Doctors' dilemma: to see or not to see unvaccinated children


Vaccinate or do not vaccinate. This is a problem that occurs many times, despite evidence of the effectiveness of vaccination in the fight against the disease.

The use of vaccines around the world has eradicated smallpox and almost did the same for polio. In the United States, diphtheria, bacterial flu, measles, mumps, rubella, tetanus and others are also on the verge of eradication.

Yet, there has been a major measles outbreak this year in Oregon and Washington State. To date, cases have been reported in 2019 in a total of 10 states.

The Centers for Disease Control attributes the persistence of epidemics to an increase in the number of travelers who catch measles abroad and bring it back to the United States, which spreads it into pockets of unvaccinated people.

Parents have various reasons for not wanting to vaccinate their children, ranging from the fear of side effects to finding that vaccines are useless because their children will be protected by collective immunity. In other words, the risk of infection is low because enough of the population is immune. prevent most infectious diseases.

In Pennsylvania, children must have received the prescribed vaccinations to attend public schools, except for medical or religious / philosophical derogation.

But here's another factor to consider: you may have trouble finding a pediatrician or family doctor who will see your child unvaccinated.


Find another doctor

"If someone refuses to vaccinate, my policy is to ask him to consult another doctor," says Dr. David Wyszomierski, pediatrician of the medical group Excela Health.

Wyszomierski followed this policy in his Latrobe practice for more than five years.

"To my knowledge, there are no pediatricians in Westmoreland County who believe that it is normal not to vaccinate, although some may see these patients because they want to care for children, regardless of their parents' decisions, "he says.

"Our policy is that at the age of 2, (our patients) must be fully vaccinated, and we encourage them to use the calendar (Centers for Disease Control)," says Dr. Ned Ketyer of the Health Network Allegheny Pediatric Alliance Charters / McMurray Division.

This policy was put in place in 2015.

"It's clear that parents will not do it, we're asking them to find another provider," says Ketyer.


Why people do not vaccinate

Anti-vaccination sentiment has existed for as long as vaccines themselves, often linked to fear.

Some people believe that the chemicals in vaccines pose a greater threat to children than the diseases they prevent, citing side effects such as neurological damage.

Others say that doctors and pharmaceutical companies are pushing unnecessary vaccines in search of financial profit.

An "anti-vaxxer" movement appeared at the turn of the 21st century, under the impulse of an article published in 1998 in the medical journal The Lancet, in which Dr. Andrew Wakefield and his colleagues claimed There was a link between vaccines and autism – a retracted study turned out to be fraudulent.

The vaccination-autism link gained ground around 2008 when celebrity Jenny McCarthy claimed that her son had developed autism after the vaccination. Since then, she has come back to her position, saying she has never taken anti-vaccination but advocated for safer vaccines and more research into the possible effects of vaccines on children with autoimmune diseases.


False experts

"Jenny McCarthy is a fake expert," says Ketyer. "Many anti-scientific deniers follow all those same" experts ", and these fake experts are a big problem."

"Vaccines are one of the most effective and safest strategies for preventing disease, and there is no good reason not to have them," said Wyszomierski. "Parents (who do not vaccinate) put their children at risk, as well as other people in the community."

"Can we say that there will be absolutely no side effects?" It's impossible, "says Ketyer. "Doctors have to be honest and say it's not 100% safe, but 99.9% safe.

"Most parents (who do not vaccinate) do so for fear of chemicals, and I'm actually empathetic about it, but I do not subscribe to that idea," he says. "We live in a chemical world. But you are probably exposed to more chemicals that crawl on the ground than during vaccination.

"There is going to be someone who will have an unplanned and unfortunate event after the vaccination, but all the vaccines are very well tested and studied for their safety and effectiveness," he says.


Lack of experience

Ironically, according to Ketyer, the effectiveness of vaccines over the years has something to do with the fact that people are denying their importance now.

"More and more parents and doctors have never seen a child with measles or meningitis, but I'm old enough to have seen it and to be able to tell you how horrible it is," he says. he.

"Some people have the philosophy that what does not kill you makes you stronger and that in the long run you will be better off (having the disease), but that is clearly not the case," Ketyer says. . "Having measles can weaken the immune system. We have learned to our cost how terrible these things are. "

"The vast majority of parents vaccinate, and that's a good thing," says Wyszomierski. "A small number, maybe 2%, who come into our office did not do it, so I had these conversations with the parents. Sometimes I can convince them, sometimes no.

"Physicians need to spend more time talking to parents about what they are concerned about, what they are afraid of," says Ketyer. "It really has to start before birth in the OB / GYN office. The good news, especially in the Pittsburgh area, is that there are many very good practitioners who do a very good job in taking care of public health. "

Shirley McMarlin is an editor-in-chief of Tribune-Review. You can contact Shirley at 724-836-5750, [email protected] or via Twitter .

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