Four in 10 pediatricians say children in their care skipped medical appointments during the past 12 months because of fears about immigration status, according to a survey of about 2,600 pediatricians published in Pediatrics. The American Academy of Pediatrics conducted the survey, and another 38% of respondents said they were not sure whether immigration concerns played a role, STAT reported.
The authors wrote that the large share of uncertain answers suggests "an underestimation of the families affected." The finding reflects what doctors believe is happening in their practices. It is not a count of missed visits drawn from medical records.
For families, a skipped appointment is rarely just one lost hour. Well-child visits are where infants and children receive vaccines, developmental screenings, hearing and vision checks, and prescription refills. Children who are U.S. citizens can be affected too when a parent or relative fears contact with any institution.
Physician Perceptions, Not Medical Records
This is a survey of physicians, and the AAP both conducted it and publishes the journal. It shows how often pediatricians believe immigration fears affected attendance, but it cannot establish how many appointments were missed, which children missed them, or whether fear was the only reason. MedicalDaily was not able to review the full paper's response rate and methods before publication.
The 38% of doctors who were unsure is itself notable. Families do not always explain why they miss an appointment, so physicians may not know when fear is a factor. The authors read that uncertainty as a sign that the true effect may be larger, although the survey cannot confirm it.
Missed appointments also have other causes, including cost, transportation, and work schedules, which makes it hard to separate immigration fears from other barriers. Current medical guidance has not changed. Pediatric groups continue to recommend routine checkups and on-time vaccines, and catch-up schedules exist for children who fall behind.
Clinic Data from Minnesota and Texas Point the Same Way
Harder numbers have come from individual health systems. A separate Pediatrics study from Children's Minnesota analyzed more than 129,000 appointments at two hospital-based general pediatrics practices on the health system's Minneapolis and St. Paul campuses. During Operation Metro Surge, a Department of Homeland Security and Immigration and Customs Enforcement initiative that ran from December 1, 2025, to February 12, 2026, the missed-appointment rate among Hispanic and Latino patients rose 51.2% compared with the same weeks in the prior two years, climbing from 20.7% to 31.3%.
Missed appointments also rose 80.4% among Spanish-speaking families and 53.1% among families needing interpretation, the study found. Requests to reschedule well-child visits rose 51%, while telehealth appointments did not change significantly, Healio reported.
Dr. Asitha Jayawardena, a pediatric otolaryngologist at Children's Minnesota and the study's lead author, described children with hearing loss and other conditions whose care was delayed, Stateline reported. "It's just very disheartening knowing that there's something I can do, but I am prohibited from doing it because families don't feel safe," Jayawardena told Stateline.
In Texas, Dallas health department clinics gave 50% fewer back-to-school vaccinations to Hispanic children in August 2025 than in August 2024, STAT reported. Clinicians quoted in Medscape's reporting on missed pediatric appointments have described similar no-show patterns at community clinics.
Children Most Likely to Fall Behind
The children at greatest risk are those whose care cannot easily wait. That includes infants due for early vaccines; children with asthma, diabetes, ADHD, or hearing loss who need regular follow-up; and children in mixed-status families whose parents avoid clinics, pharmacies, or public benefit offices. About one in four U.S. children is born to immigrant families, according to the Migration Policy Institute, as cited by Stateline.
Stateline also described a patient of Dr. Gabriela Maradiaga Panayotti, a pediatrician in Durham, North Carolina. The boy, a U.S. citizen on Medicaid, stopped taking an ADHD medication after his parents grew afraid of being targeted through Medicaid paperwork, and his grades began to drop again. Health workers have also reported rising anxiety and depression among young patients.
Missed care can also have public health effects. Gaps in routine vaccination can leave pockets of children vulnerable during outbreaks, a concern heightened by this year's measles activity. The CDC has confirmed 3,294 measles cases nationwide this year as of September 10.
Options for Families Worried About Visits
Families who are anxious about in-person visits can call their clinic ahead of time to ask about telehealth options, appointment policies, and who will have access to their information.
Parents should not stop a child's prescribed medication without speaking with a pediatrician or pharmacist, since stopping some drugs abruptly can cause harm. Community health centers generally serve patients regardless of insurance status or ability to pay, and many offer interpretation services. Keeping copies of vaccination records and medication lists at home can make catch-up visits easier. Parents whose children have fallen behind can ask for a catch-up vaccine schedule, which generally allows missed doses to be given without restarting a series.
Some situations cannot wait. A child with trouble breathing, signs of dehydration, or a seizure, or an infant younger than 3 months with a fever, needs emergency care right away. Under federal law, hospitals with emergency departments that participate in Medicare must provide a medical screening exam to anyone who seeks emergency care and must stabilize an emergency condition, regardless of ability to pay. Families with legal questions can consult a qualified immigration attorney or a legal aid organization.
For now, the best available evidence combines physician perceptions with data from a handful of health systems. Together, they point to a real risk that some children are going without needed care.
Key Questions Answered
What did the survey find? About 40% of roughly 2,600 pediatricians surveyed by the American Academy of Pediatrics said children in their care skipped appointments in the past year because of immigration-related fears. Another 38% were unsure.
Does this mean 40% of children missed appointments? No. The figure is the share of doctors who reported seeing the problem, not the share of children who missed visits.
Is there harder data on missed visits? Yes, from individual health systems. At Children's Minnesota, missed appointments among Hispanic and Latino patients rose 51.2% during a federal immigration enforcement operation.
Which children are most affected? Infants due for vaccines, children with chronic conditions that need follow-up, and children in mixed-status families, including U.S. citizens.
Can families get care without an in-person visit? Many clinics offer telehealth. Families can call ahead to ask about options and policies.
When should a family go to the emergency room anyway? Seek emergency care for trouble breathing, dehydration, seizures, or fever in an infant younger than 3 months. Hospitals with emergency departments that participate in Medicare must screen anyone seeking emergency care and stabilize emergency conditions.
