Many parents these days are anxious about vaccinations, thanks to the proliferation of misinformation both on and off the internet. As well as being worried about vaccines causing autism (they don’t) and containing dangerous toxins (they don’t), another worry is that babies are getting too many vaccines all at once and they are spaced too close together. Admittedly, nowadays, babies and toddlers do get a lot of vaccines – up to 27 shots before their second birthday, including vaccines for rotavirus, tetanus, measles, and whooping cough (pertussis). Consequently, alternative vaccine schedules are becoming more and more popular with parents.
So what exactly is an alternative vaccine schedule?
In an alternative schedule, vaccines are delayed and only a few are administered together. For example, on one delayed schedule, children only receive vaccines for eight diseases by 15 months of age. They miss out on measles, mumps, rubella, chickenpox, hepatitis A, and hepatitis B. In addition they will have had to visit the doctor’s office nine times – almost twice as many as children who are getting vaccinated according to the standard Center for Disease Control (CDC) schedule. In comparison, a child vaccinated according to the CDC schedule will be vaccinated against 14 diseases in that same period of 15 months.
However, although the number of vaccines has increased, these vaccines are way more efficient than the older vaccines. The older vaccines required more proteins (antigens) to adequately stimulate the immune system, compared with the newer vaccines.
When we were children (in the 70s, 80s, and early 90s) we were vaccinated against fewer things (which were nonetheless still deadly). As an example, let’s take the CDC’s vaccine schedule from 1983. There were seven diseases we were protected against including measles, mumps, rubella, (MMR), diptheria, tetanus and pertussis (DTaP), and polio. Because of how vaccines were made at the time, overall we were exposed to approximately 3000 antigens by the time we were one year old and around 12,000 by the age of four, if we were vaccinated according to the CDC schedule.
However, if a child today receives all their vaccines on schedule and has received all doses by 12 months, they will have been exposed to 150-204 antigens, depending on the timing of their 12 month shots, for protection against 14 diseases. If children have received all the recommended vaccines by age four, depending on the timing of their four year shots, they will have been exposed to exactly 359 antigens for ALL vaccines from birth through age four.
But aren’t alternative schedules safer?
Unfortunately there is no evidence that alternative schedules result in fewer adverse reactions to the vaccines and in fact there is evidence that delaying the MMR vaccine past 15 months of age can put your child at a higher risk of seizures. A large study in the US of more than 300,000 children found that child who received the MMR vaccine between 16 and 23 months were 6.53 more times likely to suffer from a seizure than children who received the MMR vaccine according to the CDC schedule. This effect was even greater in children who delayed the mumps, measles, rubella and varicella (MMRV) vaccine; children who received the MMRV between 16 and 23 months were 9.8 times more likely to experience a seizure than children who received this vaccine according to the CDC schedule.
In addition, as well as being associated with a higher risk of seizures, alternative vaccine schedules put children at greater risk of infectious diseases. One of the reasons that babies start to receive vaccinations so young is that this is precisely the age that they are susceptible to diseases such as whooping cough and measles, both of which are diseases that should not be taken lightly.
But surely there must be some benefits?
No evidence to date shows any benefits for delaying vaccines. In a study comparing children who received delayed vaccinations versus children who received vaccinations according to the CDC schedule, no differences in cognitive or behavioral outcomes were found when the children were aged between 7 and 10 years.
Who puts together the alternative schedules?
At best a doctor will come up with an alternative vaccine schedule, and although they do receive training in immunology, it is still only around the level of an undergraduate. However, many alternative vaccine schedules are created by people who do not have a medical degree or even an undergraduate degree in immunology. Compare this with the CDC schedule, which is put together by medical and public health experts who review available data on newly licensed and existing vaccines. These experts, who include vaccine experts, scientists, doctors, and public health professionals, form the Advisory Committee on Immunization Practices (ACIP) and the vaccine specialists in particular have a very deep understanding of the immune system.
ACIP meets 3 times each year to discuss vaccine recommendations. They consider
- How safe and effective the vaccine is when given at a specific age
- The severity of the disease the vaccine prevents
- How many people get the disease if there is no vaccine
- How well the vaccine helps the body produce immunity to the disease
Nobody is arguing that the risks of vaccines are zero – serious reactions can occur. However these are extremely rare, and the fatal and/or debilitating consequences of the infectious diseases they prevent mean that the benefits of vaccines far outweigh the risks. Delaying vaccines means that not only is your child more vulnerable to these diseases but so are children and people who can’t be immunized. The CDC schedule is put together by experts with the goal of maximizing the effectiveness of the vaccines while also ensuring that they are as safe as can possibly be. Personally I would rather follow the schedule that is put together by experts in vaccines than the ones that are created by people who are not.