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Heather, your questions continue to be very detailed and important, as well as difficult to answer in a few sentences.

The success of any vaccine administration depends upon inducing the correct immune response that leads to production of antibodies, and timing of subsequent doses of vaccines are pretty important in terms of taking advantage of having an immune system that is appropriately "primed" to get a better response on subsequent doses. This is why, for example, we RARELY have a significant fever with the first of any vaccine series.

When the FDA licenses a vaccine that requires multiple doses, it requires data on the appropriate timing of those doses, and that is why you should give the doses at the specified interval, and NOT SOONER. During the peak time of making antibodies, usually between 2 and 6 weeks after the shot, there can actually be a period of decreased ability for the body to form antibodies to a new stimulus (the next shot), and this can sometimes suppress the ability to respond to OTHER vaccines as well.

So, my advice would be that if you want to spread them out you do it by at least 2 months (unless there is data to show that sooner is OK). This, of course can mean that the total series of all scheduled vaccines takes much longer than usual, but I believe would be the safest way to go. It is not the case for all vaccines, and so each one you plan to delay should be researched by your provider (or by him or her talking with an infectious disease or immunology specialist) since the body's responses to different stimuli can be so complicated.

As an aside, all vaccines that are currently recommended to be given together, or are manufactured to be administered together, have been tested and found to maintain the same or better degree of what is called immunogenicity (ability to induce the immune response) as when given separately.

Hope this helped.
There may be some docs lurking out there who have a different opinion, or want to add their commentary--PLEASE DO

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