Parents' Use of Alternative Vaccination Schedules – Better Safe Than Sorry?

Background: Little information is available nationally about the use of, and attitudes about, alternative vaccination schedules among parents of young children.   

Objectives: To determine among a nationally representative population of parents: 1) the prevalence and types of alternative vaccination schedules used ; 2) the proportion of parents who have changed from one type of vaccination schedule to another; and 3) differences in attitudes about vaccines between parents who do or do not follow an alternative  vaccination schedule. 

Methods: Web-based nationally representative survey of parents of 6 months–6 year olds.  Chi-square tests and multivariable logistic regression assessed associations between alternative vaccination schedule use and potential predictor variables.

Results: Twelve percent of parents reported using an alternative vaccination (AV) schedule.  Most AV parents chose to delay (55%) and/or skip (53%) certain vaccines.  Only 17% of AV parents (2% of parents overall) refused all vaccines.  White race and not having a regular health care provider were associated with increased odds of using an AV schedule in a multivariable model.  30% of AV parents reported initially following the vaccination schedule recommended by the CDC.    AV parents were significantly more likely than those following the recommended schedule to hold negative views about vaccines.  However, even among non-AV parents a substantial proportion believed that delaying vaccine doses is safer than providing them according to the recommended schedule (18%), and disagreed with the idea that delaying (35%) or skipping (22%) vaccine doses increases the risk that their children will get sick and spread infection.

Conclusions: More than 1 out of 10 parents of young children use an alternative vaccination schedule. Additionally, a substantial proportion of parents following the recommended vaccination schedule appear to be ambivalent about this practice.  These parents may be inclined to switch to alternative vaccination schedules in the future.