There Should Be Separate Pediatrician’s Offices For Kids Who Aren’t Vaccinated

shutterstock_176448347__1395159850_142.196.167.223If you read the news at all, I’m sure you are aware that there is a measles outbreak in NYC. As of last week, there’s a total of 19 confirmed patients with the highly contagious virus. A doctor weighed in on the outbreak in Slate today, wondering if he should start only treating vaccinated children. I think he may be on to something.

So here is where pediatricians find themselves: Even if we believe—as virtually all of us do—that immunization is tremendously important and valuable, what do we do about the parents who don’t want their kids to get vaccinated?

Personally, I draw the line at vaccines protecting against diseases that kids might catch from exposures in my office. If parents want to withhold protection from hepatitis B or cervical and oral cancer, I think it’s not so smart, but I’ll still care for their children because not even the friskiest teen is likely to transmit these diseases in my office.MeaslesWhooping cough? These are another matter. My sense of responsibility to the health of the vast majority of kids coming to see me says “no.”

This sounds reasonable to me. You want your child to remain unvaccinated? Find a pediatrician who will treat him. Maybe the sheer inconvenience of having to search for medical doctors who actually believe vaccination against deadly disease should remain a person choice will convince these parents to make better decisions.

Clearly there is a part of this that feels like children would be punished for the bad decision-making of their parents. I hate the idea of that – but at the same time, parents who actually believe vaccinations are dangerous instead of one of the most amazing scientific accomplishments, ever – need to be dealt with somehow. These parents have reaped the health benefits of living in a time where they never had to deal with deadly outbreaks because of vaccinations, yet they still act like it’s their own amazing immunity that has accomplished this feat. It’s not. Vaccinations and herd-immunity have ensured you a safe, deadly disease-free environment in which to grow and thrive – an environment that you would deny your own children and future generations because of what? Conspiracy theories?

Will it take the sweeping return of diseases like whooping cough and measles to wake these parents up? I’m not willing to sacrifice years of built up herd immunity for these idiots. I’m sorry for their children – but I’m totally behind treating these individuals as what they are – a danger to public safety.

(photo: Tom Wang/ Shutterstock)

Be Sociable, Share!
You can reach this post's author, Maria Guido, on twitter.
Be Sociable, Share!
  • tk88

    I think this is a good idea. I mean think about someone who brings in their 3 week old infant only to be followed by a five year old with measles. Why should the infant’s health or even life be put in danger because another child’s parents are stupid?

  • CMJ

    Some “choices” have consequences. Sure, you can choose not to vaccinate your child, but you have to deal with the repercussions of your choices. This is just one of the many repercussions.

    • JLH1986

      Precisely. I remember growing up that some kids didn’t get vaccinated on time for school to start (this was public school and everyone was required to be vaccinated) and they didn’t start on time. Period. End of Discussion. There was no debate and parents usually felt bad and rushed to get it done. Consequences and Repercussions.

    • val97

      I still don’t understand how people get out of vaccinating, not that I would want to but we did have a situation because my son is one of the youngest kids in his grade. My son needed to have a Tdap booster before 6th grade. He was turning 11 at the end of August, and his doctor wouldn’t administer the vaccination before his 11th birthday. The school wouldn’t send me his schedule or his locker number until I got him vaccinated. We were in a standoff until the doctor’s office sent a letter to the school with his confirmed appointment time for his booster the day after his birthday.

    • EX

      The laws vary state to state. In my state you can get an exemption on religious grounds. You don’t have to prove that you practice a religion, you just have to say that it’s against your religion, which is what the anti-vaxers do here. You do have to fill out a form, but from what I understand it’s a simple process.

    • JLH1986

      That’s how it is here now. Whereas when I was in school it wasn’t up for debate. I was an athlete and had to get additional vaccinations because I could conceivably come into contact with blood (Contact sports). Again, if I didn’t get the vaccinations…I didn’t play. There was no lawsuits or arguments. My younger cousin doesn’t like shots so she was able to “opt out” of vaccinations despite playing contact sports. She cited “religious reasons”. Until I explained that she could get a blood born disease. She sucked it up then.

  • Andrea

    Some practices already do not accept patients whose parents do not vaccinate them. My pediatrician’s practice is one of them.

    I get that it seems like a punishment; but here’s the real punishment: an innocent baby (who is too young to be fully vaccinated) or a child that cannot (because of whatever illness that doesn’t allow it) get infected in the waiting room by these people’s Typhoid Marys. THAT’S punishment!

    The good of the many (at least in this case) out weights the inconvenience of the few idiots who choose not to believe in hard scientific FACT.

    • EX

      That’s just what I was going to say. As it is now it is our children (those of pro-vaccine parents) who are being punished by the actions of the anti-vaccination crowd. As a parent of a newborn the thought that I could take my child to her next well-child visit and have her be exposed to measles in the waiting room thanks to the actions of an anti-vaccination conspiracy nut makes me all kinds of ragey. I would go out of my way to take my kids to a pediatrician’s office that had this kind of policy.

    • SusannahJoy

      As far as I know, my ped will see anyone, but infants all come in on the same day to avoid being exposed to too many germs. It means you might have to rearrange your schedule if Mondays don’t normally work for you, but overall I’m pretty thrilled with the practice.

    • PreciousLostThings

      Not to mention adults, whose vaccines might have worn off or been weakened by things like illness or chemo. Unvaccinated kids put them at risk, as well. If you’re over 30 there is a decent change that your MMR at least has worn off, and i have adult friends who caught whooping cough last year when there was a mini epidemic in this state. One of them almost died.

  • Lee

    I love the Penn and Teller Bullshit episode on vaccines. Totally worth a watch.

    • MerlePerle

      Just went and watched that! Thanks for the tip!

