Home > Expert Insights, Preventable Diseases > How Providers Address Vaccine Hesitant Parents

How Providers Address Vaccine Hesitant Parents

DrZibnersToday Dr. Lara Zibners addresses an inquiry from our Vaccinate Your Baby Facebook page that pertains to provider policies on vaccine refusal.  If you have a vaccine related question that you would like us to address, please email shotofprevention@gmail.com or send us a message on our Facebook page.

 

“I am finding an increasing number of new patients whose parents are refusing vaccination. As I am not the medical police, I give my best advice, but continue to accept these patients into my practice. There will always be parents who are dubious about the safety of vaccinations. Any thoughts from MD’s about how you deal with patients who choose to not vaccinate their children?”

Ah, this is a tough one. As doctors we never know what may come through the front door – the vaccinated, the under-vaccinated or the non-vaccinated— yet we do our best to deal with the situation at hand. As a mother, I willfully steer my own children clear of play-dates where I know the other child is likely unvaccinated. But the question is, once stepping back into my white coat and sensible heels, what should we do?

Some pediatricians have chosen to not allow families that refuse to vaccinate into their practices. And I completely understand their reasoning. Vaccine refusal puts the unvaccinated child and others at risk.  And this is a deeply emotional issue for many of us, isn’t it? We spend years and years training, and then dedicate our entire lives to the health and well-being of children. And I mean entire. I know a pediatrician who grocery shops at 11pm just to avoid the “Hi Doc! By the way, while we’re standing in the cereal aisle, would you mind taking a peek at Johnny’s left elbow…” Not that we don’t love our patients and their families, but this career does have a way of taking over your days, nights, weekends and occasionally even your choice of mayonnaise.

When you’re as invested as the pediatricians I’m proud to know, it’s difficult not to take vaccine refusal personally since this can mean that our patient’s family is openly disagreeing with our medical advice. Especially when we know their reasoning is often based on fear and misperception, rather than fact and science. And anyone who has tried to counter these misbeliefs (as I do) can quickly become frustrated (as I have). Parents who refuse to vaccinate are often so deeply committed to their decision that reversing their reasoning may seem exhausting, if not impossible.

Plenty of physicians feel strongly that their first commitment has to be to the health of all the children in their practice, so it’s understandable that some may decide not to see patients who refuse vaccination. After all, how can you ask a family, who willingly takes your advice, to sit in your waiting room with their infant child – who is not yet old enough for her first set of shots – alongside a whooping and unvaccinated two year-old with a florid case of pertussis? So maybe a separate waiting room for the vulnerable and another for the unvaccinated is the way to go if you have the space.

But as for refusing immunizations outright, that two year-old didn’t make the decision to not vaccinate. So doesn’t he also deserve the same excellent care as the rest of the children in your practice? That is the basis of the American Academy of Pediatrics (AAP) position: avoid discharging patients from your practice solely for a refusal to vaccinate. So good for you for stepping forward and offering a safe medical home to the families that question vaccines, as well as those who readily immunize.

But that doesn’t really answer your question, does it? The AAP believes that every visit with a family is an opportunity to readdress the issue of immunization and continue to educate and correct misconceptions about vaccine safety and efficacy. It’s entirely possible that a family will eventually make the decision to vaccinate.

A few other tips are:

*  Try discussing each vaccine separately. Usually there are 1 or 2 vaccines that a family is specifically concerned about. Addressing their concerns about those particular vaccines may allow for some—if not all—of the recommended vaccines to be accepted.

*  Address concerns about multiple shots in one visit, including steps your practice takes toward pain control and observation of potential reactions.

*  Don’t be afraid to ask if cost is a factor. Some parents may be overwhelmed at the thought of yet another co-payment,or may have concerns unrelated to safety or efficacy, so be sure to identify their reasons for refusal.

*  Just keep at it. Keep communication open as you work toward building a relationship of trust and respect.

Some physicians have also opted to have parents sign a vaccine refusal information form, similar to the recently approved California consent. This ensures that parents review printed information provided by credible resources and allows an opportunity for you to address any questions they have as a result.  In the time between visits, maybe new questions arose, or some of the information presented will have changed a parents’ ability to properly research and reconsider their initial concerns.

