University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Clin Pediatr (Phila). 2023 Jan;62(1):24-32. doi: 10.1177/00099228221108801. Epub 2022 Jul 26.
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.
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。