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Alternative Childhood Vaccination Schedules in Israel: A Mixed-Methods Study on Prevalence, Patterns, and Public
Efrat Sales1, Eliya Cohen2, Deena R Zimmerman3,4
1Department of Politics and Government, Ben Gurion University of the Negev, Beersheva 84105, Israel.
Vaccines
|January 28, 2026
Summary
Parental requests for alternative vaccine schedules using single-antigen vaccines are rare but impact public health. Addressing parental concerns and misinformation is crucial for maintaining high vaccination coverage.
Area of Science:
- Public Health
- Vaccinology
- Health Services Research
Background:
- Parental hesitancy towards combination vaccines drives demand for alternative schedules.
- Limited empirical data exists on single-antigen vaccine use and public health implications in high-coverage countries.
- Israel's national guidelines recommend combination vaccines, yet informal accommodations for alternative schedules are present.
Purpose of the Study:
- To examine the prevalence, patterns, and parental motivations for requesting alternative vaccination schedules in Israel.
- To understand the real-world use of single-antigen vaccines versus recommended combination vaccines.
- To assess the public health implications of these alternative schedules.
Main Methods:
- A mixed-methods approach combining retrospective cohort analysis (2018-2021) and semi-structured interviews.
- Analysis focused on measles and pertussis vaccination data.
- Interviews included Maternal and Child Health providers, policymakers, and parents.
Main Results:
- Alternative schedules using single-antigen measles or pertussis vaccines occurred in less than 1% of vaccinations.
- Outcomes included delayed administration, reduced combination vaccine uptake, and incomplete protection.
- Parental motivations stemmed from safety concerns, fear of immune overload, and mistrust, often amplified by misinformation.
Conclusions:
- Vaccine hesitancy translates into service utilization, creating tension between individual choice and collective health.
- Effective communication strategies and tailored service designs are needed to address community concerns.
- Sustaining high vaccination coverage requires balancing parental preferences with public health goals.
Keywords:
Israelalternative vaccination scheduleschildhood immunizationpublic health policysingle-antigen vaccinesvaccine hesitancyMore Related Videos
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