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词条 Alternative vaccination schedule
释义

  1. Effects

  2. Popularity

  3. Proponents

  4. Types of schedules

  5. See also

  6. References

  7. Further reading

An alternative vaccination schedule is a vaccination schedule differing from the schedule endorsed by the Advisory Committee on Immunization Practices (ACIP).[1] These schedules may be either written or ad hoc, and have not been tested for their safety or efficacy.[2][3] 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.[4] 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 vaccination's benefits.[4] However, use of alternative vaccination schedules is associated with an increased risk of vaccine-preventable disease.[6]

Effects

Contrary to the claims made by some advocates of alternative vaccine schedules, there is no scientific evidence for the existence of "immune system overload", and according to the UK National Health Service the idea is a "myth".[5][6] In addition, the amount of chemicals in vaccines such as aluminum and formaldehyde is much lower than natural exposure levels.[7] Intentional deviation from the ACIP's schedule leaves children vulnerable to infection and increases the likelihood of outbreaks of vaccine-preventable diseases.[8] These schedules also increase the chances of infection among individuals who could not be vaccinated for medical reasons, because they were too young, or who did not develop a sufficient immunologic response to the vaccine.[9][10]

After one of the most notorious outbreaks of measles in the United States, in California, legislation was passed to make vaccination mandatory, as alternative vaccine scheduling and/or avoidance had been prevalent before the outbreak.[11]

Popularity

An increasing number of children are undervaccinated, of whom an estimated 13% or more are believed to be so because of parental choice.[12] One survey, published in Vaccine, found that 9.4% of parents in King County, Washington used an alternative vaccine schedule,[1] 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.[13] In a 2011 survey of Washington State pediatricians, 77% of them reported that their patients "sometimes or frequently" asked for alternative vaccination schedules.[14] The same survey found that 61% of pediatricians were comfortable with using such a schedule if a parent asked for it.[14] 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.[15][16] Research on well-off American families suggests that even parents who are ostensibly pro-vaccine can be misled by disinformation, and this can lead them to delay having their children vaccinated, and to tolerate such delay in others.[17]

Proponents

Among the most prominent proponents of alternative vaccination schedules is notable pediatrician and vaccine critic Robert Sears.[15][18] Sears has been criticized by vaccine expert Paul Offit for what Offit states is Sears' "misrepresentation of vaccine science."[19] In June 2018, the Medical Board of California placed Sears on probation for improperly granting a medical exemption from all future vaccines to a two-year-old child without obtaining any of the child's medical records, including which vaccines the child had received to date.[20][21][22]

Types of schedules

A 2016 study identified five different types of alternative vaccine schedules: Sears' schedule, a shot-limiting schedule, selective delaying or refusal, making vaccine decisions visit-by-visit, or refusing all vaccines.[23] Regardless of the type of alternative schedule used, skipping or delaying recommended vaccines has been shown to result in an increased risk of contracting and spreading vaccine-preventable diseases.[13]

