Tag: misinformed consent

Standing Orders for Vaccination

Have you heard about standing orders for vaccination?

Anti-vax folks have become overt in how they are now all about conspiracy theories.
Anti-vax folks have become overt in how they are now all about conspiracy theories.

Guess what?

Standing orders does not mean “covert vaccination without consent.”

Standing Orders for Vaccination

For one thing, there is nothing covert about them.

In addition to the Take a Stand! website, the Immunization Action Coalition has hosted workshops all over the United States on using standing orders to increase vaccination rates.

And they aren’t about vaccinating people without their consent.

So what are standing orders for vaccination?

“Standing orders are written protocols approved by a physician or other authorized practitioner that allow qualified health care professionals (who are eligible to do so under state law, such as registered nurses or pharmacists) to assess the need for and administer vaccine to patients meeting certain criteria, such as age or underlying medical condition.”

10 Steps to Implementing Standing Orders for Immunization in Your Practice Setting

Again, that doesn’t mean you can skip getting informed consent before giving vaccines.

“Having standing orders in place streamlines your practice workflow by eliminating the need to obtain an individual physician’s order to vaccinate each patient.”

10 Steps to Implementing Standing Orders for Immunization in Your Practice Setting

All standing orders do is eliminate the need for doctors and other health care providers to assess and write orders for vaccines on each and every patient they see.

Instead, standing orders help delegate that part of the vaccination process to other qualified health care professionals to help make sure that “immunizations are available at all visits, sick or well, regular hours, or weekend clinics.”

Everything else is essentially the same.

Even with standing orders, you still have to get informed consent before giving a vaccine.
Even with standing orders, you still have to get informed consent before giving a vaccine.

The health care provider giving the vaccine still has to:

So what’s the benefit of standing orders?

It removes some of the barriers to getting vaccines, such as needing a well child checkup or physical exam, allowing for vaccination-only appointments.

“The Community Preventive Services Task Force (CPSTF) recommends standing orders for vaccinations—when used alone or when combined with additional interventions—to increase vaccination rates among adults and children from different populations or settings.”

Vaccination Programs: Standing Orders

Standing orders also help make sure that you keep kids on schedule or get them caught up as health care providers automatically check their vaccination status at each and every visit to the office, even during sick visits.

For example, if you child comes in for an appointment in October with a mild ear infection or because they have a wart, a standing order for a flu vaccine can help make sure you child is vaccinated and protected before flu season starts.

Standing orders do not override laws requiring informed consent.
Standing orders do not override laws requiring informed consent and there is no single form that would give consent to all medical procedures.

It should be obvious that standing orders simply lead to fewer missed opportunities to be vaccinated and protected.

Not surprisingly, their source and evidence for forced vaccination is simply another anti-vaccine website...
Not surprisingly, their source and evidence for forced vaccination is simply another anti-vaccine website…

There is nothing covert about them.

“Consent is a communications process, not a form. The process provides an opportunity for the patient to understand the benefits, risks and alternatives to the treatment he or she is about to undergo, and for the physician to explain these in detail. Forms are used to document the process.”

Consents Policy

Not even in the way anti-vax are using them to try and scare you away from vaccinating and protecting your kids.

More on Standing Orders for Vaccination

How Jay Gordon On Bill Maher Helps Explain Our Anti-Vaccine Problems

Jay Gordon has been on TV a lot in his career.

“Parents from around Southern California choose Gordon for his outspoken and controversial stance on vaccinations, driving from as far away as Santa Barbara and Long Beach.

They know he will lend a sympathetic ear to their concerns about the possible adverse side effects of childhood vaccinations — even though several large scientific studies have failed to find a connection.

His openness to alternative approaches has earned him an avid following. With thousands of patients, his practice is so busy that he no longer accepts new patients.”

Los Angeles Times on Doctor Contrarian

Often described as a celebrity pediatrician, partly because he sees many of the kids of Hollywood celebrities, the Los Angeles Times once named him Doctor Contrarian.

