How to talk to your doctor about following an Alternative Vaccine Schedule Monday, October 29, 2007 Many parents today are looking for a different approach to vaccines. But most doctors feel that the standard vaccine schedule is so important that they are unwilling to work with such parents. Well, I have good news. Times are changing. The American Academy of Pediatrics now recommends that doctors work with parents who have questions and concerns and want to do things a little differently. The new AAP guidelines are listed in the 2006 Red Book of Infectious Diseases – a manual that almost every pediatrician owns. In the Book, the AAP suggests: A non-judgmental approach is best. Listen carefully and respectfully to the parent’s concerns. Inform the parents of the risks and benefits of each vaccine as well as the risks of each disease. For parents who are concerned about multiple vaccines at one visit, develop a schedule that spreads the vaccines out. Continued refusal to vaccinate after adequate discussion should be respected (unless the child is at significant risk of serious harm during an epidemic). In general, pediatricians should avoid dismissing patients from their practice solely because of refusal to vaccinate. But parents who have concerns and extra questions about vaccines need to understand the best way to talk to their doctor. You can’t wait until your baby’s two-month appointment, wait until your doctor is done examining the baby, then suddenly hit the doctor with a dozen questions. It takes a good 15 to 30 minutes to discuss vaccine concerns and options in detail. Us doctors don’t have the time to do this within the normal amount of time allotted to a regular checkup. You have to schedule a separate appointment, preferable well before your baby’s first shots are due. That way you and your doctor have a nice chunk of time directly devoted to discussing vaccines, without having to go over all the other questions and concerns of a normal checkup. What can you do if your doctor won’t work with you? Find another doctor. I know it isn’t easy, and my Vaccine Friendly Doctor database (see the home page) will hopefully grow bigger and bigger over the years so patients all over the U.S. can find a doctor near them who will happily discuss vaccine options. You can help it grow by asking any vaccine-friendly doctor you know to contact me through the website Labels: Alternative Vaccine Schedule posted by Dr. Bob Sears @ 9:53 AM   41 Comments: At October 31, 2007 2:40 PM ,  Anonymous said... I am having a hard time finding access to mercury free vaccines, like the flu shot. I cannot do flu mist(I have SLE) And I am pregnant. I can't find them. I live in Austin, TX   At October 31, 2007 4:37 PM ,  Dr. Bob sears said... I would suggest you don't do a flu shot then, unless you can find one. You can also check my section on boosting your immune system (check with your OB about any supplements though) to decrease your risk of illnesses.   At October 31, 2007 9:52 PM ,  Educate me, please said... Dr. Bob- My daughter will be 1 in just over a week, we are scheduled for her visit with her pediatrician. Till now we have followed the AAP vaccine schedule despite my concerns and apprehension. I've not yet rec'd your book...do you suggest I call the ped before hand to let them know I will not be continuing with vaccinations until I feel more educated about the matter? (like after I read the book) I did exactly what you said NOT to do at her first 3 visits and stopped the nurse just before she gave the shots and asked a couple questions and was COMPLETELY blown off and treated badly for even asking. My gut has told me at every visit to find a new doctor (they've been telling us to let her cry it out at night and that she didn't need to eat (breastfeed) at night since she was 4 months,...NOT FOR US! and tried to pressure us to give her cereal at 4 months despite me telling them I was waiting till at least 6 months, and told us she should NOT being sleeping with us...the list goes on and on), but there are no other ped's to choose from in our small town...pop about 30,000. Any suggestions? In your opinion, are family doctors educated well enough to see children? She seems to be very healthy and is developing very normally...we've only been to the doctor for her well baby checks because she's only had a couple minor colds, nothing more. Also, she's been exclusively breastfed till now and I am continuing until she's 2-2 1/2 (or whenever she seems ready to ween.) You mentioned on another section of the blog about omega-3's in breast milk. Do you suggest I take a prenatal with added omega-3 (if that even exists) or another supplement, flax or fish oil? I get a fair amount in my diet with omega-3 eggs and pasta, but is that enough? When you said breast milk is high in omega-3, is that naturally, or is it dependent on my intake? Thank you so much for taking the time to help...I have been SO THANKFUL to have found your family's resources (through Le Leche Leauge) and have learned so much from you all! THANK YOU!!!   