The Childhood Vaccine Schedule (and the Advisory Committee on Immunization Practices – ACIP)

We’ve already talked about how many vaccines we give. I’ll be covering each individual vaccine as we go along, but let’s talk about how we wound up with the schedule we have. A great deal of study and research goes into determining the ideal time to give each vaccine. Timing depends on a number of factors such as what age group is at highest risk from certain diseases (we want babies protected as early as safely possible), maturity of the immune system (MMR is safe down to 6 months of age but only confers lasting immunity if given after 12 months, but then risk of adverse events starts to go up after about 18 months), how many booster doses are needed to confer lasting immunity, how long it takes the immune system to fully respond and make antibodies, etc. Needless to say, it’s complicated. These factors are examined by members of the Advisory Committee on Immunization Practices (ACIP), which is a division of the CDC. They are the ones who come up with the actual schedule that is used in the US. The schedule is continually monitored for both safety and effectiveness. In current hot topics, we know that the modern acellular pertussis is safer than the old whole cell pertussis, but it doesn’t work as well. There is current discussion about whether we need to move the 4 year old dose to later, like age 6 or 7, in order the close the gap between immunity waning and receiving that 11 year old booster. On the other hand, the MMR vaccine is incredibly effective – you get your first dose at 12 months and a booster at 4 years and you’re good for life. You can read more about all the work that goes into making the schedule in the links below.

http://www.historyofvaccines.org/…/development-immunization…
http://www.chop.edu/…/vaccine-education-center/vaccine-hist…
http://www.vaccinateyourbaby.org/pdfs/Vaccine_schedule.pdf
http://www.cdc.gov/…/pa…/vaccine-decision/sets-schedule.html
http://www.immunize.org/timeline/
http://annals.org/article.aspx?articleid=744177
http://www.cdc.gov/vaccines/…/committee/members-archive.html

Here are links to good information about safety of the current schedule:

https://www.nationalacademies.org/…/ChildhoodImmunizationSc…
http://www.vaccinateyourbaby.org/safe/research.cfm
https://www.healthychildren.org/…/Vaccine-Studies-Examine-t…
http://www.hhs.gov/…/childhood-immunization-safety-june2013…
http://www.forbes.com/…/iom-finds-childhood-vaccine-sched…/…
http://www.npr.org/…/schedule-of-childhood-vaccines-declare…

But what about alternative schedules? Does it really matter when the vaccines are given as long as they’re given eventually? Actually yes, it does matter. Some of these diseases pose the greatest risk to babies under 6 months so it’s important to get them protected ASAP. Some of the vaccines are safer and/or more effective if they’re given earlier (e.g. HPV – works best if given BEFORE age 15 years). The timing of vaccines is intentional and well studied, so making changes willy nilly is not a good idea and does not increase safety. It just leaves children vulnerable to dangerous diseases for longer than they need to be and may decrease effectiveness AND (I’m about to blow your mind) DECREASE safety.  Ignore Bob, he doesn’t know what he’s talking about.

http://pediatrics.aappublications.org/content/123/1/e164
http://www.scientificamerican.com/…/delaying-vaccines-incr…/
http://www.immunizeforgood.com/fact-or-fic…/delayed-schedule
https://shotofprevention.com/…/new-evidence-of-risk-from-d…/

 

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