I've discussed the concept of "misinformed consent" multiple times before. Quacks in general, particularly the "health freedom" movement proclaim their dedication to "informed consent." "All we're asking for," they will say, "is informed consent." The antivaccine movement in particular demands "informed consent" about vaccines. Be it Barbara Loe Fisher, the bloggers at the antivaccine crank blog Age of Autism, or any of a number of antivaccine warriors, demanding "informed consent" seems to be every bit as much of the antivaccine arsenal as the "toxins gambit" or ranting about "fetal cells" in vaccines. None of this is to try to say or even imply that informed consent isn't incredibly important. It is critical to everything we do in medicine, both in clinical practice and research in the form of clinical trials. It is, quite correctly, considered a major failure when adequate informed consent is not given, and when the failure to provide informed consent is intentional or comes about through neglect it's considered highly unethical. Medical ethics demands that patients be aware of what it is they are getting as well as what the potential benefits are relative to the potential risks, and that they have the freedom to choose to undergo or refuse the proposed therapy.
However, what the antivaccine movement means when its representatives demand "informed consent" resembles true informed consent only by coincidence--and, let's be frank, not even then. In fact, as Todd points out, the actions of the antivaccine movement are profoundly inconsistent with a real desire for real informed consent. As Todd pointed out, there is a golden opportunity for the luminaries of the antivaccine movement to prove that they support informed consent. This opportunity comes in the form of a proposed law in California, AB 2109. This bill, if passed, would require parents seeking a philosophical exemption from vaccination for their child would have to obtain from their child's doctor or health care practitioner a signed statement attesting that the the doctor provided them with information on the benefits and risks of vaccines. That's it. To me that seems to be a pretty low bar to require for a philosophical exemption from vaccination. Right now, all the parents have to do is to sign a form at the school. Personally, I like the idea promoted by Douglas Diekema in a recent issue of the New England Journal of Medicine that obtaining a religious or philosophical exemption should not be less difficult or costly than undergoing vaccination and that it should require at least a visit to the doctor's office. Right now, in California, getting an exemption is easier than getting one's child vaccinated, and not just a little easier. It's way easier. Just sign a piece of paper saying that vaccines are against your personal belief system, and--voilà !--it's done. As Todd put it, "Parents are still free to put their children and their communities at risk of disease outbreaks based on personal opinions rather than facts. They just aren't allowed to be quite as lazy about it any more."
Unfortunately, the antivaccine movement has rallied not for AB 2109, but against it. Barbara Loe Fisher, all her protestations for "informed consent" notwithstanding, has issued what is in essence a call to arms to her fellow antivaccinationists to try to defeat the bill. It's full of appeals to "personal freedom," claims that doctors would not sign such forms, and, hilariously, this complaint:
- Especially in California, many families utilize health care providers not reliant on pharmaceutical drugs and vaccines, and only practitioners part of the pharmaceutical paradigm or medicine are allowed to provide the information and sign the form under this bill.
- AB 2109 discriminates against families utilizing complementary and alternative medicine by forcing them into paying money to a medical practitioner they wouldn't otherwise use who is already philosophically opposed to the parent's personal and religious convictions regarding vaccination.
Barbara says that as though prodding parents who take their children to quacks to take them to a real doctor for just one visit is a bad thing. Of course, it's "health care providers not reliant on pharmaceutical drugs and vaccines, and only practitioners part of the pharmaceutical paradigm" who tend to promote antivaccine beliefs.
Of course, I expect such nonsense from someone like Fisher. I don't expect such nonsense from a physician. In fact, call me naive, over-optimistic, or just someone who hangs with his tribe too much, but I don't even expect nonsense like that from someone like Dr. Jay Gordon.
Or Dr. Robert Sears.
Unfortunately, I was wrong. Dr. Sears has joined Barbara Loe Fisher's voice against AB 2109 by writing an editorial that was published first on that wretched hive of scum and antivaccine quackery, Mothering.com entitled California Bill AB2109 Threatens Vaccine Freedom of Choice. Not surprisingly, two days later Dr. Sears crossposted his article to that grandmother of all wretched hives of scum and quackery, The Huffington Post. His reasons for being opposed to AB 2109 are virtually indistinguishable from the reasons posted at the NVIC website, right down to Dr. Sears thinking that doctors won't sign the form:
However, what gravely concerns me is that some doctors will refuse to sign this form. I know how doctors think. Many doctors strongly believe that vaccines should be mandatory, and that parents should not have the right to decline vaccines. Some doctors are willing to provide care to unvaccinated kids, despite this difference in philosophy. But now the power over this decision will be put directly into doctors' hands. He or she can simply refuse to sign the form. Doctors who oppose vaccine freedom of choice have been frustrated for years over this issue. Finally, they will have the power to impose their beliefs on their patients. Patients will be forced to find another doctor to sign the form, submit to vaccines, or get kicked out of public school.
And, of course, there's the question of liability fears, which leads Dr. Sears to state that he knows for an "absolute fact" that some doctors will not sign the form "out of principle or fears of liability." How he knows this "for an absolute fact" he doesn't say. The only part where Dr. Sears makes a modicum of sense is that some doctors might be reluctant to sign the form for a child based on a single visit, particularly when it's obvious that that's the only reason the parents brought the child in to be seen and evaluated. That might be so for some doctors, but how many doctors do sports physicals, insurance physicals, physical exams for workers' compensation, and the like, even though they know that the patient probably won't come back to see them again? How many physicians in California, for that matter, refuse to sign medical exemption forms for vaccination? Not very many.
If you don't believe me that Dr. Sears is cribbing from the NVIC playbook, though, read this passage:
Natural and alternative health care providers can NOT sign the form; it must be a "regular" medical professional. Some families only see naturopathic or holistic health care practitioners instead of pediatricians. These families will have a difficult time getting the form signed.
Again, Dr. Sears, you say this as though that were a bad thing. Also note how his language is almost indistinguishable from that of the NVIC. Getting kids whose parents are using quacks for their primary care physicians brought in, even just once, to see a real doctor can only be a good thing. Here's a hint for Dr. Sears: It's not a good thing when passages of your blog post look as though they've been directly cribbed from an NVIC position statement! If you don't want to be perceived as antivaccine, then don't use NVIC arguments in language that could fit right in on the NVIC website without raising a single eyebrow of Fisher's fans. Besides, there are plenty of antivaccine-sympathetic (or even antivaccine-friendly) doctors like yourself, Dr. Janet Levitan (who, it should be recalled, is perfectly happy to encourage parents to lie about their religious beliefs in order to obtain religious exemptions from vaccination for their children), or Dr. Jay Gordon out there, who will probably be more than happy to sign such forms after having provided a heapin' helpin' of misinformed consent to the patient.
In fact, it wouldn't surprise me at all if one result of this law would be the creation of a cottage industry of antivaccine-sympathetic pediatricians advertising their willingness to sign philosophical exemption informed consent forms in California with only the most perfunctory of visits. It could be quite the little cash cow. Unfortunately, requiring that parents see a real pediatrician for real informed consent is no guarantee that they will actually get real informed consent based on science, but it makes it more likely. Certainly it's far more likely that parents will get something resembling informed consent if they go to a real pediatrician than if they go to a chiropractor, naturopath, or homeopath. Moreover, chances are that insurance will pay for most, if not all, of any visit required to obtain a vaccine exemption informed consent form from a physician. It's largely a win-win situation, although Dr. Sears doesn't see it that way. In fact, he doesn't even seem to agree with the purpose of the bill, namely to try to increase vaccination rates:
The sponsors of this bill may have some good intentions, as their primary "public" reason for the bill is to make sure that parents who don't vaccinate their children are making an informed medical decision under the guidance of their doctor. But it isn't difficult to see the REAL reason for the bill: to increase vaccination rates in our state by making it more difficult for parents to claim the exemption.
Again, Dr. Sears, you say that as though that were a bad thing. Or, to put it another way, why don't you think it's a good thing to try to increase vaccination rates?
Contrary to Dr. Sears' paranoia over what he apparently perceives as the dark "real" motivations of the sponsors of AB 2109, I see little evidence that the sponsors of this bill aren't being straight with us. Of course they're trying to increase vaccination rates; they're actually pretty straight about their motivations. They're intentionally trying to make it a little more difficult to get a philosophical exemption approved. And why not? I agree with Dr. Diekema. It shouldn't be so incredibly easy to get an exemption compared to actually getting one's children vaccinated. The hard core antivaccinationists will take that extra step; those who are more lazy than actually committed to not vaccinating their children will probably not. In any case, the real reason that Barbara Loe Fisher, Dr. Sears, and the rest of the antivaccine movement don't like AB 2109 is exactly because it makes it a little harder to get a philosophical exemption. More importantly, it will require some parents to take their children to a physician and have a talk about vaccines. Dr. Sears points out that by the time a parent has made up her mind to get an exemption that talking to a physician about it will probably not change her mind. That's probably true, but the current state of affairs in California is that it's so easy to get a philosophical exemption that it's much easier than actually bothering to get one's children vaccinated.
The decision not to vaccinate one's children is every bit as much a medical decision as the decision to vaccinated, and it needs to be made with adequate informed consent. The real reason antivaccinationists are so opposed to AB 2109 is because they fear informed consent. Their version of "informed consent" is a parody of real informed consent. It is, as I have characterized it many times before, in reality misinformed consent, in which the risks of vaccination are hugely exaggerated while the benefits downplayed to the point that any rational person, if she accepted such "risk-benefit" analyses at face value would decide not to vaccinate her child. Unfortunately, the average person doesn't have the background knowledge and understanding to see through the misinformation at the heart of misinformed consent. They have a hard time knowing that the claims of people like Barbara Loe Fisher that vaccines cause autism, neurodevelopmental disorders, autoimmune diseases, and so many other ills that they attribute to vaccines are without a basis in science, epidemiology, or clinical evidence. A pediatrician can help them do that by providing them with genuine informed, rather than misinformed, consent.
And that's exactly what the antivaccine movement fears. So, my readers in California, please be sure to contact your legislators to voice your support for AB 2109. You can be sure the antivaccine movement is trying to pressure them not to pass this bill.
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"informed consent" is a joke. What about all the kids out there who were given mercury vaccines without permission at school? This is unlawful and unconstitutional.
Also I have heard of girls being taken from school to abortion clinics with the parents to find out later on.
Actions like this is what gets people beaten with a large hickory stick. And rightfully so. If some punk kidnaps your daughter from school (taking a minor without parental permission is kidnapping and prison time is required)and takes here to a place where she gets an abortion here is what happens:
The personel who kidnapped her gets beaten severely. The abortionist "doctor" get beaten more severely and then they all go tto prison where they are beaten daily. even if you have to biuld your own secret prison somewhere and put them in it yourself.
It is time for parents to start taking a stand and deporting these crimnals at these schools. banishment is a necessary punishment for their crimes. Now if we could banish a few hundrend poltiicians and a few billion liberals, preferrably all to a confined space of 100 feet by 100 hundred feet.
I guess some people lack respect for OTHER people's kids and sovereignty. Time to teach them a lesson.
The flouride overdosed blueneck fat stalking elf from San Fransicko is back with a new underwear puppet.
The flouride overdosed blueneck fat stalking elf from San Fransicko is back with a new underwear puppet.