  • Kelly

    I’m surprised this is just now becoming an issue. I can see how a pediatrician would refuse an unvaccinated child as a patient. The parent has already made it very clear they don’t respect the doctor’s advice and will not follow his or her guidelines. Why would any doctor want to insert themselves into a mess where the parents prefer to get their medical information from a has been Playboy Bunny?

    • Kay_Sue

      I hadn’t considered it from the point of them not accepting the doctor’s advice, just from the point of the doctor having a responsibility to other potentially vulnerable patients. It’s a good point, though–I wouldn’t want to deal with someone that didn’t respect my advice, especially not if I’d gone through as much schooling. Not to mention, they have to be thinking about how difficulty such a parent could cause on down the line.

    • SarahJesness

      I’ve heard that some doctors have already been doing it. But I suppose more people are thinking about the matter now because of the anti-vaccine movement.

  • Larkin

    Frankly, I think that getting the measles because your parents wouldn’t vaccinate you is ALREADY being punished for your parents’ decisions… and I can’t blame pediatricians who don’t want to expose vulnerable infants and children to kids who might be carrying potentially deadly preventable illnesses. Anti-vax parents will either have to find a doctor who supports their views (which would probably make them happier anyway) or give in and get their kids the vaccines they need. Or not provide their children with critical medical care, I suppose, but I’m pretty sure that’s a CPS-worthy offense.

  • Erin Murphy

    The practice where I take my son has it on their introduction letter that if you opt not to vaccinate they won’t keep you as a patient.

  • kbates

    Our Pedi office requires that kids be vaccinated *unless for very specific medical, or religious reasons, and if you don’t want to vaccinate they state that parents should seek another doctor. Makes sense to me.

    • Williwaw

      I can see letting kids get out of vaccination for medical reasons but I don’t agree with the religious reasons. Anyone can claim they are refusing a vaccination for religious reasons. That’s exactly how a lot of anti-vaxxers get out of it.

    • AP

      I’m guessing that the “very specific religious reasons” means that the parents have to provide proof of membership in a particular religion. It probably excludes most patients who don’t vaccinate, because Crunchy Googler is not a religion.

    • Williwaw

      Ooh, but now I am tempted to found CrunchyGooglerism. You must eat nothing but raw foods and name your kids after wild animals. Nursing and no potty training till they’re ready for high school.

  • elle

    Yes, I definitely think doctors should. In fact, my son’s pediatrician WILL drop you if you don’t vaccinate. The city I went to grad school in had such a high opt out rate for vaccines that I was legitimately scared to even take my son outside when he wasn’t old enough to vaccinate yet. I can’t imagine having to fear that your child, who is either not old enough for vaccines or is immunocompromised, will get measles/whooping cough from an unvaccinated child in the peds office. Colds/flu? Ok that sucks but a serious communicable disease? No, you shouldn’t have to fear that.

  • Sexy Robotic Arms Dealer

    Unvaccinated children should be forced to wear an arm band with a yet-to-be-designed logo on it.

    The public shaming will do wonders!

    • Andrea


    • Alex Lee

      I love the smell of fried skull in the morning.

  • NYBondLady

    In the article it states: Four of the affected children were too young to have been vaccinated; three who had been vaccinated were 13 to 15 months old and two others had not been vaccinated by parental choice, the Health Department said. The affected adults range in age from 22 to 63 years.
    It also says that they do not know the source of the outbreak, or if the 7 children who were vaccinated/too young were exposed to the 2 other kids or maybe if the affected adults were parents or related to the kids.
    Also, how did the 3 kids who were vaccinated get measles? Is is not fully effective until the 2nd dose?

    • Katherine Handcock

      Most vaccines are not 100% effective (although even if you catch it, you’ll usually fight it off more easily) and yes, until you get the additional dose, the effectiveness is lower. That’s one of the reasons why the vaccination schedules try to get the doses in before kids hit the age where they are going to preschool.

    • MamaLlama

      True.. I got the mumps as a child after I was vaccinated. Having two painful ‘oranges’ on my neck hurt. That’s all I can remember, but my mom has a much longer, scarier story.

    • keelhaulrose

      I could be wrong, but if the kids are 13-15 months they just got their first round of the vaccine, and there is a second part to it to make it most effective. If I remember correctly the earliest you can give the first dose is 12 months, and the second has to be more than four weeks later, to they usually wait a little longer than that.
      Looking at my daughter’s records she got her first at 12 months, her second at 18

    • Lackadaisical

      Vaccine doesn’t mean you are completely immune, depending on the disease. A lot of people catch mumps despite the vaccine, for example, but the chances and severity are reduced.

  • Kay_Sue

    Our pediatrician requires vaccinations. I don’t blame her. I am sure in addition to the kids that were simply too young, she saw a variety of children with compromised immune systems who could not be vaccinated. As a doctor, she has a responsibility to all of her patients. Makes sense to me.

  • MissDelish

    I work as a nurse. And absolutely and utterly support this way of thinking. Unfortunately, the pervasive “I read an article on the interwebs and am now smarter than an immunologist” way of thinking has started to impinge upon my colleagues. One of whom stated yesterday that “we don’t even know what’s in vaccines!”. And then went on to give IV medications to her patients.

    rant> I understand the mistrust people have for large organizations like pharmaceutical companies and the government… Kind of. And the need to empower oneself in decisions being made to stay and be healthier. But to call health care providers nothing but shills for drug companies is insulting at best. And speaking as one of those practitioners, who truly does want people to be able to attain and maintain the highest standard of health possible, it is infuriating when people make stupid decisions based on woowoo that have the potential to do serious harm to themselves and others. /rant

    • SarahJesness

      The idea that vaccines are just a way for pharmaceutical companies to get money doesn’t make a lot of sense. First off, vaccines only represent a very small portion of profits to these companies. Second, treating a disease is a lot more expensive than getting a vaccine. Companies could make a lot more money if they convinced people NOT to get vaccines.

