Tag: medical exemptions

Who Should Write Your Child’s Medical Exemption for Vaccines?

Why would anyone go visit a new doctor just to get their child a medical exemption for vaccines?

A medical exemption should be for kids who can't be vaccinated, not just because you don't want your child to be vaccinated.
A medical exemption should be for kids who can’t be vaccinated, not just because you don’t want your child to be vaccinated.

Shouldn’t they just get the medical exemption from their regular pediatrician?

Who Should Write Your Child’s Medical Exemption for Vaccines?

As lawmakers in California debate passage of a new vaccine bill, SB277, which would put help stop doctors from writing fraudulent medical exemptions, we are learning more and more about what are thought to be fake MEs and the doctors who write them.

“The exemption practices of three doctors in the records have already come under investigation by California authorities, and many are on lists of “vaccine-flexible” pediatricians circulated online by anti-vaccine parents. Three exemptions were signed by a doctor in New Jersey, and a fourth by one in Florida.”

California’s vaccine battle: Here are the doctors behind Bay Area students’ medical exemptions

One of these doctors practices at an anti-aging clinic, so it doesn’t seem like they are the regular primary-care physicians for these kids getting exemptions.

“SB277 did not substantially change the granting of medical exemptions by physicians, which expected and anticipated that each child would be evaluated by a physician who regularly cared for that child and receiving the exemption applying the standard of care.

Instead, after passage of SB277, we witnessed physicians who advertised exemptions for cash on social media and the internet. Some parents posted that their child’s physician refused to grant their child a medical exemption, so they bought one from a distant physician.”

Richard Pan SB 277 Assembly Health Committee Testimony

And that’s why a state without non-medical exemptions continues to have schools with fewer than 50% of the kids vaccinated.

Doctors who think that they are “vaccine experts” are granting kids medical exemptions because they think that everything is a vaccine injury. Or that a family history of something that they think is a vaccine injury qualifies a child for a medical exemption.

“I’ll tell you what I do personally is I charge the same amount of money for a patient who I see for a medical exemption as I do for new patients coming in to me for a check up or a consultation. I don’t charge any more. In fact, my medical exemption appointments are actually two appointments. I don’t make any more money from medical exemption appointments as anything else.”

Bob Sears SB 277 Assembly Health Committee Testimony

Most of us don’t make any money from medical exemption appointments…

“And just to follow up – is there some other… back to the idea of a specialist in this. Could there be some other standard in which a specialist could do more of these?”

Chad Mayes SB 277 Assembly Health Committee Testimony

There are certainly situations in which a specialist will be the one writing the medical exemption.

Is your child getting chemotherapy for ALL? Then his oncologist might be the one to write the exemption.

Did your infant get immunoglobulin to treat Kawasaki disease? Then her cardiologist might write a temporary medical exemption for live vaccines.

Does your child have infantile spasms? Then his neurologist might write a temporary medical exemption for DTaP.

Why Are Medical Exemption Visits a Thing?

In most situations though, it would be your pediatrician who would write the exemption.

“When we passed SB 277, again as we mentioned, we didn’t really touch the medical exemption, but what our expectation was is that it’s going to be your child’s regular doctor who knows the child granting them… And what we’re seeing is that actually we have physicians… who are not really the primary care doctor.

I mean I find this idea of having medical exemption visits kind of intriguing because you shouldn’t really have medical exemption visits. Either you’re the doctor or you’re not. If you’re the doctor you should take care of them. You have that relationship and if they have an issue with vaccines, you write them the exemption.

That’s it. That’s what’s supposed to normally happen. People shouldn’t be going out finding other doctors for exemptions. If you happen to see a specialist, and they think you can’t get vaccinated safely, then they either submit the exemption or they tell your primary care doctor, by the way, that child should not get vaccinated, we should get an exemption. That’s how it should normally work.”

Richard Pan SB 277 Assembly Health Committee Testimony

Of course, medical exemptions to get vaccines are not very common though. If your pediatrician refuses to give your child a medical exemption, it is likely because they don’t need one.

It's amazing that they didn't know their child needed a medical exemption until they went to see Dr. Stoller...
It’s amazing that they didn’t know their child needed a medical exemption until they went to see Dr. Stoller

Remember, medical exemptions for vaccines should be for kids who can’t be vaccinated, not just because you’re scared or don’t want your child to be vaccinated.

More on Doctors Writing Medical Exemptions for Vaccines

Do Vaccines Cause Psoriasis?

Even with all of the so-called vaccine-induced diseases that anti-vaccine folks come up with, few people likely think that vaccines cause psoriasis.

