Vaccine Policy

  • When can I schedule a sick child visit?

    If you’re ever in doubt about whether your child needs a sick visit, call our office. The friendly nurse asks a few questions to determine the severity of your child’s symptoms, then helps you decide if you need to come into the office.


    You can schedule same-day sick visits any time the office is open. See our Hours and Locations. 


    We offer online scheduling through our portal for your convenience for routine sick and standard well visits. Please do not use these spots for mental health concerns, as those visits typically are much longer than standard sick visits. Call the office so we can find the best fit for anticipated long visits.

  • What happens during a sick child visit?

    The goal of a sick child visit is to quickly diagnose the problem and start treatment that will help your child feel more comfortable.


    In addition to reviewing your child’s symptoms and medical history, a physical exam to assess the symptoms will be done.


    Sick visit may require laboratory tests or imaging for identification of the source of symptoms. We can do rapid tests for Strep, flu A & B, urinalysis and COVID19 in our office.


    We can collect samples for Strep throat cultures, some PCR tests, chlamydia, gonorrhea, and urine cultures to send to laboratories. We can order further tests from local labs and radiology facilities as needed.

  • What children’s conditions can a sick visit treat?

    Sick visits treat many types of injuries and illnesses that need same-day or next-day medical care. Children’s symptoms can change quickly, so don’t hesitate to call if your child’s symptoms get worse.


    The following are some of the most common conditions treated during sick visits:


    • Flu Upper respiratory infections
    • Earaches Headaches
    • Sore throat or strep throat
    • Congestion
    • Coughs
    • Abdominal pain
    • Asthma
    • Rashes or hives
    • Allergic reactions
    • Eye discharge or infection
    • Vomiting and/or diarrhea

    We also treats minor injuries like concussions without persistent vomiting or altered level of consciousness, cuts and sprains.

  • When does my child need immediate medical care?

    Your child should be evaluated by a medical professional for the following symptoms:


    • Fever of 100.4ºF or higher in children younger than 2 months of age - this is an emergency: do not wait until office hours
    • Daily fever of 100.4ºF or higher that persists for 3-5 days (the younger the child or the more concerning the symptoms, sooner; older children who are overall well appearing can wait 5 days)
    • Unusual symptoms or any symptoms that concern caregivers 
    • Difficulty breathing should be seen immediately unless home treatment improves sufficiently to wait until business hours
    • Signs of dehydration (no tears, dry in mouth, decreased urine output or too much urine with other signs of dehydration) should be seen immediately
    • Persistent pain may require emergent treatment, depending on severity and other symptoms
    • Rash that you can't identify or know how to treat may require emergent treatment, depending on severity and other symptoms
    • Fever with a rash, stiff neck, vomiting, and headache is an emergency and should be seen immediately
    • Suspected bacterial infection, such as Strep throat (fever, sore throat, headache, nausea, vomiting , sandpaper rash in a child over 3 years - not all symptoms must be present) or urinary tract infection (painful urination, foul smelling urine, fever, vomiting - not all symptoms must be present): most of these can wait until business hours unless there are significant symptoms that are concerning

    When your child is sick, call the office as early in the day as possible so they can schedule a same-day visit if necessary or come to our Urgent Care/Walk In hours. 


    If you have questions about your child’s symptoms or you need to schedule a sick visit, call our office or book an appointment online.

  • What is appropriate for walk in visits (urgent care)?

    We have a full page about our Urgent Care (walk in) availabilities. Learn more here.


    Walk in visits work well for acute injuries and illnesses. They are not appropriate for mental health concerns, routine well visits or chronic disease management. 


    Schedule an appointment with the provider your child most often sees for ongoing conditions such as chronic pain, asthma, and constipation. Your usual provider who knows the story should see chronic concerns. Of course, if there is an exacerbation or sudden worsening of symptoms, acute management can be done at our urgent care with follow up by appointment and ongoing management with your primary care provider.

We recognize that there is much anti-vaccine rhetoric in the press today that has heightened parents’ concerns regarding immunizations. However, there is no scientific link between vaccines and autism or the other issues claimed by the anti-vaccine crowd. Thus, we feel it necessary to take a firm stand on the vaccine policies in our practice.

