Tag: alternative vaccine schedules

Why Can’t My 9-Month-Old Get the Rotavirus Vaccine?

The rotavirus vaccines are typically given when infants are two to six months old.

The first dose can be given as early as 6 weeks or as late as 15 weeks though.

The rotavirus vaccines are given between 6 weeks to 32 weeks.

And the final dose can be given as late 8 months (32 weeks).

Why Can’t My 9-Month-Old Get the Rotavirus Vaccine?

What happens if your child didn’t get their rotavirus vaccine on time?

While these vaccines are usually given on either a two and four month (Rotarix) or two, four, and six month (RotaTeq) schedule, as you can see above, there is some flexibility in that timing.

Still, the first dose of the rotavirus vaccine can’t be given any later than 15 weeks and the final dose can’t be given any later than 8 months though, so there is no way that a nine-month-old would be able to get vaccinated.

What would happen if your child did?

“Vaccination should not be initiated for infants aged 15 weeks and 0 days or older because of insufficient data on safety of dose 1 of rotavirus vaccine in older infants. The minimum interval between doses of rotavirus vaccine is 4 weeks; no maximum interval is set. All doses should be administered by age 8 months and 0 days.”

Prevention of Rotavirus Gastroenteritis Among Infants and Children Recommendations of the Advisory Committee on Immunization Practices

The rotavirus vaccines are only licensed at these specific ages, so were not studied in older infants and toddlers. If your 9-month-old did receive a rotavirus vaccine, it would be considered a vaccination error and should be reported.

So why not study them in older kids?

Since severe rotavirus infections mostly occur in younger children between the ages of 4 and 23 months, it doesn’t make any sense to wait until they are older to get them vaccinated.

“To minimize potential risk of intussusception, the World Health Organization (WHO) recommends that rotavirus immunization should be initiated by age 15 weeks and completed before age 32 weeks.”

Age restrictions for rotavirus vaccination: evidence-based analysis of rotavirus mortality reduction versus risk of fatal intussusception by mortality stratum

Also, although the risk is low, a small risk of intussusception after getting the rotavirus vaccine is thought to increase with increasing age of the first dose.

What does all of this mean?

It means that you should follow the immunization schedule and get your kids vaccinated and protected on time.

What to Know About Rotavirus Vaccine Timing

Don’t delay getting your child’s rotavirus vaccine or you may not be able to get it at all, as unlike most other vaccines, these vaccines have strict upper limits for when they can be given.

More on Rotavirus Vaccine Timing

Learn the Risks of Following Bad Advice

Who do you turn to for health advice?

Even if it’s your pediatrician, with the rise of holistic pediatricians, that doesn’t mean that you are getting good advice.

In general, if the advice you are getting lacks evidence that it is safe and effective, relies on anecdotes and testimonials, and is labeled as ‘alternative,’ then it is a safe bet that it is bad advice.

Learn the Risks of Following Bad Advice

Some folks seem to be drawn to this type of advice though.

Kat Von D has decided that she will be raising a vegan child, without vaccinations.
Kat Von D has decided that she will be raising a vegan child, without vaccinations.

As long as they think it is natural, holistic, and is the opposite of what mainstream health experts say to do, some parents will jump at the chance of trying the latest fad, even if it has no benefits and lots of extra risks.

Take giving your kids raw milk for example. Health experts have been warning about the dangers of drinking raw milk for years and even work to keep selling it outlawed in most communities, but some parents still give it to their young children. This is despite the fact that it has no health benefits and isn’t even fortified with vitamin D!

Would you give your kids raw milk if you knew it could make them critically ill?
Would you give your kids raw milk if you knew it could make them critically ill?

What’s worse than giving your kids raw milk? How about skipping your baby’s vitamin K shot? Although it has no major risks, parents of many anti-vaccine and holistic type Facebook groups on the internet are often encouraged to skip this shot.

The article, translated from Polish, describes anti-vaccine parents and their baby (Maluszek), who died of vitamin K deficiency bleeding.
The article, translated from Polish, describes anti-vaccine parents and their baby (Maluszek), who died of vitamin K deficiency bleeding because they skipped his vitamin K shot.

How come they never warn folks that their baby might die in agony if they skip the shot? After all, there is a very good reason that we started to give all babies vitamin K shots – to stop vitamin K deficiency bleeding.

