The American Academy of Pediatrics, an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists, has long advocated for the health and safety of our children.
“Pediatricians who routinely recommend limiting the numbers of vaccines administered at a single visit such that vaccines are administered late are providing care that deviates from the standard evidence-based schedule recommended by these bodies.”
American Academy of Pediatricians
Their advice to keep kids safe and healthy includes that all children, unless they have a medical exemption, be fully vaccinated on time and on schedule.
Do Pediatricians Vaccinate Their Own Kids?
Does that mean that all pediatricians vaccinate their kids on time and on schedule?
One study, How Do Physicians Immunize Their Own Children? Differences Among Pediatricians and Nonpediatricians, found that “Ninety-three percent of the surveyed physicians agree with the current official vaccination recommendations and would apply them to their own children.”
The numbers were even higher for some vaccines, like diphtheria (100%), tetanus (100%), pertussis (98.7%), polio (99.2%), measles (97.4%), mumps (95.2%), and rubella (95.7%). It was lower for those vaccines that were newer to the schedule (the study was in Switzerland in 2005), like Hib and hepatitis B.
Up to about 29% of the pediatricians gave their own kids vaccines that weren’t even on the routine schedule in Switzerland yet, including hepatitis A, flu, Prevnar, and the chicken pox vaccine.
Another study, Vaccination practices among physicians and their children, came to similar conclusions. At least 95% of pediatricians said that they followed the recommendations of the ACIP, and the “over-all rates for individual vaccines were considerably high ranging from 97% to 100%.”
That’s right! At least 99% of pediatricians said that they would give their child the MMR, Varicella, Menactra, flu, and Gardasil vaccines.
An even higher percentage would give hepatitis B, polio, Prevnar, Hib, and DTaP!
Fewer would give rotavirus (94%) and hepatitis A (98%) to their own kids, which is not that surprising, as those are among the newest vaccines.
It is a myth that a large number of pediatricians don’t vaccinate their own kids.
What to Know About How Pediatricians Vaccinating Their Own Kids
Almost all pediatricians vaccinate and protect their own kids with all of the recommended vaccines on the CDC immunization schedule.
More on How Pediatricians Vaccinate Their Own Kids
This image that has been floating around the Internets conveys a lot of information, both about vaccines and vaccine-preventable diseases. And about the propaganda being pushed by the anti-vaccine movement.
A lot has changed over the last four generations…
Four Generations of Vaccine Preventable Diseases
In the United States, we have seen:
1949 – the last smallpox outbreak
1970s – the last outbreak of respiratory diphtheria
1979 – endemic polio was declared eliminated
1979 – smallpox was declared eradicated
2000 – endemic measles was declared eliminated
2000- neonatal tetanus was declared eliminated
2004 – endemic rubella and congenital rubella syndrome were declared eliminated
2009 – endemic respiratory diphtheria was declared eliminated
But there hasn’t been as much change as some folks think.
We don’t even have 69 vaccines available to give children today!
And while 200+ vaccines are being tested or are in the “pipeline,” very few will end up on the childhood immunization schedule. For example, many of these are therapeutic vaccines to treat cancer, allergies, and other conditions. And a lot of the other pipeline vaccines are for the same infectious disease, including 36 vaccines being tested to prevent or treat HIV and 25 to prevent the flu.
So how many vaccines do kids actually get?
Kids today routinely get 13 vaccines to protect them from 16 vaccine-preventable diseases. More than 13 vaccines are available, but some aren’t used in the United States and some are only used in special situations or for high risk kids.
13 vaccines, including DTaP, IPV (polio), hepatitis B, Hib, Prevnar 13, rotavirus, MMR, Varivax (chicken pox), hepatitis A, Tdap, HPV, MCV 4 (meningococcal vaccine), and influenza
protection against 16 vaccine-preventable diseases, including diphtheria, tetanus, pertussis, measles, mumps, rubella, polio, chicken pox, pneumococcal disease, hepatitis A, hepatitis B, meningococcal disease, HPV, rotavirus, Hib, and flu
about 28 doses of those vaccines by age two years
about 35 doses of those vaccines by age five years
as few as 23 individual shots by age five years if your child is getting combination vaccines, like Pediarix or Pentacel and Kinrix or Quadracel and Proquad
about 54 doses of those vaccines by age 18 years, with a third of that coming from yearly flu shots
How do you get a number like 69?
You can boost your count to make it look scarier by counting the DTaP, MMR, and Tdap vaccines as three separate vaccines each (even though they aren’t available as individual vaccines anymore). That quickly turns 8 shots into “24 vaccines.”