Research has shown that health care providers are the most important influence on a parent’s final decision on immunization.  Therefore, it’s important to establish ongoing, non-confrontational dialogue when dealing with vaccine-hesitant parents. Evidence-based data can be used to address the specific fears and concerns of parents and should be presented using parent-friendly literature and references to credible online resources that explain the value of vaccination.  The AAP and CDC are aware of the challenges that we face and are doing what they can to help those health care providers who are struggling with this very issue.  Here are a few resources that are designed to help:

The CDC’s Provider Resources for Conversations With Parents:  http://www.cdc.gov/vaccines/hcp/patient-ed/conversations/index.html

 

AAP’s Collection of Resources to Help Communicate with Families About Vaccines: http://www2.aap.org/immunization/pediatricians/communicating.html

 

Common Misconceptions About Vaccinations and How to Respond to Them: http://www.cdc.gov/vaccines/vac-gen/6mishome.html

 

Vaccine Related Journal Articles that Explore How to Communicate to Parents:  http://www.immunize.org/journalarticles/comm_talk.asp

 

How to Communicate With Vaccine-Hesitant Parents:  http://pediatrics.aappublications.org/content/127/Supplement_1/S127.full

 

Sample Vaccine Policy Statement:  http://www.immunize.org/catg.d/p2067.pdf

After all, the only way we are going to persuade those who are vaccine hesitant is by calmly leading them to the facts: vaccines are safe and effective.

And to lead by example. My own children—including my middle-aged husband—are fully vaccinated. As a professional, I will continue to promote vaccination and educate others to the best of my ability. And I will take my hat off to those of you who assume the awesome responsibility for the general pediatric care of the children of this world.  Children who may one day encounter my own.

  1. My3sons
    April 10, 2013 at 10:03 am

    Isn’t it possible for a vaccinated child to come down with a disease they are vaccinated against? What then does that doctor do about the child that is vaccinated yet has contacted say pertussis (not really the best example since the pertussis vaccine is highly problematic and it’s claimed effectiveness has been refuted) and needs to be examined? Does he tell that mother she cannot bring her child in because there may be an infant in the waiting room that is too young for their pertussis vaccine? I’m just wondering how they can fairly handle this issue. The explanation the doctor above gave does not seem to be without argument. BTW before you start attacking my question and label me anti vaccine or anti medicine, know that I was just at the cardiologist with my 5 years old yesterday, we love our doctors and thank our lucky starts for them. We also love that they are open and honest and would never dream of refusing to treat our child based on our medical choices.

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  2. My3sons
    April 10, 2013 at 10:18 am

    *5 YEAR old

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  3. Christine Vara
    April 10, 2013 at 10:31 am

    My3sons, Yes it is possible for a vaccinated child to come down with a disease that they are vaccinated against. Though it is a whole lot less likely. I believe there are several concerns raised here. An infected child needs medical attention – regardless of whether they were vaccinated or not. That is probably why the AAP policy reads as it does. Doctors are called to serve in the interest of those who are sick, as well as those who make every attempt to remain healthy. However, this puts the doctors in a difficult situation, and it seems that they can’t possibly accommodate everyone “fairly”.

    Yet, we all want to limit the spread of the disease. If there are unvaccinated patients in the waiting room, they are more susceptible to catching the disease than those who are vaccinated. Some of these children will be intentionally unvaccinated due to vaccine hesitancy, delay or refusal. Others may be too young to have received all their vaccines or they may be more susceptible to disease because of a specific medical condition they have.

    I have seen some practices that have different waiting rooms for well visits vs. sick calls, which as Dr. Zibners mentioned may be one way to address the concern. Also, if a parent suspects something that is highly contagious, like measles or chicken pox, they are typically advised to inform the doctor’s office prior to arriving for their appointment and in most cases precautions can be taken to limit exposure to others in the waiting room. I have even known doctors who have asked a patient to come during off hours, or enter in through another door.

    However, you raise a valid concern. These are difficult cases and that is why providers often struggle with their policies. By encouraging vaccination among their patients they reduce the overall risk of disease that they may have to treat in their community. However, regardless of their decision, they are bound to upset some families.

    Perhaps the providers that read this post will also offer their experience and insight so that we, as parents, can gain a better understanding of the issues.

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  4. My3sons
    April 10, 2013 at 10:46 am

    Thanks for that terrific reply Christine. I have often wondered about this scenario. It seems very difficult to navigate. I too would love to hear others thoughts/solutions.

