WSJ has an article about the increasing number of pediatricians who fire their patients who refuse to vaccinate:
Pediatricians fed up with parents who refuse to vaccinate their children out of concern it can cause autism or other problems increasingly are "firing" such families from their practices, raising questions about a doctor's responsibility to these patients.
Medical associations don't recommend such patient bans, but the practice appears to be growing, according to vaccine researchers.
In a study of Connecticut pediatricians published last year, some 30% of 133 doctors said they had asked a family to leave their practice for vaccine refusal, and a recent survey of 909 Midwestern pediatricians found that 21% reported discharging families for the same reason.
By comparison, in 2001 and 2006 about 6% of physicians said they "routinely" stopped working with families due to parents' continued vaccine refusal and 16% "sometimes" dismissed them, according to surveys conducted then by the American Academy of Pediatrics.
"There's more noise among pediatricians, more people willing to argue that it's OK to do this versus 10 years ago," said Douglas Diekema, a professor of pediatrics at the University of Washington in Seattle. Dr. Diekema wrote the AAP's policy on working with vaccine refusers, which recommends providers address the issue at repeated visits, but respect parents' wishes unless it puts a child at risk of significant harm.
This is an interesting ethical question as there are several issues at play. Since the pediatrician is the child's doctor, is it wrong to fire the family from the practice just because the parent is misinformed? Or is it a worse practice to tolerate parental medical foolishness and expose other patients in the practice to vaccine-preventable disease? Since vaccination is one of the most important roles of the pediatrician during well-child visits, is there any point at all in having regular pediatrician visits if you refuse vaccination?
My initial feeling is that these pediatricians are justified in refusing to care for patients who refuse vaccination. The debate on vaccination is over. The vaccines work. The vaccines are safe. They do not cause autism. Prevention of diseases like measles, mumps, rubella, pertussis, tetanus, meningitis, diptheria, chicken pox, HPV, polio, etc., is as important for individual patient's benefit as well as prevention of transmission of these diseases in society and parents who refuse vaccination are bad for their children and bad for everyone else.
However, I'm still torn because it's not the kid's fault his parents reject western medicine and disease prevention. Does this further endanger the individual child as the child will no longer receive screening for childhood disease that is another highly important component of pediatric care?
In the end, a repeated point the pediatricians make in this article is that if the patients reject vaccination, they will reject most of the pediatricians recommendations. At which point, why even see a pediatrician? Why see a doctor if you don't believe in medicine? Go see a quack instead. But then this brings me back to how it's the child that is the one who is harmed by the rejection by mainstream pediatricians. What if this drives the parents further into the arms of quacks? How does that benefit the child?
I'm conflicted.
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What worked in the "old days" was state regulations requiring vaccinations prior to enrollment in public schools. Now it might just promote more movement to "private" no-science-allowed schools.
Pediatricians have one purpose and one purpose only, sell vaccines! This is why parents are being fired. They are affecting the bottom line. My kids will never go near a pediatrician again. We see a family doctor who doesn't even have vaccines in his office. Talk about quacks, pediatricians are the worst.
The danger with "firing" the family is that they may find a woo-friendly doctor (or worse, a naturopath), who will enable them in their child neglect. I think a better idea is to keep seeing the family, but keep repeating the message. If the parents don't like it, tough. They can vote with their feet. There's always a chance that the message will eventually get through, especially if the parents aren't totally thick-headed about this issue.
I liken it to keeping alcoholics or smokers in a general practice. You can give them care, which includes keeping on message about their habits that are killing them.
Wow, I guess that comment justifies my concern that firing a family from your practice might drive them towards quacks.
A pediatrician who does not offer vaccines is a quack, is committing malpractice, and the state should discipline them for failure to meet standard of care.
It's amazing that after linking an article which shows the dramatic decrease in deaths from vaccine preventable disease compared to the pre-vaccine era, you get people that accuse pediatricians, usually the sweetest and most well-meaning docs in or out of the hospital, of being corrupt. It boggles the mind how warped people become on this issue.
