Pediatricians Receiving Regular Requests for Alternative Childhood Immunization Schedules

Seventy-seven percent of Washington state pediatricians report that they are sometimes or frequently asked to provide alternative childhood vaccine schedules for their patients, according to a new study from Seattle Childrens Research Institute. 

Researchers also found that 61 percent of Washington state pediatricians are comfortable using an alternative schedule when asked by a parent. The study, Washington State Pediatricians Attitudes Toward Alternative Childhood Immunization Schedules, is published in the December 2011 issue of Pediatrics and is the first to evaluate pediatricians attitudes towards alternative schedules.

When discussing alternative childhood immunization schedules, pediatricians have to balance two things- respecting the parents decision and protecting the health of the child, says Doug Opel, MD, MPH, a bioethicist at Seattle Childrens Research Institute and a University of Washington acting assistant professor of pediatrics. This is a difficult and important discussion, and what we found was that most pediatricians are comfortable being flexible with the immunization schedule when parents ask for this flexibility. 

The group of 209 pediatricians included in the study were least willing to revise the schedule for three vaccinations: diphtheria-tetanus toxoids-acellular pertussis vaccine (DTaP), Haemophilus influenzae type b vaccine (Hib) and pneumococcal conjugate vaccine (PCV).  This suggests physicians want to prioritize immunizations that protect against some of the most common and most dangerous diseases which may occur during infancy and early childhood. Skipping the DTaP vaccine, for example, could lead to pertussis, also known as whooping cough. Pertussis is still common in the U.S. with frequent outbreaks. The Hib and PCV vaccines protect against infections like meningitis and pneumonia.

The study demonstrates the need for more research on the use of alternative immunization schedules and the safety, efficacy and consequences of delaying immunizations, says Opel.  Seattle Childrens Research Institute will continue to study this topic to better understand the effect of childhood immunization schedules on individuals and public health.

Opels co-authors were: Aaron Wightman, MD, Seattle Childrens Research Institute and University of Washington; Edgar Marcuse, MD, MPH, Seattle Childrens Research Institute and University of Washington and James Taylor, MD, University of Washington.