Tuesday, November 08, 2005

Health policy: physician reaction to parents who refuse vaccination

The Washington Post reports on a study of pediatrician attitudes to vaccine refusal:
A team of pediatricians from three major Chicago medical centers surveyed more than 300 of their colleagues around the country about their attitudes toward vaccine refusal. Slightly more than half of pediatricians said that in the previous year they had encountered at least one family that refused all vaccines, while 85 percent said they'd had a parent turn down at least one shot.
More surprising to the authors were two findings: 39 percent of those surveyed said they would consider turning away a family that refused all shots -- researchers had expected the number to be about 20 percent -- while 28 percent said they'd think about severing a relationship with a family that refused some shots.

My sister-in-law has three little kids, the most beautiful, healthy-looking kids I know-- Gerber babies, all of them. None have been vaccinated. I don't know if they ever see an M.D. When they're sick, they visit a chiropractor/naturopath/kinesiologist. On a daily basis, they take an array of herbal and homeopathic preparations.

Shortly after she had her first kid, my sister-in-law had an illness that doctors were unsuccessful in helping her overcome. I'm not sure about the details, but the important bit is that a friend got her to try a wheat- and gluten-free diet, and it made her feel a lot better. She read books like "The Yeast Connection" and got connected, in part via the internet, to a network of people who were skeptical of the traditional medical establishment. She became a devotee of applied kinesiology, bought a Chi Machine, started using magnets.

It used to make me crazy. I couldn't believe that she'd dedicated her life to quackery, that she'd entrusted the health of her children to people who defied science. I was furious when she'd send emails and links to articles about how Nutrasweet causes MS or how supplement-and-diet-book peddler Dr. Mercola considers interferon drugs for MS "a waste of money." These days, though, I'm more or less over it. We do not live in an age of reason. For whatever reason, people distrust science and the authority it claims. A Gallup Poll in February of 2005 found that about half of all Americans think "God created human beings pretty much in their present form at one time within the last 10,000 years or so." This is apparently one of the things that my sister-in-law is teaching her kids.

Now, it's a free country and you're free to believe pretty much any kooky thing you want. But isn't there a public health problem lurking here? Don't we all have an interest in maximizing the number of people receive vaccinations? What about the dreaded bird flu pandemic? What if a significant number of people refuse to follow science-based advice? More generally, as a practical matter, in our health care system, don't we all run the risk of paying for the consequences of bad health advice?

Which takes me back to the article: apparently, if you're a parent who refuses vaccination, you run a significant risk of being "fired" by your doctor. What do these docs think are the likely consequences of terminating these people? I'll venture a guess that a refusnik parent who's been fired by her pediatrician is more likely to explore so-called complementary medicine, more likely to venture further and further from science. Is this desirable, from a public health perspective?

Link to WaPo article.


Anonymous said...

Yikes, you are seriously undereducated in the history of vaccinations and the harm they cause. I love how people like you put down intelligent, thinking parents who want the best for their children. I'm sure you know everything there is to know about science and medicine. Give me a break. My children will never be immunized ... I will allow their immune systems to be exposed to illnesses naturally. I feel sorry for your own children.

mdmhvonpa said...

Unlike Anonymous, I have a pretty good understanding about what immunizations are for. They are the virus in a state that allows the body to recognize the invader and have a really good chance of creating a defense for it. I grew up in rural Minnesota. I ate my peck of dirt and got my immunity. I never was exposed to polio becasue ... I got my polio shot. I never got Rubella, etc ... either like my parents because, well, I got my damn shots. Now I hear of Polio outbreaks in Africa because people are turning down vaccinations because they believe that they are attempts by the west to make Islamic men impotent. Now my children, who did not get a Polio shot, are at risk. They are only exposed to the family dogs and have that 'germ fest' to thank for their lack of allergies (or so I believe). The basic foundation for the human immune system is really quite simple. I too am a bit irritated by some decisions by others that expose my children to unnecessary risks. If we all went without vaccinations, the family size of 8-16 would be required just for the human race to survive!

Beth said...

Lots o' topics here- but on the vaccine thing I agree with mdmhvonpa- yuppies refusing vaccines is as silly as the muslims in India saying Allah will protect their child from polio. (By the way- those refusing in Africa or India were placated after they sent the vaccine to an independent lab in Malaysia and their fears that it was contaminated with other products was unfounded).

I think we live in a place where we don't see the devastating effects of polio. Polio is still around. If your unvaccinated kid is exposed to Polio they will get Polio- period- I don't care how much yeast-free, wheat-gluten-free, crap you've been feeding them they will get polio and they will be cripple- it doesn't matter how "healthy their immune systems are".

If enough yuppie parents stop vaccinating for Small Pox and Polio will re-emerge in the US. The relative "health risks" outweight the benefits by orders of magnitude. I would rather expose my kids to a tad of mercury (which is supposidly in some vaccines) then have them cripple or die of small pox.

Anonymous- I would like to see the references to these supposed papers on the "harm" of vaccines- journal article citation, authors, year etc. to see if these papers exist and are valid.