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Vaccines: What's Right for Your Baby?

Question: Is it okay to skip or delay vaccines?

Bernadine Healy, M.D., former head of the NIH, has argued that parents can legitimately question the need to give a 1- or 2-day-old baby a vaccine against hepatitis B, a sexually transmitted disease, when babies have almost no risk for that disease. "That's a heavy-duty vaccine given on day two [of life]," Healy has said.

Robert Sears agrees that parents have the freedom to delay vaccinations for diseases that they feel don't pose a high risk to infants. He offers patients an alternative vaccination schedule that includes the most critical jabs -- for whooping cough, meningitis and rotavirus, for example -- and holds off on the others, including hepatitis A and B, chicken pox, polio and flu. "More and more parents are choosing not to vaccinate because they don't want to follow the overloaded schedule that the government mandates," he says. "I think more parents would vaccinate if doctors offered to spread the shots out in a manner that more babies can safely tolerate." Sears does believe the missed shots should be made up eventually, from age 2 to around 9, when immune systems are more developed.

Kellyx Nelson of San Francisco chooses to stagger shots for her son, Spyder, 15 months. "I space them out to help reduce discomfort," she explains, "and to isolate the variables if he does have a reaction." But she admits that it makes her nervous when the family travels around the country.

Facts: The timing of vaccines is designed to maximize children's immunity when they're most vulnerable to disease, according to the CDC. "Whooping cough is a lot worse in a 2-month old than in a 2-year old," Brown says. "By delaying vaccines, you're putting children at risk precisely when they need disease protection most."

Andrea Panico of Montclair, New Jersey, was initially disappointed that she wasn't able to split the MMR shot into its individual components for her daughter Thea, 17 months. "A week later there was a suspected case of measles in Thea's day-care," Panico recalls, "so I was pretty glad she'd gotten the vaccine for it."

If you have concerns about the timing of your child's vaccinations, discuss them with your pediatrician. What's more, not all vaccinations are mandatory in all states, and some allow for exemptions based on religious and philosophical views. (Go to immunizationinfo.org to see vaccination requirements by state.)

Ultimately, the most important question you can ask pediatricians is how they handled vaccinations with their own kids. "We wouldn't do anything different for our own children than we do for our patients," Ari Brown says. "I vaccinated my kids, and I recommend vaccinations for my patients. My patients are my kids too."

* SOME NAMES HAVE BEEN CHANGED TO PROTECT PRIVACY

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