Taking a Shot at the Alternative Vaccine Schedule: Is Anyone Really Using It?

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It seems that the media finds much more to talk about when it comes to wanting to find fault with vaccinations rather than herald their benefits. Yet, vaccines are probably one of the most important if not the most important contribution to public health of the 20th and 21st centuries. Despite this contribution, some parents are not convinced that the benefits of vaccinating on time outweigh the risks, and in some circumstances pediatricians and family physicians have had to “compromise” and provide a delayed “alternative” vaccination schedule, one not recommended by the AAP or the Advisory Committee on Immunization Practices of the Centers for Disease Control (ACIP). So how popular is using a non-recommended schedule? Robison et al. (doi: 10.1542/peds.2011-3154) address this question by studying vaccine compliance in Portland Oregon from 2004-2009. The authors used a retrospective cohort analysis of a vaccine registry to look at prevalence trends for use of an alternative schedule — taking into account the 2007-2009 Hib shortage and increased availability of combination vaccines. While the overall prevalence is just under 5%, the rate almost doubled in the latter years of this study, suggesting that more families are opting out of receiving the recommended vaccines in a timely fashion. This study only looks at one urban area, and it remains to be seen whether this will result in more break-through cases of pertussis and other preventable illnesses in the Portland area. Certainly, this is a realistic concern given the trends reported in this important article.