I wish our pediatrician group followed that school; every time you go for a routine wellness visit you wonder which of the little snowflakes in the room is today's mini typhoid Mary due to its parents' "philosophical" exemption. At least I don't have to worry about Joe's offspring frequenting the place.
I would hope families who do not vaccinate would be fired from the practice, if only for the safety of the people with whom that unvaccinated child would share a waiting room.
As an adult vaccinated forty years ago, I don't want to come down with the mumps because Woo-Mommy decided it was her "right" to not vaccinate.
My brother and his wife were asked to find another obstetrician when they (mainly my brother, really) repeatedly refused to accept the professional advice and guidance offered by the obstetrician. It seems to me that the obstetrician was correct. S/he was being put in an untenable position, in part because the family was refusing routine screening so that the obstetrician was in some cases "operating in the dark" without access to all the information that would be necessary to provide optimal care.
I don't know if the family were ever similarly "fired" by a pediatrician, but I would think that that would have been justified as well. If a professional offers advice and guidance and the lay client discounts that professional's education and expertise, it seems to me that the professional would be right in saying that the client should be working with someone else with whose approach s/he is comfortable. At the very least, the pediatrician has a right to protect her/himself from potential lawsuits should the child come to grief while under the pediatrician's care.
Cautionary tale: I asked for the DTAP at my last physical in November so that I would be part of the "herd" surrounding the infant children of my colleagues and students. Thank heavens for the timing: two weeks ago a memo was sent round to let us know that one of our graduate teaching assistants had been asked to leave campus for several days because of pertussis. Fortunately, the undergraduates are required to submit proof of vaccination for enrollment. Can you imagine what might happen if thousands of students clustered together within the confines of the dormitories were NOT vaccinated?
Any doctor who fires you for having a healthy skepticism of vaccines is doing you a favor. I would never put anything into my body that the US Congress has given protection from unsafe product liability. Find a doctor that understands you are the boss and he/she is the contractor you hire.
If every child that comes into the office is the doctor's patient, and one patient is putting everyone else at risk, then I believe the needs of the many, outweigh the needs of the individual. I'm sure the doctor would also kick the family out if every time they came in, they insisted on swinging a baseball bat around the waiting room. Sure, it's possible that no one will get hurt but it's dangerous and unnecessary and if it puts other people at unnecessary risk, it's unacceptable.
The parents are acting on behalf of the child. The child may not deserve to be denied vaccines but we have decided, as a society, that this is a right we've granted parents, and as such, they are the ones who ultimately have to bear the onus of making the choices they do.
It may be unfair to a child to deny him or her treatment because his parents refuse to vaccinate, but it's far more unfair to ask infants too young to be vaccinated, immunocompromised children and anyone whose vaccination has been 100% effective, to put themselves at a greater risk because someone has made an unhealthy and unscientific medical choice.
LS: then why do you have a problem with vaccines? Congress has not given them protection from unsafe product liability; this is an urban legend.
I think that in general, it is better to not fire patients for nonvaccination. In addition to the rare legitimate reasons (allergies, certain immune conditions, etc) that will lead to some children not being vaccinated who attend your practice, it is also punishing the children for the decisions of their parents. Perhaps during an outbreak you may want to handle them differently, but the rest of the time, I don't think they ordinarily present that much more risk. Now, if it's part of a larger pattern of refusing your advice, or if the parents are refusing advice on much more serious matters, such as cancer treatment or the management of diabetes, you might have bigger liability concerns. But otherwise, I think it's not worth driving them away for that. I like the comparison to smokers; if you fired everyone who ignored your advice, you'd have no patients left. And poor care is usually better than no care.
Can we not say "Western medicine" please? Can we just call it what it is: medicine?
Calling it "Western" medicine just gives these quacks some feeling of justification in making a distinction between actual science- and evidence-based medicine and their quackery.
