Tag: exemptions

Doctors Facing Disciplinary Actions Over Vaccines

mendelsohn
Dr. Mendelsohn was the Dr. Bob of his day.

There are many doctors and other health professionals who do and recommend things that are far out of the mainstream. They may tell their patients to skip or delay vaccines, that vaccine-preventable diseases aren’t that bad, or even that vaccines don’t work, etc.

And yet, many are surprised when some of them face disciplinary actions from their state’s medical boards, such as:

Dr. Ming Te Lin, the board certified pediatrician in Illinois who:

  • was preparing alternative vaccinations for children for more than a decade
  • gave patients modified vaccinations containing cat saliva and vodka
  • was signing state forms certifying he had given pediatric patients their conventional shots
  • used a WaveFront 2000 device to detoxify vaccines of mercury

Dr. Lin’s medical license has been suspended and he  was supposed to have “a hearing before the Medical Disciplinary Board is set for Oct. 11 in Chicago.” That hearing didn’t happen though and he is now supposed to have a new hearing on November 21.

Dr. Bob Sears is also facing disciplinary action from his state’s medical board.

With a long history of recommending his own alternative immunization schedule to parents, Sears is accused of gross negligence for the way that he granted a medical exemption for vaccines to a child.

An anti-vaccine doctor in Arizona, Dr. Jack Wolfson, a holistic cardiologist, was also investigated by his state’s medical board following several complaints that were made during a recent measles outbreak.

Joseph Mercola, D.O. is another anti-vaccine doctor who has faced trouble in the past. A frequent guest on the Dr. Oz show, he has gotten several warnings from the FDA for marketing a thermal camera as a cancer screening device and making false and misleading claims about natural supplemental products he markets.

Even Dr. Oz has gotten into some trouble in recent years, testifying before Congress about weight loss scams.

For More Information On Doctors Facing Disciplinary Actions Over Vaccines:

Vaccine Hesitant Parents

Every parent who skips or delays a vaccine isn’t so anti-vaccine that they believe every anti-vaccine myth and conspiracy theory on the Internet.

Some are simply scared or worried about what they have read or by what friends or family members have told them.

One study by Gust et al. has actually identified up to five categories of parents, including:

  • immunization advocates – the biggest group, who think that vaccines are necessary, safe, and important
  • go along to get alongs – think that vaccines are necessary and safe
  • health advocates – agree that vaccines are necessary, but aren’t so sure that they are safe
  • fence-sitters – slightly agree that vaccines are necessary and safe
  • worrieds – the smallest group, who slightly disagree that vaccines are necessary and strongly disagree that they are safe

The fence-sitters and worrieds, and some of the health advocates, are typically the ones who delay or skip one or more vaccines. They may even follow their own alternative parent-selected, delayed protection immunization schedules.

They are the vaccine-hesitant parents.

But what does it mean to be vaccine hesitant? Some people think of it as a kinder and gentler term, as opposed to someone who is anti-vaccine or a vaccine refuser.

The SAGE Vaccine Hesitancy Working Group says that:

Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite availability of vaccination services. Vaccine hesitancy is complex and context specific varying across time, place and vaccines. It includes factors such as complacency, convenience and confidence.

If you are hesitant about something, you are “slow to act or speak especially because you are nervous or unsure about what to do.” In general, you need reassurance and advice to address your concerns about what ever you are nervous or hesitant about.

That’s especially true when you talk about vaccine hesitancy. When a parent is worried and wants to skip or delay the MMR vaccine because they have been told it is going to make their child autistic or have read about toxins in vaccines, those are easy concerns for their pediatrician to address and refute.

That’s why many vaccine hesitant parents eventually get their kids caught up on all of their vaccines.

When a parent doesn’t want to believe the overwhelming evidence that vaccines are safe and necessary, then you are moving beyond vaccine hesitancy to someone who is truly anti-vaccine.

That’s not the vaccine hesitant parent though.

