advice for pediatricians in counseling families to vaccinate their children;
urges states to enact policies to support high immunization rates
Village, IL – Most parents who are hesitant about vaccines are not opposed to
immunizing their children, but rather are unsure or have questions. And the
best source of answers is their pediatrician.
pediatricians for these conversations, the American Academy of Pediatrics is
publishing a new clinical report, “Countering Vaccine Hesitancy
” in the
September 2016 Pediatrics (published online Aug. 29). The AAP advises
pediatricians to have compassionate dialogues with parents to clear up
misconceptions around vaccines, provide accurate information about the safety
and importance of vaccines, and strive over time to help parents make the
decision to vaccinate their child.
To protect all
children in every community, the AAP also urges state governments to enact
policies that will result in high immunization rates. In the policy statement,
“Medical Versus Nonmedical Immunization Exemptions for Child Care and SchoolAttendance
,” published the same day, the AAP recommends only medical exemptions
be allowed for vaccine requirements for child care and school attendance.
pediatricians, and policy-makers all have a role here in protecting children
from diseases like measles and whooping cough,” said AAP President Benard P.
Dreyer, MD, FAAP. “As pediatricians, we care about every individual child in
our practices, and we know that vaccines are an important way to protect them
from disease. We also care about the broader communities where our patients
live, play and learn, and high immunization rates are critical to keeping
disease outbreaks at bay. No child should have to suffer through a disease that
could have been prevented by a vaccine.”
the AAP, non-medical exemption laws have failed.
that states with more lenient exemptions policies have lower immunization
rates, and it’s these states where we have seen disease outbreaks occur as the
rates slip below the threshold needed to maintain community immunity,” said
Geoffrey R. Simon, lead author of the medical exemptions policy statement and
immediate past chair of the AAP Committee on Practice and Ambulatory Medicine.
exemptions to immunizations should be eliminated.”
children are often geographically clustered, creating pockets in a community
with a higher vulnerability to disease. In January 2015, for example, a measles
outbreak occurred in California, where an estimated 3 percent of kindergartners
had a non-medical exemption from the measles, mumps and rubella (MMR) vaccine.
Unimmunized children acquired measles during this outbreak.
immunization rates protect vulnerable individuals, including children who
cannot be vaccinated because of medical problems or because they are too young
to be vaccinated. The AAP recommends public health authorities release
immunization rate data for individual schools and communities, so that parents
can make decisions about their children’s safety in those settings.
outbreaks show how critical vaccines remain for children’s health, said Kathryn
M. Edwards, MD, FAAP, an author of the clinical report on vaccine hesitancy and
a member of the AAP Committee on Infectious Diseases.
may not remember that before vaccines, diseases like whooping cough, measles,
polio, meningitis, and diphtheria sickened and claimed the lives of thousands
of children and adults each year in the United States,” Dr. Edwards said.
“Serious disease can occur if your child and family are not vaccinated.”
In the United
States 2009 birth cohort, routine childhood immunization will prevent about 42,000
early deaths and 20 million cases of disease, according to the report, saving
$13.5 billion in direct costs and $68.8 billion in societal costs. According to
the AAP, the recommended immunization schedule is the only one that has been
tested for safety and effectiveness. Non-standard schedules have not been
The AAP urges
pediatricians to address the specific concerns individual parents may have
about vaccines, noting that one-on-one contact with an informed, caring and
concerned pediatrician is the “single most important influence” on parents’
acceptance of vaccines. In one study, 80 percent of parents said their decision
to vaccinate was positively influenced by their primary care provider. If after
counseling efforts are exhausted, parents decline immunizations, the AAP says
pediatricians may request that they sign a vaccine refusal form and/or seek
care from a different health care provider. Unimmunized children are at risk of
vaccine preventable diseases and in a practice setting also create risk of
disease outbreaks in young infants and those children who medically cannot be
know some parents have concerns about vaccines, and the best way to answer
these questions is by discussing them with the doctor,” said Jesse Hackell, MD,
FAAP, an author of the vaccine hesitancy clinical report and member of the AAP
Committee on Practice and Ambulatory Medicine. “Both parents and pediatricians
are in agreement in wanting the best for a child’s health and well-being.”
offering a free online training course for pediatricians in counseling vaccine
hesitant parents. The PediaLink Challenging
Cases: Vaccine Hesitancy course is available starting Aug. 29
American Academy of Pediatrics is an organization of 66,000 primary
care pediatricians, pediatric medical subspecialists and pediatric
surgical specialists dedicated to the health, safety and well-being of
infants, children, adolescents and young adults. For more information,