How do you approach parents who refuse pediatric vaccines?

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I'm an FNP student doing my peds clinicals now. I'm amazed at the number of parents who casually refuse vaccines that could make a huge difference in their children's lives. HPV is one; flu is another. There seems to be a baseline suspicion about vaccines that make some parents not think twice about saying no. I find that refusing does not follow any social pattern; I see it in both younger and older patents, wealthy and underserved, well-and less educated. One exception seems to be immigrants. I find that those parents are less likely to refuse, possibly because, in some cases, they actually see the ravages of the diseases that we try to immunize against. This is completely an anecdotal finding on my part.

Do you support patents who refuse to immunize? Challenge them? Educate them?

We had a well known pediatrics group that would discharge the patient/family from the practice. In their intake material that the parents signed it was stated up front that the parents would comply with recommended vaccines unless their was a medical exception.

That seems excessive! I'm all for vaccines but they do carry real, albeit rare, risks. It's up to parents to make an informed decision and providers to ensure parents are properly informed but not to coerce compliance. What next, cardiologists discharging pts who don't want invasive procedures?

Signing away one's autonomy for medical care = :no:

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That seems excessive! I'm all for vaccines but they do carry real, albeit rare, risks. It's up to parents to make an informed decision and providers to ensure parents are properly informed but not to coerce compliance. What next, cardiologists discharging pts who don't want invasive procedures?

Signing away one's autonomy for medical care = :no:

Worse than losing herd immunity based off of something moms read on some random blog site? C'mon no contest, the benefits outweigh the risk, hell every med we give from motrin to epi has deadly risk. Moot argument.

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My only issue came with a mom with barely a high school education (but apparently an MS in Google!) who declined all vaccines. I am never confrontational and do all the things suggested here. But do not come into our office smack dab during a pertussis outbreak and then in the middle of flu season and allow your unvaccinated 18 month old to walk around barefoot and in general crawl/climb/play over every inch of my exam room! I won't allow it! NASTY.

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Specializes in General.
My only issue came with a mom with barely a high school education (but apparently an MS in Google!) who declined all vaccines. I am never confrontational and do all the things suggested here. But do not come into our office smack dab during a pertussis outbreak and then in the middle of flu season and allow your unvaccinated 18 month old to walk around barefoot and in general crawl/climb/play over every inch of my exam room! I won't allow it! NASTY.

20 years ago my husband had a bone marrow transplant and they had to delay his immunizations, he had family members who wanted to visit with all 9 unvaccinated children we asked that they not visit and gave them our reason, well talk about starting the family feud to end all. We were told we were being unreasonable and how unfair it was too keep cousins apart . That was my WTH moment. Haven't heard from them since . They also told us well can't he just wear a mask .

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I wish I could tell Jenny McCarthy to close her pie hole!! Her circuit on talk shows seemed to start such a big no vax movement

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I wish I could tell Jenny McCarthy to close her pie hole!! Her circuit on talk shows seemed to start such a big no vax movement

Pretty much, there are only a few vaccines with very very low mercury content and even those can be substituted for non mercury if someone is that anal. Yay pseudo blog science....

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Worse than losing herd immunity based off of something moms read on some random blog site? C'mon no contest, the benefits outweigh the risk, hell every med we give from motrin to epi has deadly risk. Moot argument.

Yes every single med carries a risk which is precisely why, aside from very narrow circumstances, individuals have the right to decline. It's a huge Orwellian jump to go from choosing to assume the risk vs. having risk forced on you.

And if parents are declining vaccines just because of some blog they read, their healthcare provider is woefully negligent for not educating/inquiring about reasons for refusal.

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Specializes in Adult Internal Medicine.
Yes every single med carries a risk which is precisely why aside from very narrow circumstances, individuals have the right to decline [/quote']

Absolutely. I give my patients the data, urge them to follow it, and if they refuse I understand their personal choice.

Remember it is also the provider's choice to continue to provide that individual with care; I wouldn't hesitate to assist a patient in transferring care to another provider who shares their views and is better able to care for them.

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Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
Absolutely. I give my patients the data urge them to follow it, and if they refuse I understand their personal choice. Remember it is also the provider's choice to continue to provide that individual with care; I wouldn't hesitate to assist a patient in transferring care to another provider who shares their views and is better able to care for them.[/quote']

The problem is many providers are telling their patients "vaccinate or get out". I think it's wonderful so many have said they educate and work with the patient and continue to offer care. If you force the patient out...they actually may not have someplace to get care.

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Specializes in Adult Internal Medicine.
The problem is many providers are telling their patients "vaccinate or get out". I think it's wonderful so many have said they educate and work with the patient and continue to offer care. If you force the patient out...they actually may not have someplace to get care.

The vast majority of providers will assist in the transition of care; my office assists and gives 30 days of continued care after dismissal.

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Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
The vast majority of providers will assist in the transition of care; my office assists and gives 30 days of continued care after dismissal.

Not around here...they tell you to pack your bags and leave. Simple.

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Specializes in Adult Internal Medicine.
Not around here...they tell you to pack your bags and leave. Simple.

For right or wrong that is the provider's prerogative. I have only abruptly cut ties twice; once was a patient that forged a script and another was a failed drug test narcotic user that got nasty with my staff.

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