Washington, D.C ? Vaccines and their effects on small children have been one of the great medical debates of this decade. And last month, the issues become a little muddier. In addition to releasing the latest vaccine recommendation schedule, the American Academy of Pediatrics journal “Pediatrics” is ran an article by Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia, that attacks a popular vaccine book by Dr. Bob Sears, the son of well-known pediatrician and “The Baby Book” author William Sears.

In “The Vaccine Book,” Sears recommends two “common sense” delayed vaccination schedules for children. One is designed for parents who want to decline or delay vaccines. The other is designed for parents who want to minimize the number of shots per office visit to no more than 2, requiring 12 office visits by the age of 2. Sears is also a proponent of separating the measles, mumps and rubella (MMR) shot into three separate shots and not combining vaccinations with live cultures (MMR and chicken pox). Currently, MMR and Varicella, or chicken pox, are recommended for kids ages 12-15 months.

“Increasing the number of vaccines, the number of office visits, and the ages at which vaccines are administered will likely decrease immunization rates. In addition to the logistic problem of requiring so many office visits, Sears’ recommendation might have another negative consequence; recent outbreaks of measles showed that several children acquired the disease while waiting in their pediatricians’ offices,” writes Offit.

“At the heart of the problem with Sears’ schedules is the fact that, at the very least, they will increase the time during which children are susceptible to vaccine-preventable diseases. If more parents insist on Sears’ vaccine schedules, then fewer children will be protected, with the inevitable consequence of continued or worsening outbreaks of vaccine-preventable diseases. In an effort to protect children from harm, Sears’ book will likely put more in harm’s way.”

Offit is not one to shy away from controversy. When the TV drama “Eli Stone” was about to air an episode in which the lawyer argued — fictionally — that a mercury-based preservative in a vaccine caused her son’s autism, Offit spoke up, saying the show conveyed “a highly distorted and confusing message about the role of vaccines.”

Not surprisingly, Sears disagrees with Offit’s assessment of his book, writing on his Web site’s blog: “While Dr. Offit and I share the same opinion on the importance of vaccines, at the end of the day we will have to continue to agree to disagree on one major point: He believes that offering parents the option of an alternative vaccine schedule that spreads out the shots and allows worried parents to vaccinate their babies in a manner they are more comfortable with will result in LOWER vaccination rates because it legitimizes these parents fears about vaccines. I, on the other hand, believe that providing parents (who otherwise would NOT vaccinate at all) with a schedule of vaccines that they feel right about for their baby will allow such parents to vaccinate, and we will achieve HIGHER vaccination rates.”