See also

  • MMR vaccine controversy
  • Vaccine controversies

References

1. ^1 {{cite journal|last1=Opel|first1=Douglas J.|last2=Banerjee|first2=Ashmita|last3=Taylor|first3=James A.|title=Use of alternative childhood immunization schedules in King County, Washington, USA|journal=Vaccine|date=October 2013|volume=31|issue=42|pages=4699–4701|doi=10.1016/j.vaccine.2013.08.036|pmid=23981431}}
2. ^{{cite journal|last1=Opel|first1=Douglas J.|last2=Marcuse|first2=Edgar K.|title=The Enigma of Alternative Childhood Immunization Schedules|journal=JAMA Pediatrics|date=1 March 2013|volume=167|issue=3|pages=304–5|doi=10.1001/jamapediatrics.2013.786|pmid=23338852}}
3. ^{{cite book | url=https://books.google.com/books?id=9z0qBAAAQBAJ&pg=PA8 | title=Understanding and Managing Vaccine Concerns | publisher=Springer |author1=Boom, Julie |author2=Cunningham, Rachel | year=2014 | pages=8–9| isbn=9783319075631 }}
4. ^{{cite journal|last1=Healy|first1=C. Mary|last2=Montesinos|first2=Diana P.|last3=Middleman|first3=Amy B.|title=Parent and provider perspectives on immunization: Are providers overestimating parental concerns?|journal=Vaccine|date=January 2014|volume=32|issue=5|pages=579–584|doi=10.1016/j.vaccine.2013.11.076|pmid=24315883}}
5. ^{{cite web |publisher=NHS |title=Myths about children's vaccines |url=https://www.nhs.uk/conditions/vaccinations/myths-truths-kids-vaccines/ |date=7 April 2016}}
6. ^{{Cite web|url=https://www.sciencemag.org/news/2018/03/vaccines-won-t-overload-your-child-s-immune-system-or-increase-their-risk-other|title=Vaccines won't overload your child's immune system—or increase their risk of other infections|last=HickokMar. 6|first=Kimberly|last2=2018|date=2018-03-06|website=Science {{!}} AAAS|language=en|access-date=2018-12-30|last3=Am|first3=11:00}}
7. ^1 {{cite journal|last1=Jackson|first1=Michael L.|title=Challenges in comparing the safety of different vaccination schedules|journal=Vaccine|date=April 2013|volume=31|issue=17|pages=2126–2129|doi=10.1016/j.vaccine.2013.02.054|pmid=23470238}}
8. ^{{cite journal|last1=Nadeau|first1=Jessica A.|last2=Bednarczyk|first2=Robert A.|last3=Masawi|first3=Munyaradzi R.|last4=Meldrum|first4=Megan D.|last5=Santilli|first5=Loretta|last6=Zansky|first6=Shelley M.|last7=Blog|first7=Debra S.|last8=Birkhead|first8=Guthrie S.|last9=McNutt|first9=Louise-Anne|title=Vaccinating My Way—Use of Alternative Vaccination Schedules in New York State|journal=The Journal of Pediatrics|date=January 2015|volume=166|issue=1|pages=151–156.e1|doi=10.1016/j.jpeds.2014.09.013|pmid=25444525}}
9. ^{{cite journal|last1=Wheeler|first1=Marissa|last2=Buttenheim|first2=Alison M|title=Parental vaccine concerns, information source, and choice of alternative immunization schedules|journal=Human Vaccines & Immunotherapeutics|date=27 October 2014|volume=9|issue=8|pages=1782–1789|doi=10.4161/hv.25959|pmid=23900266|pmc=3906282}}
10. ^{{cite journal|last1=Siddiqui|first1=Mariam|last2=Salmon|first2=Daniel A|last3=Omer|first3=Saad B|title=Epidemiology of vaccine hesitancy in the United States|journal=Human Vaccines & Immunotherapeutics|date=1 December 2013|volume=9|issue=12|pages=2643–2648|doi=10.4161/hv.27243|pmid=24247148|pmc=4162046}}
11. ^{{cite journal| author=Hussain A, Ali S, Ahmed M, Hussain S| title=The Anti-vaccination Movement: A Regression in Modern Medicine. | journal=Cureus | year= 2018 | volume= 10 | issue= 7 | pages= e2919 | pmid=30186724 | doi=10.7759/cureus.2919 | pmc=6122668 |type=Review }}
12. ^{{cite journal|last1=Glanz|first1=Jason M.|last2=Newcomer|first2=Sophia R.|last3=Narwaney|first3=Komal J.|last4=Hambidge|first4=Simon J.|last5=Daley|first5=Matthew F.|last6=Wagner|first6=Nicole M.|last7=McClure|first7=David L.|last8=Xu|first8=Stan|last9=Rowhani-Rahbar|first9=Ali|last10=Lee|first10=Grace M.|last11=Nelson|first11=Jennifer C.|last12=Donahue|first12=James G.|last13=Naleway|first13=Allison L.|last14=Nordin|first14=James D.|last15=Lugg|first15=Marlene M.|last16=Weintraub|first16=Eric S.|title=A Population-Based Cohort Study of Undervaccination in 8 Managed Care Organizations Across the United States|journal=JAMA Pediatrics|date=1 March 2013|volume=167|issue=3|pages=274–81|doi=10.1001/jamapediatrics.2013.502|pmid=23338829|quote=In our cohort, we also estimate that approximately 13% of children were undervaccinated because of parental choice, which aligns with other published estimates of 10% to 25% from cross-sectional survey and population-based ecologic studies. However, this likely represents an underestimate of the true prevalence of intentional undervaccination and alternative vaccination schedules.}}
