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Vaccine Hesitancy and New AAP Policy

Posted By Wesley S. St Clair, Tuesday, September 6, 2016

Dr. St. Clair is a pediatrician who practices in Boone at Blue Ridge Pediatrics and Adolescent Medicine.  He also currently serves as President of the North Carolina Pediatric Society.


“Doc, we have heard some scary things about these vaccines.  Do you really think we should do this?”  While most patients in my practice want to know and follow the recommended schedule from the CDC and AAP, there are a small number of parents like the one described here who are vaccine hesitant.  My experience with this group is actually quite positive.  The point and tone of the question is seeking out expert advice from someone they trust.  Usually, with good information and assurance, the vast majority of these conversations lead to parents choosing to give the recommended vaccines to their children.

“I don’t believe in vaccines.  Why should we do this to our child?”  This question is an entirely different conversation.  These parents are usually very distrustful of the medical field in general.  They typically do not want or are not receptive to physician advice specifically around vaccines.  It usually does not matter what information I provide or how many conversations that I have - these parents do not want to give recommended vaccines.

Because of this, our practice instituted a new vaccine policy in January of 2015.  We require some core vaccines in order to stay in our practice.  We did this to improve the health of our patients but also the health of the overall community.  We also must be concerned with the medico-legal risks that are associated with offering phone advice for sick patients that are unvaccinated.  But, more broadly, we feel that vaccines are one of our core functions as pediatricians.  If medical providers and families are not able to trust each other on this vital issue, it becomes extremely difficult to form a healthy, functioning relationship to provide quality pediatric care.

Because of our vaccine policy, most vaccine hesitant parents have chosen to give these required vaccines to their children.  For those who are adamant about not receiving vaccines, we have had to dismiss them from our practice.  A new AAP clinical report about vaccine hesitancy addresses this issue.  Specifically, it says that dismissal of families who refuse vaccinations is an acceptable option for pediatricians.

Immunizations remain at the core of pediatrician’s efforts to provide high quality, evidence based health care that aims to prevent disease and save healthcare dollars at the same time.  While each practice must make their own decision about their vaccine policy, the AAP and the NC Pediatric Society remain supportive of all their members regardless of whether they choose to dismiss families who refuse to vaccinate or to continue seeing families who remain unvaccinated.

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