There is plenty of evidence that the standard immunization schedule is safe and effective.
What about the alternative vaccine schedules that some folks push?
Is there any evidence that is safe to delay or skip any of your child’s vaccines?
Alternative Vaccine Schedules
Many people think of Dr. Bob Sears when they think of alternative vaccine schedules.
Bob Sears appeared on Fox & Friends for the segment “Vaccines: A Bad Combination?”
He created both:
Dr Bob’s Selective Vaccine Schedule
Dr Bob’s Alternative Vaccine Schedule
He didn’t invent the idea of the alternative vaccine schedule though.
Well before Dr. Bob appeared on the scene, Dr. Jay Gordon had been on Good Morning America with Cindy Crawford to discuss vaccines and how she had decided to delay vaccinating her baby.
Where did she get the idea?
After the segment, Dr. Jay stated:
“They edited the segment to make me sound like a vaccination proponent. We also have to understand the impact of a person as well-known as Cindy Crawford delaying vaccines for over six months.”
Jay Gordon
Dr. Jay has long talked about only giving infants one vaccine at a time and waiting until they are “developmentally solid” before vaccinating.
When Bob Sears came out with his vaccine book, Jenny McCarthy was also pushing the too many too soon myth and rallying folks to go back to the 1983 schedule that left kids at risk for meningitis, pneumonia, blood infections, severe dehydration, epiglottitis, and cancer from Hib, pneumococcal disease, rotavirus, hepatitis B, hepatitis A, chicken pox, HPV, and meningococcal disease.
Similarly, other folks have pushed ideas about delaying and skipping vaccines before Dr. Bob, including:
Donald Miller and his User-Friendly Vaccination Schedule – no vaccines until age two years and no live vaccines and when you begin vaccinating your child, give them one at a time, every six months (first published in 2004)
Stephanie Cave – starts at 4 months and delays many vaccines
homeopaths with immunization schedules that say to wait until six months and then start giving nosodes every five days
chiropractors with immunization plans that say to get regular chiropractic adjustments instead of vaccines
Of course, Dr. Bob is the one who popularized the idea of the alternative vaccine schedule in 2007, when he published The Vaccine Book: Making the Right Decision for Your Child.
That’s when parents started to bring copies of his schedule into their pediatrician’s office, requesting to follow Dr. Bob’s schedule instead of the standard immunization schedule from the CDC.
What’s the Evidence for Alternative Vaccine Schedules?
There is no evidence that following an alternative vaccine schedule is safe for your kids.
“No alternative vaccine schedules have been evaluated and found to provide better safety or efficacy than the recommended schedule, supported by the Advisory Committee on Immunization Practices of the CDC and the Committee on Infectious Diseases of the AAP (the committee that produces the Red Book).
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 Pediatrics
What’s the first clue that these so-called alternative vaccine schedules have absolutely no evidence behind them?
They are all different!
Paul Thomas, for example, doesn’t even offer his patients the rotavirus vaccine. Dr. Bob, on the other hand, has it on his list of vaccines that “that could protect a baby from a very potentially life-threatening or very common serious illness” and is sure to give it at 2, 4, and 6 months.
How slow should you go?
Both Dr. Bob and Dr. Paul give two vaccines at a time with their schedules, but Dr. Jay and Dr. Miller say to give just one at a time.
“Would any scientist give SIX vaccines at once to a baby? Asking for trouble. One at a time makes so much more sense.”
Jay Gordon
And while some start their schedules at 2 or 4 months, others delay until 6 months or 2 years.
There is also the fact that the folks who create these schedules admit that there is no evidence for what they are doing…
“No one’s ever researched to see what happens if you delay vaccines. And do babies handle vaccines better when they’re older? This is really just a typical fear that parents have when their babies are young and small and more vulnerable. Since I don’t know one way or the other, I’m just happy to work with these parents, understand their fears and their worries, and agree to vaccinate them in a way that they feel is safer for their baby.”
Unvaccinated kids aren’t healthier – they just get more vaccine preventable diseases. Most of which are life-threatening, even in this age of modern medicine, with access to good nutrition and sanitation.
So whether you only get one or two vaccines at a time; delay until four months, six months, or two years before you get started; skip all live vaccines or just wait until your child is “developmentally solid” to give them; or go with some other non-standard, parent-selected, delayed protection vaccine schedule, the only things that you can be sure of is that there is no evidence to support your decision and that you will leave your kids unprotected and at risk for getting a vaccine-preventable disease.
