Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases

Saad B. Omer, Daniel Salmon, Walter A. Orenstein, M. Patricia DeHart, Neal A Halsey

Research output: Contribution to journalArticle

Abstract

Vaccines are among the most effective prevention tools available to clinicians. However, the success of an immunization program depends on high rates of acceptance and coverage. There is evidence of an increase in vaccine refusal in the United States and of geographic clustering of refusals that results in outbreaks. Children with exemptions from school immunization requirements (a measure of vaccine refusal) are at increased risk for measles and pertussis and can infect others who are too young to be vaccinated, cannot be vaccinated for medical reasons, or were vaccinated but did not have a sufficient immunologic response. Clinicians can play a crucial role in parental decision making. Health care providers are cited as the most frequent source of immunization information by parents, including parents of unvaccinated children. Although some clinicians have discontinued or have considered discontinuing their provider relationship with patients who refuse vaccines, the American Academy of Pediatrics Committee on Bioethics advises against this and recommends that clinicians address vaccine refusal by respectfully listening to parental concerns and discussing the risks of nonvaccination.

Original languageEnglish (US)
Pages (from-to)1981-1988
Number of pages8
JournalNew England Journal of Medicine
Volume360
Issue number19
DOIs
StatePublished - May 7 2009

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Immunization
Vaccines
Parents
Immunization Programs
Bioethics
Whooping Cough
Measles
Health Personnel
Disease Outbreaks
Cluster Analysis
Decision Making
Pediatrics
Vaccination Refusal

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. / Omer, Saad B.; Salmon, Daniel; Orenstein, Walter A.; DeHart, M. Patricia; Halsey, Neal A.

In: New England Journal of Medicine, Vol. 360, No. 19, 07.05.2009, p. 1981-1988.

Research output: Contribution to journalArticle

Omer, Saad B. ; Salmon, Daniel ; Orenstein, Walter A. ; DeHart, M. Patricia ; Halsey, Neal A. / Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. In: New England Journal of Medicine. 2009 ; Vol. 360, No. 19. pp. 1981-1988.
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