We require all patients to follow the American Academy of Pediatrics Immunization Schedule unless they meet one of the following criteria:

  • Severe allergy to one of the components of the vaccine. Minor allergies may require observation after vaccination, but the vaccine may be given.
  • Vaccine is unavailable at an office visit.
  • Immune suppression in the patient or caregiver that precludes vaccination. Most often it is better to vaccinate all people around an immune compromised person to help protect them against the vaccine preventable diseases. This includes live virus vaccines.
  • Fever or significant illness within the previous 24 hours prior to scheduled vaccine. It is recommended to vaccinate with mild illnesses.
  • Inability to vaccinate with a live virus due to another live virus vaccine being given in the previous 28 days.
  • Chronic high dose steroid of at least 2 weeks duration might exclude certain vaccines.
  • A child is past the age for which the vaccine is approved for use.
  • Chronic illness that precludes vaccination.

Note: These are based on Pinkbook recommendations.

The only vaccines that are excluded from this policy due to the difficulties enforcing standard scheduling, but are still strongly recommended, are:

  • Seasonal Influenza
  • HPV
  • COVID-19

What if we've missed doses of vaccine, but are willing to vaccinate?

If a newborn did not get the Hepatitis B vaccine in the hospital for whatever reason, they will need to start it with the standard 2 month vaccines.

If a child transfers in to our office and requires a catch-up schedule, we will catch up according to the AAP Catch Up Schedule.

What if we already started the alternate vaccine schedule?

For those who have already started on an alternate vaccine schedule, we will begin a catch up schedule. Any future children in your family will need to follow our vaccine policy.

What are the legal requirements?

If you want to know what is required by your state for daycare and school requirements, please see  the Kansas  or  Missouri Department of Health websites.

Why do we not allow an alternate vaccine schedule?

Safety: A number of studies have shown that the standard vaccine schedule is safe and effective. There are no studies supporting a slower schedule.

Protection: We want our patients to be protected as soon as possible against these preventable illnesses. Delaying vaccines increases the time that children are susceptible to diseases. Because of increased rates of inadequately vaccinated children, there are increasing rates of these preventable diseases. This increases the chance that susceptible children will be exposed to and catch a potentially deadly illness.

Too Many Too Soon? For those who are worried that there are too many vaccines too soon and they will overwhelm the immune system: This fear is simply unfounded. The schedule has been shown to be safe. We are exposed to a few hundred thousand viruses and bacteria each minute through normal breathing. Children receive about 130 antigens from vaccines. This is not a significant number compared to the millions upon millions of viral and bacterial antigens that enter a child’s lungs daily. The number of antigens has dropped over the same years that the number of illnesses being prevented has increased.

Law of unintended consequences: Separating vaccines also requires more visits to our office, which can expose children to more illness and unnecessarily increases the cost of healthcare.

Stress: Studies have shown that the first injection causes a stress response (measured by elevated heart rate, blood pressure, cortisol levels, cry), but subsequent injections given at the same time do not increase as significantly the stress when compared to returning on different days to get further injections. So children with delayed schedules are actually subjected to more stress.

Perspective: We are more likely to suffer death from car accidents than to have an adverse reaction to a vaccine.

As summarized in Addressing Parents’ Concerns: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System?:Current studies do not support the hypothesis that multiple vaccines overwhelm, weaken, or “use up” the immune system. On the contrary, young infants have an enormous capacity to respond to multiple vaccines, as well as to the many other challenges present in the environment. By providing protection against a number of bacterial and viral pathogens, vaccines prevent the “weakening” of the immune system and consequent secondary bacterial infections occasionally caused by natural infection.

Not Vaccinating Your Infant or Child

If you do not plan on having your infant or child vaccinated according to the standard vaccine schedule as recommended by the American Academy of Pediatrics (AAP) and required for daycare and school entry, then we respectfully ask you to find a physician who is willing to take this risk with you.

Worried about the vaccines causing pain?