Matthew, some kids do get kidnapped from school to get abortions and some injections are given against the will of the parents. That is a crime and crimes must be prosecuted or dealt with.
Hi chris,my stalker, with no chromosomes. Nice to know your intelligence has decreased since my last visit. Must be the gardasil or the flouride. Or both. Then again it could GENETIC!
There is every reason not to get your child vaccinated at least from some of the more dangerous shots like Garadsil and other such nonsense.
Our county health department is racist. Forget going in there and getting anything if you are a white male. They assume for some reason all white people are rich. Must be the democrat subconscious speaking.
Militant Eggnogstick is a moron. Chris has no chromosomes. I guess that explains why he is jealous of shapeshifters. I wonder why NARAD didn;t bother to put his two cents worth in. Oh well. Medicien sucks. More importantly Gardasil the killer vaccine that is unnecessary sucks even more. Saving sex for marriage will make Gardasil useless as having only one partnet in life may make STDs become extinct. We can;t have that though. The pervert sex addicted sodmite left wing secular oppressives love immorality to much to give up sin in exchnage for being normal and healthy. I guess Obamacare pays for sin caused viruses as well? Probably. Sounds about right.
I guess that's what we get when we elect an illegal alien muslim with ties to terrorists and communist as leader of the most powerful nation on earth. OOps. Beter be quiet. Under NDAA he could have me assasinated or put in a concentration FEMA camp.
NJ is easily recognizable. All ya gotta do is recognize his style, out him and prod him a little bit. And out comes a torrent of looney. The truly funny thing is that he doesn't realize that he's making a permanent record of his being unhinged.
Viewed objectively, it's a sad testament to the failure of his mother and father to teach him wrong from right.
He has a few obvious tells - aka Robin Hood men in tights is one, as are discussions of SB, Orac, (my personal favorite) puppeteered socks and underwear.
Once outed, he tends to rant a bit (search SB for examples) in dazed flouridated confusion, so if our gracious host has a policy against such behavior, he may want to keep an eye out.
Clearly, he is living rent-free in a dirty old man's basement. The furnishings are out of date and the place needs badly to be fumigated and the crapper stopped working years ago. Oh well. That's how social justice works.
FIFTY.
Your argument is a little backward. It would make more sense to make sure the parents giving their children vaccines were informed of the possible risks. Consent means allowing a medical procedure, not avoiding it. Why on earth should it cost as much to not get a procedure as to get it? Besides, those who choose not to vaccinate have usually taken a lot of time to research the pros and cons of vaccines on their own. Saying there are no risks to vaccination is ignorant. Yes, there are risks to not vaccinating, but there are very real risks to vaccinating as well. Unfortunately, most doctors don't talk about that. And they should.
I don't really think the following is the best solution, but it makes more sense than the current bill. If the state feels that more parents need educating, a better solution would be to make a film that can be shown at public health centers. Have ALL parents attend. It would be less costly to the state and to the parents.
@ Mary F:
"Besides, those who choose not to vaccinate have usually taken a lot of time to research the pros and cons of vaccines on their own."
Want to provide some of your research "sources", Mary?
"Saying there are no risks to vaccination is ignorant."
I've viewed all the posts on this site and I don't see anyone who has ever stated that there are "no risks to vaccination". Perhaps you want to enlighten us and provide the name and the number of a poster who has claim that.
"Yes, there are risks to not vaccinating, but there are very real risks to vaccinating as well."
Do the risks to not vaccinating greatly exceed the "real risks to vaccinating"...or...do the "real risks to vaccinating" greatly exceed the "risks to not vaccinating", Mary? Perhaps you would provide some citations, for us Mary.
"Unfortunately, most doctors don't talk about that. And they should."
Indeed they should Mary...that is the purpose of AB 2109...so why are you against AB 2109, Mary?
"I don't really think the following is the best solution, but it makes more sense than the current bill. If the state feels that more parents need educating, a better solution would be to make a film that can be shown at public health centers. Have ALL parents attend. It would be less costly to the state and to the parents."
But Mary, you are fighting the passage of AB 2109 which will require that parents will receive one-on-one advice from their child's pediatrician. How disingenuous of you Mary, to force parents to go to health clinic to view a movie and not see their child's pediatrician, to receive counseling from a doctor who knows your child's unique medical conditions.
Mary F:
And exactly what is the quality of that "research"? From the responses we have seen from several here who are protesting this bill, there is lots of misinformation. And that even includes the contributions from Dr. Jay!
Please point to Orac article or comment from someone here who has every said there was no risk to vaccination. You are making a claim that this is what is being said here, please prove that we have said there are no risk.
And how do those risks compare? Show us exactly how the risks to getting the MMR vaccine twice compares to actually getting measles. Then tell us what the risks are to the DTaP and Tdap vaccines are compared to getting diphtheria, tetanus and pertussis.
Be sure to provide the title, journal and titles of the PubMed indexed papers explaining what the risks between the diseases and the vaccines. We want to see definite proof of your "research."
I swear that "Chris" and I are NOT sock puppets...yet our posts are uncannily similar :-)
Toxic Fillers is the name of my new punk band.
Mary F,
This is, in fact, what this bill mandates.
Why is that a problem?
1. Vaccine-refusing families would need a new signature (a) at kindergarten entry
(b) Every time they change schools (c) entering 7th grade, for the whooping cough booster.
I ran the numbers:
AB 2109 would take effect in 2013. Entering kindergarteners would have been born in 2007; there were about 566,000 kids born in that year. According to The Bay Citizen, the average Personal Belief Exemptions sought are 2.28% of kindergarten enrollment.Thatâs about 13,000 in the whole state â hardly a huge burden to the state or to pediatricians/family practice doctors.
2. Who can sign the form?
"e) For purposes of this section, âhealth care practitionerâ means a physician and surgeon, licensed pursuant to Section 2050 of the Business and Professions Code, a nurse practitioner who is authorized to furnish drugs pursuant to Section 2836.1 of the Business and Professions Code, or a physician assistant who is authorized to administer or provide medication pursuant to Section 3502.1 of the Business and Professions Code."
Dr. Sears has not responded to the facts. Such a surprise!
@Orac
Thanks for the links!
@Liz Ditz
I thought I read in the bill that a copy of the signed, written statement from the physician would be acceptable. That gives me the impression that if they refused the vaccine once and received the statement, they would not need to go to the doctor (or other accepted health care provider) for another signed statement, as long as they had a copy of the original. So if they changed schools, they could submit a copy of whatever statements they had already received, and would only need new ones if there were some other vaccine that they had not yet refused.
You say: "I like the idea ... that obtaining a religious or philosophical exemption should not be less difficult or costly than undergoing vaccination...." This implies that you recognize paying for vaccinations, or even getting a day off to take your kids to the doctor and transporting them there and back, is difficult and costly for many in the working (or out-of-work) class, and that economic and time pressures may contribute to some people's decisions to avoid vaccination. Unfortunately, your solution to that is the negative, punitive one of making sure that not vaccinating is also costly and burdensome.
How about the opposite approach: Make vaccination cheap, or better yet free, and easy, and see what that does to acceptance rates. There is already a strong moral argument to be made that any treatment mandated by government should be paid for by tax dollars. Why shouldn't every vaccination with a significant public health benefit be free to the parents?
And why should you have to take off work and bus all your kids to a doctor's office each time one is scheduled for a shot? In third world countries, they can't run things like that or nobody will get vaccinated. The vaccinations come to you. Well, we are rapidly becoming a third world country and had better learn to start doing things that way. How about making shots available (with prior parental consent) from visiting nurses who occasionally stop by every daycare in town? How about having a van that comes around the neighborhood every so often, or sets up at the branch library or local grocery store?
I bet pediatricians would scream about it, but why, other than to protect their income? The fact is that for any kid who has not already had a problem, the basic vaccines are so safe that a child does not need to have a medical exam before receiving one or be under an MD's watch afterward. These shots are regularly given in some countries by home-visiting nurses or the equivalent and nobody dies. The pediatricians just love being able to charge for "checkups" on healthy children over and over again.
Those would be good things to do in addition to making philosophical exemptions more difficult to obtain.
@jane
They should be free to parents. And, most insurance programs do cover the entire cost of an immunization visit. For those without insurance, states have a number of programs to pay for preventive care. Under the current system of pay-for-service insurance, though, there will still be those who get skipped over. I'm completely in favor of universal health care to cover preventive medicine.
And, what a surprise that Sears, Babs and other anti-vaxers are *concerned* that parents won't be "covered" by their medical insurance carriers or, reimbursed for well-child visits and physicals. Here is the AAP Practice Guidelines (click to enlarge Figure 1. for scheduling chart)
http://practice.aap.org/content.aspx?aid=1599
BTW, if you have medical coverage for your child, your insurance company "covers" all well-child visits and physicals, using the AAP Practice Guidelines Schedule.
jane,
I do think it is sad that vaccines can cost so much in the US. I actually doubt Orac feels much differently about this than you do. Sadly there is a lot of pressure in the US not to change such things. While heathcare coverage in Canada is province by province, so I am unsure of the situation in other provinces, I have happy to see that we cover most vaccines for free.
I was happy to see that this list was expanded last year to include rotavirus, the MMRV vaccine, a second dose of the chicken pox vaccine, and a pertussis for adults.
I remember (through the fog of almost forty(!!) years) getting my inoculations in the public school gym. Darned third-world Canadian socialized medicine!
An OT ASD study alert: Autism Biomarkers!
I think this means that a protein or peptide anomaly is linked to autism. I also believe this pushes the debate over causes further away from vaccines, toxins and the other crap and closer to genetics. Small study, and it doesn't mention (in any way I can understand) what part or how much of the spectrum can be identified. Cool nonetheless.
Re: #3 @jane
I am a practicing Pediatrician in Missouri. The Majority of our vaccine is VFC, provided to us at no cost by the state, given by us at no cost to those who qualify for it (uninsured and Medicaid). "Paid" vaccine is bought by our clinic and and charged to the individual or the respective insurance. The physician income derived from these vaccines? $0.00. Some of our underinsured patients go to the Health Department for vaccines where payment is by donation. That is fine with me. I do not care where my patients get their vaccines. I only care that they get their vaccines. Do I get paid for well checks? Yes I do, but with that comes vision, hearing, nutritional, and developmental screening, discussion of safety, behavior, and discipline, and usually a couple of "by the way" issues that I address. Yes, most of the kids I see are healthy, and in hindsight, they didn't "need" a checkup, just like I've never "needed" my own checkups with the doctor, or for that matter, I've never "needed" my seatbelt, or "needed" my homeowner's insurance, but I can tell you that a week does not go past that I don't identify an issue that needs addressed sooner rather than later on a routine "well" check. I earn my money. I'm not asking for more visits to discuss vaccines with people who don't want to get vaccines. I'll do it, because I feel I owe it to the children to try to help parents to work through their fears, and in some cases, stupidity, but it takes time, energy and patience, every time. I guarantee that I could make more money seeing four or five other patients in the time it takes to counsel one of these vaccine questioning parents. But I do counsel them. I give them the best information I can, and if they refuse, I will have them sign a refusal form. Most of the time, however, I am able to allay their fears and answer their questions, so it's worth it.
