New guidelines issued this week by the American Academy of Pediatrics urge pediatricians and lawmakers to get tougher with parents who exempt their children from required immunizations – which could be an uphill battle in New Mexico.
The report urges lawmakers to eliminate “non-medical” factors that allow parents to exempt their children from immunizations. And for the first time, the association said pediatricians “may consider dismissal of families who refuse vaccination” if other efforts fail to convince parents to vaccinate their children.
New Mexico pediatricians contacted this week said they plan to continue treating unvaccinated children, but expect the guidelines to prompt new discussions about how physicians should respond to “vaccine-hesitant” parents.
“That’s an interesting transition, because the party line from the American Academy of Pediatrics has been that we shouldn’t do that (dismiss patients),” said Dr. Randall Knott, a University of New Mexico Hospital pediatrician.
The AAP report, called “Countering Vaccine Hesitancy,” urges state lawmakers to eliminate non-medical factors that allow parents to exempt their children from required vaccines.
New Mexico law contains an exemption for religious beliefs, but not for “philosophical” reasons, as do 20 states. A measure that would have eliminated New Mexico’s religious exemption died in legislative committee last year.
Anti-vaccination parents include a mix of views – from religious communities to families practicing alternative medicine and libertarians who shun government interference. The AAP report cited a survey of vaccine-hesitant parents who cited a range of concerns, from worries that vaccines cause autism and chronic illnesses, to pain for children receiving multiple vaccinations at a time.
Many are Americans with college degrees living in liberal communities. Statewide, about 0.8 percent of New Mexico children ages 4 to 18 are exempt, but New Mexico has pockets of higher concentrations of exempt children in prosperous, well-educated communities such as Taos and Los Alamos counties, where just over 3 percent of children are exempt.
Amy Pisani, executive director of the Washington, D.C.-based Every Child By Two immunization advocacy group, said well-educated people often respond with skepticism to official requirements.
“It’s basically people who feel they do know more and question authority more,” Pisani told the Journal last year.
Knott said physicians have good reason to worry about unvaccinated patients visiting their clinics.
“If you have a child with measles in your waiting room – your well-waiting room – you’re going to expose a lot of very young babies to a deadly disease,” Knott said.
Knott said UNMH’s pediatric clinic plans to continue treating all children regardless of their immunization status “in the hope that we can continue to have a conversation” about the value of immunization.
Knott and others said they are unaware of any significant movement among New Mexico pediatricians to turn away vaccine-hesitant families.
Dr. Lance Chilton, who heads the New Mexico Pediatric Society’s immunization committee, said he knows of only one New Mexico pediatrician who turns away unvaccinated children. The Journal could not reach that physician for comment this week.
Vaccine exemption became a nationwide issue last year after a measles outbreak began in California, where 3 percent of children lacked the measles-mumps-rubella vaccine.
Pediatricians in several states began to turn away unvaccinated children, saying they wanted to protect the health of their other patients.
Chilton said several pediatricians who attended an AAP conference in March argued passionately that physicians need to take a harder line and ban vaccine exemptors from their clinics.
“There is division of opinion among physicians about whether that’s a good strategy or not,” Chilton said.
The AAP guidelines advises pediatricians that nearly half of parents who were initially skeptical about vaccines ultimately decide that immunization is the best option. Chilton, now retired, said he never turned away patients who refused vaccinations, and often convinced parents that vaccination was best for their children.
“I could keep talking with them about the importance of immunizations,” Chilton said. “There were times when initial refusal could be overcome by constant repetition or force of logic.”