Just like there is a reason that we started to pasteurize milk – to keep us all from getting critically ill from contaminated milk.

And why we take antibiotics for severe infections, and not essential oils.

“If one gets a cancer diagnosis, they need to detox the toxins that have accumulated in the body, minimize further exposure and boost the immune system to fight the cancer. This is done NATURALLY. Traditional medical approaches (drugs, chemo, radiation) only FURTHER damage the body and immune system.”

Brandy Vaughan for Learn the Risk

And why we take chemotherapy for cancer, and not coffee enemas.

Mud wraps don't cure liver cancer.
Mud wraps don’t cure liver cancer.

And why most of us don’t think to try chiropractic, acupuncture, Ayurveda, homeopathy, Reiki, reflexology, or other non-evidenced based therapies when our kids are sick.

Could someone search for advice on Google on treating a bite from a rabid animal and come away thinking their child doesn't need rabies shots from an anti-vaccine website?
Could someone search for advice on Google on treating a bite from a rabid animal and come away thinking their child doesn’t need rabies shots from an anti-vaccine website?
Can an unvaccinated child really get tetanus after a toe nail injury?
Can an unvaccinated child really get tetanus after a toe nail injury? Photo by Petrus Rudolf de Jong (CC BY 3.0)

Why don’t people get rabies very often any more? It’s not because folks are no longer at risk, although the risk is less because dogs and cats are now vaccinated. It is because the vast majority of people get treated if they are exposed to an animal that might have rabies.

Remember when the six-year-old boy in Florida didn’t after touching a rabid bat? He died.

It’s just like the reason kids don’t get stuck by lightning very often. It’s not because lightning doesn’t happen anymore. It’s because we get a lot of warnings about thunderstorms and we know to go inside at the first sign of lightning in the area. Lightning strikes are rare because we take steps to reduce our risk of getting hit.

Why don’t folks get tetanus that much anymore? Again, most people are vaccinated, and they get boosters if they have wounds that puts them at extra risk. While we know what happens when unvaccinated kids are exposed to tetanus and don’t get treated, that isn’t a risk that you will read about on anti-vaccine websites or Facebook groups.

They also don’t tell you that kids in the US still die of diseases like Hib and rotavirus. And there are still measles deaths in the US.

That’s why the great majority of us get vaccinated, because we understand that vaccines are safe and necessary, and that skipping or delaying any vaccines simply puts our kids at risk to catch one of the diseases the vaccines are designed to prevent.

What to Know About the Risks of Following Bad Advice

You might get lucky and have a good outcome when you follow bad advice, but you should at least understand the risks of what might go wrong if you truly think you are making an informed decision.

More on the Risks of Following Bad Advice

How To Counter Vaccine Hesitancy

There is nothing wrong with having questions about vaccines. And there is certainly nothing wrong with doing a little, or even a lot of research about vaccines.

“We are not against vaccines. Just because we have hesitancies and valid concerns about injecting our baby with specific chemicals and toxins does not mean we are anti anything…

As a soon-to-be-parent [and especially as a first-time-mom] I do feel it my responsibility to have questions, and to listen to my motherly instinct to question things, and do my research.”

Kat Von D

The problem comes when the answers folks get come from misinformation, and it leads them to skip or delay their child’s vaccines, leaving them unprotected.

What is Vaccine Hesitancy?

To counter vaccine hesitancy, you likely first need to understand what it means.

“Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite availability of vaccination services. Vaccine hesitancy is complex and context specific varying across time, place and vaccines. It includes factors such as complacency, convenience and confidence.”

SAGE Vaccine Hesitancy Working Group

So it means someone who is anti-vaccine, right?

Not exactly.

“Although many may characterize all individuals who eschew vaccines as “anti-vaccine” or “vaccine deniers,” in reality there is a broad spectrum of individuals who choose not to have themselves or their children vaccinated.”

Tara C Smith on Vaccine Rejection and Hesitancy: A Review and Call to Action

Many of the folks who are vaccine hesitant aren’t truly anti-vaccine. They are likely being misled by anti-vaccine myths and propaganda, but at least they aren’t the ones spreading it across Facebook or on their own blogs and anti-vaccine websites.

How To Counter Vaccine Hesitancy

How do you counter vaccine hesitancy?

“It’s unfair for anyone to expect me [or any parent] to take the word of the pharmaceutical companies who have much to gain from and industry worth billions without question – and then have to dismiss any concerns of my own.”