Regards
@ jane: how about this citation for reimbursement of physicians who administer vaccines?:
http://pediatrics.aappublications.org/content/124/Supplement_5/S466.full
Have you a clue Jane, about the physician's costs to purchase vaccine directly from the manufacturers?:
http://www.cdc.gov/vaccines/programs/vfc/cdc-vac-price-list.htm
Jane, these costs do not include "wastage" and vaccines that are discarded upon expiration date. Nor do these costs include the costs of syringes/needles when vaccines are not preloaded with the vaccine, direct from the manufacturer.
Jane, I worked as a public health nurse and I had to adjust my workweek to staff immunization clinics during evening hours and on Saturdays. I was not paid overtime...I adjusted my workday or, in the case of Saturday immunization clinics, took a compensatory day off the following week.
BTW, the VFC (Vaccines For Children) Program covers "underinsured" children whose parents have private medical insurance that does not pay for childhood immunizations.
Plus California has an insurance program for those with low income, Medi-Cal. So there should be no excuses.
I learned about the Medi-Cal program on a paper that discusses the financial hit California had during the 1990 measles epidemic:
West J Med. 1996 Jul-Aug;165(1-2):20-5.
Pediatric hospital admissions for measles. Lessons from the 1990 epidemic.
It says: "Hospital costs amounted to $18 million, two thirds of which was paid for by Medi-Cal."
The direct cost of the shot itself isn't the only issue. Taking time off work for the appointment is often a major concern for many poor people. Some may fear they will lose their job if they do, and others simply can't afford to lose the wages for those hours.
That's a much harder problem to solve.
It's trivial to find free or low cost vaccination programs; just checking my local area, I found thirteen options. There is a time cost, but it's not particularly large.
First let me say that all my children were vaccinated on schedule and if I were to change anything it would be that we would wait until they were at the older end of the normal vacination schedule. Doctors are unlikely to be well informed on the pros/cons of vaccinations (like their ignorance of nutrition generally for example). A nurse Practioner would be just fine and cheaper (why make medical costs as expensive as possible? AMA influence?). Walmarts etc. could offer the service economically. Those that get their children vacinated should ALSO be required to be "informed" as well. Finally on a related note, the vacine industry's special exemption from vaccine failures and damage should be removed.
@Another Joe - your statement that pediatricians aren't educated on vaccines is farcical (especially since you through in the old nutrition gambit).
You may not know that Barbara Lee Fisher (a prominent anti-vax loon) was instrumental in helping to set up the Vaccine Court & the VAERS database.
"creation of a cottage industry of antivaccine-sympathetic pediatricians "
Or Dr. Bob could just set up book signings across the state and sign a form when parents buy his book. That's my guess for how he handles this when AB 2109 passes.
False equivalence, because they already are informed. The reason is that physicians and health care practitioners are already required by medical ethics and law (not to mention also some fear of malpractice litigation) to obtain informed consent before administering vaccines.
Another Joe...you haven't read the prior posts, have you?
Private doctors who purchase vaccines from manufacturer do not make any money for administering vaccines.
Some states do permit stand-alone Nurse Practitioner practices and many states do permit pharmacists to administer some, but not all, vaccines. No matter which licensed professional administers vaccines, the costs of the vaccines and the costs associated with administering vaccines, result in no net profit (read the comments).
VFC vaccines are available in all 50 states and there are many licensed professionals who are VFC Providers:
http://www.cdc.gov/vaccines/programs/vfc/parents/default.htm
I refuse to comment on your off-topic thread derailing statements,
"Doctors are unlikely to be well informed on the pros/cons of vaccinations (like their ignorance of nutrition generally for example). A nurse Practioner would be just fine and cheaper (why make medical costs as expensive as possible? AMA influence?). Walmarts etc. could offer the service economically. Those that get their children vacinated should ALSO be required to be "informed" as well. Finally on a related note, the vacine industry's special exemption from vaccine failures and damage should be removed."
Says the one holding a Hemostat?
why the hell would i want the medical communities doses of highly toxic chemicals in my children. read all the research studies done on pubmed.com. its astounding at what these "vaccinations" due to these children and long term as adults. wake up. don't be so brainwashed by our government that they have your best interests at heart. They could care less. Plus all the diseases that are caught are by vaccinated children, not the unvaccinated. Grow a set people and say no to vaccines.
Orac, may I make a suggestion, that you put the Thing's comments in the moderation hopper?
It may not prevent Thing from posting Its brain droppings, but it will certainly piss It off, while awaiting you to release It from moderation purdah.
@ Vincent Ianelli, MD:
The way I look at it, the entire "vaccines-cause-autism" so-called community is essentially a massively inter-twined matrix of *cottage industries* ( medical, legal and literary- and I use all of those terms very loosely) which has been bringing in pounds and dollars ( of various types) since about 1995 or so.
Biscuits:
Citation needed, seriously.
I would ask for citations about the toxins, but that last bit is pretty hilarious, especially in light of the recent measles outbreak in Europe. And make sure that the citation is less than ten years old.
@8 Richard:
"I remember (through the fog of almost forty(!!) years) getting my inoculations in the public school gym. Darned third-world Canadian socialized medicine!"
I got at least SOME of my childhood shots in the school gym, in Pennsylvania. Darned USAmerican socialized medicine!-)
Anyone wanting California-specific information on required vaccines might want to visit the cryptically-named http://www.shotsforschool.org/index.html
There's always http://www.immunizeca.org/, too.
The initial rounds of polio vaccine were given in the schools (at least in Chicago). I had a childhood friend who had had polio -- it was not a rare thing.
I don't know the details in California, but in New York City parents can get their children's vaccinations for school absolutely free, with a relatively short wait if they turn up at 9 a.m. I think they'll bundle lots of vaccines at once, if the parents ask, though they don't provide flu vaccines. (I was there for a vaccine of my own, in late August, about ten days before public school started: I arrived at about 8:55, the doors opened at 9, and I was vaccinated, walked 1/3 of a mile, took a crosstown bus another mile, and was at work by 9:30. So, yes, potentially some burden on the parents, but less so than a lot of other things they'll need to deal with in raising a child.)
Biscuits
WTF does this attempt at a sentence mean? Babelfish needs to add a Whackaloon to English translator. Oh well, at least Biscuits was able to find the the shift key halfway through their highly edifying post.
Lawrence
Is that a Coopertino or have you been reading too many antivaxxer comments?
@lilady 22
"Orac, may I make a suggestion, that you put the Thing's comments in the moderation hopper? "
Don't bother with this guy. Frankly, folks need to just stop attempting to respond to him, and call him what he is: a fucking moron.
@Chris:
If a large enough majority of the population is vaccinated against disease X, then the majority of the those infected with X will be the vaccinated; it's simple statistics, based on the fact that vaccines aren't 100% effective. Of course, Biscuits might be falsely implying that "the majority of the infected are vaccinated" means that the vaccine is ineffective, or even that the vaccine increases the chance of catching the disease. [Cue Th1Th2]
@Militant Agnostic:
I think s/he's claiming that vaccination causes chronic diseases.
Matthew Cline, I was actually thinking of recent measles outbreaks. Like the one in Europe where:
I'd like to see Biscuits now claim that the 10% that were vaccinated are most of those with measles.
The redneck scat-talking troll Rob Hood, from Eupora Mississippi, is back, with a new sock puppet.
Hey, Smarterthanyou, welcome back!
1) Do you have a citation for this, like a news article or something?
2) Do you mean that the no permission form whatsoever was signed, and the vaccine in question happened to contain mercury? Or that a permission form was signed, but the permission form failed to inform the parents that the vaccine contained mercury?
Unconstitutional? I'd be interested as to what part of the constitution covers a situation like that.
SmartherThanYou:
Two questions:
1: Please give us a link where children under age thirteen are given vaccines at school without permission. I qualified the age because teenagers do not need parents permission for certain medical procedures.
2: Please tell us which of the vaccines on the American pediatric schedule are only available with thimerosal. Read that carefully, because I do not want you to blurt out "influenza" when there at least four without thimerosal available.
Has our old commenter Smarter Than You returned? We missed your big announcement a few years back. He made this claim a few years ago:
It has been over a year, what happened to that big reveal?
I was responding to a sock-puppet? Oops, oh well.
Wait, so were the previous two iterations of "Smarter Than You" also Rob Hood?
Oops, it looks like lilady was right, it was the annoying Sir Robin RightWing the ever Morphing Troll. Because now he's gone!
I am so disappointed that it was not Smarter Than You, because he never did tell us the results of his big project.
Jane, to add to what lilady and Ebeneezer have already said; in Illinois, vaccinations for low-income families are free or very low cost, covered by VFC or the All Our Kids (AOK) program.
For working parents who can't take time off to bring in their children -- our county health department offers at least one weekend and one evening clinic per month, as well as appointments between 0800-1630 most weekdays. I believe most county health departments in this state do likewise. There is also a program that allows a parent to designate in writing a grandparent or other family member to bring the child to the clinic in his/her stead.
There is no reason not to get your child vaccinated.
Matthew Cline:
No. Someone I know had the old STY comment to her blog, so she shared the ISP information, he lived in Colorado.
Daran, explain how Gardisil is dangerous. Post actual scientific documentation.
And only one state requires it for public school, and it is not California.
Ah, I see that Daran is Sir Robin RightWing Morphing troll.
That's an excuse, Daran. Not a reason.
(btw, my sister the RN informs me that both her sons and her daughter will be getting the Gardasil vaccine).
And I would say that between 30-35% of the children who get immunized by our county health department are white and male. The percentage of white males coming to the HD's STD clinic is much higher.
Chris - Daran is Rob Hood as well.
@ Chris...the link you provided to Matthew Cline about the French measles epidemic is very informative.
I see that the first of the two dose measles series is administered at 12 months...except for children in day care who should get the first dose at 9 months of age...and then one additional dose to complete the series after 12 months age.
This recommendation is quite different than the USA recommendation. A child age 6-12 month, in special circumstances (exposure to a case of measles or travel to a measles-endemic country), should be immunized, yet that dose "does not count". The child should receive 2 additional doses of MMR vaccine after one year old.
I located a website that contains immunization schedules for European Countries and it is a fact that French kids in day care should get measles vaccine at 9 months...but only one additional dose to complete the two dose series:
http://www.euvac.net/graphics/euvac/vaccination/france.html
As far as my research goes, maximum protection is provided when a child receives the 2-dose series after one year of age.
I see from Sears' "'normal' medicine" reference to real medicine that the quacks aren't about to let their iron grip on that terminology victory with the "complementary and alternative medicine" go any time soon.
They try to make this issue more complex but what it really boils down to is that they have no right to endanger the children of others by refusing to comply with measures designed to protect us all, measures that they can't prove do harm.
How about the "personal freedom" not to have your kid die because he or she got unlucky and didn't mount a full immune response and some anti-vaxxer kid came along with a disease that no one needs to get anymore. Any government that panders to these people is showing a serious failure in priority assessment.
I would say that's a pretty important personal freedom right there.
MikemA@9 That article tells me nothing.There are countless different genes and bio markers that are out of whack in a lot of those on the spectrum.The real work comes from sifting through them in each patient,and finding those that apply to the patient,and fit with all the comorbids,and the family medical history.For me,it's most likely this
http://www.nature.com/mp/journal/vaop/ncurrent/pdf/mp2011175a.pdf
Good lord! I just read Dr Bob's Huff Po piece (linked above) and he includes this gem:
Coming from a man who advocates spacing out vaccinations into separate office visits? For which his patients will (based on my own experience) get charged separately! What a hypocrite!
