Two St. Louis doctors are calling for pediatricians to respond to parents' concerns about the safety of vaccines with more understanding and empathy.

In their review published Monday in the journal for the Missouri State Medical Association, the doctors explained why some parents are fearful and how physicians have been dismissive in debunking those fears.

"If we do express emotion about vaccination, it often comes across either as anger at parents who just don't care enough to do what is best for their children or annoyance on our part for having to waste our time with such nonsense," they wrote.

The review was written by Dr. Kenneth Haller, a pediatrician at Cardinal Glennon Children's Medical Center and associate professor at St. Louis University School of Medicine; and Dr. Anthony Scalzo, director of the division of toxicology at St. Louis University School of Medicine.

"We need to tell (parents), it's reasonable to have these fears," Haller said in an interview. "If you completely discredit those fears and misgivings, it is not going to get at the root of what we want, which is that kids stay healthy."

The article comes after results of a national survey released last fall showed more than 1 in 10 parents were skipping or delaying vaccines for their young children.

Even parents following the recommended schedule of shots had doubts — about 25 percent thought delaying immunizations until children got older would be safer, the survey found.

Before the birth of their adopted daughter, parents Michael Guinti and Don Lindsay were considering delaying vaccinations for her until, in their search for a pediatrician, they came across Haller. During interviews with two other pediatricians, Guinti said he felt their vaccine concerns were not taken seriously.

"I got the impression they were thinking, 'Why are you questioning me? I'm a doctor' and 'Are you serious?' " said Guinti, who last fall moved with Lindsay to Iowa, where they legally married.

When the couple interviewed Haller, he spent nearly two hours answering their questions about vaccines, showing them numerous studies and articles, Guinti said. "He put us at ease." The couple went ahead with the recommended schedule for their daughter, Gabriella, now 18 months, because they did not want to risk her getting ill as an infant.

Haller points out several reasons why parents are fearful: Official-looking websites touting the dangers of vaccines abound. One 1998 study showing a link between autism and the measles-mumps-rubella vaccine has been shown to be seriously flawed but damage is difficult to undo. Because many diseases and infections are now rare as a results of immunizations, some parents think it's not as risky to skip the shots.

Haller points out in the article, however, that cases of pertussis, measles and Haemophilus influenzae disease have seen increases. Not getting immunized also places those who are unable to get vaccines because of medical reasons at risk.

"We as medical professionals have not done a very good job at presenting our case ... ," Haller said. "Even eloquent spokespeople have said things like, 'There's a war out there between doctors and parents, and kids are caught in the middle.' That's not the kind of imagery that will bring people to your way of thinking."

Some pediatricians across the country have refused to treat patients unless their parents agree to have them vaccinated. On the flip side, Haller points out, anti-vaccine groups try to appear to have families' best interests at heart.

The American Academy of Pediatrics in 2005 released guidelines for responding to parents' refusals to vaccinate. Most important is to listen respectfully to parents' concerns, the report stated, "recognizing that some parents may not use the same decision criteria as the physician and may weigh evidence very differently."

Haller said he understands pediatricians are pressed for time, but "if we can sit down with one family and have a heart-to-heart about the importance of vaccines and consequences of not getting vaccinated, that family can go into the community and say, 'You know, I talked to my doctors about it, and this is what he says or she says.' "

Guinti said if they had not had that discussion, their toddler would not be immunized.

"If we hadn't found Dr. Haller, we would've done the delayed vaccination schedule," Guinti said. "We would've not done anything until we absolutely had to for school."

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Editor's note: Updated to correct the names of the Missouri State Medical Association and Cardinal Glennon Children's Medical Center.