"Looking for a Pediatrician Who Doesn’t Push Vaccines”
What vaccine-hesitant parents are told, what pediatricians are actually doing, and the legislation caught in between
If you spend any time in parenting groups on Facebook, you’ve seen the posts.
“Looking for a pediatrician who doesn’t push vaccines.” “Does anyone know a doctor who won’t drop us if we don’t follow the vaccine schedule?” “We just got told our ped won’t see us anymore. Send recs for a holistic doc who won’t push shots.”
I (Jess) see these constantly. And I understand the frustration behind them. No parent wants to feel judged. No parent wants to feel like their doctor is issuing ultimatums instead of having a conversation.
But there’s a lot of context getting lost in these discussions, and that missing context has real consequences for children who can’t advocate for themselves and for the pediatricians who are trying to protect them. Let’s discuss…
Every child in that waiting room is a patient
A pediatrician’s obligation isn’t just to the child in front of them. It extends to every patient in their care. When a family declines vaccines, their pediatrician is left with two competing responsibilities: 1) respecting that family’s autonomy and 2) protecting patients who cannot protect themselves.
We’re talking about newborns who are too young to have completed their vaccine series. Kids undergoing chemotherapy. Children with immune disorders who can’t receive certain vaccines. Of course, these children didn’t choose their vulnerability… and their pediatricians made a commitment to protect them.
Dr. Rana Alissa, president of the Florida Chapter of the American Academy of Pediatrics, put it plainly: “When you have somebody that is unvaccinated and coming with fever, what if that patient has measles? If they are going to come and be in the waiting room with people who have leukemia, or for any reason they do have a lower immune system, they are going to expose them to measles.”
For these pediatricians, it is about the duty to care — a foundational ethical principle in medicine that requires physicians to prioritize their patients’ wellbeing and to take reasonable steps to prevent harm. The same basic principle underlies why hospitals have surgical protocols and why immunocompromised patients receive special precautions. Nobody is being blamed. The vulnerable patients in the waiting room simply need protection.
This is not a first-resort decision
I think this is the piece that gets lost most often. Pediatricians with vaccination policies use these only as a last resort.
We’ve spoken to several pediatricians who describe a process that plays out over multiple visits, sometimes over the course of a year or more. They answer questions. They address specific concerns. They provide resources. They try. Most told us they typically give families around three real opportunities to have these conversations before they ever consider ending the relationship. And even then, it’s not a decision anyone takes lightly.
The AAP’s 2024 clinical report reflects this. It says dismissal is “an acceptable option” but emphasizes it should not be taken lightly, that pediatricians should use evidence-based communication strategies first, and that they should respect families’ perspectives throughout the process. A 2020 JAMA survey found that 51% of pediatric offices had dismissal policies. Among pediatricians who used these policies, nearly one in five reported that families often or always changed their minds and agreed to vaccinate after learning that dismissal was a possibility.
That statistic tells you something about what these conversations can accomplish when they’re given room to happen. These are families who can be reached, which is why the clinical relationship, not the dismissal policy, is what actually moves the needle.
This is a genuine debate within medicine, too. The New England Journal of Medicine published a clinical decisions piece presenting two expert perspectives on this exact scenario. One argued that pediatricians should accept unvaccinated patients and work to build trust over time, because vaccine refusal is a modifiable behavior and the relationship itself is the most powerful tool a doctor has. The other argued that declining is ethical, primarily because of the obligation to protect vulnerable patients already in the practice from diseases like measles, which can easily spread through a waiting room. Neither position was labeled right or wrong. Both sides believe they are doing what is best for their patients. That’s an important thing for families to understand. This isn’t a coordinated agenda. It’s clinicians navigating a genuinely difficult decision, and reasonable doctors land in different places.
I (Dr. Higgins) have come full circle on this question myself. I have practiced in settings that dismissed families who refused vaccines, and in practices that chose not to. Over time, I’ve come to believe that preserving the relationship is usually the better path. Not dismissing families over vaccine decisions gives me the best opportunity to protect that child’s health over time. But I also understand why thoughtful colleagues, motivated by a duty to protect medically vulnerable patients, may reach different conclusions.