I have decent health insurance. Last year I delayed some vaccinations for two weeks when one of my children developed a cold the same day as the well child visit. I had to pay an extra co-pay when we came back in to get the vaccines once my child was completely healthy.
Guess what, Dr Bob? Following your stupid "alternative vaccination schedule" is what's a waste of time and money.
What a freaking hypocrite. I may cross post this comment to thread where lurker's moaning about how Dr Offit is mean to Dr Bob.
Regarding the claims that it's unfair to make parents take their children to the doctor to get an exemption from vaccination because that's just as hard as taking the kids in for their shots...
Are parents really signing off the philosophical exemption form just because they don't want to take time to get their kids vaccinated? Are they also ignoring the recommended well-child exams?
Even if they are uninsured and skipping preventive care, vaccinations are available outside business hours at drugstores, such as Walgreen's. I believe they accept Medi-cal as payment for shots for low-income patients (they definitely take Medicare for flu shots and pertussis boosters).
https://www.walgreens.com/pharmacy/immunization/immunization_index.jsp
If I had a job where I couldn't take any time off to take care of my children's health, I sure wouldn't want to risk them catching something that lasts 2-3 weeks--or having to stay home from school 2-3 weeks during an outbreak of infectious disease. That would mean either staying home to care for them, or having to pay someone to come care for them. Assuming I could find someone willing to care for them during a quarantine...
Dave, doctors won't sign these forms.
It's a very poorly written law.
The merits or risks of vaccinating or refusing can be left out of this discussion.
The bill is a mess in its present form.
That's the present issue.
Jay
Really, Dr. Jay? And you know this...how, exactly?
@ all griping about vaccines not being free...
If you can't spend a few hundred bucks to protect your kid against all of these diseases for the rest of their life, how the heck are you going to feed them for 18 years?
None of this was a problem before all of the Wakefield BS started. Is our memory so short that we have to invent such problems to blame it on?
Oh yes, adding a few health care visits vs. numerous emergency room vists, hospital stays, lost productivity, etc, etc, etc.....what a bunch of crap Dr. J.
> read all the research studies done on pubmed.com.
> its astounding at what these "vaccinations"
> due to these children and long term as adults.
>
> Posted by: Biscuits | March 23, 2012 5:36 PM
From the fool who wanders the forest without illumination, we should expect no less than a theory on the hazards of trees.
IANAL (I am not a lawyer), but wouldn't the form say that the provider has talked to the parent, not that they agree/disagree with the anti-vax views? Wouldn't it be unethical to discuss the pros and cons of vaccines with your patient and then refuse to sign a form that said you did? Isn't is lying to not sign it? You know, like it's lying to sign a religious objection form when your objections are due to fear rather than religion?
Just saying.
@Ren:
Here it is:
http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201…
This is the only part which describes the required doctor's statement:
"A written statement signed by a health care practitioner that indicates that the health care practitioner provided the parent or guardian of the person, or the person if an emancipated minor, who is subject to the immunization requirements of this chapter with information regarding the benefits and risks of the immunization and the health risks of the communicable diseases listed in Section 120335 to the person and to the community."
@ Ren:
@ Conspicuous Carl:
Well, that doesn't sound very complicated to me: aren't physicians *supposed* to inform parents about general health issues appropriate to the child's age *as a matter of routine*? Or doesn't that apply to the US, maybe that's only in France.
Wouldn't doctors, in some manner, have to represent the guidelines of the medical association of which they are members?
So what would be so terrible about having to sign a form that states that you are doing your job?
Am I missing something? I *must* be.
Dr Jay Gordon
You've got that wrong. It's the current law (Section 120365 giving your vaccine-refusing patients the gigantic loophole) that's "a mess in its present form."
Folks can judge for themselves whether or not this bill is "very poorly written" or "a mess":
http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201…
Orac @50
That is such a great all purpose reply to Dr. Jay that everyone should have it in a text file for quick copy paste.
Boy Wonder Ace Reporter posted last night on the Ho-Po on Dr. Sears article about defeating California Bill AB 2109; went completely o/t and is promoting a new autism study.
I just got a post through and requested that Dr. Sears deny that he was the pediatrician who did not immunize the index case against measles, and that his office waiting room was the site of transmitting 4 additional cases of measles...during the recent measles outbreak in San Diego:
http://www.huffingtonpost.com/dr-bob-sears/california-vaccination-bill_…
What are the chances that my post will not be removed?
What are the chances that Sears will answer my questions?
I see that Dr. Jay has weighed in with an inane comment and his "legal" opinion about the pending legislation.
What's the matter Jay...are you afraid that you will have to lie on a document that you provided accurate information to your *mommies*, about the risk to their child and the risk to other children in your practice...and the wider community?
We have already argued the merits of the legislation and provided information about the availability of VFC vaccine to any parent who wants to protect their child. Why do you assume Dr. Jay, that any child's doctor would not provide this information and would not comply with the law?
Index case. That hilarious. It's the measles not the Andromeda strain.
Oh, Bisquits . . . smug, fearful, righteous Bisquits,
How well I recognize that Worried Well dialect in which you so valiantly attempt to express yourself. I really do get it. I used to live in that weird fear of science and medicine, even though I was a total science geek as a small child. Maybe you're like I was and death hasn't darkened your door a great deal, not on a personal, in your face level. I'll also speculate that maybe you've never really been sick, sick enough to require hospitalization, or have to battle a chronic illness through pharmaceutical intervention, or watched a dear friend die from HIV denial or measles.
Admittedly, this speculation is projected through the lens of my own time in the ranks of the Worried Well. Arent you just a bit tired of all the magical-thinking and potions required to keep death at bay? If you want to dump the constant Worrid Well anxiety and join the real world, but you're lucky enough to never have required surgery or daily prescriptions, go volunteer at a hospice or nursing home. Become familiar with, and accepting of, the terrible beauty of death. If you are at all like me (oh noez), it's fear that animates your reason-crushing animosity toward all things scientific.
For me, watching the courage and grace of acceptance transform several loved ones in the last months and weeks of their lives led me away from fear-based hubris to humility. And in that humility reason stirred unencumbered, and vanquished my existential fear. All at once, I was able to leave the patchouli scented confines of Wooville and deal with my own mortality and accept the fact that I would someday die and that no amount of magic water, or orgone blankets, or liver cleansing would prevent it. Now, whatever time I have left on this miraculous little planet will have its moments of joy and terror, but the gnawing, low grade fear of death that fuels the anti-reality rantings of the Worried Well is gone.
That, and think of all the time youll save when commenting without having to type so many "scare quotes."
@ Pareidolius:
Oh my! We seem to be 'on the same page' on, um... different "pages" ( " Andy Wakefield exonerated...")..
Oh well, same page, same MO, same COIs. All in a day's work.
@lilady
It's not a study and it's not new. Jake just wants to bring up that review of cases by some law center, which was lacking in every way possible. I think he's just polishing up his epidemiologist anti-vaxer abilities by calling "studies" those things which are not. I'd pay good money to see him present that "study" to the professors at GW. Hilarity would surely ensue. One year at GWU, wasted. We'll see what his second year has to offer.
Yes, Jake, it is my opinion as a professional epidemiologist for 5 years that you calling that review of cases by lawyers and not scientists a "study" and trying to use it to link vaccines to autism shows me that your first year at GW was a waste.
Now, you could reply here, but I should expect an email to the health department (whose opinion I do not represent) instead.
@Sid
In epidemiology, that science you continue to argue against though you know nothing about it though we try very hard to teach you, the "index case" is the first recognized or identified case in a cluster or outbreak of disease. This is not to be confused with "patient zero", which is the first recognized of identified case ever of a disease or condition.
Really, Bob. I'm disappointed. You were such an avid follower of the Epidemiology Night School.
Dr. Jay claims "the bill is a mess", but it is considerably more lax that the recommendations from the Pediatric Infectious Disease Society: Position Statement Regarding Personal Belief Exemption from Immunization Mandates from The Pediatric Infectious Diseases Society March 2011 emphasis added
Annual renewal; state-certified curriculum. I wish Assemblymember Pan had started with the PIDS recommendations and backed down from that.
Oh goodie, Offal our "resident fire science expert" has offered his opinion...
"Index case. That hilarious. It's the measles not the Andromeda strain."
Really, Offal...if you have trouble with the phrase "index case", why don't you notify the WHO, the CDC and the California health department, to give them your *expert* advice?
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e222a1.htm
The opinion of a libertarian anti-vaxer who is clueless about immunology and epidemiology, will be given all the consideration that is warranted.
So Jay's now giving a legal opinion?
Wasn't he the one insisting that he did not give opinions outside of his area of expertise, and chastised Orac for discussing vaccines despite not being a pediatrician?
But Jay expects us to accept his opinion that "this law is a mess"?
@Ren
Wiki
"Patient Zero" was used to refer to the index case in the spread of HIV in North America
Back to night school for you, Ren.
Sorry, Bob. I may not be writing in legible English.
Index case - First in a cluster or outbreak.
Patient zero - First ever.
They are not mutually exclusive (nor collectively exhaustive). I know that's a big term for you. I mean that an "index case" can be "patient zero". But you can also have many index cases if you have many outbreaks, like with measles.
Is anyone keeping score? Because I think Bob is batting in the single digits. (Watch him correct me about baseball analogies. Such a contrarian libertarian.)
This isn't the first time Dr. Jay has made legal arguments, even though he's not a lawyer:
http://scienceblogs.com/insolence/2009/02/dr_jay_gordon_get_away_from_m…
Singles digits = Ren's IQ
Fellow disdainers of all things woo, I am in need of help. I am one of the co-moderators of a list for people with End Stage Renal Disease and their caregivers, although not everyone on the list is currently on dialysis; some, like me, are living with a transplant and some are in Chronic Kidney Disease late Stage 4 and are making their plans for dialysis and choosing their method. And then there are people who get on under false pretenses and peddle false hope to our list members, which I find nothing short of cruelty. This latest one, below, needs a more thorough takedown than my usual dismissal of "this it is for patients with CKD and ESRD only, and their caregivers. Your ability to get off dialysis was because you had acute kidney failure, which is something else entirely" or "It is cruel to peddle that fakery here. This list is for patients and caregivers only". We get a woo peddler every few months, but this one takes the prize so far, and I'd welcome help with the takedown. Have fun.
Sorry to drag this off-topic but I don't know where it would be more appropriate to post this. The user has already been removed from the list for this (we have a zero-tolerance policy for this sort of thing) but the takedown will be educational and fun for our members, and I'll make sure the poster is emailed a copy. I'd welcome any help you have time to give.
Thanks,
WBP
Warning: great steaming stinking piles of woo follow.
This is my first post. I do health consulting, so I am all into supplements. Just got involved with someone who is 91 years old and in 1 month of supplements has gone from 20% function in 30% according to the doctor after starting supplements.
