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Increased Vaccination Refusal Heightens Public Health Risks

Last Updated: May 06, 2009.

 

Article urges pediatricians to become informed to be effective advocates for childhood vaccination

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The number of parents refusing vaccination for their children is on the increase, challenging pediatricians to be effective vaccination advocates while respecting the decisions of those who opt to forego them, according to an article in the May 7 issue of the New England Journal of Medicine.

WEDNESDAY, May 6 (HealthDay News) -- The number of parents refusing vaccination for their children is on the increase, challenging pediatricians to be effective vaccination advocates while respecting the decisions of those who opt to forego them, according to an article in the May 7 issue of the New England Journal of Medicine.

Saad B. Omer, Ph.D., of Emory University in Atlanta, and colleagues noted that while all states permit medical exemptions, 48 provide for religious exemptions and 21 allow exemptions based on personal belief. From 1991 to 2004, the mean state-level non-medical exemptions increased from 0.98 to 1.48 percent. For personal belief exemptions, the mean exemption rate increased from 0.99 to 2.54 percent. While these rates are low, geographic clustering of vaccination refusal can occur, as has been reported in Washington, Michigan and elsewhere, creating the potential for localized disease outbreak.

The researchers report that in a nationwide survey by the American Academy of Pediatrics, almost 40 percent of pediatricians said they would not deliver care to a family that refused all vaccines. The academy's Committee on Bioethics advises against this attitude and recommends that clinicians respectfully listen to parents, discuss specific vaccine concerns and explain non-immunization risks.

"Vaccine refusal not only increases the individual risk of disease but also increases the risk for the whole community. As a result of substantial gains in reducing vaccine-preventable diseases, the memory of several infectious diseases has faded from the public consciousness and the risk-benefit calculation seems to have shifted in favor of the perceived risks of vaccination in parents' minds," the authors write.

Several article authors report relationships with pharmaceutical companies who manufacture vaccines.

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