    • Williwaw

      This whole issue infuriates me (I’m also in a region with a measles outbreak). I have a two year-old, and he has had all his vaccinations, but I assume he is still not as protected against measles as he could be because the second MMR is not given till a child is four. Why do some people think they have the right to endanger my child because they spent a couple hours reading anti-vax websites?

      I also note that although every day care we have used “requires” that kids be vaccinated, but I have noticed they aren’t very careful about checking for the documentation. This is stupid, and it gives the anti-vaxxers an easy pass. I abide by the no-nut rule at day care (even though my child has no allergies, I am 100% behind doing what I can to keep other children safe). Other parents should have to abide by the get-your-kid-vaccinated rule, because I want to keep my kid safe…so day cares should be forcing every enrolled child to show proof they have been vaccinated. I don’t even know how many unvaccinated kids are out there. We have key cards to get into the day care, and we sign our child in and out each day…how hard is it to follow a basic set of safety rules?

    • whatlight

      To be fair to you colleagues, I have absolutely no clue what is in this delicious hot pocket I am holding but I don’t care and I’m going to eat it anyway. AND IT WILL BE DELICIOUS.

      I kid though. You’re absolutely right.

  • March

    I also don’t understand why an anti-vaccine parent would want to stay with a pro-vaccine doctor. If you refuse to follow your doctor’s advice you are assuming that said doctor is a)incompetent or b) malicious (greedily working for big pharma). Why would you stay?

    • Lee

      They stay because there aren’t any anti-vax doctors.

    • Aimee Ogden

      Oh, there are, but they’re mostly chiropractors, not pediatricians. (My sister sees an anti-vax chiro, who helps to fuel her own anti-vax paranoia.) Not to malign chiropractors – I know at least 2 who are sensibly pro-vax – but that seems to be the largest reservoir of vaccine denialist sentiment I’ve seen in the medical community.

    • krock

      Agreed! I went to a chiropractor who was vehemently opposed to vaccines. Meanwhile, she specialized in treating pregnant moms and babies. I had to find a different chiropractor because it stressed me out that she was CONSTANTLY warning moms against vaccines. Whenever a new baby would come into the waiting room, I was worried they would get something from another person that wasn’t vaccinated.
      I live in a big city so I feel like its doubly irresponsible since viruses can spread quickly.
      My new chiropractor may or may not be pro-vaccine but I’ve gone to her many times and she’s never mentioned it.

    • Maria Guido

      I had the same experience with my chiro during pregnancy. She actually tried to lecture me about it.

    • Aimee Ogden

      I don’t blame you for leaving, that would make me SO upset. :(

    • Angela

      Chiropractors are not doctors. They are not licensed to practice medicine nor can they write prescriptions. Even if a chiropractor is pro-vax they still cannot give them to patients.

    • Rachel Sea

      They are doctors, in fact, but they are no more qualified to discuss immunology than someone with a doctorate in marine biology.

    • Tinyfaeri

      There is a doctor of chiropractic degree in some countries, but they are not medical doctors. It’s more like a PhD in alternative medicine.

    • Marie

      If by some countries you include the United States, then yes, the degree is Doctor of Chiropractic.

    • Angela

      True. Even someone with a PhD in linguistics is a doctor of sorts. I should have clarified that they are not a medical doctor. You may as well use your dentist as your pediatrician.

    • Williwaw

      They may have doctorates in chiropractic but they are not medical doctors. They do not have the same level of training as MDs.

    • Marie

      I would venture to guess that marine biologists have never done coursework in immunology or the like, whereas I can assure you that chiropractors have and continue to do so. Doesn’t make them experts, and I never claim to be one, but they are not ignorant.

    • Aimee Ogden

      Yeah, like has been discussed below they are doctors of a variety, but to the public at large, unfortunately, adding the prefix “Doctor” to someone’s name often means “this person is qualified to provide all medical counsel that I may require” (and that public at large includes several of my family members, unfortunately). To some of them, I think the fact that they’re not associated with “Big Pharma” or “Big Medical” indicates that they are MORE trustworthy than someone with an MD.

    • Lee

      Uggh, my sister in law pays $500/month for phone consultations with a chiropractor several hours away about food allergies. Without ever seeing her in person or any tests he has told her she is allergic to apples, black pepper, and olives/olive oil on top of her dairy and corn allergies and gluten free diet. I don’t have a lot of faith in chiropractors right now.

    • Aimee Ogden

      Why use the actual medical tests available to test for allergies when you can guess randomly?!? This is about the same advice my friend’s mom gets from a homeopath (cut ALL THE THINGS out of your diet) – wonder what the price tag is on that?

    • Marie

      Lots of us are pro-vax actually…….
      (Always makes me sad to see my profession crop up on vaccine topics. No one likes to read hateful things about something they dedicate their life to, you know?)

    • Aimee Ogden

      I’m glad to hear from a pro-vax chiro and I certainly didn’t mean to come across as hateful (I did specifically say that I didn’t want to malign chiropractors and knew some pro-vaccination ones in person); my sister sees a chiro who has counseled her to avoid vaccinating my nephew, though, which is very frustrating; and unfortunately statistics suggest that anti-vax sentiment is pretty widespread (as much as 1 in 3, although some of the surveys from this study are from the 1990′s):

    • Marie

      I apologize, my wording did make it seem like I was calling your particular post hateful and that was not my intention. I obviously can’t speak for your sister’s chiro, but it certainly sounds frustrating. We all want our patients to be healthy and receive the best care that we can provide.

