The practice of vaccine delay and refusal has recently held the attention of the medical community, most notably due to outbreaks of vaccine preventable diseases. It is a loaded subject both for parents/guardians and pediatricians; to the point of pediatricians being more likely to dismiss families who refuse vaccinations for their children. Within the field of pediatrics, this is a topic that poses a threat to the physician-patient relationshp. Studies have shown an increase in vaccine refusals in the last decade; therefore, further examination of the reasons behind this decision remains key in better understanding what drives this decision when made by some parents and guardians. This survey will attempt to cite the most common reasons for this decision directly from parents/guardians, as well as to examine if there is any significant difference between the degree of trust in pediatricians amonst parents/guardians who refuse or delay vaccines when compared to non-refusing parents/guardians. The ultimate goal of such a survey will be to better understand the "why" behind parental vaccine delay and refusal. Ultimately it is unquestioned that both sides want the best for the child and patient; the hope of this survey is to better understand the gap between the two sides.

Universal lipid screening (ULS) is recommended for all 9- to 11-year-old children. We investigated ULS outcomes and long-term pediatrician management of children with dyslipidemia using a retrospective chart review of well-child visits between 2014 and 2016. Descriptive statistics summarized demographics, ULS results, and follow-up visits/testing. Pearson χ² test examined differences between those with and without an abnormal screen. A total of 1039 children aged 9 to 11 years were seen for a well-child visit; only 33.3% (343/1039) completed screening. Of children screened, 18.1% (62/343) had abnormal screen results and were more likely to have an elevated body mass index (P < .001), though 30.1% (19/62) had no risk factors. A total of 10.2% (35/343) had dyslipidemia. A total of 77.1% of children with dyslipidemia received nutrition/exercise counseling and 57.1% received dietitian referrals; only 68.6% had a follow-up visit and 31.4% had repeat lipid testing. Pediatricians would benefit from more practical strategies for universal testing such as point-of-care testing and long-term management to ensure ULS is an effective screening tool.