“…when I give your six-week-old seven different vaccines with two dozen antigens, I am supposed to try to convince you that the adverse reactions you have heard about are just coincidences.”
Jay Gordon
Better yet though. Find a pediatrician who will listen and answer your questions about vaccines, concerns about vaccine myths and misinformation, explain that no vaccine is optional, and not just simply pander to your fears.
What to Know About the Evidence for Alternative Vaccine Schedules
There is no evidence that skipping or delaying any vaccines with an alternative vaccine schedules can keep your kids safe from vaccine preventable diseases.
More on the Evidence for Alternative Vaccine Schedules
If you are following the latest immunization schedule and your kids are up-to-date on all of their vaccines, then they will likely be ready to start daycare, kindergarten, high-school, or college.
There aren’t usually any extra vaccines that they will need to start school.
Of course, if you have skipped or delayed any vaccines, then they might have to catch up on some immunizations before starting school.
Another situation where you might need to do some catching up is if you move, and instead of following the CDC schedule, you were just getting the minimum number of vaccines that were required to attend school where you used to live. For example, your kids could have been all set to start kindergarten in Arkansas, but if you suddenly moved to Texas, they might need a second MMR, a booster dose of Varivax, and two doses of hepatitis A vaccine, as none of those are required in Arkansas.
Immunization Requirements to Start Daycare and Preschool
Daycare rules in Idaho give parents a month to stay on schedule with all of the CDC immunization requirements.
Since many new parents have to go back to work when their baby is only about two to six weeks old, they won’t have time to get their first set of vaccines at two months.
That won’t keep them out of daycare, but delaying too much longer, usually more than a month, probably will.
To start daycare or preschool, infants and toddlers need to get most of the vaccines on the CDC immunization schedule. This includes DTaP, hepatitis B, Hib, Prevnar, and IPV (polio), and then once they are 12 months old, booster doses of the primary series of vaccines and the MMR, Varivax (chickenpox), and hepatitis A vaccines.
The only vaccine that is missing from many state mandates is the rotavirus vaccine. And that simply has to do with the strict timing requirements of when you need to start (before 15 weeks of age) and finish this vaccine (by 8 months).
Some states do require rotavirus though, and simply state that kids must follow “age appropriate dosing.” That way, if they are too old, they just don’t need to get it.
Immunization Requirements to Start Kindergarten
In addition to most of the vaccines they needed to start daycare or preschool, to start kindergarten, kids need their 4 to 6 year old boosters:
the fifth dose of DTaP to protect them against diphtheria, tetanus, and pertussis
the fourth dose of IPV to protect them against polio
the second dose of MMR to protect them against measles, mumps, and rubella
the second dose of Varivax to protect them against chicken pox
If using combination vaccines, these four immunizations can be combined into just two shots – Proquad (MMR + Varivax) and either Kinrix or Quadracel (DTaP + IPV), which your preschooler will appreciate to help reduce the pain from getting these shots.
If your kids were missing any vaccines, they will also need to get caught up on those before starting school.
Immunization Requirements to Start Middle School
Preteens and teens get a few vaccines when they start middle school when they are around 11 to 12 years old, including:
a dose of Tdap to protect them against diphtheria, tetanus, and pertussis
a dose of Menactra or Menveo to protect them against meningoccocal disease
Although not required by most schools, the HPV vaccine is also usually given around this time.
Immunization Requirements to Start College
And then, before going off to college, at around age 16 years, kids will usually need:
a booster dose of Menactra or Menveo to protect them against meningoccocal disease
They can also get the MenB vaccine, although it isn’t yet required for all students. This vaccine (Bexsero or Trumenba) has a “permissive” recommendation, in that parents are told they can get it if they want their kids to avoid meningococcal B disease, but it is not required yet.
While an extra dose of the MMR vaccine is now being given in some situations, it is mainly if your child is at high risk because of a current mumps outbreak. A mumps booster shot is not currently recommended just because your child is going off to college.
What to Know About Immunization Requirements for Incoming Students
If you have been following the latest immunization schedule and your kids are up-to-date on all of their vaccines, then they will likely be ready to start daycare, kindergarten, high-school, and college without needing any extra vaccines.
