Understanding Childhood Vaccine Schedule Options
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The first time most Americans thought childhood vaccines were about more than crying babies and scary needles was when the media went into an uproar about claims that the vaccine's mercury-based preservatives caused autism.
According to the Centers for Disease Control and Prevention (CDC), those claims have been discredited through research, and the mercury has been removed from almost all vaccines, but the worries about vaccination safety remain.
In 2007, Dr. Robert Sears published The Vaccine Book: Making the Right Decision for Your Child, which seeks to address the biggest concerns of parents who are looking for a middle ground between the official CDC vaccine schedule and not getting any vaccines at all. Dr. Sears' book includes what he calls an alternative vaccine schedule, which allows for fewer shots at each visit and sometimes pushes back specific vaccines for months or even years after the official schedule's recommendations.
Before you decide about vaccinations, learn about the diseases they prevent.
According to the Centers for Disease Control and Prevention (CDC), those claims have been discredited through research, and the mercury has been removed from almost all vaccines, but the worries about vaccination safety remain.
In 2007, Dr. Robert Sears published The Vaccine Book: Making the Right Decision for Your Child, which seeks to address the biggest concerns of parents who are looking for a middle ground between the official CDC vaccine schedule and not getting any vaccines at all. Dr. Sears' book includes what he calls an alternative vaccine schedule, which allows for fewer shots at each visit and sometimes pushes back specific vaccines for months or even years after the official schedule's recommendations.
Before you decide about vaccinations, learn about the diseases they prevent.
Learn about the vaccinations and the diseases they prevent.
Hep B and Hep A
Vaccines are administered to prevent two kinds of hepatitis, A and B. Hepatitis affects the liver and is transmitted through bodily fluids—especially through sex, fecal matter, sharing needles or from a mother to child. Hepatitis B is more common and deadly. In mild cases, it can last a few weeks. In severe cases, it can lead to liver disease and death. Between 800,000 and 1.4 million Americans have the virus, and 2,000 to 3,000 die of it every year.
DTaP
The DTaP shot contains several vaccines. DTaP stands for diphtheria, tetanus and pertussis. Because of vaccination policies, diphtheria is not common in the United States. It spreads quickly, moving from what could be mistaken as a sore throat or fever to something much more serious—signs of shock and life-threatening organ complications. Tetanus bacteria can cause an infection that leads to muscle spasms and lockjaw. Pertussis, commonly called whooping cough, is a respiratory infection. It's one of the leading causes of vaccine-preventable deaths worldwide—and the risk of death in newborns is particularly high.
MMR
Like the DTaP, this single shot contains three vaccines for measles, mumps and rubella. The CDC says measles is the most deadly of childhood illnesses that cause fever and rash. Mumps causes fever, headaches, tiredness and swollen glands in the neck—but rarely progresses to more severe inflammations. Rubella causes fever and rash that can last for two to three days. Side effects from this vaccine include fever, rash, malaise and joint pain. The vaccine was the subject of decade-long controversy claiming that it caused autism in some children, which lead many parents to avoid the vaccination. Recent outbreaks of measles and mumps have been reported in countries like the United States, Canada, Japan and the United Kingdom.
Rotavirus
According the CDC, rotavirus is the most common cause of severe diarrhea in children, resulting in the death of 600,000 children worldwide annually. Before the vaccine was introduced in 2006, more than 200,000 American infants were taken to emergency rooms because of rotavirus infection.
PCV
Pneumococcal conjugate vaccine fights the bacteria that cause pneumococcal pneumonia (when the bacteria invades the lungs), bacteremia (when it gets in the blood) and meningitis (when it gets to the brain's covering). The CDC reports it is one of the most common causes of vaccine-preventable diseases in America.
Hib
Haemophilus influenzae type B bacteria were once a leading cause of childhood blood infections, pneumonia and meningitis. Hib can also lead to inflammations in the throat, bone marrow, joints and connective tissue. After the introduction of the vaccine, Hib infections have declined 99 percent.
MCV4
While there are two vaccines against meningococcal diseases, the MPSV4 and the MCV4, the MCV4 is more commonly used. Without a vaccination, meningococcal diseases can cause meningitis (inflammation of the protective layer around the brain and spine) and sepsis (infection of the blood). Those most at risk of infection include college students, military recruits or anyone living in close proximity to other people. Meningococcal infection has a fatality rate of 10 to 14 percent, and between 10 and 19 percent of survivors suffer serious side effects including deafness, amputation and brain damage. The CDC is investigating reports of adolescents who, after getting the MCV4 vaccine, contracted Guillain-Barré syndrome—an autoimmune disorder. The data suggest there may be a small increase of risk in the vaccine in relation to Guillain-Barré syndrome, but the CDC recommends doctors inform parents of the investigation before the vaccination.
