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拒绝接种疫苗而被俄克拉荷马州儿科医生拒诊的患儿家庭特征。

Characteristics of Oklahoma Pediatricians Who Dismiss Families for Refusing Vaccines.

机构信息

University of Oklahoma College of Medicine, Oklahoma City, OK, USA.

Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

出版信息

Clin Pediatr (Phila). 2023 Jan;62(1):24-32. doi: 10.1177/00099228221108801. Epub 2022 Jul 26.

Abstract

Vaccine refusal is increasing. Objectives were to assess frequency of declining or dismissing patients who refuse vaccines, which vaccine(s) prompt pediatricians to decline/dismiss patients, and demographics of pediatricians who decline/dismiss patients. Active members of the Oklahoma American Academy of Pediatricians (AAP) were surveyed. Chi-square tests with non-overlapping 95% confidence intervals compared proportions of providers across various metrics. In all, 47% (48/103) versus 35% (34/98) reported declining versus dismissing patients for refusing vaccines, respectively. Pediatricians were unlikely to decline/dismiss patients if they refused influenza, human papilloma virus (HPV), or MenB vaccines. Pediatricians with more years in practice were less likely to decline 15% (9/62) versus 44% (16/36), = 0.002 and dismiss 8% (5/62) versus 33% (12/36), = 0.002 patients. Rural pediatricians were less likely than urban to decline 12% (2/17) versus 29% (26/89), = NS and dismiss patients 0% (0/17) versus 21% (19/89), = 0.04. Dismissing/declining patients for vaccine refusal is more common among Oklahoma pediatricians than nationally reported. Patterns differ by practice setting, years in practice, and specific vaccine refused.

摘要

疫苗接种拒绝率正在上升。本研究旨在评估拒绝接种疫苗的患者的比例、促使儿科医生拒绝/遣返患者的疫苗类型,以及拒绝/遣返患者的儿科医生的人口统计学特征。对俄克拉荷马州美国儿科学会(AAP)的活跃成员进行了调查。使用具有不重叠 95%置信区间的卡方检验比较了不同指标下提供者的比例。总的来说,分别有 47%(48/103)和 35%(34/98)的医生报告因拒绝接种疫苗而拒绝或遣返患者。如果患者拒绝接种流感、人乳头瘤病毒(HPV)或 MenB 疫苗,儿科医生不太可能拒绝/遣返患者。从业年限较长的儿科医生拒绝患者的可能性较低(9/62,占比 15%),而不是 44%(16/36), = 0.002,遣返患者的可能性较低(5/62,占比 8%),而不是 33%(12/36), = 0.002。农村儿科医生比城市儿科医生更不可能拒绝患者(2/17,占比 12%),而不是 29%(26/89), = NS,遣返患者的可能性也较低(0/17,占比 0%),而不是 21%(19/89), = 0.04。与全国报告相比,俄克拉荷马州的儿科医生更倾向于因疫苗接种拒绝而遣返/拒绝患者。这些模式因实践环境、从业年限和具体拒绝的疫苗类型而异。

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