New study examining annual American Academy of
Pediatrics member surveys finds more parents request to delay or refuse
vaccines, but the reasons vary
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).
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.
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.
findings illustrate a need for pediatricians to ask why a parent is refusing a
vaccine, authors said, and tailor educational guidance to address specific
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,