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Keeping kids on vaccination schedule can be a struggle

With more shots recommended than ever before, doctors look for tools and strategies to keep children's immunizations up to date.

By Victoria Stagg Elliott, amednews staff. April 25, 2005.

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Every summer, when the appointment schedule tends to be lighter, Marsha Raulerson, MD, a pediatrician from Brewton, Ala., reviews her medical charts, looking for patients who might be missing a shot. She writes letters, and, if necessary, she phones their homes to encourage them to come in for missing vaccinations.

"Lots of families don't bring their children in for a well-child visit, and they miss their schedule," she said. "I do a lot of calling."

The challenge of getting kids their shots is in part due to the fact that physicians such as Dr. Raulerson have to convince parents to stick to a schedule that is increasingly crowded and frequently changing.

For example, in 1983, the schedule from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommended eight vaccines before age 2. It was reissued again in 1989 with only a minor change.

The schedule is now issued annually, and the one issued this January calls for more than 20 shots for most toddlers. It's the first one in several years that hasn't changed from the previous one.

"It does make it difficult for people to keep up to date," said Paul Darden, MD, professor of pediatrics at the Medical University of South Carolina. "The change in the vaccine schedule has been dramatic over the last 20 years. You have to pay attention."

It is not an issue of reducing the number of vaccines on the schedule, most agree. And, in some ways, the current situation is an improvement over 20 years ago.