Too often, vaccination of children is portrayed not as the significant public health question it is, but rather as a matter of choice: should parents have the right to choose not to immunize their child, even in the face of substantial scientific evidence that they should immunize?
In response, a large medical group in Texas has posed a question of its own: should other parents have the right to visit a doctor without worrying about exposure to health threats that immunizations are meant to protect against?
The Austin Regional Clinic recently announced that children in the care of its physicians and staff will need to be either vaccinated or in the process of completing vaccinations deemed necessary for public health. “If you plan not to immunize your child, we prefer that you choose another practice,” the policy reads. “We do not want to place the rest of our patients at risk of contracting vaccine-preventable illnesses.”
This decision may strike some as controversial or harsh. It isn’t. It’s an evidence-based, ethical and appropriate response to a growing problem that jeopardizes public health.
In the Metroplex and across the state, far too many children avoid vaccinations due to non-medical reasons cited by their parents. In the 2013-14 school year, more than 38,000 Texas students – about 0.75 percent of the overall school-age population – received non-medical exemptions to school immunization laws, according to a Texas Tribune report on Texas Department of State Health Services data.
While those percentages were lower in Dallas ISD and most Dallas County districts, they were higher than the state average in Highland Park ISD, Coppell ISD and other parts of North Texas. In Collin County, the Allen, Frisco, McKinney and Plano districts showed that 1.46 to 1.69 percent of their children – more than 1-in-70, or 2,230 children total – received these exemptions.
Nationally, we are facing new outbreaks of vaccine preventable diseases such as measles. We have been fortunate in Texas but nevertheless had one outbreak of measles in 2013.
As the number of unvaccinated children increases, so does the threat of more frequent and severe outbreaks of vaccine-preventable diseases, such as this year’s outbreak in California that was traced to a case at Disneyland.
Measles and other vaccine preventable diseases can have serious consequences, and it is crucial to maintain a high rate of vaccination in the population. In response to the recent outbreak, California passed a law requiring nearly all schoolchildren to be vaccinated in order to attend school, regardless of their parents’ personal or religious beliefs.
Hopefully, parents who have questions about vaccinating their children will take this opportunity to sit down with their pediatrician and have a thorough and honest discussion about the benefits versus risks of immunizations. On this issue, scientific evidence is overwhelmingly in favor of vaccinations being safe and effective, for both the children being vaccinated and the general public exposed to these children.
There is no scientific basis supporting delayed vaccination schedules, vaccination omissions, or otherwise not providing vaccines to all but a very few children with clear medical contraindications.
Pediatricians put their children’s health where their policies sit. All of my now adult children were fully vaccinated on schedule throughout childhood, and this is true for nearly all pediatricians. We simply are doing what we believe is right, and what the evidence demonstrates is overwhelmingly best for the children we love.
Clearly, some parents will continue to be unswayed by the overwhelming scientific and medical evidence in favor of vaccinations. But pediatricians also have a right and responsibility to protect the children in their practice.
Policies such as these serve an important purpose, whether as a public health action, a simple and clear statement, or a wake-up call – which is why ARC’s decision almost certainly, and hopefully, won’t be the last. It deserves my support and that of the people of Texas.
Steven Abrams is a professor and the inaugural chair of the department of pediatrics at the Dell Medical School at The University.
A version of this op-ed appeared in the Austin American Statesman, Corpus Christi Caller Times, San Antonio Express News, Houston Chornicle and the Dallas Morning News.
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— Texas Perspectives (@TexPerspectives) July 14, 2015
