“I have been pleasantly surprised at the support of this decision from the outside.”
said. “So they’re fearful of another child having the same problem. I understand that … and I can agree with them that if they want to decline, it’s fine. It’s their risk, and I always tell them that.” Dr. Terk believes vaccine-hesitant parents fall into three general categories:
• Parents who have heard about the perceived potential effects of vaccinations and simply want to ask questions, and “if you answer their questions in a respectful way, they’re going to be comfortable with it”;
• Parents convinced that vaccines pose potential harm but who will often con- sent to vaccination once a physician respectfully uses the evidence to push back against their concerns; and
• The most challenging category for physicians, parents who are inflexibly an- tivaccine.
“They’re absolutely convinced there is a pharmacy/medical/government con-
spiracy, and you’re not going to reach those people,” Dr. Terk said. “So I think you have to understand your audience. You have to understand whom you’re dealing with to be able to have a chance of success.” Dr. Terk adds the third group of parents may “self-select themselves out after
a time because they’ll understand that you’re not going to be in an environment that’s friendly to maintaining nonvaccinated kids or kids who will be vaccinated according to a nonstandard schedule.”
THE EARLY REACTION One week after ARC implemented its new policy, Dr. Avila Edwards says she had spoken to one mother who historically had objected to a particular vaccine. Dr. Avila Edwards says she had always been open with the family about her lack of support for their decision to forego that immunization, which she declined to identify. “I’ve always known for this specific vaccine, they didn’t feel it was necessary.
But getting to the crux of exactly why never had really come out,” she said. She adds that the family was considering the vaccine and planning to make a decision at press time. Other than that, Dr. Avila Edwards says so far, the overwhelming reaction
from patient families has been “thank-you.” From past experience testifying to the state legislature on behalf of TMA and
TPS, she said, “I’m just very aware that parents who choose not to vaccinate are very vocal, and so I was expecting probably a lot more outspoken members of our community to speak on their disapproval of it, and I have not heard anything. I have been pleasantly surprised at the support of this decision from the outside.” Although she was waiting to hear more about family-pediatrician conversa-
tions, Dr. Ziari says a few patients had requested transfers, “which we knew was going to happen.” “Certainly, the media part of it has been fairly positive,” she said. “I mean, cer-
tainly there have been some negatives, but … the majority have been positive on social media and on our website and Facebook posts. We have an informational number; [reaction there] has been generally positive.” Other practices and groups could follow ARC’s lead. “Really, every group, every individual pediatrician out there … even large
groups, they have to consider what’s best for their patients,” Dr. Ziari said. “And we’re not trying to create policy for other people. We really just want to protect the 400,000 whom we take care of.” n
Joey Berlin is a reporter for Texas Medicine. You can reach him by phone at (800) 880-1300, ext. 1393, or (512) 370-1393; by fax at (512) 370-1629; or by email at
joey.berlin@
texmed.org.
30 TEXAS MEDICINE September 2015
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