RT Journal Article
SR Electronic
T1 Characteristics of Physicians Who Dismiss Families for Refusing Vaccines
JF Pediatrics
JO Pediatrics
FD American Academy of Pediatrics
SP 1103
OP 1111
DO 10.1542/peds.2015-2086
VO 136
IS 6
A1 O’Leary, Sean T.
A1 Allison, Mandy A.
A1 Fisher, Allison
A1 Crane, Lori
A1 Beaty, Brenda
A1 Hurley, Laura
A1 Brtnikova, Michaela
A1 Jimenez-Zambrano, Andrea
A1 Stokley, Shannon
A1 Kempe, Allison
YR 2015
UL http://pediatrics.aappublications.org/content/136/6/1103.abstract
AB BACKGROUND AND OBJECTIVES: Physicians dismissing families who refuse vaccines from their practices is controversial. We assessed the following among pediatricians (Peds) and family physicians (FPs): (1) reported prevalence of parental refusal of 1 or more vaccines in the infant series; (2) physician response to refusal; and (3) the association between often/always dismissing families and provider/practice characteristics and state exemption laws.METHODS: Nationally representative survey conducted June to October 2012. A multivariable analysis assessed association of often/always dismissing families with physician/practice characteristics, state philosophical exemption policy, and degree of difficulty obtaining nonmedical exemptions.RESULTS: The response rate was 66% (534/815). Overall, 83% of physicians reported that in a typical month, ≥1% of parents refused 1 or more infant vaccines, and 20% reported that >5% of parents refused. Fifty-one percent reported always/often requiring parents to sign a form if they refused (Peds 64%, FP 29%, P < .0001); 21% of Peds and 4% of FPs reported always/often dismissing families if they refused ≥1 vaccine. Peds only were further analyzed because few FPs dismissed families. Peds who dismissed families were more likely to be in private practice (adjusted odds ratio [aOR] 4.90, 95% confidence interval [CI] 1.40–17.19), from the South (aOR 4.07, 95% CI 1.08–15.31), and reside in a state without a philosophical exemption law (aOR 3.70, 95% CI 1.74–7.85).CONCLUSIONS: Almost all physicians encounter parents who refuse infant vaccines. One-fifth of Peds report dismissing families who refuse, but there is substantial variation in this practice. Given the frequency of dismissal, the impact of this practice on vaccine refusers and on pediatric practices should be studied.