Saturday, January 24, 2009

Parents calling the shots

Posted on Sat. Jan. 24, 2009 - 08:11 am EDT E-mail this story Print this


Parents calling the shots
More are requesting Dr. Robert Sears' ‘selective' schedule to decline or delay certain vaccines

By Jennifer L. Boen
As rumors, anecdotes and parental concern grow about vaccine safety, Super Shot Inc., the largest provider of childhood vaccines in the county, is wrestling with an issue not previously seen, said Kelly Zachrich, executive director.

“Parents are actually coming in with a schedule of when they want their children to be vaccinated,” in some cases, even from their doctor, Zachrich said. The schedule does not follow the standard of care set by the Centers for Disease Control and Prevention’s Advisory Committee on Immunizations. In most cases, the schedule is from Dr. Robert Sears’ book, “The Vaccine Book: Making the Right Decision for Your Child,” in which alternative schedules are outlined.

Sears’ approach is discussed in the Jan. 6 journal “Pediatrics,” in which Dr. Paul Offit and Charlotte Moser write, “Unlike typical anti-vaccine books, (Sears) offers a middle ground, allowing parents to act on their fears without completely abandoning vaccines. Unfortunately, Sears sounds many anti-vaccine messages.” Offit points out parental concern is understandable in light of the fact by age 2, a child will have had at least 26 inoculations.

A recent survey of Super Shot parents found 15 percent said they were worried about vaccine safety issues, Zachrich said. “What surprised us was that we had never heard this before.”

With more parents not wanting to follow the approved schedule, “It became such a problem we wondered if we could refuse to vaccinate these kids.”

Zachrich is still waiting for guidance on the issue from the CDC. In the meantime, Super Shot nurses are doing more education with parents, as are nurses at the county health department. Those who still refuse the standard of care must sign a declamation of refusal.

Sears’ “selective” vaccine schedule is aimed at parents who want to decline or delay certain vaccines. With his “alternative” schedule, just two vaccines are given at a time and only one with live virus, such as the measles/mumps/rubella, at a time. Similarly, only one aluminum-containing vaccine, such as the tetanus/diphtheria/pertussis (TDaP), is given at a time. According to the CDC, multiple studies have found no harm in the tiny amount of aluminum in a vaccine dose.

On his Web site,, Sears says his alternative schedule “… gives the most important vaccines first, and slightly delays the less important vaccines,” with the end result being a fully vaccinated child. He maintains parents need choices on how frequently, or if, they should have their child vaccinated.

“By doing so, do we increase or decrease vaccination rates among such families? That’s the main question.”

Dr. Amy Fuchs is medical director of Super Shot and says two to three times a week a parent in her private practice at Fort Wayne Pediatrics requests to follow an alternative vaccination schedule. In some cases, if parents refuse all vaccinations, she tells them she is not the right doctor for them.

“This is a big concern,” she said, noting, “We saw polio in our Amish community last year,” although many Amish fully immunize their children. A few U.S. children die each year from chickenpox. “Young parents have never seen whooping cough or measles. They think they’re gone, but they’re still here.”

She tells parents a vaccination creates a picture in the body, telling the body to “remember” the disease. But an infant’s body memory is short-lived, and Fuchs said, “It takes more than one shot to get the antibody levels where they need to be.

“A generation ago, kids died from pneumonia, from whooping cough. If there was that hint that vaccines cause autism, I would be the first to tell you,” Fuchs said.

In his critique of Sears’ book, Offit writes the harm will come because “…fewer children will be protected, with the inevitable consequence of continued or worsening outbreaks of vaccine-preventable diseases.”

Fuchs agrees, saying parents are on the Internet, reading Sears’ blog and a host of data that even well-educated parents have difficulty deciphering what is legitimate and what is flawed.

“It’s going to break my heart,” she said, “but it will happen at some point that one of these children will get a vaccine-preventable disease and die from it.”

No comments: