TIME Infectious Disease

Spacing Out Kids’ Vaccines Can Hurt Their Health, Experts Say

Girl getting immunization
Getty Images

All those shriek-inducing pokes may seem excessive but the rewards of following national vaccination guidelines far outweigh the risks, experts say

“Like any parent, I don’t like to see my child get a shot,” says Dr. Michael J. Smith, a pediatrician at the University of Louisville who has studied immunizations and developmental health outcomes among kids. “But these vaccine schedules are in place for a reason.” Smith compares skipping or postponing one of your child’s vaccinations to not buckling him or her in during a car ride. “You never know when you’re going to get hit. And if you delay or space out your child’s shots, not only are you putting your kids at risk, but you’re putting other people’s kids at risk too.”

The urgency of Smith’s warnings are borne out in the recent outbreaks of measles and pertussis, diseases that had been almost totally eradicated in the U.S. but have made a frightening comeback since the turn of the century—right around the time two now-discredited scientific papers suggested a possible link between vaccines and autism. Dozens of subsequent studies have demonstrated there are no links between vaccinations and autism. But while stats show most parents understand the importance of immunizing their kids, research from the University of Michigan indicates plenty of moms and dads—roughly 1 in 4—worry that current immunization guidelines may overburden their babies’ tiny immune systems.

The Centers for Disease Control and Prevention (CDC) currently recommend that all healthy babies be vaccinated against 12 different diseases or viruses during the first two years of life. That’s compared to eight back in the early 1990s. Recently added to the list are vaccinations against potentially deadly illnesses like hepatitis and chicken pox.

But while the number of vaccines (and needle pricks) has grown during the last two decades, the amount of antigen in those shots, which is the substance that triggers a response from your child’s immune system, has plummeted, Smith explains. “The actual burden on your child’s immune system is far lower that it was 10 or 20 years ago, even though kids now receive more shots,” he says. That’s credited to advances in protein science and a better understanding of the way diseases and children’s immune systems interact.

In an effort to provide some answers for concerned parents, Smith and his colleagues looked at kids’ scores on tests related to motor skill, verbal memory, attention span, and several other neuropsychological factor to see if vaccine timing had any impact—good or bad—on a child’s brain development. His research shows kids vaccinated on time score the same or better than children who receive their vaccinations late or not at all.

Related research from Canada looked specifically at the immunization decisions made by parents of children diagnosed with autism. “Our study found that roughly 60 percent of parents who had a child with autism delayed or declined vaccinations for a later-born child,” says Dr. Jessica Brian, a developmental psychologist at the University of Toronto. According to Brian’s research, those children who did not receive their shots on time or altogether were slightly more likely to develop autism. “I don’t want to suggest that vaccines offer some protection against autism,” she says. “But our data show that there’s no increased risk of autism among kids who are vaccinated on time.”

Brian, Smith and other vaccine researchers repeatedly point to the Internet as a source of misinformation and, in some cases, unsubstantiated fear mongering when it comes to vaccines. Not uncommon are conspiracy theories involving pharmaceutical companies and the CDC. But travel overseas, and the picture changes slightly.

In Europe, where some diseases were never eradicated as thoroughly as they were in the U.S., health officials say there isn’t as much “too much, too soon” concern among parents when it comes to immunizations. Still, European moms and dads do harbor fears about potential vaccine side effects, says Niklas Danielsson, deputy head of the vaccine-preventable diseases program for the European Centre for Disease Prevention and Control. Danielsson says the “unprecedented success” of vaccination programs has created a generation of young parents who aren’t familiar with the reality of something like a measles outbreak, so they’re focus is on a shot’s rare risks as opposed to its many proven benefits.

The lingering presence of diseases in other countries is one of the big reasons having your children vaccinated on time is so important, says Dr. Simon Hambidge, a professor of pediatrics and epidemiology at the University of Colorado. “We live in a world of international travel, and people are coming into our country all the time who may be carrying these diseases,” Hambidge says. “Unfortunately, the vast majority of the new outbreaks we’re seeing involve unvaccinated children.”

Hambidge has looked closely at one possible vaccine side effect that has parents worried: seizures. The CDC recommends that all healthy infants receive their first measles vaccination between the ages of 12 and 15 months, and some research has linked the measles vaccine to higher rates of febrile seizures. Though frightening for parents, seizures of this type are relatively common and almost never cause lasting damage, Hambidge explains. “About one in 2,000 to 4,000 kids will experience one of these febrile seizures after receiving the measles vaccine,” he says. “But we found that that seizure rate rises to one in 1,000 or 2,000 if the measles vaccine is given late, or between 16 and 23 months of age.” Hambidge says this is just one example of how a slight deviation from the CDC’s vaccination schedule can put your child’s health at risk.

“The risk of measles is far, far more serious than the risk for febrile seizures,” Hambidge says. “Even if your child is unlucky enough to have a seizure after a vaccination, these seizures are short-lived and don’t lead to any long-term issues, while measles is a life-threatening disease.”

Despite the overwhelming amount of research and real-world evidence that points to the reliable safety of vaccines, experts acknowledge that parents will continue to worry about the chemicals and additives in immunization shots. To those who have doubts, Dr. Smith says, “Vaccines are one of the most rigorously tested and effective health products on the planet. Nothing involving them is done lightly.”

And when it comes to the CDC’s recommendations regarding vaccination schedules, he adds, “As a pediatrician and as a parent, if my family’s on vacation and we have to put off my daughter’s doctor visit, I get anxious each day that she goes unvaccinated. I think the timing is that important.”

TIME vaccines

The Anti-Vaxxers Simply Won’t Quit

Safe baby: a child in Africa receives an oral vaccine
Safe baby: a child in Africa receives an oral vaccine ranplett; Getty Images/Vetta

Even as cases of whooping cough, polio, measles and mumps soar, vaccine deniers continue to leave children and babies unprotected. Stubbornness may be part of human nature—but the price is just too high

It’s never easy to say oops. You know it if you’ve ever said something nasty during an argument and found it hard to apologize later. You know it if you’ve ever caused a fender bender on the road and been unable to say “my bad.” And you know it if you’ve ever failed to inoculate your baby against a range of disabling and deadly diseases that can be easily and harmlessly prevented with vaccines, in effect failing to perform the most basic job of parenthood, which is to keep your children safe.

What’s that? You think that under those circumstances an oops wouldn’t be hard to get out? Not so, according to a disturbing study presented Monday at the annual meeting of the Pediatric Academic Societies in Vancouver. Researchers looked at vaccination rates both before and during an outbreak of whooping cough in Washington state in 2011 and 2012, and found that even as the disease was spreading and unvaccinated children were suffering, the percentage of parents who brought their 3- to 8-month olds in for their scheduled inoculations didn’t budge.

Nope, the parents effectively said, still not persuaded.

“We have always assumed that when the risk of catching a disease is high, people will accept a vaccine that is effective at preventing the disease,” said lead author Dr. Elizabeth Wolf of the University of Washington, in a statement that accompanied the release of the study. “Our results may challenge that assumption.”

That says something deeply troubling not just about the outlook for childrens’ health, but about human obtuseness, particularly as outbreaks of measles strike New York City, Orange County, Calif. and elsewhere, while mumps cases spread throughout Columbus, Ohio. Despite this real-time, real-world evidence of the damage caused by the anti-vaccine crazies—who have spent the better part of 16 years peddling the fable that vaccines are filled with never-fully-specified “toxins” that cause autism and an ever-changing pu pu platter of other imaginary ills—many parents and even some doctors continue to close their eyes.

That’s a problem not just for the unprotected kids, but for everyone. If we got smoking rates in the U.S. down to just 10% of the population, we’d celebrate that fact as a great public health victory. But as virologists and epidemiologists remind us again and again and again, when 10%—or even 5%—of parents opt out of vaccines for their kids or insist on making up their own vaccination schedule, they destroy the herd immunity effect that should protect the handful of people in any population who can’t get vaccinated for legitimate medical reasons. If a virus can’t find an entry point into a community, it can never make its way to the most vulnerable members. Every parent who opts out opens one more infectious avenue.

The U.S. is not alone in playing craps with vaccine-preventable diseases. The Vancouver report was issued on the same day that the World Health Organization (WHO) declared a public health emergency concerning the spread of polio from Pakistan, Syria and Cameroon, and the presence of the virus in Iraq, Afghanistan, Israel, Equatorial Guinea, Ethiopia, Somalia and Nigeria. The emergency did not arise because of some new, especially tenacious strain of polio. Indeed, the disease has been at the brink of eradication for a few years now, with only 160 endemic cases in three countries—Afghanistan, Pakistan and Nigeria—in 2013, and 257 cases in countries into which the virus was imported by carriers crossing the border. But attacks on medical field workers by militant groups in Pakistan have disrupted inoculation efforts there, and war or unrest in Syria and elsewhere have made the safe passage of vaccinators impossible.