And that’s fine – as long as you are consistent. You can’t count them each as three vaccines today, but just as one when mom, grandma and great-grandma got them. If you are counting individual components of those vaccines, then great-grandma didn’t just get two vaccines, especially when you consider that she almost certainly would have gotten multiple doses of the DPT vaccine.
Paradoxically, even more antigens have been taken off the schedule with the removal of the smallpox and DPT vaccines. In 1960, kids got exposed to 3,217 different antigens from the smallpox, polio, diphtheria, tetanus and whole cell pertussis vaccines. All of today’s vaccines on the schedule expose them to just 177 different antigens!
Why does that matter? It is the antigens that are stimulating the immune system, so if you were really concerned about a number, that would be the one to look at.
More Vaccines Equal More Protection
Of course, the number of vaccines kids get and how they have increased over time is very important. But not in they way anti-vaccine folks like to think.
It is important because kids today are protected against and don’t have to worry about the consequences of many more life-threatening diseases, like bacterial meningitis (Hib and the pneumococcal bacteria), epiglottitis (Hib), liver failure and liver cancer (hepatitis B), severe dehydration (rotavirus), and cervical cancer (HPV), etc.
If you think kids get too many vaccines today, then you have no idea what things were like in the pre-vaccine era.
don’t vaccinate your kids – risking a deadly disease because they are unvaccinated or the possibility that someone will come and force you to get them vaccinated
How do you figure out the truth to help you make the right decision for your family?
The Truth Behind Your Vaccine Decision
Most parents vaccinate their kids on time and on schedule.
Do they all have a hard time making their decision?
They understand the risks their children face if they aren’t vaccinated.
“When a well-meaning parent like Jenny McCarthy blames vaccines for her child’s autism, placing the fear of God into every parent who has a baby, it’s not only irresponsible – it’s dangerous. Why? It’s simple math: vaccines are less effective when large numbers of parents opt out. And the more who opt out, the less protected ALL our children are.
Celebrity books come and go . . . but the anxiety they create lives on in pediatricians’ offices across the country. A small, but growing number of parents are even lying about their religious beliefs to avoid having their children vaccinated, thanks in part to the media hysteria created by this book.”
Most importantly, parents who choose to vaccinate their kids don’t believe the myths and conspiracy theories that might lead them to skip or delay any recommended vaccines.
“If you see a turtle sitting on top of a fence post, it didn’t get there by accident.”
President Bill Clinton
Ironically, the anti-vaccine “experts” and websites that scare some parents often talk about choice and informed consent.
Understand though, that by exaggerating the risks of vaccines and vaccine injury (no, vaccines are not full of toxins), playing down the risks of vaccine-preventable diseases (no, they are not mild diseases that should be thought of as a rite of passage), and ignoring the benefits of vaccines (yes, vaccines do work), they are violating the basic tenets of informed consent themselves.
And that limits your ability to make the right choice for your family.
Making the Right Decision About Vaccines
There is nothing wrong with asking questions and being skeptical about the answers you get.
With all of the things you see and hear about vaccines, there is nothing wrong with being a little scared and wanting to do more research, instead of blindly following the advice of your pediatrician.
But remember that if you are going to be skeptical and are not going to blindly follow the advice of someone you know and maybe trust, then don’t blindly believe everything you read on the Internet that says vaccines are bad.
“My husband and I agreed we would just not have our new baby vaccinated until she was at least 1 year old, which seemed like enough time to continue looking for information. Also, we were not concerned that she was at risk of contracting any serious childhood illnesses.
We were wrong.
A week before our baby girl’s first birthday, she was feverish and listless. When she refused to nurse for 24 hours, I took her to see our pediatrician. She was hurriedly admitted to intensive care with the diagnosis of spinal meningitis caused by Haemophilus influenzae, type B, which is a vaccine-preventable disease.”
Suzanne Walther on A Parent’s Decision on Immunization: Making the Right Choice
Suzanne Walther discovered that “it is easy for parents to be misinformed. It is a real challenge to be well informed.”
What questions did she want answers to?
Are vaccines really effective at preventing diseases? – Yes, although they aren’t 100% effective, vaccines do work well at preventing and controlling 16 different vaccine-preventable diseases on our childhood immunization schedule. And yes, vaccines did help eliminate smallpox and herd immunity is real.
How are vaccines made? – Vaccines are made in a multi-step process that begins with generating the antigens that will go in the vaccine and then moves to releasing and isolating the antigen from the growth medium, purifying the antigen, strengthening and stabilizing the vaccine, and then combining it all into the final vaccine. Unlike videos you may have seen on the Internet, there is nothing scary about this very scientific process.
Are they tested for safety? – Vaccines are extensively tested in Phase I, II, and III trials before they are approved and added to the immunization schedule. This entire vaccine development process may take as long as 10 to 15 years.
Suzanne Walther learned about vaccines the hard way – after her infant contracted Hib meningitis, a vaccine-preventable disease. She also discovered that you can sometimes delay or wait too long to vaccinate your child.
What will you do to be well informed and to make sure you are making the right choice?
What to Know If You Are on the Fence About Vaccines
It is easy to be misinformed about vaccines, especially if you are on the fence and aren’t sure what to do. Get educated and and be sure you are making the right decision for your family.
In addition to learning how to give vaccines properly, it can help you answer any questions parents might have and help them understand that vaccines are safe, vaccines work, and vaccines are necessary to protect our kids.
Who needs to get educated about vaccines?
Everyone of course. While it’s great if all of the medical assistants and nurses have done their research about vaccines, you will have missed opportunities to get kids vaccinated and protected if the folks making appointments aren’t.
Learning the Immunization Schedule
How do you know when to give a particular vaccine to an infant, child, or older teen when they come to the office, besides the fact that someone else ordered it or the school says they need it?
“There is no ‘alternative’ immunization schedule. Delaying vaccines only leaves a child at risk of disease for a longer period of time; it does not make vaccinating safer.
Vaccines work, plain and simple. Vaccines are one of the safest, most effective and most important medical innovations of our time. Pediatricians partner with parents to provide what is best for their child, and what is best is for children to be fully vaccinated.”
Karen Remley, MD, Executive Director, American Academy of Pediatrics
For example, while some vaccines must be refrigerated, others must be frozen.
What happens if vaccines aren’t stored at the proper temperature?
If a vaccine gets too warm or too cold, it can lose some of its potency and it probably won’t work well. That can mean vaccinated kids don’t get the immunity you expect and are left unprotected to one or more vaccine-preventable diseases. Hopefully, the office discovers the problem before any kids have gotten the vaccine though and they are just left throwing out some unusable vaccines.
What To Know About Vaccine Education for Pediatric Offices
Vaccines are safe, necessary, and still needed to protect all of our kids from vaccine-preventable diseases. Help make sure everyone in your office is educated about the latest immunization schedule and understands how to give and store vaccines safely.
Why does the United States give so many more vaccines than other countries?
The easy answer might be that we want to protect kids from more vaccine-preventable diseases. Of course, it is much more complicated than that.
But why does it matter?
It still matters because Jenny McCarthy has pushed the idea that we have an ‘autism epidemic‘ in the United States because “other countries give their kids one-third as many shots as we do.”
And some folks still believe her.
They also believe anti-vaccine myths and misinformation linking giving more vaccines to having higher infant mortality rates.
Immunization Schedules from Other Countries
Which vaccines a country routinely gives often depends on the risk a diseases poses to the people that live there. For example, some countries routinely give the BCG and Japanese encephalitis vaccines, but only give the hepatitis B vaccine in high risk situations.
And while many folks still push the myth that the United States gives many more vaccines than other developed countries, you just have to look at their immunization schedules to see that it isn’t true.
Remember that in the United States, children typically get:
36 doses of 10 vaccines before starting kindergarten that protect them against 14 vaccine-preventable diseases
at least three or four more vaccines as a preteen and teen, including a Tdap booster and vaccines to protect against HPV and meningococcal disease, plus they continue to get a yearly flu vaccine
So by age 18, that equals about 57 dosages of 14 different vaccines to protect them against 16 different vaccine-preventable diseases. While that sounds like a lot, keep in mind that 33% of those immunizations are just from your child’s yearly flu vaccine.
Immunization Schedules from Europe
How do immunization schedules from European countries differ from the United States?
Surprisingly, they don’t differ by that much, despite what you may have heard or read.
And in many European countries, even if you don’t get more vaccines overall, you do get more dosages at an earlier age, often with two dosages of MMR and the chicken pox vaccine by the time your child is 15 to 24 months old.
Some vaccines, like hepatitis A and chicken pox aren’t routine in every European country, like Iceland and Sweden, but many countries give vaccines that we don’t, like BCG and MenC. And even Iceland and Sweden have recently added the HPV vaccine to their schedule and Sweden may soon add the rotavirus vaccine too.
Immunization Schedules from Other Countries
Many countries, in addition to those in Europe, have vaccine schedules that are very similar to the one that is used in the United States.
What about Japan? They must give fewer vaccines than we do in the United States, right? After all, aren’t they the country that banned the use of the HPV vaccine?
