New York’s law is paradigmatic: a neglected child is one whose “condition has been impaired or is in imminent danger of becoming impaired” because the parent has failed “to exercise a minimum degree of care in supplying the child with adequate” health care. 4Īlthough child welfare laws vary by state, the legal concept of medical neglect has a common denominator. 3 One strategy recently promoted is to treat vaccine refusal as neglect and report parents to child protective services (CPS) or another comparable agency. With increasing numbers of parents exempting their child from required school-entry vaccines 1 and few evidence-based interventions to address vaccine hesitancy, 2 pediatric providers are struggling with how to respond to parental vaccine refusal. Parental refusal of childhood vaccines is a contentious issue in pediatrics and public health. Each state should clarify whether, under its laws, vaccine refusal constitutes medical neglect. Some states have a legal precedent for considering parental vaccine refusal as medical neglect, but this is based on a small number of cases. In the 4 cases decided in jurisdictions that permitted religious exemptions, courts either found that vaccine refusal did not constitute neglect or considered it neglect only in the absence of a sincere religious objection to vaccination.Ĭonclusions. Most courts (7 of 9) considered vaccine refusal to constitute neglect. Our search yielded 9 cases from 5 states. We also delineated if religious or philosophical exemptions from required school immunizations were available at the time of adjudication. We used the Westlaw legal database to search court opinions from 1905 to 2016 and identified cases in which vaccine refusal was the sole or a primary reason in a neglect proceeding. To examine the relation of vaccine refusal and medical neglect under child welfare laws.
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