Doctors should address concerns over vaccines
Parental anxiety about childhood vaccines has prompted the Canadian Pediatric Society to speak out, issuing strategies for frustrated doctors who want their young patients immunized.
In a paper released Friday, the society urges pediatricians not to discharge patients whose parents refuse to vaccinate. Instead, they should take the time to listen to parents’ concerns and address each one.
Vaccination against infectious diseases such as measles, mumps and meningitis is one of the most effective weapons available to prevent illness, says the paper, so “addressing the concerns of vaccine-hesitant parents must be a priority.”
The paper comes at a time when declining immunization rates in Canada are a worry among physicians and public health experts, says co-author Dr. Jane Finlay, staff pediatrician at B.C. Children’s Hospital in Vancouver.
It also follows rising outbreaks of potentially fatal diseases such as measles and pertussis that have swept through Europe and Britain as a result of falling vaccination rates.
In southern Ontario, a spike in pertussis cases (also known as whooping cough) prompted the chief medical officer of health to issue a statement last year urging parents to make sure shots are up to date.
The decline in rates has been blamed on Internet and social media campaigns by the anti-vaccine movement, which has undermined messages from public health authorities about the importance of disease prevention and stoked fears about adverse reactions.
At the same time, the vaccination schedule has been loaded up with an expanding roster of recommended shots, creating “vaccine fatigue” among parents, says Finlay.
Seeing children hospitalized for vaccine-preventable diseases is frustrating when they haven’t been immunized and lower rates have reduced the protective factor of the “herd,” she adds.
But it’s critical that doctors continue to work with parents, because once their concerns have been acknowledged and countered with facts, most will change their minds, even though “it can take months, or even years.”
The society’s paper includes a fivepoint strategy for addressing parental concerns, providing accurate information about vaccine benefits and risks and solutions for a child’s pain or fear of needles.
Immunization rates are difficult to calculate because there is no central vaccination registry.
But last month, a Unicef report found only 84 per cent of Canadian children are up to date on doses of vaccine for measles, polio and the combination diphtheria-pertussis-tetanus shot for kids ages 1 to 2.
That put Canada at the bottom of the list of 29 well-off countries when it comes to overall health and safety of children. The statement from the pediatric society is important because it encourages physicians to be proactive and not give up on young patients who require health care beyond vaccination, says Dr. Kumanan Wilson, Canada Research Chair in Public Health Policy and senior scientist with the Ottawa Hospital Research Institute. In 2007, Wilson wrote a similar paper in the journal Canadian Family Physician urging physicians not to dismiss patients who refuse to immunize. When parents don’t have correct information, doctors can make a big difference by taking the time to provide it and changing their minds, he says, adding that when dealing with adults who mistrust in the broader system, it’s even more important to keep the discussion going and gradually building a trusting relationship.