The measles outbreak that started at Disneyland has expanded to at least 98 cases in several states. How much of this spread is due to parents who opt not to vaccinate their children against the disease is not known. Now, some doctors are opting not to treat children whose parents do not have a medical reason for refusing vaccination.
Several physicians over the past few years have asked patients who do not want vaccinations to seek other regular medical care. They came to this decision because they feel that a child who has not been vaccinated puts other children at risk. An unvaccinated child can bring a disease like measles or rubella into a waiting room and infect others. However, this movement is increasing in the face of the large outbreak of measles.
Vaccination rates against measles need to stay about around 94% to provide what is called herd or community immunity. Keeping vaccination rates high protects people who cannot be vaccinated for medical reasons or have not yet been vaccinated. This is because almost all the people around them have been vaccinated and cannot infect them.
The risk of a disease being spread in a waiting room is not theoretical. Arizona is currently quarantining unvaccinated people who were at a medical center the same day that a woman came in with measles.
The American Academy of Pediatrics has stated that pediatricians should respect a parent's decision about immunizations, even though the group strongly urges vaccination. However, the AAP notes that if the relationship between a pediatrician and parents becomes unworkable, the doctor may ask them to switch to another pediatrician.
California parents may opt out of vaccinations by signing a waiver. Other states require a religious objection. Parents who opt not to vaccinate often have strong beliefs that vaccines are linked to autism, a link that has been disproved many times.
Legally, physicians do not have to accept a person as a new patient. They cannot refuse to give care to someone on the grounds of ethnicity, race, or religion, but they can refuse nonemergency service to someone who cannot pay them or for other reasons. For example, some physicians have refused to treat patients who will not try to stop smoking.
