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To Get Kids Vaccinated, Some Pediatricians OK With Delays

Anxious parents sometimes ask the pediatrician if they can postpone vaccines for young children. And a new survey suggests quite a few doctors go along with the requests, despite standing recommendations they stick to a strict schedule.

In a survey of more than 200 pediatricians in Washington state, 61 percent of the doctors said they are OK with spacing out or delaying some vaccines. That approach flies in the face of the immunization schedule from the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the American Academy of Family Physicians, which calls for each child to get 25 shots in the first 18 months of life.

The study was published in the journal Pediatrics.

There's abundant proof that vaccinations protect children from deadly diseases, such as polio, measles and pertussis. Some parents cringe when they see their 4-month-old getting five different shots at a well-baby visit. That inclination and worries about vaccine side effects has sparked interest in alternative immunization schedules that space the shots out.

Indeed, 1 in 10 parents say they've delayed or skipped some vaccines, according to a survey published in Pediatrics last month.

What's more, a new analysis by the Associated Press finds "that more than half of states have seen at least a slight rise in the rate of exemptions" from vaccine requirements for school attendance in the past five years. And in eight states, more than 1 in 20 kindergartners in public school aren't receiving all the required vaccines.

Exemption rates are highest in in the West and Upper Midwest. In Washington state, 6 percent of public school parents have opted out of vaccination, the AP reports.

There's no evidence that delaying or skipping vaccines benefits children's health. And recent outbreaks of measles among unvaccinated children are clear reminders of the dangers posed by infectious diseases.

The alternative vaccine schedule has been popularized by pediatrician Robert Sears, whose The Vaccine Book: Making the Right Decision for Your Child, was published in 2007.

Many of Sears' claims, such as the one that vaccines cause chronic disease, have no basis in science. Vaccine expert Dr. Paul Offitt rebutted the claims in a 2009 article in Pediatrics: "The Problem With Dr. Bob's Alternative Vaccine Schedule."

Still, as the latest survey shows, more than half of pediatricians said they are willing to try an alternative vaccination schedule if asked. Three-quarters of the doctors said they had been asked to do so. Almost all said the Sears book didn't influence their thinking on vaccine schedules.

The doctors were most likely to consider delaying hepatitis B; varicella (chickenpox), and polio for four months or more.

But the docters balked at delaying Hib, which prevents meningitis and pneumonia caused by a bacteria; pneumococcal immunization, which prevents pneumonia and ear infections; and DTaP, which protects against diphtheria, tetanus, and whooping cough.

What gives? The study authors suggest that doctors are engaged in a tricky balancing act. "Primary care physicians should be recognized for seeking to immunize their patients against common and devastating diseases of infancy while maintaining a therapeutic alliance with parents," the authors wrote.

In other words: We'll bend a bit so we don't alienate parents. But we're going to make darned sure kids get their shots.

When it comes to their own kids, 96 percent of the surveyed pediatricians said they would stick to the recommended vaccination schedule.

Copyright 2011 National Public Radio. To see more, visit http://www.npr.org/.

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