Many Parents Request Delays in Vaccine Schedule

Recent studies have shown that more parents are delaying or skipping certain vaccines, typically citing safety concerns, such as a link between vaccines and autism.

NEW YORK (Reuters Health) - More than three quarters of pediatricians said they sometimes or often get asked by parents to use an "alternative" vaccination schedule that strays from national recommendations, according to a new survey of Washington State doctors.

And while almost all of them agreed with the current vaccination schedule for babies and young kids, and would follow it for their own child, most paediatricians were willing to give in to parents' wishes to delay vaccines for infections like chicken pox, hepatitis B and measles.

"I was a little surprised at the high level of pediatricians who reported having parental requests for (alternative schedules)," said Dr. Amanda Dempsey, who studies immunization and infectious diseases in kids at the University of Michigan in Ann Arbor, but wasn't involved in the new study.

"This seems to indicate that this is an ever-increasing problem."

Recent studies have shown that more parents are delaying or skipping certain vaccines, typically citing safety concerns, such as a link between vaccines and autism -- a theory which scientists now agree holds no water.

Researchers worry that with an increasing number of kids unvaccinated or under-vaccinated, diseases like measles or whooping cough could spread through schools and communities, putting at risk even those who do get recommended vaccines on time.

For youngsters under six, the Centers for Disease Control and Prevention's recommended vaccination schedule includes MMR (measles, mumps and rubella) shots, and vaccines to protect against whooping cough, chicken pox, hepatitis and seasonal flu, among others. (The full schedule is on the CDC website here: 1.usa.gov/k23A6d).

For the current study, researchers led by Dr. Aaron Wightman from the University of Washington in Seattle surveyed more than 200 pediatricians in their state about how often parents ask them for an alternative vaccination schedule -- and how likely they are to agree to one.

In the online questionnaires, 77 percent of the doctors said parents "frequently" or "sometimes" asked to skip or delay certain vaccines. And six out of ten said they were comfortable using an alternative schedule if parents asked for it.

Pediatricians were more likely to budge from the recommended schedule for certain vaccines over others -- for example, most said they would feel comfortable delaying hepatitis B or chicken pox vaccines, whereas fewer would consider straying from the diphtheria, tetanus and pertussis vaccine (DTap) recommendations.

That suggests doctors are more adamant about going through with vaccines that prevent potentially dangerous bacterial infections that hit infants and young kids, researchers wrote in their Pediatrics report on Monday.

Still, "it's kind of a slippery slope," Dempsey told Reuters Health. Delaying any vaccine "undermines the importance of the schedule in general."

Her own research has suggested that more than 10 percent of parents use an alternative vaccination schedule, and two percent refuse vaccines altogether (see Reuters Health story of October 3, 2011).

But there's no evidence that any alternative schedules are safe or effective, she emphasized. What's more, because no vaccine gives 100 percent protection, even kids who have been vaccinated are put at risk when many of their school or community peers skip or delay their vaccines, Dempsey added.

She said that pediatricians should talk to every parent and try to help them make the safest decision for their child -- but that may become increasingly difficult if the popularity of alternative vaccination schedules continues to grow.

The new study, Dempsey added, "suggests to me that it's possible that this may become more the norm in the future, as more and more pediatricians are being asked to do this."

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Pre-Pilates Flexibility & Exercises for the Upper Back

Pilates instructor Jennifer Gianni walks through several upper back exercises that will help keep you flexible and limber, and less prone to injury.

What It Is:

A flexible and limber body that is capable of moving in all directions is much less likely to experience any kind of injury.

As we discovered in our last instalment on upper back strength, we must have proper posture in order to work the strength of the upper back. Posture means length, which in turn means flexibility.

The hunching of the shoulders and the slumping in our seats that we all tend to sink into during the day can cause back pain, headaches, tension and tightness in the back, neck and shoulders. These problems are painful, uncomfortable, and avoidable.

Our Goal:

The following Pre-Pilates upper-back stretches target the upper back, neck, and shoulders. Taking time to do these stretches throughout the day can help increase flexibility and reduce tension and stress. This is also a great way to take a much-needed break so that you can continue your activities with a renewed energy.

Here’s How:

Exercise – Thread the Needle

This first exercise may not be the best one to do in the middle of the day at the office but it is one of the best upper back openers I've found. This would be a great way to start or end your day, or both.

• Start on all fours. Line your wrists up under the shoulders with your knees lined up under the hips.
• Lift your right hand slightly and turn the palm up to the ceiling.
• Now, reach across your body and thread the right arm under the left bent arm.
• The right arm and right side of the face should rest on the floor.
• Feel the shoulder blades stretch away from each other.
• Hold for twenty to thirty seconds.
• Gently switch sides.
• Repeat three to four times.