How Jay Gordon On Bill Maher Helps Explain Our Anti-Vaccine Problems

Jay Gordon has become a bit of a celebrity in his own right too, with appearances on Good Morning America, with Cindy Crawford, the Ricki Lake Show, the Doctors, and he was even a regular on ABC TV’s Home Show back in the 1990s.

#SaidNoDoctor, except Dr. Jay Gordon, who made this statement about the HPV vaccine on the Ricki Lake Show.
#SaidNoDoctor, except Dr. Jay Gordon, who made this statement about the HPV vaccine on the Ricki Lake Show. How many kids ended up getting HPV because their parents listened?

Although he claims he is not anti-vaccine, Jay Gordon has made many other statements over the years that had vaccine advocates shaking their heads.

His main idea is that vaccines should be given on a slower schedule, just one or two at a time and that some shouldn’t be given until kids are “developmentally solid.”

Jay Gordon has no proof or evidence to back up any of his statements.
To clarify my statement, a severe reaction isn’t a reason to stop vaccinating a child all together.

Of course, giving vaccines later just leaves these kids at risk to get a vaccine-preventable disease while they are waiting, without any extra benefit of fewer side effects.

Sure, we would see fewer reactions associated with vaccines, because the same conditions would be occurring, but the kids would not have gotten a vaccine to be associated with it.

Jay Gordon has been at the front lines of taking care of parents who don't want to vaccinate their kids.
His “front lines” are parents in Southern California who don’t want to vaccinate their kids…

Is Jay Gordon an expert on vaccines?

Jay Gordon dismisses the statements of a true vaccine expert.
Jay Gordon lists all of the credentials of Dr. Hotez, none of which he has, and then tells him he is wrong!

It should be clear that he is not.

“I talk much more quietly, because I have no proof.”

Jay Gordon

Talking on TV is not exactly talking quietly…

But let’s take a quick look at some of his statements on Real Time with Bill Maher to help those who might think that he is.

B. Maher: I’m just saying vaccines, like every medicine, has side effects… So let’s not deny that or pretend it doesn’t happen. Which ones? How much? How do we manage this? This is not crazy talk.

Jay Gordon: We don’t do it the way we should do it. Manufacturers don’t put… We don’t manufacture vaccines as well as we could. We have a schedule that is invariable for every single child, one size doesn’t really fit all. The polio vaccine that I would get as a 180 lb. man is the same that I give to a 12 lb. baby. We could do it a lot better. I don’t want to bring polio back. I don’t want to bring measles back. Measles is a nasty illness.

No one denies that vaccines have side effects. The thing is, vaccines do not cause each and every thing that anti-vax folks claim that they do. They don’t cause autism, SIDS, most non-febrile seizures, eczema, diabetes, MS, ADHD, asthma, cancer, food allergies, rheumatoid arthritis, or POTS, etc.

What about Jay’s comments?

Interestingly, Jay has often said that measles isn’t that bad…

“This measles outbreak does not pose a great risk to a healthy child. And quite frankly I don’t think it poses any risk to a healthy child.”

Jay Gordon on Doctor explains why he lets kids avoid the measles vaccine

Healthy kids can just die with measles though. And healthy kids are at later risk to develop SSPE, which is fatal.

And if he doesn’t understand that vaccines aren’t given based on the weight of the child or adult, then he is clearly not a vaccine expert.

Jay Gordon believes that his middle of the road approach gets more kids vaccinated.
If you are scaring parents away from getting vaccinated, then giving vaccines on an alternative schedule may mean that you are anti-vaccine…

If he doesn’t understand the consequences of his slow vaccine schedule, especially if more parents actually started listening to him, then he is clearly not a vaccine expert.

Mostly, he seems to be an expert on pandering to parents who already have fears of vaccinating and protecting their kids.

