Parent’s Guide to Childhood Immunizations

Last updated April 2026 — refreshed to reflect the latest edition of Dr. Mumper’s guide.

Deciding whether to vaccinate, when to start, and how to space doses is one of the hardest calls parents face. It deserves more than a rushed waiting-room conversation. It deserves time, information, and room to think things through.

That’s what Dr. Elizabeth Mumper, Dr. Liz to the families she’s cared for over four decades, offers in ‘A Parent’s Guide to Childhood Vaccination Decisions.’ She’s a board-certified pediatrician and the host of Kid’s Corner with Dr. Liz. Some of the families she advises decide not to vaccinate. Others proceed with a modified schedule. Her role is to help each family arrive at whatever is right for them, with clear information and without pressure.

Download the full guide below, or keep reading for a summary.

Dr. Mumper’s 6 Recommendations for Childhood Immunizations

Over the course of her practice, Dr. Mumper has been tracking something the typical pediatric visit doesn’t cover: how children on the CDC schedule fare over time compared to children who vaccinate less or not at all. Her findings, alongside those of colleagues doing similar work, turn up patterns that any parent making this decision deserves to see.

What the Data Shows

Dr. Mumper’s guide highlights several childhood health concerns that appear linked to current vaccine practices:

• Autism prevalence. In Dr. Mumper’s practice, 1 in 297. The CDC’s latest national estimate (based on a 2014 birth cohort) is 1 in 31. In California’s 2018 birth cohort, autism rates among 4-year-old boys ranged from 5.3% in white children to 12.1% in Black children, with Asian and Hispanic children falling in between.
• Broader health patterns. A 2020 analysis in SAGE Open Medicine found higher cumulative vaccine counts correlated with higher rates of ear infections, developmental delays, and asthma, with vaccination before the first birthday flagged as a particular risk.

These findings shaped Dr. Mumper’s six-step framework for childhood vaccination decisions:

1. Understand what informed consent means.
2. Understand the purpose of childhood immunizations.
3. Understand vaccines and their risks.
4. Check state and local requirements and allowable exemptions.
5. Seek information from a wide variety of sources.
6. If you choose to vaccinate, talk to your pediatrician about a modified approach.

1. Understand what informed consent means

Before saying yes to any vaccine, you have the right to ask questions and get real answers. Your provider should lay out the risks and benefits of the proposed treatment, and mention whatever alternatives exist.

That process has a name: informed consent. It means you’re in on the decision, fully briefed on what could go right and what could go wrong, and given the space to think it through without anyone rushing you or pressuring you. The conversation should happen well before you’re in the exam room with a vaccine already drawn up.

Questions worth considering before birth:

• What is the risk of vaccine-preventable diseases in my region?
• Should we give the hepatitis B vaccine at birth if the mother is hepatitis B-negative and the infant is not at risk?
• Do we want to follow the CDC-recommended schedule, or modify timing and spacing?
• Is there a benefit in spacing vaccines to reduce cumulative exposure to adjuvants such as aluminum?
• Should vaccines be delayed if the child is sick or taking antibiotics? Should vaccination be postponed if developmental or neurologic concerns are emerging?
• Do we have religious or philosophical beliefs that influence our decisions?
• Are there differences in health outcomes between vaccinated and unvaccinated or undervaccinated children?

2. Understand the purpose of childhood immunizations

The U.S. childhood schedule includes HepB, Rotavirus, DTaP, Hib, IPV, Prevnar 20, MMR, Varicella, and several combination vaccines. Each has a different purpose, a different risk-benefit profile, and a different level of real-world effectiveness. Dr. Mumper’s take varies accordingly.

• Pertussis. The acellular pertussis component of DTaP doesn’t prevent infection or transmission. Waning immunity is documented. Most pertussis cases in the U.S. occur in vaccinated individuals. In 2024, a peak outbreak year, surveillance reported zero pertussis deaths in children ages 7-19.
• Measles. Outbreaks have been documented in populations with 98%+ vaccination coverage. Primary vaccine failure can reach 10%, and vaccine-induced immunity may wane, while natural infection generally produces lifelong immunity.
• Rotavirus. The vaccine manufacturer’s own data reports irritability in roughly 70% of infants and loss of appetite in 30%. Most rotavirus cases in families with clean water and medical care can be managed at home.
• Hepatitis B. Vertical transmission only occurs when the mother is HepB-positive, which happens in about 0.5% of pregnancies. The CDC itself acknowledges that the universal birth-dose contribution to declining cases is likely very small.

3. Understand vaccines and their risks

All pharmaceutical products, including vaccines, carry two primary risks: the product may not be effective enough to prevent disease, and it may cause harm. With vaccines, there is an additional legal consideration. Under the National Childhood Vaccine Injury Act of 1986, vaccine manufacturers and the physicians who administer childhood vaccines are generally not liable for injuries or deaths that follow an FDA-licensed childhood vaccine.

Some children are at greater risk of vaccine injury than others. Family history of autoimmune conditions, severe allergies, neurological disorders, and prior vaccine reactions should all be factored into the conversation. Package inserts for all vaccines are available online and list known side effects along with their reported frequencies.

