Doctors refusing to treat unvaccinated families get academy’s backing

In this Aug. 27, 2010 file photo, nurse practitioner Susan Brown prepares a flu vaccination for a customer. (AP Photo/Evan Vucci, file)

AUSTIN (KXAN) — Doctors choosing not to treat families who don’t vaccinate their children are now getting support from the American Academy of Pediatrics.

In a new report, the Academy acknowledges that dismissing a patient is an option in certain circumstances. They say it should be a last resort, and not before parents are fully educated by the doctor.

According to the Academy, more pediatricians are seeing patients refuse vaccines. In a survey done in 2006, 75 percent of pediatricians reported encountering parents who refused a vaccine. In a follow-up study in 2013, that figure rose to 87 percent of pediatricians.

“We were starting to see lots of kids coming into the practice that were not vaccinated and their parents were refusing vaccines,” said Dr. Alison Ziari, a pediatrician with the Austin Regional Clinic. “It’s not a monolithic group of people, different people have different reasons.

Last summer the clinic changed their policy to no longer accept new pediatric patients whose parents will not permit vaccination. The Austin Diagnostic Clinic also implemented a similar policy.

“It’s tough. We love these families, they’ve been our patients for a long time. And it was just coming to the point where we had to do something to make sure we were protecting all our patients, so our most vulnerable patients, the newborns, the immunocompromised patients. It was a long time coming and a difficult decision to make,” said Dr. Ziari.

Dr. Ziari says dismissing a patient is the last option because they’re working to educate families. She says the majority of patients are confused and don’t fully understand vaccines because they’re very complicated.

A study done by AAP identified reasons why parents did not want their children vaccinated, including unease over receiving too many vaccines in a visit and concern the vaccine could lead to a chronic illness.

“We’re happy, we’re excited, because we feel like it validates what we were trying to do, and the approach that we’re taking. The most important thing is compassion and important conversations between the doctor and the parents to try and come to a good decision for the baby.”

The AAP is also calling for states to use their public health authority to eliminate non-medical exemptions from immunization requirements for school entry.

After Texas lawmakers expanded reasons why parents could “opt-out” back in 2003, the rate of vaccine exemptions rose in Texas.

The average vaccine exemption rate in the state is 0.84 percent, but a handful of schools in Travis County are far higher. The Austin Waldorf School was 40.51 percent for 2015-2016. The Austin

Discovery School was around 30 percent, and the Khabele School at 22 percent.

The list of mandatory vaccinations for Texas school children is meant to protect them from 11 communicable diseases. They include:

  • Hepatitis A and B
  • Meningococcal Meningitis
  • MMR – to protect against Measles, Mumps, and Rubella.
  • Polio
  • Tdap/Td – to provide immunity against Diphtheria, Tetanus, and Pertussis – better known as whooping-cough
  • Varicella – Chicken Pox vaccine.

Parents must provide proof of these vaccinations or provide a signed, notarized affidavit stating they are choosing the exemption for reasons of conscience.

KXAN also reached out to nearby hospitals on whether the AAP would impact policies at their facilities.

Dr. Mark Shen, president of Dell Children’s Medical Center of Central Texas, said:

“We do not have a policy on vaccine refusal as a hospital. We are a community resource for all children, regardless of the origin or source of their illness. However, we also take care of the most vulnerable kids in the community, in whom we want to prevent any type of unnecessary infection. Thus, vaccines are quite literally life savers for many of the children we see every day, because vaccines help to prevent the transmission of diseases that often have devastating effects in immunocompromised or otherwise vulnerable children. The real issue to focus on is not whether pediatricians should turn away families, but how families can have trusted conversations with pediatricians on a topic critically important to the health of all our children.”

We also reached out to St. David’s: “We encourage parents to vaccinate their children, and we explain why vaccination is important, but the hospital does not force vaccination, nor does it dismiss families who do not vaccinate.”

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