Putting other kids at risk

Some US doctors are dropping patients who refuse to get their children vaccinated. Good.

With California gripped by a measles outbreak, Dr. Charles Goodman posted a clear notice in his waiting room and on Facebook: His practice will no longer see children whose parents won’t get them vaccinated.

“Parents who choose not to give measles shots, they’re not just putting their kids at risk, but they’re also putting other kids at risk — especially kids in my waiting room,” the Los Angeles pediatrician said.

You know…kids who are there because they are ill, and don’t need to be exposed to measles or mumps on top of that.

The American Academy of Pediatrics says doctors should bring up the importance of vaccinations during visits but should respect a parent’s wishes unless there’s a significant risk to the child.

“In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child,” according to guidelines issued by the group.

So they should put all their other patients at risk. Bad advice, if you ask me. Unethical advice. Better to respect the other parents and their children than to “respect” the no-vaxxers.


  1. peterh says

    No ethical physician would let her/is facility become a vector for infectious disease. Anti-vaxxers are as stupid as Flat Earthers and in addition they present a grave potential danger to their children and the children of others (and not a few adults as well).

  2. Stevarious, Public Health Problem says

    If I were a doctor, I would discharge anti-vax patients simply because it would mean that they did not trust me on basic medical matters.

  3. jenniferphillips says

    I’ve been a bit surprised at the official American Academy of Pediatrics position on this, which recommends NOT excluding those families and trying to advocate for the health and well-being of the kids from within. Sounds sort of reasonable in general but not in light of what we know about the extremity of the anti-vax movement.

    I’m wondering how long it will take for the AAP to modify their position, given the ample evidence that these people are largely not open to changing their minds. We’ve been dealing with increasing pertussis outbreaks for a few years now the consequence of diminished herd immunity on a vaccine that doesn’t work super duper well. Measles–for which the vaccine is actually very effective–has been regaining a foothold over the past couple of years as well. At some point you would think the AAP would consider that the risks of having unvaxed patients in the waiting room would outweigh the hope that those parents can be convinced.

  4. says

    I’ve always thought policies of exclusion were correct for precisely this reason. And schools and day care operations should do the same. People can refuse to vaccinate their children based on religious/woo beliefs, but no one else should have to be put at risk. Of course, this should be combined with education.

  5. says

    Ya. I was surprised to see that.

    I found the article on Facebook earlier today, along with a long passage by a pediatrician who cited his patients with leukemia, his patients with this vulnerability and others with that…and I can’t find it again, even after searching my FB activity. I’d meant to quote from it; it’s very persuasive.

  6. sqlrob says

    I’m of mixed feelings on this.

    One one hand, good for them.

    On the other, is this going to result in children not getting treatment they need (over and above not getting vaccinated)? Will it lead to the rise of quacks that don’t have this ethical limitation?

  7. Blanche Quizno says

    I have what’s perhaps a unique perspective on this topic among the contributors here at this site – I can speak to this as a parent who got caught up in the Andrew Wakefield sensationalized fallout.

    Andrew Wakefield’s fraudulent research caused incalculable harm – it was truly a crime against humanity. It took over TEN YEARS to get charges against him filed and to get his paper retracted – and during that decade, people believed that the dreaded autism could be caused by immunizations. It was all over the media. I’m well-educated (3 degrees), but when someone who is also educated (teaching degree) is telling you that one of your son’s best friends was harmed by an immunization (and now needs a special ed IEP), and someone else you know tells you her grandchild was likewise harmed and now has autism, that’s impact. I was homeschooling my children, and it is in that community that there is a far higher proportion of antivaxxers – one can’t help but be influenced by one’s environment. Remember, this was all before Wakefield’s fraud was uncovered and that key Lancet paper of his was retracted. Given that my children were interacting with a smaller number of children via the charter schools that we joined (these cater to homeschoolers), I stepped back from immunizations for a while, a few years, until more research could become available. My children were 5 and 3 at that point.

