Health-care providers should explain vaccine refusal risks

May 6, 2009

Physicians and nurses need to explain the risks of vaccine refusal while respectfully listening to parents' concerns, a special article in the May 7 issue of the New England Journal of Medicine urges.

Lead author Saad B. Omer, MBBS, PhD, MPH, is assistant professor of global health and epidemiology at Emory University's Rollins School of Public Health, with coauthors from the Johns Hopkins Bloomberg School of Public Health, the federal National Vaccine Program Office and the Washington State Department of Health.

Perceptions and concerns about vaccine safety have led to a jump in vaccine refusal in the United States over the last decade. Several states allow "personal belief" exemptions from school vaccination requirements in addition to exemption for religious or medical reasons.

In the article, Omer and his colleagues review evidence from several states that vaccine refusal puts children in communities where the practice has increased at substantially higher risk for infectious diseases such as measles and pertussis.

Even children whose parents did not refuse vaccination are put at risk because "herd immunity" normally protects children who are too young to be vaccinated, can't be vaccinated for medical reasons, or whose immune systems do not respond sufficiently to vaccination, the authors explain.

"The implication of recent research findings is that everyone who is living in a community with a high proportion of unvaccinated individuals has an elevated risk," Omer says.

In a recent survey of pediatricians, almost 40 percent said they would not provide care to a family that refused all vaccines, and 28 percent said they would not provide care to a family that refused some vaccines.

The authors advise primary care physicians and nurses not to break off relationships with parents that decline vaccines, citing the "critical role clinicians can play in explaining the benefits of immunization and addressing parental perceptions and concerns about its risks."

The attitudes of physicians and nurses overlap with and have an influence on the families they serve, the authors say. Research shows primary care providers for unvaccinated children were less likely to have confidence in vaccine safety and vaccines' benefits. In focus groups, parents who were uncertain about vaccinating their children were still open to discussions with clinicians.

The authors note an emerging trend for parents to delay rather than omit vaccination for their , a phenomenon whose consequences could include exacerbation of health inequities.

More information: refusal, mandatory immunization, and the risks of vaccine-preventable diseases. Omer, S.B., Salmon, D.A., Orenstein, W.A., deHart, M.P. and Halsey, N. N Engl J Med 360: 1981-8 (2009).

Source: Emory University (news : web)

Related Stories

Recommended for you

Amber-tinted glasses may provide relief for insomnia

December 15, 2017
How do you unwind before bedtime? If your answer involves Facebook and Netflix, you are actively reducing your chance of a good night's sleep. And you are not alone: 90 percent of Americans use light-emitting electronic devices, ...

Warning labels can help reduce soda consumption and obesity, new study suggests

December 15, 2017
Labels that warn people about the risks of drinking soda and other sugar-sweetened beverages can lower obesity and overweight prevalence, suggests a new Johns Hopkins Bloomberg School of Public Health study.

Office work can be a pain in the neck

December 15, 2017
Neck pain is a common condition among office workers, but regular workplace exercises can prevent and reduce it, a University of Queensland study has found.

Regular takeaways linked to kids' heart disease and diabetes risk factors

December 14, 2017
Kids who regularly eat take-away meals may be boosting their risk factors for heart disease and diabetes, suggests research published online in the Archives of Disease in Childhood.

Simulation model finds Cure Violence program and targeted policing curb urban violence

December 14, 2017
When communities and police work together to deter urban violence, they can achieve better outcomes with fewer resources than when each works in isolation, a simulation model created by researchers at the UC Davis Violence ...

Your pets can't put your aging on 'paws'

December 14, 2017
(HealthDay)—In a finding that's sure to ruffle some fur and feathers, scientists report that having a pet doesn't fend off age-related declines in physical or mental health.

2 comments

Adjust slider to filter visible comments by rank

Display comments: newest first

goldengrain
not rated yet May 06, 2009
"The authors advise primary care physicians and nurses not to break off relationships with parents that decline vaccines . . .:

I was always taught that it is 'people WHO' and 'objects(things other than people) THAT' - never 'people that'.

This is a subtle difference, but it is a bit disrespectful to refer to people as objects.

I notice that, later on, the correct 'people who' is used.
Ashy
1 / 5 (1) May 07, 2009
Will they tell all parents about ALL side effects of vaccination and give them TRUE statistics? I don't think so.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.