More on Immunization Requirements for Incoming Students
From the nurses who refuse to get vaccinated, even though they are routinely around high risk children, to other health care providers who push the idea that it is okay to skip or delay some vaccines, they all put our kids at risk.
“One would anticipate that this medical advance would be universally embraced by both parents and health care professionals. Sadly, however, the antivaccine movement, fueled by a lack of respect for the evidence and a profound paranoia, remains alive and well. It is not an overstatement to lay the blame for a resurgence of deadly childhood infections, stemming from declining vaccination rates, at the feet of this movement. Nurse practitioners (NP) also bear some degree of the blame. While certainly not scientific, the anecdotal evidence from letters to JNP documents that some proportion of our readers buy into the pseudoscience of the antivaccine movement. Comments have ranged from bafflingly uninformed (“I don’t think there is enough evidence to support widespread immunizations”) to profoundly unethical (“I recommend to my patients that they not vaccinate their children”).”
Laurie Scudder, DNP, NP on The Importance of Vaccinations
They are often joined by one or more vaccine-friendly nurse practitioners…
Nurse Practitioners on Vaccines
Of course, most nurse practitioners support getting kids vaccinated and protected though.
That’s reflected in the position statement of the National Association of Pediatric Nurse Practitioners (NAPNAP):
“NAPNAP supports the prioritization of immunization education for parents, guardians and other caregivers of infants, children, and adolescents. This education must include the most current scientific evidence related to vaccine safety, risk, benefits and current resources available to ensure that parents and caregivers receive adequate information about immunizations. This includes, when necessary, relaying the risk of not immunizing their child and potential devastation that can occur when a child is infected with a vaccine-preventable disease. It is incumbent that a PNP also be aware of misinformation in the public domain and provides the correct information to the public as well as the health care community.”
Fortunately, most NPs do a great job educating parents and getting kids vaccinated.
Not all of them though.
You can still find some pushing classic anti-vaccine propaganda about vaccines being made in China, that vaccines don’t work, that vaccine-preventable diseases aren’t dangerous, and that natural treatments work are safer – including many, like essential oils and vitamins that they will be very happy to sell to you.
“It’s time for NPs to be part of the solution. We must preach the importance of vaccines, and then we must practice what we preach and be appropriately immunized ourselves.”
Laurie Scudder, DNP, NP on The Importance of Vaccinations
Actually, it’s time for everyone to get educated and to be part of the solution!
What To Know About Nurse Practitioners on Vaccines
Like the great majority of other health care providers, most nurse practitioners fully support getting kids vaccinated and protected against vaccine preventable diseases.
“Vaccines protect the health of children and adults and save lives. They prevent life – threatening diseases, including forms of cancer. Vaccines have been part of the fabric of our society for decades and are one of the most significant medical innovations of our time.”
More than 350 medical, professional and advocacy organizations in a 2017 letter to President Trump
It is the hundreds of thousands of experts at every major health organization around the world!
American Academy of Pediatrics
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.
“Vaccines are safe. Vaccines are effective. Vaccines save lives.
Claims that vaccines are linked to autism, or are unsafe when administered according to the recommended schedule, have been disproven by a robust body of medical literature. Delaying vaccines only leaves a child at risk of disease. Vaccines keep communities healthy, and protect some of the most vulnerable in our society, including the elderly, and children who are too young to be vaccinated or have compromised immune systems.”
Fernando Stein, MD, FAAP, President and Karen Remley, MD, MBA, MPH, FAAP, CEO/Executive Vice President, American Academy of Pediatrics
Vaccine friendly pediatricians who are pushing non-standard, parent-selected, delayed protection vaccine schedules are leaving kids at risk for vaccine-preventable diseases.
“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.”
AAP on Countering Vaccine Hesitancy
Vaccines are necessary.
“Because rare medically recognized contraindications for specific individuals to receive specific vaccines exist, legitimate medical exemptions to immunization requirements are important to observe. However, nonmedical exemptions to immunization requirements are problematic because of medical, public health, and ethical reasons and create unnecessary risk to both individual people and communities.”
AAP on Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance
Society of Pediatric Nurses
“Immunizations are safe and effective in promoting health and preventing disease.”
