The Holistic Pediatric Association is dedicated to the full communication, cooperation, and partnership between pediatric health care providers and parents. Parents manage the health care, emotional care, and educational care of their children with the help and guidance of pediatric and educational specialists. A fundamental HPA policy is the full support of parents in making informed health care decisions. This includes the use of drugs, vaccines, and the full range of holistic healing modalities. The HPA family includes parents, health care providers, support networks, and other organizations dedicated to the holistic care of children. We honor a parents’ right to make informed decisions, and do not condone coercion of parents or pressure to do anything that would contradict their own beliefs. Questions arise only when a parent’s decision may compromise the health or safety of their child. Then the judgments of providers and parents may be called into question.

Any policy of pediatricians that would prevent families from receiving medical care based on a parent’s convictions and beliefs is contrary to the principles of the HPA.

A sharp division has occurred and, in some cases, battle lines have been drawn over the issue of vaccination. A survey published in the October 2005 issue of Archives of Pediatrics and Adolescent Medicine documents the recent trend among pediatricians to terminate the medical care of children whose parents refuse vaccines that the pediatrician recommends. This authoritarian stance assumes that the pediatrician not only knows what is best, but also implies intolerance of any other opinion.

The survey polled pediatricians regarding their experience with parents who declined vaccination. The terms repeatedly used in the survey and the report of this survey are “refuse vaccines” and “refusal of vaccines” rather than “decline vaccines,” implying that parents are obstreperous or contrary, rather than thoughtful and considered in their decisions.

The question asked of pediatricians was, “If after numerous attempts at vaccine counseling and education, a parent continues to refuse, would you dismiss them from your practice?” Of the pediatricians who responded, 39 percent said they would dismiss a family for refusing all vaccinations, and 28 percent said they would dismiss a family for refusing select vaccines.

The astounding finding in this survey was that 79 percent of pediatricians recognized that parents decided not to vaccinate because of safety concerns. Parents are justly concerned about the safety of vaccines because of research they have read about vaccine adverse effects, the toxicity of vaccine components, the questionable use of vaccines with side effects to prevent relatively benign diseases of childhood such as chickenpox, and the media presentations that also question the safety of vaccines. For pediatricians to ignore or discount these concerns of parents suggests an autocratic, dictatorial, and dismissive attitude that is bound to further alienate parents and further polarize the emotional and volatile climate that surrounds the national policies of compulsory vaccination.

The authors note specifically that, “our survey questions regarding family dismissal asked pediatricians to indicate what they might do if faced with a vaccine refusal. We did not measure actual practice.” In fact, the actual rate of dismissal over vaccine decisions may be much higher than revealed in this study. I have spoken to parents who reported that 90 percent of the pediatricians they interviewed refused care to their children based on the family’s vaccination choices.

An accompanying editorial in the journal notes that 95 percent of pediatricians in this study rated traditional vaccines as extremely important. That article’s author also states that preventive care through immunization is stressed throughout a pediatrician’s training and career. Moreover, “Immunization rates and timeliness of administration are often measured and referred to as a marker for high-quality pediatric care.”

We can note and debate how much influence the pharmaceutical industry has on the attitudes of pediatricians, but the fact that pediatricians are coercing parents to vaccinate with threats of dismissal is possibly unethical and potentially dangerous. In communities with limited access to pediatric care, where parents do not have another recourse, such refusals of care could result in children with inadequate medical care who suffer much worse problems than not receiving a vaccine.

Flanagan-Klygis EA, et al. Dismissing the family who refuses vaccines. Archives of Pediatrics and Adolescent Medicine2005 (Oct) 159:929-34.

Excerpt from Child Health Guide: Holistic Pediatrics for Parents, North Atlantic Books, 2005