Back to News

American Academy of Pediatrics Advises Firing Patients Who Object to Vaccines
Gary Marshall, MD, of the University of Louisville School of Medicine says to "fire" parents who object.

If parents refuse to vaccinate their children, it's ethical and legal to dismiss the child as a patient, a pediatrician told attendees of the American Academy of Pediatrics meeting in Washington.

"In the middle of treatment, you can't just say, I'm done," Gary Marshall, MD, of the University of Louisville (Ky.) School of Medicine, said during a session that addressed parental concerns about vaccinations and how pediatricians can respond. “But if it becomes obvious that you and the family will never see eye to eye on a specific issue, there's no reason not to ‘fire’ them.”

Tampa pediatrician Marcy Baker, MD, said she has stopped seeing children because parents refuse to vaccinate them, and knows her colleagues are doing the same.

"We'll work with them a little, but if they refuse to have the child vaccinated, we'll discharge them," she stated, after Marshall's presentation. She said that many parents want to discuss the potential harm of vaccines before their kid gets a flu or MMR shot, for instance.

Marshall said one of the most persistent -- and endlessly frustrating -- reasons parents give for not wanting to vaccinate their children is that "vaccines cause autism".

"This is like a train out of control," Baker said. "Proving that autism is not caused by any of these things is not going to stop the train."

However, Marshall does admit that vaccines are not 100% safe. For instance, for every 2,000 kids vaccinated with MMR, one additional febrile seizure will occur.

Febrile seizures are convulsions brought on by a fever in infants or small children. During a febrile seizure, a child often loses consciousness and shakes. Less commonly, a child becomes rigid or has twitches in only a portion of the body. Most febrile seizures last a minute or two; some can be as brief as a few seconds, while others last for more than 15 minutes.

Certain children who have febrile seizures face an increased risk of developing epilepsy.

Marshall offered some tips for persuading parents who don't want to vaccinate to change their mind:

• Start early. Hold group sessions with pregnant mothers and stress early the importance of vaccinations.
• Give patients books. Marshall recommends "Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure," by Paul Offit, MD.
• Fight fire with fire. The antivaccine movement plays on parents' sympathies by telling heartbreaking stories about deaths and illnesses in children. Marshall said he's not above telling his own story about the child he encountered during his first rotation who was dying from Haemophilus influenzae type b, the leading cause of bacterial meningitis among children before a vaccine was developed.

It should be noted that the book recommended was authored by Dr. Paul Offit, who has received at least $29 million from his share of royalties for Merck's Rotateq vaccine after using his position with the Centers for Disease Control and Prevention to ensure that childhood vaccination with the vaccine became compulsory.