I joined this forum to see what alternative treatments people were discussing, but it appears no posts are about that...But seeing how there is PUBLISHED RESEARCH on supplements and kidney failure, I can't help but throwing it out there. Below is a copy and paste from an email I sent to someone, so you can see the studies, etc.:
- Replace CoQ10 with Liposomal CoQH: Coq10 in a water soluble form (probably "micellized" coq10) has been studied to treat kidney failure remarkably well: http://www.rejuvenation-science.com/n_coq10-kidney_failure.html Liposomes are in my estimation much more effective than micelles as carriers and deliverers of nutrients. And the liposomes will be carrying CoQH, which is better than coq10. So for these two reasons, liposomal ubiquinol should outperform the micellized coq10 used in the above study, possibly by a lot.
Furthermore, I would take this at a high dose: 200mg twice a day. The authors of the above study thought that better results could have been achieved at higher doses, and I think so too. And to top if off, ubiquinol may have significant anticancer effects which are discussed on my website: [removed link to my site]
You buy liposomal ubiquinol from here: [I get a commision on that link, so I am removing it too]
I would definitely not neglect this supplement. This may be the one most important change I can suggest.
- Start Kibow Probiotics http://www.kibowbiotech.com/biotics.php This brand of probiotics has been studied in humans to treat chronic kidney disease: http://www.springerlink.com/content/k3h2742x870458rq Study showed measurable improvements. And "almost all subjects expressed a perceived substantial overall improvement " These bacteria are specially bred to eliminate the waste products the kidneys eliminate. It in essence provides a third kidney in your intestines in the form of specially trained bacteria. I would use this at double the maximum dose stated on the bottle.
- Start drinking magnetized water Magnetized water has been studied to increase the elimination of acids from the body: http://greenmagnetfoundation.org/abstracts_of_magnetized_water This is the reason why even mainstream doctors give patients calcium bicarbonate or sodium bicarbonate by mouth, because these are alkaline and help to manage the chronic acidity caused by kidney failure. You do this by buying the following magnet and strapping it on a water jar: http://www.biomagscience.net/magnet-therapy/water-jar-energizers You can drink the water after it was been exposed to the magnets for at least 30 seconds.
sodium bicarbonate (baking soda) has bee studied to greatly slow kidney failure. Warning, the file below opens in a PDF: http://jasn.asnjournals.org/content/20/9/2075.full.pdf+html
He should aim to consume about 2,000mg of baking soda a day, mixed into his drinking water. Ideally this should be done only with drinking water taken away from meals. You can get Arm and Hammer baking soda from any local grocery store. You will have to read the label and figure our how much it takes to get 2,000mg. Then just spread that out in his water across the whole day.
zeolite I have heard of a few anecdotes of kidney failure being reversed with just zeolite. It may also have some anti cancer properties. Buy it from here: http://www.amazon.com/Natural-Cellular-Defense-Zeolite-Cleanse/dp/B000V… One bottle has 300 drops. For the first 4 weeks, a higher dose is used, then the dose is reduced to a maintencance dose. The first 4 weeks should ideally finish 4 bottles. That is a dose of 10 drops, 3 times a day. Then after the first 4 weeks, dose is decreased to 3 drops, 3 times a day. At this point, one bottle lasts about one month.
This should be taken in some water, ideally away from food, but it is okay to take it with food. This supplement may make him more thirsty in general. It can also cause a detoxification reaction. For this reason, the initial higher dose of 10 drops 3 times a day should actually be worked up to over a few days, just to make sure there is no such reaction. If there is a reaction, just lower the dose until there is no such reaction caused by it. Probably there will be no reaction, and within a few days, he will be taking 10 drops 3 times a day. Then do that for 4 weeks. Then reduce to 3 drops 3 times a day.
Liposomal Silibinin (milk thistle) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142951/Been studied to benefit kidneys and increase low hemoglobin caused by kidney failure. This will help his anemia. Also has anticancer properies. Liposomal silibinin has been studied to have much greater bioavailability that regular silibinin: http://www.phytosomes.info/public/siliphos.asp
Buy it from here: http://www.swansonvitamins.com/SWU162/ItemDetail? SourceCode=INTL405&CAWELAID=129499662 I would take 1 capsule, three times day.
Anyone else know of any altnerative kidney failure treatments that have some reasonable evidence behind them?
David
Whoa! Breathtaking!
Our friend Robert makes inferences about another person's state of knowledge implying that an epi doesn't know how to use epi terms correctly and that he can correct him via wiki.
Dunning-Kruger: in-expert and un-aware
Meta-cognition Fail: ideas about cognition and its workings
Recursive thought Fail: ideas about what others think, know.
Executive functions Fail: include ability to evaluate own and others' performance
I believe that that is a Trifecta Dunning-Kruger.
You know you're correct and that you've threathened Bob's view of the world when his answer to the explanation of an epidemiological concept is an insult. I'm surprised he hasn't called me what Augustine called me yet.
Offal, instead of relying on your *expertise*, why didn't you check a medical dictionary to see what "index case" means?
Oh look here, there are a bunch of medical dictionaries that provide their definitions of "index case":
http://medical-dictionary.thefreedictionary.com/index+case
Stick with your "fire science expertise", Offal.
@baglady and Denice "Dunning-Kruger" Walter
Let me walk you through you this s-l-o-w-l-y. I stated the term index case is used to create unwarranted fear. Ren responded with a non sequitur about index cases not being patient zero then some gibberish about not confusing patient zero with the index case. But then he states:
I mean that an "index case" can be "patient zero"
- which means the two can be confused with one another.
Young master Jake was referring to:
It was one hot mess of a "study" -- see Prometheus's critique at 2 1/2 studies (Hint: Holland et al. is the 1/2 a study); David Gorski at Science-Based Medicine Anti-Vaccine Warriors vs. Research Ethics; Autism News Beat on
Unanswered questions from Pace law journal study: Ethical standards for research on human subjects and Sullivan at LeftBrain/RightBrain Study by NYU and Pace: Another Failure in Obtaining Ethical Approval.
Not so fast, Bob-o. Let's review.
1) You wrote: "Index case. That's hilarious. It's measles not the Andromeda strain." No mention in there about "unwarranted fear". You were just making fun that someone would use the term "index case" to refer to an index case.
2) I wrote that index case is perfectly well-used in the discussion about the outbreak because index cases are the first cases identified in outbreaks or clusters. I also wrote that it should not be confused with "patient zero" because patient zero is the first case EVER identified of a disease or condition. "Ever" is the operative word there.
3) You quoted only what you wanted to quote of my correction of you and missed the entire definition I gave of "patient zero" after the comma. You then used, of all things, Wikipedia to try and correct me on an epidemiological term.
4) I explained it to you again, s-l-o-w-l-y.
5) You countered with an insult about "singles digits" (sic) being my IQ. Of course, I referred to "single digits" as your "batting average" when it comes to your arguments here. You replied that "singles digits" (sic) is my IQ. So, since you believe that you're always right, you could very well be complementing me and saying that my IQ is one thousand.
6) Denice and Lilady point out your stupidity.
7) You lash back with more insults.
Lucky for us, you don't have control over the commenting system and everyone reading you right now can go back and see the evidence of your trolling and how you managed to get all convoluted while trying to make fun of someone for using "index case" when they were using it properly to begin with.
"Let me walk you through you this s-l-o-w-l-y. I stated the term index case is used to create unwarranted fear."
Gee Offal, Let me walk you through this s-l-o-w-l-y....here is what you stated:
Index case. That hilarious. It's the measles not the Andromeda strain.
Posted by: Sid Offit | March 24, 2012 12:53 PM
When I pointed out to you that "index case" is proper terminology and provided you with the link to the actual MMWR article about the San Diego measles outbreak, you then commented:
@Ren
the "index case" is the first recognized or identified case in a cluster or outbreak of disease. This is not to be confused with "patient zero",
Wiki
"Patient Zero" was used to refer to the index case in the spread of HIV in North America
Back to night school for you, Ren.
Posted by: Sid Offit | March 24, 2012 1:30 PM
Stop obfuscating Offal, your original post was quite clear that you confused "index case" with "zero case".
That's what happens when our resident "fire science expert" wades in and shoots his mouth off, before "Googling" a phrase. Liar.
I am not an epidemiologist, doctor or any other medical professional. My entire medical education consists of AED (defibrillator) and CPR courses. I had no trouble figuring out what index case meant without having to look it up. All index case implies about a disease is that the disease is uncommon enough that the index case can be identified. I did not even for a second think it meant "scary new disease from outer space".
Apparently being a libertarian means never having to admit you are ever wrong - see Micheal Shermer's idiotic arguments that a lack of regulation played no role in the financial meltdown.
Investigating a measles outbreak is not for "amateurs" or "pretenders". I would refer Offal to the CDC-Manual for Surveillance of Vaccine Preventable Diseases...but Appendix 8-Measles is being revised.
Here for RI regulars is the New York State Measles Outbreak Control Guidelines:
http://www.health.ny.gov/prevention/immunization/providers/docs/measles…
I bet Militant Agnostic derives some useful information from the Guideline, but it is far too complicated for Offal.
@ Ren: I see you have commented on Jake's referral to the Pace Law School "study" on Ho-Po...I have also commented. My first comment requesting Dr. Bob to deny he was the pediatrician implicated in the San Diego measles outbreak is still "there". I'm waiting for Sears to reply; his fans have not come to his defense.
If we're going with baseball analogies, Sid-sanity's batting exactly .000
Using a tee.
Sid, continuing to play the fool, may have accomplished his intended goal of thread derail. At least Dr Jay stays on track even if he adds little to the discussion.
And Sid, stay up to date. Andromeda Strain is OLD. Contagion has a near perfect depiction of zero case.
Offal: How about "manning-up" about your fabrications?
"(Self) love means never have to say you're sorry"
http://www.imdb.com/title/tt0066011/quotes
(Bastardized quote from the worst movie ever made)
You're a tribute to semiliterate troglodytes everywhere, Bob. If you only you were three feet shorter, toothless, and had a slightly flatter head, you could be a leader of sorts.
I'll raise you Newt's three wives on that one.......what a lunatic.
Joe the Poe I hope. That is one perfect storm of stoopid.
Not a Poe, just Brave Sir Robin Wingnut spewing his usual dreck. Sir Robin, do us all a favor... put down the alcohol and step away from the keyboard.
"Joe the Handsome One" aka Rob Hood the undertreated mentally ill character who visits a number of places at SB @85:
Oh, look, the Autism Action Network has an opinion on AB 2109
This is the "editable text" they urged followers to send
Hmmn. What does all of the above have to do with autism? Why is an autism advocacy organization activating their members on a vaccine issue?
Oh cripes is the scat-talking redneck back? Why doesn't the deranged Rob Hood haunt someone in Eupora Mississippi?
@ Liz: Palindrom, Ren and I have been having a rousing good time at Ho-Po, posting on Dr. Bob Sears screed about AB 2109 and "parental right to chose".
Say, Rob Hood, KE5BMP, do you share these homilies with your pastor, or are you kind of a self-servicing sort of guy? Is it true what I hear about 'ragchewing' and '2x3' not, ah, meaning what they used to when it comes to the late Group D types?
If all children were vaccinated this would not be an issue. So I'm left to question who is filling their pockets full of money? What does it matter if a parent does not vaccinate their child? It is their choice. It should not be the states responsibility what a parent chooses to do. I see that this is just a way to keep kids from getting sick so that they do not miss school. Everyday a child is not in their chair at school the school loses money.
