The American Academy of Pediatrics has urged state governments and pediatricians to take a firmer approach in forcing vaccine-hesitant parents to immunize their children.
The policy statement released Monday suggests legislators prohibit nonmedical vaccine exemptions for children entering school and day care, as done by California’s Senate Bill 277, which took effect last month.
California became one of three states to mandate vaccinations for all children entering public and private school and day care, with the exception of children with specific medical issues.
“It’s clear that states with more lenient exemptions policies have lower immunization rates, and it’s these states where we have seen disease outbreaks occur as the rates slip below the threshold needed to maintain community immunity,” Geoffrey Simon, lead author of the policy, said in a news release. “Nonmedical exemptions to immunizations should be eliminated.”
A sister report, titled Countering Vaccine Hesitancy, guides pediatricians on how to confront parents who are opposed to or unsure about vaccinating their children.
It recommends that pediatricians have one-on-one conversations with parents to address vaccine concerns, but – in a change from previous guidelines – that physicians request that a patient who refuses to immunize their child find another medical provider.
Dr. Dean Blumberg, a pediatrician at UC Davis Medical Center, said vaccine-hesitant parents present a unique challenge to physicians.
In 2014, when California law required parents to get a physician signature on their personal belief exemptions, Blumberg opened a clinic where he could counsel parents on immunization risks and benefits. If at the end of that conversation parents still refused to vaccinate, he would sign their forms. He saw 40 families and signed 38 forms during the year that he ran the clinic, he said.
“I didn’t play hardball with parents,” Blumberg said. “If they came in and had researched and were certain in their views, I didn’t try to convince them.”
Since SB 277 took effect in California, Blumberg said he’s seen a surprising number of parents who were strictly against vaccination bringing their children in for shots and asking to be put on a catch-up immunization plan. Those parents don’t want their children to be turned away from school, he said.
The new AAP statement “really validates what California did,” he said. “Now it’s incumbent on the other 47 states to take a look at their environments and see if it’s feasible to follow California’s lead.”