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  5. Christine Vara
    April 10, 2013 at 11:26 am

    I also wanted to add that this concern has also been discussed in a previous post on Shot of Prevention entitled “Should Doctors Refuse Patients Who Refuse?: https://shotofprevention.com/2012/03/13/should-doctors-refuse-patients-who-refuse/#more-2910

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  6. April 10, 2013 at 11:27 am

    This is a great point. Thanks Christine. Yes, it is true that not all vaccines are 100% which is why we are so dependent on “herd immunity.” If there is a child who is vaccinated and still comes down with a vaccine-preventable illness, of course they risk transmitting that to other children in the waiting room. Pertussis is a great example. On the other hand, a child who has had the varicella vaccine can still get mild chickenpox but is far less contagious than an unvaccinated child with wild-type infection. We all need to be mindful of the risk to our patients from infectious disease, both the vaccine preventable and those that don’t even have vaccines, like the common cold. That is 100% true.

    Some offices have a small baby waiting area that is separate. Others have a “clean” and a “dirty” area. Still others put potentially contagious children immediately into an examination room or other separate area. However we structure it, the goal is to prevent every single child from unnecessary illness. Which, gee, sounds a lot like why we promote vaccinations.

    I’m going to rally up some of my doctor friends and see if we can’t get some more input!

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  7. Maritza
    April 10, 2013 at 11:51 am

    You have evidently not experienced vaccine damage in your own family, and have apparently not read any of the excellent books on vaccine damage. You will not have to live with the burden if a child is damaged by a vaccine you give them, and, indeed, would apparently just deny the whole thing. Forgive me if I’m judging you wrong and your reaction would be one of guilt and regret instead.

    It is the responsibility of the parents to make the vaccine decision, after doing a lot of research and discussion about the issue. I think the clean and dirty waiting areas for unvaccinated children and vaccinated children who get pertussis anyway (like my daughter) is a good idea, and closes the book on that argument. Doctors may give their opinion if the parents ask for it, but after that it is their professional duty to respect the parents’ decision, whichever way it goes.

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  8. Chris
    April 10, 2013 at 12:44 pm

    Maritza:

    You have evidently not experienced vaccine damage in your own family, and have apparently not read any of the excellent books on vaccine damage.

    True. But my oldest son experienced damage from getting an illness before there was a vaccine available. Calling 911, having paramedics come to your house and ambulance rides to the emergency department are not fun. Add to that finding out later that he had a severe speech/language disability and wondering if the seizure due to that illness was the cause.

    I believe your argument would be better served if instead of an anecdote and editorial opinion that you had presented some actual scientific evidence. Like if seizures are more common with the vaccine instead of the disease (like we experienced). If you feel the DTaP vaccine is dangerous, then present the title, journal and dates of the PubMed indexed studies to support your claim.

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  9. Jetcityjewel
    April 10, 2013 at 1:38 pm

    Washington state’s Department of Health has produced a brochure called Plain Talk about Immunization that is written at a higher level aimed at parents hesitant with a higher education background. As is stated often many of the parents currently hesitant or opting out have plenty of education just not necessarily in immunology. http://here.doh.wa.gov/materials/plaintalk/15_PlnTalk_E08L.pdf

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  10. April 10, 2013 at 3:28 pm

    Christine Vara :
    …I have seen some practices that have different waiting rooms for well visits vs. sick calls, …. Also, if a parent suspects something that is highly contagious, like measles or chicken pox, they are typically advised to inform the doctor’s office prior to arriving for their appointment and in most cases precautions can be taken to limit exposure to others in the waiting room. I have even known doctors who have asked a patient to come during off hours, or enter in through another door.

    I was born in the early 1950s, and this sort of separating the sick from the well was standard operating procedure at the clinic my parents used.

    Also, doctors did housecalls, as did the Visiting Nurse.

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  11. dingo199
    April 10, 2013 at 7:21 pm

    There is certainly a need for housecalls, which could be used in some scenarios.
    Pity docs are not usually receptive to doing this nowadays.

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  12. John Armstrong
    April 10, 2013 at 8:46 pm

    Jetcityjewel: Wonder why there isn’t an anecdotal story from a parent of a vaccine injured child along with the other anecdotal stories at the end? I am educated and this information did not convince me of the safety of vaccines which is the most important aspect to me.

