The list of vaccinations that a child receives by the time they are 18 is lengthy. Some parents wonder if receiving so many vaccinations on such a tight schedule is in their child's best interest. For this reason, parents may choose a delayed vaccine schedule. Find out why some parents choose this option and learn if it is safe.
Parents can purposely choose to delay childhood vaccinations.
Delayed vaccination can leave a child vulnerable to life-threatening illnesses.
Alternative vaccine schedules are not recommended or supported by scientific research.
Remaining up-to-date with vaccines is possible on an alternate or delayed vaccine schedule.
What is a delayed vaccine schedule?
A delayed or alternative vaccine schedule means that a parent has chosen to give their children vaccinations at a different time or pace other than what is recommended by the Centers for Disease Control and Prevention (CDC). This delay may include limiting recommended vaccines, limiting the number of vaccines received in one visit, or skipping a vaccine series.
The American Academy of Pediatrics (AAP) Advisory Committee on Immunization Practices (ACIP) has conducted reviews on timely vaccine administration in the United States and found:
- 58% of children aged 19 to 35 months were up-to-date with ACIP-recommended immunizations.
- 63% of children followed the recommended schedule for immunization.
- 23% of children followed an alternate schedule.
- 14% of children followed an "unclassifiable" schedule.
It is essential to know that choosing a delayed vaccine schedule for your child is a parental decision that you may discuss with your pediatrician, but, it is not recommended by the CDC or the AAP because no scientific evidence supports the benefit of vaccine delay.
Reasons why you may choose to delay
In recent years, a few vaccination trends have highlighted parents' and some pediatricians' concerns that have led to alternative or delayed schedules.
- Effectiveness. Decreased confidence in the effectiveness of vaccinations.
- Necessity. Reduced belief in the need for vaccination.
- Safety. Increased concerns regarding the safety of vaccinations.
- Amount. Parental desire to limit the number of vaccinations received at one time.
- Illness. Delays due to childhood illness.
- Side effects. Concerns about adverse, potentially long-term side effects of vaccinations
Research has shown that some vaccinations are associated with adverse effects, but these cases are very rare. The benefits and protection that vaccines provide need to be fairly weighed against the risks.
Research has shown that the rate of vaccine adherence is associated with race, ethnicity, and poverty status. Factors include access to healthcare providers, provider facility type, parental education level, participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and insurance type.
Pros of delayed vaccination
A few positive outcomes of delaying vaccinations include:
- Limiting child discomfort by receiving fewer vaccination shots at one time.
- Decreasing potential side effects of some vaccinations.
- Parental confidence that they are acting in the best interest of their child.
Cons of delayed vaccination
A few negative outcomes of delaying vaccination include:
- The child is vulnerable to potentially life-threatening illnesses.
- More frequent doctor's visits to receive vaccinations.
- Up-to-date vaccination status is not maintained.
What are the recommended vaccines?
The CDC provides a strict vaccine schedule for birth through 18 years of age. Along with this schedule, the CDC has established guidelines for special considerations, precautions, contraindications — medical reasons not to administer a vaccine — and "catch-up" protocols.
CDC vaccine list birth to 15 months
The CDC recommends that the following vaccines are received by 15 months of age:
- Hepatitis B
- Pneumoccoal conjugate
- Hepatitis A
- Annual influenza
- Annual COVID-19
CDC vaccine list for 18 months to 18 years
The CDC recommends that the following vaccines are received between 18 months and 18 years of age:
- Hepatitis B
- Hepatitis A
- Annual influenza
- Annual Covid-19
A child may not need to receive all of these vaccines if the vaccine given in infancy still provides immunity. Immunity status can be confirmed by a blood test with antibody titers.
Considerations about vaccinations
There are a few things to remember when deciding whether your child should follow a recommended or alternative vaccination schedule.
Providing valuable protection
Vaccinations are an impactful advancement of modern medicine. Childhood vaccinations have saved countless lives from severe illness and disability. Children in this modern era rarely suffer from serious illnesses such as whooping cough, tetanus, polio, and meningitis.
Consider each vaccine independently
It may be tempting to consider an all-or-nothing approach to childhood vaccinations. If you are concerned about your child receiving vaccinations, it is crucial to consider what protection that vaccine is providing. Some vaccines protect against serious, life-threatening illnesses. It is within your parental right to refuse vaccination, but this refusal should only come after carefully evaluating each vaccine independently.
The internet is full of anti-vaccination information. Over the last two decades, much content has been circulated regarding vaccinations and the potential link to autism spectrum disorder (ASD) and sudden infant death syndrome (SIDS). There have also been concerns about thimerosal, a preservative in some vaccines.
As a parent, if you are concerned about the safety of vaccinations, you must do your own research using scientific studies, evaluating the recommendations of trusted organizations, and speaking with your child's physician as your foundation for decision-making. Social media platforms are not a reliable source of health information.
Staying up-to-date is possible
Following an alternate or delayed vaccination schedule and remaining up-to-date with recommended vaccines is possible. However, be aware that the gaps in vaccination status leave your child vulnerable to potentially debilitating illnesses.
Purposely delaying vaccination is not an uncommon practice and is a parental right. At the same time, it is essential to consider the positive and negative aspects of delaying vaccine coverage for your child. Your child's physician and high-quality scientific research should guide you in making this decision for your family.
- CDC. Child and adolescent immunization schedule.
- American academy of pediatrics. Adherence to timely vaccinations in the united states.
- American academy of pediatrics. Safety of vaccines used for routine immunization of US children: A systematic review.
- Public health reports. The association between intentional delay of vaccine administration and timely childhood vaccination coverage.