Although that myth is still pushed by many anti-vaccine websites, the HPV vaccine is not banned in Japan. It was removed as a vaccine that is actively recommended in 2013, but it still available and is still on the Japanese immunization schedule.
All of our other vaccines are also on the Japanese immunization schedule. In addition, they give infants the BCG and Japanese encephalitis vaccines.
What to Know About Immunization Schedules from Other Countries
Many countries use a similar immunization schedule and give the same types of vaccines as we do in the United States.
More On Immunization Schedules from Other Countries
It is surprisingly easy to get behind on your child’s immunizations, even if you are trying to stay on schedule.
How do you miss a shot?
Your child could have been sick when they were supposed to get their vaccines, your pediatrician might have been out of one or more vaccines, or you might have simply missed one of your child’s well checkups.
Catching Up On Vaccines
If your child gets behind and misses one or more vaccines, be sure to get caught up as soon as possible.
If your child needs to get caught up quickly, like to start daycare or school, to travel out of the country, or because of a disease outbreak in your area, you can even use an accelerated immunization schedule, using minimum intervals between doses.
Depending on your child’s age, you might even be able to skip a few doses or vaccines.
For example, with rotavirus vaccines, vaccination should not be started if an infant is already 15 weeks old and the final dose must be given by 8 months of age.
And if your child gets their first dose of Hib after they are 15 months old, they don’t need any more doses. And they wouldn’t need any doses at all if they are already 5 years old.
Prevnar, IPV, and DTaP might also need to given on an alternative schedule when given on a catch-up schedule.
Specifically, your child might be able to skip:
the fifth dose of the DTaP vaccine, if the fourth dose was given at age 4 years or older.
the fourth dose of the IPV vaccine, if the third dose was given at age 4 years or older.
one or more doses of Prevnar, depending on when the other doses were given
Is this a good way to get out of getting some doses or vaccines?
Of course not. In addition to missing out on those vaccines, your child is missing out on the protection from those vaccines.
“Combination vaccines can be used for children who have fallen behind. Combination vaccines may be used when any of the components are indicated and none are contraindicated. The minimum interval between doses is the greatest interval between any of the individual antigens.”
Immunization Action Coalition on Combination Vaccines
Using combination vaccines, like Pediarix, Pentacel, Kinrix, Quadracel, and ProQuad, etc., can make getting caught up easier too.
For More Information on Catch-Up Immunization Schedules
Technically, the first official immunization schedule that was approved by the ACIP, AAP, and AAFP – a harmonized immunization schedule, just like we have today – was published in 1995.
Past Immunization Schedules
Of course, there were immunization schedules before that, including these immunization schedules that were published by the AAP in 1983, 1989, and 1994:
The Hib vaccine was added in 1985.
Next came the hepatitis B vaccine and expanded age ranges for the Hib vaccine.
What’s still missing?
Vaccines and protection against rotavirus, hepatitis A, chicken pox, flu, pneumococcal bacteria, meningococcal bacteria, and HPV.
Even Older Immunization Schedules
While the anti-vaccine movement often claims that kids now get too many vaccines (the too many too soon argument), not understanding that they get far fewer antigens than they once did, with far more protection, most of them will be surprised that some children got even more immunizations that the 1980s schedules they long for.
So in the 1940s, some children received:
3 doses of the pertussis vaccine
2 doses of the smallpox vaccine
3 doses of the typhoid vaccine
3 doses of a DT vaccine
a DPT booster
a tetanus booster
a typhoid booster
2 pertussis boosters
Some children also received a flu vaccine and pneumococcal vaccine.
With reference to the influence viral vaccine we have endeavored to give it those children who have repeated, frequent, severe upper respiratory tract infection.
Dr. Francis A Garbade – Galveston, Texas 1948
And in 1938, the AAP’s Special Committee on Prophylactic Procedures Against Communicable Diseases published a pamphlet, Routine measures for the prophylaxis of communicable diseases, which became the first Red Book.
Among its recommendations were vaccines to protect against seven infections, including:
It also mentions vaccines for erysipelas, scarlet fever, staphylococcal infections and chicken pox.
The bottom line is that many kids got a lot more vaccines in the old days than many parents realize or remember.
For More Information on Historical Immunization Schedules:
References on Historical Immunization Schedules
Offit, Paul A. Addressing Parents’ Concerns: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System? Pediatrics. Vol. 109 No. 1 January 1, 2002 pp. 124-129
Pickering, Larry K. The Red Book Through the Ages. Pediatrics. November 2013, VOLUME 132 / ISSUE 5
Sako, Wallace. Practical and Immunolgic Aspects of Pediatric Immunizations. Pediatrics. 1948;2;722.