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http://shine.yahoo.com/channel/parenting/pediatricians-turn-away-kids-who-arent-vaccinated-2509592

When an investigation proved early this year that research linking autism and vaccines was fraudulent, it seemed the debate over when or whether to immunize children might quiet down. But new voices have piped up in the vaccine controversy, and this time, they belong to pediatricians.

While most parents do choose to vaccinate their children on schedule with their doctors' recommendations, the trend of delaying or opting out of scheduled shots worries many pediatricians. And some www.chicagotribune.com/health/ct-x-0706-vaccine-refusal-20110706,0,1447486.story">pediatric practices are responding by requiring patients to get immunized on schedule or to find another doctor -- no shots, no service.

Why would a pediatric practice show anti-vaccine families to the door? Dr. Scott J. Goldstein of the www.sweetbabies.com/">Northwestern Children's Practice in Chicago, where a vaccine policy was implemented June 1, said they do it to protect children and to provide better care for all the patients he and the seven other staff pediatricians see.

Pointing to a strong scientific record supporting vaccinations, Goldstein said his practice's policy serves the most vulnerable children -- like infants and those with critical illnesses who are not able to be immunized  -- by protecting them from diseases. All of those children could be in the waiting room together, some pediatricians note, and the unvaccinated ones could be putting the more vulnerable ones at risk.

"Vaccines are safe and have been studied for a long time and continue to be studied," Dr. Goldstein told Shine. "Vaccines are responsible for saving millions of lives and keeping millions of other children safe and healthy."

Vaccinating most children contributes to "herd immunity," which helps kids who are too ill to be on the recommended schedule and lowers the overall risk of disease outbreaks.

"It is a minority of our patients who opt to go off the schedule recommended by the www.aap.org/">American Academy of Pediatrics and www.cdc.gov/">CDC (Centers for Disease Control) or not have vaccines at all," Dr. Goldstein said. "This makes it very complicated for our staff to follow. We don't just ask those families to leave. We give them every opportunity to ask questions, to schedule vaccines, to work with us."

Some parents may not feel the need to put the brakes on vaccines, but do want to compromise by slowing the schedule. Dr. Goldstein said this also poses a danger.

"Vaccines are scheduled to be given at the time when children are most vulnerable to that disease. Slowing down the process only puts the child at a higher risk of contracting the illness," Dr. Goldstein said.

The main fear of vaccinating children, he said, is that kids will contract autism, even though www.healthychildren.org/English/news/pages/Thimerosal-in-Vaccines-Not-Linked-to-Autism.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token">research has put to rest those concerns. Other parents are simply afraid that their child will be exposed to too many things early on in their life. Dr. Goldstein said it will take better communication with parents to change the fear-based mindset against vaccinations.

So far, Dr. Goldstein's practice has mostly heard positive reactions from parents about the new vaccine policy.

"They are happy we are taking a stand," he said.

This stand might seem harsh but the wording and the strictness varies among pediatricians. www.wmpeds.com/policies/vaccine-policy.cfm">One Massachusetts-based practice puts it bluntly in the policy that takes up a full page of their website: "Parents who refuse to vaccinate their children are not a good fit for our practice and will be referred elsewhere."

The policy goes on to offer parents who "insist on diverging from the recommended vaccine schedule" a waiver taking responsibility for any risks that result from delaying or opting out of vaccines and offers research, literature, and further conversation to parents on this "worrisome subject."  They also thank parents for entrusting the practice with the care of their children, but the pro-vaccination message is clear.

www.fourseasonspediatrics.com/four-seasons-pediatrics-vaccine-policy/">A pediatric practice in New York takes a gentler, storytelling approach to explaining the historic debate and reasoning around vaccinating, but makes its position very clear (in bolded print on its website): "If, despite our recommendations, you feel you cannot follow the CDC and AAP recommendations for these vaccines, we will ask you to find another health care provider who shares your views."

The AAP warns that vaccination policies may undermine children's access to health care, stating: "Families with doubts about immunization should still have access to good medical care, and maintaining the relationship in the face of disagreement conveys respect and at the same time allows the child access to medical care. Furthermore, a continuing relationship allows additional opportunity to discuss the issue of immunization over time."

Although instituting a policy has been working well for Dr. Goldstein's practice, he said he hopes that refusing to see unvaccinated children does not become a trend nationwide.

"I know the AAP has cautioned against these policies. If I was the only doctor around, I certainly wouldn't want to throw these families to the wind. In our case, in a neighborhood and city with many pediatricians and options for families, we are choosing to protect kids' health," Goldstein said. "We are not making them sick. We are not forcing them. We are not neglecting them."

Re: wdwwt?