Also, calling it "western" medicine can be insulting to those non-westerners that practice medicine.
Hit post a bit too quickly, sorry about double posting.
I think firing patients is wrong due to the principle of autonomy. We give the information, risks, benefits, etc... but patients have the ultimate decision in what they want to do. They deserve treatment even if they are doing something we consider detrimental to their health. From an individual practitioner's point of view, at least. Public health policies are a different matter. (Personally, I believe anyone not vaccinating is recklessly putting other people in danger.)
News Flash! Patients are the boss and they fire the doctors! Not the otehr way around. Got it?
Somehow liberals suddeny think doctors are in charge. PATIENTS ARE THE BOSS! The doctor is the employee. The employee can get fired from the employer. At least that's how it used to be.
Same way with lawyers. Fire their ass if they do not perform according to needed services. Any doctor who would try to force vaccination needs to be stripped of his degree and deported immediately. He is a threat to freedom and the nation.
Hear that. Parents are the boss. They get to come into your practice and tell you how to do your job. They have every right to force somene to provide substandard care and they aso have every righ to kill their children through neglect too ya know.
What about the doctors freedom to practice medicine as he or she feels is right? How can you force a person to do something they believe to be wrong? Can a customer force a chef to lower their standards?
get over yourself. If you wat to be a liar who promotes poor science in the name of freedom then by all means go to a naturoquack. But please, don't try to force someone else to submit to your delusions
The patient is in charge. if he/she does not want an operation or a certain type of medicien, then the patient can freely get up and walk out and fire their doctor. get over it. Doctors cannot force patients into treatments. End of story.
Doctors can practice whatever they feel is right, but if a patient refuses such treatment, then the pateint can walk out and go home and never come back. The doctor is fired! get over it.
Yes customers can control what they partake of. it's called free market and only conservatives would know how it works. You don't. The chef can fix whatever he likes, but if the market for it is not there he will be out of a job. get it? No ne would "bail him out" either. You can't serve raw neckbones and tongues in a classy steakhouse. Customers will not buy it. Economics 101.
Kill children? You mean through abortion? 55 million and counting as of last january. Looks like YOUR policy kills more children than mine.
I was also referring to grown ups, not children. A grown man or woman does NOT have to accept any form of treatment or operation that he/she does not want. If one denies chemo then it is their own personal private sovereign right to do so and no one on this planet has the authority to over rule it. They may think that they have such authority, butthis type of thinking is what invented the word asshole. Morons who think they can control someone else are usually pretty useless.
naturoquack? Yeah tell that to the injured victims of your aluminum vaccines.
Look, some vaccines may be "necessary" but Gardasil is not one of them. I know big pharma and a bunch of neo nazi assholes are pushing for boys to get this vaccine. The easiest thing is abstinence, not vaccines. vaccines do not prevent nor cure sin. Even is this sex disease vaccine becomes mandatory, it still will not prevent extramarital sex from being a sin.
get over yourself and stop promoting sodomy. Stop trying to force your secular depressive 1967 hippy views on children. That in itself is a sin. If only vietnam had not happened and the beatles never existed. What a better world we would have. The hippies and druggies and godless fascists would have never took over.
"Medicien Man" aka Rob Hood @ 15 & 17:
Gee, Rob, couldn't you think up a new 'nym for a different blog? You have to reuse one that has been banned for sockpuppetry over at Orac's place?
And now you're back on the vaccines & sodomy & Nazis shtick. No mention of "flouride" or HAARP or Canadians yet? You must be losing your edge.
NJ still has his face stuck up a possum butt. It must be his version of quantum jumping. If only he would take his mother's underwear off of his face so that he could see where he is going, he might not fall down so much.
Nj is one of those sneaky little fartblossom stalkers that never knows when to quit being a pest. he could qualify as a new species of pest. Maybe he has pine bark beetles in his butt. Explains the mindless stalking.
@NJ
FIFTY!
BFF (Beans, Farts, Frowns?)
