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Poll: Should Primary Care Providers Accept Unvaccinated Patients?

Since 2001, the number of children not vaccinated for preventable diseases has quadrupled. This cultural shift has left pediatricians, as well as primary care and family medicine providers, in a tough spot. While many feel an obligation to educate vaccine-hesitant patients, they also must consider the concerns of vaccine-compliant parents at their practice. And the latter responsibility may be more demanding than previously thought, according to a recent survey.

How Do Parents Feel About Their Providers Treating Unvaccinated Patients?

RELATED: 4 Tips for Talking to Patients About Vaccine Hesitancy

Based on the responses of 2,032 parents with at least one child 18 or under, the national Mott Poll Report from the University of Michigan found roughly 4 in 10 parents were either very (12 percent) or somewhat likely (29 percent) to switch providers if theirs welcomed unvaccinated families.

Some other findings of the survey include:

  • 28 percent of parents say their child’s provider should ask parents who refuse all vaccines to find another health provider.
  • 27 percent wanted providers to require unvaccinated children wear a mask in the waiting room.
  • 17 percent wanted unvaccinated children banned from the waiting room.
  • 28 percent said unvaccinated children should continue using the office with no restrictions.
  • 43 percent of parents say they would want to know if there were unvaccinated children at their provider’s office; 33 percent say they wouldn’t.
  • 38 percent of parents don’t know if their child’s provider has a policy about unvaccinated patients.

Why Do the Survey Results Matter?

“A completely unvaccinated child is unprotected against harmful and contagious diseases, such as measles, pertussis and chicken pox,” said Mott Poll co-director Sarah Clark, MPH, in a statement. “Children who skip vaccines also pose a risk of transmitting diseases to other patients. This can be especially risky exposure for vulnerable populations, including infants too young to receive vaccines, elderly patients, patients with weakened immune systems or pregnant women.”

Clark added that the current measles outbreak — because it’s mostly affecting communities with large, unvaccinated populations and the disease is so contagious — highlights the urgency for providers to establish their own policies for vaccine-hesitant patients.

RELATED: 5 Things Nurses and PAs Can Do to Stem the Spread of Measles

“Parents may assume that when they take their child to the doctor, they are in a setting that will not expose their child to diseases. Parents may not have considered that there could be another child in the waiting room whose parents have refused all vaccines,” Clark explained. “When prompted to think about it, most parents want the doctor’s office to have some policy to limit the risk from unvaccinated children.”

What are some arguments around unvaccinated patients that providers should consider?

For non-medical professionals, it’s easy enough to assert that the needs of parents deliberately disregarding pediatric best practices should be secondary. But providers know the issue is more complicated, at least in part because there are many reasons why parents may refuse vaccines.

According to a 2016 article Pediatrics article, the two most common arguments in favor of dismissing anti-vax parents are:

  • Their refusal suggests such lack of trust in the provider’s recommendations that it undermines the basis for a meaningful provider–patient–parent relationship.
  • Unimmunized children present an unacceptable risk to other children in the waiting rooms.

RELATED: Beliefs Cloud Best Practices with Infection Control

Arguments in favor of continuing to treat unvaccinated children include:

  • The provider can continue to try to convince the parents to immunize their children.
  • Continuing to see unvaccinated patients means you can feel confident in the quality of care they’re receiving and can uphold your responsibility to advocate for the child’s health.

Do you agree with any of these arguments? Share your thoughts in the poll below.

References:

Should Doctors Accept Unvaccinated Children as Patients?, University of Michigan Health Lab.

Should Pediatric Practices Have Policies to Not Care for Children With Vaccine-Hesitant Parents?, Pediatrics.

Last updated 8/22/2019

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