Tag: ethics

Reactions to SB 276 Passing the Assembly

On the same day that the LA Times wrote what some are calling a false balance about Bob Sears, SB 276 passed the California Assembly and Gavin Newsom called for the addition of amendments that would protect doctors who have been writing an excessive amount of medical exemptions.

Gavin Newsom's proposed amendments could weaken SB276.
Exempting individual medical information on exemptions from the Public Records Act is not a bad idea.

Coincidence?

Reactions to SB 276 Passing the Assembly

As the amendments only serve to weaken SB276, Governor Newsom should consider backing off on his request to change the bill, especially as he had previously said he would support it.

Protecting kids from vaccine preventable diseases is unethical and evil???
Protecting kids from vaccine preventable diseases is unethical and evil???

While the amendments will protect those who have been writing inappropriate medical exemptions, they won’t appease most people who are against SB 276.

Who is talking about forcibly injecting people with vaccines? Remember, mandates don't force anyone to get vaccinated and protected...
Who is talking about forcibly injecting people with vaccines? Remember, mandates don’t force anyone to get vaccinated and protected…

Especially as most of those folks still don’t understand exactly what SB276 does!

SB 276 does not eliminate all medical exemptions.
SB 276 does not eliminate all medical exemptions.

What silent loophole are these folks talking about?

The nephew of California State Assemblymember Lorena Gonzalez is immunocompromised.

“His doctor said no, he can’t have live vaccines, so no, he can’t be immunized against measles or chicken pox. Every time he is not in the hospital, he wants to be in school, but those diseases could kill him. Definitely put him back in the hospital. These are the children, the truly medically fragile children that we are trying to prevent from getting these diseases and why it’s so important.”

California State Assemblymember Lorena Gonzalez Assembly Floor Session, Tuesday, September 3rd, 2019

He has a medical exemption to getting vaccinated.

Unless the medical exemption is to all vaccines and not just live vaccines, he won’t lose his exemption and won’t need a “silent loophole.”

Having a “known severe immunodeficiency” is a well known contraindication to getting live vaccines, including MMR and the chickenpox vaccine.

Not only would his exemption be allowed, it not be one of only 5 exemptions that his doctor is allowed to make!
Not only would his exemption be allowed, it would not be one of only 5 exemptions that his doctor is allowed to make!

SB276 also doesn’t limit the number of medical exemptions that doctors can write. It just states that if a doctor writes 5 or more exemptions in a calendar year, then those exemptions will be reviewed by a medical panel to make sure that they are legitimate.

Why do 5 exemptions trigger a review? Because the average doctor will likely not need to write that many medical exemptions, as there are very few true medical reasons to avoid or skip vaccines. What if a doctor writes 10 or 15 legitimate medical exemptions? If they are reviewed and found to be legitimate, then 10 or 15 of their patients will have medical exemptions!

How will they revolt - because they don't want to vaccinate and protect their kids?
How will they revolt – because they don’t want to vaccinate and protect their kids?

Are Newsom’s amendments going to stop folks who are talking about revolutions?

Wait, which amendment is she talking about???

Is it going to protect kids from those who might continue to get unnecessary, permanent exemptions until the protections of SB 276 finally do take effect?

More on SB276

V is for Vaccine

The California Assembly Appropriations Committee votes Friday on SB276. Today anti-vaccine folks in Californians who oppose this bill gathered at the state capitol encouraging legislators to continue to allow doctors to write fake medical exemptions.

There was plenty of violent imagery on display at the V for Vaccine rally. How many times did RFK, Jr mention guns and homicide?

In addition to the anti-vaccine propaganda signs that we are getting used to seeing, folks got to hear from the usual suspects.

V is for Vaccine Rally

Surprisingly, Robert F Kennedy, Jr started things off.

Why is that a surprise?

Well, he’s not from California…

He does do a good job of pushing anti-vaccine misinformation.

And it’s all stuff we have heard before.

But he added some new stuff that was suprising.

“They are saying that… any child who is unvaccinated has ever passed measles to another child in a school since 1963. No evidence.”