Last night I saw a child that was teething (3 am, good example of "night").
I'm an ED doc, not a paediatrician. The child had had no vaccinations (parent choice, not child). Parents refused "chemicals" for the child. Parents were concerned that the child was in pain and would not sleep.
The obvious choice was paracetamol (Tylenol in the USA), but the parents refused "chemicals" for the child.
In that situation, what can a doc do? All I could do was advise effective treatment. If the parents are not prepared to accept the advice given then the child continues to suffer. I can't "fire" the patient.
I ended up being very unhappy about a child that I knew I could help, but the parents were refusing to accept that help. It's very much like parents refusing to immunise their child. If they do not wish to accept the benefits that medical science can offer, then why do they present at an ED at "ungodly" hours then refuse all assistance?
If this comment has a point at all, then I guess that it's a retorical question.
If parents are refusing to accept medical science (vaccines, analegesics, antibiotics) then why, when they perceive that there is a medical emergency with a child, do they resort to doctors or emergency departments?
Is it that they recognise that CAM is useless, or is it that CAM practitioners recognise they are useless and so never offer after hours services?
Sorry that this comment has a pretty lame ending, but I think it is a serious question. Why, when things come to the crunch, do people seek the opinion of modern medicine and abandon the woo that they previously have held in high esteem?
Woops, analgesics, not analegesics.
1. I'm a libertarian so I actualy respect the free market.
2. It goes both ways. You can't force a doctor to serve someone in a way that they know to be wrong. Their practice. Ther private practice. I find it odd conservatives only value freedm when it's something they want but then infringe on someone elses privacy when they disagree.
3. You seriously tried to cange the subject when I called you out on the limits of your perceived freedom?
Yes.
If you won't trust your doctor to inform you, why are you still going there, for a start.
And if you're contagious and proud of it, then you're endangering all the other patients of the doctor, so if I were their patient, I'd want you out too. And there are a lot more of "us" than "you", and in a democracy, you know what that means, don't you?
If the doctors colluded to ban you (or similarly for health insurance companies), then this would be wrong. If only under current collusion laws.
"It may be unfair to a child to deny him or her treatment because his parents refuse to vaccinate"
Only to the same extent as parents are unfair to deny children treatment. Or that the laws say that the parents can refuse.
So until those two unfairnesses are addressed, so what if it's unfair to the child? There are two other options to redress the unfairness, and at least those alternatives would work: making the doctor responsible for changing the parents minds relies on the parents being able to change their minds.
Well, if I was a physician in a malpractice-suit-rich environment, I'd do the same, rather than face charges when some precious snowflake coughed his lungs out while contaminating the rest of his classmates. Most laws tend to assume parents are relatively well-informed and have their children's best interest in mind, but one of the two is clearly untrue for people who allow their children to go unvaccinated. Choosing to believe a well known hack who decided to capitalize on parents' inability to deal with the realities of having autistic children without someone to demonize. 300 years ago they'd probably be blaming witches.
So, Medicien Man, now you support slavery? Where only the boss can fire you, but you have to keep working as long as the boss desires it?
Who determines that every child needs the same amount of vaccinations to achieve immunity? One size does not fit all in any other area of medicine except vaccinations. Universal vaccination recommendations don't take into account that we are not all one, and the same.
Some people are genetically more susceptible to cancer, colds, flues and infectious diseases than others (suppressed immunity). Some are more genetically susceptible to inflammatory conditions, allergies and autoimmune disorders, such as rheumatoid arthritis and lupus (over-active immune response).
One of a patient's greatest complaints with the medical system is that doctor's do not listen. They know better. But, we are not cookie-cut-outs of each other. We are individuals who all react differently to medications (including vaccinations) and we 'present' differently with different illnesses. Their blindness to these facts are hard to understand.
"Who determines that every child needs the same amount of vaccinations to achieve immunity?"
Nobody.
"One size does not fit all in any other area of medicine except vaccinations."
Except that's the opposite of what you said earlier.
