All naturopaths are against vaccinations, right?

Continuing on the hot-button issues in the field of Complementary and Alternative Medicine (CAM) is that of vaccinations.  Once again I'm going out on a bit of a limb with this one, because I'm presenting my personal views and not necessarily those of the profession as a whole.  I can, however, share my experience of what I've seen most naturopaths advocate...

So all naturopaths are against vaccinations, right?  Certainly there are vehement opponents of vaccination amongst naturopathic physicians.  Conversely, our community of physicians also has a group who are vocal supporters of rigidly following the CDC schedule.  Most naturopathic physicians, especially those who specialize in naturopathic pediatrics, take a third stance, which I call the knowledge-based approach. 

The knowledge-based approach is based on educating the parents to make an informed decision on which vaccines to administer, and allows parents to choose the timeline.  Naturopathic doctors clearly list the risks of each vaccine, based on actual scientific evidence, not heresay or celebrity endorsement.  Physicians also clearly state the risks of each disease, and the potential consequences of not vaccinating.  Parents are informed of which age group benefits from each vaccine (meningitis and pertussis are typically more deadly in early infancy), so they are aware of appropriate timing.  Parents are given the CDC guidelines and explained the rationale behind the CDC schedule's timing.  Physicians will often point toward alternative vaccine schedules if the parents are so inclined (like Dr. Sears' vaccine schedule).

The drawbacks to this approach are somewhat obvious - Yes, this explanation takes time! This is another reason why office visits to a naturopathic pediatrician are double or triple the length to a conventional pediatrician.  It also requires intelligent and responsible parents to weigh many options and make difficult decisions, especially if they decide on an alternative vaccine schedule.

Sound like too much?  Personally, I don't think so.  Most parents are happy to be given hard data.  It makes the decision less vague, less based on the nebulous fears of "what if I do this," or "what if I do that?"  Parents, after all, only want what is best for their child.

So, after highly promoting the "knowledge based approach," here is my opinion with regards to vaccination:

1. Ignorance is never a valid reason to either vaccinate or not vaccinate your child.  Frankly, I've been surprised by some of the experiences I've had with parents in the clinic.  One parent brought in her 6-month girl (who was sick, of course), and when I asked her about the child's vaccinations she replied "I haven't decided whether to vaccinate yet."  Yet? Parents should know that there is a window of protection given by certain vaccines, that some cannot be given at all after a certain age, and that some are most necessary in early infancy.  Also, vaccines should be planned well in advance, because they cannot be administered when a child is ill.

On the other hand, I believe parents should be informed before they blindly follow a physicians recommendation to use a certain vaccine schedule.  Friends, Facebook, and the Internet are a wealth of misinformation that are bound to leave an uninformed parent terrified (whether they vaccinate or not).  Parents should also know what ingredients are in each vaccine, and whether the virus is "live" or not.  They should also know what to expect, what to do if their child has a bad reaction, and what not to do under normal circumstances (like give Tylenol - but that's another blog post by itself). 

2. All children should have a vaccine plan in place by the age of 2 months.  2 months is when the CDC recommends initiating the vaccine schedule (with the exception of those given at birth). If parents are going to delay vaccinations they should have a schedule completed - in writing - by the age most children begin vaccinations.  One copy of the vaccine schedule should be kept at home (for planning and appointment purposes), and another signed copy should be given to the child's pediatrician. This is for practical and legal reasons - the child's physician needs to have documentation of any delayed vaccines both to avoid potential lawsuits and to always have record of when the child is due for what vaccine.

The document is also helpful for pediatricians in managing sick kids.  Parents who plan to delay or refuse certain vaccines (like pertussis or those for meningitis) need to be aware of the warning signs of those diseases.  The child's physician should educate the parents on what to look for, and to let the parents know that kids who are unvaccinated may need to be taken to urgent care a little earlier than a vaccinated child.  This isn't to scare the parents, but rather to be practical so parents know what to expect. The child's vaccine schedule is incredibly useful for the physician when managing sick kids - it helps the doctor know what disease the child is likely to have or not have, and when the child may need to be referred to a specialist.

3. Every child should see a naturopathic physician.  Just kidding.  Picking a pediatrician should be based on many factors, and it is essential for parents to have a doctor they can trust.  If you feel that your doctor isn't giving you the time you deserve - give me a call!

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