198087 Pediatricians' experience with parental vaccine safety concerns and vaccine refusals: A survey of Connecticut pediatricians

Tuesday, November 10, 2009: 8:35 AM

Susan Mezey Leib, MD MPH , Ridgefield Pediatric Associates, Ridgefield, CT
Penny Liberatos, PhD , School of Health Sciences & Practice, New York Medical College, Valhalla, NY
Karen S. Edwards, MD MPH , Westchester Institute for Human Development, New York Medical College, Valhalla, NY
Objectives. Physicians are seeing increasing numbers of parents who question the safety of vaccines or refuse to vaccinate their children. This study examined how frequently pediatricians in one New England state encounter parental vaccine safety concerns and vaccine refusals, how often physicians dismiss families from their practices for vaccine refusal, and how parental vaccine refusal impacts on pediatricians personally.

Methods. A survey consisting of 28 closed-ended questions was developed and tested. It was sent to a random sample of 600 out of 900 members of the local chapter of the American Academy of Pediatrics, which included an estimated 300 primary care pediatricians. A total of 133 primary care pediatricians returned the survey either by mail or electronically, for a response rate of 45% from primary care pediatricians.

Results. The majority of responding pediatricians reported experiencing an increase in parental vaccine safety concerns/refusals during the previous 5 years. Over 30% of respondents had dismissed families because of parental refusal to immunize. Suburban physicians serving wealthier, better educated parents reported significantly more vaccine concerns/refusals and were more likely to dismiss families for vaccine refusal. Vaccine refusals had a negative personal impact on one-third of physician respondents. Physicians who reported more vaccine concerns/refusals were significantly more likely to report a negative personal impact.

Conclusions. Parental vaccine safety concerns and refusals have the potential to undermine gains made by childhood vaccinations. A better understanding of which parents are refusing and how physicians are responding could lead to interventions that would help address parental concerns.

Learning Objectives:
Discuss changes in frequency of parental vaccine concerns and vaccine refusal, whether parental vaccine refusal leads to patient dismissal from practice, and whether these vary by socioeconomic status, as reported by primary care pediatricians. Explain how parental concerns about childhood vaccines and parental refusal of vaccines impacts personally on the pediatricians who serve them.

Keywords: Immunizations, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Having recently completed my MPH program I successfully presented on a range of public health topics in multiple classes. My thesis, on which this abstract is based, was awarded honors status and I received the “Excellence in Research” award. As a primary care pediatrician I have presented at hospital based conferences for colleagues, most recently on parental vaccine refusal and pediatric ethics. I present at community forums for parents on a regular basis on a variety of pediatric topics.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.