‘The right thing to be doing for our baby’
Pediatricians alarmed as more parents delay young children’s vaccines
As measles cases have popped up across the country, one group of children is stirring deep concerns among pediatricians: the babies and toddlers of vaccinehesitant parents who are delaying their child’s measles-mumps-rubella shots, known as MMR.
Pediatricians across California say they have seen a sharp increase recently in the number of parents with concerns about routine childhood vaccinations who are demanding their own inoculation schedules for their babies, creating a worrisome pool of young children who may be at risk of contracting measles, a potentially deadly yet preventable disease.
“Especially early on, when a parent is already feeling really vulnerable and doesn’t want to give something to their beautiful baby who was just born if they don’t need it, it makes them think ‘Maybe I’ll just delay it and wait and see,’ ” said Dr. Whitney Casares, a pediatrician and author who has written on vaccination for the American Academy of Pediatrics.
“What they don’t realize is, if they don’t vaccinate according to the recommended schedule, that can really set their child up for a whole lot of risks.”
Dr. Eric Ball has seen the shift firsthand. At his Orange County pediatric practice, Ball said, he has noticed an increase in parents asking about delays since the COVID-19 pandemic, as politicization of and misinformation about that vaccine has seeped into discussions about routine childhood vaccinations, including measles-mumps-rubella.
Rather than an outright refusal, however, these vaccine-hesitant parents express a softer kind of reluctance, asking if it’s possible to use an “alternative schedule” of vaccines, rather than sticking to the Centers for Disease Control and Prevention’s recommendations.
“I have patients who have three kids, and they vaccinated the first two kids on schedule. And then since COVID, with their third kid, they are like, ‘I don’t know if this is safe. I want to wait until the kids are older,’ or ‘Instead of doing two shots today, I want to do one shot,’ ”
Ball said. “It just prolongs the time where you have a child who’s unprotected and potentially can get sick from these diseases.”
He explains to parents the importance and safety of vaccines, including MMR. He even brings out his own children’s vaccine records to prove his point, and he is often successful.
At Children’s Hospital Los Angeles, about half of parents are questioning the CDC’S recommended vaccine schedule, pediatrician Dr. Colleen Kraft said — a significant increase since the pandemic.
“Even my most reasonable parents ask questions. So it’s definitely in the mainstream,” she said.
In Marin County in Northern California, parents’ requests to delay shots have become so frequent that Dr. Nelson Branco recently said his practice decided to tighten vaccine requirements as cases of measles and pertussis have spread. Babies seen by doctors in the practice will need to have their first set of vaccines completed by 4 months of age. The primary series of vaccines against the most serious and common diseases, including measles, must be completed by 24 months. If parents don’t agree, they must leave the practice.
“Kids are doing a lot of things that are high risk before they’re 5 and are required to be vaccinated to attend kindergarten,” Branco said. “They’re getting on international flights, they’re going to Disneyland where there are lots of kids,” leaving kids vulnerable to measles when they could be protected.
The CDC recommends that the first dose of MMR be given when a baby is 12 to 15 months old. Usually this happens at a child’s 12-month well visit. A second dose is then given at 4 to 6 years old.
Low vaccination rates have led to measles outbreaks in several states over the past decade. The rate of kindergartners fully immunized against the measles nationally dropped from 95% in the 2019-20 school year to 93% in 202223, according to the CDC.
And those postponing vaccinations have created a potential vulnerability gap in a child’s first 4 years.
One in 5 unvaccinated people who get measles in the U.S. will be hospitalized. Since there is no good treatment for measles, doctors can do little more than offer supportive care. One in 1,000 children with measles will develop brain swelling that can leave a child deaf or with an intellectual disability; 1 to 3 children in 1,000 will die, according to the CDC.
In the Children’s Hospital Orange County primary-care network in Southern California, which has more than 130 pediatricians, the share of 15-month-olds with an MMR vaccine has been dropping consistently over the past few years, from 98% in 2019 to 93.5% in 2023.
In the early 2000s, antivaccine sentiment was at an all-time high after the publication of a nowdebunked and retracted study that falsely tied the MMR vaccine to autism.
A Pew Research poll conducted in March 2023 found that 88% of Americans are confident that the benefits of an MMR vaccine outweigh the risks, a percentage that has remained fairly consistent since before the pandemic.
But support for all school-based vaccine mandates has fallen; 28% say parents should be able to decide not to vaccinate their kids, even if it causes health risks for others, up from 16% in October 2019.
Tara Larson, a former ER nurse, said she became concerned about childhood vaccination when she was pregnant last year. The Santa Monica resident started watching anti-vaccine documentaries, reading vaccine safety inserts and following several social media accounts “to make us an informed vaxxer. We’re not anti-vax,” she said.
Larson decided that she wanted to delay vaccinating her son until he was 3 months old, to limit him to just three vaccines in his first year that she felt were essential, and to spread them out so he would only get one shot a month. “By the time he starts playing on the playground and goes to school, he’ll need to start his course of Hep B, but why overload his course of vaccines right now?” she said.
The first pediatrician she saw refused to follow her requested schedule. But, Larson said, “in my gut, I just felt like this is the right thing to be doing for our baby, and I left.” After weeks of searching, she found a holistic provider who charges a $250 monthly fee and agrees with her approach.
She said she hasn’t yet decided whether to give her son, who is now 8 months old, the MMR vaccine when he becomes eligible.
“I think some doctors will say to wait until they’re 3, but that was when there wasn’t a resurgence of measles,” she said. “That’s my next thing to dive into.”
But there’s no scientific basis and no known benefits to delaying vaccines except in very rare medical circumstances, Casares said.