One study, “Validity and reliability of a survey to identify vaccine-hesitant parents,” described vaccine hesitant parents as a “heterogeneous group of parents who may purposefully delay or choose select vaccines, have moderate concerns about vaccine safety, and yet still want to trust and receive immunization information from their child’s provider.”

More importantly, the study also said that of vaccine hesitant parents,  “their child’s provider remains in a position of influence, their immunization attitudes are not extreme, and they are a larger group than those who completely reject vaccines.”

That makes it important to truly make dismissing families who don’t vaccinate from pediatric practices a very last resort that is saved for the “entrenched nonvaccinators” and antivaccination activists who are never going to change their minds.

After all, you can’t talk to your pediatrician about vaccines if you are no longer going to a pediatrician who advocates that vaccines are safe and necessary.

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National Catholic Bioethics Center on Vaccines

Although most states allow religious exemptions to vaccines, it is important to keep in mind that very few religions actually oppose vaccines.

That’s where the National Catholic Bioethics Center comes in.

They answer a lot of questions people might have on the Catholic Church’s teaching on vaccines, including “the Church’s teaching about the use of certain vaccines that have a distant historical association with abortion.”

They also state that:

One is morally free to use the vaccine regardless of its historical association with abortion. The reason is that the risk to public health, if one chooses not to vaccinate, outweighs the legitimate concern about the origins of the vaccine. This is especially important for parents, who have a moral obligation to protect the life and health of their children and those around them.

On the question of “Am I free to refuse to vaccinate myself or my children on the grounds of conscience?,” the National Catholic Bioethics Center answers that:

One must follow a certain conscience even if it errs, but there is a responsibility to inform one’s conscience properly. There would seem to be no proper grounds for refusing immunization against dangerous contagious disease, for example, rubella, especially in light of the concern that we should all have for the health of our children, public health, and the common good.

So they are saying you are both “morally free” to use the vaccines and “have a moral obligation” to get vaccinated.

For more information:

One-Size-Fits-All Immunization Schedule

Some people say that they are not anti-vaccine, instead they oppose our so-called one-size-fits-all vaccine policy and immunization schedule.

With so much flexibility and exemptions built into the immunization schedule though, it is wrong to call it one-size-fits-all.

For example, infants and toddlers can get their:

  • third dose of IPV and hepatitis B vaccines any time between 6 and 18 months
  • first dose of MMR and the chicken pox vaccines any time between 12 and 15 months
  • fourth dose of DTaP any time between 15 and 18 months
  • first dose of the hepatitis A vaccine any time between 12 and 23 months, getting the second dose six months after the first
  • get their “four year boosters” any time between four and six years of age

Jenny McCarthy who was one of the first to champion the one-size-fits-all argument against vaccines once said that:

Should a child with the flu receive six vaccines in one doctor visit? Should a child with a compromised immune system be treated the same way as a robust, healthy child?

It is easy to see that they don’t have to with our current immunization schedule. Your child’s pediatrician has the flexibility to temporarily delay one or more vaccines if your child has any precautions at the time of the visit, such as  a “moderate or severe acute illness with or without fever.”

There are also medical contraindications that keep some children from getting one or more vaccines on the immunization schedule. For example, children with severe combined immunodeficiency (SCID) should not get live vaccines. They are not treated the same way as children who do not have immune system problems.

This is reaffirmed by the American Academy of Pediatrics:

The schedule is not “one size fits all.”

It is considered the ideal schedule for healthy children, but it has flexibility built in. There are established medical reasons why some children should not receive certain vaccines; for example, allergies to one or more ingredients in the vaccine, or a weakened immune system due to illness, a chronic condition, or another medical treatment. Sometimes a shot needs to be delayed for a short time, and sometimes it may need to be skipped altogether .

Your pediatrician is educated and updated about such exceptions to the immunization schedule. This is one reason your child’s complete medical history is taken at the pediatrician’s office, and why it is important for your child’s health care providers to be familiar with your child’s medical history.

