Keānuenue Pediatrics, LLC Vaccine Policy

At Keānuenue Pediatrics, we believe in vaccines. We believe they’re safe, effective, and save lives, and as pediatricians, vaccinating children is one of the most important things we do.

We follow the Center for Disease Control (CDC) Immunization Schedule, which has been extensively researched and validated to be the most effective and is also endorsed by the American Academy of Pediatrics (AAP).

Because vaccine safety and efficacy are based on indisputable science and data, and because it’s such an important part of our practice, we do not accommodate alternative or delayed vaccination schedules for any patient.

[Note: For patients with contraindications, such as cancer, a weakened immune system, or a history of a severe allergic reaction to a previous vaccination, of course we support modifications for their safety. Thankfully, the above conditions are exceedingly rare.]

We have lots of reasons for this policy, but the most important is that vaccines, which is the ultimate preventative care, is fundamental to pediatrics, and if we can’t see eye to eye on something as well-proven as vaccines, it’ll be difficult to form a therapeutic, trusting relationship to collaborate on other important decisions for your child’s health. We instead recommend that you find a pediatrician who shares your philosophies to partner with. 

Here are a few FAQs. If your questions aren’t answered here, please reach out to us via text, phone, or email if you’d like to learn more or have a thoughtful discussion.

1. My baby doesn’t have risky behavior, so why do they need to get Hepatitis B vaccine at birth?

   
   Over a million people in America are living with lifelong hepatitis B infection, and anyone can be infected, including children. Hepatitis B is incurable and isn’t only transmitted by sexual activity and IV drug use. The virus can be transmitted by prolonged casual contact or by use of everyday objects shared with an infected person. One third of infected people have no idea how they got infected and many who have Hepatitis B don’t appear ill or even know they have it, so your child could be in contact with someone with the virus and not even know it yet. The risk of the vaccine is so low and the protection lasts a lifetime and is 95% effective after 3 doses.

2. Why are there so many vaccines at once? Won’t that overwhelm their system?

   
   Vaccines contain antigens that teach your immune system how to defend against future exposures to the real virus or bacteria. Your baby’s immune system is still developing, but it’s already smart and strong enough to handle thousands of antigens or germs everyday. Just being alive in the world, babies are exposed to 5000 antigens daily. The number of antigens they’re exposed to in all their vaccines from 0 to 18 years of age totals a mere 150 antigens (just a few per shot). Your baby can handle much more than these vaccines.
   
   

3. Why can’t we have a delayed scheduled?

   The current vaccine schedule has been researched and validated to be most effective as it is. Modifying the vaccine schedule in any way then makes vaccines less effective by not providing the most ideal coverage for your child. Delaying a vaccine by even a week is not necessary, not recommended, and leaves your child more vulnerable than they need to be.
   
   

4. What about heavy metals and preservatives? Won’t that damage my baby’s brain?
   The ingredients in vaccines are simple and safe. Besides the antigens (see question #2), they also contain ingredients to help keep the vaccines fresh and improve the strength of their immune response. Who doesn’t want fresher, stronger vaccines? No ingredient in the vaccine is dangerous for your child or their developing brain.
   
   
5. Why are there so many more vaccines now than when we were young?

   Science is always at work. More vaccines are available now, including rotavirus, chickenpox, and HPV vaccines. Children (and eventual adults) no longer have to suffer from any of those diseases since vaccines were developed and rigorously tested for safety and effectiveness. Compared to when we were kids, vaccines today provide more coverage against disease, so our kids benefit from time and continued research and development.

   The entire vaccine schedule was researched and vetted by the world’s top disease experts, and it’s reviewed at least annually and continually reevaluated. The schedule and recommendations may change as more data is available, so it’s not static, it’s evolving with the goal so providing the most protection possible.

6. Shouldn’t we space the vaccines out just in case they have a reaction, so we can identify which vaccine they reacted to?
   
