Last week I was interviewed for an article that appeared in the Observer-Reporter about parents who opt out of vaccines for their children.  The reporter asked me if I was seeing a trend of vaccine delay or refusal — as has been seen in other areas of the country — in my own office-based practice.  My answer was “no.”

One of the most satisfying aspects of being a pediatrician is establishing and maintaining meaningful relationships with families in the office and with the community at large.  One of the most challenging tasks is earning trust, and that begins (and ends) with honest and credible communication, which is bi-directional.

Over almost 25 years in practice, I’ve had very few parents who outright refuse vaccines.  Almost all of these parents believe that they can better-build and -maintain a healthy immune system in their children by teaching them to live “right” (eating organic, avoiding processed food, exercising, etc) in order to prevent or deal with the childhood diseases we’re immunizing against. Vaccines, they say, are just putting something else unnatural or artificial (like preservatives in food, hormones in milk, or GMO’s) into their children’s bodies.  I think these parents feel that their child either won’t ever acquire a vaccine-preventable illness or, that if they do, they won’t get very sick from it because they are so “strong.” These parents also completely misjudge the amount of unnatural, artificial, polluted, and toxic “antigens” their infants and children encounter daily in the air they breathe, the food they eat, the water they drink, and the soil and floors they play on.  I’ve found that trying to convince this group of parents otherwise is impossible.  Most of them didn’t get vaccinated as children themselves and see — they survived!  Still, this remains a very, very small percentage of families I see in the office.

A second, larger (though still small) group of parents who refuse vaccines do so initially but with time, patience, education, and respect, most will get their children immunized — usually completely, though usually not on time.  These parents delay their kids’ vaccines for one reason only: fear that vaccines will harm their children.  The fear stems from things they’ve heard from other parents, things they’ve read on the internet, or something their “gut” is telling them.  Many admit that they know their fears are unfounded, yet they persist in their refusal to vaccinate. Others, however, are firm in their personal beliefs that vaccines cause autism, or that vaccines make you sick, or that vaccines are too new to know the long-term side effects, or the dozens of other thoroughly debunked-by-science excuses pediatricians listen to. I’ve found that if I continue to listen respectfully and engage the family in continuing dialogue over months and years, they will let me protect their children from diseases that still, today, can sicken, maim, and kill children who aren’t immunized, by vaccinating them (even if we do one at a time).

What should be made crystal-clear is that the vast majority of parents understand the importance of protecting their children (and my children) from these diseases, and they get them immunized completely and on time.  How big a majority?  Steven Reinberg reports that 93-95% of children who enter kindergarten in the United States receive their required immunizations on time:

However, there was still a persistent 1.8 percent of kids whose parents didn’t want their children vaccinated, the U.S. Centers for Disease Control and Prevention researchers noted.


The bad news for this group of kids is obvious.  But the good news, I told the newspaper reporter, is that this percentage of parents who refuse to vaccinate their children is very, very small and does not appear to be increasing.  It’s important to understand, though, that vaccine refusal rates are not uniform throughout the country; some communities do worse than others.  We’ll take a closer look at who exactly does most of the refusing tomorrow.  You may be surprised.