Catherine Hough-Telford1, David W Kimberlin2, Inmaculada Aban1, William P Hitchcock3, Jon Almquist4, Richard Kratz5, Karen G O'Connor6. 1. University of Alabama, Birmingham, Alabama; 2. University of Alabama, Birmingham, Alabama; dkimberlin@peds.uab.edu. 3. Rady Children's Hospital, San Diego, California; 4. University of Washington, Seattle, Washington; 5. Pennridge Pediatric Associates, Sellersville, Pennsylvania; and. 6. Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois.
Abstract
BACKGROUND: Parental noncompliance with the American Academy of Pediatrics and Centers for Disease Control and Prevention immunization schedule is an increasing public health concern. We examined the frequency of requests for vaccine delays and refusals and the impact on US pediatricians' behavior. METHODS: Using national American Academy of Pediatrics Periodic Surveys from 2006 and 2013, we describe pediatrician perceptions of prevalence of (1) vaccine refusals and delays, (2) parental reasons for refusals and/or delays, and (3) physician dismissals. Questions about vaccine delays were asked only in 2013. We examined the frequency, reasons for, and management of both vaccine refusals and delays by using bivariate and multivariable analyses, which were controlled for practice characteristics, demographics, and survey year. RESULTS: The proportion of pediatricians reporting parental vaccine refusals increased from 74.5% in 2006 to 87.0% in 2013 (P < .001). Pediatricians perceive that parents are increasingly refusing vaccinations because parents believe they are unnecessary (63.4% in 2006 vs 73.1% in 2013; P = .002). A total of 75.0% of pediatricians reported that parents delay vaccines because of concern about discomfort, and 72.5% indicated that they delay because of concern for immune system burden. In 2006, 6.1% of pediatricians reported "always" dismissing patients for continued vaccine refusal, and by 2013 that percentage increased to 11.7% (P = .004). CONCLUSIONS: Pediatricians reported increased vaccine refusal between 2006 and 2013. They perceive that vaccine-refusing parents increasingly believe that immunizations are unnecessary. Pediatricians continue to provide vaccine education but are also dismissing patients at higher rates.
BACKGROUND: Parental noncompliance with the American Academy of Pediatrics and Centers for Disease Control and Prevention immunization schedule is an increasing public health concern. We examined the frequency of requests for vaccine delays and refusals and the impact on US pediatricians' behavior. METHODS: Using national American Academy of Pediatrics Periodic Surveys from 2006 and 2013, we describe pediatrician perceptions of prevalence of (1) vaccine refusals and delays, (2) parental reasons for refusals and/or delays, and (3) physician dismissals. Questions about vaccine delays were asked only in 2013. We examined the frequency, reasons for, and management of both vaccine refusals and delays by using bivariate and multivariable analyses, which were controlled for practice characteristics, demographics, and survey year. RESULTS: The proportion of pediatricians reporting parental vaccine refusals increased from 74.5% in 2006 to 87.0% in 2013 (P < .001). Pediatricians perceive that parents are increasingly refusing vaccinations because parents believe they are unnecessary (63.4% in 2006 vs 73.1% in 2013; P = .002). A total of 75.0% of pediatricians reported that parents delay vaccines because of concern about discomfort, and 72.5% indicated that they delay because of concern for immune system burden. In 2006, 6.1% of pediatricians reported "always" dismissing patients for continued vaccine refusal, and by 2013 that percentage increased to 11.7% (P = .004). CONCLUSIONS: Pediatricians reported increased vaccine refusal between 2006 and 2013. They perceive that vaccine-refusing parents increasingly believe that immunizations are unnecessary. Pediatricians continue to provide vaccine education but are also dismissing patients at higher rates.
Authors: Leila C Sahni; Julie A Boom; Sarah S Mire; Leandra N Berry; Lauren R Dowell; Charles G Minard; Rachel M Cunningham; Robin P Goin-Kochel Journal: Child Health Care Date: 2020-03-17
Authors: Stacey R Finkelstein; Wendy Attaya Boland; Beth Vallen; Paul M Connell; Gary D Sherman; Kristen A Feemster Journal: Hum Vaccin Immunother Date: 2019-12-12 Impact factor: 3.452
Authors: Laura A Shay; Austin S Baldwin; Andrea C Betts; Emily G Marks; Robin T Higashi; Richard L Street; Donna Persaud; Jasmin A Tiro Journal: Pediatrics Date: 2018-05-15 Impact factor: 7.124