Amherst Pediatric Associates’ Vaccination Policy

Please correct the errors described below.

The providers at Amherst Pediatric Associates firmly believe in the safety and effectiveness of vaccines to prevent serious illness and save lives. As pediatricians we are honored and grateful that you have entrusted us with the care of your child and feel that in partnership with you our sole job is to protect them. The single best way we have to protect your child is immunizations.

As medical professionals, we believe that vaccinating children on schedule as recommended by the American Academy of Pediatrics (AAP) and the Center for Disease Control (CDC) is absolutely the right thing to do. This vaccine schedule is a result of years of research and studies by some of the country’s leading scientists and physicians. It provides the most effective and safest coverage from multiple life-threatening illnesses.

Our policy is that:

  • We adhere to the AAP immunizations guidelines that are available at
  • Children must receive all vaccines recommended by the AAP that are mandated for school entry by the state of New York (regardless of intention to attend school/daycare). These vaccines include:

DPT (Diphtheria, Pertussis, Tetanus)

Pneumococcal Conjugate

MMR (Measles, Mumps, Rubella)

IPV (Polio)

Hepatitis B

Meningococcal A, C, W, Y

HIB (Hemophilus Influenza Type B)

Varicella (Chickenpox)

  • Vaccines which are equally recommended by our providers, the AAP and CDC but not mandated by NYS for school/daycare entry are encouraged based on the developed schedule. These vaccines include:


HPV (Human Papillomavirus)

Hepatitis A

Annual Influenza

Meningococcal B


  • We do not allow for “alternative schedules” or “breaking up vaccines”.
  • The only exception to vaccinate is a true medical exemption. Medical exemptions may be specific to a vaccine and should be discussed with your provider. In many cases medical exemption only results in a temporary delay not a lifelong exclusion.

We hope you understand that we have created this vaccine policy to protect your child, your family and our entire community from life threatening preventable diseases. Please feel free to discuss any questions or concerns you may have about vaccines with any one of us.

I have read and understand Amherst Pediatric Associates’ Vaccination Policy. I agree to comply with the stated policy and understand should I at any time decide to deviate from this policy I will be asked to find another health care provider.

DISCLAIMER: By typing your name below, you are signing this form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.

Your information will be encrypted.