We know vaccines work, but many parents apparently don’t agree. A growing proportion of pediatricians (up to 87% in 2013, according to this study by Hough-Telford and colleagues) report facing vaccine-refusing parents who do not think vaccines are necessary. Approximately three-quarters of pediatricians believe parents delay vaccines because of the anticipated discomfort their child would experience or concerns that so many vaccines will overwhelm their infant’s immune system.
Therefore, we explain, extol, and emphasize the real value of vaccines every day in clinical practice. But here’s the conundrum. Hough-Telford and colleagues also documented that the proportion of pediatricians who always dismiss vaccine-refusing families nearly doubled from 6.1% in 2006 to 11.7% in 2013. Parental concerns can range from being hesitant about certain vaccines to outright refusal of all vaccines. With the internet making information ubiquitous for everyone, more research is needed to clarify the evolving reasons families are hesitant about or even refuse all vaccines in order to develop effective, targeted educational strategies to promote vaccination.
So what if our efforts to educate, encourage, and cajole parents to accept vaccines for their children fail? Do we accept the family’s decision and keep providing care to that family whose child remains unimmunized OR do we ask the family to seek medical care with another provider who is more in line with their personal philosophies? Each pediatric practice can decide what feels right and fits best for its local community, but in my opinion, there first must always be open communication and ongoing conversations with families before making a decision in either direction. More research needs to be done to develop and test different methods of communication and relationship-building that may help pediatricians convince parents of the safety and efficacy of vaccines, as well as their role and responsibility in the health of not only their own child, but also of other children in the practice, in their communities, and throughout the nation. As pediatricians, we owe it to children, whose lives are at stake.
Henry (Hank) Bernstein, DO, MHCM, FAAP
September 15, 2016