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Pediatricians Say Parents' Concerns About Vaccines Have Shifted In Past Decade

8/29/2016
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New study examining annual American Academy of Pediatrics member surveys finds more parents request to delay or refuse vaccines, but the reasons vary

A national survey of pediatricians illuminates shifting concerns that parents express about their children’s immunizations compared to a decade ago.

The study in the September 2016 Pediatrics, “Vaccine Delays, Refusals, and Patient Dismissals: A Survey of Pediatricians,” (published online August 29) compared data from the American Academy of Pediatrics (AAP) Periodic Survey of Fellows in 2006 and 2013. The surveys were sent to random samples of AAP members. The study included responses from pediatricians who routinely provide patient care including immunizations. A total of 629 pediatricians participated in 2006, and 627 participated in 2013.

In 2013, 87 percent of respondents encountered vaccine refusals, up from 75 percent in 2006. Pediatricians perceive the reasons parents delayed vaccines differed from the reasons they refused vaccines; in 2013, they perceived parents who delayed vaccines most commonly acted out of concerns for their child’s discomfort and immune system burden, while they said they felt that parents who refused vaccines more often considered vaccines unnecessary.  Overall, the number of pediatricians who said they perceived parents refused vaccines because they didn’t see a need for them rose by 10 percent between the time periods studied. However, three of the top six reasons for vaccine refusal significantly declined in frequency, including the concern about autism and/or thimerosal (74 percent in 2006 versus 64 percent in 2013).

The 2006 survey was distributed just after the first Human Papillomavirus (HPV) vaccine was approved but before it was widely offered by pediatricians. Despite that vaccine’s proven effectiveness against cervical and other cancers, it continues to have lower acceptance rate than other recommended vaccines. Study authors said the perceived increase in refusals may be, in part, because the HPV vaccine was recommended when the follow-up survey was conducted.

“The perceived rise in refusals and delays does not seem to be solely attributable to any one vaccine, because pediatricians reported increased rates of parents who refused just one vaccine and those who refused more than one immunization,” said study author Catherine Hough-Telford, MD, FAAP. This supports prior research findings that suggest the public’s collective memory of vaccine-preventable diseases may be fading, she said. “Clearly, though, additional research is needed to evaluate vaccine hesitancy and how it relates to different vaccines,” she said.

The study also found that the number of pediatricians who dismiss patients whose parents refuse vaccines has increased. In 2006, 6 percent of pediatricians reported “always” dismissing patients for continued vaccine refusal, and by 2013, that increased to nearly 12 percent.

The study’s findings illustrate a need for pediatricians to ask why a parent is refusing a vaccine, authors said, and tailor educational guidance to address specific concerns.

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The 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, visit www.aap.org.


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