Robert Kennedy, JR

What?

Although the first measles vaccine was introduced in 1963, it took some time before measles was brought under control and the endemic spread finally eliminated in the United States (2000).

Who was his pediatrician?

No evidence indeed!

He goes on about the MMR being a failed vaccine and that no one should be worried about the unvaccinated if they are vaccinated and protected.

Kennedy even claimed that he read a protocol from Johns Hopkins and not only does it not say anything about immunocompromised people staying away from the unvaccinated, but he says it warns about shedding from the recently vaccinated!

“The increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children. The immunosuppressed subject is particularly at risk in crowded living conditions because of the spread of these diseases by aerosol droplets or through the oral-fecal route.”

Medical Advisory Committee of the Immune Deficiency Foundation. Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts

I don’t know what protocol from Johns Hopkins he might have read, but maybe he should have read the Medical Advisory Committee of the Immune Deficiency Foundation. Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts. It clearly warns about the risks of being around someone who is unvaccinated.

Next up was Joshua Coleman.

“These are all undisputed facts. Everyone should know these things.”

Joshua Coleman

Coleman is talking about the “facts” on his anti-vaccine propaganda signs.

He basically hit every anti-vaccine talking point that there is…

We also heard about hot lots and Vaccine Court compensation claims.

“Cesar Chavez did this. We are the new Cesar Chavez generation.”

Latinos for Medical Freedom

Cesar Chavez did not work to put kids at risk for life-threatening vaccine preventable diseases!

Who did the V is for Vaccine Rally end with?

Del Bigtree.

Is he anti-vaccine?

He says that he is against forced vaccination, which makes you wonder why he is there, as there is no forced vaccination in the United States.

He also says that he has debunked the idea of herd immunity!

“Gavin Newsom if you can hear me, please, please ask yourself, what is the need for this law?”

Del Bigtree

What’s the need for SB276?

How about all of the abuse of medical exemptions that has led to clusters of unvaccinated kids in California schools?

To be very clear – SB276 doesn’t eliminate medical exemptions.

It stops doctors from writing inappropriate medical exemptions.

“My concern with this bill, is that it’s going to take every exemption I’ve ever done under those guidelines, which are not restricted to CDC contraindications – under those old guidelines, they can now review every single one of my exemptions I’ve done and disqualify each and every one of them and kick those kids out of school. They are sort of retroactively changing the guidelines – so all of the exemptions that I’ve ever done, and other physicians have ever done, and to me that’s a very very concerning precedence for a government to go back like that and negate years of medical care that’s been done legally and properly under the guidelines of 277.”

Bob Sears SB 276 Assembly Health Committee Testimony

SB276 is needed because too many doctors took advantage of SB277.

And because too many parents are scared to vaccinate their kids because they listen to folks like Del talk about mercury in vaccines, VAERS, 400 deaths a year from vaccines, vaccinated vs unvaccinated studies, placebo studies, infant mortality rates, and the rise in childhood illness because our kids get 72 vaccines.

“What else needs to be said?”

Del Bigtree

It should be clear what else needs to be said…

The Catholic Church teaches that it is lawful to get vaccinated to protect "our children, public health, and the common good."
The Catholic Church teaches that it is lawful to get vaccinated to protect “our children, public health, and the common good” and that we have a “moral obligation to protect the life and health of their children and those around them.”

Stop listening to these folks and their misinformation.

Anti-vax folks will never win if they try to talk about science, but they will lose even faster if they use people to push their agenda.
Anti-vax folks will never win if they try to talk about science, but they will lose even faster if they use people to push their agenda.

Vaccines are safe, with few risks, and they are obviously necessary.

More on the V is for Vaccine Rally

Do Anti-Vaccine Pediatricians Lose Millions Not Vaccinating Kids?

Paul Thomas is upset…

He thinks that Willamette Week, an alternative weekly newspaper in Portland, is trying to discredit him.

How are they using their platform “to try to discredit an ethical top Pediatrician in the community?”

An “ethical top pediatrician” who made up his own immunization schedule???