Jay Gordon's middle of the road approach only works because his kids can still hide in the herd, getting protected from everyone else who vaccinates and protects their kids.
The kids that are vaccinated at “a different pace and thought process” are simply hiding in the herd. They don’t get sick because the rest of us are vaccinated and protected, but that system breaks down if more people start listening to Dr. Jay.

And what he has never understood, even if he does get some of these parents to vaccinate on a slower schedule, his rhetoric likely gets many more parents started on the road to thinking vaccines are harmful or not necessary.

Jay Gordon has been wrong before, as you can see in the way he has changed his stance on the HPV vaccine, which he says he now gives, and he is wrong now.

Why is Jay Gordon still in the AAP?

And his advise is indeed contrary to that of the American Academy of Pediatrics, which makes you wonder why he is still allowed to be a member.

“There is no ‘alternative’ immunization schedule. Delaying vaccines only leaves a chil​d at risk of disease for a longer period of time; it does not make vaccinating safer. 

Vaccines work, plain and simple. Vaccines are one of the safest, most effective and most important medical innovations of our time. Pediatricians partner with parents to provide what is best for their child, and what is best is for children to be fully vaccinated.”

Karen Remley, MD, MBA, MPH, FAAP, Executive Director, American Academy of Pediatrics​

Maybe its time that Doctor Contrarian stopped thinking everyone else is wrong and he takes a long and hard look at his own views on vaccines.

“Nothing I do is free. I feel like I should give you a little bit of a discussion before I recommend Tylenol, because of the impact on the liver. A discussion about ibuprofen, because of the impact on the kidneys. And when someone gets antibiotics from me, I talk to them. You know, there could be a yeast infection. You could get diarrhea and a rash. Sorry about the diarrhea and the rash. But with vaccines, the discussion is closed.”

Jay Gordon

Health care providers are hopefully all giving their patients a vaccine information sheet and informed consent, so the discussion is certainly not closed when they give kids vaccines.

Does Jay discuss the potential risks of delaying or skipping vaccines?

Will he say sorry about the rotavirus, measles, tetanus, and diphtheria?

Vaccines are safe, with few risks, and are very necessary.

Although he thinks he is taking the middle road, Jay Gordon simply helps fuel the modern anti-vaccine movement.

To be sure though, along the way, he certainly has been in the middle of things…

Jay Gordon was named Doctor Contrarian way back in 1997.
March 1997 article in the LA Times describing how media savvy “skeptics” were attacking vaccines.

From his appearance on Good Morning America in 2000 to discuss why Cindy Crawford wasn’t vaccinating her baby, just as Wakefield was getting started, to testifying against SB277, California’s vaccine law, that didn’t work because doctors simply started writing unnecessary medical exemptions, he has been there. And let’s not forget that he was Jenny McCarthy‘s pediatrician!

“I’m just saying, ‘we don’t know shit,’ that’s why when doctors, when you get a diagnosis, the other doctor gives you another one. They say, right away, get a second opinion.”

Bill Maher

Bill Maher was right about one thing, if you are going to Jay Gordon for advice about vaccines – get a second opinion.

More on Jay Gordon and Bill Maher

The Missing Information That Big Pharma Won’t Tell You About Vaccines

Do you know why some folks still don’t vaccinate and protect their kids, even as we are seeing more and more outbreaks of vaccine-preventable diseases?

Why don't anti-vax folks have to give informed consent?
Why don’t anti-vax folks have to give informed consent?

Yup.

They are in on the “missing information” about vaccines that the rest of us don’t seem to know about…

The Missing Information That Big Pharma Won’t Tell You About Vaccines

Of course, we all know about this “missing information.”

It is the misinformation about vaccines that anti-vax folks spread to scare parents and make them think that vaccines are dangerous, don’t work, and aren’t necessary.

“We feel that there’s things that public health are not telling the people and these are facts that are not well known. That are not given. So it’s not misinformation, it’s missing information. And there’s always two sides and more to information that should be given to all of us, right? We should be getting fully informed consent, right?”

not an anti-vaccine protestor

What else can you call this missing information?

