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Video: Won’t vaccinate? Find care elsewhere, some docs say

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    >>> this morning on today's health, the vaccine debate about that some doctors are now putting their feet down by turning away families who refuse to vaccinate their children. here's dra nancy snyderman .

    >> reporter: at just seven weeks, this baby came down with a cough. but it wasn't just any cough.

    >> daterrifying. definitely terrifying. she got better, she got worse. and she did have pertussis.

    >> reporter: it's a highly contagious disease . she was vulnerable because at the time she was exposed, she was too young for the pertussis vaccine.

    >> terrible. i wouldn't wish it on anybody.

    >> reporter: but now at 7, she's a growing healthy kid. the possibility that michaela hey have been exposed this her own pediatrician's office by an unvaccinated child is just one example of why her doctors, husband and wife team, recently create what had's becoming a growing policy. everyone who walks through their door must be vaccinated.

    >> we felt very committed to make our office a safe place for families to come with newborns who aren't vaccinated yet. and children who hadn't received certain vaccines yet.

    >> reporter: a letter was september out to all families in the practice.

    >> we believe that it is medically appropriate to exclude unvaccinated children from a pediatric practice to protect the vaccinated children from communicable infectious diseases .

    >> reporter: it was a decision that cost the office a few patients. but something these doctors firmly believe in.

    >> we did have a little bit of push back. anytime someone is looking for a physician or a practice, it's finding the right fit. and i think that he's kind of how we looked at this, that if you don't want to vaccinate, we're not the right fit.

    >> reporter: the american cad might have pediatrics says vaccines are one of the most successful medical advance of all time. but they worry that with the increase of physicians severing ties with families who don't vak p vaccinate, it's the children caught in the middle .

    >> i think we have to be skaf about refusing to take care of the kids simply because their parents may make decisions that we don't always agree with.

    >> reporter: it was a strict vak sin thags policy th vak sin nation polic y that attracted this family to the practice.

    >> bringing in where they're possibly not vaccinating their children puts our children at risk .

    >> reporter: and while the decision to vaccinate is an individual one, for michelle, the choice was clear.

    >> definitely not easy watching your child go through vaccinations in a visit. it's upsetting as a parent. but it's better than watching them secretary in a hospital. no comparison.

    >> dr. snyderman is here along with dr. thornton. and we know how you feel about vaccinations.

    >> very pro vaccinations.

    >> but will this idea according to the american academy of pediatrics is a trend that's growing. pediatricians turning away patients because their children are not getting vaccinated.

    >> the concern is you're going to turn away people and the physicians, you're there to help people and take every any. but let's give you the converse side. let's say you have a child with pneumonia or asthma or leukemia. and your child comes to me for health care and in that same office is a child who is carrying a virus that he or she hasn't been vaccinated against. that child is literally a walking typhoid marian, puts your child at risk. i think it's unconscionable for parents not to vaccinate your children. you have to have a certain part of the population vaccinated for all of us who can be vaccinated to be protected. so while i recognize there was push back, i do understand.

    >> you're a pediatrician. where do you come down on this?

    >> it's important to say that these pediatricians are not abandoning these children. they spend hours with parents who don't want to imunionize explaining the science and truth and trying to help them become comfortable with the thought. they're engaging parents. but if at the end of that lengthy discussion explaining how this endangers a lot of other children, in the just your own, then they decided that's not a good fit.

    >> it's interesting, vaccinations have become such a phenomenal success. they've almost become a victim of their own success. so mothers your age have never seen poll i don't. they don't think pertussis will hit their kid. but if we don't vaccinate, those are exactly the problems we'll see. measles outbreaks in the last year. pertussis, i worry that things like polio could be around the corner.

    >> and they are if parents continue to not vaccinate. we lose herd immunity.

    >> bottom line , i think pediatricians turning -- well, i guess we're out of time. bottom line , sometimes doctor and patient are not a good fit. have an amicable divorce.