Before any vaccine appointment, the National Vaccine Information Center suggests asking these eight questions:

1. Am I or my child sick right now?
2. Have I or my child had a bad reaction to a vaccination before?
3. Do I or my child have a personal or family history of vaccine reactions, neurological disorders, severe allergies, or immune system problems?
4. Do I know the disease and vaccine risks for myself or my child?
5. Do I have full information about the vaccine’s side effects?
6. Do I know how to identify and report a vaccine reaction?
7. Do I know I need to keep a written record, including the vaccine manufacturer’s name and lot number, for all vaccinations?
8. Do I know I have the right to make an informed choice?

4. Check state and local requirements and allowable exemptions

School vaccination requirements, and allowable exemptions, vary across states and local health departments. Some vaccines are required, some are recommended, and some are optional. Medical, religious, and personal belief exemptions are available in different combinations depending on the state.

State legislatures periodically review and update their vaccine laws, so it’s worth confirming your current state and local requirements before making a decision.

5. Seek information from a wide variety of sources

Parents are usually directed to the CDC website for information about vaccines, but many other credible resources exist. Dr. Mumper’s updated guide recommends the following:

Books:

• Vaccines 2.0: The Careful Parent’s Guide to Making Safe Vaccination Choices for Your Family, by Mark Blaxill and Dan Olmsted
• The Vaccine-Friendly Plan, by Paul Thomas, MD, and Jennifer Margulis, PhD
• The Vaccine Book: Making the Right Decision for Your Child, by Robert W. Sears, MD
• Turtles All the Way Down: Vaccine Science and Myth
• Vax Facts: What to Consider Before Vaccinating at All Ages and Stages of Life, by Paul Thomas, MD, and DeeDee Hoover
• Dissolving Illusions: Disease, Vaccines and the Forgotten History, by Suzanne Humphries, MD, and Roman Bystrianyk

Websites:

• National Vaccine Information Center
• Children’s Health Defense
• Informed Consent Action Network (ICAN)
• Physicians for Informed Consent

6. If you choose to vaccinate, talk to your pediatrician about a modified approach

For families whose schools or day cares require vaccination, and who can’t realistically homeschool or pay for private school, the question shifts from whether to vaccinate to how.

For parents who opt to vaccinate for these or other reasons, Dr. Mumper’s guide details a modified vaccine schedule. The approach spaces out doses, eliminates some vaccines entirely, and aims to reduce a child’s exposure to adjuvants such as aluminum in the first year of life. The full schedule is in the guide, but here is the shape of it:

• 0 to 12 months. Vaccines only when the child is well. No HepB unless the mother is HepB-positive. Giving one or two vaccines at a time makes it easier to identify the source of any reaction. Hib and IPV spaced across the 2-, 4-, and 9-month visits. DTaP and Prevnar spaced across the 3-, 5-, and 6-month visits.
• 12 to 24 months. MMR and varicella given separately, not together. MMR delayed until age 2 for most children, age 3 for Black children. HepB series (if required for school) started between ages 2 and 5.
• 3 to 5 years. Wellness visits each year. Kindergarten vaccines (DTaP, IPV, MMR, varicella) given no more than two per visit.

For families whose infants are breastfed and not in day care, Dr. Mumper also describes a minimalist alternative that starts even later and eliminates more. Full details are in the guide.

You Have Childhood Vaccination Questions. You Aren’t Alone.

If you’ve ever felt like you couldn’t ask questions at a vaccine visit without getting a look, you’re not imagining it. Questions about side effects, timing, and whether every shot on the schedule is right for your child are reasonable questions, and more parents are asking them every year.

The usual answer stack (CDC, the American Academy of Pediatrics, Canadian public health websites) provides information, but often doesn’t address the specific questions a parent has about their own child’s health, family risk factors, or tolerance for multiple exposures at once.

After working through the guide with their pediatrician, about one-third of Dr. Mumper’s families choose not to vaccinate. Others proceed with a modified schedule that delays or removes several routinely recommended vaccines. The right answer for your family is the one you arrive at with clear information and without pressure.

Dr. Mumper’s Stance on Specific Vaccines

After more than four decades in pediatric practice, Dr. Mumper has settled on clear positions for several routinely offered vaccines. The guide details her reasoning in full; here is the summary.

Vaccines she recommends declining:

• The rotavirus and Gardasil vaccines, based on safety and risk-benefit considerations.
• COVID-19 vaccines for healthy children, citing clinical trial limitations, reported side-effect rates, and concerns about how parents were pressured into the decision during the pandemic.
• Administering live vaccines (MMR and varicella) alongside any other vaccines. Each should have its own visit.

Vaccines worth a careful conversation with your provider:

• Hepatitis B can typically be delayed until at least 1 year of age, unless specific risk factors are present. If required for day care or school, the three-dose series can be started between ages 2 and 3.
• The flu vaccine may be worth discussing for children with chronic respiratory conditions, chronic illness, or immunocompromise. Flu shots are not mandated for school attendance, reported efficacy ranges from 13 to 50% depending on the season, and IMA does not recommend routine flu vaccination for healthy children.
• Hepatitis A, Trumenba (meningitis B), and Menactra (meningitis ACWY) are typically most relevant between ages 11 and 18 for high-risk settings like college dormitories or military housing. Protection may wane if administered too early.

Wrapping Up

The full guide goes deeper into each vaccine, walks through the modified schedule month-by-month, and closes with 29 peer-reviewed references. Whatever you decide for your family, we hope it helps you arrive there with more clarity and less second-guessing.

Thanks to Dr. Mumper for updating this resource to reflect the latest clinical evidence. For more approachable pediatric advice, visit Kid’s Corner with Dr. Liz.