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 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 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 American Academy of Pediatrics and 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 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. 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.
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."
Do you agree with a pediatric policy to refuse care to kids who aren't vaccinated?
More on Shine:
- 8 celebs who take sides in the vaccine debate
- A look back at the history of the autism-vaccine link
- Japan's problem with vaccines
- Mom confession: "3 reasons I won't vaccinate my children"