With kids' ear infections, get vaccinations - and keep the well visit
June 3rd, 2013
05:47 PM ET

With kids' ear infections, get vaccinations - and keep the well visit

More than a third of infants who were taken to the doctor for an acute ear infection, and who were also due for a scheduled immunization, were not immunized during their sick visit and didn't go back to the doctor for a subsequent well visit, according to a new study published Monday in the journal Pediatrics.

That put the infants significantly behind in their vaccines, compared to other infants who were immunized while sick.

"I think a lot of providers are thinking, 'We can put this off and they'll come back,'" says the study's author, Steve G. Robison, an epidemiologist with the Oregon Health Authority.

"But if you don't use this chance to give an immunization, over a third of (those patients) you're not going to see again."

For new parents, the findings mean two things: Children with acute ear infections can be immunized during a sick visit if they're due for a vaccine. And regardless of whether an infant is immunized while sick, it's important parents keep the child's subsequent well-visit appointment. Pediatricians use that time to cover issues like sleeping, nutrition and developmental milestones - topics there often isn't time to address during a sick visit.

Robison gathered data on 1,060 infants who went to the doctor with cases of an acute ear infection at 2, 4 and 6 months. At the time of the sick visit, all the infants were due for a scheduled immunization but had not received it yet.

"The contraindication for getting a vaccine is for moderate or severe illness," explains Dr. Lisa Thebner, a pediatrician in New York City who is not affiliated with the study.

"For a mild or minor illness (like an acute ear infection), there is no contraindication to get the vaccine and you want to take advantage of that."

Robison and Thebner agree that physicians should base their decision on whether to vaccinate during a sick visit, or wait until a subsequent well visit, on how confident they are that the parents and infant will return for their scheduled follow-up. If the health care provider doesn't know the family well, or is not confident they'll make a later visit due to child care or work concerns, they say the practitioner should take advantage of having the child in the office but strongly encourage the family to show up for a later well visit.

"The ideal is to vaccinate during a sick visit unless there is a proven track record of coming for every well visit, then perhaps it can be deferred," says Thebner.

"But otherwise it seems reasonable to take advantage of having the child in the office and then encourage the family to come back for a well visit to over all the other points covered during one of those visits."

If practitioners aren't comfortable immunizing a child during a sick visit, he advises doctors to make sure families have their appointments scheduled before leaving the building.

"When you don't know the patients well, if the parents are going to leave the visit without getting a shot for their child, it would at least be nice to know they have an appointment to come back," he says.

soundoff (55 Responses)
  1. liss

    this article is all about a child getting behind on their vacc's because the parents may forget to reschedule. They didn't even hit on the topic of WHY doctors or educated parents would not want to give a vacc to a sick child, when their immune system is already down and may not have the same response as a non sick child. Not to mention the potential side effects of the vaccine (fever or worse) when a child is already sick. It would be nice if the journalist gave a more well rounded story.

    June 4, 2013 at 01:08 | Report abuse | Reply
  2. jake

    This vaccination obsession is crazy. My child is not getting their body overwhelmed with a severe infection AND vaccination. Shots are hard enough without their tiny bodies also having to deal with a severe infection. A doctor more concerned with the herd than my child is going to have a lot of parents never come back to their office because they are a terrible doctor. Statistics are not more important than children.

    June 4, 2013 at 04:41 | Report abuse | Reply
    • CJG

      I would assume that the doctors aren't giving vaccinations during a sick visit because what starts as a simple ear infection can get worse, and they don't want to risk a pointless vaccination.

      If anything this is more a case for doctors to remind their patients that well visits are important and that the vaccines will be given then.

      June 4, 2013 at 13:17 | Report abuse |
  3. ser

    @Jake-speechless....just speechless...it's because of people like you who buy into the ramblings of un-licensed Dr. Jenny McCarthy that are putting children and the population at risk. Sadly, while some children do have extreme reactions to vaccinations I am sure this is a rare occurrence and certainly not the norm. Vaccines have stood the test of time and have helped mankind eradicate some awful diseases..New vaccines in the works for things Like cancer and HIV could one day eradicate these diseases as well...wouldn't that be great.

    June 4, 2013 at 12:27 | Report abuse | Reply
    • antpillage

      Actual, statistics show you are incorrect with the eradication of diseases. There was an natural decline before any vaccines were introduced. Roughly 96%.

      Here are some graphs to prove it:


      June 5, 2013 at 20:47 | Report abuse |
  4. jake

    My niece has life threatening egg allergies on top of severe asthma. The same doctors who think the herd is more important than one sick kid think it's perfectly fine to for my severely allergic niece to get vaccines that very well could contain traces of egg. They say it's perfectly fine as long as she gets shots at a doctor's office equipped to treat the inevitable anaphylaxis. Apparently, the bean counter statisticans that call themselves Doctors the CDC are concerned too many severely allergic kids aren't being vaccinated, so for the sake of the herd. They are fine with little kids being sent to emergency room in anaphylaxis as long as they get to check off one more vaccinated kid on their box. These bean counters are fine with a few hundred kids getting rushed to the hospital each years unable to breath just so the freaking herd can have immunity. That is not acceptable. Keep your newborns at home where they belong. My niece is homeschooled so she can stay vaccine free and safe.

    June 4, 2013 at 13:06 | Report abuse | Reply
    • ser

      I get your point, but you still can't downplay vaccines for the greater public good. obviously in severe cases like yours, alternatives can be given.

