One in five pediatricians dismiss families for refusing vaccines, study shows

Sean O'Leary, MD, MPH, associate professor of pediatrics, and his colleagues surveyed more than 800 physicians across the country and found 21 percent of the responding pediatricians dismissed families from their practice when the families refused vaccines.

"Even though the American Academy of Pediatrics discourages providers from dismissing families, some providers continue to do so," O'Leary said. "Instead of dismissing families, we need a better understanding of the reasons for vaccine refusal to find evidence-based strategies for communication that are effective at convincing hesitant parents to vaccinate."

The survey was designed to assess characteristics of physicians who dismiss families who refuse to vaccinate and to examine factors that contribute to the likelihood of dismissal.

"Pediatricians who dismiss families for vaccine refusal are more likely to practice in a private setting, to be from the South, and to be in states without philosophical exemption laws and/or without more difficult exemption policies," O'Leary and his colleagues wrote in the article.

In states that allow families to opt out of vaccinations for philosophical reasons, physicians were less likely to dismiss those families choosing not to vaccinate, but O'Leary said it's unclear whether that's a cause of the lower rates of dismissal.

"It may be that in states that allow philosophical exemptions, physicians perceive vaccine refusal as more societally acceptable because of the exemption law and therefore are less likely to dismiss families from their practice," they wrote. "Alternatively, attitudes in these states may be driving policy, and therefore because vaccine refusal is more of a social norm, dismissing families is less acceptable for physicians."

O'Leary and his colleagues note that recent outbreaks of vaccine-preventable diseases, such as measles and mumps, show that even small proportions of parents refusing vaccines can have major consequences.

"States that have a philosophical exemption law and an easy exemption process have lower vaccination rates and higher rates of vaccine-preventable diseases," they wrote.