Although parents who choose to not vaccinate their children get the bulk of coverage for the antivax movement, parents who do vaccinate but use an alternate schedule — such as the Dr. Sears schedule — over the Advisory Committee on Immunization Practices (ACIP) schedule also are an important part of the movement. This is evidenced by a new study in Pediatrics examining how many people are choosing to not vaccinate their children in a timely fashion.1
Researchers used 2014 National Immunization Survey vaccination data to divide vaccination patterns into recommended; alternate, which means limiting the number of shots given at a visit or skipping at least 1 vaccine series; or unknown or unclassifiable, meaning that vaccinations were not in line with the ACIP recommendation or limiting shots or vaccines is clearly evident.
Slight majority of children vaccinated on schedule
While the majority of children (63%) were vaccinated according to the recommended schedule, 23% were on an alternate schedule and 14% an unknown schedule. Researchers found that 58% of children were up-to-date with all ACIP-recommended vaccines by 19 to 35 months of age. Being on an alternate schedule (prevalence ratio, 4.2, 95% confidence interval, 3.9–4.5) or unknown or unclassifiable schedule (prevalence ratio = 2.4, 95% confidence interval: 2.2–2.7) were linked to a child not being up-to-date.
When examining demographics, researchers found that children who:
- lived in the northeast, were non-Hispanic black below the poverty line, moved across state lines, and were not the firstborn were more likely to be on an alternative schedule.
- who received vaccinations from only public providers, lived below the poverty line, and received Special Supplemental Nutrition Program for Women, Infants, and Children benefits were more likely to follow an unknown or unclassifiable schedule.
Investigators concluded that more than one-third of US children are not following the ACIP schedule, which can leave a child vulnerable to a preventable disease.
Targeted interventions are one way to reduce the number of children who aren’t vaccinated in a timely fashion. Interventions could include reviewing completed vaccines before a family moves away from the practice; reviewing a family’s insurance to ensure vaccinations are completely covered, likely the result of being preventive care under the Affordable Care Act; or giving a presumptive recommendation for the vaccine, eg, “Tim is due for his varicella vaccine.”
1. Hargreaves AL, Nowak G, Frew P, et al. Adherence to timely vaccinations in the United States. Pediatrics. 2020;145(2): e20190783.