    • Kati

      Show me an anti-vax doctor and I’ll show you where to send a letter of complaint to his/her state certification board. Absolutely inexcusable on a physician’s part

  • rrlo

    I am all about questioning. Questioning safety of vaccines. Looking into side effects. Understanding how they work.

    But I can’t trust the judgement of anyone who did the questioning and come up with the conclusion that vaccines are unnecessary or vaccines do more harm than good.

    Because this is truly a wing-nut, fringe groups wearing tin foil hats versus everyone else issue. In this one particular case, there really isn’t a debate.

    So as much as I don’t want children to suffer as a result of their parents decision, I support doctors choice to not treat un-vaccinated patients who have contracted the infectious disease.

    • Williwaw

      I don’t want my family doctor to refuse to treat unvaccinated patients who have contracted the infectious disease – I want my family doctor to refuse to treat unvaccinated patients, period. Someone may be contagious before they are diagnosed. It’s not fair that my child should be exposed to contagious diseases from anti-vaxxers sitting in the same waiting room. Let them find a doctor who is as delusional as they are. (I feel sorry for the kids born to such parents, though, because it isn’t their fault.)

    • rrlo

      I would support that decision (not to see unvaccinated patients period) as well. It’s weird, it never even occurred to me that my GP may have patients who are no vaccinated. I suppose it’s definitely possible. However, in my neighborhood it would be more immigrants with spotty immunization records than “vaccines have chemical” types.

  • Mikster

    What about the group for which certain vaccinations are contra-indicated, cannot receive them and are in GREATER need of protection from exposure than the typical child, but also more likely to be in places where an outbreak might arise and therefore be a greater odds to be contagious?
    Three rooms.

    • darras

      I was actually thinking this.. I agree, three rooms.

    • Rachel Sea

      Immune compromised patients have to take their own precautions everywhere they go, it’s not a stretch for them to continue their own normal protocols in waiting rooms.

    • Mikster

      What are those precautions? Are they recent? They never gave me a protocol once our eldest suffered brain damage from the DTwP and could not receive any further pertussis components, putting him a higher risk of contracting pertussis and higher risk of complications due to the nature of his physical disabilities that arose from that brain damage.
      That’s very interesting since no information, counseling, educating, was ever offered by any of the specialists who worked with him.

    • MaebykittyRN

      Did the brain damage cause him to have a weakened immune system? If it did, then they definitely should have given you information on staying safe.

    • Mikster

      Yes, he had spastic quadriparesis, sever gastritis & G-E Reflux, was ambulatory and non-verbal, needed 24/.7 hand-overhand care. A simple cold often developed into bronchitis and/or pneumonia. But due to the encephalitic type of reaction he had to his first 3 DTwP vaxes, he was not permitted to receive anymore.

    • MaebykittyRN

      These are some pretty standard precautions for the immunocompromised.

    • Mikster

      Thank you. Though that wouldn’t reduce risk of contracting airborne infections.

    • Rachel Sea

      Masks are a common tool of the immune compromised.

    • Mikster

      I wonder why they never recommended one. We were 23, first child, and totally devastated and overwhelmed by the changes the damage wreaked on his system and his care. But given the sensory stimulation issues he suffered, I don’t know if he would have tolerated that. Things around his face generally elicited the Moro Startle in a greatly exaggerated form. Throughout all of his therapy, we were never able to help him integrate that and evolve it into a proper righting reflex. But still, in doctors’ offices a mask during “sick season” might have helped- with the amount of time we spent in them.

    • MaebykittyRN

      If he won’t tolerate a mask, it is totally reasonable for you to ask for a private place to wait at the doctors office. Just tell the receptionist he has a compromised immune system.

    • MaebykittyRN

      True. The best way to prevent airborne infection is to wear a mask.

    • Mikster

      Thank you, but he died from sepsis after a hip osteotomy in 94. Due to the spasticity from the damage.

    • Bethany Ramos

      I know this was long ago, but I really am sorry for your loss.

    • Mikster

      Thank you also.

    • MaebykittyRN

      I am so sorry for the loss of your son.

    • Mikster

      Thank you.

    • MaebykittyRN

      Immune compromised patients and parents with preemies are often advised to ask for a private waiting area when they go to the doctor.

    • Mikster

      That would be good. They never offered that to my son though.

    • Lackadaisical

      Those are the very children that other children should be vaccinated to protect. By vaccinating my children they are less likely to pass on infectious diseases to a child who can’t vaccinate and would be hit far harder by the disease. I agree that they ought to be kept out of the plague room, even if that means passing on a few diseases to those in the “clean” room because the devastating effect that some of those diseases can have on them makes those kids a priority.

  • Mikster

    Y’all do realize that the DTaP vaccine has only about 80% and most of the people who contract it [pertussis/whooping cough] are fully vaccinated, right?

    • Alex Lee

      I do not know what you mean by “DTaP vaccine has only about 80%”

    • personal

      I think she means the shots are only 80 (to 90%) effective at making someone immune.
      Still much better than not being vaccinated, of course.

    • Mikster

      But when that bacterial infection is spread to that baby in the waiting room- or, more likely, at the bank, the restaurant, the grocery store, it doesn’t come in a less vicious strain just because the person who spread it to you was vaxed. False sense of security,. If you want to keep young babies safe, limit their exposure to the general public- as we did until they had their first vaccine at least.

    • Missy

      I’m sorry, but I will be a working mother when I have my child in 2 months. I have no family where I am, so I have to get day care to help out. Not everyone has the “luxury” of limiting their child’s exposure to the general public before they are vaccinated. Stating “if you want this to happen” is a moronic view, and you should probably know that a couple of the children that got the infection in the article were 13 and 15 months old. They already had their first round. And you’re actually less likely to get sick in those other places that you stated because most people who are sick -go to a doctor’s office-. As an infant/child is really the only time that we go when we aren’t sick, which leaves us open to more disease when we do go.