Kat Von D

You learn to answer all of the questions and concerns that these parents might have about vaccines and vaccine-preventable diseases, including the risks and benefits of vaccines and the risks of being unvaccinated.

“Well, if you’re going to inform yourself about vaccines, I think anybody who’s truly informed will realize that getting a vaccine is much better than not getting one. If you’re choosing not to vaccinate your child, it’s because you’re getting, frankly, bad information about vaccines.”

Paul Offit, MD

You also make sure that parents, teachers, nurses, doctors, pharmacists, reporters, and everyone else gets good information about vaccines.

And you call out the misinformation and out-right lies of the anti-vaccine movement, especially when they say that vaccines never work, are always dangerous and full of toxins, or aren’t necessary.

You don’t let parents get manipulated by the anti-vaccine industry, which has gotten very good at selling fear – literally.

Like the card trick in My Cousin Vinny, anti-vaccine talking points are easy to explain because they are all an illusion.
Like the card trick in My Cousin Vinny, anti-vaccine talking points are easy to explain away, because they are all an illusion.

Remember, there is not one anti-vaccine argument or talking point that ever holds water.

Why not?

Because unless you go cherry picking, the evidence overwhelmingly shows that vaccines work, vaccines are safe, and vaccines are necessary.

What to Know About Countering Vaccine Hesitancy

If you are on the fence or scared to vaccinate your kids, let us help you learn why vaccines are safe and necessary and arguments against vaccines never hold water.

More on Countering Vaccine Hesitancy

How Anti-Vaccine Are You? Take Our Quiz.

It’s easy to be anti-vaccine when you are hiding in the herd. You don’t get vaccinated and you don’t vaccinate your kids, and instead, you simply rely on the fact that everyone else around you is vaccinated to protect you from vaccine-preventable diseases.

Would you vaccinate your high-risk child?
Would you vaccinate your high-risk child? Photo by Janko Ferlic.

Of course, this is a terrible strategy, as we are seeing with the increase in cases of measles and pertussis, etc. It is much better to learn about the importance and safety of vaccines, get fully vaccinated, and stop these outbreaks.

This hasn’t seemed to have deterred most anti-vaccine “experts” yet, as they continue to spout their anti-vaccine myths and misinformation and push their anti-vaccine talking points.

But as they continue to tell you that vaccines don’t work, how about asking what they would do in these ten high-risk situations?

Amazingly, some folks continue to try and justify skipping vaccines and accept the risk of disease, even when that risk is much higher than usual and they could be putting their child’s life in immediate danger!

How will you do with our quiz?

Would you choose to vaccinate in these situations?

1. Baby born to mother with hepatitis B.

You are pregnant and have chronic hepatitis B (positive for both HBsAg and HBeAg). Should your newborn baby get a hepatitis B shot and HBIG?

Background information:
Many anti-vaccine experts tell parents to skip their baby’s hepatitis B shot, saying it is dangerous, not necessary, or doesn’t work (typical anti-vax myths and misinformation).

However, it is well known that:

  • from 10 (HBeAg negative) to 90% (HBeAg positive) of infants who are born to a mother with chronic hepatitis B will become infected
  • 90% of infants who get hepatitis B from their mother at birth develop chronic infections
  • 25% of people with chronic hepatitis B infections die from liver failure and liver cancer
  • use of hepatitis B immune globulin (HBIG) and hepatitis B vaccine series greatly decreases a newborn’s risk of developing a hepatitis B infection (perinatal transmission of hepatitis B), especially if HBIG and the first hepatitis B shot is given within 12 hours of the baby being born

Would your newborn baby get a hepatitis B shot and HBIG?

2. Your child is bitten by a rabid dog.

Your toddler is bitten by a dog that is almost certainly rabid. Several wild animals in the area have been found to be rabid recently and the usual playful and well-mannered dog was acting strangely and died a few hours later. The dog was not vaccinated against rabies and unfortunately, the owners, fearing they would get in trouble, disappeared with the dead dog, so it can’t be quarantined. Should your child get a rabies shot?

Background information:
Although now uncommon in dogs, rabies still occurs in wild animals, including raccoons, skunks, bats, and foxes. These animals can then expose and infect unvaccinated dogs, cats, and ferrets, etc.

