Is Measles' Return the 'New Normal'?
Pediatricians and parents struggle with keeping children safe amid concerns over vaccine
"In 2013 when pertussis [whooping cough] went through my practice area, I decided to stop seeing electively non-vaccinating families when an older unvaccinated child came into my waiting room coughing to the point of turning blue and retching," said Dr. Christopher Hickie, a pediatrician at Cottonwood Pediatrics in Tucson, Ariz.
"Thankfully my waiting room was not crowded and no infants were present. But the episode helped me to realize that spread of vaccine-preventable diseases via my waiting room is much more likely to happen if there are electively non-vaccinating families in my practice," Hickie said.
Officially, a policy statement from the American Academy of Pediatrics urges pediatricians not to "discharge patients from their practices solely because a parent refuses to immunize a child." But carrying out that policy in practice presents challenges, say doctors who care for children.
"This is an issue many practicing pediatricians struggle with," said Dr. Roy Benaroch, a pediatrician at Pediatric Physicians in Alpharetta, Ga. "We know that if we refuse to care for non-vaccinated children, or children with 'spaced out' or 'alternative schedules,' we'll drive these kids further away from good medical care."
At the same time, Benaroch said, pediatricians must balance the choice of some parents not to vaccinate their children against the health of more vulnerable patients.
"All of us see a great number of special needs kids -- babies too young to vaccinate and kids with health issues that prevent vaccines. We've got pregnant women and premature babies in our waiting rooms," Benaroch said. "We need to do everything we can to ensure the safety of all of our families, and we know that unvaccinated kids in the waiting room mean more potential for exposures."
Measles can also come with a financial cost to the public, experts say.
"The costs to others from measles are quite high," said health economist Adam Powell, president of Payer+Provider Syndicate Healthcare Consulting. He said estimates for the public cost of a single measles case exceeds $10,300, and placing an infant too young to be vaccinated in quarantine for three weeks costs an estimated $775 per child.