http://file.scirp.org/html/22932.html

Open Journal of Pediatrics, 2012, 2, 228-235

OJPed http://dx.doi.org/10.4236/ojped.2012.23036
Published Online September 2012 http://www.SciRP.org/journal/ojped/

Vaccination practices among physicians and their children

Michael Martin1, Vahe Badalyan2
1Department of Pediatrics, Inova Fairfax Hospital for Children, Falls Church, USA
2Department of Gastroenterology, Children’s National Medical Center, Washington DC, USA

Received 1 May 2012; revised 3 July 2012; accepted 30 July 2012

ABSTRACT

The purpose of this study was to identify vaccination patterns of both general pediatricians and subspecialists with regards to their own children and projected progeny. A 14 question survey was sent randomly to 1000 members of the Academy of Pediatrics in 2009. Two categories of questions included 1) how physicians with children vaccinated them in the past, and 2) how all respondents would vaccinate a child in 2009. A comparison was made between the answers of general and specialty pediatricians. 582 valid questionnaires were received (58.2% response rate) of which 431 were general pediatricians and 151 sub-specialists. No statistical difference was found between general and specialty pediatricians on how they vaccinated their children up until 2009 (95% vs 93%). When asked about vaccinating a future child, a significant proportion of respondents would deviate from CDC guidelines, specialists more than general pediatricians (21% vs 9%). Generalists were more likely to give a future child Hepatitis A (OR: 3.6; 95% CI 1.3 - 10.4), Rotavirus (OR: 2.2; 95% CI 1.1 - 4.4), Meningococcal (OR: 9.9; 95% CI 3.3 - 29.9), and influenza (OR: 5.4; 95% CI 1.1 - 26.7) vaccines. Specialists were more likely to postpone MMR vaccination (OR: 4.4 95% CI 2.3 - 8.6). Safety was listed by both groups as the most common reason for altering the recommended immunization schedule. Until 2009, general pediatricians and pediatric specialists have largely adhered to ACIP recommendations, but due to vaccine safety and other concerns, both groups, albeit a higher percentage of specialists, reported greater numbers willing to diverge from these recommendations.

http://www.walknowforautismspeaks.org/site/c.igIRL6PIJrH/b.7734443/k.955C/Upcoming_Walks.htm

Walk Name City State Event Date Total Raised
Walk Now for Autism Speaks: Los Angeles Pasadena CA Saturday, April 18, 2015 $1,496,069

California Education Committee changes were made this morning, see http://sedn.senate.ca.gov/ for the new list.

Huff is replaced (he would have voted against SB277) by Sharon Runner (R, she voted against SB2109 2 years ago but unknown views on SB277). Senator Monning (D) was added as the 9th member, he voted for SB277 last week.

SOURCE: Comment on April 16, 2015 at 12:59 PM @ AOA

http://www.mercurynews.com/health/ci_27919779/vaccine-exemption-bill-temporarily-stalls-california-senate-education

...Pan and other health experts believe the rising number of parents taking advantage of California's personal belief exemption that allows them to forgo their children's vaccines was a factor in the outbreak. In 2000, fewer than 0.77 percent of California kindergartners had vaccination exemptions. By 2014, the rate had more than tripled to 2.5 percent, or 1 in every 40 children.

http://www.calchannel.com/recent-archive/

CA Senate Education Committee on SB277 April 15, 2014 3h41m LINK
CA Senate Health Committee on SB277 April 8, 2015 5h53m LINK

http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9133.page

Opinion 9.133 Routine Universal Immunization of Physicians

"As professionals committed to promoting the welfare of individual patients and the health of the public and to safeguarding their own and their colleagues’ well-being, physicians have an ethical responsibility to take appropriate measures to prevent the spread of infectious disease in health care settings. Conscientious participation in routine infection control practices, such as hand washing and respiratory precautions is a basic expectation of the profession. In some situations, however, routine infection control is not sufficient to protect the interests of patients, the public, and fellow health care workers.

In the context of a highly transmissible disease that poses significant medical risk for vulnerable patients or colleagues, or threatens the availability of the health care workforce, particularly a disease that has potential to become epidemic or pandemic, and for which there is an available, safe, and effective vaccine, physicians have an obligation to:

(a) Accept immunization absent a recognized medical, religious, or philosophic reason to not be immunized.

(b) Accept a decision of the medical staff leadership or health care institution, or other appropriate authority to adjust practice activities if not immunized (e.g., wear masks or refrain from direct patient care). It may be appropriate in some circumstances to inform patients about immunization status. (I, II)

Issued June 2011 based on the report "Routine Universal Immunization of Physicians for Vaccine-Preventable Disease,"PDF FIle adopted November 2010."

http://leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb_277_cfa_20150407_101248_sen_comm.html

...13. Concerns. The ACLU of California writes that while they
appreciate that vaccination against childhood diseases is a
prudent step that should be promoted for the general welfare,
they do not believe there has been a sufficient showing of
need at present to warrant conditioning access to education on
mandatory vaccination for each of the diseases covered by this
bill. ACLU of California writes that unlike other states,
public education is a fundamental right under the California
Constitution, and equal access to education must therefore not
be limited or denied unless the State demonstrates that its
actions are "necessary to achieve a compelling state
interest." ACLU of California writes that this bill does not
declare what this interest might be, nor does it explain why
denying students access to education is necessary to advance
that interest. If there is, in fact, a compelling governmental
interest in mandating that all students in every school be
vaccinated against each of the enumerated diseases except for
medical reasons, the bill should be amended to explain
specifically what that interest is, where it exists, and under
what conditions and circumstances it arises.

ACLU of California further states that the reforms enacted by
AB 2109 had been in effect for only about 12 months before
this bill was announced, and that those reforms should be
allowed an opportunity to work before they are stricken and
replaced by an approach that restricts the fundamental right
to education. If AB 2109 is thought not to be working, its
effects should be analyzed and any deficiencies should be
corrected. If for example herd-immunity levels have not been
achieved for certain diseases in geographic areas where school
districts may not be not fully complying with the law, those
districts should be provided with additional resources and/or
compliance incentives. ACLU of California writes that in some
cases it appears the deficiencies may reflect a need for
better data-keeping and reporting, rather than the actual rate

of vaccinations. It has been reported for example that in
just one week the Los Angeles Unified School District
increased its vaccination rates significantly after the recent
measles outbreak by temporarily hiring additional staff to
replace nursing and clerical staff that had been laid off.
Other media reports indicate that some districts may not be
complying with existing law because there is no penalty and no
mechanism for enforcement. ACLU of California states that in
any event, herd immunity is a concept that applies to the
entire population in a geographic area, not simply to public
school students.

http://www.slate.com/articles/health_and_science/medical_examiner/2015/04/california_anti_vaccine_movement_politics_wealth_bob_sears_and_robert_f.html