At November 1, 2007 7:23 AM ,  Jen said... Is there a vaccine schedule that is online that is your recommended schedule?   At November 1, 2007 9:14 AM ,  Dr. Bob Sears said... Educate me - the best thing to do would be to simply cancel your one-year checkup for now, and wait until you have read more and educated yourself. There's no harm in delaying the one year visit. THEN when you are ready, make an appt with your doctor to discuss. Family practice doctors have about a year less training in pediatrics, BUT once they've been in practice for a few years, their experience is the best training and most are just as knowledgable as pediatricians. So you should feel free to look around for a family practice doctor. Yes, it is good to supplement a breastfed mom with omega 3's. I don't recommend a certain brand or anything - you can read more about that on www.AskDrSears.com Jen - I have not yet posted this schedule online anywhere.   At November 1, 2007 12:43 PM ,  Anonymous said... Dr.Bob - is there harm in delaying a 4 month check up so that I may have more time to read your new book and make decisions on vaccinating my daughter? I apprehensively went ahead with the full spectrum of vaccinations at her 2 mo well being check up. Concerned Mom   At November 1, 2007 4:44 PM ,  Dr. Bob sears said... Anonymous - there is no problem at all putting this off for a few weeks. IF there are other medical problems or worries that you have that you need checked now, then keep your appt, just wait on the shots. Theres no harm in that   At November 5, 2007 7:41 AM ,  Anonymous said... I have read your new book. We have followed the recommended vaccination schedule for my son's 2 and 4 mos visit. I have his next appointment with his doctor on 5 december. It is for his 6 month visit, but he will almost be 8 mos. I am done with the rotavirus and want to use your recommended schedule; how do you recommend i proceed at this time? Also, as a nursing mom i received the mercury free flu shot, am i correct to assume that since i am nursing and my husband and baby-sitter have the flu shot then my son does not need one? thanks -beth   At November 5, 2007 10:10 AM ,  Dr. Bob Sears said... To start following an alternative schedule, just cross off what you've had already and pick up with whatever is due next on MY schedule. Your doctor can help you figure that out. I guess that since everyone around the baby had a flu shot, and the baby is nursing and NOT in daycare, the flu shot would be a low priority for your baby.   At November 6, 2007 7:50 AM ,  Anonymous said... Dr. Sears, My son is due for his 4 month checkup tomorrow, but I would like to read your book first (it won't be here for 3 days.) I called my pediatrician's office and let them know that we would be coming in for the visit but would not be getting the shots until I could educate myself more. The nurse told me that was fine, but that he would be getting the same shots he received at his two month and that there was no reason to hold off. I had the shot spaced out last time (2 then 2 more plus rota 2 weeks later). What do you suggest I do? Hold off until I read the book or just follow the same schedule I did for the two month shots?   At November 6, 2007 10:47 AM ,  Dr. Bob Sears said... I would hold off. Maybe reschedule your appt? Or have your appt. but just tell the doctor you want to come in a week or two later to get the shots. Most offices wouldn't have a problem with that.   At November 7, 2007 6:39 PM ,  Anonymous said... Dr. Sears, My daughter has been on the regular vaccination schedule up to 9 months. At 12 months we found out she had an egg allergy and we skipped all vaccines, at her 15 month she did not get a flu or the MMR because I had read that it has an egg base. My dr is pushing for that vaccine at 18 months but I want to wait to see if my daughter outgrows her mild allergy....do you think its as safe as my dr is telling me to give to a baby who has this allergy? Thanks!   At November 7, 2007 10:16 PM ,  Dr. Bob Sears said... It depends on how bad her allergy to eggs is. Let me know what her egg reaction has been.   At November 9, 2007 6:50 AM ,  Anonymous said... Dr. Sears, Thank you, thank you, thank you for writing this book. After reading, I have a few questions: 1. my daughter is approaching 4 months, I held off on starting her imms so that I could do more research & read your book. I want to follow your alternative imms schedule. Do I just add 2 months to each line on the schedule or are further adjustments necessary? 