"is that doctor's do not listen."
Given this is about patients who don't listen, rather off the point, isn't it?
Now, if your doctor "won't listen", why do you want to keep them? Why aren't you leaving? And if you are going to leave, why does it matter that they fired you? Just say "Nuh, uh, you don't fire me, I quit!".
@Rachel #28: Can you provide some evidence that peoples' susceptibility to immunization from vaccinations varies on an individual basis? Or, to start, that vaccines even follow a dose/response curve? From what I understand of how vaccination works, the following should all be true:
1. Vaccines work in an 'all or nothing' fashion.
2. The quantity required to have an effect is fairly consistent from person to person.
3. There are no negative consequences of giving someone more of a vaccine solution than is strictly required.
There are, of course, significant negative consequences from giving someone _less_ of a vaccine than is required.
Can you point to anywhere in the scientific literature that states otherwise?
@Rachael
Can you explain how a parent determines this perfect dose needed to impart immunity on her child, that a doctors wouldn't know about?
Did you ever wonder why some people don't get the flu? Why under the exact same conditions of exposure to germs do some people get sick and others don't?
âMany people might conclude that if you are exposed to a virus and you donât get sick, itâs because the virus didnât stick or it was so weak, it just passed right through your system and your system didnât notice. Thatâs not a correct notion,â says Alfred Hero, professor at the University of Michigan College of Engineering and author of the study, which was published Thursday in the journal PLoS Genetics.
He continues, âThere is an active immune response which accounts for the resistance of certain people getting sick, and that response is just as active as the response we all know and hate, which is being sick with the sniffles, fever, coughing and sneezing. Itâs just that the responses are different.â
Some people have naturally resilient immune systems and a powerful ability to combat invaders.
http://www.msnbc.msn.com/id/44275043/ns/health-cold_and_flu/t/why-some-…
Yes, doctors have the right to kick the parents out of their practice.
The issue goes much deeper: if a child gets a disease that would have been preventable by vaccination, then health insurance should refuse to pay for follow up treatments if the parents did not listen to the doctor. They should pay! If they believe they are the boss, they should take full responsibility for the consequences (in my opinion, if the child dies, they should go to jail!).
Marnie said: "Can you explain how a parent determines this perfect dose needed to impart immunity on her child, that a doctors wouldn't know about?"
************
Vaccine Blood Titer Tests, however, doctors are hesitant to adjust any clinical regimen they have adopted or is accepted as "usual and customary." All children are vaccinated with all doses of vaccine, regardless if the additional doses are needed to create an antibody response. Vaccination protocols should not be a one-size-fits-all healthcare.
http://drtenpenny.com/titer.aspx
Did you ever wonder why the majority of people never get cancer?
"Every year, millions of people are diagnosed with cancer - a remarkably high number. But what about the flipside of those statistics? That is, two out of three people never get cancer, and more than half of heavy smokers donât get cancer, either. A recent study points out this overlooked fact, and suggests that researchers might discover something by asking why so many people are resistant to the often deadly disease."
http://www.physorg.com/news151840958.html
@Rachael,
I seriously don't know what your argument is. You are saying that doctors should not ask patients to leave who refuse vaccinations, because some people never get cancer or are more resistant to flu, and your argument is that you can do titers on people who have had vaccinations. I don't believer there's a titer for lung cancer resistance in smokers but that wouldn't apply to children's vaccinations regardless. The question is not about whether titers are effective to determine if boosters are needed, this is a question of whether doctors should refuse to allow patients who take the unnecessary risk of not vaccinating their children.
But let's go ahead and just take your arguments at face value; that some people have less need for vaccinations than others because they are naturally more resistant to getting sick from an illness. This is like arguing that chefs shouldn't have to wash their hands if they are more resistant to ecoli or salmonella. It's not just about the individual. Since the risk of vaccines are incredibly low and there are people who cannot be vaccinated or whose vaccinations are not effective because of illness or medical treatment such as chemo, vaccinating protects not just the individual but everyone that individual comes in contact with. You may not experience a strong reaction to an infection but you can still carry and transmit the disease.
