Does Immunization Refusal Warrant Discontinuing a Physician-Patient Relationship?

Pediatricians' Experience with and Response to Parental Vaccine Safety Concerns and Vaccine Refusals: A Survey of Connecticut Pediatricians

“…In Hendricks' editorial about the article by Flanagan-Klygis et al, 19 he takes issue with the authors for assuming that parental vaccine refusals negatively affect the physician-parent relationship. 23 The findings from the current study support Flanagan-Klygis and colleagues' assumption that parental vaccine refusals are viewed negatively by pediatricians. 19 Physicians who report a negative impact are significantly more likely to self-report working in suburban, solo/group practices with families from higher physician-estimated SES, and to care for larger numbers of families with vaccine concerns and/ or refusals.…”

Qualitative Analysis of Mothers' Decision-Making About Vaccines for Infants: The Importance of Trust

“…Many of these suggestions have also been proposed by other authors, including the recent statement from the American Academy of Pediatrics Committee on Bioethics. 10,37,[49][50][51][52] The question remains unanswered as to how busy pediatric providers can have time to follow these suggestions. It is possible that new Current Procedural Terminology codes for counseling about vaccination are a small step toward facilitating these efforts.…”

Characteristics of Physicians Who Dismiss Families for Refusing Vaccines

“…Dismissing families from a practice for refusing vaccines is controversial. 21,23–27,39 In 2005, the AAP published a guideline stating that “pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child.” 13 This guideline was reaffirmed in 2009 40 and 2013, 41 with a slight change in wording in 2013, perhaps reflecting some of the controversy surrounding this practice among Peds (“…should endeavor not to discharge patients…” replaced “… should avoid discharging patients…”). We are aware of 2 previous national surveys assessing the practice of dismissing families.…”

“…12,13 The practice of dismissing families has also come under media scrutiny recently, 14–19 primarily because of a high-profile measles outbreak that started at an amusement park in California. 20 Although many have argued against dismissal on ethical and practical grounds, 21–27 dismissing families appears to be relatively common; a study from 2002 reported that 39% of Peds would dismiss families for refusing all vaccines. 28…”