    Plus, when my daughter was an infant, her pediatrician recommended the new Rotashield immunization. I had her immunized against rotavirus, only to see that product pulled from the market just months later because too many infants had been harmed by it. That sort of experience sticks with you – I determined at that point that my children would never again be on the “bleeding edge” for new immunization rollouts. During that same time period, the AMA started recommending annual mammograms for all women starting at age 40; on the basis of the papers I read in various scientific journals, I decided to wait until my 50s. Plus, I was still nursing at the time. Since then, the policy has been changed to a recommendation for every other year mammograms for women starting in their 50s. Official medical guidelines DO change.

    Once the truth about Andrew Wakefield and his fraud and misconduct became available, I sat my by-then-teenage children down and explained what would happen in an immunization, the risks and the benefits, and of course, being bright kids, they chose immunization. My children are now fully immunized.

    In other words, it’s not just crazy parents; it’s not just ignorant parents; it’s not just stupid parents. It’s the fallout from a full decade of Andrew Wakefield’s criminal misinformation and too many well-meaning but abysmally ignorant high-profile individuals like Jenny McCarthy spewing nonsense. Why should anyone take medical advice from actors???

    When people have believed something for a decade, and believed that they were protecting their children’s health, it will take time to work through that. You have *no idea* how many different sources there are now, all perpetuating the misinformation and frightening parents. A megachurch pastor in Texas, Terri Copeland Pearsons, was preaching antivaxxing, until an outbreak of measles tore through her church – then she changed her tune. I think this measles outbreak and doctors coming down on anti-vaxxing parents are two factors that are going to help break through the anti-vaxxor movement, but it’s going to take time. Too many people have been lulled into thinking that dangerous childhood diseases are a thing of the past and so we don’t need to worry about them any more.

  8. Jenora Feuer says

    Re: the AAP.

    There’s been a lot of discussion about kicking the AAP over on Respectful Insolence. Though given that Dr. Robert ‘Bob’ Sears, who is one of the biggest anti-vax doctors in California and almost certainly a good part of the reason for the current measles outbreak, still lists himself as a Fellow of the AAP… nobody’s holding out a lot of hope that the AAP is going to break out of its current wishy-washy state anytime soon.

  9. mildlymagnificent says

    In my view, the only doctors who should keep vaccination refusing kids/families on their books are the few who have the luxury of alternative entrances-waiting rooms-amenities.

    The last thing a doctor should want is an unvaccinated kid with “the sniffles” or a cough or a rash to share a waiting room with other children or ill or elderly patients. I notice our doctor has a waiting room notice asking people with common flu symptoms to identify themselves to the receptionists and they will probably be taken to another area away from other patients. (On a fine day they might end up with a chair provided on the very wide verandah outside or asked to go back and wait in the carpark.)

  10. karmacat says

    Re: the AAP
    It can be a difficult balancing act for doctors. It is hard to deny a child treatment even if the parents are idiots. But it is important to isolate the non-vaccinated kids from others. I am disappointed thought that the AAP doesn’t kick Dr. Sears out and challenge his medical license.
    By the way, I checked out the rotavirus vaccine on WebMD and the new ones are safe. Rotavirus can be deadly for infants.
    To Blanche: the reasons mammograms in the 40’s are less effective is because the breast tissue is still dense until a woman goes through menopause. Overall, in the population, mammograms in the 40’s don’t have an effect on preventing early death from breast cancer. And it can lead to unnecessary procedures. However, for a few women it can be live saving. It is hard to know what to do because medicine sometimes doesn’t have good and clear answers

  11. says

    Governments deem people with certain diseases as risks to public health. People with hepatitis A, for example, pose a risk to others if they work in the food industry. Don’t governments take action to prevent such people from working with food?

    I have to wonder if people’s refusal to get vaccinated should be treated the same way.

  12. says

    No, that’s the link I included in the first sentence – I was looking for the passage you quoted in your FB post. But you’re right that it’s your post I was looking for!

  13. Steve Cuthbertson says

    Ooh poop, it stripped my hyperlink (or I entered the tag incorrectly, which is more likely.)
    Never mind, you got it anyway. It was the Mike Ginsberg Facebook photograph.

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