If your personal wellbeing is not adversely impacted from being vaccinated, and if the vaccine protects you and other people, it's, minimally, selfish and at worst, a public nuisance, to forego vaccination.
This comment applies to the *same* thing as the whole "why do some people not get cancer".
So, here goes. 1. Some people have naturally higher responses, but not necessarily to all diseases. Its a crap shoot. 2. Getting one thing isn't a huge problem, being exposed to several at once, can result in your immune response being so overworked, in that time period, that it can't fight off *all* of them, so one of them will nail you. If that happens, the stresses get even higher, and you can, again, catch more as a result. 3. Some things you simply can't avoid, but you might not, depending on the strain, be effected as long as someone else. You can, however, pass it to others. 4. Some people have such a non-response to a disease that they become "Typhoid Mary" types. They don't "fight off" the disease at all, they host it. They will literally never suffer the symptoms, but their body doesn't kill the disease immediately (if ever, without treatment), so they infect dozens, hundreds, possibly thousands, who don't have that response, because a) not knowing they have it, they never get treated, and b) their immunity doesn't convey itself to those around them.
Finally, taking herbs, eating right, and all the other BS that quacks suggest has been shown to have ***insufficient***, and sometimes *no* effect on whether you recover faster, whether you avoid infection, and how many people you infect, if you do end up with the disease. The only means to do any of those things is a) prevention, which involves "priming" the immune system to respond to the disease, i.e. vaccine, b) treatment, which involves medicine, not herbs, magnets, or the like, and/or c) isolation, so you don't infect everyone else, while you have the problem.
Cancer is similar, in that while its not transmittable, save where viruses are involves, like HPV, in which case all of the above matters, otherwise, its **purely** whether or not you have a genetic susceptibility to certain factors, which make it more likely to get some form of it. While some dietary factors can have an impact, they do not "prevent" or "cure" cancer, if you are at extreme risk. At best, they might delay it, or provide "some" people with a bit of help in regressing it. But, since ***every single*** cancer type is different, involving different active genes, different causes, and thus different characteristics, its also quite probable that what helps fix cancer X might actually make cancer Y worse, which is why targetting the cancer with something to kill it, instead of relying on guesses about how your diet might "help" or hinder, is more effective, and in the cases of some, might not do more then help you live a bit longer, even if you do *everything* possible to try to stop it.
Yeah, there are differences with some people. But the amount of vaccine given is within the "this is how much people in general need", precisely because it would cost 50 times as much to "special dose" it, and doing so isn't really necessary. If you want to look at who is making money off this, here is a hint: A vaccine might "cost" $7 a dose someone had a case a while back where they where being charged $150 for something like that, and the Pharmacist looked up what the actual cost of the product actually was). That is $143 of added cost, all of it in paperwork, having to deal with multiple insurance companies, instead of one, legal BS to cover their asses, if something goes wrong, general operating costs, and a lot of middle men, all of them trying to take a cut, not because "Big Pharma" is selling us $150 vaccines, but because they are selling us a $7 vaccine, and the state/fed/insurance industry, etc. are all allowing **everyone eles** to pad the samn bill to where it is over 21x higher than needed.
Now, lets look at the "nature" types though. Among their list of things that they provide is a) homeopathy, b) herbal suppliments, and c) referals to things like reflexologists, and the like. In terms of cost, you might get "charged" $50 a bottle, $100 a bottle, or $200 for a referal, without even adding the cost of the "treatment", which, depending on how dishonest they are, might be $500 a session, or more. The actual cost - 10 cents, for the homeopathy, $5 for the herbs, $30 for the referal and fake treatment. Though, in the later cases, it might cost the same, if they called themselves a massues/masseur, but at least they would be honest about what they are doing.
