Characteristics of Physicians Who Dismiss Families for Refusing Vaccines

O’Leary, Sean T.; Allison, Mandy A.; Fisher, Allison; Crane, Lori A.; Beaty, Brenda; Hurley, Laura P.; Brtnikova, Michaela; Jimenez-Zambrano, Andrea; Stokley, Shannon; Kempe, Allison

doi:10.1542/peds.2015-2086

Cited by 45 publications

(37 citation statements)

References 37 publications

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“…Once parents refuse vaccines, 83% of physicians reported that they never dismiss families from their practice, which is similar to a prior study done by O’Leary and colleagues. 24 This study indicated that only about one fifth of physicians dismiss families from their practice after refusing a vaccine. A question of ethics has argued for and against letting physicians dismiss families from their practice for refusing vaccines, and our study indicated that many family physicians in Kansas are reluctant to dismiss families from their practice.…”

Section: Discussionmentioning

confidence: 89%

“…Within our study, most physicians who reported administering vaccines had experienced a vaccine refusal at some point during their career, which was consistent with prior literature. 3 , 24 Nearly 45% of physicians reported an increase in the level of concern for parents refusing vaccinations and most physicians surveyed reported that there is a proportion of parents who refuse vaccinations for their children.…”

Section: Discussionmentioning

confidence: 99%

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Kansas Family Physicians Perceptions of Parental Vaccination Hesitancy

Mills

Nilsen

2020

kjm

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Introduction. In the past few decades, patients expressing the idea that vaccines are unsafe or unneeded have been experienced increasingly by physicians and other healthcare providers. Discussions with patients regarding their reasons for vaccine refusals are important, as it may provide information that can be utilized in an intervention to increase vaccination rates and combat the spread of diseases that are making a resurgence in the United States. The main objective of this study was to explore the perceptions of family physicians as to why parents in Kansas may be vaccine hesitant. Methods. An electronic survey was distributed to family physicians in the State of Kansas via the University of Kansas School of Medicine-Wichita Family Medicine Research and Data Information Office (FM RADIO). Several aspects of physician perceptions regarding patients’ vaccine hesitancy were measured in this study, including vaccines that are most often refused, reasons for refusing vaccinations, as well as what responses physicians employ when presented with vaccine concerns. Results. The majority of physicians surveyed have experienced vaccine hesitancy or refusal in their practice, and the human papillomavirus (HPV) and flu vaccines were reported to be the primary vaccines refused for children. In addition, physicians reported frequently employing various practices in response to vaccine refusals, including requiring parents to sign a form (40%) and dismissing families from their practice (1.5%). Physician perceptions on the reasons as to why parents/guardians refuse vaccinations also were measured, and the most common response was that parents possess a fear of long-term complications for their children as a result of vaccines (74%). Additionally, the three most commonly refused vaccines were HPV, influenza, and measles, mumps, and rubella. Conclusion. Physicians must not only deal with time constraints that vaccine hesitant discussions require, but also must try and implement discussions or interventions suited to the varying reasons why parents/guardians refuse vaccines to convince parents of their safety. The results suggested that vaccine refusals by parents/guardians seemed to be affecting Kansas family physicians’ clinics in more than one way. This study could be a useful tool to help physicians better understand why vaccine refusals occur and be able to combat unwarranted concerns about vaccines.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Kansas Family Physicians Perceptions of Parental Vaccination Hesitancy

Mills

Nilsen

2020

kjm

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“…Provider-led education may also face opposition from parents who feel strongly about not vaccinating their children and may backfire [ 18 ]. This requirement may place strain on the patient–provider relationship, with some providers choosing to discharge patients whose parents continue to refuse vaccination [ 22 ]. Parents seeking exemptions for their children may seek care from providers who are more willing to accommodate this choice, thereby reducing the impact of any education provided [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Immunization Mandates, Vaccination Coverage, and Exemption Rates in the United States

Shaw

Mader

Bennett

et al. 2018

Open Forum Infectious Diseases

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BackgroundVaccination coverage among children entering kindergarten in the United States is high, but interstate variations exist. The relationship between state immunization laws and vaccination coverage has not been fully assessed. We evaluated associations of state laws on both measles, mumps, and rubella (MMR) and diphtheria, tetanus, and pertussis (DTaP) vaccination coverage and exemptions to school immunization requirements.MethodsWe conducted a retrospective, longitudinal analysis of the effect of state immunization laws on vaccination coverage and exemptions among US kindergarteners from SY 2008 to SY 2014. The primary outcome measures were state-level kindergarten entry vaccination coverage rates for 2-dose MMR and 4-dose DTaP vaccines. Secondary outcome measures included rates of state-level exemptions (ie, medical, religious, philosophical) to school immunization requirements.ResultsWe found that state policies that refer to Advisory Committee on Immunization Practices recommendations were associated with 3.5% and 2.8% increases in MMR and DTaP vaccination rates. Health Department–led parental education was associated with 5.1% and 4.5% increases in vaccination rates. Permission of religious and philosophical exemptions was associated with 2.3% and 1.9% decreases in MMR and DTaP coverage, respectively, and a 1.5% increase in both total exemptions and nonmedical exemptions, respectively.ConclusionsWe found higher vaccination coverage and lower nonmedical exemption rates for MMR and DTaP vaccines in states adopting Advisory Committee on Immunization Practices guidelines for school entry. Adherence to these best practices was a successful strategy to increase vaccination coverage and reduce vaccination exemptions.

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“…I would reassure the mother that, no matter what she decided, I would continue to be their GP and, in particular, if she did go overseas to have the procedure, I would be prepared to provide care on their return. I could choose, as some US Paediatricians do in relation to vaccination [45], to refuse to care for the girl if her mother does not agree with my advice. However, my view is that building trust and maintaining a relationship is the best way to provide the best outcome for the daughter.…”

Section: Values and Traditions Of Minority Groupsmentioning

confidence: 99%

(Bio)Ethics in a Pluralistic Society

Gray

2019

Challenges

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Traditional (bio) ethics relies to a large degree on the analysis of problems to determine the right course of action. In particular, in medicine, a dominant text declares that there is a “Common Morality” that applies to all people. This paper will argue that ethics is culture bound and that, in a pluralistic society, a common morality approach to the resolution of problems has significant limitations. I will argue that more attention needs to be paid to the process of agreeing to a way forward given that there is disagreement. I will illustrate how this applies not only at the clinical level but also at the level of national and international politics. A theoretical understanding of compromise and a look at ways of describing the way people make ethical decisions as opposed to seeking an ideal ethical code is presented as a way in which we can manage problems better in a pluralistic society.

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Characteristics of Physicians Who Dismiss Families for Refusing Vaccines

Cited by 45 publications

References 37 publications

Kansas Family Physicians Perceptions of Parental Vaccination Hesitancy

Kansas Family Physicians Perceptions of Parental Vaccination Hesitancy

Immunization Mandates, Vaccination Coverage, and Exemption Rates in the United States

(Bio)Ethics in a Pluralistic Society

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