Should doctors refuse to treat families who won't vaccinate or encourage through education?
SALT LAKE CITY — Some pediatricians across the county are drawing a line in the sand when it comes to following the schedule of vaccines recommended by the Centers for Disease Control and the American Academy of Pediatrics: No shots, no service.
One pediatric practice in Westfield, Mass., tells parents on its website: "Parents who refuse to vaccinate their children are not a good fit for our practice and will be referred elsewhere."
Others politely encourage parents to follow vaccination recommendations. But a website of a pediatric practice in New York goes on to say "if you cannot follow the CDC and AAP recommendations for these vaccines, we will ask you to find another provider who shares your views."
Salt Lake pediatrician Dr. Thomas Metcalf is strong proponent of childhood immunizations. But he also believes policies that exclude children from a pediatric practice because they have not been immunized will eliminate opportunities for building trust with parents and educating them about the safety and benefits of childhood vaccines.
Metcalf recalled one not-so-routine patient visit that involved two polygamist wives and their eight children. One of the children had symptoms of whooping cough. As it turned out, three of the children had contracted the disease, which is a highly contagious infection of the respiratory tract. Whooping cough can be prevented with the pertussis vaccine, which is often given in combination with diphtheria and tetanus vaccines.
"We crowded into our biggest exam room and it was still too small," said Metcalf. "It took an hour and a half to see and treat all them."
As he drove home that night, Metcalf grumbled to himself, "I'm not going to see these people unless they start immunizing their kids."
But Metcalf soon had a change of heart. "This is job one, seeing and taking care of kids. You're there to treat kids and work with the different societies and cultures the best you can," Metcalf said.
West Jordan pediatrician Dr. Keith Ramsey said he, too, attempts to educate parents about the safety and effectiveness of childhood vaccines. Despite scare tactics of opponents, credible medical studies have consistently upheld the safety of vaccines and the benefits of developing "herd immunity" against childhood diseases.
"Vaccines are good. We've seen a dramatic drop in every disease I can think of after we started a vaccine program for that disease," Ramsey said.
At least one pediatrician along the Wasatch Front has asked parents who refuse to immunize their children to sign a waiver releasing the pediatric practice from liability.
Ramsey says parents who refuse to immunize their children are few. "If someone flat out refuses, we try to work with them and work with their concerns and try to get them to vaccinate and discuss the benefits of vaccinations."
Despite an investigation that proved that research linking autism to vaccines was fraudulent, the debate over childhood vaccines is ongoing.
Metcalf advises patients to trust the science and the training and experience of their health care providers.
"Most people are not as knowledgeable as their doctors. They usually end up telling me 'OK, Metcalf. If you say it's OK, it's OK.'"
But that sort of trust must be cultivated over time. Policies that exclude patients because of issues of choice, bad information or ignorance can put children at risk.
"A kid could show up with an issue that a doctor might pick up but a parent might miss. What you do (with strict immunization policies) is shut the door on all the issues that might come up. That's not what we bought into when we got into this," he said.
"To shut the door because of one factor, no matter how egregious you think it might be, is regrettable."
Contributing: Mary Richards
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