Delaying or skipping one or more vaccine to create a customized alternative vaccine schedule for your child, a non-standard, parent-selected, delayed protection vaccine schedule, isn’t safer than the immunization schedule from the CDC. It simply puts your child at greater risk for vaccine-preventable diseases.

For more information:

Latex Allergies and Vaccines

Can you get vaccines if you have a latex allergy?

“Dry, natural rubber is used in the tip of syringe plungers, the tip on prefilled syringes, vial stoppers,” and could cause a problem for some people with latex allergies.

According to the CDC:

If a person reports a severe (anaphylactic) allergy to latex, vaccines supplied in vials or syringes that contain natural rubber latex should not be administered unless the benefit of vaccination clearly outweighs the risk for a potential allergic reaction. In these cases, providers should be prepared to treat patients who are having an allergic reaction.

For latex allergies other than anaphylactic allergies (e.g., a history of contact allergy to latex gloves), vaccines supplied in vials or syringes that contain dry, natural rubber or natural rubber latex may be administered.

Many vaccines use synthetic rubber or synthetic latex though, so getting vaccinated with one of these vaccines would be a good alternative if your child has a severe allergy to latex.

Keep in mind that you aren’t supposed to simply remove the latex stopper from a vaccine vial to try and avoid triggering an anaphylactic reaction. That did work for one patient in the case report “Anaphylaxis after hepatitis B vaccination.” She got her second dose using “rubber free technique” and didn’t have a reaction.

Still, latex allergies with vaccines doesn’t seem to be a big problem.

One study “Vaccination of persons allergic to latex: a review of safety data in the Vaccine Adverse Event Reporting System (VAERS),” in the journal Vaccine “revealed only 28 cases of possible immediate-type hypersensitivity reactions in vaccine recipients with a history of allergy to latex.” And only two of those required hospitalization.

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Vaccines for Premature Babies

Do premature babies get different vaccines or vaccines on a different immunization schedule than full term babies?

Not usually. Being a preemie is not a contraindication to getting vaccinated.

Vaccines work and are safe for preemies. They should not usually be delayed.

In fact, the CDC states that:

In the majority of cases, infants born prematurely, regardless of birth weight, should be vaccinated at the same chronological age and according to the same schedule and precautions as full-term infants and children.

The only exception is for the hepatitis B vaccine, which may not work as well in premature infants with low birth weight. They should still get it if their mother is has hepatitis B, but it will need to repeated when they are one month of age.

If the premature baby’s mother is HBsAg-negative, and they weigh less than 2000g (4.4 pounds), then they can wait to be get their first hepatitis B vaccine when they are one month old or when they are discharged from the hospital.

So except for the hepatitis B vaccine in low birth weight infants, premature babies should be vaccinated according to the same immunization schedule that we use for other children.

For more information:

Contraindications to Vaccination

While not as common as some folks think, there are contraindications to getting vaccines.

That’s where medical exemptions for vaccines are used.

Most of these contraindications are specific to one or a few vaccines, such as having a severe allergic reaction, a known severe immunodeficiency, or being pregnant, etc.

For example, you wouldn’t get a live virus vaccine if you had severe combined immunodeficiency disease (SCID), but you should get all of the other inactivated vaccines.

When thinking that a contraindication should apply to all vaccines, remember that:

“The vaccines are all made differently. They’re all based on different biological principles,” said Dr. Paul Offit, infectious diseases expert at Children’s Hospital of Philadelphia. “I can’t understand how a physician could conclude that a person shouldn’t get any vaccines” for the rest of childhood.

And while some are permanent contraindications (a severe allergic reaction), others are temporary. For example, having a “moderate or severe acute illness with or without fever” is a precaution to getting most vaccines, but you can get vaccinated as soon as you get over the acute illness.

Also keep in mind that many things are falsely seen as contraindications to getting vaccinated, such as being autistic or having a sibling with autism.

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