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Vaccine Refusal, Pediatric

Kristen A. Feemster, MD, MPH, MSHP and Renee D. Boss, MD, MHS Reviewed 10/2018
 


BASICS

DESCRIPTION

  • A decision by a patient or parent to delay or refuse a vaccine recommended by a health care provider

  • Comprises a range of behaviors from unquestioning acceptance of vaccines to cautio...

DIAGNOSIS

HISTORY

  • Likelihood of vaccine refusal or hesitancy may not be evident until the time that a vaccine recommendation is made.

  • Evidence of delayed/missing vaccines when reviewing a child’s immuni...

TREATMENT

GENERAL MEASURES

  • Provider recommendation is the most important predictor of vaccine acceptance.

    • Evidence suggests that a presumptive recommendation is more effective than a participatory recom...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Families who express hesitancy about vaccines or who have delayed or refused a vaccine should be followed closely with ongoing counseling and education toward goa...

ADDITIONAL READING

  • Edwards KM, Hackell JM; for Committee on Infectious Diseases, Committee on Practice and Ambulatory. Countering vaccine hesitancy. Pediatrics.  2016;138(3):e20162146. [View Abst...

CODES

ICD9

  • V64.05 Vaccination not carried out because of caregiver refusal

  • V64.06 Vaccination not carried out because of patient refusal

ICD10

  • Z28.82 Immunization not carried out because of caregiver refu...

FAQ

  • Q: Are alternative vaccine schedules safer?

  • A: The routine recommended schedule was evaluated by the Institute of Medicine (now National Academy of Medicine) who found no increased risk for several...

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