Orginally posted on the Doctors for America Blog by Dr. Nilesh Kalyanaraman on Nov. 3, 2010
Pediatrician’s offices are strange territory for me. The last time I was in one was almost a decade ago when I was in medical school. But there I was last week, sitting on a kiddie bench surrounded by colorful posters listening to the pediatrician tell stories during the open house. With our first child on the way we were like any of the other parents in the room, eagerly parsing the doctor’s words to figure out if he was the one for us. And then it came, the question I was waiting for. One of the fathers-to-be raised his hand and asked, “What is your stance on vaccines?”
Vaccines prevent disease. It’s that simple. Yet despite the wealth of information on their benefits the vaccination rates in this country are too low and countless preventable disease occur each year. Infants in California are dying from whooping cough (pertussis) because children are not being vaccinated out of a misguided fear of the side effects. Doctors are rediscovering the horrible sounds of a child with whooping cough struggling to breathe. To improve our vaccination rates it’s going to take a concerted effort on the part of parents, doctors and insurers to fix things.
Parents: Vaccines are one of the greatest achievements of modern medicine. The same scientific process and medical decision making that developed asthma medications, car seat recommendations and newborn genetic screening also created vaccines. The scientific process is about testing ideas, putting those that work into use and maximizing the benefit to people while minimizing the harm. Every year there are reports of handful of deaths due to car seats and a few brands are recalled. Yet you would never consider putting your child in a car without a car seat because you know that a car seat is far more likely to protect your child than to harm her. Vaccines are no different. They prevent diseases like pertussis, polio, chicken pox and influenza just to name a few. Every once in a while children do have a reaction to vaccines but the benefit of not getting these diseases far outweighs any negative from the vaccine itself.
Doctors: It is our job to ensure that vaccinations are given. We know the studies that show that vaccines work and that they have drastically reduced the incidence of certain childhood illnesses. We know the vaccination schedule. When parents refuse vaccines it’s because they are concerned. Parents want what’s best for their children and we should never forget that. It is our job to improve our communication with parents so that we can address their concerns and take care of their child to the best of our ability.
Government and Insurance Companies: Stop shortchanging doctors. Current reimbursement rates for some vaccinations for children are below cost for doctors. A recent study found that the average reimbursement by Medicaid for the flu vaccine was $9 but the cost to doctors was $20. This means that every time a pediatrician gives a flu vaccine she loses money. A similar problem exists for many other vaccines. Pay doctors fairly for the work they do particularly for something so essential as vaccinations.
Parents, doctors and insurers each need to take steps to make sure that children receive their vaccinations. Pediatricians are the front line in this effort which makes their actions so critical. So what was the pediatrician’s response to that question about vaccines? He told the concerned father-to-be that they could talk about his concerns and that the main thing was to make sure that their child grew up healthy and safe. It wasn’t an answer as much as it was an acknowledgement of this parent’s concerns. We’ve found our pediatrician.