Bob Sears is being investigated by the California Medical Board for giving these medical exemptions because he thinks vaccines cause psoriasis.
Bob Sears is being investigated by the California Medical Board for giving these medical exemptions. Were they legitimate?

Some do though…

Do Vaccines Cause Psoriasis?

Bob Sears thinks that these kids shouldn’t be vaccinated because “vaccines can trigger psoriasis or make existing psoriasis worse.”

Dr. Bob did his research and thinks that vaccines are a risk to cause lifelong psoriasis.
Dr. Bob did his research and thinks that vaccines are a risk to cause lifelong psoriasis.

He even provided a list of studies that he thinks support his case.

“Nevertheless, the likely very low incidence of psoriasis following vaccination emphasizes the safe profile and the relevance of vaccination strategies in psoriasis patients, especially in candidates for immunosuppressive treatments.”

Sbidian et al on National survey of psoriasis flares after 2009 monovalent H1N1/seasonal vaccines.

Do they?

“The risk of psoriasis was also increased in subjects who reported a history of a recent infectious episode. The analysis by individual diagnosis pointed to acute pharyngitis as the disease with the strongest association and the only one providing statistically significant results…”

Naldi et al on Family history of psoriasis, stressful life events, and recent infectious disease are risk factors for a first episode of acute guttate psoriasis: results of a case-control study

Let’s see, although I’m not sure he actually read more than the abstracts or understands that guttate psoriasis isn’t the same as plaque psoriasis

  1. Possible Triggering Effect of Influenza Vaccination on Psoriasis – a small group of patients (36) either had an exacerbation of their psoriasis, or new onset of psoriasis (7), within a couple of weeks to months after getting a flu shot.
  2. Psoriasis triggered by tetanus-diphtheria vaccination – a case report of a 50-year-old with chronic psoriasis for 6 years who developed an exacerbation a week after getting a tetanus booster.
  3. Psoriatic skin lesions induced by BCG vaccination – a case report of a 6-month-old who developed a BCG-induced tuberculid-like eruption accompanied by psoriatic skin changes one month after vaccination. They went away without treatment within 3 months.
  4. Guttate psoriasis-like lesions following BCG vaccination – a case report of a 7-year-old who developed guttate psoriasis-like lesions one week after his BCG vaccination. He was treated with steroid creams and the rash went away within three weeks.
  5. New Onset Guttate Psoriasis Following Pandemic H1N1 Influenza Vaccination – a case report of a 26-year-old who developed guttate psoriasis after getting a flu shot. Her rash went away within three weeks.
  6. National survey of psoriasis flares after 2009 monovalent H1N1/seasonal vaccines – a small group of patients (10) who either developed new onset psoriasis or had an exacerbation after getting a flu shot.
  7. Psoriasis vaccinalis; report of two cases, one following B.C.G. vaccination and one following vaccination against influenza – from 1955, two case reports of psoriasis after BCG vaccine and the flu shot.
  8. Family history of psoriasis, stressful life events, and recent infectious disease are risk factors for a first episode of acute guttate psoriasis: results of a case-control study – a case control study that “confirmed that recent pharyngeal infection is a risk factor for guttate psoriasis. It also documented the strong association between guttate psoriasis and a family history of psoriasis. Finally, the study added evidence to the belief that stressful life events may represent risk factors for the onset of psoriasis.” The study doesn’t mention vaccines, but does remind us that “it has been estimated that only one third of cases of guttate psoriasis progress to chronic plaque psoriasis, whereas a history of guttate psoriasis is not frequent in patients with psoriasis.”
  9. Genetic background of psoriasisdoesn’t mention vaccines.

So, none of Bob’s studies were in children, they are mostly about flu shots and the BCG vaccine (which isn’t used in the United States), they are mostly case reports (low on the hierarchy of evidence), and a few don’t mention vaccines…

And most aren’t about chronic psoriasis!

Explaining the Correlation of Psoriasis After Vaccines

Is there anything that might explain the case reports that do show an association between vaccines and psoriasis flares?

“Psoriasis can appear in areas of the skin that have been injured or traumatized. This is called the Koebner [KEB-ner] phenomenon. Vaccinations, sunburns and scratches can all trigger a Koebner response. The Koebner phenomenon can be treated if it is caught early enough.”

National Psoriasis Association on Causes and Triggers

Experts also talk about Th1- and Th17-predominant immunologic responses of flu shots and the BCG vaccine’s Th17 activity. It is known that Th17 cells play a role in psoriasis.

Are there any other studies about vaccines and psoriasis that Dr. Bob left out?