Paul Thomas was barred from the Vaccines for Children Program.
Paul Thomas was barred from the Vaccines for Children Program.

Willamette Week published a story about how Paul Thomas was kicked out of the Vaccines for Children Program.

“VFC (Vaccines for Children) does not provide any funding (no real dollars) just free vaccines for the underprivileged. What I lost was the ability to provide this free federal program to my patients who qualify for this program. This is simply a major inconvenience to those affected. Financially it is neutral to me.

My clinic had actually stocked the vaccines Rachel mentions – we just didn’t comply in a timely manner, so you got this part right “I didn’t jump through their hoops fast enough.”

Paul Thomas

To make a long story short, he got kicked out of the Vaccines for Children Program because he didn’t follow the rules of the program.

What about the idea that he “just didn’t comply in a timely manner?”

This all started over two and a half years ago???

Although Paul Thomas says in his post that his “clinic had actually stocked the vaccines Rachel mentions,” the order kicking him out of the VFC program says otherwise.

“Dr. Thomas submitted a Declaration signed under penalty of perjury stating his office does not keep stock of HPV vaccines and instead sends patients to pharmacies.”

Default Order Terminating Integrative Pediatrics from VFC

He also did not have any rotavirus vaccine in his office.

Not exercising medical judgement in accordance with accepted medical practice? Where is the Oregon Medical Board???

To get to the point of being terminated and which Paul Thomas characterizes as “I didn’t jump through their hoops fast enough,” actually involved:

  • ignoring an offer for a probationary agreement (August 2018)
  • asking for a contested case hearing (October 2018) which was scheduled for July 12, 2019
  • withdrawing his request for a contested case hearing on July 10, 2019

I’m surprised they gave him that much time!

Did he lose Medicaid funding?

I’m not sure he even takes Medicaid, but he did lose the ability to give his patients vaccines that he didn’t have to pay for.

“One huge misconception, and I see the comments on this, is that pediatricians don’t make money on vaccines or that they are not financially incentivized to vaccinate. There are profits from vaccine mark-ups and huge profits from vaccine administration fees. The average admin fee is about $35 per vaccine. For the 715 patients born into my practice who have refused to give any vaccines (each child would have had 28 vaccines by age 2 and over 60 vaccines in their childhood) amounting to income of $700,000 for the 2 years and $1.5 million over their childhood. Those are real dollars lost for Integrative Pediatrics. The money lost when considering that we serve over 15,000 patients, with most being selective about how they vaccinate would have driven most practices out of business.

There are also built in incentives in many contracts with health plans. Vaccines are a quality measure (if your practice does not reach a bench mark in numbers vaccinated) you loose a % on all services provided to patients under that insurance contract.

Is it any wonder most of my peers discharge patients from their practices who won’t follow the CDC schedule? Often these patients are told to call Dr. Thomas (Integrative Pediatrics).

Let us be clear. It is not a good business decision to allow families not to vaccinate or to permit selective vaccination.”

Paul Thomas

Let us be clear. He certainly doesn’t understand vaccine administration fees…

Some things he gets wrong?

  • pediatricians might charge $35 as an admin fee, but they are lucky if insurance companies pay them 1/3 or 1/2 that or even less. Your average vaccine administration fee is only going to be $35 if you don’t take insurance and can set your own fees!
  • you get a lower vaccine administration fee for the second vaccine component given (you use a different CPT code – 90461) vs the first (90460), and it pays less, so doctors make less when they give multiple vaccines at the same visit. Is that why many vaccine friendly doctors recommend giving one vaccine at a time?

And he misses the whole point behind vaccine administration fees.

It costs pediatricians money to order, stock, monitor, and give vaccines!

“This study shows that the variable costs of vaccine administration exceeded reimbursement from some insurers and healthplans.”

Glazner et al on Cost of Vaccine Administration Among Pediatric Practices

Do they make any money?

Hopefully they do, as health care is a business in the United States, but they certainly aren’t making millions in net profit as Paul Thomas suggests. And if they aren’t very careful, after considering all of the factors that go into giving a vaccine, it is very easy to lose money.