SPN Position Statement on Immunizations
National Association of Pediatric Nurse Practitioners
Established in 1973, with more than 8,500 members, the National Association of Pediatric Nurse Practitioners (NAPNAP) is the professional association for pediatric nurse practitioners (PNPs) and all pediatric-focused advanced practice registered nurses (APRNs).
“NAPNAP supports the prioritization of immunization education for parents, guardians and other caregivers of infants, children, and adolescents. This education must include the most current scientific evidence related to vaccine safety, risk, benefits and current resources available to ensure that parents and caregivers receive adequate information about immunizations. This includes, when necessary, relaying the risk of not immunizing their child and potential devastation that can occur when a child is infected with a vaccine-preventable disease. It is incumbent that a PNP also be aware of misinformation in the public domain and provides the correct information to the public as well as the health care community.”
NAPNAP Position Statement on Immunizations
American College of Preventive Medicine
“Vaccine-preventable diseases were a major cause of mortality and morbidity in the United States in the 20th century. With the advent of immunizations, there have been dramatic rates of decline in these diseases. Clinical studies have shown vaccines to be efficacious and cost effective. ”
ACPM on Childhood Immunizations
American College of Obstetricians and Gynecologists
Founded in 1951, the American College of Obstetricians and Gynecologists (The College) represents more than 58,000 members.
“Health care providers and patients should be aware that the reassuring safety data for use of the aforementioned vaccines in pregnancy are compelling, and there is no link to vaccine administration and miscarriage. An added benefit to immunizing during pregnancy is the potential for disease prevention in newborns by way of passive antibody transfer to the fetus. Hence, offering pregnant patients influenza and Tdap vaccines is an avenue to protect newborn infants at a critically vulnerable time and before neonates can be vaccinated.”
ACOG on Immunization for Pregnant Women
American Public Health Association
The American Public Health Association was founded in 1872, the APHA represents over 25,000 public health professionals.
“And further noting that the Institute of Medicine has recently released a report10 describing the U.S. immunization system as “a national treasure that is too often taken for granted” and calling for substantial increases in federal and state allocation of funds to support immunization infrastructure; therefore
Reaffirms its support for immunization as one of the most cost-effective means of preventing infectious diseases;”
APHA on The Need for Continued and Strengthened Support for Immunization Programs
American Medical Association
The American Medical Association, which was founded in 1847, has just over 240,000 members.
“The AMA fully supports the overwhelming body of evidence and rigorous scientific process used by the Advisory Committee on Immunization Practices which demonstrate vaccines are among the most effective and safest interventions to both prevent individual illness and protect the health of the public.”
William E. Kobler, MD, member of the AMA Board of Trustees.
Immune Deficiency Foundation
“The development of immunizations for common bacterial and viral infections has represented a major advance in the battle against microbial organisms that constantly threaten the welfare of humankind and particularly the pediatric population. However, the alarming increase in nonimmunized persons could lead to a return of the epidemics seen in the past.
…critical need for maintenance of herd immunity in the population at large. It is particularly important for family members of patients with defective T and B lymphocyte–mediated immunity to receive all of the available standard immunizations (excluding live poliovirus).”
Medical Advisory Committee of the Immune Deficiency Foundation on Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts
American Nurses Association
The American Nurses Association (ANA), founded in 1896, represents “the interests of the nation’s 3.6 million registered nurses.”
“To protect the health of the public, all individuals should be immunized against vaccine-preventable diseases according to the best and most current evidence outlined by the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP). All health care personnel (HCP), including registered nurses (RNs), should be vaccinated according to current recommendations for immunization of HCP by the CDC and Association for Professionals in Infection Control and Epidemiology (APIC).
…
As stated in the Code of Ethics for Nurses (ANA, 2015, p. 19), RNs have an ethical responsibility to “model the same health maintenance and health promotion measures that they teach and research…,” which includes immunization against vaccine-preventable diseases.”
ANA Position Statement on Immunizations
Autism Science Foundation
“Multiple studies have been completed which investigated the measles, mumps and rubella vaccination in relation to autism. Researchers have also studied thimerosal, a mercury-based preservative, to see if it had any relation to autism. The results of studies are very clear; the data show no relationship between vaccines and autism.”
The American Association of Immunologists (AAI) is the largest professional association of immunologists in the world, representing more than 7,600 basic and clinical immunologists.