      June 4, 2013 at 14:37 | Report abuse |
    • kmkm

      Jake, your niece being allergic to vaccines is exactly why most children should get vaccinated – she is supposed to be a part of the herd that is protected! She should not be vaccinated with an allergy, and she should be able to go to school. Herd immunity also helps the small percentage of people that don't respond at all to the vaccine and can therefore get sick. But this is why it is very important for normal healthy children to get vaccinated. Many vaccines are also made without eggs, or alternatives are available, your sibling should ask.

      June 4, 2013 at 15:40 | Report abuse |
  5. AbbyJ

    I wouldn't have my baby get vaccinated if they were sick, I feel that's asking a lot of their bodies. My baby gets all his vaccines, we do split them into 2 visits though. (Half done at one visit, the other half done at another visit two weeks later.) If my baby was sick, then that would just mean I'd take him to 3 doctor visits that month.

    I'm appalled at parents skipping well-baby visits. If there are developmental delays that the parents don't realize, the pediatrician may notice them. Early intervention is important!

    June 4, 2013 at 16:52 | Report abuse | Reply
  6. Squeezebox

    Parents skip well baby exams because they can't afford them and don't see anything wrong with the kid. I agree with grab 'em while you can.

    June 4, 2013 at 18:16 | Report abuse | Reply
  7. Michelle

    There you have it.....It's all about "convenience". At the recent Congressional hearings on the vaccination schedule and incidence of autism, when the CDC panel was questioned why so many vaccines in one visit for a 2 month old baby, she said because they don't want to take the chance that the parent will not come back in a timely manner if the vaccines are spread out. Congressman asked has there ever been a study conducted to the safety of injecting 4-5 shots at one time in a child? She answered "no", combined doses of vaccines have not been tested or studied.

    And Jeff, I'm assuming your an adult. Almost all vaccines wear off in about 5-10 years, so that child who skipped a vaccine while sick until they are well poses no greater "risk" to society than yourself. I'm 38 years old, had all my vaccinations as a child, I had 10 vaccines total by age 10. I have not had any boosters in my adulthood. Amazingly, I have managed to survive! My son had 38 vaccinations by the time he was 3 years old. He suffered encephalopathy and seizures after multiple vaccinations. Walk a mile in my shoes and I can guarantee you would not have posted that above comment.

    June 4, 2013 at 21:25 | Report abuse | Reply
  8. liss

    People who are more educated on vaccines have weighed the pro's/ con's. I am not totally against them, but I make sure my children get what I feel is most important and absolutely space them out. I can respect a parent who does not get them, because they have their reasons. As long as they have done appropriate research and not just going off of what others say. The studies done have only been on perfectly healthy children. Not premature babies, kids with cancer, allergies or or certain genetic predispositions.
    I know of a baby who stopped breathing from the MMR, and therapists I work with have many stories of parents saying the same thing how their babies changed overnight from certain vaccines. Why is it that SIDS occurs most frequently in the US around 2 & 4 months.
    There is a lot of corruption on behalf of the CDC, they are not totally honest with the public, withhold information and they use a lot of scare tactics. Why do you think they removed thimerosal back in the 90's? hmmm. Maybe if they did more research on using more safe ingredients other than the harmful adjuvants, such as aluminum, squalene, human & animal DNA, formaldehyde just to name a few...parents would feel a little safer administering them to their children.
    Do yourself a favor, look up the VAERS website to see all of the countless severe adverse side effects that have been reported. If the vaccines work as well as they say they do, why should you feel so threatened?

    June 4, 2013 at 23:52 | Report abuse | Reply
  9. Adri

    I'm so sick of these provaxxers thinking that non-vaccinating parents owe them and the public something. News flash!! My only responsibility as a parent is to ensure the well-being of MY child, that's it! And if my way of doing that is through stellar nutrition and not with vaccines, then that's my prerogative. My 10 month old is vaccine free and has had only 1 minor cold and I know not many parents of a fully vaccinated 10 month old can brag about that 🙂 I've even been sick myself and somehow the little manages to not catch my bugs. So obviously, I'm doing something right by supporting his immune system with an impeccable organic diet. So go feed your kids their daily McDonald's feast and then shoot them up and expect them to be healthy

    June 5, 2013 at 00:44 | Report abuse | Reply
    • antpillage

      I agree with you. My son is two, was not vaccinated and has only one minor cold. My wife and I both focus on nutrition and him being active outdoors. He was breastfed so I am sure that has something to do with his good health. (but that is a whole different debate). Almost all the other parents I know have had all the vaccination shots and their kids are constantly sick, have asthma, food allergies etc. Maybe those symptoms are exactly correlated with immunization shots, or not being breastfed, but logic suggests it is a combination.

      It was not an easy decision to not vaccinate my child. I did a lot of research prior to making a decision about not vaccinating my son. I think there is still a lot of research that is needs to be done by scientists regarding vaccinations. Science is getting better ever day, I just don't think we are completely there yet regarding vaccinations. Also, my state has a rule to be allowed to go to public schools. Either get all the mandatory vaccines or get none. You, as a parent, have only 2 choices. Something needs to be done about that. There might have been a chance I had some of the immunization shots..maybe.

      I feel that the pro-vaccination people just think parents that didn't vaccinate their children are irresponsible but that is not the case. Also, people need to stop stating that vaccinations stopped all these diseases (smallpox, polio etc) If you actually did your research, roughly 96% of those diseases were eradicated prior to vaccination for that disease was introduced.

      June 5, 2013 at 21:14 | Report abuse |
  10. Shawn Siegel

    LOL. Ear infections are one of the most common adverse vaccine reactions. What a preposterous article.

    June 18, 2013 at 09:46 | Report abuse | Reply
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