News

1 in 3 Pediatricians Would Dismiss a Family That Refuses Vaccinations

doctor talking to mother and baby about vaccines

 Getty Images

Key Takeaways

  • In recent years, parents have been pushing back on pediatricians' vaccine policies.
  • Parents reserve the right to delay or refuse vaccinations, but pediatricians are increasingly dismissing these families from their practices.
  • Dismissing families can have legal and ethical ramifications.

A recent study published in JAMA Pediatrics found that about half of pediatricians' offices had a policy of dismissing families from their practice if they refuse vaccinations for their children, and 37% would do so with or without such a policy.

That means a large number of children in the United States could go without care. According to the most recent National Immunization Survey, the number of unvaccinated kids in the U.S. has grown significantly in the last 30 years. This rejection of unvaccinated children could lead to a much larger public health crisis if the issue is neglected.

Vaccine Rates Decline

The decline of vaccination rates is a result of the rising issue of parental refusal of routine childhood vaccinations in the U.S. In fact, in 2019 the World Health Organization declared vaccine hesitancy as one of the 10 biggest threats to global health, calling vaccinations one of the most “cost-effective ways of avoiding disease.” But ironically, that’s a big part of the problem. 

Trina Blythe, MD

The success of vaccines has made certain diseases uncommon, so many people have never seen diseases like measles, polio, or diphtheria. The lack of common experience of these diseases makes it difficult to convince families of the importance of vaccines.

— Trina Blythe, MD

“The success of vaccines has made certain diseases uncommon, so many people have never seen disease like measles, polio, or diphtheria,” says Trina Blythe MD, FAAP, a pediatrician with Way To Grow Pediatrics and Assistant Professor of Pediatrics at Washington University. “The lack of common experience of these diseases makes it difficult to convince families of the importance of vaccines.” 

How Does COVID-19 Affect This?

Indeed, childhood vaccines are more important than ever as we enter our eighth month of a global pandemic. “COVID-19 has everyone scrambling for a vaccine as potentially our best protection from this deadly virus. The current pandemic is eerily reminiscent of a time before vaccines, with large numbers of people suffering and dying before the current vaccines were available,” says Blythe. 

And although drug companies are working hard to produce a vaccine, informal polls indicate a relatively low rate of parental acceptance even for the COVID-19 vaccine, despite everyone’s overwhelming desire to return to life as we knew it before. Some of this rejection comes from the same suspicions leveled at childhood vaccinations like TDAP, MMR, and even the flu shot. In other cases, it is rooted in historical incidents of medical malpractice done to marginalized communities. Scientific experts are working hard to alleviate everyone's concerns before the vaccine is ready.

Pediatricians Dismissing Families For Lack of Vaccinations

Now, doctors are responding by dismissing these families from their practice. But there are legal and ethical considerations to doing so. “Families that are turned away may not find a medical home, and the child misses out on much-needed well exams and medical care. The child may remain unvaccinated and can have a poor outcome,” Blythe says.

But while it’s not illegal to discontinue care to a family that refuses vaccinations, physicians should be aware that the law tends to fall on the side of the family. A study in the Journal of Pediatrics and Child Health states, “In negligence, a physician can be held liable for harm to a patient if the physician had a duty to the patient and if the failure to meet that duty resulted in harm to the patient.”

Legal Considerations

“Once a family has become established with a doctor, there is an obligation to that patient,” says Blythe. In those cases, a physician should make an attempt to have the parents understand why they believe strongly in routine childhood vaccinations prior to dismissing the parents.

According to Blythe, “If a patient knowingly refuses to vaccinate and then suffers adverse outcomes, legally they can claim that the doctor had superior knowledge and should have worked harder to convince them to vaccinate." 

Ethical Considerations

Whenever a physician and a parent fail to see eye to eye on whether a child will receive vaccinations, the argument goes beyond legal ramifications. From an ethical standpoint, doctors should consider that “patients and families dismissed for vaccine refusal and unable to find a new physician may become marginalized from health care and thus vulnerable,” according to the JAMA study. 

What This Means for You

In a perfect world, a physician wishing to operate with a more strict vaccination policy would be able to inform potential patients before they join the practice. Blythe advises they can do this by, “making sure that everyone in the office understands the policy. When new patients call to schedule an appointment, notify them of the office policy upfront.”

Was this page helpful?
Article Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. O’Leary ST, Cataldi JR, Lindley MC, et al. Policies among us pediatricians for dismissing patients for delaying or refusing vaccinationJAMA. 2020;324(11):1105. doi:10.1001/jama.2020.10658

  2. Nis | national immunization surveys | home | vaccines | cdc.

  3. Warren RC, Forrow L, Hodge DA, Truog RD. Trustworthiness before trust — Covid-19 vaccine trials and the black community. N Engl J Med. 2020. doi:10.1056/NEJMp2030033

  4. Halperin B, Melnychuk R, Downie J, MacDonald N. When is it permissible to dismiss a family who refuses vaccines? Legal, ethical and public health perspectives. Paediatr Child Health. 2007;12(10):843-845.