Parents who refuse to get their children vaccinated might find it more difficult to find a pediatrician, a new survey finds.

Researchers in Colorado and at the Centers for Disease Control and Prevention in Atlanta surveyed U.S. pediatricians from April to July 2019. Physicians were recruited to fill sampling quotas representative of American Academy of Pediatrics membership with respect to region, practice location and practice setting and asked to complete two to four surveys each year.

The survey asked pediatricians about their current practices, experiences and office policies regarding dismissal of families who refuse or ask to “spread out” either vaccines in the primary series or any other vaccines.

The researchers found that 51% of pediatricians reported their office had a policy to dismiss families if they refused vaccines in the primary series, while 37% of physicians reported often or always doing this dismissal themselves. Physicians more frequently dismissed families for refusing (37%) than for spreading out (6%) vaccines in the primary series, and a similar pattern was seen for office policies (51% for refusal vs 28% for spreading out).

Some argue that having a dismissal policy for vaccination leads resistant parents to agree to vaccinate, the researchers wrote. This study showed some pediatricians perceive this to be true, with more than half of pediatricians with a dismissal policy reporting parents at least sometimes agreeing after learning of the policy.

“Future work should explore the effect this practice has on vaccination rates, whether it results in parents changing their mind about vaccination, and whether it decreases access to medical care or erodes trust in clinicians,” the researchers wrote.

The researchers' letter was published in the Journal of the American Medical Association.