1. A total of 83% of physicians reported encountering parents who refuse vaccines for their child, 14% stated that they would discontinue care for these patients.
2. Pediatricians who were in private practice, lived in the South region of the United States, or lived in a state who did not allow philosophical exemptions for vaccines were more likely to discontinue providing care to families who refused vaccines.
Study Rundown: Parental refusal to vaccinate children remains a continuing issue and has contributed to recent recurrences of vaccine-preventable diseases, including measles. Some pediatricians (Peds) and family physicians (FPs) have begun to discontinue care for families who have adopted this practice. In the current study, researchers sought to examine the prevalence of vaccine refusal, the physician response to refusal, and the association between family dismissal and provider characteristics as well as state exemption laws. The majority of physicians stated that they encounter parents who refuse vaccines, and 1 in 5 Peds reported refusing care for these families. Peds who discontinued care to vaccine-refusing families were more likely to be in private practice, live in a state that doesn’t allow philosophical exemptions, and to be live in the South region of the United States. This study may be limited as data was not based upon actual observed practices. However, the results of this study should encourage providers to explore the consequences of dismissing families.
In-Depth [cross-sectional study]: A total of 282 Peds and 252 FPs were included for analysis. A survey assessing physician practices in response to vaccine refusal was created collaboratively with the Centers for Disease Control (CDC). Physicians from all regions of the country, practice locations (urban, suburban, or rural), and type of practices (private, managed care, or hospital/university/community health center) were included. Peds from states not allowing philosophical exemptions reported more frequently that no parents refused vaccines in a typical month (17% vs. 8%, p =.03). A total of 83% of physicians encountered parents each month who refuse vaccines, and 14% stated that they often or always dismiss these families (21% [Peds] vs. 4% [FPs], p < .0001). In states where philosophical exemptions are not allowed, 34% of Peds reported dismissing families compared to 9% in states where this is allowed (p < .0001). After multivariate analysis, Peds in private practice (aOR 4.90, 95%CI 1.40-17.19), the absence of a philosophical exemption policy (aOR 3.70, 95%CI 1.74-7.85), and the South region (aOR 4.07, 95%CI 1.08-15.31) were associated with physicians dismissing families.
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