What to Know About Delayed Immunization Schedules

As a pediatrician, I am frequently asked this question at my “meet the doctor” visits. In fact, if the question is not brought up by a parent, I usually bring it up myself because I know a lot of parents are hearing mixed reports on this topic.

delayed immunization scheduleMy answer to this question is that I’m not a fan of a delayed immunization schedule. I don’t recommend giving shots if your child is “moderately to severely ill,” but otherwise I like to vaccinate well children on time. I think people need to think about why they want to change the schedule from one with proven efficacy and reasonable convenience to an unproven, less convenient, potentially dangerous schedule.

The most common reason given is concern that the vaccine schedule as recommended is just too many shots at time. Parents are concerned that their immune systems can’t handle it or will be overwhelmed resulting in autism or worse. Let me say first that I understand the fears because I too found it terrifying to hand over my own precious baby to a nurse and trust that this was all going to be ok. But the facts are in our favor as to the safety and wisdom of the schedule, and I quickly realized that the whole immunization experience wasn’t as bad as I had feared.

Let’s look at some of the issues

1. There is no evidence to support that a delayed schedule is beneficial.

A study was published in 2010 that looked at over 1,000 children from 1993-1997 who received vaccines in the first year of life either on the recommended schedule vs. a delayed schedule. It then compared their neuropsychological outcomes 7-10 years later. The result was that those following the recommended schedule performed better on all the testing! Thus does not mean that getting your child’s shots on time makes them smarter, but it is reassuring that there is no harm done in doing so.

2.MMR does not cause autism!

There has been so much research refuting the claims that MMR causes autism, but it has been hard to shake this unfortunate association in parents minds. One thing parents might find reassuring is just how weak and silly the claim was in the first place. The doctor responsible for the fateful study claiming a link between receiving the MMR vaccine and developing autism lost his license and the article (initially published in a British medical journal in 1998) was publicly retracted because it was SO bad!

The doctor (Dr. Wakefield) was being paid to provide evidence to support a lawsuit against the vaccine company on behalf of 11 developmentally delayed children. I read an almost comical article divulging just how faulty his evidence was. There were only 11 children included in his study, and when parents were interviewed later, some couldn’t even match their child with the histories of any of the children in the study (including one family who was told their child #13 in the study and there were only 11 children!) And most of them weren’t even diagnosed with autism! One had a chromosomal abnormality, one had a serious heart defect, and one had major developmental delays evident before age 1 and didn’t even get his MMR vaccine until age 4! So let’s all try to forget Dr. Wakefield and the damage his article caused.

3. Delaying the shot schedule is not without risks.

The recommended immunization schedule is designed to protect infants as early as their immune systems can respond because many of the vaccine preventable illnesses are most likely to be serious, even deadly if children are less than one year of age. Pertussis (whooping cough) is most deadly in infants less than 6 months old so the recommended schedule has infants getting vaccinated at 2, 4, and 6 months of age so they have finished their primary series by 6 months old.  Likewise, most serious infections from pneumococcal disease (for which Prevnar vaccine is given) are in children less than 2. So the idea is to protect children as soon as we can. A delay just means they remain unprotected for longer periods of time.

There are several good reasons to follow the recommended vaccine schedule and no good medical reasons to try to reinvent it. ¬†Nobody likes shots, but the diseases we are protecting kids from are worth remembering, and the babies are almost always smiling again by the time they reach the lobby to make their next appointment. So I’m a fan of following the schedule recommended by the American Academy of Pediatrics which is the same schedule endorsed by the American Academy of Family Practice and the Centers for Disease Control.

About Debra Berry

Dr. Debra Berry is a board-certified pediatrician in Lone Tree, Colorado providing comprehensive pediatric care at Lone Tree Pediatrics. Her primary goal as a physician is to help each of her patients live a healthy life and grow into a happy productive adult.