How about alternative facts?

They certainly aren’t true facts about vaccines or vaccine-preventable diseases.

And that makes it ironic that they talk about getting fully informed consent.

You can’t get or give fully informed consent if you are misleading people, as these folks do with their “not protesting” signs about vaccines.

After vaccines became "liability free" you had to first sue in Vaccine Court.
After vaccines became “liability free” you had to first sue in Vaccine Court.

Take the sign about doses of vaccines tripling after they became liability free.

Is that true?

Of course not.

For one thing, as most people know, vaccines are not liability free.

But for the sake of argument, let’s try and think about what they are trying to say.

They are implying that ‘we’ tripled the number of vaccine doses after the passage of the National Childhood Vaccine Injury Act of 1986, which set up the National Vaccine Injury Compensation Program.

Of course that didn’t happen.

What's missing from the anti-vax protestors sign? That the immunization schedule hardly changed in the 1980s.
What’s missing from the anti-vax protestors sign? That the immunization schedule hardly changed in the 1980s.
This sign is missing information on years of development and testing that occur before a vaccine is approved.

Most new vaccines weren’t added to the immunization schedule until the late 1990s and after.

Their other sign covers a few different anti-vax talking points – that vaccines are only tested for 4.5 days and that vaccines aren’t tested as thoroughly as drugs.

Of course, neither are true.

As you do even a little research on these kind of immunization signs, you can see that the “missing information” they are talking about is simply more anti-vax misinformation.

More on Anti-Vax Misinformation

Do 54% of Children Have a Chronic Health Condition?

Have you heard the claim from anti-vax folks that kids today are sicker than they used to be? That 54% of children have a chronic health condition?

Do you really want to be misled by anti-vax propaganda?
Do you really want to be misled by anti-vax propaganda?

Is that true?

Do 54% of Children Have a Chronic Health Condition?

Of course not.

The number comes from a 2011 report, A national and state profile of leading health problems and health care quality for US children: key insurance disparities and across-state variations, a study that is being misused by anti-vax folks.

“An estimated 43% of US children (32 million) currently have at least 1 of 20 chronic health conditions assessed, increasing to 54.1% when overweight, obesity, or being at risk for developmental delays are included; 19.2% (14.2 million) have conditions resulting in a special health care need, a 1.6 point increase since 2003.”

Bethell et al on A national and state profile of leading health problems and health care quality for US children: key insurance disparities and across-state variations.

For one thing, the study doesn’t say anything about vaccines.

And another, the researchers don’t actually say that 54% of children have chronic health conditions!

“And before parents panic, both studies — but especially the 2011 Academic Pediatrics paper — use rather broad definitions of chronic disease.

The 54% of kids with a chronic condition in 2007 include children with asthma, environmental allergies, ADHD, chronic ear infections, kids 10 or older who are overweight or obese, and young children “at risk” for a developmental delay, among many others.

Environmental allergies alone affected 24% of kids, while nearly a third of the older children were overweight or obese, and more than a quarter of the young children were considered at risk for developmental delay.”

Williamson Misleads on Children’s Health, Vaccines

Even more importantly, the survey on which the study was based actually says that the great majority of parents consider their kids to be in excellent or very good health!

The survey did not say that 54% of children had chronic health conditions.

And the percent of kids with excellent or very good health had been very steady in recent years.

The percent of kids with excellent or very good health has been very steady in recent years.

In fact, in the very latest survey, it is up to 90%!

Not only are 54% of children not in poor health, with chronic health problems, 90% of today's parents describe their children's health as excellent or very good!
Not only are 54% of children not in poor health, with chronic health problems, 90% of today’s parents describe their children’s health as excellent or very good!

Which effectively destroys the anti-vax argument that immunizations are causing kids to have a lot of chronic health conditions, as they have been getting more immunizations and greater protection against even more vaccine-preventable diseases during this time!

More on Kids and Chronic Health Conditions