Alternative Vaccination Schedules
A very important part of preventative care in children is routine immunizations, or vaccinations. Vaccines are discussed just as much during well-child check ups for infants and toddler as nutrition, developmental milestones, and safety. They play a vital role in keeping children healthy and in avoiding many preventable diseases that used to cause significant illness, harm, and death in young children.
The American Academy of Pediatrics has a great article titled, “14 Diseases You Almost Forgot About Thanks to Vaccines.” Fortunately or unfortunately, vaccines have become a victim of their own success – they have been very effective at lowering the rates of certain diseases to the point that people forget about them and how severe the infection can be, and therefore don’t realize why the vaccine is necessary in the first place.
Recommended Vaccination Schedule
Each year, experts review and potentially make changes to the recommended vaccination schedule for children. The most recent scientific data is reviewed by this panel of experts that includes infectious disease specialists, immunization specialists, and public health and prevention specialists.
This schedule is approved by the Advisory Committee on Immunization Practices (ACIP) and then recommended by the Center for Disease Control (CDC) and the American Academy of Pediatrics (AAP), among others. The schedule only includes vaccinations that have been approved by the Food and Drug Administration.
This approved schedule is recommended for all children, with few rare exceptions. It has been thoroughly researched to ensure that the timing of vaccines occurs at a point in which it is most beneficial for the child, works best with the child’s immune system, and can be the most effective. For example, research has shown that disease caused by Pneumococcal bacteria are most prevalent in children under age 5, so the vaccination schedule includes this vaccine and it’s booster doses at earlier ages.
Alternative Vaccination Schedules
These days, it is fairly common for parents to ask about alternatives to the recommended vaccination schedule. There are many reasons for this, from lack of understanding of how vaccines work, to hesitancy regarding the safety of vaccines, to a mistrust of anything that is “not natural.” There are many sources out there that claim their alternative vaccination schedules to be more safe, but in truth this has not been studied like the recommended schedule has. There is no proof that the alternative vaccination schedules are beneficial, and in fact they leave children vulnerable to disease for a longer time. It is important for parents to keep remember that ACIP recommendations are in place to ensure children are protected as early as possible, as safely as possible.
“Natural” Immunity
Sometimes parents will express interest in helping their child develop immunity from disease “in a more natural way,” by which they mean through actual infection. This idea produced the concept of chicken pox parties, in which uninfected children are closely exposed to an infected child in order to develop the chicken pox infection. This infection, once resolved, leads to immunity without vaccination.
The problem with this idea is that every child handles infection differently. With chicken pox, for instance, most children are mildly to moderately affected and may be miserable for a few days but recover fully and without lasting effects. Some children, however, are very seriously ill with chicken pox infection and may develop severe illness and long-lasting effects. It is impossible to predict which children will experience the mild to moderate versus severe infection.
Additionally, some of the vaccine-preventable illness are fatal if not treated – Tetanus, for example. It is not worth the risk to the child to prefer “natural” immunity over vaccination-induced immunity.
Final thoughts
In my humble opinion, the development of vaccinations has been one of the most important public health improvements in science. It has greatly impacted the lives of hundreds of thousands of children who may not have lived to adulthood without them. When I was in medical training some of the older Pediatricians would tell stories of riding in ambulances from the clinic to the hospital, ready to place breathing tubes at a moment’s notice into young children infected with Haemophilis influenza, a bacteria that causes severe swelling of the throat that can lead to death very quickly. I have never once seen a case of H influenza, let alone experienced a patient die of it, thanks to the Hib vaccination.
My fear as a Pediatrician, is that the growing number of alternative vaccination schedules (and the outright refusal of vaccinations) will give these diseases the chance to come creeping back in. Herd immunity – the idea that a few who are unable to be vaccinated will still be protected by the overwhelming numbers of vaccinated people who surround them – will only work if the majority of the population are immune to infection. I certainly do not want to start seeing children paralyzed by Polio, or dehydrated to the point of requiring hospitalization from Rotavirus, or dying from H influenza infections. I want these young, vulnerable patients to remain protected as much as possible, and I strongly believe in the vaccinations that can do so.
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