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  13. Chris
    April 10, 2013 at 8:56 pm

    Mr. Armstrong, it depends on which side the science is on. My son had seizures from an actual disease. What you need to do is provided the verifiable scientific evidence that vaccines cause more seizures than the diseases.

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  14. John Armstrong
    April 10, 2013 at 9:17 pm

    Ms. Chris: That doesn’t make any sense. On one hand you are purposely getting a vaccination and on the other hand you are trying to avoid the disease.

    You need to provide the odds of me getting the disease that is going to cause the seizures. If I avoid the vaccine, then my risk is zero of getting seizures from a vaccine. What are the odds that I will get a disease that will give me seizures?

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  15. Chris
    April 10, 2013 at 9:22 pm

    By the way, Mr. Armstrong, that document is over fifty pages long. There are less than three pages with the three personal stories, but also three pages of references with at least eight scientific studies. Plus, there are several more scientific references in the other sections of that document.

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  16. John Armstrong
    April 10, 2013 at 9:29 pm

    Ms. Chris: Yes, I know, I read all of it. What is your point?

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  17. Jetcityjewel
    April 10, 2013 at 9:39 pm

    What would it take to convince you of vaccine safety Mr. Armstrong? What doesn’t make sense is your statement about “on the one hand.” Actually on the one hand you get the vaccine to avoid the disease and on the other hand you take your chances with nature and shun the history, studies, and stats that tell us the best bet is to get the vaccine if you are interested in avoiding the disease (and interested in not giving it to others) and interested in avoiding the suffering from a VPD’s worst effects including death and/or severe permanent disability.

    The good news? Washington state’s vax rate is going up among the educated too in part because of access and promotion of better information and also in part sadly to a pretty awful pertussis epidemic.

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  18. Chris
    April 10, 2013 at 9:41 pm

    My point is that you criticized the document that jetcityjewel linked to because it did not have anecdotes about about “vaccine injury.” But you ignored that it was well referenced, and starting on page 25 lists the relative risks.

    Take for example haemophilus influenzae type b, which used to infect 20000 children each year, where one in twenty died and a third ended up with permanent neurological damage.

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  19. Narad
    April 11, 2013 at 4:46 am

    Doctors may give their opinion if the parents ask for it, but after that it is their professional duty to respect the parents’ decision, whichever way it goes.

    An excellent example of the sort of attitude that leads some peds to instruct clients to seek care elsewhere.

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  20. Christine Vara
    April 11, 2013 at 9:12 am

    Narad, I agree. I go to the doctor myself, and bring my children to the doctor because I appreciate their education and training. I realize that their area of expertise can guide me in making the best health decisions for me and my children. They aren’t there to make the decisions, only guide me, but I need their opinions in order to do that. That doesn’t mean I don’t question their advice at times. And it doesn’t mean that I “take their word for it”. What it means is that we have an intelligent exchange in which I come to them with questions that I have based on the research I have done. I have learned a great deal from many doctors but I have also noticed that they seem to respect the fact that I have a lot of questions and take responsibility for the health of my family. And because of that, they have always had respect for my decisions. I don’t really understand why someone would bother going to a doctor if they weren’t going to want to get the doctor’s opinion on something. Unless of course they just need a physical for school or something.

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  21. My3sons
    April 11, 2013 at 11:14 am

    Narad, I have a huge problem with that reasoning. We can all agree that doctors and scientists can make mistakes. Correct? Symptoms can be misdiagnosed, underlying causes can be overlooked, warning signs can be missed, etc. After all they are human and can make mistakes, and have been proven over the years to have made some rather big ones. In fact in the US:

    “Medical errors remain a leading cause of death and injury at hospitals nationwide, and the effort to improve patient safety at the facilities “is too slow and should be a cause for great alarm,” according to a study released on Monday by HealthGrades, the Syracuse Post-Standard reports. For the study, researchers examined the records of Medicare beneficiaries treated at about 5,000 hospitals nationwide between 2002 and 2004 and used 13 patient safety indicators developed by the federal government to evaluate admissions (Mulder, Syracuse Post-Standard, 4/3). The study finds that about 1.24 million patient safety incidents occurred between 2002 and 2004, compared with 1.14 million between 2000 and 2002, at a cost of $9.3 billion.”

    It is the parent’s responsibility to always question any treatment, medications, injections, any medical procedure! I will not put blind faith in anyone when it comes to my children, even if they do wear a white coat.

