Table of ContentsView AllTable of ContentsACIP RecommendationsState-Mandated VaccinesAlternative SchedulesCurrent Vaccination Rates
Table of ContentsView All
View All
Table of Contents
ACIP Recommendations
State-Mandated Vaccines
Alternative Schedules
Current Vaccination Rates
In the United States, the immunization schedule for children 0 to 18 years of age is based on recommendations of the Advisory Committee on Immunization Practices (ACIP), an independent group of experts housed within the Centers for Disease Control and Prevention (CDC).A total of 14vaccinesare included in the ACIP recommendations.
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Recommended ACIP Immunization Schedule
The Advisory Committee on Immunization Practices (ACIP) is a committee tasked with preparing recommendations for the routine vaccination of adults and children.
The committee is made up of 15 members who meet three times yearly to review data and vote onvaccine recommendations. ACIP recommendations are made with the input of the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), and others.
In the United States, ACIP statements are official federal recommendations.
To ensure that parents can make aninformed choiceaboutchildhood vaccinationsfrom birth to 18 years, the National Childhood Vaccine Injury Act requires all healthcare providers to provide parents or patients with copies of vaccine information statements before administering a vaccine.
Recommended Vaccines From Birth to 15 Months
Vaccinations are scheduled at an age when they are most beneficial. Vaccinations usually are delivered in a series of doses to build durable immunity to the disease.
In the United States, the first round of vaccinations starts at the time of birth and continues every one to three months until the age of 15 months.
The 11 vaccines that will have been started (and in some cases completed) between birth and 15 months are:
There is also a nasal spray flu vaccine calledFluMist, which is available to healthy children 2 years of age and older. With the exception of the age restriction and the route of administration (one spray into each nostril), FluMist is given on the same schedule as the flu shot.
Recommended Vaccines From 18 Months to 18 Years
Combination Vaccine Options
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State Mandated Immunizations
One common exception is the human papillomavirus (HPV) vaccine which is only mandated in Hawaii, Rhode Island, Virginia, and the District of Columbia.
States will allow for a varying degree of medical, religious, and philosophical exemptions, wherein parents can opt out of certain vaccines without the threat of having their child barred from participating in school, sports, or other activities.
Alternative Immunization Schedules
Alternative immunization schedules are those that veer from the ACIP recommendation, either in terms of which vaccines should be given or when they are given.
Two widely published alternative schedules—called the “Donald Miller User-Friendly Schedule” and “Dr. Bob’s Alternative Vaccine Schedule”—incorporate many of these features.
Donald Miller User-Friendy Schedule
Miller’s schedule is based largely on personal observation and the foundational belief that “medicine is not a science.” In an article published in 2014, Miller argued that “populations cannot be tested to demonstrate strict regularity of outcome in every individual.”
In response to these beliefs, Miller proposed a more “user-friendly” approach that he insists is safer than ACIP recommendations despite a lack of supporting evidence.
This includes:
Dr. Bob’s Alternative Vaccine Schedule
A well-known vaccine critic, Sears stated in 2014 that “the disease danger is low enough where I think you can safely raise an unvaccinated child in today’s society.”
Sears' 2007 best-selling book,The Vaccine Book: Making the Right Decision For Your Child,was said to have sold over 180,000 copies and garnered endorsements from many celebrities.
According to Dr. Bob’s schedule, immunizations are rolled out as follows:
Can Vaccines Overload a Child’s Immune System?No, vaccines do not overload or overburden the immune system. Every day, a child’s immune system is exposed to and successfully fights off thousands of germs. With vaccination, a child is simply getting a weakened or dead version of a germ that does not cause disease but instead helps reduce the risk of a more serious infection from the live germ.
Can Vaccines Overload a Child’s Immune System?
No, vaccines do not overload or overburden the immune system. Every day, a child’s immune system is exposed to and successfully fights off thousands of germs. With vaccination, a child is simply getting a weakened or dead version of a germ that does not cause disease but instead helps reduce the risk of a more serious infection from the live germ.
How Alternative Schedules Affect Healthcare and Health
While vaccine hesitancy and vaccine complacency are hardly new phenomena, the rise in social media disinformation has led to a rise in the number of under-vaccinated children in the United States.
Despite this, many pediatricians are accommodating parents' requests for adjustment to the ACIP schedule. According to a 2017 survey inClinical Pediatrics,58% of pediatricians reported frequent alternative immunization schedule requests and 24% reported feeling comfortable using them.
And this is despite the fact that low vaccination rates have given rise to vaccine-preventable diseases in the United States and abroad, including measles, varicella, and rotavirus.
Summary
Vaccine schedules are designed to ensure that a child is protected from preventable diseases. The recommended schedule from the Advisory Committee on Immunization Practices (ACIP) helps prevent diseases that, in the past, caused large numbers of children to become sick, disabled, paralyzed, or die.
23 Sources
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Centers for Disease Control and Prevention.Vaccines & immunizations: requirements and law.
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Los Angeles Times.Vaccination controversy swirls around O.C.’s ‘Dr. Bob’.
OC Weekly.Dr. Robert Sears takes on both sides of the great vaccination divide.
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Newcomer SR, Michels SY, Albers AN, et al.Vaccination timeliness among US children aged 0-19 months, National Immunization Survey–Child 2011-2021.JAMA Netw Open.2024;7(4):e246440. doi:10.1001/jamanetworkopen.2024.6440
Mohanty S, Feemster KA, Buttenheim A, et al.Factors associated with pediatrician responses to alternative immunization schedule requests.Clin Pediatric. 2018;57(2):180-188. doi:10.1177/0009922817696467
Committee on the Assessment of Studies of Health Outcomes Related to the Recommended Childhood Immunization Schedule; Board on Population Health and Public Health Practice; Institute of Medicine.Summary. In:The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies. Washington (DC): National Academies Press.
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