    • Mikster

      Moronic? How very civil.
      Nwo back to what I actually said: IF you want to keep them safe, limit their exposure, as the efficacy on the acellular form is poorer than most vaccines. Sorry if that doesn’t fit your life, but it’s the truth. Vaccinated children can and DO contract and transmit pertussis. And they are contagious BEFORE the symptoms erupt that send them to the doctor’s offices. Look at the California outbreaks. I’d Google but you are just too rude in your reposnses. Do it yourself.

    • Missy

      Oh, I see. Since I want to work and be able to pay for the things my child needs, I guess I don’t want to keep them safe. That’s what you’re saying with the word “IF”, right? Because that’s exactly what I was going on before, which is exactly what I quoted.

    • Mikster

      Missy- do the best you can. But don’t think all the vaxed kids are as safe as you think. Make your choices, like I did. And our first one is DEAD from his DTwP vaccine reactions. Don’t worry though, the subsequent 3 are up to date- and I am as well. When was your last TDaP vaccine, BTW?

    • Missy

      3 weeks ago. Before that, it was 5 years since my last one.

    • Mikster

      Good! You’re already ahead of the curve on that one. Most adults are not.

    • Williwaw

      According to the CDC, the pertussis vaccine is 80-90% effective. Protection is about 90% effective in the year following the fifth dose, and declines thereafter. Children who have been vaccinated but still get the disease are less likely to have a severe infection.

    • Mikster

      Sorry- omitted “efficacy” after the 80-%.

    • Alex Lee

      Eighty percent effective at stopping three major diseases.

      But you’re choosing to focus on the 2 out of 10 people where the vaccine was not effective?

      Are you seeking a vaccine that has 100% efficacy?

    • Mikster

      I’m not *seeking* anything. Despite the fact that the whole cell DTwP caused severe enough adverse reactions (encephalytic) to our eldest who died of those complications, our subsequent 3 children, as well as myself, are fully up-to-date on that series of vaccines. In fact, the only ones we refuse are Gardisil, with our pediatrician’s blessings, support and agreement. But I digress, what I seek to do is this: don’t let vaccines give you a false sense of security- especially for those whose risks of complications from pertussis are greatest: unvaccinated infants. Better to limit their exposure to the public, especially in the first 2 months.

    • Rachel Sea

      DTaP is 80%-90% effective against the combined three, with a suspected lower efficacy against whooping cough, with studies in progress to reach a determination since 2005. Hence why herd immunity is so bloody important.

      And most people who get whooping cough either are not vaccinated, or do not have a current vaccination.

    • Mikster

      According to th3e AAFP:
      “According to a Sept. 13 article( in the New England Journal of Medicine, the ability of the diphtheria and tetanus toxoids and acellular pertussis adsorbed (DTaP) vaccine to fight off pertussis is relatively short-lived and diminishes sharply in the years following the fifth and final dose.
      This Gram-stained photomicrograph depicts numbers of Bordetella pertussis bacteria, the etiologic pathogen for pertussis.
      Outbreaks of whooping cough continue to occur regularly,
      with each successive outbreak recording an increase in peak incidence, so researchers from the Kaiser Permanente Vaccine Study Center set out to uncover why DTaP is not doing a better job. To answer the question, the researchers selected 4,281 children in Kaiser Permanente’s Northern California health care system who had received a pertussis polymerase chain reaction (PCR) assay test result between January 2006 and June 2011. They assessed waning immunity after DTaP vaccination by comparing patients who were PCR-positive with two sets of controls. What they found was that protection against pertussis waned significantly during the five years after the last dose of DTaP.
      “Increasing time since the fifth dose of DTaP was associated with an
      increasing percentage of positive PCR tests,” the authors wrote. “The time since the fifth dose of DTaP was significantly longer for
      PCR-positive children than for PCR-negative controls, (while) case
      children received their fifth dose of DTaP significantly earlier than
      controls … indicating that each year after the fifth dose of DTaP was
      associated with a 42 percent increased (risk) of acquiring pertussis.”"

    • Mikster

      According to “Vaccine efficacy is 80%–85% following 3 doses of DTaP vaccine.”

    • Rachel Sea

      There should be 5 doses in childhood, so I would expect that there would be lower efficacy after 3. I got my numbers from the CDC.

    • Mikster

      Until 5 years later when it diminishes sharply, with a 42% increased risk each year after, of acquiring pertussis, according to the latest in the NEJM published in September 2012.

    • Lackadaisical

      Vaccines tend to have much better success rates that 80%, and not only do they decrease the risk of infection but they also decrease the severity. Also, if you choose a disease like whooping cough as an example if an overwhelming majority of your population are vaccinated then of course a lot of the people who contract it will be the unlucky ones who don’t get full immunity because people without the vaccination are far rarer. However the percentage of people who have the vaccine yet contract whooping cough compared to the percentage of people who haven’t had the vaccine yet contract whooping cough will show a different story.

    • Mikster

      You seem to think I don’t support this vaccine. In fact I do- despite the fact I’ve buried one child due to encephalitic reaction to it, and went on to immunize the subsequent 3. But this vaccine does NOT have a good track record and has a dismal drop=-off after the 5th, lulling many into a complacent position wrt its efficacy.

