As a pediatrician, you know it as well as I do--fewer parents are vaccinating their children in the US. Some by completely skipping all vaccines, others by selectively vaccinating or following untested "alternate" vaccine schedules.
We have seen a continual rise in vaccine-preventable disease outbreaks (most notably pertussis and measles) here in the US over the last 10 years, with the rate of these outbreaks accelerating over the last 3-5 years. There have been pediatric-aged deaths from these outbreaks (e.g. 10 infant deaths in California, an infant death in Arizona, and an infant death in Colorado)
We continue to be bombarded with anti-vaccine propaganda in the media from the likes of Jenny McCarthy, Oprah, Larry King, etc--who claim (or allow others to claim on their shows) that vaccines are unsafe, ineffective, untested, etc--all of which are untrue. They completely ignore all the scientific and clinical research to the contrary showing that vaccines are safe, effective, and well-tested.
Then there are anti-vaccine propaganda groups like the NVIC, Autism Speaks and Age of Autism, who through their pseudo-scientific web sites also try to scare parents into not vaccinating. Thankfully the AAP has publicly and openly opposed these groups when they try to play their anti-vaccine propaganda to large crowds, such as on jumbotron boards and in-flight commercials --action that is so very critical to help keep parents from being deceived by these anti-vaccine groups.
But what worries me most (and it should you, too) is that there are two FAAP pediatricians, Dr. Robert Sears (aka "Dr. Bob") and Dr. Jay Gordon, who have been publishing (and also monetarily profiting) from their anti-vaccine views for much of the last 10 years. Dr. Sears is most notable for "The Vaccine Book" and his oft-parent-liked facebook page. Dr. Gordon is most notable as being pediatrician for Jenny McCarthy's autistic son, selling anti-vaccine DVDs and webinars online and having a very anti-vaccine web site (He also has a new book, incredibly, telling parents how they can "prevent" autism, including by not vaccinating) They both have created (out of thin air based on only their own personal feelings), "alternate" vaccine schedules that have no scientific testing behind them. They both have told parents it is ok to delay or even skip vaccines. And both have told parents that diseases like pertussis and polio aren't always dangerous. These two anti-vaccine pediatricians are more than happy to appear on TV, radio or internet to promote their lies and swag. And, I will bet you've had parents come in to your practice wanting to delay or skip vaccines because of what these two have said and written.
How popular are Sears and Gordon? Answer: Very. How do you know? Answer: Go to their web sites and facebook pages. Or, go to Amazon.com and read the many 4-5 star reviews by tragically misled parents actually commending Sears and Gordon for telling them the "truth" about vaccines. Finally, know this: Sears' book is now in its SECOND EDITION ("revised" in its lies and misinformation, of course) and his book has sold over 200,000 copies combined according to its publisher (as of 2012,).
What damage has been done by the promotion of "alternate" vaccine schedules by Sears and Gordon? Answer: quite a lot. You can read about a recent poll of Washington-area pediatricians showing that over 77% of them are regularly asked by parents to use "alternate" vaccine schedules. Even more worrisome, a recent article in Pediatrics found that 1 in 10 parents of young children are using "alternate" vaccine schedules. Also alarming is recently published research in Pediatrics showing that "alternate" vaccine schedules have directly caused a large part of the recent decrease in vaccination rates in a large metropolitan area. Finally, a recent abstract in Pediatrics has shown what many of us in primary care have suspected for the last decade: "the variable most predictive of parents' vaccination decisions was the percent of parents' people networks recommending nonconformity." Drs. Sears and Gordon live and thrive in "people networks" (especially online--again, please check out their websites and social media pages and search online how often they appear in "mommy blogs"). Would you care to guess where these "alternate" schedules come from? Answer: Sears (most notably via his book) and Gordon (who says he wants no infants to be vaccinated before 6 months of age). Now, who are the doctors parents trust when it comes to the care of their children? Answer: PEDIATRICIANS. And here we are in, in 2013, with two very mediagenic anti-vaccine PEDIATRICIANS named Robert Sears and Jay Gordon openly working to spread lies false fears about vaccination.
UPDATE: (August 2012): Dr. Gordon shows just how dangerous he is by going on TV news to openly oppose MMR vaccination despite a measles outbreak in nearby (to his practice) Ventura County (California). How much more plain and obvious can the danger of these two antivaccine pediatricians to child/public health be?
Now, here comes the most disappointing part. While the AAP does an commendable job of going after anti-vaccine groups such as the NVIC (as above) and also rapidly challenging vaccine lies propagated in articles by non-physician writers, they have done nothing to counter the lies and misinformation put out by Sears and Gordon--two of their own FAAP members. You may feel that the Offit & Moser 2009 article in Pediatrics was the AAP's counterstrike, but that article was (1) written for pediatricians (honestly, how many parents read Pediatrics?), and, (2) written by individual authors (Dr. Offit and Ms. Moser--NOT the AAP). It is neither a policy statement nor a media release from the AAP. Go ahead (I challenge you) and search the AAP.org and healthychildren.org web sites (or even the CDC or AAFP web sites, too) for information on alternate vaccine schedules. There is nothing parent-friendly on either web site to tell parents to stay with the ACIP/CDC schedule and avoid those of Sears or Gordon. This absence of any information by the AAP is silent approval of what Sears and Gordon say and do. To me, this is JUST PLAIN WRONG. And it should feel wrong to you as well.
By silently tolerating Sears and Gordon within their ranks, the AAP talks the talk, but it isn't walking the walk. As a practicing pediatrician, I feel very frustrated when parents tell me they are going to deviate from the ACIP/CDC vaccine schedule based on lies that Sears or Gordon has told them. Most sadly of all, I have NOTHING from the AAP that directly counters what I consider is medically criminal advice by Sears and Gordon. Instead, it's me and my word against Sears and Gordon in what is usually a losing argument. I'll bet you feel this way, too, since Sears and Gordon have esentially obtained celebrity status as pediatricians--though for all the worst reasons.