Hep B and Hep A
Vaccines are administered to prevent two kinds of hepatitis, A and B. Hepatitis affects the liver and is transmitted through bodily fluids—especially through sex, fecal matter, sharing needles or from a mother to child. Hepatitis B is more common and deadly. In mild cases, it can last a few weeks. In severe cases, it can lead to liver disease and death. Between 800,000 and 1.4 million Americans have the virus, and 2,000 to 3,000 die of it every year.
DTaP
The DTaP shot contains several vaccines. DTaP stands for diphtheria, tetanus and pertussis. Because of vaccination policies, diphtheria is not common in the United States. It spreads quickly, moving from what could be mistaken as a sore throat or fever to something much more serious—signs of shock and life-threatening organ complications. Tetanus bacteria can cause an infection that leads to muscle spasms and lockjaw. Pertussis, commonly called whooping cough, is a respiratory infection. It's one of the leading causes of vaccine-preventable deaths worldwide—and the risk of death in newborns is particularly high.
MMR
Like the DTaP, this single shot contains three vaccines for measles, mumps and rubella. The CDC says measles is the most deadly of childhood illnesses that cause fever and rash. Mumps causes fever, headaches, tiredness and swollen glands in the neck—but rarely progresses to more severe inflammations. Rubella causes fever and rash that can last for two to three days. Side effects from this vaccine include fever, rash, malaise and joint pain. The vaccine was the subject of decade-long controversy claiming that it caused autism in some children, which lead many parents to avoid the vaccination. Recent outbreaks of measles and mumps have been reported in countries like the United States, Canada, Japan and the United Kingdom.
Rotavirus
According the CDC, rotavirus is the most common cause of severe diarrhea in children, resulting in the death of 600,000 children worldwide annually. Before the vaccine was introduced in 2006, more than 200,000 American infants were taken to emergency rooms because of rotavirus infection.
PCV
Pneumococcal conjugate vaccine fights the bacteria that cause pneumococcal pneumonia (when the bacteria invades the lungs), bacteremia (when it gets in the blood) and meningitis (when it gets to the brain's covering). The CDC reports it is one of the most common causes of vaccine-preventable diseases in America.
Hib
Haemophilus influenzae type B bacteria were once a leading cause of childhood blood infections, pneumonia and meningitis. Hib can also lead to inflammations in the throat, bone marrow, joints and connective tissue. After the introduction of the vaccine, Hib infections have declined 99 percent.
MCV4
While there are two vaccines against meningococcal diseases, the MPSV4 and the MCV4, the MCV4 is more commonly used. Without a vaccination, meningococcal diseases can cause meningitis (inflammation of the protective layer around the brain and spine) and sepsis (infection of the blood). Those most at risk of infection include college students, military recruits or anyone living in close proximity to other people. Meningococcal infection has a fatality rate of 10 to 14 percent, and between 10 and 19 percent of survivors suffer serious side effects including deafness, amputation and brain damage. The CDC is investigating reports of adolescents who, after getting the MCV4 vaccine, contracted Guillain-Barré syndrome—an autoimmune disorder. The data suggest there may be a small increase of risk in the vaccine in relation to Guillain-Barré syndrome, but the CDC recommends doctors inform parents of the investigation before the vaccination.
Polio
The polio vaccine is one of the true miracles of modern science. In the early 20th century, polio killed or paralyzed hundreds of thousands of people, as many as 20,000 cases of paralytic polio a year in the United States. With the development of vaccines in the 1950s and 1960s, the disease has been almost completely eradicated in the United States. While polio is no longer a high threat in the United States, the vaccine—children in America now receive the inactivated polio vaccine, or IPV—is still recommended. In 1988, the World Health Assembly agreed to eradicate polio in every country. That mission has been successful, but it is not yet complete—four countries still report cases of polio. Discontinuing vaccinations now could allow for a resurgence of worldwide.
HPV
The newest of the childhood vaccines, the human papillomavirus vaccine, is recommended for adolescent girls at age 11 or 12. The HPV virus is almost always present in cases of cervical cancer—which is called a "silent cancer" because it often isn't diagnosed until it has spread and becomes life-threatening.
Read why this vaccine is controversial for some parents.
Influenza
Children generally begin getting the seasonal influenza vaccine—the yearly flu shot— after they at least 6 months old. Because the strain of influenza changes every year, a new shot will be needed every year. Flu shots are commonly available starting in September. Because of their weakened immune systems and the close contact of schools, it's recommended that children get flu shots every year until they are 19 years old.