2. & since we are in winter months; would it still be reasonable to get DTaP 1st then wait a month to get Hib & Pc? 3. I exclusively breastfead my daughter & still take my prenatals & use super food supplementation. Is it safe to supplement her with A & C like you suggested? Do breastfed infants need extra supplementation when mom is supplementing? Is there a risk for overdose/toxicity? 4. When a breastfeeding mom gets a vaccine (flu for instance or Tdap); is any protection passed on from that new vaccine? Now just crossing my fingers for finding a fabulous pediatrician (like yourself) open to an alt imms schedule! shame I don't live in the OC! Thanks Jenn   At November 9, 2007 11:56 AM ,  Anonymous said... Dr. Sears - Thank you for this book. I just wanted to share my experience with putting your Alternative Vaccine Schedule into play. I had held off on vaccines for my now 3-month old until I could get a copy of your book. Our 2-month appt was a little tense with our pediatrician - I think she thought that we were going to come back with a radical anti-vax plan. But, after reading your book, I made a copy of your Alternative Vaccine Schedule (as you suggested in the book), brought it to our appointment today and got 2 thumbs up on the plan from our pediatrician. The photocopy is now in my baby's chart, and it is the vaccination plan that we all agreed that we will follow. I do have a question..It looks like our one hurdle might be splitting up the MMR. My state (NC) provides the combined MMR vaccine to pediatricians. My doctor's office is going to research ordering the individual shots. But in the meantime, do you know how any other folks have dealt with this challenge? I didn't see that you addressed this issue in the book. I am concerned that placing an order for individual shots may be cost-prohibitive. Any insight that you may have is appreciated. Again, thank you for the book. I feel so much more empowered knowing that I have comprehensive information to make vaccine decisions for my baby.   At November 9, 2007 2:26 PM ,  Dr. Bob Sears said... Jenn Yes, you just start and always be 2 months behind. Don't worry about overdosing on the vitamins. Adding the extra ones that I suggest is fine. You getting a shot only offers a bit of protection thru breastfeeding - not enough to really matter. Yes, I would get DTaP and aluminum-free HIB first, then get Pc a month later (since you're not getting rotavirus - baby is too old). Anonymous - I'm glad your ped was so open to all this. You should try giving her a Book and see if she'll read it. As for separate MMR, if you are one of the first to ask your doctor about it, they will probably say no. But once 10 other patients ask for the same thing, your doctor will probably start to do it. I would just keep putting off the MMR until you can get them separately, even if it takes a couple years.   At November 9, 2007 6:20 PM ,  Anonymous said... This is the woman (Katty) with the baby with the egg allergy. Thanks for asking and responding. Her reaction has been a rash around her mouth and on her back and once in a while a hive if she eats too many pancakes or something, but a few bites of them doesn't have any reaction. I worry about injecting something directly into her that she is allergic too and my dr didn't seem concerned and reminded me that she'd get the MMR at her 18 month appt. I think I should give her more time, she didn't react well to her last batch of vaccines that included chicken pox and ended up with a rash and a hard spot in her leg and I am going to sit down and look at what's left for her and do a alternative schedule. Is it okay to wait on MMR until she outgrows her allergy? And are there other vaccines that I should keep a look out for that may bother her because she has this allergy? I appreciate your answers so much. Katty   At November 10, 2007 6:48 PM ,  Dr. Bob Sears said... Katty the only ones with egg are MMR and flu. it is ok to delay until she outgrows the allergy, if she does. just be aware that this leaves her open to the diseases (fortunately which are very rare)   At November 12, 2007 8:51 AM ,  Anonymous said... Just ordered your book and am anxiosly awaiting it, however my doctor is not very open to an alternative schedule. Can you suggest any dr's in the LA/OC area that are more open to this kind of thing?   At November 12, 2007 9:23 PM ,  dr. bob sears said... There are 2 of us listed in the Vaccine-Friendly Doctor's database on the homepage.   