Alternative vaccination schedule

An alternative vaccination schedule (or alternative childhood immunization schedule) is a vaccination schedule differing from the schedule endorsed by the Advisory Committee on Immunization Practices (ACIP). These schedules may be either written or ad hoc, and have not been tested for their safety or efficacy. Proponents of such schedules aim to reduce the risk of adverse effects they believe to be caused by vaccine components, such as "immune system overload" that is argued to be caused by exposure to multiple antigens. Parents who adopt these schedules tend to do so because they are concerned about the potential risks of vaccination, rather than because they are unaware of the significance of their benefits.

Contrary to the claims made by some advocates of alternative vaccine schedules, there is no scientific evidence for the existence of "immune system overload". In addition, the amount of chemicals in vaccines such as aluminum and formaldehyde is much lower than natural exposure levels. Intentional deviation from the ACIP's schedule leaves children vulnerable to infection and increases the likelihood of outbreaks of vaccine-preventable diseases. These schedules also increases the risk of children who cannot be vaccinated, or did not increase the financial costs to patients, since they require the use of more expensive single-antigen vaccines and additional office visits. They also increase the chances of infection among individuals who could not be vaccinated for medical reasons, because they were too young, or did not develop a sufficient immunologic response to the vaccine.

An increasing number of children are undervaccinated, of whom an estimated 13% or more are believed to be so because of parental choice. One survey, published in Vaccine, found that 9.4% of parents in King County, Washington used an alternative vaccine schedule, while another survey found that more than 1 out of 10 parents of children aged between 6 months and 6 years used an alternative vaccine schedule. In a 2011 survey of Washington State pediatricians, 77% of them reported that their patients "sometimes or frequently" asked for alternative vaccination schedules. The same survey found that 61% of pediatricians were comfortable with using such a schedule if a parent asked for it. A 2012 survey found that the percentage of shot-limiting children—defined as children who received no more than two vaccines per visit between their birth and the age of nine months—had increased from 2.5% to 9.5% in Portland, Oregon. Even pro-vaccine parents often tolerate other parents' decisions to adopt alternative vaccine schedules.

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