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The Daily Tar Heel

Most doctors have allowed parents to delay children's vaccines, study finds

A recent study has found that a majority of doctors have acquiesced to parents’ wishes to delay children’s vaccinations, even against the prevention schedule recommended by the Centers for Disease Control and Prevention. 

The CDC advises that delaying vaccinations reduces their effectiveness in preventing diseases such as measles and whooping cough. Parents often ask to delay vaccines because they're concerned their child will suffer long-term complications from vaccines and because they believe their child is unlikely to get a vaccine-preventable disease due to herd immunity. 

“Vaccines are victims of their own success. Now that they have gotten rid of most of these diseases, parents do not think vaccines are needed so they are more scared of the risk of the vaccination than the benefits when the benefits outweigh the risks,” said Sean O'Leary, one of the study's co-authors and a professor at the University of Colorado's medical school.

The study found that most physicians reported agreeing to spread out vaccines when requested. Thirty-seven percent said they give in to parents' wishes often or always, 37 percent said they did so sometimes, and just 26 percent said they rarely did. 

The study says the current routine immunization schedule for children is estimated to prevent 42,000 deaths, 20 million cases of disease and save $14 billion in direct medical costs per U.S. birth cohort. 

In North Carolina, it is illegal to refuse vaccinations unless it's for religious or medical reasons, said Michael Steiner, a pediatrics doctor in the UNC School of Medicine. 

“Despite the law, there are children who are exempted outside of religious and medical reasons, which is illegal. State law makes children receive vaccines — however, they are usually enforced at time of public school entry,” Steiner said.

According to a survey cited in the study, 13 percent of parents reported using an alternative vaccination schedule for their children — which leads to under-immunization in the population, significantly increasing the risk of acquiring and transmitting vaccine-preventable diseases. 

Vaccine delays are becoming increasingly common, even though 84 percent of physicians said it is more painful for children to return repeatedly for separate injections. Eighty-seven percent of physicians said parents who choose to spread out vaccines are putting their children at risk for contracting disease. 

“The immunization schedule has been well studied for effectiveness, and when you go beyond the schedule, we don’t know the impact on safety or effectiveness. It leaves kids at risk for diseases,” O’Leary said.

Most pediatricians have parents sign a form for refusal to vaccinate for protection or document the delay, to prevent the doctor from being held liable if the child gets sick.

The study listed strategies often used by physicians that are effective when parents ask to delay vaccines — for example, explaining that deviating from the current vaccination schedule puts children at risk for preventable diseases and discussing recent outbreaks of vaccine-preventable diseases. 

“We should try to make vaccinations less an area of controversy and more standard part of preventive services,” O'Leary said.

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