@T
you wrote:
"What does it matter if a parent does not vaccinate their child? It is their choice. It should not be the states responsibility what a parent chooses to do."
Framing this bill as a threat on medical freedom ignores that the individuals effected by this are the children, not the parents. If an adult want to take wanton risks with their own skin, then that is their free choice. But parents do not have the right to take irresponsible risks with their children. Disagree? lets rephrase your statement:
"What does it matter if a parent uses cigarettes butts to punish their children? It is their choice. It should not be the states responsibility what a parent chooses to do."
Seat belt laws, and child abuse and neglect laws are the state exercising its responsibility to protect members of society that are unable to protect themselves. The state has every right and responsibility to protect children because they cannot protect themselves. It is a long settled legal issue that the state has the right, in the name of public safety, to limit personal freedoms to stop and inhibit the spread of dangerous infections. In the case of vaccine, the state has a protective responsibility not only to the child being vaccinated, but also to that of those too young, or too ill to receive or respond to vaccination.
This is not a medical or religious freedom issue freedom issue. It is a simple argument about the risk vs. the benefit of vaccination. If the anti-vax crowd is worried that 10 minutes in front of a pediatrician will be able to crack their arguments, then they must have really lame arguments, which of course they do. Which explains their resistance.
And by the way, there is little to no money in giving vaccines, much less having an extended risk-benefit discussion. And pediatricians are among the lowest paid medical specialties, and IMO, among the noblest people on the planet.
OT, but:
Not to rain on your parade, but not all "sodmite" are left wing. Or godless. If you want Christian perverts, let's just mention all of these boy-raping catholic priests in Ireland, Holland, USA (OK, that's pedophiles, not homosexual).
For 6000+ years, we didn't have Gardasil, but we had plenty of people telling us not to sleep around. Didn't stop us from having plenty of STDs.
As for sex before marriage being "liberal", ask Sarah Palin's daughter. Actually, teenagers pledging themselves to abstinence are as likely to have sex, and more likely to have risky behavior (i.e. more likely to get STD). See the following article:
Patient teenagers? A comparison of the sexual behavior of virginity pledgers and matched nonpledgers.
Rosenbaum JE. Pediatrics 2009 (PMID: 19117832)
Funny. It seems plenty of right-wing people manage to be immoral without any help from liberals. Maybe they are human.
go volunteer at a hospice or nursing home
This is such admirable advice, even out of context, that I wanted to repeat it.
Bulletin: Dr. Sears has posted at the Ho-Po to deny that he was the pediatrician involved in a measles outbreak.
I located the video segment from the Dr. Oz show where Dr. Ari Brown stated he was the physician whose patients were involved in the outbreak...and Dr. Sears did NOT correct Dr. Brown...and changed the subject.
I posted the video on the Ho-Po with a challenge to Dr. Sears to explain why he evaded Dr. Brown and changed the subject; out of moderation now. Please monitor the site for me as I have to be away from my laptop...thanks.
Orac, have you heard of Tetyana Obukhanych? She's got a PhD in immunology from Rockefeller and is a post-doc at Stanford, just wrote an anti-vax book called the "Vaccine Illusion" and gives lectures out in California about boosting natural immunity rather than vaccinating. She did research on humoral immunity and vaccine strategies, but she did not vaccinate her child.
The anti-vaxers have a new hero, and I think my head is going to explode.
I need a hero, Orac.
@Lilady
I've posted one of Seth's quotes where he mentions Dr. Bob specifically. I don't have the book with me, so I quoted Seth's blog. Let's see Dr. Bob explain this one.
SC @101: I live in the area where Tetyana Obukhanych has been proselytizing & sent Orac material about her...delusions back in January. I also reached out to pediatricians I know in Santa Clara county.
From Emily Willingham at Biology Files What Makes An Expert Dangerous
SC:
Emily Willingham wrote about her at What makes an expert dangerous?. Her immunology PhD was petri dish research, and her post doctorate stuff is in psychiatry.
A check on Amazon shows that her book is only a little Kindle book going for $9.99. It does not have a page count, but it is only a 132 kb. For comparison Vaccine Epidemic by Louise Kuo Habakus and Mary Holland is over 1300 kb (it is only $3, and the Kindle version of Wakefield's Callous Disregard is less than one dollar!). So it looks like Ms. Obukhanych book is tiny, and only self published.
While I applaud my comrades' meritorious work @ HP, I notice that the hive is again living up to its reputation as the gathering of the woos: (courtesy of AoA) Kim S links to her post @ HP's religion section. True, it is not anti-vax per se but reveals her more reality-based ideas on birth control vs the RC Church but still, self-promotion for an author of two books- both fictional, only one of them correctly labelled as such. In my *opinion*.
@curtw -- If vaccines are so safe why did one of my kids suffer seizures after being injected with a vaccine? Why did my other kid suffer an allergic reaction after being injected with the flu vaccine? if all vaccines are safe why did this happen? And yes there is money to gain here. There is always money behind everything. If all kids were vaccinated this would NOT be an issue!! So if kids butts are not in their seats at school the school is losing money. Plain and simple! It is about money. What if they made a new law that said all boys had to be circumcised? This causes a public health threat right? Or what about a law making it mandatory for all people with cancer had to do chemo? Where do we draw the line?
I'm always puzzled by some anti-vax arguments about physician greed - as a fellow Canadian already stated, vaccines here are not only free (with the exception of travel vaccines), they are not even given at the doctor's office. Shortly after birth, parents are contacted by a public health nurse for a post-birth check. Subsequent well-baby visits at 2, 4 & 6 mos are scheduled at the local public health clinic and all others (MMR at 1 yr etc, boosters at 4 1/2) are also given at public health. Hep B is not given here until Grade 5, and is given at school by public health, 2 doses 6 months apart. Happily, Grade 5 girls are now also given Gardasil with the exception of those in Catholic schools, who have to get it on their own. Even for travel vaccines, doctors don't necessarily have to be involved - pharmacists are now able to prescribe some vaccines, and administer them as well. Flu shots are handled in public health and pharmacies more than doctor's offices. With a severe doctor shortage, no one is complaining that docs don't give vaccines much anymore.
Not really studied up on the merits of giving Hep B at birth over age 10, but it's kind of funny to see those anti-vax arguments come up on Canadian news articles - it's like they don't even understand that the process here is very different.
@ Ren: I did not know that the Dr. Oz video segment video existed, and was unaware of Seth Mnookin's video.
I *think* Dr. Bob is feeling uneasy now...that we have both posted...we make a great team!
I posted again, a few minutes ago, *suggesting* to Dr. Bob that he was well aware of the allegations and couldn't defend himself, against the truth.
Denise...I'm going to check out Stagmom's post at AoA now. Thanks for the heads up.
Bogeymama @107: why the US opted for the birth dose of HepB (hint: different demographics and higher risk groups, such as Asian & Pacific Islanders). Article at Science-Based Medicine by Joe Albietz MD.
We don't claim that "all vaccines are safe." What we claim, and have evidence to support, is that on average vaccines are a lot safer than many things you would do for your children without hesitation, like letting them ride in a car, and they are safer than the diseases they protect against.
No one can offer you perfect safety, which means that someone who does, like an antivaxer who says "Don't get your kids vaccinated because those diseases aren't dangerous anyways", is lying to you.
This may be an article of faith for you, but what you're actually claiming is "there is enough money to be made in vaccination that it makes it worth the while of the entire medical profession to collude in a giant fraud that's been going on for centuries to produce evidence of vaccine effectiveness," and that's really a bit much to expect anyone to take simply on faith. Doctors also say it's important to get exercise; does this mean they must be in collusion with Big Exercise? Exercise is part of "everything" and you say there's money behind everything... there's a certain problem with trying to explain the world with non-falsifiable hypotheses like "there's always money behind everything."
If it were that "plain and simple," I wouldn't have such trouble figuring out just what you're even claiming here. Are you claiming that the government which pays for most children to be educated at public schools in the first place somehow makes a profit off a child being schooled for ~13 years if that child gets vaccinated?? I seriously can't even understand what you're claiming people are doing to make money in this situation, let alone who you think the people are or how their actions are resulting in a profit.
I'll point out that there is a very obvious line to be drawn between circumcision and chemo, where your decision to do it or not do it doesn't affect your neighbors, and vaccination, where your decision to be a reservoir of infection if an outbreak comes along does affect those around you.
In all fairness, Lilady, there is no evidence that the child sat in his office. The evidence points to that happening at another office, an internist's from what I've read. Now, if the family skipped out on the MMR based on faulty advice, then, yes, the blame is on the provider of said advice, at least some of the blame and a lot of it on the parents. That could be his way out of that situation, saying that it was his patient but the patient did not sit in his office.
Anyway, I'm done fighting the good fight for a few days. I have a major project to work on. As always, though, I'm around.
@t
Wow your argument is all over the place. First off this is a state law. Where does the money for when kids go to school, it from the state. This only covers public schools. Private schools are whole other story and there are many private schools that don't allow vaccine exemptions other than medical, which is great. They are not receiving money for the kids showing up, they only get it from tutiotion. As for your other arguments. First off, nobody here, or for that matter has ever said that vaccines are 100% safe. What we do say is that the very rare serious side effects are rarer than serious out comes of VPDs.
As for your two other examples those are nowhere near vaccines. Chemo for example only helps those that have cancer and it many late stage cancers won't help them. While circumcision I'll let you think that is the same as vaccinating, because that's just an idiotic question.
t:
For the latter, it may because your kids are allergic to eggs and need herd immunity protection for influenza. Egg allergy is a known contradiction against influenza vaccine.
As to seizures: why did my newborn baby suffer several seizures before he had any vaccines, and again when he had a now vaccine preventable disease? Now all seizures are related to vaccines.
Now, t, what you have to do is provide the actual scientific evidence that vaccines cause more seizure than the disease. Does that MMR cause more seizures than measles? Does the Hib vaccine cause more seizures than haemophilus influenzae type b? Be sure to provide the title, journal and date of the studies that support your statements. Please do not provided anymore unverifiable anecdotes, news reports or random websites.
t:
Sure, t. Go and tell us exactly how much cheaper it is to treat the diseases instead of preventing them. Show us how much a family will save by skipping the two varicella shots, and having someone stay home from work for two weeks to care for a kid covered in itchy painful wounds. Then tell us how much more cost effective it is to treat over one out of a thousand kids in the hospital for measles than to given each child two MMR doses (presently Europe has one in four measles cases hospitalized, they must be saving lots of money!).
Come on, t, show us those numbers! We want to know how it would be cheaper to scrap vaccines and go back to the good ol' days where every kid had measles by age fifteen, and the average family was familiar with funerals for children.
Ren: I posted an "early release" article from the MMWR, here is the (one week) later issue of the MMWR:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a3.htm
"The index patient was an unvaccinated boy aged 7 years who had visited Switzerland with his family, returning to the United States on January 13, 2008. He had fever and sore throat on January 21, followed by cough, coryza, and conjunctivitis. On January 24, he attended school. On January 25, the date of his rash onset, he visited the offices of his family physician and his pediatrician. A diagnosis of scarlet fever was ruled out on the basis of a negative rapid test for streptococcus. When the boy's condition became worse on January 26, he visited a children's hospital inpatient laboratory, where blood specimens were collected for measles antibody testing; later that day, he was taken to the same hospital's emergency department because of high fever 104°F (40°C) and generalized rash. No isolation precautions were instituted at the doctors' offices or hospital facilities."
