Why parents should not consider an alternative vaccination schedule

Recently, Bob Sears, MD, a long-time vaccine-skeptic pediatrician was given hefty punishments from the California medical board for allegedly knowingly embellishing a patient's medical conditions to justify the parents' wishes to forgo vaccines.

In California, a recent law did away with personal belief exemptions for vaccinations in public-school-attending kids and the only way a California child can be exempt is if that child has a documented medical condition which precludes vaccination. Sears allegedly signed off on an exemption which stated that the 2-year-old's kidneys and intestines "shut down" after a vaccine despite having no real medical evidence to back this up. Currently, Sears has four other cases against him being filed.

In our state, parents can seek to have their children exempted from vaccinations for religious, medical or philosophical reasons. Philosophical reasons must meet the requirement of being "strong moral or ethical conviction similar to a religious belief." It's hard to imagine an opinion that would meet such a requirement, but parents do submit such exemptions at times.

Sears has for a long time now, played the role of a purveyor of "middle ground" public health. In a confident writing voice, he has forged an image of a balancer between the recommendations of internationally accepted modern medicine and the siren-song reverence of maintaining children in their natural state. However, one would have to accept that Sears' take is more desirable than the enormous body of science that clearly shows modern vaccines are safe and offer unparalleled protection.

Sears' "The Vaccine Book" focuses on his alternative schedules for vaccination, which recommends slower, more spaced-out administration. Most pediatricians use the schedule endorsed by the American Academy of Pediatrics. A deeply held belief of the anti-vaccine movement is that multiple immunizations given together can hurt or overwhelm the immune system. This belief stems from the idea that infant immune systems are more delicate compared to an adult's.

The evidence does not support this at all. In fact, newborns possess a robust and extremely competent system. Compared to the thousands of viruses, fungi and bacteria the infant immune system contends with on a daily basis, the relative handful of molecules a vaccine delivers is a drop in the ocean.

So what's the harm in spacing vaccines out? First, it creates missed opportunities for protecting children against dangerous diseases such as whooping cough and meningitis. The longer you wait, the higher the chance of illness. These schedules are also exceedingly difficult to follow and demand many extra visits to the doctor, and extra needles. In other words, evidence shows alternate schedules offer less protection, more visits, and no benefit.

When I meet with parents who want to follow Sears' alternative vaccination schedule, I often show them his book to help make my argument against his advice. For example, a passage regarding the MMR vaccine says, "I'm not surprised when a family…tells me they don't want the MMR [vaccine]…Since the fatality or complications rates for these childhood diseases are fairly low, I don't have much ammunition with which [to change their minds]." He then unashamedly adds, "I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we'll likely see the diseases increase significantly."

I ask parents how they would feel if I used his advice: "I'm going to recommend you skip this vaccine, but don't tell anybody else. Because if everyone starts doing it, kids might get sick or die". Would they trust me? Would they consider me a quack or fraud? Sometimes this changes their minds, but other times they still follow Sears' advice. Once the idea that vaccines are risky and not very effective is planted into a caring parent's mind, it is exceedingly difficult to uproot.

Pediatricians work hard to keep children safe. They rely on reams of evidence to support their interventions and spend their careers striving to deliver the best care possible. One voice should not drown out thousands of others simply because that voice invokes unnecessary fears.