Tag: reporting vaccine side effects

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

Bobby Kennedy’s Vaccine Injury Debate

Why do some folks think that vaccine injuries are so common?

Unlike Bobby Kennedy, the CDC explains that severe injuries from vaccines are very rare.
Unlike Bobby Kennedy, the CDC explains that severe injuries from vaccines are very rare.

Oh, the usual suspects…

Bobby Kennedy’s Vaccine Injury Debate

Hopefully everyone sees what Bobby Kennedy is doing here.

He is mixing up a lot of different things, hoping you won’t notice and that you will walk away scared to vaccinate and protect your kids.

First things first.

Does the CDC say that 1 in 1,000,000 may be injured by shots?

Actually, no.

That sounds like the rate for severe vaccine injuries, like anaphylaxis and death.

What Bobby Kennedy is talking about though, that Federal Study, is a report, Electronic Support for Public Health–Vaccine Adverse Event Reporting System (ESP:VAERS), that was conducted at Harvard Pilgrim Health Care, Inc.

“Preliminary data were collected from June 2006 through October 2009 on 715,000 patients, and 1.4 million doses (of 45 different vaccines) were given to 376,452 individuals. Of these doses, 35,570 possible reactions (2.6 percent of vaccinations) were identified.”

Electronic Support for Public Health–Vaccine Adverse Event Reporting System (ESP:VAERS)

The study identified all possible reactions, including minor reactions, like pain and fever, and wasn’t looking at just vaccine injuries, unless that is what you consider to be a vaccine injury. And since the study was looking at VAERS and possible reactions, they were not even necessarily causally related to the vaccines that the kids were given.

What else does Bobby Kennedy say?

“Slide 3 is a table from HHS’s 2016 Neiss-Cades survey published in JAMA reporting an astonishing 19.5% of children under five who are admitted to emergency rooms for drug reactions are suffering vaccine injuries.”

Bobby Kennedy

What kind of vaccine injuries?

They are vaccination reactions – any adverse effect from a vaccine. They could be fever, hives, or a febrile seizure – we don’t know. Importantly, only a very small percentage of those kids who went to the ER were hospitalized.

Lastly, Bobby Kennedy wonders how a pediatrician might claim to have never seen a vaccine injury.

It’s easy to understand his confusion.

Getting listed in a vaccine insert doesn't automatically make something a vaccine injury.
Getting listed in a vaccine insert doesn’t automatically make something a vaccine injury.

Most people reserve the term vaccine injury for the more severe reactions covered under the Vaccine Injury Table, like anaphylaxis, VAPP, thrombocytopenic purpura, and intussusception.

And they use the term side effects for the more temporary reactions that are thought to be caused by a vaccine.

All of these vaccine adverse events can be reported to VAERS online or using a downloadable form.
All of these vaccine adverse events can be reported to VAERS online or using a downloadable form.

That’s very unlike those folks who consider anything and everything that happens after a child is vaccinated, even if it is many months later, to be a vaccine injury, including things like ADHD, diabetes, and autism, etc.

More on Vaccine Injuries

How Long Do Side Effects of Immunizations Last?

Immunizations are safe, but they can have some risks and side effects.

Vaccine side effects can be reported to VAERS online or using a downloadable form.
Vaccine adverse events can be reported to VAERS online or using a downloadable form.

Fortunately, most are fairly mild, like pain and fever.

How Long Do Side Effects of Immunizations Last?

And most vaccine side effects go away quickly.

For example, fever and fussiness, two of the most common vaccine reactions, typically only lasts a day or two.

Others can last a little longer, but still usually go away on their own:

  • when kids get a rash after their MMR vaccine, it might last three or four days
  • even when kids get swelling of an entire arm or leg after the DTaP shot is given, it might last for 1–7 days
  • pain at the injection site typically only lasts a few days
  • shoulder injury related to vaccine administration (SIRVA) can last months and sometimes doesn’t go away
  • arthritis after a rubella containing vaccine, which mostly occurs in adults, typically only lasts a few days
  • febrile seizures are usually brief and rarely lead to non-febrile seizures
  • immune thrombocytopenic purpura (ITP) after a measles containing vaccine resolves in two weeks to six months, typically without any treatment
  • intussusception after a rotavirus vaccine resolves with treatment, either an air contrast enema or surgery
  • Guillain-Barré Syndrome after a seasonal flu vaccine, which is very rare, resolves in the majority of people over a period of years

Do any have more long lasting effects?

VAPP or vaccine-associated paralytic polio after the oral polio vaccine might not resolve. Fortunately, it only occurs in about 1 in every 1.27 million children receiving their first dose of OPV. It is even less common after bOPV, which is oral polio vaccine that is now being used. And won’t happen at all once we stop using oral polio vaccines.

Encephalitis or encephalopathy after a pertussis or a measles, mumps, and rubella virus containing vaccine might also lead to long lasting effects.

And some, like anaphylaxis, are life-threatening.

Fortunately, most long-term vaccine studies have shown that immunizations are safe, rarely causing severe reactions, and don’t have many long term side effects.

What to Know About How Long Immunization Side Effects Last

Most vaccine side effects are mild and only last a few days.

More on Immunization Side Effects

What is SIRVA?

Vaccines are safe.

Of course, they aren’t 100% safe.

One possible problem though, SIRVA, isn’t necessarily caused by the vaccine itself, but how it is given.

Or more precisely, where it is given.

What is SIRVA?

SIRVA is an acronym for shoulder injury related to vaccine administration.

It can occur when a vaccine is injected into the underlying bursa of the shoulder joint, instead of the deltoid muscle, causing shoulder pain and limited range of motion.

“These symptoms are thought to occur as a result of unintended injection of vaccine antigen or trauma from the needle into and around the underlying bursa of the shoulder resulting in an inflammatory reaction. SIRVA is caused by an injury to the musculoskeletal structures of the shoulder (e.g. tendons, ligaments, bursae, etc.). SIRVA is not a neurological injury and abnormalities on neurological examination or nerve conduction studies (NCS) and/or electromyographic (EMG) studies would not support SIRVA as a diagnosis (even if the condition causing the neurological abnormality is not known).”

Vaccine Injury Table

Why would someone want to give you a vaccine in the shoulder joint?

They shouldn’t!

In addition to giving shots in the correct location, to prevent SIRVA, it is also important to use the proper needle length.
In addition to giving shots in the correct location, to prevent SIRVA, it is also important to use the proper needle length.

In older kids and adults, intramuscular injections are typically given “in the central and thickest portion of the deltoid muscle – above the level of the armpit and approximately 2–3 fingerbreadths (~2″) below the acromion process.”

Giving the shot properly can prevent SIRVA.
Giving the shot properly can prevent SIRVA, keeping in mind that you might use a 5/8 inch needle in younger children.

If the shot is given in the shoulder joint, then it was given too high, typically in the upper 1/3 of the deltoid muscle.

Improved education will hopefully decrease SIRVA cases, but tell your doctor and report your case to VAERS if you think you developed SIRVA within 48 hours of getting a vaccine in your upper arm.

As a table injury, folks with SIRVA can also get compensated under the National Childhood Vaccine Injury Act of 1986.

More on SIRVA