Pediatricians aren’t kicking out anti-vaxxers. Here’s why.
A few weeks back, the mother of a two-month-old was tearful on arrival to my clinic. Her baby, a sweet little boy with a severe milk protein allergy, was finally doing great. His severe GERD was better, and he was gaining weight like a champ. So what was upsetting this young mother?
“It’s shot day. I don’t want to give him everything.” She went on to explain why and her fears, and we settled on what we would do that day. After a while, now calm, she said, “I thought you would ask me to leave your clinic if I didn’t do all the shots at once.”
With the frightening spread of measles in the US very much in the news, people are talking about vaccines in a way they haven’t before. Beyond the debate of to vaccinate or not, people are realizing that doctors can dismiss them from clinics if they do not vaccinate. My patient’s fears of being turned away drove home the point that people can be fearful of dismissal. While this is a very complicated topic, let me explain how this generally works.
Pediatricians who choose not to treat families who do not believe in vaccines post this policy clearly in their office, on their website, and in new patient documents. So it is usually pretty obvious before you even set foot in the office if you are not a good vaccine doctor-patient match. Prenatal visits are also a good time to inquire about vaccine policies. The number of pediatricians who outright refuse to see patients who are not vaccinated is actually quite small. They have many reasons for their choice and will point you toward another doctor who might be a better fit.
The great majority of pediatricians would like to see your child vaccinated according to the CDC 2015 Immunization Schedule. That means all vaccinations on time and at once when more than one shot is indicated. Nevertheless, the American Academy of Pediatrics does NOT recommend we dismiss a family for failing to follow the guidelines unless “a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists.” In those cases, we are encouraged to help the family find another source of care. They will, however, address vaccination at each and every visit with the goal that sooner rather than later your child is up to date with all recommended immunizations.
So no, I will not be dismissing this family. For starters, as an office we have developed a vaccine policy that accepts the few families in their position. In addition, we have a good relationship, and the doctor-patient trust is there. I listen to their concerns and in turn they listen to mine. We will get this infant vaccinated together if not according to my perfect schedule, then according to the one that makes this family feel safe. It’s not my ideal, but it works for them and therefore it works for me.