To help prevent rabies, which is not usually treatable, in addition to immediately cleaning the wound, people should get human rabies immune globulin (RIG) and rabies vaccine.

The rabies vaccine is given as a series of four doses on the day of exposure to the animal with suspected rabies and then again on days 3, 7, and 14.

Although rare in the United States, at least 1 to 3 people do still die of rabies each year. The rabies vaccine series and rabies immune globulin are preventative, however, without them, rabies is almost always fatal once you develop symptoms. A few people have survived with a new treatment, the Milwaukee protocol, without getting rabies shots, but many more have failed the treatment and have died.

Would your child get a rabies shot? What if he had picked up a rabid bat?

3. Traveling to Romania.

You are traveling to the Romania to see family with your 9-month-old baby. Neither of you have had the measles vaccine. Should you both get vaccinated before making the trip?

Background information:

Over the past few years, over 100 people have died in measles outbreaks across Europe, with many in Romania.

Although the first MMR vaccine is routinely given when children are 12 months old, it is now recommended that infants get vaccinated as early as age six months if they will be traveling out of the country.

Since the endemic spread of measles was stopped in 2000, almost all cases are now linked to unvaccinated travelers, some of whom start very large outbreaks that are hard to contain.

Would you both get vaccinated before making the trip?

4. Tetanus shot.

Your unvaccinated teen gets a very deep puncture wound while doing yard work. A few hours later, your neighbor comes by to give you an update on his wife who has been in the hospital all week. She has been diagnosed with tetanus. She had gotten sick after going yard work in the same area and has been moved to the ICU. Do you get him a tetanus shot?

Background information:
Most children get vaccinated against tetanus when they receive the 4 dose primary DTaP series, the DTaP booster at age 4-6 years, and the Tdap booster at age 11-12 years.

Unlike most other vaccine-preventable diseases, tetanus is not contagious. The spores of tetanus bacteria (Clostridium tetani) are instead found in the soil and in the intestines and feces of many animals, including dogs, cats, and horses, etc.

Although the tetanus spores are common in soil, they need low oxygen conditions to germinate. That’s why you aren’t at risk for tetanus every time your hands get dirty. A puncture wound creates the perfect conditions for tetanus though, especially a deep wound, as it will be hard to clean out the tiny tetanus spores, and there won’t be much oxygen at the inner parts of the wound.

These types of deep wounds that are associated with tetanus infections might including stepping on a nail, getting poked by a splinter or thorn, and animal bites, etc. Keep in mind that some of these things, like a cat bite, might put you at risk because you simply had dirt/tetanus spores on your skin, which get pushed deep into the wound when the cat bites you.

Symptoms of tetanus typically develop after about 8 days and might include classic lockjaw, neck stiffness, trouble swallowing, muscle spasms, and difficulty breathing. Even with treatment, tetanus is fatal in about 11% of people and recovery takes months.

Would you get your teen a tetanus shot?

5. Cocooning to protect baby from pertussis.

Both of your unvaccinated teens go to school with a personal belief vaccine exemption. You are due in a few months and are a little concerned about the new baby because there have been outbreaks of pertussis in the community, especially at their highschool. Should everyone in the family get a Tdap shot?

Background information:
Pertussis, or whooping cough, classically causes a cough that can last for weeks to months.

While often mild in teens and adults, pertussis can be life-threatening in newborns and infants. In fact, it is young children who often develop the classic high-pitched whooping sound as they try to breath after a long coughing fit.

In a recent outbreak of pertussis in California, 10 infants died. Almost all were less than 2 months old.

Since infants aren’t protected until they get at least three doses of a pertussis vaccine, usually at age 6 months, experts recommend a cocooning strategy to protect newborns and young infants from pertussis. With cocooning, all children, teens, and adults who will be around the baby are vaccinated against pertussis (and other vaccine-preventable diseases), so that they can’t catch pertussis and bring it home.

There is even evidence that a pregnancy dose of Tdap can help protect infants even more than waiting until after the baby is born to get a Tdap shot.

Would everyone in your family get a Tdap shot?

6. Nephew is getting chemotherapy.

Your nephew was just diagnosed with leukemia and is going to start chemotherapy. Your kids have never been vaccinated against chicken pox and haven’t had the disease either. Your brother asks that you get them vaccinated, since they are around their cousin very often and he doesn’t want to put him at risk.

