As more and more parents refuse once-standard immunizations for their children, pediatricians are fighting back by discharging unvaccinated patients. To support pediatricians in that battle, the prestigious Mayo Clinic created the Clinician's Guide to the Anti-Vaccinationists' Galaxy, published in the journal Human Immunology. 

"Thousands of children are at increased risk because of under-vaccination, and outbreaks of highly transmissible diseases have occurred," says Mayo vaccinologist and lead author Gregory Poland, M.D. "Primary care physicians have less time than most to explain the scientific case for vaccination. This article gives them the background and tools to debunk some of the major myths."

Some of those 'myths' include: 

 Babies' systems aren't ready for the number of vaccines given today.

 Vaccines can cause autoimmune diseases.

 Natural immunity is safer and better.

The Mayo experts stress that vaccines are safer than ever, with a far lower number of active molecules than in the past. While natural immunity does offer some protection, the Clinic suggests "the risk of illness and death is far higher than with a vaccine."

The Guide also describes the harm that the anti-vaccine movement has done, with concrete examples of needless death and avoidable diseases such as measles and whooping cough, due to under-vaccination. 

“[Anti-vaccination parents'] whole philosophy on care is not consistent with how I practise my medicine,” said Dr. Fatima Kamalia, a Thornhill-based pediatrician who effectively dismisses patients who ignore her advice. “So it’s probably better that they find a doctor who they’re comfortable with, who they can talk to, and who can handle their specific needs better than me.”

That said, Kamalia discharges fewer than one percent of her estimated 3,000 patients, and according to the Ontario College of Physicians and Surgeons, she is well within her rights to do so when there has been a “breakdown of trust and respect.” 

Kamalia insists that she offers parents a modified vaccination schedule, and that a child is only discharged as an absolute last resort.

It's estimated that one in 25 to 30 parents in Ontario refuse immunizations or place their child on a modified vaccine schedule. Some pediatricians blame the internet for the wealth of medical information (some of it inaccurate) for the current paranoia surrounding vaccinations. 

Then there was the now-infamous 1998 report linking autism with the measles-mumps-rubella (MMR) vaccine. Even though the Lancet retracted the study in 2010, and its author Andrew Wakefield was since stripped of his medical licence, some studies die hard. 

Toronto-based pediatrician Marvin Gans prefers to deal diplomatically with vaccine-adverse parents. “If you turn them off, they may feel that nobody cares and medicine doesn’t listen,” Gans said. “And there’s no hope of them coming back.”

Should pediatricians have the right to discharge patients who refuse immunizations? Would the threat of being dropped by your child's doctor sway you into giving your child vaccines, or would you simply track down a more sympathetic doctor?