Why are vaccines spaced out

I offer them an optional schedule that gets their child fully vaccinated, but at a slower pace. If they were, many would vaccinate. I believe this approach would actually increase vaccination rates, not decrease them as Dr. Offit suggests. I think that is our main area of disagreement. Open debate and discussion is healthy in the field of medicine.

Offit does as well. However, I must take issue when a person very clearly misrepresents information in my book, selectively quotes certain sections out of context, and attributes statements and ideas to the book and to myself that I never even wrote. Offit was reading some other vaccine book instead of mine. We are in an environment now where for some parents, somebody can say something, can just make something up and that can hold sway with a parent as much as hundreds of scientific studies," O'Leary said.

And multiple office visits are a pain for everyone. He tried explaining they were putting their child in far more danger by driving in the car to multiple visits than the children would ever be in from a vaccine. But they have been tested for years before any vaccine goes on the market, and are constantly scrutinized as they are used in a general population.

IE 11 is not supported. For an optimal experience visit our site on another browser. Politics Covid U. News World Opinion Business. To obtain a copy, go to www. When a 3-month-old infant presents having had no prior immunizations, would you start the accelerated schedule? The accelerated schedule should be used when the child is more than a month behind schedule, until you get them caught up. An accelerated schedule is acceptable as long as minimum ages and minimum intervals are observed for each dose.

Once you have the child back on schedule, use the recommended ages and intervals on the childhood schedule. In this case you can give the child the first set of recommended vaccines at age 3 months and then bring him back at age 4 months and give the second set of vaccinations.

At this point the child will be caught up and can return to the usual schedule. Be sure to educate the parents and talk to them about the importance of bringing the child back on time. If a child falls behind on immunizations, is it recommended to use only minimum intervals to get the child caught up?

Or should we use a minimum interval for the same vaccine only once? If a child is behind on immunizations, the Advisory Committee on Immunization Practices ACIP recommends using the minimum intervals between each dose until the child is caught up. The minimum interval for a vaccine can be used as many times as necessary, until the child is back on schedule. If two live virus vaccines are inadvertently given less than 4 weeks apart, what should be done? Two or more injectable or nasally administered live vaccines not administered on the same day should be separated by at least 4 weeks to minimize the potential risk for interference.

If two such vaccines are separated by less than 4 weeks, the second vaccine administered should not be counted and the dose should be repeated at least 4 weeks later.

Alternatively, one can perform serologic testing to check for immunity, but this option may be more costly, may not be practical if multiple antigens are involved such as measles, mumps and rubella , and may provide results that are difficult to interpret. The oral vaccines Ty21a typhoid, cholera and rotavirus vaccines can be administered on the same day with or at any interval before or after other live vaccines injectable or intranasal.

However, oral cholera vaccine should be administered before Ty21a vaccine, and 8 hours should separate the oral cholera vaccine and the first dose of Ty21a. We gave a dose of vaccine too soon after the previous dose. When can we give another valid dose? If vaccines are given too close together, it can result in a less than optimal immune response. However, in most instances, a difference of a few days is unlikely to have a negative effect on immune response.

With the exception of rabies vaccine, ACIP allows a grace period of 4 days i. However, if a dose was administered 5 or more days earlier than the recommended minimum interval between doses, it is not valid and must be repeated. Note that for hepatitis A vaccination, if the second dose is administered too early and must be repeated, the recommended interval between the invalid dose and the repeat dose is 6 months; however, if the repeat dose is administered earlier than 6 months no further doses are recommended as long as the interval between the first and final dose is at least 6 months.

If the first dose in a series is given 5 days or more before the recommended minimum age, the dose should be repeated on or after the date when the child reaches at least the minimum age.

If the vaccine is a live vaccine, ensuring that a minimum interval of 28 days has elapsed from the invalid dose is recommended. Avoid such errors by knowing the minimum intervals and ages for routinely given vaccines.

The 4-day "grace period" should not be used when scheduling future vaccination visits, and should not be applied to the day interval between live parenteral vaccines not administered at the same visit. It should be used primarily when reviewing vaccination records for example, when evaluating a vaccination record prior to entry to daycare or school.

Two live virus vaccines can be given on the same day. How do you define "day"? The "same day" generally means at the same visit.

This interval has not been precisely defined and probably will never be since it would be extremely difficult to study in order to develop an evidence-based recommendation.

Immunization programs and their computer systems likely define this differently. It seems reasonable that if two vaccines were given on the same date then they would both be valid. For the purpose of vaccine spacing, what constitutes a month: 28 days 4 weeks , 30 days, or 31 days?

For intervals of 3 months or less, you should use 28 days 4 weeks as a "month. Does live oral cholera vaccine need to be administered at an interval from other live oral or injectable vaccines? In general, no. According to ACIP's General Best Practice Guidelines for Immunization, concerns about spacing between doses of live vaccines not given at the same visit applies only to live injectable or intranasal vaccines.

So, live oral cholera vaccine may be administered simultaneously with another vaccine, or at any interval before or after administration of another vaccine. An exception is that live oral cholera vaccine should be administered before live oral Ty21a typhoid vaccine, and 8 hours should separate the oral cholera vaccine and the first dose of Ty21a. The package insert for VaxChora oral cholera vaccine states that effectiveness and safety have not been established for revaccination or for individuals with previous immunity.

Does the CDC have any recommendations on revaccination or is one dose considered lifetime immunity at this time?

At this time, CDC does not have any recommendation related to revaccination with oral cholera vaccine. The duration of immunity beyond 6 months following one dose is unknown. As more information becomes available, CDC will update its recommendations accordingly. Can these doses be counted toward kindergarten vaccinations? Whether these doses count as part of the child's series depends on the intervals between these doses and the ones that preceded them. No additional doses are indicated.

The 4th dose of IPV is recommended after the 4th birthday. In this case, the child would need a fifth dose of IPV on or after her fourth birthday. The fifth dose of DTaP should not be given earlier than age 4 years. Assuming this dose of DTaP was the fifth the child received, it was given much too early and should not be counted. The DTaP should be repeated on or after the child's fourth birthday. If I give a pneumococcal polysaccharide vaccine to my patient now, how long must I wait before giving the influenza or Td vaccine?

Influenza vaccine and Td or Tdap may be given at the same time or at any time before or after a dose of pneumococcal polysaccharide vaccine. The only time you have to wait is when two LIVE vaccines are not given at the same visit; then you need to wait at least 4 weeks to give the second live vaccine. LAIV can be administered at any time before or after receipt of a blood product. See www. Do any of the bacterial vaccines that are recommended for people with functional or anatomic asplenia need to be given before splenectomy?

Do the doses count if they are given during the 2 weeks prior to surgery? When preparing a patient for splenectomy, follow the dosing recommendations for a patient who is already asplenic. Vaccine doses administered within the two-week period before surgery or after surgery are valid; however, administration at least two weeks before surgery ensures the patient is protected from the moment the spleen is removed.

Completing all doses preoperatively requires advanced planning based on the age and vaccination history of the patient. If vaccinations cannot be completed, administer as many as feasible at least 2 weeks prior to surgery.