Photo Advertisement Continue reading the main story 
 
 A wide majority of pediatricians and family physicians acquiesce to parents who wish to delay vaccinating their children, even though the doctors feel these decisions put children at risk for measles, whooping cough and other ailments, a new survey has found. 
 
 
 
 
 
 
 
 
 
 Physicians who reluctantly agreed said they did so to build trust with families and to avoid losing them as patients. 
 
 The survey, published Monday in the journal Pediatrics, asked a nationally representative sample of 534 primary care physicians in 2012 how often parents in their practices postponed one or more vaccinations for children younger than age 2. 
 
 The Centers for Disease Control and Prevention advises that children be vaccinated for 14 diseases before age 6 on a schedule, which entails roughly 29 shots, sometimes several at once. 
 
 Ninety-three percent of doctors reported that in any given month, they had been asked at least once to delay vaccines. A fifth said more than 10 percent of parents in their practices had asked them to delay vaccines. 
 
 One-third of doctors said they acquiesced “often” or “always”; another third gave in only “sometimes.” 
 
 Such deference is in keeping with today’s doctoring style, which values patients as partners, said Dr. Paul A. Offit, a pediatrician specializing in infectious diseases at the Children’s Hospital of Philadelphia, who was not involved in the study. 
 
 “At some level, you’re ceding your expertise, and you want the patient to participate and make the decision,” he said. The downside is that “you have to be willing to stand back and watch them make a bad one.” 
 
 Too many doctors compromise on vaccines, instead of mounting a passionate plea, Dr. Offit said. 
 
 “It is sad that we are willing to let children walk out of our offices vulnerable to potentially fatal infections,” he said. “There’s a fatigue here, and there’s a kind of learned helplessness.” 
 
 Part of the problem is the lack of a proven strategy to guide physicians in counseling parents. 
 
 “Unfortunately, we don’t have a solid evidence base in terms of how to communicate to patients about vaccines,” said Saad Omer, an epidemiologist at Emory University. “A lot of approaches are wisdom-based, not evidence-based.” 
 
 Dr. Omer said that he did not sanction the use of alternative vaccine schedules, but that he understood why primary care physicians keep treating these patients — just as doctors do not kick smokers out of their practices when they fail to quit. 
 
 “Physicians recognize it’s not ideal, but they’re saying, ‘Let’s continue this relationship’ to the family,” he said. 
 
 The American Academy of Pediatrics advises doctors to keep skeptics in the fold, lest the doctors lose the opportunity to educate, cajole or persuade them. 
 
 Physicians in the survey reported trying various strategies, like telling skeptical parents that they had immunized their own children, or warning them that outbreaks will continue if too few people are fully vaccinated. 
 
 A disproportionate amount of time is spent discussing vaccines during doctor visits, the survey also found. For hesitant parents, counseling can take 10 to 14 minutes or longer — more than half of the average 18-minute visit. 
 
 Advertisement Continue reading the main story 
 
 Advertisement Continue reading the main story 
 
 Guidance on safe sleep or toilet training is being crowded out, the study authors said. Forty percent of the doctors reported that dealing with changes to vaccine schedules had decreased their job satisfaction. 
 
 In late February, Dr. Nivedita More, a pediatrician in Rancho Santa Margarita, Calif., sent letters ending her relationship to parents who refused all vaccinations. 
 
 “If they aren’t getting their act together to even start the process, I’ll discharge them within 30 days,” said Dr. More, a board member of the Orange County chapter of the pediatrics academy. 
 
 By contrast, her stance on vaccine delays is much more flexible. “I do allow that most times,” she said. “The reason is, ultimately they will get vaccinated.” 
 
 Many of those parents are simply hoping to limit the number of shots their children receive at once, she added, and are willing to accept combination vaccines. 
 
 But “the people who didn’t want to vaccinate at all — I had a really hard time converting them,” she said. “They are never going to change.” 
 
 In the midst of the current measles outbreak, which began nearby at Disney parks, Dr. More said she also felt the need to safeguard vulnerable patients in her waiting room from unvaccinated patients. Infants in particular do not get their first measles-mumps-rubella shot until age 1. 
 