When a family does leave a practice, they aren’t left without options. Federally Qualified Health Centers, community health centers, and local health departments can provide pediatric care regardless of vaccination status. But access to these alternatives varies greatly by community, and for some families, finding a new health care team can be quite difficult. This reality can get lost when this is framed simply as a matter of parental choice.
They’re not getting rich off your kid’s vaccines
This is one of the most persistent myths we encounter, and it’s directly tied to the idea that pediatricians “push” vaccines because they profit from them.
We spent six months investigating this. We analyzed commercial reimbursement data from four major insurers across all 50 states. We reviewed state Medicaid fee schedules. We interviewed pediatricians about the reality of vaccine economics in their practices. We published a white paper with the full findings. Bottom line: pediatricians are not getting rich off of vaccinating our kids.
Pharmaceutical companies do not pay pediatricians to vaccinate children. That is illegal under federal anti-kickback laws. The “bonuses” that circulate in viral posts come from insurance quality programs that measure dozens of care metrics — developmental screenings, chronic disease management, patient satisfaction — of which immunization is just one component. These are not vaccine quotas from pharma companies.
And many pediatricians, especially those serving kids on Medicaid, actually lose money on every vaccine they administer. Nearly 1 in 4 has considered stopping vaccine delivery altogether because the financial strain is unsustainable.
The idea that your pediatrician is pushing vaccines because it’s a lucrative business doesn’t hold up when you look at the actual numbers. Can we put this nasty claim to rest?
Not quite, apparently. Texas Attorney General Ken Paxton recently launched an investigation into pediatricians who vaccinate children, claiming they’re part of an illegal financial incentive scheme — in the same state where two unvaccinated children died during last year’s measles outbreak. The doctors trying to protect kids are now being investigated for it.
Informed consent already exists
There’s a version of the current debate that frames vaccine-hesitant families as people who simply haven’t been given enough information, as if the problem is a gap in disclosure that better paperwork could fix. But that framing misses what informed consent actually is, and what it already requires.
Federal law requires that every patient or parent receive a Vaccine Information Statement (VIS) before any vaccine is given. These documents, developed by the Advisory Committee on Immunization Practices after careful analysis, outline the disease the vaccine prevents, how the vaccine works, the benefits and risks, and potential side effects. They are available in over 40 languages. Clinicians are legally required to go beyond just handing you the sheet. They need to discuss the information, answer your questions, and document that it happened.
The National Childhood Vaccine Injury Act of 1986 requires VIS distribution for all routine childhood vaccines. State laws add additional consent requirements on top of that, and those vary by jurisdiction. But the baseline is federal law.
You absolutely have the right to decline vaccines after being informed. That is literally part of the consent process. It’s built in. Having a practice vaccine policy in place does not remove your right to say no. It means one clinician, weighing their obligations to all of their patients, has decided their office may not be the right fit for your family. You can still decline. You can find another clinician. Your autonomy has not been taken away.
Genuine informed consent is a two-way ethical obligation: the provider’s duty to disclose, and the patient’s right to decide. Both already exist. What a practice policy reflects is a separate ethical judgment, about the doctor’s duty to other patients, that operates alongside consent, not instead of it.
When parental frustration becomes legislation
No one is forced to vaccinate. But that doesn’t mean opting out is consequence-free. In some practices, it means finding a new pediatrician. In most states, it means navigating an exemption process to send your child to school. Because of that, some families feel they aren’t truly being given an option at all — and that frustration has become the engine behind a wave of legislation now moving through statehouses across the country.
A few weeks ago, Florida First Lady Casey DeSantis and Surgeon General Joseph Ladapo held a roundtable at which parents shared stories of struggling to find pediatricians willing to treat their unvaccinated children. DeSantis called it “discrimination.” Ladapo called it “coercion” and said pediatricians who have vaccination policies are making it “impossible to obtain informed consent.”