   The risk of a vaccine reaction is exceedingly low. It’s not zero, but it’s not high enough to recommmend that all children space their vaccines out. If the risk was high, the schedule would have been created with that in mind. Decades of research show that children can safely receive multiple vaccines at the same time. The Vaccine Adverse Event Reporting System also constantly monitors reports of vaccine reactions.
   
   
7. What about my rights as a parent?
   
   Being a parent is rewarding but tough. We’re an ally, and we would never trample on your rights. For this reason, our vaccine policy is clearly stated kind of everywhere: our website, our registration forms, and by our staff when you call to inquire about our office. It’s not a secret, and we’re totally ok if our policy doesn’t jive with your parenting decisions. We love you anyway, but we kindly ask that you find a pediatrician that you can trust. That’s super important, and you have the right to choose anyone else.
   
   
8. Isn’t HPV only sexually transmitted? My 12 year old isn’t having sex so they don’t need it.
   
   Vaccines work because we prepare the immune system today for the dangers of tomorrow. Children don’t need to be sexually active to reap the benefits of a vaccine, but they’ll be protected for whatever the future holds for them (which probably includes having sex, even if we don’t want to think about it).
   
   
9. We choose not to give the flu shot and we’re on the fence about COVID vaccines, is that ok?
   
   We’ll always offer flu and COVID vaccines in our office, and we highly recommend them. But both vaccines are currently optional in our office. You can decline for your child, but we’ll offer it again to you next year, just in case you change your mind.
   
   
10. I only want to get what’s required for school. Is that ok?
    

    
    Thankfully in the State of Hawaii, that’s everything, so yes, that’s ok!

    Per the Department of Education website:

    Which immunizations are required?

    Immunizations are required for all students entering childcare or preschool, kindergarten, and seventh grade, and for those students entering school in Hawai‘i for the first time, regardless of age.

    Childcare or Preschool	Kindergarten – Grade 12	Grade 7
    Diphtheria-Tetanus-Pertussis (DTaP)	Diphtheria-Tetanus-Pertussis (DTaP)	Human Papillomavirus (HPV)
    Haemophilus influenzae type b (Hib)	Heptatis A (Hep A)	Meningococcal Conjugate (MCV)
    Heptatis A (Hep A)	Heptatis B (Hep B)	Tetanus-diphtheria-pertussis (Tdap)
    Heptatis B (Hep B)	Human Papillomavirus (HPV)
    Measles-Mumps-Rubella (MMR)	Meningococcal Conjugate (MCV)
    Pneumococcal Conjugate Vaccine (PCV)	Measles-Mumps-Rubella (MMR)
    Polio (IPV)	Polio (IPC)
    Varicella (chickenpox)	Tetanus-diphtheria-pertussis (Tdap)
    	Varicella (chickenpox)

    *All students entering school in Hawaii for the first time in 7th grade or higher must show evidence of receiving these immunizations prior to school attendance.

11. I know of children that have [insert terrible outcome] because of vaccines. Why would you force me to give it to my child?
    
    Whether or not to vaccinate is 100% your choice. But we have a choice too, and based on all of our medical training and experience, the choice is easy: we choose to protect the patients we’re responsible for against diseases that could harm them. We would choose to vaccinate our own children and advise our loved ones just the same. Our policy simply reflects our values, medical expertise, and commitment to child health.

12. What are side effects of the vaccines?
    
    The most common side effects are tiredness/sleepiness, redness and swelling at the injection site. Some vaccines can cause dizziness, which we keep you in the office to monitor for. Some vaccines can lead to a low grade fever. Most vaccine reactions, if any, are brief and self resolving within a few days.

Finally, we encourage you to take caution with the sources that you trust when making any important decisions about your child’s health. Here are trusted experts that share lots of facts about vaccines and can answer any other qeustions you have:

• American Academy of Pediatrics
• Healthy Children, by the American Academy of Pediatrics
• Parent FAQs on Immunizations by Healthy Children
• CDC Vaccines & Immunizations
• Immunization Action Coalition