To Vaccinate or Not to Vaccinate

April 5, 2011

One area where it is challenging to allow parents to parent according to their own conscience is the issue around vaccine refusal.

So I’m both a mom and a doctor. This gives me an affinity with many of my patients, who know that I do truly understand what it is like to deal with a colicky baby, try to breastfeed while working full time, or wrestle with whether to just tough out the fever one more day or take your kid into the doctor already.

I try to extend grace whenever and wherever possible, recognizing that many of the choices we make about and for our children really don’t matter that much in the grand, big view of life, scheme of things. Bottle-fed babies still grow up to be President of the United States. Allowing your child to sleep in your bed until kindergarten may actually result in better rest for the whole family. And, my confession to you - I let my kids eat sugar cereal.

But one area where it is challenging to allow parents to parent according to their own conscience is the issue around vaccine refusal. Some parents refuse all vaccines outright. Though this extreme is actually pretty unusual, what is more common is partial or conditional refusal. Some moms and dads will accept all recommended vaccines except: a) the ones that “cause autism”; b) the ones that protect against sexually transmitted infections; c) the flu vaccine; and the list goes on.

Having come to terms with treatment refusal and negotiation in numerous iterations and flavors, I guess I put vaccine refusal in the same category that contains insulin refusal for diabetic patients, exercise refusal for patients with coronary artery disease, or smoking cessation refusal for patients with COPD.

I think the patients are making the wrong choice, medically speaking, but respect that they are ultimately the ones that know themselves best and who will be the ones to live with the consequences of their decisions. Of course, when it comes to moms and dads, they get to make all kinds of decisions for their kids that may affect them adversely down the line, but we trust that they are ultimately motivated by love and a desire for their children to be well and healthy.

Not all doctors agree. I know some who fire patients who refuse vaccines. This seems a little shaky to me, unless you happen to fire every patient who doesn’t follow your treatment recommendations. And then, let’s be honest here, who’s left to take care of? I make sure the parents in my practice who refuse vaccines have the best information I can provide so that they are at least making an informed decision. But one more thing is required - the why. Why do you want to postpone/avoid vaccination? In that answer, I’m able to begin the true therapy of our physician-patient relationship - understanding their fears and concerns and trying to bring them a little bit closer to what I think, as their doctor, is the best thing for them medically-speaking.

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