 Dr. Allison Kempe, the study’s lead author and a pediatrician at Children’s Hospital Colorado, thinks the time has come to acknowledge that the idea that “vaccine education can be handled in a brief wellness visit is untenable.” 
 
 Dr. Omer said doctors should be paid separately for vaccine counseling in cases where a “substantial proportion of time is being spent on vaccines.” 
 
 In addition to compensation, Dr. Kempe said, vaccine counseling should begin during a woman’s pregnancy, and pro-vaccine parents — perhaps even celebrities — should star in marketing campaigns to help “reinforce vaccination as a social norm.” ||||| Jenny McCarthy would like to know, "What happened to critical thinking?" Jenny McCarthy wonders, "What happened to asking questions?" In an Op-Ed this weekend in the Chicago Sun-Times, the former co-host of "Singled Out" would like to make a case for reasoned skepticism and debate. Or maybe she feels like digging herself a little deeper in the hole of her own making. 
 
 "The View" co-host has spent the past several years making a name for herself as an advocate for autism awareness and treatment – and a staunch critic of the American pediatric system of vaccination. In her Sun-Times piece, she fires back at critics she says have misrepresented her, insisting unambiguously, "I am not anti-vaccine" and that "For years, I have repeatedly stated that I am, in fact, 'pro-vaccine.'" McCarthy says that she was inspired by her "beautiful son Evan" to a "desire for knowledge that could lead to options and alternate schedules, but never to eliminate the vaccines." And she says that "I believe in the importance of a vaccine program and I believe parents have the right to choose one poke per visit. I’ve never told anyone to not vaccinate. Should a child with the flu receive six vaccines in one doctor visit? Should a child with a compromised immune system be treated the same way as a robust, healthy child? Shouldn’t a child with a family history of vaccine reactions have a different plan? Or at least the right to ask questions?" 
 
 When she puts it like that, she sounds perfectly reasonable. She's simply asking that parents advocate for their children and ask questions about their vaccine schedules. She's encouraging individualized treatment, and dialogue between parents and pediatricians on what works best for each child. And if you've ever watched your baby or toddler lapse into droopiness and fever after getting shots, you can surely understand a little the power of these drugs that are being injected into tiny bodies, and the need for doctor-patient communication. 
 
 We are, furthermore, a nation of increasingly skeptical, outspoken parents, and that's generally a good thing. We speak up and say that maybe we don't want our children to be test monkeys for the dubious Common Core standards. We demand better labeling on the foods our children eat and stand up against sexism in the toy aisle. We don't passively accept conventional behavior if it's not in the best interests of our children. And so why wouldn't we question the pharmaceutical industry? Just this week the FDA recalled several batches of potentially contaminated Paxil and tampered weight loss drugs, while the makers of the antibiotic Suprax issued a voluntary recall. What happened to critical thinking and asking questions, Jenny McCarthy? I'd say plenty of us are all for them. 
 
 But if McCarthy is wondering why people make fun of her on Twitter, let me assure her it's not because of her far too subtle and sophisticated powers of reasoning. In her Sun-Times piece, she presents herself as just a regular mom with "concern with inflexible thinking." She conspicuously doesn’t mention her son Evan's autism, and her very well-documented speculation that his condition was related to his vaccines. Sure, in a 2009 Time story she said that "People have the misconception that we want to eliminate vaccines. Please understand that we are not an anti-vaccine group. We are demanding safe vaccines. We want to reduce the schedule and reduce the toxins." But then she rather confrontationally added, "If you ask a parent of an autistic child if they want the measles or the autism, we will stand in line for the f_cking measles." 
 
