It happens every once in a while in my practice: Parents ask if we can delay or skip certain vaccines, or spread them out.
According to a study just published in the journal Pediatrics, I’m not alone — in fact, 93 percent of pediatricians get asked the same thing.
Now, it’s important to point out that most families don’t ask for this. Most families are fine with the current vaccine schedule — as they should be, since it has been carefully studied and is felt to be safe. We give so many vaccines to babies because they are the ones who are most likely to get very sick from vaccine-preventable diseases. Not only do we think they can handle it, we think it’s the best thing for their health and safety.
But some families worry. They have heard things. They don’t like all the shots at once. There are certain shots that particularly frighten them — or that they don’t want at all. It’s uncommon for parents to refuse all vaccines, but refusing some or wanting to do them differently is more common — a recent survey showed that 13 percent of parents of young children used some kind of alternative schedule.
Now, most of us pediatricians don’t like this alternative schedule idea. The reasons doctors gave in the study are the same ones I have. Mostly, we think it puts children at risk of disease. I have seen babies die of meningitis caused by haemophilus influenza or pneumococcus, or get very sick from whooping cough or rotavirus (there have been deaths from whooping cough in newborns). I am worried about the resurgence of polio. I am very worried about the resurgence of measles.
When my older children were in elementary school, I sent in cupcakes for their birthdays or for class parties.
My youngest is in elementary school now, and for his birthday, I sent in pencils and temporary tattoos for classmates — because the school doesn’t allow us to send in sweets anymore.
When the change was first made, my reaction was: For real? Banning sweets? Since when did some cupcakes at a birthday party become so dangerous and a big deal? Even as a pediatrician, I thought it was silly. There’s nothing wrong with eating sweets as long as your diet is overall a healthy one.
But therein lies the problem. Not all kids’ diets are healthy. And, as I’ve thought about this more, I’ve decided that there’s something to be said for setting standards — and an example.
Cases of measles linked to an exposure at Disneyland continue to spread, not just in California, but in several other states and in Mexico. The numbers of cases are climbing — and so are the number of exposed people who might get sick — and expose more people before they realize they are sick. Measles is extremely contagious; if someone has it, they will infect 90 percent of the people around them who aren’t immunized.
It’s scary, because measles can be dangerous. 1 in 20 people who get it will get pneumonia. 1 in 1,000 will get encephalitis, a brain inflammation that can lead to seizures and brain damage. 1 or 2 in 1,000 will die.
But as scary as this outbreak is, it may ultimately be a good thing — because it may get more parents to immunize their children.
In a way, it’s our success with vaccination that is causing us problems these days. Vaccines work. They prevent the diseases they were created to prevent. And so very few people have seen measles — or polio, or diptheria, or bacterial meningitis or even chicken pox. It’s even true of doctors; recently, some younger doctors asked me to come look at a child’s rash and see if it was chicken pox, because they’d never seen the rash themselves (it wasn’t).
When you haven’t seen these illnesses, it’s easy to think that a) they aren’t a big deal, and b) they aren’t going to happen to your child. And if they aren’t a big deal and they aren’t going to happen to your child, why take the risk of immunizing?
With all the news about Enterovirus D68 sending hundreds of children to hospitals, it’s easy to panic when you hear about a case in your neighborhood—or, even worse, if your child starts coughing.
But please, don’t panic.
This virus has certainly caused trouble. Enteroviruses are incredibly common, causing 10-15 million illnesses a year—but usually, those illnesses are minor. This one, for reasons we don’t fully understand, is stronger, and is worse for kids than for adults.
I can hear you saying: so why shouldn’t I panic? Here’s why.