I think I'll link to this issue of the MMWR for Dr. Bob at AoA, to see.
T
Thanks for responding. The discussion is about vaccines, so your straw man comments about circumcision and chemotherapy are irrelavant. And you seem to be arguing that having kids home sick somehow saves schools money, interesting, if so I wonder if you can cite some data , or are you just pulling stuff out of your arse? in any case not relevant to risk benefit though it could be relevant to a cost benefit analysis.
So your children had a seizure and some allergic reactions. OK, now we are on topic, super. these are recognized side effects of vaccines. So you've had first hand experience with some of the risks of vaccines. These are quantifiable risks (meaning we have a firm idea about what percentage of recipients experience these side effects when compared to placebo). Now I want to ask if you have any first hand experience with the diseases these vaccines prevent? No? Thank goodness,...... well actually thank a doctor and the vaccines they gave you and your children, because without these vaccines you would be familiar with children dying in infancy, as they did, in large numbers, before vaccines were introduced. That is the other half of risk benefit: prevention of large numbers of children (adults too) dying. It seems to me that the risk of some minor local reactions, rare serious allergic reactions, some fevers and a rare febrile seizure (much less of a problem since switching to the acellular pertussis) is a small price to pay to prevent lots of children dying, right? In the case of every vaccine given to our children, the risk vs the benefit has been carefully weighed and extensive data collected and debated by experts who do have experience with both the side effects, but also with th diseases being prevented. This forum is a great place to learn the facts about both the risk and benefits, because that is the core of this controversy, not "health freedom". That is a distraction tactic.
What about shedding after vaccination?
Detection of measles virus RNA in urine specimens from vaccine recipients http://www.ncbi.nlm.nih.gov/pmc/articles/PMC228449/pdf/332485.pdf95 Sep;33(9):2485-8.
lurker, that was just another reason why you should not drink urine.
Is this the same lurker who flounced off in another thread threatening never to return? Or some other braindead nymrod?
From Chris's link above @112
http://www.euro.who.int/en/what-we-publish/information-for-the-media/se… "The majority of European cases (90%) were amongst adolescents and adults who had not been vaccinated or for whom vaccination history was not reported."
So I guess Chris never changed a urine soaked diaper.
Um, that would be the same nimrod, doktor bimler...our hit and run poster who links to an 18 year old article...and is clueless about what the article states.
"lurker, that was just another reason why you should not drink urine."
lurker, that was just another reason why you should not inject urine into your body and,
lurker, that was just another reason why you should not put urine in this machine, http://www.buzzle.com/articles/nebulizer-machine.html
lilady @119 --
"lurker, that was just another reason why you should not put urine in this machine,"
Gives "whiz kid" a whole new meaning!
Hey, Mike in the last thread taught me a new magic trick! All he did was to post the following -- and Thingy never returned to that thread.
Watch this:
---------------------------
Hey Th1Th2!
Good to see you!
Still claiming to have worked in a hospital before dishing out 'medical advice'?
What hospital, what job?
(The question Thing cannot ever answer. Watch and see.)
What about shedding after vaccination?
Detection of measles virus RNA in urine specimens from vaccine recipients http://www.ncbi.nlm.nih.gov/pmc/articles/PMC228449/pdf/332485.pdf95 Sep;33(9):2485-8.
palindrom: I'm lizzing right now
http://www.urbandictionary.com/define.php?term=lizzing
From Chris's link above @112
http://www.euro.who.int/en/what-we-publish/information-for-the-media/se… "The majority of European cases (90%) were amongst adolescents and adults who had not been vaccinated or for whom vaccination history was not reported."
So I guess Chris never changed a urine soaked diaper.
@Lurker - what about measles virus RNA detection in urine/viral "shedding"?
Exactly - what of it?
1. The virus is attenuated, and incapable of causing new measles infections in contacts. In fact the measles vaccine virus strains are so "harmless" in this regard that they are used as carrier vaccine viruses for other things like cancer vaccines.
2. So what? According to antivax folklore, measles is a trivial and entirely harmles illness, just part of the growing-up experience, something that makes you stronger. So why should it bother you whether RNA is found in anything?
@dt- Thank you for an answer compared to Chris, lilady, novalox,palindrom, herr D
@lurker - thanks for admitting that you are full of crap.
@Lawrence- you were just added to the fanatical and extremely biased list.
I asked a simple question which evidently maybe others are still concerned about.
I don't care what lilady and Chris say but think of all those with questions who read this blog. Those were really arrogant and low class replies. Trash talk.
Clean up your acts guys- anti-vaxers are mutiplying and you sure aren't converting them.
Notice your projections please!
Perhaps before you post another "gotcha!" article, lurker, you might try reading it. You get disrespectful reactions due to your previous disrespectful behavior, starting by using insults when you first appeared here. In fact you are behaving like a troll by posting the paper that you did not read on multiple threads.
If you want respect, then open up your mind to respecting the real data, and those of us who post here.
@Chris-
Now that's better Chris, but I think the sequence of insults started with you.
I did read your post, and even linked to it.
No where was "gotcha" That's your overdefensive position and projection to anything
I post. I even linked to Liz Ditz and Offit in the past.
The links I post are from nih.gov and respected medical journals.
lurker...you have been posting here for months. We have referred you to reliable websites and even taken the time to explain the science behind immunology, epidemiology and vaccine-preventable diseases.
You continually post and re-post, ask the same questions over and over again, re-phrase questions and post eons-old articles that have nothing to do with the thread...and that you, in your stupendous ignorance, are clueless about.
I second Lawrence's opinion and Chris' opinion. You are a troll and you're full of crap.
lurker:
Except they did not say what you thought they said, hence the advice that you actually read them.
When lurker came on and stated that she had rubella about sixty years ago it was no big deal, I told it was a nice story and asked her how many pregnant women she infected. She must be very sensitive because she called me an idiot and said she did not infect any strangers. Which makes us wonder how did she know very adult female stranger she encountered was not pregnant.
@lilady- stop projecting.
lurker..stop projecting, stop re-posting, stop "trolling" and, stop posting.
You're full of crap.
No $#!+.
--Monsters vs Aliens, 2009
@lurker - happy to be joined in such illustrious company. Time and time again you've either been pointed to relevant material or shown where you are incorrect. Since you have proven yourself completely unable to understand the materials with which you have attempted to prove your points - it stands that you are full of crap.
I guess Chris thinks this is an intelligent question to ask. I lived in a very small town,
I was 8 and quarantined, walked to school, we had no malls, and had nuns as teachers who I don't think were pregnant. What female adult strangers? You had to live in a small town to realize how few strangers there were.
@lurker:
And of course you remember every single adult female with whom you came in contact and are prepared to swear that none of them were pregnant. What a phenomenal memory you have.
@lilady-belligerence is a sign of approaching dementia.
@Shay- Check the periods of contagion. The stats are with me.
Still going with that I-think-I'll-just-cut-and-paste-the-same-thing-over-and-over-haha! routine, eh?
lilady, this is Dr. Ari Brown's direct quote from Dr. Oz:
As you can see, the accusation is that both the index case and Megan Campbell's son (whom I wrote about) were Dr. Bob's patients and he didn't deny this, rather coincidental that transmission occurred between his patients but his waiting room was not the source. The child (index case) went to see a family physician first, then a paediatrician. I notice that Dr. Bob won't flatly deny that the child was never in his waiting room with measles.
lurker:
Ah, new information: quarantined. At least the adults knew about the danger of rubella.
When you walked to school did you not pass by houses of your neighbors who would be coming and going? Even if there were no malls there would be grocery stores and other stores. And there are more people in a school than the teachers, there are also secretaries, custodians and the mothers of the other students who come in to help. It was the post WWII baby boom, there were always pregnant women around.
As it is, lurker, you have no excuse in not knowing that rubella is dangerous to unborn babies. If you grew up in the late 1940s to 1950s you would have known about the baby boom.
Chickenpox Attributable to a Vaccine Virus Contracted From a Vaccinee With Zoster pediatrics.aappublications.org/content/106/2/e28.full
How many pregnant women did these children infect-
From above link-
"Five months after 2 siblings were immunized with varicella vaccine, 1 developed zoster. Two weeks later the second sibling got a mild case of chicken pox. Virus isolated from the latter was found to be vaccine type. Thus, the vaccine strain was transmitted from the vaccinee with zoster to his sibling. Vaccinees who later develop zoster must be considered contagious. varicella-zoster, zoster, vaccine, transmission, rash, PstI."
From that paper:
A mild case. Did you notice it said that.
It is a case report, which is just a pair of anecdotes. Now show that event is just as common now.
Every link to a paper from Lurker can be summed up thus: "A really weird or isolated event occurred, or it occurred in lab conditions, so it must always happen in real-world circumstances. This eventhough epidemiological studies show that is not the case. Also, you're all [psychiatric term here]."
You guys are saints for wanting to spend time in engaging this age-old troll.
lurker (I'm reposting from #47 above just in case you didn't see it before),
Since you've noted that you're a fan of Dr Bob Sears on one of the other threads, could you explain this to me - it's from his recent piece at the Huffington Post (linked in Orac's post above):
In his Vaccine Book, doesn't he advocate spacing out vaccines into separate office visits? For which patients will get charged separately? Why's he complaining about the costs now?
@Ren- saints not- maybe you should tell those researchers who publish these papers to start investigating real-world issues. A lot of that money could be used for research into the causes of autism and develomental disabilities.
Oh FFS you dipshit; evidence of viral RNA does not indicate live, whole, replicating, infectious virus.
A mild case of VZV re-infection acquired from an infectious sibling with vaccine-induced herpes zoster. Copy that 10-4. Over.
"I have them vaccinated because I wanted them to be immune to chicken pox"---That's the anecdote Chris. Do you copy?
Roll up your sleeves.
Speaking of trolls, Th1Th2's comments can be summed up thus:
"[QUOTE FROM SOME OTHER POSTER]
Comment that is either a non sequitur or a direct insult, like 'infection promoter' or something similar.
[ANOTHER QUOTE FROM ANOTHER POSTER]
Another comment that shows ignorance and lack of understanding of the most basic principles of science, let alone biology.
No response to continued questions about medical training, because there is none."
How do you guys do it? Respond day and day out to these people?
@ Ren:
Just amazing! Not only are they truly patient but they somehow manage to effectively inhibit the naturally emergent and free-flowing stream of derision, exasperation and obscene language that would be totally justified in the situation.
When I steel myself for similar duty I repeatedly tell myself: "It's for the lurkers." It occasionally helps.
Self-regulation through inner speech.
@Denice- you're slipping or not reading-Obviously Chris telling me to not drink urine is an intelligent response @117 and the following responses to nih paper.
Chris is basically telling you, lurker, to exercise due diligence and to stay on the sidewalk.
Dt posted an answer @126 that I thanked him for.
Keeping up with lurkerâs links: his Pediatrics reference is from 2000.
Iâve got one from last summer:
http://pediatrics.aappublications.org/content/early/2011/07/21/peds.201…
Pay special attention to the mortality rates in Table 1, especially for those children under 1 year old (and therefore not yet immunized) since 2004.