      “September 25, 2012 05:55 pm News Staff – According to a Sept. 13 article( in the New England Journal of Medicine, the ability of the diphtheria and tetanus toxoids and acellular pertussis adsorbed (DTaP) vaccine to fight off pertussis is relatively short-lived and diminishes sharply in the years following the fifth and final dose.
      This Gram-stained photomicrograph depicts numbers of Bordetella pertussis bacteria, the etiologic pathogen for pertussis.
      Outbreaks of whooping cough continue to occur regularly, with each successive outbreak recording an increase in peak incidence, so researchers from the Kaiser Permanente Vaccine Study Center set out to uncover why DTaP is not doing a better job. To answer the question, the researchers selected 4,281 children in Kaiser Permanente’s Northern California health care system who had received a pertussis polymerase chain reaction (PCR) assay test result between January 2006 and June 2011. They assessed waning immunity after DTaP vaccination by comparing patients who were PCR-positive with two sets of controls. What they found was that protection against pertussis waned significantly during the five years after the last dose of DTaP.
      “Increasing time since the fifth dose of DTaP was associated with an increasing percentage of positive PCR tests,” the authors wrote. “The time since the fifth dose of DTaP was significantly longer for PCR-positive children than for PCR-negative controls, (while) case children received their fifth dose of DTaP significantly earlier than controls … indicating that each year after the fifth dose of DTaP was associated with a 42 percent increased (risk) of acquiring pertussis.”
      The CDC currently recommends(5 page PDF) immunizing children at age 11 with the tetanus, diphtheria and acellular pertussis (Tdap) booster and vaccinating children as young as 7 in certain circumstances.
      According to the study, DTaP’s limited protection duration raises the question of whether the Tdap booster should be generally approved for children as young as eight. But before that can happen, several issues must be clarified, including Tdap’s overall effectiveness and duration of protection.
      “The findings suggest that whooping cough control measures may need to be reconsidered,” lead author Nicola Klein, M.D., Ph.D., said in a news release( “Prevention of future outbreaks may be best achieved by developing new pertussis-containing vaccines or reformulating current vaccines to provide long-lasting immunity. That said, the DTaP vaccine is effective and remains an important tool for protection against whooping cough for children and the communities in which they live, and following current CDC recommendations remains important.”"

    • Lackadaisical

      I am very sorry to hear of your loss and the hell you went through. It sounds like they have a long way to go to develop a better form of the vaccine that is safer and more affective as the fatality rate and complications associated with whooping cough make it an important vaccine.

      I apologise if my tone was too aggressive and condescending in the face of your far greater knowledge on the vaccine and it’s tragic side affects.

  • Alex Lee

    “Please have a seat in our isolated, vaccine-free waiting area. Or as we like to call it – ‘Mumpsburg’.”

    I suppose we could genetically-modify vaccines to make them airborne and transmissible.

    Also, because I’m liking Mother Gothel this month…

  • Zettai

    I read the article too and 100% agree with this pediatrician’s stance. It makes me extremely angry to think that so many kids are getting sick because, ultimately, a couple celebrities got on their bullhorns citing a study that was proven falser than Washington’s wooden teeth that said vaccines are linked to autism. *cough*JennyMcCarthyOprah*cough*

    (Speaking of, when I saw the responses to the JennyAsks (askjenny?) hashtag yesterday I could not smiling. Hopefully it will open some people’s minds and help them realize that a celebrity is not a doctor of any sort and has the same amount of medical knowledge as my cat. The dumber one.)

  • Jayamama

    To be honest, I mistrust vaccinations. But I also don’t want my child getting sick. When my younger daughter was one month old, she came down with a nasty cough that stuck around for a month or so. The doctors tested for pertussis, and though it came back negative, the antibiotics they gave her just in case while waiting for the results totally zapped it, so they don’t know what it was. But it was scary, to be sure. I have no idea where she picked it up.

    I had an alternate schedule for my now two-year-old when she was little, but that was because she was born at home and didn’t get her hepB at birth. I also hate the idea of getting two live-virus vaccines at one time at her one year check up (MMR and chickenpox) so I had her get the latter at a 15-month check up. I support a parent’s right to choose what to put into a child’s body, but I do not support or understand a parent’s decision to completely skip vaccines.

  • MellyG

    I’m all for this idea. I can’t understand not vaccinating your kid. I’m all for investigating things and assessing risk, but surely even simple research suggests that the good of vaccines FAR outweigh the bad?

  • Frannie

    This is an excellent point. I’ll have to ask if my pediatrician does this already. Honestly, I don’t even think kids who aren’t vaccinated should be allowed to attend public school. When I was in middle school one of my classmates was diagnosed with Hodgkins disease. I’m sure if someone with measles had spent any time around him it could have killed him. My own mother died from a simple cold that got out of hand when she was fighting cancer- it doesn’t take much to harm someone with a compromised immune system.

  • Angela

    I can certainly understand this doctor’s point of view, but I also understand the point of view of doctors who don’t want to turn them away. In some places anti-vaxers do have a hard time finding a pediatrician to see their kids and while this prods some into vaccinating others simply never take their kids to the doctor ever. This means that these kids are hospitalized or even die from illnesses that could have been easily treated early on. It means that developmental delays are frequently missed.

    Having separate offices for vaxers and non-vaxers isn’t realistic either because while there are some pediatricians will grudgingly tolerate anti-vaxers I can’t imagine that any would want to base their entire practice off of it. I think that a middle ground might be for pediatricians to disclose their vaccination policy to all new clients. Every parent would find out upfront whether their pediatrician allows delayed schedules, opting out for non-medical reasons, etc and then could decide whether it’s a good fit for their family.

  • Jennifer

    We were given a recommendation for a pediatrician’s office when I was pregnant, and it had two reviews online: one was five starts and the other was one star. The latter was from some asswipe who was pissed that they wouldn’t see his/her child because they were unvaccinated. It made our choice very easy. :)

    We did actually delay some vaccines. Because my daughter was a preemie, and it seemed incredibly cruel to stick her 5 pound, 12 ounce chicken legs with five vaccines all at once at her two-month visit. We came back for two consecutive weeks. Done.