That is a $500 percent marck up, 20x markup, etc., and they don't even **have to** do any of the paperwork, deal with middle men, lab work, etc. that hikes the costs of the real thing. Its nearly 100% profit, as apposed to maybe 10% profit for the doctor being slandered as "providing unneeded things, at high costs".
Oh, and seriously, Gardisil? Some poster is still ranting about this? How many times do people have to point out that it isn't even used in most vaccines, and hasn't for decades, in those given to children? Oh, wait, sorry. Facts and evidence is meaningless, sort of like Chemtrails, it doesn't matter if there is no evidence for any of it, one just needs to believe they exist. Here is an idea, squirt vinegar at it. That works for chemtrails. I saw it on Youtube...
Cancer is a disease which manages to defeat the immune system. For years cancer immunologists assumed that the cells of the immune system simply couldn't recognize tumour cells. New evidence indicates otherwise. In a study designed to investigate exactly how cancerous cells defeat the immune system, a collaborating group of scientists found some very interesting results.
"Characterization of circulating T cells specific for tumor-associated antigens in melanoma patients".
http://labs.fhcrc.org/pgreenberg/Publications/10371507.pdf
Joe:
I find this line of logic fascinating. You could please give us the actual data that shows it is more cost effective to treat an illness instead of preventing it? Having seen how much it costs for someone to be in the hospital for two days ($20,000 and rising), I am curious how the over 7000 hospitalizations in Europe from measles is actually saving money versus providing each child with two MMR doses (plus at least six deaths in France).
Please do come up with some real evidence to show that it is too costly to vaccinate, but hospital treatment is a bargain (along with the occasional funeral).
Twenty years ago there was a measles epidemic in the USA, here is a paper on some of the costs:
West J Med. 1996 Jul-Aug;165(1-2):20-5.
Pediatric hospital admissions for measles. Lessons from the 1990 epidemic.
We also go to a family doctor. Yes, he makes sure we are all properly vaccinated.
Rachael, yes, we know why some people get sick and other don't: different codons. Go look it up.
And, Rachael, I have a financial question for you: How is getting blood titers (which require a full blood draw) safer and cheaper than being vaccinated. Please provide real documentation, not from someone's website. Provide the journal, date and title of the PubMed indexed. Some examples below:
Arch Pediatr Adolesc Med. 2005 Dec;159(12):1136-44.
Economic evaluation of the 7-vaccine routine childhood immunization schedule in the United States, 2001.
J Infect Dis. 2004 May 1;189 Suppl 1:S131-45.
An economic analysis of the current universal 2-dose measles-mumps-rubella vaccination program in the United States.
Pediatrics. 2002 Oct;110(4):653-61.
Impact of universal Haemophilus influenzae type b vaccination starting at 2 months of age in the United States: an economic analysis.
Vaccine. 1998 May-Jun;16(9-10):989-96.
A benefit-cost analysis of two-dose measles immunization in Canada.
Why do some people get sick and others don't? Did you know that even though approximately one third of the world's population has been exposed or infected with Mycobacterium tuberculosis, only 10% have become ill; that some people infected with HIV never develop full blown AIDS and some people have a natural immunity to HIV? Infection from a superbug (MRSA, c difficule) is an opportunistic infection and can be completely harmless in a healthy person. But, let's treat everyone like they are all immune-compromised carbon copies of one another, instead of finding out why some people have such resilient immune systems?
Seeing the comments from these anti-vaxxer wackos makes me think pediatricians should be firing parents for stupidity.
Rachael, you are making no sense. Take a beginning biology class.
I KNOW, RIGHT? It's not like anyone is doing research into that, right? I mean, it's not like any researcher who would figure this out would instantly become so gobsmackingly rich as to be able to laugh at the $1000000 that comes with the Nobel prize that would follow within a week or so, right?
You're implying that every single medical doctor and researcher in the world is corrupt and/or dumb as toast. Now, would you care to calculate the odds of that versus you being wrong?
