Counselling parents who refuse vaccination

What it is

Parents may refuse routine recommended vaccines for a healthy child because of their personal beliefs. Patient-centeredness and concern for the health of the population point the same way here: not to accept the decision without further action, and not to force it, but to document the refusal and keep discussing the vaccines at later visits.

How it is treated

Experts recommend that a refusal to vaccinate form be signed by the patients or parents who refuse a recommended vaccine. That form should document that the patient or the parents were provided the vaccine information statement. Physicians should then continue to discuss the benefits of immunizations at subsequent visits, because some patients or parents may reconsider their decision not to vaccinate.

Not every condition is a contraindication. The following are not contraindications, and infants with these conditions should be immunized: allergy or asthma, except a known allergy to a specific component of the vaccine; any minor illness such as respiratory tract infections or diarrhea with or without fever; family history of adverse events following immunization; family history of convulsions, seizures or fits; treatment with antibiotics; known or suspected HIV infection with no signs and symptoms of AIDS, and signs and symptoms of AIDS; child being breastfed; chronic illnesses such as chronic diseases of the heart, lung, kidney or liver; stable neurological conditions such as cerebral palsy or Down's syndrome; premature or low birth weight, where vaccination should not be postponed; and recent or imminent surgery. Vaccine recipients should be kept under observation for at least 15 minutes after immunization, and 30 minutes is a safer interval when there is a specific concern about possible vaccine allergy, since most instances of anaphylaxis to a vaccine begin within 30 minutes after administration of vaccine.