13. ^1 2 {{cite journal|last1=Dempsey|first1=AF|last2=Schaffer|first2=S|last3=Singer|first3=D|last4=Butchart|first4=A|last5=Davis|first5=M|last6=Freed|first6=GL|title=Alternative vaccination schedule preferences among parents of young children.|journal=Pediatrics|date=November 2011|volume=128|issue=5|pages=848–56|doi=10.1542/peds.2011-0400|pmid=21969290}}
14. ^1 {{cite journal|last1=Wightman|first1=A|last2=Opel|first2=DJ|last3=Marcuse|first3=EK|last4=Taylor|first4=JA|title=Washington State pediatricians' attitudes toward alternative childhood immunization schedules.|journal=Pediatrics|date=December 2011|volume=128|issue=6|pages=1094–9|doi=10.1542/peds.2011-0666|pmid=22123877|pmc=3387893}}
15. ^1 {{cite journal|last1=Robison|first1=S. G.|last2=Groom|first2=H.|last3=Young|first3=C.|title=Frequency of Alternative Immunization Schedule Use in a Metropolitan Area|journal=Pediatrics|date=18 June 2012|volume=130|issue=1|pages=32–38|doi=10.1542/peds.2011-3154|pmid=22711719}}
16. ^{{cite web | url=https://www.reuters.com/article/2012/06/18/us-oregon-vaccine-idUSBRE85H08D20120618 | title=More Oregon kids on "alternative" vaccine schedules | work=Reuters | date=18 June 2012 | accessdate=7 February 2015 | author=Seaman, Andrew M.}}
17. ^{{cite journal|last1=Wang|first1=Eileen|last2=Baras|first2=Yelena|last3=Buttenheim|first3=Alison M.|title="Everybody just wants to do what's best for their child": Understanding how pro-vaccine parents can support a culture of vaccine hesitancy|journal=Vaccine|date=November 2015|volume=33|issue=48|pages=6703–6709|doi=10.1016/j.vaccine.2015.10.090|pmid=26518397|pmc=5554443}}
18. ^{{Cite journal|date=2012-08-01|title=The clinician's guide to the anti-vaccinationists' galaxy|journal=Human Immunology|language=en|volume=73|issue=8|pages=859–866|doi=10.1016/j.humimm.2012.03.014|pmid=22504410|issn=0198-8859|last1=Poland|first1=Gregory A.|last2=Jacobson|first2=Robert M.}}
19. ^{{cite journal|last1=Offit|first1=Paul A.|authorlink1=Paul Offit|last2=Moser|first2=C. A.|title=The Problem With Dr Bob's Alternative Vaccine Schedule|journal=Pediatrics|date=1 January 2009|volume=123|issue=1|pages=e164–e169|doi=10.1542/peds.2008-2189|pmid=19117838}}
20. ^https://arstechnica.com/science/2018/06/doctor-with-dangerous-vaccine-views-gets-probation-for-gross-negligence/
21. ^{{Cite news|url=https://www.latimes.com/local/california/la-me-ln-sears-license-20180629-story.html|title=California doctor critical of vaccines is punished for exempting 2-year-old boy from all childhood immunizations|last=Karlamangla|first=Soumya|work=latimes.com|access-date=2018-12-30|language=en-US}}
22. ^{{Cite web|url=http://www.ocregister.com/dr-bob-sears-renowned-vaccine-skeptic-placed-on-probation-for-exempting-child-from-all-vaccinations|title=Dr. Bob Sears, renowned vaccine skeptic, placed on probation for exempting child from all vaccinations|date=2018-06-29|website=Orange County Register|language=en-US|access-date=2018-12-30}}
23. ^{{cite journal|last1=Saada|first1=A.|last2=Lieu|first2=T. A.|last3=Morain|first3=S. R.|last4=Zikmund-Fisher|first4=B. J.|last5=Wittenberg|first5=E.|title=Parents' Choices and Rationales for Alternative Vaccination Schedules: A Qualitative Study|journal=Clinical Pediatrics|date=7 September 2014|volume=54|issue=3|pages=236–243|doi=10.1177/0009922814548838|pmid=25200366}}

Further reading

  • {{cite journal| author=Hulsey E, Bland T| title=Immune overload: Parental attitudes toward combination and single antigen vaccines. | journal=Vaccine | year= 2015 | volume= 33 | issue= 22 | pages= 2546–50 | pmid=25891399 | doi=10.1016/j.vaccine.2015.04.020 | pmc= |type=Review }}
{{Vaccines}}

1 : Vaccine controversies
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