Extremists in the Middle East and Africa are hardly motivated by the same ideas as rumor-mongers and frightened parents in the U.S. But both are committing the same moral crime, jeopardizing the health and welfare of blameless babies. It’s those babies who will pay the price—and the parents and extremists who must bear the blame.

TIME anti-vaccinators

Chili’s Burns Anti-Vaxxers — and Probably Saves Some Kids’ Lives

Bad science on the menu?
Bad science on the menu?

Discredited science can lurk in seemingly innocent places, and a national restaurant chain very nearly paid the price

Correction appended: April 7, 2014

Today’s tip of the tinfoil hat goes to the antivaccine kooks who nearly contaminated one of their biggest victims. This time it wasn’t just a child who became infected with a vaccine-preventable disease or an entire community of children and adults coming down with measles (hello, New York City and Orange County, California) or mumps (you too, Columbus, Ohio). This time it was poor Chili’s, the restaurant chain that tried for a feel-good and do-good moment, announcing that it would donate 10% of Monday’s revenues to the National Autism Association (NAA), in recognition of Autism Awareness Month.

Good for you, Chili’s — and good for you too, NAA, for looking out for struggling kids. Except there’s this, from the NAA’s website: “Vaccinations can trigger or exacerbate autism in some, if not many, children.” Worse, there’s this: “While mainstream science discounts vaccinations as a cause, members of the National Autism Association feel vaccinations have triggered autism in a subset of children.”

Chili’s got flamed on Facebook and elsewhere for cozying up to crazy and canceled the planned donation day, which is good. The company did the right thing and the antivaxxers lost a round. But the larger, more troubling issue is what poseurs like the NAA are doing hiding in plain sight anyway. The phrasing the group chooses, all by itself, ought to disqualify them from dispensing purported wisdom. When you open by acknowledging that “mainstream science discounts” the very case you’re about to make, you have pretty much bankrupted your argument before you begin.

Of course, in this case the word mainstream, which ought to suggest credible, is code for something else entirely — for the elite, the bought-off, the blinkered, the usual cabal of Big Pharma, Big Government and the media. The truth, the NAA and others will tell you, is to be found outside of the mainstream, in the crazy, swirling eddies of the Internet and the conspiracy blogs and the actresses and models who refuse to vaccinate their children because it’s “the best decision” for them, as shoe designer and TV star Kristin Cavallari put it. Never mind that the mainstream includes virtually every serious medical institution, journal, governmental body and health-policy NGO in the world. Never mind either that the antivaxxers never begin to explain how — or why — this vast conspiracy would have come together to hurt children. Who you gonna’ believe, the scientists or the celebs?

The NAA is not alone in gift-wrapping rubbish to make it look real. There’s the far more odious National Vaccine Information Center (NVIC), which touts itself with the giveaway motto, “Your health. Your family. Your choice.” The implication is that you, the discerning parent and information consumer, should make that same “best decision” Cavallari did. Of course, the NVIC does not mind helping you along, and so its homepage menu features such helpful tabs as Injury Compensation (“The vaccine injured can apply for aid”), Informed Consent (“The human right to voluntary risk-taking”), and yes, the Vaccine Victim Memorial (“Honoring those whose lives have been lost or forever changed by vaccination”).

O.K., so let’s honor lives that have been lost or changed. Let’s honor Jeremiah Mitchell, 10, profiled in a devastating piece in today’s USA Today, who lost both arms, both legs and parts of his eyelids at age 6 after he contracted meningitis — a disease against which his parents did not vaccinate him. Let’s honor too Brady Alcaide, who, as described in the same story, died, unvaccinated, at 9 weeks old, after he contracted whooping cough.

Simply invoking the “your choice” talisman does not mean that you are making a smart or informed or morally defensible choice. And while we’re on that, let’s be clear about one thing: the people who have the most at stake in the antivax follies are the kids, who get absolutely no choice at all. Instead, they are denied the protection their no-doubt nonautistic, fully vaccinated parents received when they were their age. For those babies, the “voluntary risk-taking” the NVIC applauds is nothing of the kind.

If there is anything good about the stubborn, gum-on-the-shoe nature of the antivaxxers — the way they won’t go away no matter how hard science tries to scrape them off — it’s that the toll their nonsense is taking is finally becoming evident. The rise in measles and mumps this year is no accident, nor is the 2010 whooping-cough outbreak in California — nor are the lost lives or the ruined bodies of children like Jeremiah and Brady. A blandly named website can conceal all manner of deadly mischief. Medical science, on the other hand, usually plays it straight.

An earlier version of this article misspelled the surname of Kristin Cavallari.

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