Parents who don't follow recommended vaccine schedule increase risk of preventable outbreaks

ANN ARBOR, Mich. – A national survey of parents of young children found more than 1 in 10 use an alternative vaccination schedule, and a large proportion of parents using the recommended schedule seem to be “at risk” for switching to an alternative schedule.

“Small decreases in vaccine coverage are known to lead to dramatic increases in the risk of vaccine preventable disease outbreaks,” says Amanda Dempsey, M.D., Ph.D., M.P.H., assistant professor in the department of pediatrics and communicable diseases and a member of the Child Health Evaluation and Research Unit at C.S. Mott Children’s Hospital. “Not following the recommended schedule leaves kids at risk for these diseases unnecessarily.”
Following a vaccination schedule that deviates from those recommended by recognized groups such as the Centers for Disease Control and Prevention and the American Academy of Pediatrics leads to under-immunization.  Under-immunization has been shown to significantly increase the risk of contracting and spreading vaccine preventable diseases like measles and whooping cough,” Dempsey adds.

This research shows that the problem of under-immunization is likely to continue to worsen in the future given that many parents have attitudes that indicate they are not convinced about the safety of having their kids vaccinated at recommended times.

The study, “Alternative vaccination schedule preferences among parents of young children,” was published online today ahead print in the journal Pediatrics. It involved a survey of 771 parents of children ages 6 months to 6 years.

Among this group, surveyed in May 2010, 13 percent reported deviating from the recommendations, though only 2 percent refused all vaccines.

Most of the parents using an alternative schedule said they themselves (41 percent) or a friend (15 percent) developed the schedule, and 8 percent reported using a well-known alternative schedule such as the one developed by Dr. Bob Sears of

Using an alternative vaccine schedule was strongly associated with not having a regular health care provider for the child. The vaccines most commonly delayed were the measles-mumps-rubella (45 percent) and diphtheria-tetanus-acellular pertussis (43 percent) vaccines.

A large minority (30 percent) of parents using an alternative schedule said they had initially followed the recommended vaccination schedule; most said they switched because it “seemed safer.”

Additionally, 1 in 4 parents who followed the regular vaccination schedule thought that delaying vaccination was still safer. Study authors conclude this highlights the need to develop strategies to prevent the spread of attitudes and beliefs that counter vaccination.

“More resources need to be devoted to finding ways to successfully change where attitudes are going,” Dempsey says. “Clearly this problem is not going to go away, and our data suggests it will actually get worse over time.”  

Doctors are already working hard to stress the importance of timely vaccinations, but many people have their minds made up by the time they see the doctor.  The Centers for Disease Control and Prevention, the American Academy of Pediatrics and many other medically-oriented websites have a wealth of information about vaccines that parents can easily access.

Authors: In addition to Amanda F. Dempsey, M.D., Ph.D., M.P.H., authors are: Sarah Schaffer, M.A., Dianne Singer M.P.H., Amy Butchart M.P.H., Matthew Davis M.D., M.A.P.P., Gary L. Freed M.D., M.P.H., all of the University of Michigan

Financial disclosure/conflict of interest: Amanda F. Dempsey receives compensation for service on an advisory board for Merck & Co related to male HPV vaccination.  This company had no input into the design, implementation, analysis or presentation of the results of this study. Dempsey receives no research support from Merck.  This study was funded by the Clinical Sciences Scholars Program at the University of Michigan. The other authors have no financial disclosures of conflicts of interest to declare.

Child Health Evaluation and Research Unit:

U-M C.S. Mott Children’s Hospital

Centers for Disease Control and Prevention Vaccine Schedule:

American Academy of Pediatrics Vaccine Schedule:


About C.S. Mott Children’s Hospital:
The University of Michigan C.S. Mott Children’s Hospital is consistently ranked as one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in the U.S. News Media Group’s 2011 edition of “America’s Best Children’s Hospitals” including third in the country for heart and heart surgery. In November, the hospital moves to a new 1.1 million square feet, $754 million state-of-the-art facility that will be home to cutting-edge specialty services for newborns, children and women.

About the U-M Child Health Evaluation and Research (CHEAR) Unit:
Founded in 1998, U-M’s CHEAR Unit is a national leader in the analysis of the American health care system and the organization and financing of care for children. Since its inception, the CHEAR Unit has been awarded over $40 million in research grants from federal, state, and foundation sources. Based in the Division of General Pediatrics in the School of Medicine, the CHEAR Unit comprises faculty from the Schools of Medicine, Social Work, Dentistry, Pharmacy, Nursing, Public Health, Business and Law. Multidisciplinary teams provide the structure for research of community, state and national child health policies, practices, and programs. There are more than 30 faculty affiliated with CHEAR.


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