FA16 Immunization Module’s Updates

Spacing Out Vaccines

Immunization schedules, which are set and annually updated by the CDC based on recommendations by the Advisory Committee on Immunization Practices (ACIP), provide ideal age checkpoints for when to give children vaccinations [1]. This may include administering multiple vaccines simultaneously, a fact that has caused many parents to worry whether such a bombardment of shots could be too much for their child’s immune system. In effect, there has been a shift towards spacing immunizations over a longer period of time. Many issues arise from this deviation in schedule, such as prolonged vulnerability to illness, possible trauma/fear from repetitive needle sticks, increased exposure to contagion at multiple office visits, and potential errors in administration due to “non-standard schedule”; this may involve missing doses or receiving extra when unnecessary [2].

In a survey done by the journal Pediatrics, 93% of the participating primary care physicians and pediatricians said they were asked monthly by parents to space out the recommended immunizations. 37% agreed to do so despite acknowledging that this would put the children and community at risk of spreading infectious diseases. Their main reasons were to maintain good rapport with their patients and that if they refused, these same patients would more than likely leave to find a doctor that would agree to space. They also expressed a lot of frustration with not having effective methods of convincing parents to follow the vaccination schedule, especially due to time constraints [3].

I think this raises a lot of questions on where you draw the line between satisfying your patients but also educating and discussing, even if this may cause minor controversy. Even if you disagree, do you still accommodate? Do you refuse and let them leave? Many of us may go into family practice/pediatrics, and so we will be dealing with myriad situations like these involving vaccinations, and I think we should all be aware of how we would go about handling them.   

 

Resources:

[1]: http://www.cdc.gov/vaccines/parents/vaccine-decision/sets-schedule.html

[2]: http://commonhealth.legacy.wbur.org/2011/09/spacing-out-vaccines

[3]: http://time.com/3726887/doctors-space-out-vaccines/

  • Janell Mathus
  • Emily Acton