Designing a Vaccination Program for Your Child

by Kelly Dorfman, MS, DDR Co-founder

(This article provides information only. Check state laws and consult your pediatrician regarding all immunization decisions.)



Headlines like these increasingly alert parents to the possible consequences of mandated vaccinations. As disturbing evidence mounts, parents are dismayed that they must either follow a prescribed schedule, or find a way around it so that children can attend school. Another choice is to individualize an immunization program to suit each child. Here are some considerations:

State Requirements

Determine the precise requirements where you reside, because laws vary among states. Some vaccinations may not be mandatory in your state, although well-intentioned doctors may push them.

For required vaccinations, you may be able to receive an exemption for religious, medical, or personal (philosophical) reasons. All states have religious and medical exemptions, and their interpretations vary dramatically. A religious exemption may mean getting all or none of the vaccines. In states with personal exemptions, there is more flexibility, and declining vaccines is easier.


In healthy newborns and infants, the immune system has not developed a mature cellular response and may be unable to tolerate the introduction of viruses and bacteria, even if weakened. For preemies or babies born with complications, the immune system is weaker still. A body‘s immune system can only respond to so much.

A large number of vaccinations are typically given between 12 and 18 months, a critical developmental period. Toddlers who are teething, walking and beginning new foods are already assaulting their immune system with foreign antigens. The added burden of vaccinations could seriously impair or alter both immunological and neurological development. Some countries start vaccinations after 18 months, when individual immunological idiosyncrasies are more obvious and can be taken into account. Use this model and consider asking your doctor to delay immunizations until your child is two, as many vaccine laws are tied to school admission.

Another timing issue pertains to MMR and DPT vaccinations. Measles, mumps, and rubella (MMR) are viral induced illnesses, while diphtheria, pertussis, and tetanus (DPT) are bacterial based. Getting both viral and bacterial vaccines at the same time could be overly stressful. When in doubt, spread them out. Also, absolutely never allow a sick child to be immunized.

Allergy Considerations

If some family members have allergies, check vaccinations for antigen contaminants. MMR vaccine, for example, contains traces of egg. Families with a strong history of immune based illnesses, like asthma, may have children with unpredictable vaccination reactions. Having one child with autism/PDD also suggests potential trouble. Treat subsequent siblings with caution, even if the first child did not exhibit a clear negative reaction following shots.

Another immunological issue relates to toddlers who, having taken numerous antibiotics, may have battered intestinal linings. Some researchers believe this problem leads to impaired vitamin absorption and susceptibility to MMR vaccine injury.

Disease Risk

Is the disease worse than the vaccine? Consider your child‘s risk to exposure and the severity of the illness for each recommended vaccine. Examine the shot‘s safety record. The dead (injectable) polio vaccine has a long, safe history. Many children, however, still get the live (oral) polio vaccine because the policy is in transition. While the live vaccine protects these children, others without immunity who come into contact with them may possibly be exposed to polio.

The pertussis and measles vaccines have been changed over time because old versions were found to cause problems or be ineffective. Additionally, MMR vaccine is given twice because merely 5% of the population need a second dose to confer protection. A child‘s titer levels can be tested to determine sufficient (or aggressive) responses to an immunization. Contact Antibody Assay Lab, 800-522-2611, about the "Encephalopathy Panel B" blood test. This test can be used with youngsters who have received some of their shots, to determine which boosters are essential.

You may have other individual considerations, and, even if your doctor privately agrees, state law may prevent the doctor from supporting any decision other than fully vaccinating your baby. On the other hand, you must consider the chance of your child‘s contracting a serious illness. Weigh the options carefully and make healthy choices for your family.

To learn about your state laws, contact the National Vaccine Information Center at 800-909-SHOT or state-based monitoring groups, such as Vaccine Information and Action in Maryland

[Initially published in New Developments: Volume 5, Number 4 - Spring, 2000]

All material in this web site is given for information purposes only and is not to be substituted for advice from your health care provider.

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Page last modified: February 23, 2009
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