Varicella
Before the vaccine was approved for use in 1995, this disease—commonly called chicken pox—each year attacked as many as 4 million Americans, landed 10,000 in the hospital and killed 100 to 150. The vaccine prevents 80 to 90 percent of children from getting this disease. For those who were vaccinated yet still catch chicken pox, the vaccination has been show to reduce the severity of the case—just a few pox and only a mild fever. Some questions have been raised about how long a vaccination provides immunity. While the CDC reports that Japanese data show the vaccine provides immunity for 25 years, there are studies under way to determine if additional booster shots will be necessary.
The polio vaccine is one of the true miracles of modern science. In the early 20th century, polio killed or paralyzed hundreds of thousands of people, as many as 20,000 cases of paralytic polio a year in the United States. With the development of vaccines in the 1950s and 1960s, the disease has been almost completely eradicated in the United States. While polio is no longer a high threat in the United States, the vaccine—children in America now receive the inactivated polio vaccine, or IPV—is still recommended. In 1988, the World Health Assembly agreed to eradicate polio in every country. That mission has been successful, but it is not yet complete—four countries still report cases of polio. Discontinuing vaccinations now could allow for a resurgence of worldwide.
HPV
The newest of the childhood vaccines, the human papillomavirus vaccine, is recommended for adolescent girls at age 11 or 12. The HPV virus is almost always present in cases of cervical cancer—which is called a "silent cancer" because it often isn't diagnosed until it has spread and becomes life-threatening.
Read why this vaccine is controversial for some parents.
Influenza
Children generally begin getting the seasonal influenza vaccine—the yearly flu shot— after they at least 6 months old. Because the strain of influenza changes every year, a new shot will be needed every year. Flu shots are commonly available starting in September. Because of their weakened immune systems and the close contact of schools, it's recommended that children get flu shots every year until they are 19 years old.
Varicella
Before the vaccine was approved for use in 1995, this disease—commonly called chicken pox—each year attacked as many as 4 million Americans, landed 10,000 in the hospital and killed 100 to 150. The vaccine prevents 80 to 90 percent of children from getting this disease. For those who were vaccinated yet still catch chicken pox, the vaccination has been show to reduce the severity of the case—just a few pox and only a mild fever. Some questions have been raised about how long a vaccination provides immunity. While the CDC reports that Japanese data show the vaccine provides immunity for 25 years, there are studies under way to determine if additional booster shots will be necessary.
To make sure that children receive their vaccines on time, the CDC, American Academy of Pediatrics and Academy of Family Physicians have established a recommended schedule of shots.
At birth
Hep B
2 Months
Hep B (second dose should be given between 2 months and 4 months)
Rotavirus
DTaP
Hib
PCV
Polio
4 Months
Rotavirus (second dose)
DTaP (second dose)
Hib (second dose)
PCV (second dose)
Polio (second dose)
6 Months
Hep B (third dose should be given between 6 months and 18 months)
Rotavirus (third dose)
DTaP (third dose)
PCV (third dose)
Polio (third dose should be given between 6 months and 18 months)
Influenza (and given every year until at least 19 years old)
1 year
Hib (third dose should be given between 12 months and 15 months)
PCV (fourth dose should be given between 12 months and 15 months)
MMR (first dose should be given between 12 months and 15 months)
Varicella (first dose should be given between 12 months and 15 months)
Hep A (starting at 1 year, two doses are needed at least 6 months apart)
15 months
DTaP (fourth dose should be given between 15 and 18 months, as long as it is six months after the third dose)
4 to 6 years
DTaP (fifth dose)
Polio (fourth dose)
MMR (second dose)
Varicella (second dose)
11 to 12 years
HPV (for girls, three doses should be given over the span of six months)
At birth
Hep B
2 Months
Hep B (second dose should be given between 2 months and 4 months)
Rotavirus
DTaP
Hib
PCV
Polio
4 Months
Rotavirus (second dose)
DTaP (second dose)
Hib (second dose)
PCV (second dose)
Polio (second dose)
6 Months
Hep B (third dose should be given between 6 months and 18 months)
Rotavirus (third dose)
DTaP (third dose)
PCV (third dose)
Polio (third dose should be given between 6 months and 18 months)
Influenza (and given every year until at least 19 years old)
1 year
Hib (third dose should be given between 12 months and 15 months)
PCV (fourth dose should be given between 12 months and 15 months)
MMR (first dose should be given between 12 months and 15 months)
Varicella (first dose should be given between 12 months and 15 months)
Hep A (starting at 1 year, two doses are needed at least 6 months apart)
15 months
DTaP (fourth dose should be given between 15 and 18 months, as long as it is six months after the third dose)
4 to 6 years
DTaP (fifth dose)
Polio (fourth dose)
MMR (second dose)
Varicella (second dose)
11 to 12 years
HPV (for girls, three doses should be given over the span of six months)
On the website AskDrSears.com, Dr. Sears offers his alternative vaccine schedule. "My main worry about [the CDC's] schedule is that there really hasn't been enough research on the various chemicals and ingredients in many vaccines to prove that they are 100 percent safe," he says. "It has also been my experience that giving five or six vaccines at a time can increase the likelihood of a severe reaction."