Exercise – Roll Down at the Wall

• Stand with your back against the wall with the feet six to eight inches away from the wall.
• Your feet should be parallel.
• Soften (bend) the knees a bit.
• Align your neutral spine against the wall.
• Try to rest the middle of the sacrum and mid back ( at the bra line) and back of the head against the wall.
• On an exhale, start with your head and slowly peel the spine away from the wall from top to bottom. Imagine that your head,
• arms, shoulders and upper back are filled with sand as you curl forward.
• It’s okay to bend the knees more to accomplish the roll down.
• Stop the roll down at the top of the pelvis just before the fingers touch the floor.
• Imagine that you are hanging over a railing and hold for a few seconds.
• Keep the upper body and arms heavy and then allow the arms to circle freely at the top of the arm bone.
• After 5 circles in each direction, inhale and roll back up the wall slowly- one vertebra at a time.
• When you reach the top, find your anchors and neutral spine.
• Repeat three to four times.

Exercise – At the Desk Stretch

This is a simple, anytime, anywhere stretch that opens your upper back, shoulders and neck.

• While seated, bring the left arm across the chest.
• Hook the inside of your right elbow above the left elbow and use your right arm to help stretch the left shoulder by pulling
• the left arm to back and to the right.
• Drop the right ear to the right shoulder and turn the head so the eyes are looking toward the floor.
• Hold for ten to thirty seconds.
• On an exhale turn the eyes forward and gently bring the head back up.
• Release the arm and switch sides.
• Repeat.

HOT TIP---

To intensify Thread a Needle, lift the top arm so the fingers reach to the ceiling or behind the torso.

To intensify Roll Down at the Wall, use 2 lb weights in the hands to increase the downward pull. Remember to keep the upper
body, head and arms heavy and relaxed.

To intensify the At Your Desk Stretch, add a rotation in the spine. Try to look behind yourself as you stretch the opposite arm across your chest and down toward the side your rotating to.

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Acupuncture Deemed Safe for Children

Canadian researchers have established that treating children with the age-old practice of acupuncture is safe, and poses little risk if performed by a qualified practitioner.

After reviewing studies spanning more than 60 years, Canadian researchers have concluded that treating children with acupuncture is safe when administered by trained practitioners. The details of the review were recently published in the journal .

Although the evidence did show that some hospitalizations occurred due to serious infections and other effects suffered from unsuccessful procedures, senior study author Dr. Sunita Vohra, a professor in the department of pediatrics at Edmonton Canada’s University of Alberta, noted that little risks exist when a qualified practitioner provides acupuncture treatment. 

She pointed out, “When you’re dealing with children, you really would like to know about safety before you go ahead and try a new therapy.” She also added that this is especially true if you are not sure about a treatment’s effectiveness.

Acupuncture is a type of alternative medicine used in the treatment of such ailments as joint pain, headaches, migraines, constipation, and nausea due to chemotherapy. The treatment involves the insertion and manipulation of thin, solid needles at various points in the body.

Until now, little evidence has existed regarding long-term safety or effectiveness of the treatment’s use in children. Based on the review of more than half a decade of evidence gathered from 37 studies, Vohra concluded that “in trained hands, acupuncture is safe for children.”

The studies in the review included both randomized trials that looked at the side effects of acupuncture in comparison to those of other treatments, as well as isolated incidents of illness and injury due to treatment with acupuncture.

Findings showed that among the 1,422 children and teens included in the analysis who received treatment with acupuncture, mild side effects, such as pain, bruising, or numbness, were experienced by 253 of them, while one suffered moderate side effects.

Another 25 experienced more serious side effects, including 12 thumb deformities among patients at one particular Chinese center during the 1980s, a 16-year-old who suffered nerve damage due to more than 70 needles having been left in his body, and a French male diagnosed with HIV at age 17 after being treated with acupuncture for tendonitis. Other serious side effects included bleeding, infections, and heart and lung problems.

While some of these incidents seem particularly gruesome, Vohra told Reuters Health that most are “pretty unusual circumstances,” and that “those sorts of things don’t really seem to happen now under modern-day circumstances.” She pointed out that while states differ in their regulation of acupuncturists, certain national and state organizations keep lists of trained and certified practitioners.

Dr. Adeline Ge, senior Chinese medicine consultant with the U.S. National Institutes of Health in Bethesda, Maryland, agreed that “If practitioners had good training before, this kind of thing should completely be avoided.” However, she noted that acupuncture is not recommended for children under the age of two.

Ge offered advice for parents looking to get acupuncture treatment for their children. When seeking treatment for a child, asking for a recommendation from the family pediatrician is a good place to start.

Once a recommendation is made, it is important for parents to consult with the acupuncturist to discuss the medical condition of their child and the proposed treatment.

In addition, parents should accompany their children to observe treatment, and to be sure that clean needles are used, and that their child’s skin is well cleansed. Beware of practitioners who offer bargain prices. First session costs normally start at about $100.

The use of acupuncture dates back thousands of years. Traditional Chinese theory suggests needle placement helps balance the body’s energy flow, known as “qi.” It is estimated that 150,000 American children receive treatment with acupuncture each year.

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