    >> that's right. thanks so much. back after your local news

By
TODAY
updated 9/1/2011 10:51:15 AM ET 2011-09-01T14:51:15

The story of Michayla Kubasiak, hospitalized at seven weeks old with whooping cough, may prompt parents to ask their pediatricians an important question: Does your office treat unvaccinated patients?

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Michayla developed a cough that landed her in the pediatric intensive care unit for two weeks.

“It was terrifying, definitely terrifying,” her mother, Michelle Kubasiak, told TODAY. “She got better, she got worse. She got better, she got worse. They found that she did have
pertussis -- whooping cough.”

Little Michayla was vulnerable to the highly contagious disease, which is dangerous in infants and children, because at the time she was exposed she wasn’t old enough for the pertussis vaccine.

The fact that she may have been exposed in her pediatrician’s office by an unvaccinated patient was one reason her doctor’s office recently imposed a policy requiring all patients to be immunized.

“We believe it is medically appropriate to exclude unvaccinated children from a pediatric practice to protect the vaccinated children from communicable infectious diseases,” read a letter her doctors sent to their patients.  

The practice is part of a small but growing controversial trend of pediatricians dropping patients whose parents refuse to allow their children to be vaccinated. The American Academy of Pediatrics, which supports universal immunization, says refusal to immunize should not be the only reason a doctor turns a family away.

“In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child,” the group says in a report. “However, when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists, the pediatrician may encourage the family to find another physician or practice.”

Dr. Douglas Diekema, lead author of the academy’s report, told TODAY: “I think we have to be really careful about refusing to take care of the kids simply because their parents may make decisions that we don't always agree with.”

While there may be no greater regularly scheduled anguish for parents than watching their infants and toddlers being held down to get shots, the medical and scientific community calls them safe and effective lifesavers.

Still, some parents refuse some or all vaccines for their children for various reasons, including a belief that they cause autism, and some long-forgotten diseases are now becoming threats again. The Institute of Medicine released a safety review last month that found no link with autism, reiterating earlier studies that have looked at hundreds of thousands of children.

NBC News chief medical editor Dr. Nancy Snyderman, who calls herself “very pro-vaccination,” sees both sides of the issue doctors are facing.

On one hand, doctors are there to treat everyone, and turning patients away leaves them still unvaccinated and without care. But, she added, an unvaccinated child who is carrying a virus is “literally a walking Typhoid Mary” who puts other children in a waiting room at risk.

Snyderman says vaccines have worked so well in combating disease that they’ve
almost become victims of their own success, as most moms and dads today don’t know what it’s like to suffer from diseases like measles.

Today’s parents “have never seen polio,” she said. “They don’t think pertussis is going to hit their kid.

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“But if we don’t vaccinate, those are exactly the problems we’re going to see,” Snyderman told TODAY's Natalie Morales. “I worry that things like polio could be around the corner.”

The children most at risk from contracting a disease from an unvaccinated child in a waiting room are infants who have not yet received all of their shots and kids with compromised immune systems from conditions like cancer and HIV, said Dr. Carrie Byington, vice chair of the American Academy of Pediatrics' committee on infectious diseases. Some children with compromised immune systems are unable to be vaccinated, while others may develop a condition after being immunized that renders the vaccine ineffective, she said.

But parents with older healthy kids whose vaccines are up to date don’t have much to worry about, she said.

“A healthy child who’s fully immunized should be protected from exposure in waiting rooms to infectious diseases for which they are immunized,” she said.

Pediatrician Lisa Thornton says she worries about a possible rise in disease if parents don’t vaccinate because of the loss of herd immunity, which occurs when enough people in a population are vaccinated that a disease can’t move through a community.

To immunize or not remains an individual choice. For Kubasiak, whose daughter Michayla is now a healthy 7-year-old, the decision was an easy one.

“It's definitely not easy watching your child get three or four vaccinations in a visit and it's definitely something that's upsetting as a parent, but it's nothing like watching them be sick in a hospital,” Kubasiak told TODAY. “No comparison.”

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