In Oregon, the percentage of parents who delayed or cut back on the recommended number of vaccinations received by their children jumped almost four-fold between 2003 and 2009, from 2.5 percent to 9.5 percent, according to a study published online Monday in the journal Pediatrics.
These aren’t the parents who outright refuse to have their children receive any vaccinations. These are parents who are following “alternative” vaccine schedules — ones not recommended by public-health officials, but touted in best-selling books, in online parenting chat rooms, or on TV talk shows. Such schedules tend to spread out the required immunizations over a much longer period of time.
The parents may have planned to eventually have their children receive all the recommended shots by following these alternative schedules, but the study found that such an outcome did not always happen. By the time they were nine months old, the Oregon babies on delayed schedules had been to the doctor for more immunization visits (4.2 versus 3.3, on average), but had received significantly fewer injections (6.4 versus 10.4).
As a result, the study’s authors say, the parents’ decision to follow an alternative vaccine schedule puts their children at greater risk of developing preventable and sometimes life-threatening diseases. It also raised the risk for others in their families and communities — babies who have not yet completed their immunization series, for example, and people with immune-system-compromising illnesses like cancer or AIDs. Such individuals must rely on everybody else being vaccinated to reduce their risk of exposure to these otherwise preventable diseases.
Similar trend seen anecdotally in Minnesota
Although the study looked only at vaccination compliance in Oregon — a state with a particularly high rate of unvaccinated children — its authors believe the findings may be applicable to other areas of the country. A study published in Pediatrics last fall, for example, reported that 13 percent of parents were following some kind of delayed vaccination schedule for their children.
An increasing number of Minnesota’s parents may also be stretching out or skipping their children’s vaccinations, said Lynn Bahta, an immunization clinical consultant with the Minnesota Department of Health (MDH), in a phone interview Tuesday.
“We don’t have any hard data on trends,” she said, “but we do know anecdotally that clinicians are reporting that parents are requesting delayed schedules for their infants.”
Pediatricians will often agree to the parents’ request for a delayed vaccine schedule, she added, because they fear that if they don’t, the parents may not have their child vaccinated at all.
Bahta, like the authors of the Oregon study, is concerned about such delays. “The kids who are on a delayed schedule often don’t get caught up, so it leaves them vulnerable” to many serious diseases, including measles, mumps, rubella, chicken pox, hepatitis, and tetanus, she said.
There are no known benefits to delaying vaccination, Bahta added, but there are real dangers, including disability and death, to not getting vaccinated.
In many respects vaccinations are a victim of their own success. Before the development of the measles vaccine, for example, some 450 children died in the United States from the disease each year and more than 1,000 others suffered brain damage or deafness as a result of measles-related complications, according to the Centers for Disease Control and Prevention. Today’s parents, however, often think of measles as an innocuous illness.
In 2011, Minnesota had its first measles epidemic in many years. Some 23 children (including 14 who were hospitalized) came down with the illness — more cases than had been reported in the state in the previous 14 years combined. The sources of the epidemic were believed to have been two unvaccinated children who became exposed to measles while visiting relatives abroad. They then brought the illness back to Minnesota.
This year has seen a jump in the incidence of another vaccine-preventable disease: pertussis, or whooping cough. According to Bahta, MDH officials have documented more than 1,000 cases of this highly contagious bacterial disease in the state since January 1 — more than twice the number of cases for all of last year.
The Pediatrics study cited several reasons for why parents are opting to delay their children’s vaccinations, including “skepticism about the safety of vaccines, fears that too many vaccines are given at young ages, pain associated with multiple injections, concerns about the effect of vaccines when a child is ill, and questioning whether certain vaccines are necessary.”
Last summer, a team of experts for the Institute of Medicine analyzed more than 1,000 scientific articles and concluded that vaccines cause few health problems and that adverse side effects (such as allergic reactions to the shot and fever-related seizures) are rare. The health risks from not getting vaccinated were found to be much greater than those from the vaccines themselves.
Many parents don’t realize, said Bahta, that although children get more vaccines these days, those vaccines contain fewer antigens (immune-response-producing proteins) than the ones given children a generation ago. The number of antigens in the pertussis vaccine, for example, has dropped from about 3,000 in the early 1980s to less than 10 today.
“What children received back in 1980 and 1970 with just the few vaccines was far more challenging to the immune system that what the infants receive now,” Bahta said. “They are getting more vaccines with less immune challenge. It’s important for parents to know that.”