A recent survey of practicing pediatricians shows that most will change around the immunization schedule for parents who insist on modifications. These doctors also know that the consequences of these changes are unknown since none of the alternative schedules commonly found online or in books by Williams Sears, MD, and others have any testing of effectiveness.

These parents, and maybe my readers, use phrases such as "too many antigens together will overwhelm the baby's immune system," or "too many shots will cause too much pain." But testing has shown that neither of these is true.

Parents will also say "they will eventually get all their shots" assuming that shots given in untested orders and spacing work just as well as they do in the standard spacing, but they do not. The MMR (measles, mumps and rubella – also called German measles) immunization given together with Varicella (chicken pox) immunization are very effective and have minimal side effects. But MMR and varicella vaccines given two weeks apart may not work at all.

Also, MMR and Varicella given in the same needle (rather than two needles) at the same time has a much higher chance of a high fever afterwards. The immune system is quite complex and one cannot assume almost anything. Just last month, it was shown that not giving peanut butter to babies under 1 year (something doctors have been suggesting to parents for at least 30 years)  does not reduce the chance of peanut allergy, but actually increases it.

So why do pediatricians comply with these parental requests when they know it might harm the individual child and definitely will harm the public's protection against serious diseases? There are many reasons:

1. Some doctors are afraid they would lose patients, which could hurt the doctor's income and, just as important to many, hurt their egos.
2. Some, very few, agree with the parents and are skeptical about immunizations.
3. Others, like Senator Rand, are doctors who immunized their own children, but are politically and philosophically Libertarians who believe that the public good is less important than the individual's right to make their own decisions no matter how poor those decisions may be.
4. Some doctors are just wimps and cannot say "no" to anyone.  I suspect that the doctors in the last category are the ones that give antibiotics to everyone that asks for them even when those medicines will do more harm than good.

Here's another example of how practitioners can differ in their approaches to care. Almost 20 years ago, I helped found an organization to promote good asthma care called Philadelphia Allies Against Asthma.  We tried to educate health providers to modernize their care of asthma. In addition, we tried to educate the families of children who ended up in emergency rooms with asthma attacks in what care they needed to stay out of the ER.  Practitioners quickly divided into those who wanted to change their asthma care immediately and those who were "too busy" to learn new methods of care.  Many of the "too busy" practitioners did eventually change their asthma care, but only after the now educated families with asthmatic children demanded for new methods of care.

Doctors want to please their patients. Sometimes that improves care and sometimes that seriously harms care.

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