At November 13, 2007 8:36 AM ,  Anonymous said... First of all, I want to say thanks! Your book was great. Thanks for taking the time to educate parents on vaccines! There are many of us that are just to afraid to ask our dr's about them because we don't know enough but you have given us all the info we could possibly need. One suggestion if I may for upcoming revisions of the book, I think it would be useful to have a table of the different manufacturers and their ingredients side by side so that parents can easily select which vaccines they want to give and also go into their dr's office with the list to see if they are able to obtain those certain ones. I am a so cal resident and am surprised to see only 2 dr's on your vaccine-friendly dr list, it is rather disappointing! It is about a 45 minute trek to your office but I think it may be well worth it to go see you and feel comfortable that my children are being vaccinated as safely as possible! Thanks again!!   At November 14, 2007 7:15 PM ,  Ashley Erbesfield said... This post has been removed by the author.   At November 14, 2007 7:22 PM ,  Anonymous said... My baby is now 4 months. He had all his vaccinations at 2 months. We are now holding off future vaccinations until he is 12 months old. Our ped has reluctantly ok'd this. Do we have to start over with the vaccinations at 12 months or do the vaccinations that we already did at birth (hep b) and 2 months count?   At November 16, 2007 2:34 PM ,  dr. bob sears said... The 2 month and birth shot count. you don't have to start over.   At November 19, 2007 2:20 PM ,  Melissa said... Spoke to my dr today about the alternative schedule and she seemed open to it yet still tried to talk me into taking all 5 at one and said that each shot has a different incubation period? She said each of them activate at different times so giving 5 at once doesn't mean that they will all be active at the same time..what is this all about? 2ndly she said that the MMR doesn't come separate?? Can only certain doctors get this separate? I think my doctor uses sonofi pasteur products since I see their posters all over the office.   At November 23, 2007 9:58 AM ,  dr. bob sears said... no, that's not true about the incubation periods. MMR is available to all doctors separately, although the mumps component is on back order.   At November 26, 2007 9:29 AM ,  Shannon said... Are there any vaccination risks to babies with a milk/dairy allergy? His symptom from dairy is severe nasal congestion. Thank you so much!   At November 26, 2007 10:29 AM ,  Shannon said... I should also add that my child is almost 7 months, and is breastfeeding. When I eat dairy, he gets nasal congestion. He has recieved 3 DTAP's, 2 Comvax's, 3 IPV's, and 2 Prevnars. No major side effects after the vaccines. Also, when do YOU recommend the MMR?   At November 26, 2007 1:12 PM ,  Melissa said... Thanks Dr Sears.Is the separate MMR available through a certain manufacturer? Also I gave a copy of your book to my pediatrician..she said she will read it and give me her opinion!! We'll see, hopefully she will read it with an open mind and maybe get on board with the alternative schedule! If she isn't willing, would there be any problem with me coming to your office for vaccines and still keeping her for well visits since your office is so far from me??   At December 7, 2007 3:03 PM ,  Dr. Bob Sears said... Shannon - there is no worry with milk allergy kids having worse vaccine reactions. I've never seen a connection there. Melissa - The separate MMR shots are made by the same company that makes the MMR - Merck. Sorry, we don't do just shots for anyone - only those who are our patients for checkups too.   At January 17, 2008 7:23 PM ,  Feeling helpless said... Dr. Sears - Just talked to our dr. about your alt schedule. He said no b/c if he made 1 exception he would have to do it for more people and he can't do the additional visits because it would be a nightmare for his practice. So what do I do now if I can't find a dr. in our area that will allow an alternative schedule? We live in CT and I haven't found a doctor open to this. I love our dr., but don't feel comfortable with the AAP schedule. Does this mean I'm just forced to follow the AAP schedule or do no shots at all? I hate extremes - feeling helpless   At January 28, 2008 5:20 PM ,  Christa said... Dr . Sears< I am going for my 2 month check-up and shots tomorrow. I have been looking everywhere for your recommended alternative shot schedule. Is this something you would send/post for me?   At March 25, 2008 1:53 PM ,  Charlie and Andrea said... Dr. Sears, I don't know if I'm too late on this discussion, but I'm hoping maybe you could answer my questions. I have 3 children, my oldest is almost 4 and hasn't been vaccinated since she was 1 and up until then she was on the typical plan. My middle one is 2 1/2 and has only had the recommended vaccines up to 3 months. My youngest is 8 months and she has had zero vaccinations, including the hep A in the hospital, which I declined. I was given the advice to just wait on any vaccinations until I knew what I wanted to do; I couldn't decide if I wanted to vaccinate, do an alternate plan, or do none at all. After my research, I have finally decided on an alternate plan. With my baby, I'm sure things will go fine. With the older two, will we just be extremely delayed, or should I have to worry based on their older ages? Secondly, in your opinion as a busy doctor - would the best way to approach this be calling around to find a pediatrician who is open to an alternate schedule? Or, should I just make an appointment with someone and go in with questions? I don't want to waste their time, or mine, or my money! Thank you thank you thank you for your help. Your website has been a great source of inspiration and help to me even aside from the vaccination issue!   