More Parents Put Children on Alternative Vaccination Schedules


More than one in 10 parents of young children has departed from the official vaccination schedule recommended by the CDC, a nationwide survey finds.

A nationwide survey of parents with young children has found that more than one in 10 has departed from the official vaccination schedule recommended by the Centers for Disease Control and Prevention and that many of those following the official schedule have doubts about its appropriateness. The results of the survey were posted online last week in Pediatrics.

The survey, which was conducted via the Internet, sampled 748 parents of children aged six months to six years, 13% of whom reported following a vaccination schedule different from that recommended by the CDC. Of these, just 17% (or 2% of all those surveyed) refused all vaccines, but more than 80% of parents pursuing an alternative vaccination schedule made more than one departure from the official schedule.

Among parents who refused at least one vaccine, those most frequently refused were H1N1 (86%), seasonal flu (76%), varicella (46%), and rotavirus (44%). Among parents who delayed at least one vaccine, the most frequently delayed were measles-mumps-rubella (MMR) (54%), varicella (44%), seasonal flu (35%), and H1N1 (34%). Among parents who spread out doses over a longer interval than recommended for at least one vaccine, the most frequently spread out were MMR (45%), diphtheria-tetanus-pertussis (43%), pneumococcal conjugate (33%), and hepatitis B (29%).

Alternative vaccinators reported a range of reactions from their children’s doctors: 8% had to change providers because their provider would not go along with their vaccination preferences; 30% said their child’s physician “seemed hesitant to go along” with their vaccination preferences, but ultimately did so; 40% said their child’s physician “seemed supportive” of their vaccination preferences; and 22% said their child’s doctor suggested the alternative vaccination schedule in the first place.

More than eight in 10 alternative vaccinators agreed that delaying vaccine doses is safer and associated with fewer side effects than following the recommended schedule. Of those following the recommended schedule, 18% agreed that delaying doses was safer and 25% agreed that it was associated with fewer side effects, indicating that many following the recommended schedule are at risk of departing from it. Indeed, almost a third of alternative vaccinators started out following the recommended schedule before charting their own course.

The survey also found some indications that alternative vaccinators are aware of the risks they are taking in delaying or refusing vaccines. 28% agreed that children who skip vaccines are more likely to get sick and spread infections, and 19% agreed that children whose vaccine doses are delayed are more likely to get sick and spread infections.

The current survey found that nonblack parents were more likely and parents whose children do not have a regular health care provider were far more likely to pursue an alternative vaccination schedule. It did not, however, find associations between alternative vaccination schedules and other demographic criteria that have been reported in previous surveys.

The study authors note that this lack of association may be due to the fact that the survey counted any parent whose child had departed from the recommended schedule as following an alternative schedule, regardless of whether the missed vaccination was due to active parental choice. They also suggest that it is possible that in recent years, alternative vaccination schedules have gone mainstream and are no longer limited to a particular subpopulation.


Alternative Vaccination Schedule Preferences Among Parents of Young Children (abstract) [Pediatrics]

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