And then explain to me how that is a bad thing.
@ lurker:
I think that Chris was being facetious- you know, hyperbole in the service of jest and all that jazz.
Now here's what's *not* funny:
do you reallly think that I feel emnity or anger at people with views differing from my own SB one?
No, not at all: in fact, one of the reasons I got involved is because I am aware that many well-meaning, decent people- who aren't stupid- are deliberately being misled by alt med proselytisers like the ones I survey, by anti-vaxxers with axes to grind and last, and certainly not least, people who lie about the causation, transmissibilty and treatment of HIV/AIDS.
I sometimes attempt tongue-in-cheek jibes or creative language-( and I wish I had better skill at being clear about this-) but at heart the issue is very serious: I hate seeing waste of human potential, time, money and effort.My argument is really and truly with those who perpetuate the myths, not those who may have been influenced by them.
Re my own post #159: I forgot to note that both lurker's and my references discuss chicken pox and vaccine.
@Chemmomo-I wish Chicken Pox on no one. Parents who throw pox parties are abusive.
But the incidence is not impressive in this study-
"from 0.41 per million population in 1990â1994 to 0.05 per million population in 2005â2007.
pediatrics.aappublications.org/content/early/2011/07/21/peds.2010-3385
lurker, I'm not sure I'm following your complaint here (#162). Are you saying that we didn't have enough chicken pox deaths during 1990-1994 to bother caring about, or that the 88% reduction we've achieved since then is negligible?
By the way, would you care to comment about Dr Bob Sears and his apparent turn around on the issue of costs of pediatric visits vs how many appointments are needed to get a child vaccinated?
But you said you're not an anti-[chicken pox] vaccine, right? I see.
You should totally try this routine on OkCupid.
But you said you're not an anti-[chicken pox] vaccine, right? I see.
No, it's patently obvious that you don't see. By the way, Thingy, you still haven't told us -- what hospital, what job?
A little off-topic:
There's been a lot of talk here about insurance companies' willingness to pay for vaccination. Which made me wonder, "How do antivaxers explain the complicity of the insurance industry in the immunization program?"
After all, if there was even a Hint of a Whiff of a Trace (TM) of evidence that vaccines cause autism, brain damage, and all manner of other serious and costly medical problems, wouldn't the insurance companies be the first ones to speak out against vaccines? And yet they happily pay for them. Please, Barbara Loe Fisher, explain to me your conspiracy theory of how that works. Kthxbye.
I see lurker was a child during the rubella epidemics that swept the US in the 1960s. In 1964/5, there were about 30,000 rubella still births and 20,000 cases of braindamaged, crippled cases of congenital rubella syndrome.
I wonder how many of those cases and deaths lurker was personally responsible for?
Oh, and before I forget - if a woman contracts rubella in the 4 wek period BEFORE she gets pregnant, the child still has a 50:50 chance of getting congeniatl rubella. So I guess lurker not only studiously avoided everyone who she thought might be pregnant, but also eveyone who was trying to become pregnant too.
Dandover @167:
I've wondered the same thing myself, dandover.
lurker @162:
I suppose lurker felt the same way about smallpox toward the end of the Eradication. By that time the incidence must have been even lower than 0.05 per million, so we should have just stopped the program, right, lurker? And then when the disease broke out again we could vaccinate until the incidence was low, and then stop again. And so on, forever.
dt,
Nice to know that you're reading the vaccine package insert.
And nice to know that you're advising women planning to get pregnant to exercise due diligence and to stay on the sidewalk.
Th1Th2,
At which hospital did you work, and which position did you hold?
Before moving on, I feel I should point out recent examples of rhetorical excess by anti-vaccine advocates; certainly speaking this way helps to inflame followers who may be trying to cope with autistic children or other serious problems in their daily lives:
at Thinking Moms' Revolution, Lisa Goes compares the autism "epidemic" to the H-l-caust in N--i Germany, she expounds upon this trope in detail.
Natural News' MIke Adams today (" A hundred Trayvons...")declares the tragic shooting of a young man "rare" while " at least a hundred African-Americans are killed every day by drug companies, vaccine pushers and cancer clinics" - "led by white men", of course.
@ AoA, Jake again talks about being "libelled" because he doesn't accept others' verbal descriptions of his actions at public events.
Remember that these folks believe that calling a struck-off doctor a 'fraud' or a 'cheat' is defamation worthy enough to waste court time on both sides of the pond. Well, what exactly should we call him, if he committed research fraud?
Perhaps the little brat should sue; I hear there are a few in his circle that are more than happy to pony up some money to do just that.
I see that Mr. Crosby is now a "contributing editor" over there. He is moving up in the world. We can't wait to dissect his first epidemiological study. We just can't. It will be something worth celebrating.
A certain "Epi" told me that Jake emailed a certain health department with all sorts of accusations, including one that I am that Epi. He's in for a surprise of monumental proportions when I finally reveal myself to the Jedi Sith them on 10/23/2023. It's a bit of a wait, but it's going to be worth it.
@ Reuben:
I'm waiting for Jake's in-depth expose of the financial and social ties of pharma shills and minions, completely diagrammed with circles, arrows and bold print : the regulars @ RI, despite their far-flung locations, are all second cousins and were sent to elitist universities by Mr Murdoch: thus we refer to him as 'Uncle Rupert' even tho' we don't really like him. We ladies all look terrific because of rx skin care graciously provided by pharma giants as perks. I won't disclose what the gentlemen get. What do you think?
See you at the *grand fete* Saturday!
Our secrets aren't safe anymore now that Jake's on the prowl! He'll probably wear a 'wire'.
Hmmm, I think Jake has been lurking here, again. I was the poster who located the NIH Record that described Jake's behavior and exit from the NIH meeting.
Jake begins today's screed at AoA with this:
"Thirty-seven days after I was thrown out of an NIH lecture by congressionally reprimanded millionaire vaccine industrialist and vaccine injury cover-up spokesman Paul Offit, the newsletter NIH record ran an article repeating Offitâs libel that I was a âstalker.â The story also said I stormed out of the room and slammed the door behind me."
@ Jake Crosby: Your first sentence that describes Paul Offit as a "vaccine industrialist" and "vaccine injury cover-up spokesman" is libel.
Jake, further along in your screed you state "...NIH record ran an article repeating Offit's libel that I was a stalker". Wrong again Jake, Dr. Offit's SPOKEN WORDS (that only you consider defamatory), are considered under the law to be slander.
You better stick with your public health *career path* and try not to play lawyer, Jake. You'll find that *your chances to gain employment in the public health sector*, are far better than your amateurish musings about the law.
Funny how what "they" do is freedom of speech but if "we" characterise them with some richly-deserved pejorative, it's "libel" or "slander" or "lies". Hey Jake, if you want to stalk the big players, then you had better put your big boy panties on and quit whining.
How does Paul Offit manage to fit that on his business cards?
Oopsie. Bob Sears seems to be prevaricating about having spoken to Seth Mnookin and about the index case in the San Diego outbreak. http://blogs.plos.org/thepanicvirus/2012/03/26/bob-sears-bald-faced-liar-devious-dissembler-or-both/.
@ lilady:
Well, maybe Jake *should* play lawyer- I think that Andy can use all the help that he can get- also, a career in public health may threaten others' lives.
@ ScienceMom:
I don't think that they can manage that turn-the-tables and recursive thought stuff that the big boys ( and girls) are doing these days.
@ Militant Agnostic:
Answer: next to an asterisk, in very small print below the 'Dark Lord of Vaccination' line.
I have to go.
Oops, I better add 'allegedly' to the first two.
Ace Reporter, Boy Wonder, Mph-Epidemiology Candidate, and legal scholar...now has a total of 74 articles written for AoA.
Just perusing the TITLES of these 74 articles, I see that Paul Offit as the subject of the entitled article 7/74 times.
Jake also used Brain Deer as the entitled subject of his article 6/74 times.
(I have not read the body of any of his other screeds, but I'm confident that Dr. Offit and Brian Deer have been libeled, multiple additional times, as well).
Jake, you better put your big boy panties, get your self to lawyer, copies of your AoA articles in hand, to find that you have committed libel against Offit and Deer...which is indefensible in any jurisdiction, both in the USA and in the U.K.
You're in deep sh*t now, Jake.
Sorry if this has been posted before (scrolling issues!)
Seth Mnookin picking up on Lilady's stylish cornering of the Bobster:
http://blogs.plos.org/thepanicvirus/2012/03/26/bob-sears-bald-faced-lia…
@Militant Agnostic:
Easy, it's tacked on at the end, acronym style -- Paul Offitt, CRMVIVICUS
@ Autismum: My first comment directed at Dr. Bob, was a "pick-up" on other comments that appeared on the Ho-Po, about Dr. Bob's unimmunized patient, who turned about to be the index patient in the 2008 San Diego measles outbreak.
I asked for a reply...and a clarification...because I had the actual video clip from the Dr. Oz show where a pediatrician stated (that she believed), the index patient and others children in his practice were infected during the outbreak. That pediatrician also stated that she believed some of the cases were exposed in his waiting room. I also questioned why he did not "set the record straight" on the Dr. Oz show and why he deliberately changed the subject.
In that same comment, I mentioned that Seth Mnookin and other science bloggers have discussed Dr. Bob's "index patient" and the measles outbreak in San Diego.
Dr. Sears admitted in his first reply that his unimmunized patient was the index case, and denied that any of his other patients were also infected during the outbreak...whether in the office waiting room or elsewhere:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a3.htm
"Two generations of measles cases were identified. The first generation (eight cases) included the index patient's two siblings, two playmates from his school, and the four children from the pediatrician's office. The second generation cases included three children from the index patient's school: a sibling of a child from the first generation and two friends of one of the index patient's siblings (Figure)."
Even if we "exclude" the four cases, that Dr. Bob says were not exposed to the "index case" in his waiting room, his umimmunized "index case" patient did expose 4 first generation cases in a doctor's waiting room and is directly responsible, or tangentially responsible, for 100% of the "first and second generation transmission" measles cases
Dr. Bob, in his comments directed at me denied he has ever communicated with Seth Mnookin...which Seth has now blogged about to prove that Dr. Bob is a pathological liar.
Required immunizations for school entry vary by state, as individual states set vaccine policy.
In case you are wondering, I have posted exactly which vaccines you need for entrance into daycare and entrance into kindergarten (which is the only data California publishes; it tracks but doesn't publish a report on 7th grade compliance).
Click on my name, above.
@ Liz Ditz: California has published a new requirement (Tdap booster), for 7th grade entry September 2011, and for September 2012 and thereafter, for 7th grade school entry:
http://www.central.k12.ca.us/district/nurse/2011_CA_Immunization_Requir…
Interesting, isn't it, that the San Ramon Unified School District (where Greg Marvel, School Board President went "rogue" recently), posts this on their homepage:
http://www.srvusd.k12.ca.us/
Yes, lilady, the new incoming-7th-grade tdap booster was a big deal last fall because some schools had to exclude students who hadn't complied, thus losing per-student-day funding.
Some schools even had in-school vaccine clinics.
The district I live is a k-8 district, and had some difficulty because some of the schools are k-8; others are k-5 feeding into the two 6-8 middle schools. And of course our district budget has been slashed so far that there aren't enough administrators, so the communication with families has been adversely affected.