At April 10, 2008 12:46 PM ,  Kate said... Hi Dr. Sears, My son has had the first polio shot at his 2 month check-up. Our pediatrician was concerned that if we pick up your alternative schedule and wait on the next polio until he's 12 months, that it may not be as effective--may have worn off or something. Do you know for sure that waiting doesn't lessen the efficacity of that first polio shot? Thanks so much for your book and this blog! -Kate T.   At April 22, 2008 9:22 AM ,  Anonymous said... Dr. Sears, Today was my sons 15 month visit. We have had him on the recommended schedule until now after reading your book. We asked our Dr. about breaking up the MMR and he said he couldn't find it in single doses. He is open to your schedule if I can find the single doses. We delayed the MMR and my son only received the HIB. Can you give me some advice on how to get the single dose MMR. Does it matter what state you live in? Thank you, Rebecca   At April 24, 2008 10:09 AM ,  Anonymous said... Thanks Dr Sears for writing this book! It's exactly what I have been looking for. I only wish it had been around a few years ago when my oldest was born but this book is still going to be a great help!   At April 29, 2008 2:42 PM ,  Anonymous said... Dr. Sears, I just discovered your book exists and am ordering it. In the meantime, I've been following Dr. Kenneth Bock's alternative vaccination schedule (in his book "Healing the New Childhood Epidemics"). He suggests separate MMR vaccines, with measles at 15 months, mumps 6-12 months later, and rubella 6 -12 months after mumps. I just got my 17-month old daughter a measles vaccine last week. I gave her multivitamin and breast fed, but no other supplements (Dr. Bock suggested extra A, C, and Transfer Factor, but I admit I didn't give these). My daughter wasn't sick at the time and has no allergies that I know of. Although she has no fever, this week she has a rash on her body and is sleeping more than usual. She is a bit spacey and pale. I am worried sick that I have hurt her by giving her this vaccine. She's usually so exuberant, talkative, interactive, and physical. Now she's about 85% of normal in this regard. What can I do to make sure that I improve her chances to fully recover from the ill effects of the vaccine? I wonder if I've done something to regret. - Worried sick   At May 23, 2008 5:36 PM ,  Krista said... How are we supposed to get these different brands of vac? I spent all day trying to find daptacel and will have to drive an hour to pick it up!   At June 25, 2008 3:30 AM ,  Nikole said... We had our son's 1 year appointment and I showed the doctor the book and the alternative schedule we would like to start following. She told me the only problem she had was that they cannot get them individualy. She had one of the nurses call a local pharmacy to see if they could order just the mumps vaccine and she was told no. So we had them give our son the Varicella & PC vaccine. I told the pediatrician that I didn't want to give my son the MMR shot until he is older of that is the only way they could give it. We live in York, PA, so I have no idea why they can't order it in separate vaccines. If that is the case at what age should my son receive the first MMR vaccine?   At September 24, 2009 8:30 AM ,  Colleen said... I am looking for a copy of your vacaination schedule....something that has it all laid out completely, where can I find that?   At October 28, 2009 2:44 PM ,  Anonymous said... My son is 9 1/2 weeks old, and I have a question about the adult tdap shot. If I get the shot, and I am exclusively breastfeeding, would that live virus be passed to my son through breast milk?   Post a Comment << Home   The 12 Childhood Vaccines Vaccine-preventable Diseases Boost Your Child's Immune System FAQs Parents Who Choose not to Vaccinate Current Outbreaks and Epidemics Vaccine Discussion Forum Read Dr. Bob's Online Interviews Updates & Corrections to The Vaccine Book Find a vaccine-friendly doctor near you Alternative Vaccine Schedule American Academy of Pediatrics 2007 Vaccine Schedule Vaccine News Vaccines and Autism Vaccines and their diseases

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