Do you get your kids vaccinated with the chicken pox vaccine?

Background information:
Kids with cancer who are getting chemotherapy become very vulnerable to most vaccine-preventable diseases, whether it is measles, flu, or chicken pox.

According to the Immune Deficiency Foundation, “We want to create a ‘protective cocoon’ of immunized persons surrounding patients with primary immunodeficiency diseases so that they have less chance of being exposed to a potentially serious infection like influenza.”

Would your get your kids vaccinated with the chicken pox vaccine?

7. Outbreak of meningococcemia at your kid’s college.

Your child has just gone off to college. There is an outbreak of meningococcemia in her dorm (8 cases already). It is the strain that is included in the Menactra and Menveo vaccines, although she has not been vaccinated. Do you encourage her to get vaccinated?

Background information:
Neisseria meningitidis is a bacteria that can cause bacterial meningitis and sepsis (meningococcemia).

Depending on the type, it can occur either in teens and young adults (serogroups B, C, and Y) or infants (serogroup B).

Although not nearly as common as some other vaccine-preventable diseases, like measles or pertussis, it is one of the more deadly. Meningococcemia is fatal in up to 40% of cases and up to 20% of children and teens who survive a meningococcal infection might have hearing loss, loss of one or more limbs, or neurologic damage.

Meningococcal vaccines are available (Menactra and Menveo) and routinely given to older children and teens to help prevent meningococcal infections (serogroups A, C, Y and W-135). Other vaccines, Bexasero and Trumenba, protect against serogroup B and are recommended for high risk kids and anyone else who wants to decrease their risk of getting Men B disease.

Would you encourage her to get vaccinated against meningococcemia?

8. Cochlear implants.

Your preschooler has just received cochlear implants. Should he get the Prevnar and Pneumovax vaccines?

Background information:
Cochlear implants can put your child at increased risk for bacterial meningitis caused by the Streptococcus pneumoniae bacteria (pneumococcus).

Would he get vaccinated with Prevnar and Pneumovax, as he is no at high risk for pneumococcal disease?

9. Splenectomy

Your child is going to have his spleen removed to prevent complications of hereditary spherocytosis. Should he get the meningococcal and pneumococcal vaccines first?

Background information:
Without a spleen, kids are at risk for many bacterial infections, including severe infections caused by Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis bacteria.

In addition to their routine vaccines, kids with asplenia might need Menveo or Menactra, Bexsero or Trumenba (Men B), and Pneumovax 23.

Would your child get these vaccines that are recommended for kids with asplenia?

10. Ebola

Ebola is returning, but this time an experimental vaccine is available.

Background information:
There were nearly 30,000 cases and just over 11,000 deaths during the 2014-16 Ebola outbreak in West Africa.

You are in an area that is seeing an increasing number of Ebola cases and there is still no treatment for this deadly disease. An experimental vaccine is being offered.

Do you get the vaccine?

How Anti-Vaccine Are You?

It’s easy to be anti-vaccine when you are hiding in the herd – seemingly protected by all of the vaccinated people around you.

Would you still delay or skip a vaccine in a high-risk situation?

More on The Anti-Vaccine Quiz

8 Myths About Pediatricians Who Fire Families Who Don’t Vaccinate Their Kids

What actually happens when a pediatrician has a vaccine policy that requires parents to vaccinate their kids or face dismissal from the practice?

Not surprisingly, there are a lot of myths about the controversial issue of pediatricians dismissing families who don’t vaccinate their kids.

1 ) It is a myth that the American Academy of Pediatrics has a policy encouraging pediatricians to dismiss families who don’t vaccinate their kids.

There is no such policy.

Instead, in 2016, about 400 leaders from AAP chapters, committees, councils, and sections voted on a resolution at the 2016 AAP Annual Leadership Forum (ALF) to support pediatricians who dismissed families who didn’t vaccinate their kids.

RESOLVED, that the Academy support, in their policy statements and clinical guidelines about immunizations, pediatricians who decide to discharge patients after a reasonable, finite amount of time working with parents who refuse to immunize their children according to the recommended schedule or who fail to abide by an agreed-upon, recommended catch-up schedule, and be it further RESOLVED, that the Academy continue to support pediatricians who continue to provide health care to children of parents who refuse to immunize their children.

