When Elyse Imamuraās son was an infant, she and her husband, Robert, chose to spread out his vaccinations at a more gradual pace than the recommended.
āI was thinking, āOK, weāre going to do this,āā says Imamura, 39, of Torrance, Calif. āāBut weāre going to do it slower so your body gets acclimated and doesnāt face six different things all of a sudden.āā
Seven years later, Imamura says her son, Amaru, is a āvery healthy,ā active boy who loves to play sports.
But delaying vaccines is risky. Many pediatricians will tell you a more gradual approach to vaccinations is better than no vaccinations at all, but they offer some hard advice to parents who are considering it.
āEvery day you are eligible to get a vaccine that you donāt get one, the chance of an invasive disease remains,ā says Dr. Charles Golden, executive medical director of the Primary Care Network at Childrenās Hospital of Orange County.
Recent outbreaks of , and have once again reignited a war of words over vaccinations.
The squabble is often painted as two-sided: in one camp, the medical establishment, backed by science, strongly promoting the vaccination of children against . In the other, a small but vocal minority ā the so-called ā shunning the shots, believing the risks of vaccines outweigh the dangers of the diseases.
The notion that there are two opposing sides obscures a large middle ground occupied by up to , who believe in vaccinating their children but, like the Imamuras, choose to do so more gradually. They worry about the health impact of so many shots in so short a period, and in some cases they forgo certain vaccines entirely.
Alternative vaccine schedules have , promoted by a few doctors and touted by celebrities such as . he idea during a 2015 Republican presidential debate.
The concept gained a large following more than a decade ago, when , an Orange County, Calif., pediatrician, published in which he included two alternative schedules. Both delay vaccines, and one of them also allows parents to skip shots for measles, mumps and rubella (MMR), chickenpox, hepatitis A and polio.
Searsā book became the vaccination bible for thousands of parents, who visited their pediatricians with it in tow. But his ideas have been widely rejected by the medical establishment and he was last year after it accused him of improperly exempting a 2-year-old from all future vaccinations. He declined to be interviewed for this column.
Imamura, who describes herself as ādefinitely not an anti-vaxxer,ā says she and her husband āfollowed Sears to a T.ā They limited the number of vaccines for their son to no more than two per appointment, compared with up to six in the official schedule. And they skipped the shot for chickenpox.
She concedes, however: āIf thereād been outbreaks like now, it would have affected my thinking about delaying vaccines.ā

The ideas promoted by Sears and others have contributed to parentsā worries that front-loading shots could overwhelm their babiesā immune systems or expose them to toxic levels of chemicals such as mercury, aluminum and formaldehyde.
But scientific evidence does not support that. Infectious-disease doctors and public health officials say everyday life presents far greater challenges to childrenās immune systems.
āTouching another human being, crawling around the house, they are exposed to so many things all the time on a daily basis, so these vaccines donāt add much to that,ā says Dr. Pia Pannaraj, a pediatric infectious-diseases specialist at Childrenās Hospital Los Angeles.
The same is true of some of the metals and chemicals contained in vaccines, which vaccination skeptics blame for autism despite numerous studies finding no link ā the published earlier this month.
In the first six months of life, babies get from breast milk and infant formula than from vaccines, public health experts say.
āWhen you look at babies that have received aluminum-containing vaccines, you canāt even tell the level has gone up,ā says Paul Offit, professor of pediatrics at Childrenās Hospital of Philadelphia (CHOP) and director of the hospitalās . The same is true of formaldehyde and mercury, he adds.
(Offit co-invented Merckās RotaTeq vaccine for rotavirus, and CHOP to it for $182 million in 2008. CHOP declined to comment on what Offitās share was.)
Parents who are concerned about mercury, aluminum or other vaccine ingredients should avoid information shared on social media, which can be misleading. Instead, check out the Vaccine Education Center on CHOPās at by clicking on the āDepartmentsā tab.
The Centers for Disease Control and Prevention also provides a detailed breakdown of in every vaccine at www.cdc.gov/vaccines.
If your child has a condition you fear might be incompatible with vaccinations, discuss it with your pediatrician. The CDC gives very on who should not receive vaccines, including kids who have immune system deficiencies or are getting chemotherapy or taking certain medications.
If your children are not among them, vaccinate them. That will help prevent outbreaks, protecting those who, for medical reasons, have not received the shots.
When parents resist, Pannaraj says, she emphasizes that the potential harm from infections is far more severe than the risks of the vaccines. She notes, for example, that the risk of getting encephalitis from the measles is about 1,000 times greater than from the vaccine.
Still, side effects do occur. Most are mild, but severe cases ā though rare ā are not unheard of. To learn about the of vaccines, look on the CDC website or discuss it with your pediatrician.
Emily Lawrence Mendoza, 35, says that after her second child, Elsie, got her first measles, mumps and rubella (MMR) shot at 12 months of age, she spiked a fever and developed a full body rash that looked like a mild version of the disease.
It took three visits to urgent care before a doctor acknowledged that Elsie, now almost 5, could have had a mild reaction to the vaccine. After that, Mendoza, of Orange, Calif., decided to adopt a more gradual vaccination schedule for her third child.
Yet Mendoza says Elsieās adverse reaction made her realize the importance of vaccinations: āWhat if sheād been exposed to a full-blown case of the measles?ā
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