Vaccination Questions

I have also collected a set of links about vaccination on my links page, here.

Do you believe in vaccines?

YES! I know they exist, because there are a lot in my office fridge and freezer!

But, seriously: I participate in the Massachusetts Immunization Program, and I receive the recommended routine childhood vaccines from the state.

I offer vaccines according to the most current guidelines of the Massachusetts Immunization Program, the American Academy of Pediatrics, and the Centers for Disease Control in Atlanta. But this year I have also started to regularly use a modified schedule for babies, to minimize the amount of aluminum they receive at one time.

What vaccines do you give and when?

Using current guidelines, and ideas from Bob Sears, MD, a pediatrician in California who writes about pediatric vaccine safety, I advise parents which vaccines I recommend, according to the baby’s or child’s age. (You can visit his website.)

To summarize, for babies whose household members are all Hepatitis B negative, and will NOT be in daycare, I am comfortable deferring completion of the Hepatitis B series. But, I am strongly in favor of giving the DTaP, Hemophilus and Pneumococcal vaccines relatively on time. I like to give the oral rotavirus vaccine, but understand those who are prioritizing to prevent life threatening diseases may not want to accept it. I think polio can be deferred till the toddler years unless people plan exotic travel, but I also consider it safe and I am happy to give it relatively on time. Parents who agree to spread out the vaccines (to spread out aluminum exposure) need to schedule extra visits between the usual checkup ages for “vaccine only” visits.

Aside from hepatitis B, which is now routinely administered in the hospital before newborn discharge, most vaccines start at age 2 months.

For more information on vaccination scheduling, see the Childhood Vaccination Schedule from the American Academy of Pediatrics.

What if we want to have our child immunized on a different schedule, or not at all?

I know that some parents are very concerned that vaccines may be harmful in one way or another, and vaccination is at the very least anxiety-provoking if not frankly terrifying for them. I am sensitive to people's belief that a given vaccine may have done real harm to someone they know, even a previous child in the family.

My basic belief is that vaccines are protective and not harmful.

I am interested in learning people’s specific concerns so that I can address them, as able.

I am willing to accommodate parent’s concerns about too many vaccines at one visit, for example.

But I am uncomfortable with a parent’s choice not to vaccinate an infant or child at all. I would be constantly concerned about the health of a child who remained unvaccinated. Every fever or bad cough would make me shudder, and pose investigation and treatment questions that would be unpleasant for all of us.

Therefore, in general, if a family is completely opposed to vaccination of their infant, I suggest they consider a practice other than mine.

Do the vaccines you give contain thimerosal?

Thimerosal is a mercury-containing preservative previously used more widely. This substance is of concern to some parents because of reports that it may pose risks to the infant brain.

Since the Tdap (tetanus, diphtheria with whooping cough [pertussis]) replaced the Td (tetanus, diphtheria) for ages 11 years and up in 2005, none of the vaccines we routinely administer use thimerosal as a preservative.

Other vaccines may contain what are considered trace amounts, less than the amount needed to act as a preservative.

For most of our practice patients ages 6 months and up, we have again ordered thimerosal-free flu vaccine for the 2008-2009 flu season. (We already started vaccinating practice patients against the flu in August.)

We will prioritize this vaccine for children under 10 years if we don’t have enough for everyone who wants it. We will also have the live, nasal spray vaccine for low risk children from age 2 years, and the standard, state-supplied, thimerosal-containing vaccine for children aged 10 years and up.