Resolution #80.81SB Supporting Pediatricians Who Discharge Families Who Refuse to Immunize

The resolution also voiced support for pediatricians who didn’t dismiss these patients.

2)  It is a myth that pediatricians dismissing families who don’t vaccinate their kids is a new thing.

Although it is getting a lot more attention now, since that 2016 resolution and a report on Countering Vaccine Hesitancy that soon followed, dismissing or firing families who don’t vaccinate their kids is not new.

A 2005 AAP report, Responding to Parental Refusals of Immunization of Children, discusses the issue.

“In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child. However, when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists, the pediatrician may encourage the family to find another physician or practice.”

Responding to Parental Refusals of Immunization of Children

And a study, Dismissing the Family Who Refuses Vaccines, also published in 2005, made it clear that many pediatricians “would discontinue care for families refusing some or all vaccines.”

3)  It is a myth that dismissing families who don’t vaccinate their kids is an evidence based policy.

There is nothing beyond anecdotal evidence that families, when faced with the decision of getting vaccinated or getting dismissed from an office, will choose to get vaccinated.

Again, the latest resolution supporting the idea of dismissing families came because it was voted on and became an official Annual Leadership Forum resolution. In general, only the top 10 ALF resolutions are acted upon urgently by the AAP.

At the time, many pediatricians felt constrained by the previous statements from the AAP that discouraged dismissing these families.

4)  It is a myth that pediatricians dismiss families who don’t vaccinate their kids because they don’t want to be bothered talking about vaccine safety.

Although few pediatricians would want to talk to a parent who is arguing that vaccines are poison, aren’t necessary, and never work, fortunately, most vaccine-hesitant parents don’t actually talk like that. They are usually on the fence or simply scared because of all of the anti-vaccine propaganda they are exposed to and need a little extra time to understand that vaccines are safe and necessary.

A typical vaccine policy gives a parent plenty of time to get their child caught up on vaccines before they might be dismissed from the office.
A typical vaccine policy gives a parent plenty of time to get their child caught up on vaccines before they might be dismissed from the office.

And most pediatricians give them that extra time and do talk to them about their concerns. Despite the perception from some of the headlines you might see, families typically don’t get fired after one visit because they refused one or more vaccines.

5) Pediatricians who don’t dismiss unvaccinated families are supporting the use of alternative vaccine schedules.

While this is certainly true for some providers who actually advertise that they are “vaccine-friendly” and encourage parents to follow a non-standard, parent-selected, delayed protection vaccine schedule, most others understand that there is no evidence to support these alternative schedules and they are simply tolerated until the child can get caught-up with all of his vaccines.

6) It is illegal to dismiss a family who doesn’t want to vaccinate their kids.

While some pediatricians think that it is a bit of an ethical dilemma, the legal issues are very clear.

Physicians can’t simply abandon a patient so that they go without care, but they are typically free to end the physician-patient relationship after giving them formal, written notification, and continuing to provide care (at least in emergency situations) for a reasonable amount of time, giving the family time to find a new physician.

Of course, state and federal civil rights laws protect families from being terminated because of sex, color, creed, race, religion, disability, ethnic origin, national origin, or sexual orientation.

7)  It is a myth that dismissing families who don’t vaccinate their kids will protect those families who do vaccinate and protect their kids.

This is often the main reason that pediatricians use to justify dismissing families who don’t vaccinate their kids. After all, it isn’t fair to the families who come to your office, those who do get vaccinated and protected, if someone who is intentionally not vaccinated gets measles and exposes them all, right?

There seem to be several problems with this idea though:

  • relatively few exposures during outbreaks actually occur in a pediatrician’s office. Looking at most recent measles outbreaks, for example, exposures were more likely to occur while traveling out of the country, in an urgent care center, emergency room, somewhere in the community, or in their own home.
  • infants who get pertussis are usually exposed by a family member
  • while measles is very contagious and the virus can linger in an exam room for hours, other vaccine-preventable diseases are far less contagious. Mumps, for example, typically requires prolonged, close contact, which is why you are unlikely to get mumps at your pediatrician’s office.
  • when dismissed by their pediatrician, there is a concern that families might cluster together in the offices of a vaccine-friendly doctor or holistic pediatrician, making it more likely for outbreaks to erupt in their community if any of them get sick

And that’s the key point. Just because families get dismissed from a pediatrician’s office, it doesn’t mean that they leave the community. Your patients might still see them at daycare, school, at the grocery store, or walking down their street.

