Doctors bend vaccination schedule for shot-wary parents

People tend to think there are two camps in the fight over vaccinations: Those who are pro-vaccines, and those who are opposed to them.

But there's a large group of parents in the middle: They want to vaccinate their children, but on a schedule different from the one recommended by the Centers for Disease Control and Prevention. In some cases their doctors are accommodating them, just to ensure that the children will eventually get all of the required immunizations.  

Santa Monica pediatrician Dr. Marcy Hardart says about one out of every five families she sees asks to delay the vaccination schedule.

"'It seems like it's too much too soon,'" Hardart says parents tell her.  "'Can't we start later?'" she says they ask. "'Do we have to do all of them at once? Can we spread them out?'"

It's a predicament for pediatricians like Hardart. They fully support the CDC's recommended vaccination schedule (which is also backed by the American Academies of Pediatrics and Family Physicians). But because they want to see kids fully vaccinated, more and more doctors are complying with families' requests, and bending the recommended vaccination schedule.

That's worrisome to Dr. Debbie Lehman, a pediatric infectious disease expert at Cedars-Sinai Medical Center.

"The most concerning thing about alternative schedules are that they leave children unprotected during the time that they're waiting to get the next vaccine," she says.

Different schedules

The CDC schedule recommends babies receive six vaccinations when they're two months old.

But Brentwood pediatrician Dr. Samina Taha says the vast majority of the families she sees don't want their children to get that many shots at one time.

So, she says, she offers a compromise: "Instead of giving those six all at the same time, at that two month visit, let's give three around two months, and a few weeks later, come in and give three."

That approach is acceptable to the CDC; its recommended schedule allows for about a month of wiggle room for those early shots. 

But some – like the parents of 10-month old Shae Zwirn – want to space out the vaccines even more than that.

"I personally feel that waiting until his immune system is more fully matured, and developed, is the smarter route," says Shae's father, Paul Zwirn.

Shae's mother, Felicia Mollinedo, adds: "I wanted to get to know him for who he was, because I wouldn't want to have that doubt in my mind: Is he hyper because of vaccines? Is he listless because of vaccines? Is he slower?"

There's no science to back up these concerns. Even so, Mollinedo and Zwirn say they plan on waiting until Shae is at least a year old before beginning his vaccinations. Mollinedo says they already have a laundry list of vaccines to catch up on.

She says their doctors are not happy about their decision. "They're looking at me with these eyes, like, 'when are you going to do this?'" Mollinedo says.

Specific shots

Some parents want to wait on specific shots. One of the most common ones to delay is the MMR vaccine, which protects against measles, mumps and rubella. It's typically given between 12 and 15 months.

Emily Eichhorn-Nye waited about 18 months before giving her son, Owen, the MMR vaccine. She echoes the concerns of others who worry that the shot will cause autism - even though there's no proven link between the two.

"It's the fears that were created in my own head – that was the reason for the delay," she explains, while playing with her son in the waiting room of her pediatrician's office in Los Feliz. "The waiting wasn't based off fact – it was being comfortable about giving the vaccine."

Those fears are so widespread that Dr. Marcy Hardart says when she suspects a child may have developmental issues or autism, she'll suggest the parents hold off on the shot.

"I will tell the parents that the reason I'm doing it is not because I'm concerned that the MMR will do any damage – but I'm concerned that if the child's language doesn't develop, or if there is autism, I don't want the vaccine to be blamed,” she says.

'Constant conversation'

It's nearly impossible to determine how widespread these alternative vaccination schedules are, since the state doesn't begin tracking immunizations until kids enter childcare or kindergarten.

But the anecdotal evidence has experts worried, especially about delays of early vaccinations that protect against diseases that can kill, specifically meningitis and whooping cough.

When I tell Shae's mother, Felicia Mollinedo, that babies in California still die from whooping cough, she gasps – and reconsiders her position on vaccines.

"I, of course, become afraid," she says. "I, of course, question everything. And the topic comes up again. It's a constant conversation in this house."

Pediatricians say that's the most they can hope for: That parents will stay open to the idea of vaccinations, and get their kids immunized – hopefully sooner rather than later.