AAP policy statement on patients who refuse vaccination – Reaffirmed April 2013

smarty“Reaffirmation: Responding to Parents Who Refuse Immunization for Their Children” published in Pediatrics; originally published online April 29th, 2013

In light of the recent Oregonian article that seemed to suggest that patients being discharged from a Pediatrician’s office for their beliefs on immunization was OK, I offer a very different view that is shared by the Academy of Pediatrics.  It is not the role of the pediatrician to dictate and mandate to any parent how to raise or treat their child.  We are to share our knowledge and information and all we can to help parents come to an informed and educated decision.  In the end, it is their choice what to do about care decisions such as immunizations.

I am aware of rare instances, such as a child with bacterial meningitis, which is completely treatable, where a parent who refuses treatment for that child might have the court intervene and mandate treatment, by removing that child from the custody of that parent for life-saving treatment. 

When it comes to immunization, an intervention that surely can be life-saving, it is more complicated, as immunizations also can have side-effects. Since the current recommendations from the ACIP and AAP include giving pregnant moms Tdap with it’s 330 micrograms of aluminum and newborns the Hepatitis B vaccine with it’s 250 micrograms of aluminum, it may be that parents who decline these vaccines at those times (while pregnant and for the newborn if mom does not have Hepatitis B) are the more educated.  They certainly should be respected and I find it extremely arrogant that a pediatrician would discharge a family from their care for making such an educated and informed choice. 

I’m happy the Academy of Pediatrics has reaffirmed their policy stating: “In general, pediatricians should endeavor not to discharge patients from their practices solely because a parent refuses to immunize a child”.



Dr. Paul



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