Some DMV pediatricians are kicking out unvaccinated patients

This comes as the greater D.C. region has recorded several measles cases this year amid the nation's largest measles outbreak in 35 years.

Driving the news: Several local practices have publicly reaffirmed their longstanding childhood vaccination policies after President Trump's executive order recommending fewer routine childhood vaccines and more separate visits for shots.

• That includes Pediatric Associates of Alexandria, which recently announced it will continue to follow the American Academy of Pediatrics (AAP) schedule.
• Several regional clinics also state they won't work with patients who don't plan to vaccinate their kids.

What they're saying: These policies are leading some local families to seek alternate care, says a Northern Virginia nurse practitioner at a "vaccine-friendly" practice, a term used online by some vaccine skeptics for spots that will see children no matter their parents' immunization stances. (The nurse asked to remain anonymous, citing harassment that other vaccine-optional providers have faced.)

• The nurse says vaccine-optional practices can be difficult to find in the DMV, with families relying largely on word-of-mouth and "medical freedom" databases.
• "We just are all very careful," says the nurse. "It's a pretty insular community."

How it works: The nurse says the practice doesn't take a position on vaccines or require patients to follow the traditional AAP-recommended vaccine schedule, instead leaving the decision to parents.

• Some families forgo vaccines altogether. Others opt to stagger or delay them.
• The small practice doesn't administer vaccines but directs families elsewhere if they want them.
• The nurse says the practice's vaccine-optional stance isn't political: "The one thing I never do is tell them what to do."

The other side: Pediatric Associates of Alexandria adopted its strict vaccine policy around a decade ago, but pediatrician Michael Hopper says the group has recently had to dismiss more families who don't comply amid heightened White House and online discourse about vaccines.

• "It's your decision as a parent what you feel like is best for your kid," he says. "[But] we don't feel like it's fair to put other patients in our practice at risk."

Hopper points to one family the practice had dismissed whose two unvaccinated children were later hospitalized in intensive care with measles after traveling abroad.

By the numbers: Most vaccine exemptions among D.C., Maryland and Virginia kindergarteners are non-medical, according to CDC data.

• Virginia, Maryland and D.C. allow religious exemptions from school vaccination requirements, but don't offer separate personal belief exemptions like some states.
• The nurse says some local vaccine-skeptical families describe their objections less as traditionally religious and more as a broader "belief system and approach to life."

Hopper's take: "It has nothing to do with religion," he says. "It has everything to do with the skepticism that politicians are putting out there."

Zoom out: Some local clinics that aren't explicitly "vaccine friendly" will continue to work with families who want to space out, delay or avoid vaccines entirely because doctors worry that then the children will go without health care, pediatricians tell Axios.

But Hopper says that his practice feels comfortable with its mandate because families have many other health care options in the DMV.

• "Sometimes you have to take a stand on certain things, and we just felt like this was one that was worthwhile."