“Recent outbreaks have brought increased attention to vaccine- preventable diseases and have highlighted the need for robust and timely immunization to reduce preventable sicknesses and deaths. AAI strongly urges full adherence to recommended vaccination schedules and views vaccines as efficacious for individuals and crucial to public health.
…
Research has repeatedly confirmed that vaccinations are safe and highly effective for all healthy children and adults, and any suggestions to the contrary have been discredited. Ongoing vaccine research continually reaffirms its safety and efficacy, including the number of vaccines administered at any one time and the recommended vaccination schedule.”
The American Association of Immunologists Statement on Vaccines
American Osteopathic Association
“The American Osteopathic Association supports the Centers for Disease Control and Prevention in its efforts to achieve a high compliance rate among infants, children and adults by encouraging osteopathic physicians to immunize patients of all ages when appropriate ; supports the HHS National Vaccine Implementation Plan; and encourages third- party payers to reimburse for vaccines and their administration.”
AOA on Immunizations
National Association of School Nurses
#TodaysSchoolNurse is “grounded in ethical and evidence-based practice, are the leaders who bridge health care and education, provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potential.”
“It is the position of the National Association of School Nurses (NASN) that immunizations are essential to primary prevention of disease from infancy through adulthood.
…
The school nurse is well-poised to create awareness and influence action to increase the uptake of mandated and recommended immunizations. The school nurse should use evidence-based immunization strategies, such as school-located vaccination clinics, reminders about vaccine schedules, state immunization information systems (IIS), strong vaccination recommendations, and vaccine education for students, staff, and families.”
NASN Immunizations Policy Statement
American Academy of Family Practice
“With the exception of policies which allow for refusal due to a documented allergy or medical contraindication, the AAFP does not support immunization exemption policies.”
AAFP Immunization Policy Statement
American Academy of Allergy, Asthma & Immunology
The American Academy of Allergy, Asthma & Immunology (AAAAI) is a professional organization with over 7,000 members, including allergists/ immunologists, in the United States and 73 other countries.
“Immunization is perhaps the greatest public health achievement of all time, having significantly reduced the morbidity and mortality of many infectious diseases. Routine immunization of children, adolescents, and adults provides substantial protection from a large number of infectious diseases…
Patients who have experienced adverse reactions to vaccines might unnecessarily be advised to avoid subsequent immunization, which could have important adverse personal and population health consequences. Although there are some adverse reactions to vaccines that constitute absolute contraindications to administration of future doses, most such reactions do not preclude subsequent immunization. Patients who have experienced an apparent allergic or other serious adverse reaction after receiving a vaccine warrant evaluation by an allergist/immunologist. Also, patients with preexisting health conditions that might predispose to adverse reactions to vaccines could benefit from such an evaluation. In most cases, a risk-benefit analysis will favor subsequent immunization.”
AAAAI Practice Paramater on Adverse Reactions to Vaccines
CJ First Candle
“There seems to be a common misconception that vaccines are somehow associated with SIDS deaths. This is not true! Experts warn that the risk of leaving your baby unprotected is 1,000 times greater than any increased risk for SIDS. Because infants receive many immunizations during the critical development period from two to six months of age, and 90 percent of SIDS deaths occur within this time frame, it is only logical that many SIDS victims have recently received vaccines. This does not mean that the immunization had anything to do with the infant’s subsequent sudden and unexpected death. The cause and effect of immunizations and SIDS has been comprehensively studied for more than two decades. In fact, in countries where immunization schedules are different from those in the United States, the peak incidence of SIDS is still between two to four months.”
CJ First Candle on Immunizations
Infectious Disease Society of America
Founded in 1963, the Infectious Diseases Society of America (IDSA), with over 9,000 members, represents physicians, scientists and other health care professionals who specialize in infectious diseases.
“The Infectious Diseases Society of America (IDSA) recognizes the great benefits that vaccines provide for the public health. Substantial scientific evidence demonstrates vaccines’ enormous value in protecting individuals and populations from serious and life-threatening infections. Scientific evidence also demonstrates the overall safety of vaccines. Communities are most effectively protected when all are immunized.
…
Studies demonstrate that the easier it is to receive an exemption, the higher the rate of exemptions in a particular state. As the number of exemptions increases, the risk of vaccine – preventable disease increases. Therefore, states must make every effort to minimize the number of its citizens exempted from immunization mandates. Such exemptions make the state legislatures who grant them, as well as the individuals who receive them, responsible for placing the remaining state population at greater risk of acquiring potentially fatal infections.”
