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Pediatricians in States Without Vaccine Exemption Laws More Likely to Dismiss Vaccine-Refusing Families

A study to be published in the December 2015 issue of Pediatrics (published online Nov. 2) found the location where doctors practice is associated with how they handle families who decline to vaccinate their infants according to the recommended schedule. In the study, “Characteristics of Physicians Who Dismiss Families for Refusing Vaccines,” researchers found doctors in private practice, those located in the South, and those in states without philosophical exemption laws were the most likely to dismiss families refusing to vaccinate their infant. The 2012 national survey of physicians was the first to examine in detail the practice of dismissing families since the American Academy of Pediatrics (AAP) published guidelines discouraging such actions in 2005. The AAP reaffirmed the guidelines most recently in 2013, recommending that physicians “endeavor not to discharge patients. The study found that almost all physicians surveyed encountered parents who refuse at least one vaccine in the recommended infant series.  Approximately 20 percent of the pediatricians reported “often” or “always” dismissing families who refuse one or more vaccines. While it’s not clear from the study why the practice of dismissing families is associated with state laws or the Southern region, the authors surmise that the practice may be related to social norms surrounding vaccination. It is also possible that dismissing families impacts vaccination rates, as states with stricter vaccine exemption policies tend to have higher uptake of vaccines. They stress that the significant number of doctors who dismiss vaccine-refusing patients underscores the need for further research to understand its causes and consequences.


The American Academy of Pediatrics is an organization of 64,000 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, visit or follow us at @AmerAcadPeds. 


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