Feature Archive

What Is the Alternative Vaccine Schedule?

Experts debate the pros and cons of the alternative vaccine schedule, and what it means for parents.

By Katherine Kam
WebMD Feature

Reviewed by Laura J. Martin, MD

When pediatrician Robert W. Sears, MD, FAAP, wrote The Vaccine Book: Making the Right Decision for Your Child, he envisioned giving parents more choices on how to vaccinate their children if they were concerned about a vaccine's side effects or ingredients or the large number of shots that kids receive today.

"A lot of parents don't really trust the vaccine system," Sears says. "I felt that if I could give parents a better understanding of vaccines -- as well as an alternative way to approach giving vaccines -- then these families who otherwise might not vaccinate could go ahead and feel comfortable with vaccinating."

Sears, who practices in San Juan Capistrano, Calif., says that he isn't against vaccinations. Instead, his book suggests an untraditional "alternative" schedule that delays shots or spaces them further apart. If parents are skittish about any shots at all, he offers a separate "selective" schedule to encourage them to give their kids at least the "bare minimum" of vaccinations.

But public health officials say that those approaches leave too many kids unprotected for too long and aren't backed up by science.

"These altered schedules have not been studied at all," says Meg Fisher, MD, a pediatric infectious disease specialist and medical director of the Children's Hospital at Monmouth Medical Center in New Jersey and chair of the American Academy of Pediatrics' section on infectious diseases. "I would rather stay with what we know is the most likely to protect the most people."

Regular, Alternative, Selective Vaccine Schedules

The regular vaccine schedule for children aged 0-6 is approved by the CDC, American Academy of Pediatrics (AAP), and the American Academy of Family Physicians.

It recommends 25 shots in the first 15 months of life. The shots immunize against whooping cough (pertussis), diphtheria, tetanus, mumps, measles, rubella, rotavirus, polio, hepatitis B, and other diseases.

The alternative and selective vaccination schedules aren't reviewed or approved by the CDC or other public health group. They come solely from Sears.

Sears' alternative vaccine schedule spreads the shots out over a longer period of time, up to age 5-6 years. For instance, he recommends not giving kids more than two vaccines at a time. It also changes the order of vaccines, prioritizing what Sears believes are the most crucial vaccines to get, based on how common and severe the diseases are.

As Sears writes, "If some of the theoretical problems with vaccines are real, this schedule circumvents most of them. If the problems aren't real, then the only drawback is the extra time, effort, and cost for the additional doctor's office visits."

For parents who are the most reluctant to vaccinate, his selective vaccination schedule includes what he calls the "bare minimum" vaccinations against serious and common diseases, such as whooping cough and rotavirus. It also omits some vaccines, including the one for polio.

Number, Timing of Vaccinations

Many parents are wary of the regular vaccine schedule because of the number of shots kids get. Not only do children receive more vaccines than in the past, but sometimes, they get multiple immunizations in one visit.

In his book, Sears writes that his alternative vaccine schedule "does eventually provide complete protection from diseases, and it does so at an age-appropriate pace. It gives kids protection from diseases at the ages when those diseases are the most troublesome, and it doesn't necessarily overload young kids with vaccines that they don't really need until they're older."

The problem is that vaccine timing is critical, Fisher says. Shots are scheduled at the earliest possible age and at the stage when the vaccine will work best with the immune system, she says.