Some pediatric practices have begun to exclude families who refuse to vaccinate their children, raising questions about the effectiveness of such an approach.
Doctors become frustrated when they have to explain the scientific basis for immunizations repeatedly to individuals who have bought into widespread myths about vaccines, often promulgated by celebrities, Don Seidman, M.D., chair of pediatrics for DuPage Medical Group told the Chicago Tribune. Some of the recent rise in vaccine refusals may have taken place because previous immunization programs have been so successful, according to a 2013 survey that showed a large number of refusals by parents who believe vaccinations to be “unnecessary.”
Nevertheless, Seidman believes refusing patients solely because they do not want to vaccinate their children is “a lazy way out,” since it presupposes that some other practitioner will take on the task of immunization education. The American Academy of Pediatrics recently released guidelines supporting exclusion of such patients as “an acceptable option,” but only in situations where physicians have made multiple attempts to educate patients, and where physician densities are high enough that excluded families have other viable options for their care.
The communication between doctors and patients that leads to vaccine education is a two-way street, as the Chicago Tribune illustrates with the story of a mother from Palos Park who felt a pediatrician “shamed” her rather than addressing her concerns. Even where practices make an extra effort to provide resources and build trust with patients hesitant about vaccination, however, patients aren’t always swayed.
That has led to policies that effectively split the difference. At Advocate Children’s Hospital, parents of unvaccinated children get three visits to receive and digest information on vaccines, according to vice president Frank Belmonte, M.D. “If we come to an impasse, and there’s a lack of trust with the provider, at that point we terminate the relationship,” he says.