As three of the top medical organizations in the U.S. this month pronounced their support for a new vaccine schedule, leading doctors continue to disagree about how to counsel parents on the benefits and risks of vaccines.
On Jan. 4 the Centers for Disease Control, the American Academy of Pediatrics and the American Academy of Family Physicians released an updated vaccine schedule that now includes 2 additional shots.
Some families continue to set their own vaccination schedule for their children and some continue to choose not to have their children vaccinated at all. Both are practices the CDC, the AAP and the AAFP warn against.
Despite more fervent calls to ensure adherence to the CDC's published vaccine schedule, a CDC study from Sept. 2008 revealed the numbers of unvaccinated U.S. children may be grossly overestimated.
The CDC report, based on data on 17,017 children, found that fewer than 1 percent received no vaccines, suggesting a record number of U.S. children are receiving vaccinations.
However, some doctors have turned patients away from their practices due to non-vaccination. Other practices issue letters specifying the doctor's philosophy on vaccination to all patients as a form of disclaimer in the event of illness.
The tension over what to do with families who knowingly refuse to adhere to the recommended schedule is the basis for the recent conflict between two leading pediatricians, Dr. Robert W. Sears and Dr. Paul Offit.
Dr. Robert W. Sears, a California pediatrician, and author of the best selling, "The Vaccine Book", responded to an article published in Pediatrics this month, by Dr. Paul Offit, entitled "The Problem With Dr Bob's Alternative Vaccine Schedule." In the article, Offit, co-inventor of and co-patent holder for the RotaTeq vaccine, directly accused Sears of doing more harm than good with his alternative of extending the interval between shots. Other critics of Sears accuse him of creating distraction and disunity among doctors.
Sears countered Offit with a lengthy reply Dec. 29 on his website saying he agrees with Offit that vaccines are necessary to prevent dangerous diseases in children, which he says Offit irresponsibly overlooked. Last September, Offit published his own book, "Autism's False Prophets" to critique what he believes is junk science circulating in the media and online. He believes it is distracting and frightening parents unnecessarily away from vaccination. Since publication of his book, he has given several interviews in newspapers, radio and online to support his stance.
But, many of the commenters on Offit's Pediatrics article, themselves pediatricians and medical researchers, back Sears' logic. They say Sears is merely creating a healthy, open discussion that is the cornerstone of scientific debate.
Corrinne Zoli, a researcher at Syracuse University and one of the commenters on the Offit article, wrote that the CDC and the FDA through "lack of long-term studies, research by scientists employed by pharma firms" and the"use of pre-World War II data to set benchmarks" have given the impression that "parents are not equal partners and decision makers in their children's health, and they should exhibit blind trust in institutions that many perceive as marred."
Zoli writes, that when the FDA decided to remove mercury based thimerosal preservative from vaccines while around the same time declaring it safe, it gave parents the impression that "these same organizations did not value parents as partners in children's health enough to speak forthrightly with them or to address all sides of a complex issue."
She predicts "only when organizations such as the AAP, the CDC, and others choose to recognize this new cultural phenomenon, that patient-physician relationships have irrevocably changed from the 1950's 'doctor as god' model, will a real dialogue of equals and, hence, public trust be restored."