This wasn’t just a listening session. It’s part of a much larger effort already moving through the Florida legislature…
Ladapo has proposed rule changes to remove school-entry vaccine requirements for hepatitis B, varicella (chickenpox), Hib, and pneumococcal disease. Those are the ones he can change without legislative approval. For the rest, two bills are advancing. The Senate’s “Medical Freedom Act” (SB 1756) has now passed two Senate committees and heads to the Rules Committee before a full Senate floor vote. It would expand vaccine exemptions to include “conscience” objections and require new parental acknowledgment forms for all childhood vaccines. A companion bill in the House (HB 917) goes further: it would prohibit health care providers from “discriminating” against patients based on vaccine status, meaning pediatricians could face disciplinary action, including license suspension, for maintaining vaccination policies in their practices.
Ladapo has cited the statistic that 51% of pediatric offices have dismissal policies as evidence of coercion. But as we described above, the same data show something more nuanced: pediatricians are having these conversations, families are engaging, and some ultimately choose to vaccinate. That looks more like an ongoing clinical dialogue than a coercive system.
What the proposed legislation would actually do is ‘resolve’ the ethical tension these physicians are navigating by removing one side of it entirely. Doctors would no longer be permitted to weigh their duty to immunocompromised patients against their relationship with vaccine-hesitant families. The law would make that judgment for them.
These bills would weaken pediatricians’ ability to maintain safe clinical environments, expand exemptions in ways that could drive vaccination rates below outbreak thresholds, and create a legal framework in which doctors face disciplinary action for following evidence-based guidelines.
All of this is happening while Florida’s childhood immunization rate has dropped to 88%, the lowest in 20 years, and well below the threshold needed to protect communities from outbreaks of highly contagious diseases like measles.
Florida has reported dozens of measles cases already this year, including an active outbreak cluster at Ave Maria University in Collier County — though the state health department has been underreporting, so the true number is likely higher.
When asked whether his department modeled the potential health outcomes before launching this push, Ladapo said, “Absolutely not.”
Republican Sen. Gayle Harrell of Stuart, whose late husband was a physician, pushed back during the Senate committee vote. She argued that if parents seeking vaccines are required to receive education materials, the same should be true for parents seeking exemptions. Her amendment was voted down. She warned that Florida is heading toward a future in which medical students will have to learn to treat diseases we had essentially eradicated.
And this is not just Florida. A national coalition, the Medical Freedom Act Coalition, which includes Children’s Health Defense and the Brownstone Institute, is working to introduce similar legislation in all 50 states. Challenges to school vaccine requirements are already showing up in Idaho, Texas, West Virginia, South Carolina, California, Connecticut, Maine, and New York. The language is the same everywhere: “medical freedom,” “parental rights,” “informed consent.”
We share this because families deserve the full picture, not just the parts that confirm what we already believe. And because the children who can’t speak for themselves in this debate deserve to have someone name what’s at stake for them.
I (Jess) want to be clear: I understand that vaccine-hesitant parents are acting out of love. I’ve never doubted that. But love for your child and risk to someone else’s child can exist at the same time — and that tension is exactly what this discussion is about.
If you’re a parent who has concerns about vaccines, please talk to your pediatrician. Ask your questions. Take the VIS home and read it. Bring a list of everything you’ve seen online that worries you. A good pediatrician will sit with you through that. And if you feel dismissed or rushed, that’s worth addressing too. You deserve a clinician who takes your concerns seriously.
But the answer to imperfect conversations is better conversations. Not legislation that prevents doctors from protecting the kids in their care who need it most.
Stay Curious,
Unbiased Science
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I spent the first weeks of both of my kids lives going to the peds clinic because they also offer lactation services. I would have been devastated if unvaccinated children were exposing my newborns that were not vaccinated yet. They do not allow unvaccinated in their clinic for this reason.
Feel this all! I struggle with this as well all the time- keep people and risk exposing others or refuse them and they might miss out on care. And it’s so true we talk and talk and talk over and over about things. I answer questions. I give resources. These visits take extra time and mental and emotional energy. And I wonder if we keep letting people stay in practices without vaccines , will people ever find the need to vaccinate? Sometimes there has to be a push to make it happen- we’re seeing right now that people are exercising their right to refuse more and more. Yet they still participate in public events, etc. When is it time to put our foot down and say enough- this is important for you as an individual and as a member of a larger community. I don’t know the answer. Just venting. I’m so tired of it all. My years in schooling and hours building relationships feels like it makes no difference. People believe the rumors and the social media influence no matter…it’s so deflating.