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  22. My3sons
    April 11, 2013 at 11:21 am

    Why won’t my comment post? Is there a delay this morning? I don’t want to keep re-submitting my comment only to see 10 of them later because there was a delay!

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  23. My3sons
    April 11, 2013 at 11:30 am

    Odd that my second comment showed before my first. Must have been a delay or someone fixed it! 🙂

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  24. Christine Vara
    April 11, 2013 at 11:35 am

    My3sons We apologize that you are experiencing difficulties with the WordPress platform. We are aware that this has been a inconsistent, yet recent and recurring issue. We are currently working to identify the problem and fix it for our readers. However, in the meantime, feel free to send your comment to shotofprevention@gmail.com and we can post the comment on your behalf. Also, if we see the same comment has gone through multiple times, we will simply remove the duplicates for you. Again, we apologize for the inconvenience but hope you will continue to participate in the discussion.

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  25. My3sons
    April 11, 2013 at 11:43 am

    Thanks Christine. I just did not want to ruin this thread with duplicate comments. Thanks for the info.

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  26. Christine Vara
    April 11, 2013 at 1:37 pm

    We are posting this on behalf of MelodyRN:

    Doctors have a variety of patients that visit their practice. A pediatrician may see a newborn, an immuno-compromised teenager and a medically fragile patient, in addition to their typical cases within the same day. Medical providers need to be able to provide care and treatment while ensuring that their services will protect each and every one of them. I understand how confusing and complicated the topic of immunology can be, and it’s normal and welcoming for parents to have questions and concerns – that shows they are taking an active role in their child’s health. However from the viewpoint of the doctor, after many sessions of education and guidance has taken place I do understand the need to protect other Patients in the new practice. Parents have to face the consequences of their decision and if refusing or delaying immunizations jeopardizes your child’s ability to receive important and necessary healthcare perhaps the parents need a wake-up call. Being booted from a practice might be the only way. However I would stress that the doctor and nurses strive to maintain a relationship with the parents and child. While they no longer may be able to attend the office, a relationship can continue through email and or phone calls. A request for the family to leave the practice should not be an ending to the professional medical relationship between the doctor and parent.
    MelodyRN
    http://www.Facebook.com/nurseswhovaccinate

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  27. dingo199
    April 11, 2013 at 2:02 pm

    John Armstrong :
    Jetcityjewel: Wonder why there isn’t an anecdotal story from a parent of a vaccine injured child along with the other anecdotal stories at the end? I am educated and this information did not convince me of the safety of vaccines which is the most important aspect to me.

    Perhaps because this is entirely proportionate?
    3 cases are described of illness from the diseases, none about a vaccine reaction.
    If you wanted an accurate anecdotal comparison, you’d need around 2000 tales of kids suffering from the diseases to every one case of severe vaccine reaction. I don’t think the brochure had room for that.

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  28. John Armstrong
    April 11, 2013 at 3:08 pm

    Doesn’t look like my comments are going through either….have a nice day.

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  29. My3sons
    April 11, 2013 at 4:25 pm

    Maybe you should try again John. Christine was able to help me, or email to the address she posted above.

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  30. amy pisani
    April 12, 2013 at 11:17 am

    there seems to be a glitch in the system..we are working on it. This may not post either.

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  31. dingo199
    April 12, 2013 at 5:40 pm

    No problems my end…

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  32. Christine Vara
    April 12, 2013 at 10:15 pm

    Lara Lohne added this comment:

    “My3sons, you are trying to compare apples and oranges and claim they are the same thing. The study you site is regarding HOSPITAL care, not office or private care facilities. There is a big difference, because generally speaking, most people who require the opinion or consultation of a medical professional aren’t going to the hospital, but to their primary care provider. Do you have a study relating to private practice mistakes causing death? I don’t take my son to the hospital for his immunizations, he goes to visit his pediatrician, in his office. The only times my son has been to the hospital were when he broke his arm and when he had a very high fever that had lasted for a couple of days and he didn’t have a pediatrician at the time for me to make an appointment with. For non emergency medical issues, most people don’t go to the hospital, and if they are already in the hospital, that’s probably not for standard every day care to begin with, which is what we are talking about when it comes to immunization. So again, apples and oranges, two very different things.”

