous bacterial infections that hit infants and young kids, researchers wrote in their Pediatrics report on Monday.

Still, "it's kind of a slippery slope," Dempsey told Reuters Health. Delaying any vaccine "undermines the importance of the schedule in general."

Her own research has suggested that more than 10 percent of parents use an alternative vaccination schedule, and two percent refuse vaccines altogether (see Reuters Health story of October 3, 2011).

But there's no evidence that any alternative schedules are safe or effective, she emphasized. What's more, because no vaccine gives 100 percent protection, even kids who have been vaccinated are put at risk when many of their school or community peers skip or delay their vaccines, Dempsey added.

She said that pediatricians should talk to every parent and try to help them make the safest decision for their child -- but that may become increasingly difficult if the popularity of alternative vaccination schedules continues to grow.

The new study, Dempsey added, "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."

SOURCE: bit.ly/jsoh2P Pediatrics, online November 28, 2011.

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