IDSA Policy Statement on State Immunization Mandates
The Arc of the United States
“Prior to widespread immunization in the United States, infectious diseases killed or disabled thousands of children each year. The near elimination of intellectual disability due to measles encephalitis, congenital rubella syndrome, and Haemophilus influenzae type b meningitis or Hib can be contributed to vaccines.”
The Arc Facts About Childhood Immunizations
American College Health Association
“The American College Health Association (ACHA) strongly supports the use of vaccines to protect the health of our individual students and our campus communities. In recognition of the vital role that vaccine coverage plays in community immunity (herd immunity), ACHA discourages use of nonmedical exemptions to required vaccines.”
ACHA on Immunization Recommendations for College Students
What to Know About Expert Statements on Vaccines
Over the years, hundreds of organizations representing millions of families, health care providers, researchers, patients, and consumers, have repeatedly expressed their unequivocal support for vaccines, because they understand that vaccines work and that they are safe and necessary.
The American Academy of Pediatrics recommends “exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.”
They do not recommend breastfeeding as a substitute for getting vaccinated.
They also don’t recommend that anyone stop breastfeeding after their children are vaccinated.
These are just some of the myths that you might hear about vaccines and breastfeeding.
Myths About Vaccines and Breastfeeding
Breastfeeding does provide some immunity against infectious diseases.
Unfortunately, this type of passive immunity won’t keep your child from getting diseases like measles, pertussis, or the flu. Breast milk, which is high in IgA antibodies, can help protect against gastrointestinal diseases and some respiratory infections though.
And that is where the myth about the “recommendation” to stop breastfeeding comes in…
Why do anti-vaccine websites still post misinformation about fake recommendations to stop breastfeeding?
Actually, it was never a recommendation by any major health organization.
It was not a recommendation by the AAP, CDC, or even the WHO.
“Live oral rotavirus vaccines have been less immunogenic and efficacious among children in poor developing countries compared with middle income and industrialized countries for reasons that are not yet completely understood. We assessed whether the neutralizing activity of breast milk could lower the titer of vaccine virus and explain this difference in vitro.”
Moon et al on Inhibitory Effect of Breast Milk on Infectivity of Live Oral Rotavirus Vaccines
And they simply suggested that nursing mothers delay breastfeeding for up to an hour after their baby was vaccinated with an oral rotavirus vaccine. Don’t skip a feeding. Don’t stop breastfeeding. Don’t switch to formula.
“Rotavirus is the most common cause of severe diarrhea in children less than 5 years of age. Rotavirus disease is responsible for an estimated 527,000 deaths per year worldwide, with >85% of these deaths occurring in low-income countries.”
Moon et al on Inhibitory Effect of Breast Milk on Infectivity of Live Oral Rotavirus Vaccines
Why did they talk about breastfeeding at all?
They were simply looking for a way to boost the effectiveness of rotavirus vaccines in these countries, where rotavirus disease is still a big killer.
Unfortunately, in addition to the whole theory being turned into more propaganda by the anti-vaccine movement, further studies have shown that it likely doesn’t even work.
“Breastfed infants should be vaccinated according to the recommended schedule ”
CDC on General Recommendations on Immunization
What are other myths about vaccines and breastfeeding?
that breastfeeding is a substitute for getting vaccinated – it’s not – vaccines are necessary, even if you are breastfeeding your child
you can’t get vaccinated if you are breastfeeding – not true, unless you are looking to get a smallpox vaccine, which is contraindicated. Getting a yellow fever vaccine is discouraged if you are breastfeeding, but is not contraindicated if your are traveling to a high risk area.
Although it is currently not available in the United States, you can even get FluMist if you are breastfeeding.
What to Know Vaccines and Breastfeeding Myths
Why do anti-vaccine websites post misinformation about fake recommendations to stop breastfeeding and other myths about vaccines?
Why does gluten sometimes come up in discussions about vaccines?
Is it because a vaccine to treat people with Celiac disease is being tested?
Probably not.
It is more likely that it is because some people worry that vaccines contain gluten.
Which Vaccines Are Gluten-Free?
So which vaccines are gluten-free?
All vaccines are gluten-free. Do they need to labeled ‘gluten-free’ to convince some vaccine hesitant folks?