How Do Anti-Vaccine Pediatricians Make Money?

Which brings us back to the business decision of being a pediatrician who scares parents away from vaccinating and protecting their kids.

Is there any money in that?

Paul Thomas doesn't mention that he gets a big cut of the sales for a "free" summit that costs $197 as he promotes his anti-vaccine lecture.
Paul Thomas doesn’t mention that he gets a big cut of the sales for a “free” summit that costs $197 as he promotes his anti-vaccine lecture.

Books, seminars, supplements, essential oils – there are lots of things to sell parents who don’t vaccinate their kids.

Compared to these pediatricians in California, Paul Thomas is a bargain at just $295/year.

Don’t forget the annual membership fees that many of these pediatricians charge for the privilege of skipping or delaying vaccines and at extra risk to get a vaccine-preventable disease.

And the vaccine exemptions that some of them sell…

More on Do Anti-Vaccine Pediatricians Lose Millions Not Vaccinating Kids?

Is Vaccine Discrimination a Thing?

Hopefully everyone understands that discrimination is still very common these days. From race and religion to age and sex based discrimination, even with protective laws and regulations, many people face discrimination each and every day.

Is Vaccine Discrimination a Thing?

We should start by saying that vaccine discrimination is not really a thing. After all, no one is discriminating against children and adults with true medical exemptions to getting vaccinated.

Is a physician or nurse being nosy or bossy if they ask about vaccines when you go to a clinic or ER with your sick child?
Is a physician or nurse being nosy or bossy if they ask about vaccines when you go to a clinic or ER with your sick child?

It is only folks who intentionally skip or delay vaccines who think they are being discriminated against.

How does that work?

If their intentionally unvaccinated kid without a medical exemption can’t go to camp, play in a baseball tournament, or has to find a new pediatrician, they are now crying discrimination.

Which type of person is Bob Sears?
Which type of person is Bob Sears?

Bob Sears goes as far as saying that the discrimination against parents whose children are intentionally unvaccinated is worse than the treatment of blacks in the Jim Crow era!

“In my opinion, this is a new type of discrimination at its worst. It’s taking a new class of vulnerable children — the vaccine-compromised — and saying that because they refuse to finish their damn shots, they don’t get school. Forget separate but equal. This is separate … and NOTHING! No school at all. Soon it’s going to be no playgrounds and no drinking fountains either. Hey, the last time our government did this to a group of people, at least they GOT drinking fountains. They even got to ride buses, as long as they sat in the back. Because our government said “those people” were not safe for the rest of us to be around, and our society stood by and let it happen. And the discrimination we perpetrated on our equals so many years ago is one of the great evils our country is still guilty of. Is that what this article, and the California SB 276 bill it’s supporting, is asking us to go back to?”

Bob Sears

I would say that this is the worse thing that he has ever written, but I remember his post about how we were going to start making unvaccinated kids wear yellow stars

This isn’t even the first time that Bob Sears has written about vaccines and discrimination.

Life was good in 1988... if you weren't affected by discrimination, segregation, or any of these now vaccine-preventable diseases.
Life was good in 1988… if you weren’t affected by discrimination, segregation, or any of these now vaccine-preventable diseases.

Bob was right about one thing… There is a carefully crafted PR campaign going on. It’s full of propaganda to scare parents away from vaccinating and protecting their kids.

This isn’t discrimination though.

These are the consequences of their vaccine choice. Unfortunately, it is typically the kids who get stuck with the consequences of the choices their parents make.

Equating real problems of discrimination and segregation to the issue of parents choosing to keep their kids unvaccinated and unprotected is not only silly, but it is also offensive.

“We shouldn’t accept the idea that there is an ounce of discrimination when we are confronted with these bogus accounts of abuse. By conceding some degree of unfair treatment, when unwarranted, we undermine the real meaning of discrimination. Providing a soundboard to advantaged phonies who are unable to discern between a privilege and right only emboldens those at the top.”

Time to Fight Fake Discrimination

It subverts the work of all of those who are trying to end true discrimination.

More On Vaccine Discrimination