Thursday, March 5, 2015

Pediatricians and vaccination

I recently read that about 25% of pediatricians are refusing to see patients in their practices who are not vaccinated.

I can see both sides of this issue. Obviously, we are concerned about the health and well-being of these children, and just because their parents have made a decision that we don't agree with, that doesn't mean the child shouldn't have access to healthcare.  If they stay in the practice, there might be a better chance that the pediatrician can educate them and eventually get the child vaccinated.  I feel like the child should not suffer in all this.

There are a lot of arguments on the flipside though. These are a few that I've heard:

-- when you have an unvaccinated child in the practice, it puts the other patients in the practice at risk

-- A parent who refuses to follow the most basic recommendations of the pediatrician obviously does not respect their opinions and it is frustrating and often pointless to work with a patient who refuses to listen to you

-- if enough practices refuse to see unvaccinated children, parents might feel pressured into getting the vaccines just so they can see the doctor of their choice

Truthfully, I sympathize with pediatricians who do this, but I wonder if a stiff hike in insurance rates for unvaccinated children might influence parents without sacrificing the child's health.  

8 comments:

  1. It's frustrating as heck, no doubt about it. The marijuana post gave me pause for thought. I'm fine with legalizing it for medical use, but suggested that those who use it for recreational use do so in the comfort of their home. After all, I don't feel it's fair that I should be exposed to their second hand smoke. Why should I suffer for their behavior? Oh my. That's the same argument for vaccination! However, in
    this instance, it's your child, not yourself who is at risk. Yes, the life you value more than your own is being compromised and you are forced to accept it. To say it's infuriating and outrageous is an understatement. I still don't know how you achieve compliance but a surcharge on those who refuse vaccination may be a place to start. I spoke to a friend about it, and he suggested we deny the anti-vax folks vaccination. What? Tell them it's only for a select few, he went on to say, and they don't qualify. The next day they'll be out in huge numbers demanding their right to vaccinate their child! Naturally, he said it tongue-in-cheek, but I still found it amusing.
    - Paul

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  2. I'm concerned that refusal on the part of pediatricians would cause anti-vaccinationist parents to double-down on their hard-headed ignorance rather than reluctantly allow their child to be vaccinated. A surcharge or insurance hike would probably have the same effect, and would likely strengthen their notion that it's a conspiracy. I 100% sympathize with these pediatricians, though.

    I think the best approach, and what seems to be in the early stages already, would be to incur social shame on these individuals through cultural enlightenment. Shame and embarrassment is highly motivating. I realize this is incredibly difficult, especially given then prevelance of science ignorance (and anti-science sentiment) and lack of critical thought in society.

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  3. The lesser of two evils?

    http://blog.thebump.com/2015/03/03/most-doctors-allow-parents-to-alter-vaccine-schedules-says-report/

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  4. I can see either that happening, due to paying for the costs when one of their kids infects another, or lawsuits. I can see some major lawsuits playing out. With respect to NeuroTrumpet, these people don't seem to care so we have to move beyond that.

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  5. Regarding your tweets, " I pulled out all my gray hairs yesterday, started and put down at least five books in the last month," is something upsetting you, Dr. Fizzy ?
    Forgive me if I'm reading too much into it. It just seems so un- Fizzy like.
    - Paul

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  6. Wait a second. Some of these anti-vax folks are having measles "parties" for their kids. Correct? So, they want their child to be protected against measles too. However, they're opting for the "natural" way versus that "terrible" man made vaccine. However, that "terrible" man made vaccine is an attenuated/dead virus
    version which would be less taxing on their child's immune system than the "natural" way. So, what could be their objection? Oh, multiple vaccines given
    simultaneously would overwhelm their child's immune system! Okay, so, we'll "step
    down" and alter the schedule for those with concerns. By doing so, we demonstrate that we're not the "Big Bad Wolf" and their argument falls apart on its
    own. Naturally, they'll always be those who refuse vaccination, regardless. However,
    by taking this approach, it is more likely that those folks who will not comply will
    be marginalized to the fringes.
    -Paul


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  7. The standard vaccine schedule is only standard in this country - not the country with the best pediatric health by the way. In many countries with much better overall health, the schedule is very different with far fewer vaccines and starting much older. I think it's a slippery slope to mandate. My kiddo is healthy, if they get the flu they'll be fine. It worked less than 18% this year. Should that vaccine be mandated? What about the aluminum in the vaccines - they really haven't looked at this. I'm not antivaccine by any means, but I do think that the current schedule is flawed and I do believe that not all children need all the possible vaccines. Rarely do my parents choose to do no vaccines, but I have a number who do choose to do fewer vaccines and who choose to start when their child is older. These aren't evil people who want their children to suffer. Many of my patients have read more of the medical literature on vaccines than I have. If anything, that's the issue. The side-effect profile can be so scary- AND THEY READ THEM, that it seems hard to risk those side effects when their children are healthy.

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  8. My son's pediatrician is one of those who will not accept patients unless their parents are on board with vaccinations. She said that her main concern is for that of newborns who are not yet ready to be vaccinated. She is not willing to risk those little ones contracting something in the waiting room because of some ill-informed parent. The risk is just too great.

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