— The story of Michayla Kubasiak, hospitalized at seven weeks old with whooping cough, may prompt parents to ask their pediatricians an important question: Does your office treat unvaccinated patients?
Michayla developed a cough that landed her in the pediatric intensive care unit for two weeks.
“It was terrifying, definitely terrifying,” her mother, Michelle Kubasiak, told TODAY. “She got better, she got worse. She got better, she got worse. They found that she did have
pertussis -- whooping cough.”
Little Michayla was vulnerable to the highly contagious disease, which is dangerous in infants and children, because at the time she was exposed she wasn’t old enough for the pertussis vaccine.
The fact that she may have been exposed in her pediatrician’s office by an unvaccinated patient was one reason her doctor’s office recently imposed a policy requiring all patients to be immunized.
“We believe it is medically appropriate to exclude unvaccinated children from a pediatric practice to protect the vaccinated children from communicable infectious diseases,” read a letter her doctors sent to their patients.
The practice is part of a small but growing controversial trend of pediatricians dropping patients whose parents refuse to allow their children to be vaccinated. The American Academy of Pediatrics, which supports universal immunization, says refusal to immunize should not be the only reason a doctor turns a family away.
“In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child,” the group says in a report. “However, when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists, the pediatrician may encourage the family to find another physician or practice.”
Dr. Douglas Diekema, lead author of the academy’s report, told TODAY: “I think we have to be really careful about refusing to take care of the kids simply because their parents may make decisions that we don't always agree with.”
While there may be no greater regularly scheduled anguish for parents than watching their infants and toddlers being held down to get shots, the medical and scientific community calls them safe and effective lifesavers.
Still, some parents refuse some or all vaccines for their children for various reasons, including a belief that they cause autism, and some long-forgotten diseases are now becoming threats again. The Institute of Medicine released a safety review last month that found no link with autism, reiterating earlier studies that have looked at hundreds of thousands of children.
NBC News chief medical editor Dr. Nancy Snyderman, who calls herself “very pro-vaccination,” sees both sides of the issue doctors are facing.
On one hand, doctors are there to treat everyone, and turning patients away leaves them still unvaccinated and without care. But, she added, an unvaccinated child who is carrying a virus is “literally a walking Typhoid Mary” who puts other children in a waiting room at risk.
Snyderman says vaccines have worked so well in combating disease that they’ve
almost become victims of their own success, as most moms and dads today don’t know what it’s like to suffer from diseases like measles.
Today’s parents “have never seen polio,” she said. “They don’t think pertussis is going to hit their kid.
“But if we don’t vaccinate, those are exactly the problems we’re going to see,” Snyderman told TODAY's Natalie Morales. “I worry that things like polio could be around the corner.”
The children most at risk from contracting a disease from an unvaccinated child in a waiting room are infants who have not yet received all of their shots and kids with compromised immune systems from conditions like cancer and HIV, said Dr. Carrie Byington, vice chair of the American Academy of Pediatrics' committee on infectious diseases. Some children with compromised immune systems are unable to be vaccinated, while others may develop a condition after being immunized that renders the vaccine ineffective, she said.
But parents with older healthy kids whose vaccines are up to date don’t have much to worry about, she said.
“A healthy child who’s fully immunized should be protected from exposure in waiting rooms to infectious diseases for which they are immunized,” she said.
Pediatrician Lisa Thornton says she worries about a possible rise in disease if parents don’t vaccinate because of the loss of herd immunity, which occurs when enough people in a population are vaccinated that a disease can’t move through a community.
To immunize or not remains an individual choice. For Kubasiak, whose daughter Michayla is now a healthy 7-year-old, the decision was an easy one.
“It's definitely not easy watching your child get three or four vaccinations in a visit and it's definitely something that's upsetting as a parent, but it's nothing like watching them be sick in a hospital,” Kubasiak told TODAY. “No comparison.”