By Andrew M. Seaman
(Reuters Health) - Many parents ask doctors to spread out toddlers' vaccines instead of following the recommended immunization schedule, according to a new study.
Most doctors comply with the request, even though they believe the delays put the children at risk for preventable diseases and make the experience more painful, the researchers report in the journal Pediatrics.
Only about 2 to 3 percent of parents actually refuse vaccines, said study leader Dr. Allison Kempe. But, she added, "there is an increasing number of parents asking to deviate from the schedule in other ways."
Kempe, from the University of Colorado School of Medicine and Children's Hospital Colorado, had expected that most doctors would get such requests from parents, but not this often.
"I was surprised by over 20 percent of doctors saying 10 percent or more of their families (had asked) to spread out vaccines," she said.
The U.S. Centers for Disease Control and Prevention (CDC) recommends several shots during the first years of life to protect against diseases (PDF link: http://1.usa.gov/1EDPWBP). The schedule is backed by the American Academy of Family Physicians and the American Academy of Pediatrics (AAP), which publishes Pediatrics.
The AAP says the vaccine schedule is designed to work best with children's immune systems while protecting them from diseases as soon as possible.
The new report comes as the U.S. battles a large measles outbreak that had infected 154 people from 17 states and Washington, D.C. as of February 20, according to the CDC. The outbreak is tied to Disneyland in Anaheim, California.
For the study, Kempe and colleagues, in collaboration with the CDC, sent surveys to 815 pediatricians and family doctors across the U.S. in 2012. They received 534 completed surveys.
Overall, 93 percent of doctors reported at least one parental request to space out the immunizations of a child younger than two years old. And 21 percent of those doctors said at least 10 percent of families made the request.
The doctors said parents had a variety of reasons for deviating from the recommended schedule, including concerns about complications and a belief that their children won't get a vaccine-preventable disease.
Most doctors responding to the survey felt it's not in the child's best interest to space out vaccines, but most comply with the parents' wishes at least sometimes.
The percentage of doctors who often or always agree to spread out vaccines more than doubled from 13 percent in a similar 2009 survey to 37 percent in the current report.
Doctors said they tried to educate parents on the importance of following the recommended vaccine schedule, but few felt they had any effective approaches.
"A lot of them feel what they're doing isn't making a difference," Kempe said, adding that organizations like the AAP have recommended techniques for discussing vaccines.
"I am not convinced that we have the right methods to counter this," she said.
She said several techniques need to be combined, including education during pregnancy, more responsible reporting by the media, limiting the use of philosophical exemptions, and better collaboration between the public and health department.
"It can't all fall on the primary care doctors' backs," Kempe said. "It's too big and too time consuming of an issue."
SOURCE: http://bit.ly/uFc4g2 Pediatrics, online March 2, 2015.