Pediatricians who don’t dismiss families who don’t vaccinate their kids often feel that it is better to keep working to help them understand that vaccines are safe and necessary, so that they eventually do get vaccinated and protected.

What about the extra risk in their own offices?

With RSV, strep, cold viruses, and everything else that kids have in the average pediatrician’s office, it is best to take steps to reduce the chances that kids are exposed to all of them. How do you do that? Don’t have a waiting room full of kids that are exposing each other to germs!

8) Most families don’t vaccinate their kids because they don’t trust their pediatrician.

While this is likely true for some, those families who want to see a pediatrician and don’t refuse any other treatments, like their newborn’s vitamin K shot and eye ointment, likely do trust their pediatrician.

Then why don’t they vaccinate and protect their kids?

“In today’s world, smallpox has been eradicated due to a successful vaccination program and vaccines have effectively controlled many other significant causes of morbidity and mortality. Consequently, fear has shifted from many vaccine-preventable diseases to fear of the vaccines.”

Marian Siddiqui et al on the Epidemiology of vaccine hesitancy in the United States

They are likely afraid.

What are they afraid of?

More and more these day, if you ask them, they will likely tell you that they don’t know. It would be much easier if they were afraid of something specific, like the myth that a baby’s immune system is too immature to handle any vaccines, that there are hidden ingredients in vaccines, or that vaccines are somehow associated with autism.

You can answer specific questions about vaccines, but it is harder when they are afraid because they see anecdotal vaccine scare videos or because friends and family members are feeding them misinformation.

“With all the challenges acknowledged, the single most important factor in getting parents to accept vaccines remains the one-on-one contact with an informed, caring, and concerned pediatrician.”

“…nearly half of parents who were initially vaccine hesitant ultimately accepted vaccines after practitioners provided a rationale for vaccine administration.”

“Developing a trusting relationship with parents is key to influencing parental decision-making around vaccines.”

“Pediatricians should keep in mind that many, if not most, vaccine-hesitant parents are not opposed to vaccinating their children; rather, they are seeking guidance about the issues involved, beginning with the complexity of the schedule and the number of vaccines proposed.”

“Because most parents agree to vaccinate their children, this dialogue, which can be started as early as the prenatal interview visit if possible, should be an ongoing process.”

AAP on Countering Vaccine Hesitancy

Whatever their vaccine policy, pediatricians should all work to counter vaccine misinformation and propaganda, so that our families get vaccinated and protected and our communities are safe.

It is also clear that we need new ways to talk about vaccines.

And we definitely new more ways to help everyone learn to think critically, be more skeptical about the things they see and read, and overcome their biases.

What to Know About Pediatricians Who Discharge Families Who Refuse to Immunize Their Kids

Whether they have a vaccine policy that dismisses families who don’t vaccinate their kids or they continue seeing them, pediatricians want to do what is best for their kids.

More on Pediatricians Who Discharge Families Who Refuse to Immunize Their Kids

When Friends Disagree About Vaccines

If Facebook has taught us anything, it is that we aren’t going to agree with all of our friends about everything.

It is easy to think that your friends and family have very similar opinions as your own, especially about things like politics and religion, but only when you don’t actually talk about them.

But then you see your friends like, share, or post something that totally catches you by surprise…

What Do Your Friends Think About Vaccines?

What do you do when that surprise is that your friend or family member is anti-vaccine?

Is that something you would agree to disagree about, try to change their mind, or would it lead to the loss of a friendship? After all, it’s one thing if you are vegan and your baby is going to get exposed to eating meat when you go visit the home of a friend who is a carnivore, and quite another if she might get exposed to measles or chickenpox because they don’t believe in vaccines.

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

But if your kids are vaccinated, why would you even be concerned about whether or not your friends vaccinate their own kids?

Bob Sears appeared on Fox & Friends in 2010 for the segment "Vaccines: A Bad Combination?"
Bob Sears warned folks not to share their fears of vaccines and try to hide in the herd so we didn’t see outbreaks. I wonder if he knew it might lead to a loss of friendships too…

Because your vaccinated kids are still at risk. Remember, even if your child does not have any chronic illnesses or problems with their immune system, there is the fact that kids aren’t at least partially protected against:

  • pertussis until after the third dose of DTaP at six months
  • the flu until after getting a first flu shot at six months, keeping in mind that they are actually going to need a second flu shot for full protection, since it is the first time that they are being vaccinated against influenza
  • measles, mumps, and chicken pox until they get their first dose of MMR and the chicken pox vaccine when they are 12 months old

And then, even with later booster doses of vaccines, since vaccines aren’t 100% effective, many people don’t want to take an extra risk and spend time around someone who is intentionally unprotected and at higher risk to get sick, who can then expose their kids to a vaccine-preventable diseases.

Can Your Friendship Survive the Vaccine Wars?

Friends don’t have to agree on everything.

Still, you might be more likely to lose a friend over vaccines if they are intentionally not vaccinating their kids and:

  • believe that vaccines are full of toxins
  • believe that unvaccinated kids are healthier than those who are vaccinated
  • believe that vaccines don’t ever work
  • believe that vaccine-preventable diseases are mild and can be cured with natural remedies
  • believe that they need to avoid recently vaccinated kids because they might be shedding
  • believe that vaccines are associated with autism, SIDS, and other so-called vaccine-induced diseases

Why?

It’s one thing if they are on the fence or a little scared by the myths and propaganda they see on the Internet and another if they are one of the folks helping spread that misinformation about vaccines.

What to Know About Friends and Family Disagreeing About Vaccines

Are you friends with anyone who intentionally chooses to skip or delay their child’s vaccines?

More on Friends and Family Disagreeing About Vaccine

Should You Use a Vaccine Ingredient Calculator?

Do you want to make an informed vaccination decision?

Are you looking for more information about the ingredients in the vaccines your kids are about to get?

Have you tried one of those vaccine ingredient calculators?

Should You Use a Vaccine Ingredient Calculator?

As you do your research and look at the risks and benefits of your vaccine decision, you should know that those vaccine ingredient calculators that claim to help reduce toxins aren’t really helping you make an informed decision.

Calculate which vaccine-preventable diseases your child will be protected from when he gets vaccinated.
Calculate which vaccine-preventable diseases your child will be protected from when he gets vaccinated.

They are a propaganda tool that simply works to increase fear about vaccines by making you think that you need to do a vaccine lot search, compare vaccine brands, or work to reduce exposures to  specific ingredients.

Why would you need to do a lot search? There are no hot lots of vaccines that you need to avoid.

Why would you need to compare vaccines based on their brands? Vaccines are safe. Vaccine ingredients are safe. Although the ingredients might vary a bit based on the brand of vaccine, that isn’t going to impact how well a vaccine works or it’s side effects.

And the sites with these types of calculators never mention the risks of skipping or delaying vaccines.

Which Vaccines Contain More Than the FDA Approved Amount of Aluminum?

But what about aluminum?

Depending on the brand, don’t some vaccines do contain more aluminum than others?

“The alternative suggests only one aluminum-containing vaccine at a time in the infant years (the right brands must be chosen). By spreading out the shots, you spread out the exposure so infants can process the aluminum without it reaching toxic levels.”

Bob Sears in The Vaccine Book

The FDA states that “the amount of aluminum in the recommended individual dose of a biological product shall not exceed” 0.85  to 1.25 milligrams.

Not surprisingly, no vaccine exceeds that approved amount of aluminum, no matter what brand you choose.

Why do anti-vaccine folks scare parents into thinking that their kids are getting exposed to potentially toxic levels of aluminum from vaccines?

“WARNING: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.
Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 [micro]g/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.”

FDA on Aluminum in large and small volume parenterals used in total parenteral nutrition.

The FDA and AAP and others began investigating and then warning folks about aluminum in 1986. They weren’t worried about aluminum in vaccines though. They were concerned that newborns and younger premature infants might be getting too much aluminum if they were getting a lot of IV products with aluminum, especially if they weren’t able to eat on their own and were dependent on total parental nutrition for long periods of time.

So these were high risk infants who were potentially getting high doses of aluminum each and every day for weeks or months at a time. And somehow anti-vaccine folks equated this with other infants who were getting vaccines every few months, at least they did once they started to move away from worrying about thimerosal.

What to Know About Using a Vaccines Ingredient Calculator

Vaccine ingredient calculators are a propaganda tool that anti-vaccine folks use to scare parents away from vaccinating and protecting their kids.

More on Using a Vaccines Ingredient Calculator