 |
|
Dismissing the Family Who Refuses Vaccines
A Study of Pediatrician Attitudes
Erin A. Flanagan-Klygis, MD;
Lisa Sharp, PhD;
Joel E. Frader, MD
Arch Pediatr Adolesc Med. 2005;159:929-934.
Background Parent refusal or deliberate delay of their child’s vaccinations poses a challenge for pediatricians. Some pediatricians may choose to dismiss these families from their practice.
Objectives To describe pediatricians’ responses to scenarios of vaccine refusal, identify reasons pediatricians cite for both parent refusal and family dismissal, and illustrate pediatrician attitudes about well-established vs newer recommended vaccines.
Design/Methods We conducted a nationwide survey mailed to 1004 randomly selected American Academy of Pediatrics (Elk Grove Village, Ill) members.
Results Fifty-four percent faced total vaccine refusal during a 12-month period. Pediatricians cited safety concerns as a top reason for parent refusal. Thirty-nine percent said they would dismiss a family for refusing all vaccinations. Twenty-eight percent said they would dismiss a family for refusing select vaccines. Pediatrician dismissers were not significantly different from nondismissers with respect to age, sex, and number of years in practice. Pediatrician dismissers were more likely than nondismissers to view traditional vaccines (diphtheria and tetanus toxoids and acellular pertussis; inactivated poliovirus; Haemophilus influenzae type b; measles, mumps, and rubella) as "extremely important," but they were no more likely to view newer vaccines (7-valent pneumococcal conjugate, varicella-zoster virus, hepatitis B) as "extremely important."
Conclusions Pediatricians commonly face vaccine refusal that they perceive to be due to parent safety concerns. In response, many pediatricians say they would discontinue care for families refusing some or all vaccines. This willingness to dismiss refusing families is inconsistent with an apparent ambivalence about newer, yet recommended, vaccines. The practice of family dismissal needs further study to examine its actual impact on vaccination rates, access to care, and doctor-patient relations.
Author Affiliations: Department of Pediatrics, Rush Children’s Hospital, Rush Medical College (Dr Flanagan-Klygis), Department of Family Medicine (Dr Sharp) and Department of Pediatrics, Children’s Memorial Hospital (Dr Frader), Northwestern University Feinberg School of Medicine, Chicago, Ill.
RELATED LETTERS
Dismissing Families: A Slippery Slope
Kathi J. Kemper and Caryl J. Guth
Arch Pediatr Adolesc Med. 2006;160(4):452.
EXTRACT
| FULL TEXT
Dismissing Families: A Critical Issue
Michael P. Elston
Arch Pediatr Adolesc Med. 2006;160(4):452.
EXTRACT
| FULL TEXT
Dismissing Families: A Critical Issue—Reply
Erin Flanagan-Klygis, Joel Frader, and Lisa Sharp
Arch Pediatr Adolesc Med. 2006;160(4):452-453.
EXTRACT
| FULL TEXT
RELATED ARTICLE
Does Immunization Refusal Warrant Discontinuing a Physician-Patient Relationship?
J. W. Hendricks
Arch Pediatr Adolesc Med. 2005;159(10):994.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
A Web-based Tool for Designing Vaccine Formularies for Childhood Immunization in the United States
Jacobson and Sewell
J. Am. Med. Inform. Assoc. 2008;15:611-619.
ABSTRACT
| FULL TEXT
Media Coverage of the Measles-Mumps-Rubella Vaccine and Autism Controversy and Its Relationship to MMR Immunization Rates in the United States
Smith et al.
Pediatrics 2008;121:e836-e843.
ABSTRACT
| FULL TEXT
Preserving relationships with antivaccine parents: Five suggestions from social psychology
Fortune and Wilson
cfp 2007;53:2083-2085.
FULL TEXT
Preserver les relations avec les parents anti-vaccins: Cinq suggestions tirees de la psychologie sociale
Fortune and Wilson
cfp 2007;53:2093-2095.
FULL TEXT
Addressing Parents' Concerns About Childhood Immunizations: A Tutorial for Primary Care Providers
Levi
Pediatrics 2007;120:18-26.
ABSTRACT
| FULL TEXT
Association Between Health Care Providers' Influence on Parents Who Have Concerns About Vaccine Safety and Vaccination Coverage
Smith et al.
Pediatrics 2006;118:e1287-e1292.
ABSTRACT
| FULL TEXT
Qualitative Analysis of Mothers' Decision-Making About Vaccines for Infants: The Importance of Trust
Benin et al.
Pediatrics 2006;117:1532-1541.
ABSTRACT
| FULL TEXT
Dismissing Families: A Slippery Slope
Kemper and Guth
Arch Pediatr Adolesc Med 2006;160:452-452.
FULL TEXT
Dismissing Families: A Critical Issue
Elston
Arch Pediatr Adolesc Med 2006;160:452-452.
FULL TEXT
Dismissing Families: A Critical Issue--Reply
Flanagan-Klygis et al.
Arch Pediatr Adolesc Med 2006;160:452-453.
FULL TEXT
Vaccines: My Way or the Highway?
Dubik and Rathore
AAP Grand Rounds 2006;15:2-3.
FULL TEXT
When a Parent Says "No" to Immunizations
JWatch Pediatrics 2005;2005:2-2.
FULL TEXT
Families Who Refuse Vaccines Might Get "Fired" from Pediatric Practices
JWatch General 2005;2005:4-4.
FULL TEXT
Does Immunization Refusal Warrant Discontinuing a Physician-Patient Relationship?
Hendricks
Arch Pediatr Adolesc Med 2005;159:994-994.
FULL TEXT
|
