Related Experiment Video
Updated: Apr 20, 2026
Author Spotlight: Rabies-Specific Antibody Isotypes Detection in Sera or Cerebral Spinal Fluid Using an IFA Test
Published on: January 19, 2024
Vaccinating my way--use of alternative vaccination schedules in New York State
Jessica A Nadeau1, Robert A Bednarczyk2, Munyaradzi R Masawi3
1School of Public Health, State University of New York, University at Albany, Rensselaer, NY.
Insights
Nearly 25% of children in New York followed an alternative vaccine schedule, resulting in significantly lower on-time vaccination rates. This deviation increases risks for vaccine-preventable diseases.
Area of Science:
- Pediatric Health
- Vaccinology
- Public Health Surveillance
Background:
- The Centers for Disease Control and Prevention (CDC) recommends a routine vaccination schedule for optimal child immunity.
- Alternative vaccine schedules are increasingly being used by some parents, raising concerns about vaccine coverage and disease prevention.
Purpose of the Study:
- To identify children vaccinated using an alternative schedule.
- To assess the impact of alternative vaccine schedule use on vaccination coverage rates.
Main Methods:
- Analysis of immunization information system data for children born in New York State (excluding NYC) between 2009-2011.
- Classification of vaccination patterns based on visits recorded by 9 months of age.
- Comparison of up-to-date vaccination status between routine and alternative schedule groups.
Main Results:
- 25% of the 222,628 children studied utilized an alternative vaccine schedule.
- Children on alternative schedules were significantly less likely to be up-to-date at 9 months (15%) compared to routine schedules (90%).
- Alternative schedule users had approximately 2 additional vaccine visits by 9 months of age.
Conclusions:
- A substantial proportion of children are intentionally deviating from the recommended vaccination schedule.
- Intentional deviation from routine schedules leads to suboptimal vaccination coverage.
- Poor vaccine coverage increases child vulnerability to infections and the risk of vaccine-preventable disease outbreaks.
Objective:
To identify children vaccinated following an alternative vaccine schedule using immunization information system data and determine the impact of alternative schedule use on vaccine coverage.
Study Design:
Children born in New York State, outside New York City, between January 1, 2009 and August 14, 2011 were assessed for vaccination patterns consistent with use of an alternative schedule. Children who by 9 months of age had at least 3 vaccination visits recorded in the statewide mandatory immunization information system after 41 days of age were classified as either attempting to conform to the Centers for Disease Control and Prevention published recommended vaccination schedule or an alternative schedule. The number of vaccination visits and up-to-date status at age 9 months were compared between groups.
Results:
Of the 222 628 children studied, the proportion of children following an alternative schedule was 25%. These children were significantly less likely to be up-to-date at age 9 months (15%) compared with those conforming to the routine schedule (90%, P < .05). Children following an alternative schedule on average had about 2 extra vaccine visits compared with children following a routine schedule (P < .05).
Conclusions:
Almost 1 in 4 children in this study appear to be intentionally deviating from the routine schedule. Intentional deviation leads to poor vaccination coverage leaving children vulnerable to infection and increasing the potential for vaccine-preventable disease outbreaks.