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  33. My3sons
    April 16, 2013 at 9:54 am

    I responded yesterday but it looks like this site is still having issues…

    Lara my argument was based on the fact that doctors are human and do make mistakes, as documented by the fact that medical related hospital errors are the third leading cause of death in the US. Many people are intimidated by doctors because many doctors like it that way, they don’t want you to question them, they are telling you what you need and think you should just comply. After all explanations take time, time backs up appointments, less time equals more appointments. Right? I say: “no way!” Always question, research, get another opinion when it comes to any medical treatment. Many people will get several opinions when improving their house, fixing their car, etc. Why on Earth would you not put the same effort into deciding the best medical tx for you and your family?

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  34. April 16, 2013 at 12:36 pm

    @My3Sons – please provide your source for hospital errors being the 3rd leading cause of death….because this says it isn’t so:

    http://www.cdc.gov/nchs/fastats/lcod.htm

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  35. Christine Vara
    April 16, 2013 at 3:00 pm

    I’m sharing this comment on behalf of Lara Lohne, since she is still experiencing difficulty in posting:

    “From my experience, any doctor that I’ve been to, not only welcomed me to ask questions and get second opinions, but encouraged it, so I’m not sure why you would make such general statements about doctors as if they are evil, arrogant and only out for money and not there to help. If I ever went to a doctor that didn’t allow me to ask question and wouldn’t allow me to get a second opinion, I would no longer go to that doctor. I may be their patient, but I am also their customer and as their customer I deserve to be treated with dignity and respect and not allowing me to ask questions about the product I am paying for (their service/treatment) is a huge red flag. So your statements regarding doctors not liking when you question them, etc, to me says more about the customer then the doctor actually. If a doctor is arrogant and treating his/her patients in that manner, they deserve to lose business. If the customer doesn’t leave and find a new doctor, that isn’t the fault of the doctor.

    On the other hand, there are some times when too many questions and too much second opinion seeking can get in the way of your health and best interest. That being the case, questioning and seeking other providers opinions needs to be tempered with common sense. If you see three specialists and all tell a person the same thing, chances are seeing another won’t change anything and at that point it’s just the person looking for a doctor to tell them what they want to hear versus what is really going on. In that case also, the fault lies with patient/customer, not the doctors.

    You can’t blame everything that goes wrong with medical treatment on doctors. True they do make mistakes, as we all do, but if an individual is uncomfortable with a doctor they are seeing and doesn’t feel right about a treatment or diagnosis, then by all means seek a second opinion. The big issue here though, isn’t about malpractice or doctor’s making mistakes, it’s about doctors dealing with their patients that may refuse vaccination when there is no medical contraindication for them to do so. That would be on the patients head as well for refusing to accept the best protection science currently has to offer against potentially dangerous and very painful to endure, diseases. Decades of research show vaccinations to be significantly safer then the diseases they can prevent. Why would anyone refuse to accept this information as accurate to the best of our ability to determine at this time? In my experience with anti-vaccination lifestyle, it’s just pure ignorance, arrogance and stubbornness, with a little naivety and denial thrown in.”

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  36. My3sons
    April 16, 2013 at 5:13 pm

    This is one of the sites I read it on, there were a few. I don’t feel the CDC’s info is detailed enough, but that is just my opinion. Everyone should decide for themselves.

    According to recent US health care studies, preventable harm due to medical error ranks as the number three cause of death in the United States, making “preventable harm by medical personnel” less deadly than only cardiovascular disease and cancer.

    http://www.therasim.com/industry-news/medical-error-deaths/

    Like

  37. My3sons
    April 16, 2013 at 5:14 pm

    Sorry forgot to mention that post was in response to Lawrence.

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  38. April 16, 2013 at 5:31 pm

    @My3Sons – you’ll need to do better than a website that serves as a marketing device…..even seeing the CDC numbers from 2010 & 2011, I’m not seeing what you are seeing.

    Perhaps you’d like to elaborate?

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  39. April 16, 2013 at 6:00 pm

    @My3Sons – here is an examination of that “figure”

    http://www.sciencebasedmedicine.org/index.php/put-your-fears-in-perspective/

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  40. Maritza
    April 16, 2013 at 9:43 pm

    Parents must make the final call. The HIb vaccine, for instance. Classen published the results of a study in the BMJ 1999; 319:1133 and in Autoimmunity 2002 on 200,000 Finnish children in three groups, either not getting Hib, getting it once, or four times. At age 10, there were 58 more cases of diabetes per 100,000 in the group that got four doses of the Hib vaccine than there were in the group that got none. The Hib vaccine is expected to prevent a much smaller number of severe disabilities. Classen said that the increased risk of diabetes in the vaccinated group exceeded the expected decreased risk of complications of HIb meningitis, and that the potential risk of the vaccine exceeded the potential benefit.