 And that wasn't the only considerably more forceful comment she's ever made about her feelings about vaccination. Seven years ago, she sat down with Oprah Winfrey and asked, "What number does it have to be? What number will it take for people just to start listening to what the mothers of children who have autism have been saying for years? Which is that we vaccinated our baby and something happened … Right before his MMR shot, I said to the doctor, 'I have a very bad feeling about this shot. This is the 'autism' shot, isn't it?'' And he said, 'No, that is ridiculous. It is a mother's desperate attempt to blame something,' and he swore at me and then the nurse gave [Evan] the shot. And I remember going, 'Oh, God, I hope he's right.' And soon thereafter -- boom -- the soul's gone from his eyes." In 2009, McCarthy told Time, "I do believe sadly it’s going to take some diseases coming back to realize that we need to change and develop vaccines that are safe. If the vaccine companies are not listening to us, it’s their f_cking fault that the diseases are coming back. They’re making a product that’s sh_t. If you give us a safe vaccine, we’ll use it. It shouldn’t be polio versus autism." She has told CNN, "Without a doubt in my mind I believe vaccinations triggered Evan's autism. We do believe because we were the witness with our child, a firsthand witness, after we came home from the doctor's office and saw this regression of a child who was perfect slowly fading away…. People are also dying from vaccinations. Evan, my son, died in front of me for two minutes. You ask any mother in the autism community if we'll take the flu, the measles, over autism and day of the week. I think they need to wake up and stop hurting our kids." To Larry King, she has defined autism by saying, "I believe that it's an infection and/or toxins and/or funguses on top of vaccines that push children into this neurological downside." And in a HuffPo piece just three years ago, she stated unambivalently, "I know children regress after vaccination because it happened to my own son." 
 
 Yet in recent months, thanks to her high-profile gig on "The View" and a roaring resurgence of measles and other previously all but wiped out diseases, McCarthy's confident swagger has been considerably challenged. And in its attempt to distance itself from the unpopular anti-vax narrative, McCarthy's Generation Rescue organization appears to have quietly removed some of its less "gray" statements. McCarthy's narrative about her son's vaccination experience is no longer there, nor its statement of support for Dr. Andrew Wakefield's discredited work on autism -- which Lancet has called "dishonest and irresponsible." But in case you're wondering, in 2010 Generation Rescue declared that "Dr. Wakefield's journey began with twelve children with autism. Like many of our kids, all twelve of them regressed into autism, and eight of the parents blamed their child's regression on the MMR vaccine, just as tens of thousands of other parents do …. Dr. Andrew Wakefield is perhaps this debate's greatest hero." 
 
 If McCarthy wants to restate that she has not definitively told parents not to vaccinate, okey-doke. Technically speaking, she's right. But she could have chosen also to admit in her weekend Op-Ed that she's been extremely sure of herself in the past about what she believes are the risks of vaccination, and her son's own autism. Instead she either manipulatively or just plain ignorantly has now tried to rebrand herself as a dweller of the space of healthy skepticism, refusing to even address her past years and years of blatant accusations. You can't claim that you never out and out said "Don't vaccinate" without throwing it in there that you've also stated that you've no doubt that vaccinations trigger autism and that you're cool with diseases coming back. And you sure don't get to boo hoo how you've been "wrongly branded," not when your own words have done all the branding for you.
– Doctors are reluctantly delaying vaccine schedules for kids, despite knowing the risks of doing so, because they don't want to alienate parents altogether, reports the New York Times. A study published in Pediatrics that surveyed 534 primary care physicians found that 93% of them were asked to delay a vaccine by a parent in any given month; a fifth of respondents said more than 10% of parents in their practice had asked for delays. More than one-third of the physicians copped to giving in "often" or "always"; another 37% said they did "sometimes." "Doctors are feeling really conflicted because they overwhelmingly think this is the wrong thing to do, and is putting children at risk, but at the same time, they want to build trust with their patients and meet people halfway," the study's lead author says, per Time. It's not for lack of trying to reach these vaccine-wary parents, the researchers note: Doctors will often use a variety of strategies to convince parents to stick to the traditional schedule, including telling them their own kids have been vaccinated, bringing up possible future outbreaks if they buck vaccination, or even warning that the alternate schedules haven't been studied adequately. But in the end, the doctors still often acquiesce and are faced with a stressful decision. "To know I'm going to pick one [vaccine] and leave the other behind, despite all the time I spend explaining the risks and benefits to the parents—it's very difficult for me," a pediatrics professor at Baylor College of Medicine tells Time.