  • MaebykittyRN

    I really hate the idea of turning children away from healthcare because of the idiotic decisions of their parents BUT, when I bring my sick baby to the doctor, I do NOT want him in the same waiting room as someone who might give him measles/pertussis/etc. If you don’t vaccinate, be responsible and keep your children away from the general population. My child’s health is worth just as much as your child’s.

  • Kendra

    My major concern with this whole thing is why no one seems to care about the greater good of humanity, in general. I get not wanting to put chemicals into your young child’s body via needles, because that does suck. But the fact of the matter is, evidence is OVERWHELMING that these vaccines have and continue to save lives. LIVES. That is plural. That is not your child’s life in particular, but millions and millions of them. It wouldn’t be an issue if you wanted to skip vaccines and lock your child in a cellar to never leave, but how can you not care what you are exposing innocent pre-vaccine babies and young children to?? My daughter attends a daycare every day, since she was 7 weeks old. I can’t imagine choosing not to vaccinate her. For one thing, I see that as putting HER at risk. But for another, there are 5 other very young children there, and at least one of them is a baby. I feel very strongly that it should not be my RIGHT or DECISION to allow my child to be a gateway of potential infection spreading to babies who could DIE because of it. I just want to scream at these people sometimes, that hey, people…this isn’t about YOU!!!!!!!

  • Lackadaisical

    I can understand his point of view, and yet it is the child suffering for the parent’s choice or medical reasons why vaccines aren’t possible.

    Having said that if my kid comes down with something infectious I tend to ring the doctors surgery, warn them of what it is (or the symptoms) rather than bring the kid in, and the doctor tends to either call me back to discuss it or comes to my house to see my kid, depending on the severity of the disease. My children have all had the MMR vaccine but mumps is one that can still be caught even if you have had the vaccine (but thankfully less severe). When my eldest caught it I rang the doctors surgery as there was no way I would bring that in but had to discuss it with the doctor to report it as it is a notifiable disease (or is in the UK, don’t know about US).

    I have friends whose kids have had transplants or are awaiting transplants (1 liver, 1 kidney and 1 who will need a heart transplant before she hits her teens), those children are not able to have vaccines and might be more prone to complications if they caught a disease than most kids. If one of them caught an infectious disease and was brought in should they be in the infectious room (as they are) which could be risky for them or should they spread their germs in the clean room? Also, I didn’t have all of my whooping cough vaccine because although my mother tried I had a very bad reaction to the first part so wasn’t allowed the rest. Had I caught it should I have been put in the room of shame for being infectious (and without protection) or should I have been allowed to spread my germs in the approved parent room because I had all my other vaccines and my doctor was involved in the decision that I shouldn’t be allowed the rest of the whooping cough vaccine?

    • Rachel Sea

      “…comes to my house to see my kid,…” BWAHAHAHAHAHA.

      Here in the US the only doctors making house calls are large-animal vets.

    • Lackadaisical

      Could you not tell your doctor … um … vet that your child is in fact a horse?

      House calls are a far better way to prevent infection in the waiting room then two waiting rooms. While the doctor won’t come out without a very good reason the option of house calls is considered important enough here that in pre kid days I was unable to sign up for the doctors surgery near my work place because my house was out of the range it covered for house calls. When it comes to small children doctors tend to be far more understanding about house calls, and you also get an appointment at the surgery sooner for little kids. The surgery keep back a couple of slots for emergencies and our practice tends to give you one of those if they notice that the patient is very young.

      Just talking to doctors on the phone helps if your kid is infectious. My surgery will book in a couple of minutes for my doctor to call me back and then he or she can assess whether I need to see a doctor and if I need to bring the kid in or they need to come out. With a lot of infectious things there isn’t a lot the doctor can do anyway, other than give you another prescription for children’s liquid paracetamol and tell you to keep the kid in bed and give them plenty of fluids (kids also get free prescriptions here, hence the doctors give you a prescription for it even though you can buy it in the chemist). With something like chicken pox, for example, you have no reason to go pester the doctor anyway.

    • Rachel Sea

      Oh, I know house calls are a much better idea than putting a bunch of plague carriers together in a room, especially together in a room with healthy children, but good luck telling that to any practitioner in the US.

      Doctors here see patients, on average, for 7 minutes. You can’t make a house call in 7 minutes.

      I grew up in the sticks, with no doctor within 45 minutes (depending on traffic). I know I wasn’t the only kid who was taken to the vet in an emergency.

    • pixie

      “So, Dr. Smith, I have this, uh, rare breed of pony that I think is sick and I don’t want it to make the other ponies sick Could you come look at my two-legged mostly-hairless pony?”

  • whiteroses

    There is no part of this article that I don’t agree with.
    There are a lot of parenting choices that are solely a parents’. Ear piercing an infant. To circ or not. To raise your child in a religion or not. Cloth diapering. Formula versus breastmilk. I’m fine with any of these choices, since they don’t affect me or my family in any way. To each their own.
    Vaccination, on the other hand, is a public health issue.

  • aCongaLine

    I *hate* taking my infant and toddler to well baby visits for this reason… their pediatrician is EXCELLENT, but she’s located in a affluent, suburban community that is a hotbed of anti-vaxxing. My kids aren’t necessarily vaxxed against everything, since they aren’t old enough to have hit everything on the vax schedule, and I hate that it leaves them open to contamination from non-vaxxed kids. It just gives me the heebies. I always ask for a time when there are the least amount of patients scheduled, so we go a weird times, but thankfully, there is usually an empty waiting room.

  • Ennis Demeter

    I think unvaccinated children should also have to stay homo from school when there are reported incidences of diseases in the area.

    • elle

      I think they do… least where I live. Several years ago,my mom’s housekeeper had kids my age who weren’t vaccinated and anytime there was any sort of outbreak she could not take her kids to school. It hasn’t changed as far as I know.