  1. Yellow fever vaccine used in a psoriatic arthritis patient treated with methotrexate: a case report – “A case of yellow fever vaccine used in a 27-year-old Slovenian male with psoriatic arthritis during treatment with methotrexate is described. We demonstrate a positive case, since there were no adverse effects in concurrent administration of yellow fever vaccine and methotrexate.”
  2. Live attenuated varicella vaccine: A new effective adjuvant weapon in the battlefield against severe resistant psoriasis, a pilot randomized controlled trial – a study of 35 patients which found that the “use of chickenpox vaccine with low-dose cyclosporine seems to have value for the treatment of resistant psoriasis.”
  3. [Psoriasis is no obstacle to smallpox vaccination] – (I haven’t found the full article yet, but the title is intriguing, since eczema is a contraindication to getting the smallpox vaccine…)
  4. Factors associated with 2009 monovalent H1N1 vaccine coverage: a cross sectional study of 1,308 patients with psoriasis in France – mentions that more than twice as many people with psoriasis in France got a flu shot than the general population.
  5. Immune response to pneumococcus and tetanus toxoid in patients with moderate-to-severe psoriasis following long-term ustekinumab use – vaccines work when you have psoriasis!
  6. From the Medical Board of the National Psoriasis Foundation: monitoring and vaccinations in patients treated with biologics for psoriasis – addresses vaccination practices for folks with psoriasis.
  7. Challenges in the treatment of psoriasis with biologics: vaccination, history of malignancy, human immunodeficiency virus (HIV) infection, and pediatric psoriasis – actually talks about how UNDERVACCINATION is a challenge in treating kids with psoriasis, as you might have to interrupt therapy to get them caught up!
  8. Vaccinations in patients with immune-mediated inflammatory diseases – is very clear that the “Clinical evidence indicates that immunization of IMID patients does not increase clinical or laboratory parameters of disease activity. Live vaccines are contraindicated in immunocompromized individuals, but non-live vaccines can safely be given.”

The bottom line is that experts that treat people with psoriasis recommend that they be fully vaccinated.

“Psoriasis is a treatable, chronic dermatosis. The very low absolute risk of new-onset or relapsed psoriasis following influenza vaccination should not change its universal recommendation, particularly for patients with psoriasis on immunosuppressive therapy. We present this case to highlight clinical manifestations of this rare association.”

Shi et al on Widespread psoriasis flare following influenza vaccination

There is even talk of development of a vaccine to treat psoriasis!

It should be clear that neither psoriasis nor a family history of psoriasis should be a reason to get a medical exemption for vaccines.

More on Vaccines and Psoriasis

Why Is Lying About Vaccines Not Criminal?

We are in the middle of the largest measles outbreaks in over 25 years.

Measles cases and deaths are on the rise all over the world.

Much of that rise, especially in the developed world, is because parents believe the misinformation that the vocal anti-vax folks are pushing.

Why Is Lying About Vaccines Not Criminal?

Which has to make you wonder – why is lying about vaccines and scarring parents into skipping or delaying vaccines not criminal?

A sociopath wrote this... Is that the one true statement in Kennedy's rant?
A sociopath wrote this… Is that the one true statement in Kennedy’s rant?

For example, take the above Instagram post by Robert F Kennedy, Jr.

His claim that the “guidelines stipulate that a child would need to experience anaphylactic shock — a life threatening reaction — to EVERY vaccine-requiring eight near death experiences — to qualify for an exemption” simply isn’t true.

A severe allergic reaction is a contraindication to getting vaccinated.

If a child had a severe allergic reaction, anaphylaxis, to a previous dose of any vaccine or to a vaccine component, then they would get an medical exemption to that vaccine. They could also easily get a medical exemption to all other vaccines that used those same components, such as gelatin, eggs, or yeast, etc.

It is silly to think that you would have to have an anaphylactic reaction to each and every vaccine, as Kennedy claims, to get a medical exemption to getting vaccinated.

Did the CDC publish new guidelines in 2019 changing what is considered to be a contraindication, another Kennedy claim?

Mild to moderate local reactions and low-grade or moderate fever were removed as a condition commonly mispercieved as a contraindication or precaution, but that was done last January. There were no big changes recently!
Mild to moderate local reactions and low-grade or moderate fever were removed as a condition commonly mispercieved as a contraindication or precaution, but that was done last January. There were no big changes recently!

Nope.

And the thing is, these things are incorrectly perceived as contraindications or precautions to vaccination because they are not a problem with vaccination!

You would have to be a sociopath to put kids at risk for a vaccine-preventable disease for no good reason!