  • GBCKGBCK member
    Knottie Warrior 5000 Comments 500 Love Its Name Dropper
    edited December 2011
    I think the reasons I've been reding of "oh, well, they're a risk for our other patients' is rather unfounded fear-mongering.

    But in areas where there's no doctor shortage, I think docs  can fire patients, just like patients can fire doctors.

    Although, big picture, I'm sure this just forces these people into the arms of quacks who will never challenge or educate them.
  • *Barbie**Barbie* member
    Knottie Warrior 5000 Comments 500 Love Its Name Dropper
    edited December 2011
    i say good for the doctors.

    one requirement we had when looking at daycares was that all kids must be vaccinated. Our daycare requires a shot record from the pedi within the first week, or the kid is not allowed to return until this can be provided.
  • DG1DG1 member
    Ninth Anniversary 5000 Comments 25 Love Its Name Dropper
    edited December 2011

    I'm not sure the waiting room argument is the best one. If you specialize in seriously immunocompromised kids, then sure. But if you're treating generally healthy kids for rashes and ear infections and general well-kid checkups? No.

    Our pedi probably doesn't agree with our using the alternate schedule, but I think they're just grateful that we're vaccinating at all. I really appreciate not hearing a bunch of sht about it when we go in.

    But in general, no, I don't think doctors firing patients is a horrible thing, especially in places where there are lots of options.

    image
  • nicoleg1982nicoleg1982 member
    5000 Comments
    edited December 2011
    In Response to Re: wdwwt?:
    [QUOTE]i say good for the doctors. one requirement we had when looking at daycares was that all kids must be vaccinated. Our daycare requires a shot record from the pedi within the first week, or the kid is not allowed to return until this can be provided.
    Posted by *Barbie*[/QUOTE]

    That's a state law here.  Is TX not requiring the same?
    image image
  • hmonkeyhmonkey member
    Ninth Anniversary 10000 Comments 500 Love Its Name Dropper
    edited December 2011
    there are more than four pediatricians in the world.

    this is right up there with the whole brouhaha over the restaurant that doesn't allow kids under 6.  fine by me -- i can eat there without my kid, or i can eat anywhere else in the whole wide world.
    image
  • hmonkeyhmonkey member
    Ninth Anniversary 10000 Comments 500 Love Its Name Dropper
    edited December 2011
    in a lot of states, you can get a religious exemption from vaccines.  effin' amish and jhs!
    image
  • thatgrrrrlthatgrrrrl member
    1000 Comments
    edited December 2011
    Our Ped won't have unvaccinated kids in her office. I'm a-ok with that.

    Unfortunately, daycare can't blanket statement say "no vax no service" due to religious situations and the like. BUT in 180 kids at the center, there might be 2 who aren't vaccinated. I wish it would be law that they can't have unvaccinated kids in the center, but it's not the case here.
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  • mrsconn23mrsconn23 member
    Knottie Warrior 10000 Comments 500 Love Its First Answer
    edited December 2011
    In Response to Re: wdwwt?:
    [QUOTE]In Response to Re: wdwwt? : That's a state law here.  Is TX not requiring the same?
    Posted by nicoleg1982[/QUOTE]

    It's state law here, but there is a loophole for people who don't vaccinate for religious or health reasons.
  • GBCKGBCK member
    Knottie Warrior 5000 Comments 500 Love Its Name Dropper
    edited December 2011
    the requirements to get an 'exemption' are ludicrous, IMO.

    'just sign here saying you don't like it' isn't really an exemption, no?

    Although, I do actually see a difference between "look, there's some evidence that the chicken-pox shot isn't as effective agaisnt preventing future outbreaks and/or shingles, I'd like the kid to actually GET the disease" and "ZOMGS, you want him not to get POLIO?  how dare you!"
  • *Barbie**Barbie* member
    Knottie Warrior 5000 Comments 500 Love Its Name Dropper
    edited December 2011
    In Response to Re: wdwwt?:
    [QUOTE]In Response to Re: wdwwt? : That's a state law here.  Is TX not requiring the same?
    Posted by nicoleg1982[/QU

    i'm guessing it isn't. a few of the places we asked said that they would allow un vaccinated kids provided there was a dr. note saying the kid was healthy.

    (cause that's really helpful - sure they're "healthy"  - until they're not. that's called getting sick.)
  • zsazsa-stlzsazsa-stl member
    Eighth Anniversary 5000 Comments 100 Love Its First Answer
    edited December 2011

    Fire a patient that goes against basic medical advice?  I see no problems with this.  I would think that anti-vaccination parents would want to find a doctor that was okay with their decision anyway.

    image

    I just a friendly gal looking for options.

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