    • pixie

      Where I went to high school, if you didn’t get your meningitis shot by a certain time around age 15, they wouldn’t let you attend school until you got it. They even had a clinic AT the school where all the kids who were in the age-range to get it but hadn’t yet gotten it could go (which is what I did because, hey, don’t have to make a special trip to the doctor and it goes right on my school records immediately that I got the shot)

  • Joanne

    A FB friend posted one of those some ecards about “Why would my un-vaccinated kids be a threat to your vaccinated kids if you’re so sure that vaccines work” to which I replied that it isn’t about the HEALTHY kids it is about the weak – the elderly, the newborns, the immunosuppressed. She then said that since vaccines were live cultures my vaccinated kids were a bigger threat to her un-vaccinated kids because they carry the virus. She and I have little sisters who are about the same age – we are 4 years older than them and right about the age we’d have gotten the booster when the babies were born. I pointed out that we didn’t pass it on to our newborn siblings. And then someone else jumped in with a website done by a quack and I just had to give up. The whole thing made my head hurt so much.

  • Gretta

    I support the idea. It is so scary taking my unvaccinated, delicate newborn for well child checks wondering why the other kids are there….

  • brebay

    I think this is a good idea, my only issue with it is if there is a vaccine shortage. There was one about 12 years ago, my son had to wait a couple months to get his 12-month-shots because no one in the state had the vax (don’t recall which one it was), but I assume they would make exceptions for this.

  • jendra_berri

    I’m nervous about my not-year-one-year-old baby getting one of these bullshit diseases because some asshole is illogically afraid of causing autism. Like, seriously. My son is sick right now with what I hope is a normal everyday cold, and I’m taking him into a clinic tomorrow and I’m actually kinda scared… What if he comes into contact with some asshole family that doesn’t vaccinate and their sick child and he contracts something serious he hasn’t gotten a vaccine for yet?
    That actually could happen. I won’t rest easy until he’s gotten all his shots. I haven’t the slightest idea how anti-vaxxers sleep at night.

  • koolchicken

    I loved my old pediatricians office and hope we can find a new one just like them (husband and wife team). On the island I lived on most of the kids were unvaccinated and we were one sick tourist away from loosing an entire generation. So the first question I asked him was “Do you treat unvaccinated kids”. They said that fir the first couple visits (well baby checks) he was happy to treat them if they really needed a doc. But after that he sent them across the street to the “other” pediatrician. I was sold on them in that instant. I ended up having a sick preemie who only lived by the grace of God. So if he had gotten measles or something else in the waiting room… I would have probably stabbed the parent of the little germ factory that infected my kid.

  • MiMaWa

    Totally 100% agree. I wish my daughters pediatrician would also have this policy. Wouldn’t it also be nice if we could send these anti-vax families to separate schools and daycares as well? Obviously, we can’t force them to vaccinate – but the rest of us have a right to protect ourselves, no?

  • Jenna

    Same goes for adults who don’t get their flu shots, which is 63% of you. You are putting the “herd” at risk, especially for those who can’t get the flu shot. And the flu is more common and as deadly as many of these diseases. I see no difference. So if you haven’t gotten your flu shot, quit judging.

  • C.J.

    It’s not fair to punish those that need protection. People who choose not to vaccinate are putting more than just themselves at risk. I would feel so guilty if I didn’t vaccinate my kids and they gave a baby, elderly or sick person a disease that killed them. When my mother went through breast cancer I was a nervous wreck because my youngest wasn’t old enough to have all her vaccines yet. She was just over a year old. I took as many precautions as I could to try to keep my mother safe. Even catching a cold from us could have been devastating to her. There was no way I was taking any chances. That was the year of the H1N1 outbreak. We were in line at the first vaccine clinic for that too.

  • Bria

    There is a Mumps outbreak here in Ohio. 28 confirmed cases at The Ohio State University

  • Sara610

    My pediatrician only sees vaccinated children. It’s one of the reasons we chose this particular practice.

  • AugustW

    I doubt a lot of anti vaxxers think that far ahead. As an MA, if I were pregnant or had the possibility of being pregnant, or had a baby at home, I would hope at least that I would have a choice of not rooming patients who don’t vaccinate. Rubella, for example, is very dangerous for pregnant women, and since most of us get the vaccination before age six, it could very well be less effective when we are pregnancy age.

    I can’t honestly picture a real doctor opening a practice dedicated to anti vaxxers. Although, now that I think of it, he would see sick kids a lot more often!!!

  • sandra richter

    This is a fantastic post. Thank you for keeping the anti-antivaxers conversations going Maria.

  • Beth

    I wrote about this very thing on my blog. We recently had a measles outbreak here in Ottawa after decades of being disease-free because of idiots who think their children should not receive a proven, publicly funded preventative against harmful and potentially deadly diseases. I don’t want my kids anywhere near their kids. If you’re interested in what I wrote, it’s here:

  • Pingback: Some Moms Want Separate Offices for Non-Vaccinated Babies at the Doctor — Do You? - The Bump Blog()

  • Pingback: Some Moms Want Separate Offices for Non-Vaccinated Babies at the Doctor — Do You? - Nanadownload - Funny cute pictures - Daily funny pictures()

  • Lara

    Why become a doctor if you don’t want to make sick people better? A true healing professional would help where help is needed no matter the persons background, culture and beliefs…that is a therapeutic health professional, someone who makes a difference in their community. That is, someone who had become a doctor because it was their life’s calling and they were truly passionate about it. If you don’t have this attitude as a doctor, then I think you should quit your job because you are obviously motivated by other things and have tunnel vision which means you aren’t going to be very good at it anyway!

  • Pingback: How Important Is Medical History When It Comes To Kids Anyway?()