He says his alternative schedule won't overwhelm young immune systems, but it still provides complete vaccine protection.
2 months
Rotavirus
DTaP
3 months
PCV
Hib
4 months
Rotavirus (second dose)
DTaP (second dose)
5 months
PCV (second dose)
Hib (second dose)
6 months
Rotavirus (third dose)
DTaP (third dose)
7 months
PCV (third dose)
Hib (third dose)
9 months
Polio
Influenza (and given every year until at least 19 years old)
12 months
Polio (second dose)
Mumps (separated from MMR)
15 months
PCV (fourth dose)
Hib (fourth dose)
18 months
DTaP (fourth dose)
Varicella
2 years
Rubella (separated from MMR)
Polio (third dose)
2 1/2 years
Hep B
Hep A
3 1/2 years
Hep B (second dose)
Measles (separated from MMR)
4 years
DTaP (fifth dose)
Polio (fourth dose)
5 years
MMR (second dose of each vaccine)
6 years
Varicella (second dose)
12 years
HPV
12 years, 2 months
HPV (second dose)
13 years
HPV (third dose)
MCV4
He says his alternative schedule won't overwhelm young immune systems, but it still provides complete vaccine protection.
2 months
Rotavirus
DTaP
3 months
PCV
Hib
4 months
Rotavirus (second dose)
DTaP (second dose)
5 months
PCV (second dose)
Hib (second dose)
6 months
Rotavirus (third dose)
DTaP (third dose)
7 months
PCV (third dose)
Hib (third dose)
9 months
Polio
Influenza (and given every year until at least 19 years old)
12 months
Polio (second dose)
Mumps (separated from MMR)
15 months
PCV (fourth dose)
Hib (fourth dose)
18 months
DTaP (fourth dose)
Varicella
2 years
Rubella (separated from MMR)
Polio (third dose)
2 1/2 years
Hep B
Hep A
3 1/2 years
Hep B (second dose)
Measles (separated from MMR)
4 years
DTaP (fifth dose)
Polio (fourth dose)
5 years
MMR (second dose of each vaccine)
6 years
Varicella (second dose)
12 years
HPV
12 years, 2 months
HPV (second dose)
13 years
HPV (third dose)
MCV4
A 2009 article in Pediatrics, the official journal of the American Academy of Pediatrics, disagrees. This article, titled "The Problem with Dr. Bob's Alternative Vaccine Schedule," says Dr. Sears misrepresents data about vaccine science and misinforms parents. "He believes that parents' fears should be indulged by offering alternative schedules, not countered by scientific studies, and he fails to explain that good science is the only way to determine whether a vaccine causes a particular adverse event," the article reads. "A vaccine either causes a problem or it does not."
The American Academy of Pediatrics also says the required extra visits to the pediatrician—five for the CDC's schedule versus a dozen for Dr. Sears' schedule before the child turns 2 years old—will discourage completion of the vaccination process.
Information on Dr. Sears' website recommends parents educate themselves. "Before proceeding with the full regular vaccine schedule, I encourage parents to become fully informed about each disease and vaccine so they can understand the safest way to vaccinate their children."
If you were the parent of a young child, would you follow the CDC's schedule, Dr. Sears' schedule or not allow any vaccines? Share your opinion in the comments section below.
The American Academy of Pediatrics also says the required extra visits to the pediatrician—five for the CDC's schedule versus a dozen for Dr. Sears' schedule before the child turns 2 years old—will discourage completion of the vaccination process.
Information on Dr. Sears' website recommends parents educate themselves. "Before proceeding with the full regular vaccine schedule, I encourage parents to become fully informed about each disease and vaccine so they can understand the safest way to vaccinate their children."
If you were the parent of a young child, would you follow the CDC's schedule, Dr. Sears' schedule or not allow any vaccines? Share your opinion in the comments section below.
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