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Vaccine refusals and mandatory immunizations

I believe that every state except West Virgina and Mississippi has some sort of religious and/or philosophical exemption to vaccination as regards entry into school. In most of them that I've looked at, it winds up being very simple, just submit a written statement that you object and sometimes verify that you have read some literature on the benefits of vaccination (a pamphlet.)

Bet if you'd been ignorant of the two states and had been asked, you wouldn't have picked those two... At least I know I sure wouldn't have.
 
fls said:
I don't think that's true. Do you have some sort of documentation of this?

Linda
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I posted the link and the rules. Not sure what else is needed. In my MOA course we also discussed it, and transcribed a case where the doctor was referring a patient to another doctor because she was dropping a patient that wasn't following advice in regards to diabetes and was suffering a possible limb loss because of it.
 
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Eos of the Eons said:
I posted the link and the rules. Not sure what else is needed.
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The link talked about various reasons for dropping a patient and how to go about it. However, it did not document how often it occured for specific reasons. In particular, the reason you gave as happening "quite often", was mentioned only briefly in regards to "unruly and uncooperative patients". And the legal recommendations under those circumstances were relatively onerous compared to other reasons for dropping a patient. If that's all you had, then your qualification was unjustified.

In my MOA course we also discussed it, and transcribed a case where the doctor was referring a patient to another doctor because she was dropping a patient that wasn't following advice in regards to diabetes and was suffering a possible limb loss because of it.
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So if you know of a single example (made-up or otherwise) it can be assumed to happen "quite often"?

Linda
 
fls said:
The link talked about various reasons for dropping a patient and how to go about it. However, it did not document how often it occured for specific reasons. In particular, the reason you gave as happening "quite often", was mentioned only briefly in regards to "unruly and uncooperative patients". And the legal recommendations under those circumstances were relatively onerous compared to other reasons for dropping a patient. If that's all you had, then your qualification was unjustified.



So if you know of a single example (made-up or otherwise) it can be assumed to happen "quite often"?

Linda
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Oh, okay, I see what you mean. I meant to say it doesn't just happen in cases of vaccine refusals, it can happen for other reasons as well. It may not be "often", just that it can and does happen for a variety reasons. Thank you for the chance to clarify :D
 
Deetee said:
Seen the NEJM article on this subject yet?

Ivor would be interested in this bit:
Some clinicians have discontinued or have considered discontinuing their provider relationship with families that refuse vaccines.60,61 In a national survey of members of the American Academy of Pediatrics, almost 40% of respondents said they would not provide care to a family that refused all vaccines, and 28% said they would not provide care to a family that refused some vaccines.61
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Wouldn't the responses of physicians with a particular dislike of "antivaxer" parents be over-represented in such a survey?

Background Parent refusal or deliberate delay of their child’s vaccinations poses a challenge for pediatricians. Some pediatricians may choose to dismiss these families from their practice.

Objectives To describe pediatricians’ responses to scenarios of vaccine refusal, identify reasons pediatricians cite for both parent refusal and family dismissal, and illustrate pediatrician attitudes about well-established vs newer recommended vaccines.

Design/Methods We conducted a nationwide survey mailed to 1004 randomly selected American Academy of Pediatrics (Elk Grove Village, Ill) members.

Results Fifty-four percent faced total vaccine refusal during a 12-month period. Pediatricians cited safety concerns as a top reason for parent refusal. Thirty-nine percent said they would dismiss a family for refusing all vaccinations. Twenty-eight percent said they would dismiss a family for refusing select vaccines. Pediatrician dismissers were not significantly different from nondismissers with respect to age, sex, and number of years in practice. Pediatrician dismissers were more likely than nondismissers to view traditional vaccines (diphtheria and tetanus toxoids and acellular pertussis; inactivated poliovirus; Haemophilus influenzae type b; measles, mumps, and rubella) as "extremely important," but they were no more likely to view newer vaccines (7-valent pneumococcal conjugate, varicella-zoster virus, hepatitis B) as "extremely important."

Conclusions Pediatricians commonly face vaccine refusal that they perceive to be due to parent safety concerns. In response, many pediatricians say they would discontinue care for families refusing some or all vaccines. This willingness to dismiss refusing families is inconsistent with an apparent ambivalence about newer, yet recommended, vaccines. The practice of family dismissal needs further study to examine its actual impact on vaccination rates, access to care, and doctor-patient relations.
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In the full text:

The initial mailing and 2 follow-up reminders yielded 452 returned surveys (45%) with 23 returned as undeliverable. Subsequent analyses were conducted on the 302 physicians (70% of returned surveys) who indicated they currently provide routine vaccinations in a primary care setting. Table 1 presents the demographic characteristics of the sample.
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Hmm, a maximum non-vax rate of 2.54% ?

I would think that 97% is enough for herd immunity?

So where do the germs keep coming from? What is the vector for chicken pox? Chickens? Oughtn't we vaccinate chickens, instead of worrying about the last 2.5% of humans? Likewise measles?

Comparative risk vs relative risk? Just what are a child's chances of getting the disease? A six times higher rate might mean chances still 100:1, even if un-vaxxed.

You've got about 100:1 chance of dying in a car accident. Yet the few who do avoid riding are considered the weirdos. So certainly 100:1 is a reasonable risk for most of us to take.

Hmm, maybe a thread idea there- "How much risk is too much to you?"
 
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casebro said:
Hmm, a maximum non-vax rate of 2.54% ?

I would think that 97% is enough for herd immunity?

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I suspect where they uniformly distributed among population they wouldn't be such problem.But they tend to associate more making local group of unvaxed and causing local herd-immunity fail.

My 0.02€.
 
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