    The Hib vaccine has caused many cases of paralysis, meningitis, invasive pneumococcal disease, encephalitis, convulsions, and SIDS. On the other hand, the disease can be very dangerous, progress quickly, and kill the patient fairly often, though not always. It must be left to the parent to research the risks and benefits and make the decision. It is her child, not the doctor’s. The doctor will usually downplay the risks of the vaccine, while exaggerating the dangers of the disease, and the parent must be aware of this prejudice, and consider facts from the other side as well.

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  41. Maritza
    April 16, 2013 at 9:51 pm

    Come now, Lawrence, you want to counter an article promoting consumerism, in which the consumer takes more responsibility for his own health over blindly trusting the doctor, with an article from Respectful Insolence? I read the article linked, it appeared sober and trustworthy to me, and I had read in several other places that deaths in the US due to medical error were one of the leading causes of death. Are you quibbling about whether it’s in third or fourth place, or are you trying to say it’s not an important cause of death at all? You want to accept only the results of a survey of doctors as to whether they think that medical error by themselves and their colleagues is a leading cause of death? I’m sure you realize that, as a society, we’re way beyond that sort of childlike credulousness.

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  42. Gray Falcon
    April 17, 2013 at 12:46 am

    Martitza- Are parents omniscient?

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  43. Mari
    April 17, 2013 at 11:20 am

    GF, Are doctors omniscient? What’s your point?

    Chris, may I ask what the disease was for which there is now a vaccine, but which disabled him in the days before there was a vaccine? One of the meningitis vaccines? I am very sympathetic to your personal experience of disease damage which might have been prevented had the vaccine been available, but I’d also like to point out that when other people talk about their own or their children’s vaccine damage, you are quick to dismiss their accounts as anecdotal.

    All of the meningitis vaccines have killed or disabled many people. While it is true that meningitis of any kind is a very dangerous disease, it is also true that the germs are ubiquitous and found in a large percentage of people who never display symptoms of the disease. Hib was rare until the rise of antibiotics in the 1940s, when it gradually became more and more common. Taking out the HIb germs by the vaccine seems to have led to the rise of more dangerous pneumococcal bacteria, and taking them out by Prevnar to have led to the rise of the even more dangerous meningococcal microbes. Dangerous microbes always seem to expand to fill the vacated niche.

    Most people will never get meningitis of any kind. If you give a meningitis vaccine to 100,000 children to prevent the death of one of them from meningitis, you thereby permit damage or death caused by the vaccine to maybe 100 of them. Penny wise, pound foolish.

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  44. novalox
    April 17, 2013 at 11:30 am

    @mari

    [citation needed]

    Like

  45. April 17, 2013 at 11:30 am

    @Mari – and you have citations for all of your “assertions?”

    Stories are a place to start – then we follow up with hard scientific research & the current body of research (done over the past two decades) show that serious vaccine reactions are extremely rare (upwards of 1 in 1mil or 1 in 10mil vaccinations), much more rare than the diseases they prevent, or the serious side-effects that can and do occur and frightening rates – upwards of 1 in 100 or 1 in 1000 for things like pneumonia, secondary infections, and encephalitis.

    This is real Mari – unlike the myths the anti-vaccine crowd pushes.

    Like

  46. Chris
    April 17, 2013 at 12:15 pm

    Chris, may I ask what the disease was for which there is now a vaccine, but which disabled him in the days before there was a vaccine?

    No. It was in 1989, you have a choice of several vaccines (Hib, rotavirus, varicella, DTaP, HepB, HebA, meningococccal). And it was not only now vaccine preventable disease he suffered before the vaccine was available. And I am only offering up one anecdote, which is not data. I go by the science and actual data, and if you wish to be taken seriously you need to provide the verifiable scientific evidence.

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  47. Chris
    April 17, 2013 at 1:05 pm

    Some actual evidence: Vaccine. 2012 Jan 5;30(2):247-53.

    Now, Mari, it is your turn.
    .

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