Vaccine refusal: Perspectives from pediatrics

Abstract

Vaccines have been touted as one of the most significant public health achievements in human history. Because of their recent and rapid success many parents and health care providers of the twenty-first century, particularly in more developed areas of the world such as the USA and Western Europe (WE), have limited or no experience with the devastating effects of vaccine preventable diseases. We examine the history of vaccine success, philosophical exemptions to childhood vaccination, the use of alternative schedules, the reasons for parental refusal of childhood immunizations, and the ethics surrounding physician termination of the doctor-patient relationship if parental refusal persists. Published work argues strongly against termination of care, yet data indicate approximately 40% of practicing physicians surveyed support or use termination as an option. We review these conflicting viewpoints from a primary care physician's perspective.