Clinical

Many parents request delays in vaccine schedule

Last Updated: 2011-11-28 10:27:26 -0400 (Reuters Health)

By Genevra Pittman

NEW YORK (Reuters Health) - More than three quarters of pediatricians surveyed in Washington State said they are sometimes or often asked by parents to use an "alternative" vaccination schedule.

And while almost all of the pediatricians agree with the current vaccination schedule and would follow it for their own children, most would accede if parents wished to delay vaccines for chicken pox, hepatitis B and measles, for example.

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

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

Recent studies have shown that more parents are delaying or skipping certain vaccines, typically citing safety concerns, such as a link between vaccines and autism. (The full schedule is on the Centers for Disease Control website here: 1.usa.gov/k23A6d).

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

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

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

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

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

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

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

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

The new study, Dr. Dempsey added, "suggests to me that it's possible that this may become more the norm in the future, as more and more pediatricians are being asked to do this."

SOURCE: http://bit.ly/u86Ety

Pediatrics 2011.