Fortunately, they all are, so you don’t have to worry about skipping or delaying your child’s vaccines if they have Celiac disease, a gluten sensitivity, or if you are simply following a gluten-free diet.
Vaccines and Food Allergies
Non-active components of vaccines can rarely trigger allergic reactions, including antibiotics and latex.
What about non-active vaccine ingredients that might worry someone with food allergies?
There actually are some, including eggs, milk, gelatin, and yeast.
Talk to your pediatrician or a pediatric allergist if you are concerned about vaccine allergies. They can review the “Algorithm for treatment of patients with hypersensitivity reactions after vaccines,” which “provides a rational and organized approach for the evaluation and treatment of patients with suspected hypersensitivity.”
This is especially important if you think that your child is allergic to all vaccines, something that is almost unheard of, as vaccines have different components and are made in different ways.
You don’t have to worry about gluten though.
What To Know About Vaccines and Gluten
There is no gluten in vaccines and vaccines are actually in development to treat people with gluten sensitivity.
Vaccine hesitant parents sometimes don’t get time to talk with a pediatrician about vaccines.
They might not even get an appointment with their new baby if they express doubts about wanting to vaccinate their kids or about wanting to skip or delay some vaccines.
That’s unfortunate, as I think many would choose to vaccinate and protect their kids if they got answers to the anti-vaccine talking points that scare them.
Myth busting by itself doesn’t always seem to work though.
How Pediatricians Should Talk to Vaccine Hesitant Parents
Pediarix, Hib, Prevnar, and Rota vaccines for my daughter at her 2 month well visit 10 years ago. Photo by Vincent Iannelli, MD
One strategy that might work includes asking open ended questions about why the parent is hesitant to vaccinate their kids. Next, while responding to a few of their biggest concerns, be sure to affirm what the parent is saying and use reflective listening.
How might these vaccination-focused motivational interviewing techniques work during a typical visit at a pediatrician’s office? Instead of getting frustrated and accepting a copy of Dr. Bob’s alternative schedule, you might ask them:
What specifically are you afraid of?
You are really worried that your child might get sick after their vaccines.
It sounds like you think kids get too many shots.
Now, address a few of those concerns.
Pediatricians often feel like they don’t have enough time to have long discussions about vaccines, when they also need to talk about many other important topics at each visit, including nutrition, development, and safety, etc. The vaccine talk doesn’t have to be extensive though. Just get it started and come back to it again at the next visit.
You can also recommend some good vaccine books and websites to help parents do more research.
Talking About Vaccines
It is not enough to simply tell your vaccine hesitant parents to read a book, visit a website, or offer them some handouts though. It is important that pediatricians also talk to parents about vaccines.
Study after study show that pediatricians are the most influential, most convincing, and most used source of information about vaccines for many parents.
“How providers initiate and pursue vaccine recommendations is associated with parental vaccine acceptance.”
Opel et al on The Architecture of Provider-Parent Vaccine Discussions at Health Supervision Visits
Help parents who may have a skewed perception of the risks of vaccines vs risks of vaccine preventable diseases, by emphasizing that vaccines are very safe.
Avoid simply minimizing or dismissing a parent’s concerns about vaccines without providing a fact based explanation for why they shouldn’t be worried.
Avoid a “data dump,” in which you might overwhelm a vaccine hesitant parent with too much information all at once and in what they might see as a lecture about accepting vaccines.
Always use presumptive language and high-quality recommendations when you talk about vaccines.
Include stories and anecdotes about kids who have gotten sick and parents who regret not vaccinating their kids.
Become familiar with the anti-vaccine talking points that may be scaring your patients away from getting vaccinated on time. Why is this important? If they are concerned about glyphosate, you might not sound too convincing telling them not to worry if you don’t even know what glyphosate is.
Try the CASE Method for talking about vaccine concerns.
Are your kids fully vaccinated? Talk about that too.
There is much more to all of this than simply letting parents follow non-standard, parent-selected, delayed protection vaccine schedules and arguing with them about getting caught up.
What to Know About Talking to Vaccine Hesitant Parents
Learning new ways to talk to vaccine hesitant parents, including the use of vaccination-focused motivational interviewing techniques, presumptive language, and high-quality recommendations, might help pediatricians have more success and get less frustrated.
