Study: Many Doctors Grant Requests To Delay Childhood Vaccinations
A majority of primary care physicians allow parents to delay immunizations for their children, even though doctors feel it could put children at risk of contracting measles, whooping cough and other infectious diseases, according to a study published on Monday in Pediatrics, the New York Times reports.
The study consisted of responses from more than 530 physicians about how often their patients' parents asked them to postpone vaccinations for infants under age two. CDC recommends that children be inoculated for 14 diseases before age six; doing so includes about 29 shots.
According to the survey, 93% of physicians say that in any given month, they are asked at least one time to delay vaccinating a child. Twenty-one percent said that more than 10% of the parents in their practices have asked for a delay.
In turn, 37% of such physicians say they give in to such requests "often" or "always," and another one-third said they acquiesced "sometimes."
In addition, doctors are spending more time than ever talking about vaccinations with their patients -- sometimes up to 10 to 14 minutes of an appointment, edging out discussions about children's sleep needs or toilet training.
Experts say physicians are more often allowing parents to dictate their children's care in order to avoid losing patients. Saad Omer, an epidemiologist at Emory University, said, "Physicians recognize it's not ideal, but they're saying, 'Let's continue this relationship' to the family." While Omer said he did not believe in altering patients' vaccination schedules, he understood why physicians continue to see such patients.
Paul Offit, a pediatrician specializing in infectious diseases at Children's Hospital of Philadelphia, said physicians increasingly are valuing their patients as partners. He noted, "At some level, you're ceding your expertise, and you want the patient to participate and make the decision," but "you have to be willing to stand back and watch them make a bad one."
However, Offit said doctors should not compromise patient safety, noting, "It's sad that we are willing to let children walk out of our offices vulnerable to potentially fatal infections" (Saint Louis, New York Times, 3/2).
According to the AP/Philadelphia Inquirer, physicians are concerned that non- or under-vaccinated children can become ill and spread preventable diseases to others.
The survey comes amid a measles outbreak that has affected more than 150 U.S. residents.
Allison Kempe, the study's lead author and a member of the federal Centers for Disease Control and Prevention's vaccine advisory committee, said the potential problems associated with delaying vaccinations are concerning and are happening "right now with the measles outbreak" (Tanner, AP/Philadelphia Inquirer, 3/2)
Lack of Vaccination Communication Strategy Hampers Docs
Experts say a main reason physicians often allow parents to dictate their children's vaccination strategy is a lack of knowledge on how to communicative effectively to patients about vaccines.
According to the survey, physicians use a variety of ways to discuss the issue with skeptical parents. For instance, some talk about immunizing their own children, while others warn of the seriousness of potential infectious disease outbreaks that could arise without vaccination.
Kempe, who also is a pediatrician at Children's Hospital Colorado, says the idea that "vaccine education can be handled in a brief wellness visit is untenable." Instead, she says that doctors should begin having discussions about vaccines during a woman's pregnancy and pro-vaccine individuals should help "reinforce vaccination as a social norm" (New York Times, 3/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.