For example, why skip the HPV vaccine just because a child is already infection with HPV? Are they infected with all of the strains of HPV that the vaccine protects against? There is no extra risk of cervical cancer from the vaccine if you are already infected, just the fact that you might get cervical cancer because you were already infected before you got protected from the vaccine!

Why is it not homicide to scare someone away from getting vaccinated and protected with a vaccine that prevents cancer by spreading this type of misinformation?

Why is lying about vaccines not criminal?

More on Why Is Lying About Vaccines Not Criminal?

Who Is Kenneth Stoller?

It is well known that there are doctors in California writing fake medical exemptions for kids so that they can avoid getting vaccinated and protected.

Tara Zandvliet isn't the only one writing a lot of medical exemptions for vaccines.
Tara Zandvliet isn’t the only one writing a lot of medical exemptions for vaccines.

Just who these doctors are is probabaly a bit of a mystery to a lot of people.

Who Is Kenneth Stoller?

In addition to Tara Zandvliet in San Diego, Kenneth Stoller has been writing a lot of medical exemptions for kids in California.

Did Kenneth Stoller get referrals for medical exemptions through anti-vaccine groups on Facebook?
Did Kenneth Stoller get referrals for medical exemptions through anti-vaccine groups on Facebook?

In fact, he has been writing so many that he got the attention of the City Attorney in San Francisco, who is investigating “whether the San Francisco doctor has been unlawfully providing medical exemptions that allowed parents to avoid vaccinating their children, which would put those children, their playmates, their schoolmates, and the general public at greater risk of contracting a communicable disease.”

In a response to this investigation, which includes a subpoena for his medical records, Ken Stoller admits that he “issues exemptions based on considerations not listed as CDC contraindications and precaution.”

“In conclusion, the invalid interpretation that the determination of the MTFHR variant is an acceptable reason for vaccine exemptions is not based on the precepts of replication and rigorous clinical testing. It is unfortunate that the loose application of our exploratory report has been misinterpreted and used to inappropriately justify exemption of children from medically indicated vaccines.”

David M Reif, Ph.D. on the Inappropriate Citation of Vaccine Article

Since the CDC list of contraindications and precautions is what most people consider the standard of care for a medical exemption, it is a little hard to understand what his defense will be? It isn’t the continued use of MTHFR testing, is it?

“There is no published information as of yet as to how many of the 10 measles cases in children were the wild measles strain, (i.e., unvaccinated children, versus children who contracted symptoms from the vaccine, like the 38% in the Disneyland outbreak), or how many were vaccinated and contracted wild measles due to primary vaccine failure, which may be 10% or more.”

Complaint/verified Petition to Quash an Administrative Subpoena, for Declaratory and Injunctive relief against the Subpoena and in Support of an Alternative Standard of Vaccine Exemptions Recognized Under California Law

Is he going to push the myth that kids in California have vaccine strain measles?

This is not vaccine strain measles, an idea that anti-vaccine folks continue to push to scare parents away from vaccinating and protecting their kids.
This is not vaccine strain measles, an idea that anti-vaccine folks continue to push to scare parents away from vaccinating and protecting their kids.

Although some vaccine strains were detected in 2015, they were not in people who actually had measles.

“During measles outbreaks, it is important to be able to rapidly distinguish between measles cases and vaccine reactions to avoid unnecessary outbreak response measures such as case isolation and contact investigations.”

Roy et al on Rapid Identification of Measles Virus Vaccine Genotype by Real-Time PCR

They are people with a febrile rash illness. The rash and fever is a vaccine side effect. It is not vaccine-associated measles.

And primary vaccine failure is not very common at all, which is why most cases are in those who are unvaccinated.

Kenneth Stoller on Vaccines and Autism

What else does Dr. Stoller believe?

“For many children, the enviornmental illness that we have incorrectly been calling autism, is actually an illness that has been exacerbated by too many toxic vaccines. Contrary to popular belief, there are plenty of people in governmental circles who know that certain vaccine ingredients, such as ethyl mercury, found in the perservative thimerosal, will cause neurobehavioral problems and negatively impact the health of vaccinated children.”

Kenneth Stoller

Autism as encephalopathy, biomarkers, testing urine porphyrins, chelation therapy, detoxification, hyperbaric oxygen therapy – it’s all there. And it is all the type of autism-vaccine misinformation that experts say to avoid.

Many will wonder why the medical board hasn’t paid him a visit before the City Attorney in San Francisco came calling.

Is it a surprise that Kenneth Stoller found 'valid health reasons' for them to skip their daughter's vaccines?
Is it a surprise that Kenneth Stoller found ‘valid health reasons’ for them to skip their daughter’s vaccines?

But few should have any doubt that SB 276 needs to pass.

More on Kenneth Stoller