Doctors advised to drug parents who don't want their children vaccinated

• Around 15 percent of parents say they avoided discussing vaccines with their pediatrician “during the pandemic”
• A leading medical news website provides information for doctors wanting to “ace these tough discussions” and persuade parents to consent to vaccination
• And if parents still say “no”? Ontario College of Physicians and Surgeons suggests drugging the non-compliant rather than “enabling their anxiety”

According to a Rasmussen poll conducted in August, 43 percent of American parents think public schools should mandate COVID-19 vaccination for students. By mid-November, that figure was down to just 31 percent of parents supporting student mandates, as opposed to 58 percent who oppose them.

Around the same time, MedPage Today, a leading medical news website, reported that one in seven parents “avoided vaccine talk” with their pediatrician during the COVID era. Three percent of those polled added that they “outright skipped doctor's visits so they wouldn't have the discussion.”

This was despite an earlier article also published by MedPage Today suggesting ways to combat vaccine hesitancy. The article was titled, "Quash the Dread of Pediatric Vaccine Conversations – Here are a few techniques to ace these tough discussions with patients' caregivers."

Among the advice given in the article was “being attuned to what the public is hearing about vaccines and their general vaccine sentiment so we are ready to provide the most useful information.”

Doctors were urged to learn from “evidence- and experience-based techniques on how to ace the conversation,” and to keep in mind that the “CDC, AAP, ACOG, AAFP, ACIP, and many other guiding bodies strongly recommend vaccination … you're doing what you are called upon to do: optimizing the child's health…”

The writer, a doctor herself, added that pediatricians should “Acknowledge there is a lot of scary information out there and you can understand their concern … Remind the parent that you both have the same goals for the child: a healthy, happy, and long life…” but then “circle back and make a strong recommendation for vaccination…”

“Regurgitating the white-coat myth of superiority,” commented one reader, a medical professional himself. “Talking down to patients is one of the reasons they no longer trust their physicians. The majority of our [vaccine] education comes directly from pharmaceutical companies, or universities who are directly supported by these pharmaceutical companies.”

“Sounds like a recipe for no more visits,” commented another reader.

However, most readers (all scientists or doctors) commenting on the article expressed strong pro-vaccine sentiments and several stressed that they would decline to accept as patients any families where the parents refused to vaccinate their children.

According to the Ontario College of Physicians and Surgeons, doctors are not permitted to restrict in-person care to those patients who have been vaccinated. They advise “taking appropriate precautions, including screening and isolating patients, using necessary PPE, and providing care during set times" for the unvaccinated in a recent set of guidelines for physicians.

It all sounds very laudable until they address one FAQ:

Patients are asking me to write notes supporting a medical exemption from COVID-19 vaccines — what do I need to know?

and reply:

Generally speaking, there are very few acceptable medical exemptions to the COVID-19 vaccination (examples include an allergist/immunologist-confirmed severe allergy or anaphylactic reaction to a previous dose of a COVID-19 vaccine or to any of its components that cannot be mitigated, or a diagnosed episode of myocarditis/pericarditis after receipt of an mRNA vaccine). 

Given the rarity of these exceptions, and in light of the fact that vaccines have been proven to be both safe and effective, any notes written for patients who qualify for a medical exemption need to clearly specify: 

• the reason they cannot be vaccinated against COVID-19 (i.e., document clear medical information that supports the exemption); and
• the effective time period for the medical reason (i.e., permanent or time-limited).

While physicians are generally required to complete third party medical reports for patients when requested, the circumstances of the pandemic support physicians declining to write notes or complete forms when the patient making the request does not have a medical condition that warrants an exemption. If you find yourself in this situation, clearly and sensitively explain to your patient that you cannot provide them with a note or form, along with the reasons why. 

On the other hand, physicians are not to simply turn their potential patients away. Instead, they are encouraged to view them as afflicted with anxiety and to treat them correspondingly – that is, to medicate them:

It is also important that physicians work with their patients to manage anxieties related to the vaccine and not enable avoidance behaviour. In cases of serious concern, responsible use of prescription medications and/or referral to psychotherapy are available options. 

The page has since been amended to include the following addition (addition in bold).

It is also important that physicians work with their patients to manage anxieties related to the vaccine and not enable avoidance behaviour. For example, for extreme fear of needles (trypanophobia) or other cases of serious concern, responsible use of prescription medications and/or referral to psychotherapy may be available options. 

And the reason given for medicating non-compliant parents?

Overall, physicians have a responsibility to allow their patients to be properly informed about vaccines and not have those anxieties empowered by an exemption.