Rachael, as I said before, the ***biggest*** single factor is genetics. The second biggest is chance. The first you can't fix, short of genetically engineering everyone the same, and that is stupid, since immunity to one disease often means susceptibility to another. Sickle Cell vs. Malaria, for a famous example of this. As for luck. Right time, right conditions, right "version" of a disease, and you are fine. Being the one bloody person in a room that doesn't get sneezed on, and you are fine. But, if you are trusting on bloody luck to save you, then the larger the number of other idiots trusting luck too, the higher the odds that one, or all, of you wins the virus lotto, and comes down with something deadly. And, that isn't a lotto you want to win, never mind, if you are not a total asshole, want you kids to win.
"You could please give us the actual data that shows it is more cost effective to treat an illness instead of preventing it?"
Chris, though the paediatricians aren't making the money off it, a *treatment* is like a bank loan to the bank: a guaranteed income. A cure is like paying off your debt to the bank: the end of that income.
The *drug companies* create treatments because they profit from them. The paediatricians offer treatments because nobody is making cures.
This, though, has BUGGER ALL to do with vaccines, since they're not treatments, they're cures that have to repeat because of evolution.
But someone who distrusts doctors when confused about this can transfer the blame onto the wrong people. This may be where Joe's rant comes from.
Doctors, of course, get wined-and-dined and marketed to by the drug companies so that the more expensive "new and improved" version is used. However, the companies also lobby government to ensure that cheap imports and generics are to all intents and purposes banned.
"if a child gets a disease that would have been preventable by vaccination, then health insurance should refuse to pay for follow up treatments"
NO!
NO NO NO NO NO!!!
The child, the only one NOT getting a choice, should not be punished.
The parents are guilty of harm, attempted murder even, of their child and the child removed from the parents when the state or foster parents can treat the child.
Medicare/medicaid should not be offered to the parents. Insurers should refuse to pay for care that was necessitated by complications of problems to the parents *and only the parents* of their wilful refusal of treatment, making the cost of treatment higher.
But if the child CAN get treatment, they MUST get treatment. They are the only blameless one here (the doctors only getting blame for not lobbying to get the damn law changed, far more of that blame belonging to the politicians).
If responsible pediatricians "fire" families that decline immunizations, these families will end up with some sort of disreputable practitioner who agrees with them . Many of my pediatric colleagues refuse to see children whose parents will not allow immunizations. Some of these families find their way to me, and ask if I am "ok" with not immunizing. I explain that I am not ok with it, and attempt to give them a sense of the magnitude of the scientific edifice that they are rejecting. Then I explain that I am willing to see their children, and that I will not browbeat them, even though I know they are wrong. Some eventually see the wisdom in my arguments.
As to the fortune I make on shots, be aware that I am reimbursed approximately my cost (months later, and only if I submit the bills perfectly), if the insurance company "remembers " to adjust for price increases. This is not adjusted for any waste or loss (an employee once threw three thousand dollars worth in the trash) and does not include all the ancillary costs. (See the American Academy of Pediatrics for details.) I'm lucky to break even, and the labor (and the unpleasantness of hurting children, and the challenge to my relationship with my patients) is unreimbursed.
"these families will end up with some sort of disreputable practitioner who agrees with them"
But since they'll only do what they agree with, not what the reputable doctor requests, the net result is that the parents who don't want to do what's necessary don't do it, but at least the other patients of that reputable doctor aren't at risk.
Wow, how about answering the question I actually asked. How is it more cost effective to treat a disease (like measles) than to prevent with a vaccine like the MMR?
I want numbers and data from actual sources, not illusive hand waving like "The *drug companies* create treatments because they profit from them. The paediatricians offer treatments because nobody is making cures." The hint to the type of answer I wanted should have been the papers I provided, which did provide real data and numbers.
And I wanted Joe to provide that data.
Here is the paper that dcotler mentioned: Cost of Vaccine Administration Among Pediatric Practices. Take note of the conclusion:
So really, Joe, explain to me clearly with well documented data how treating a disease is more cost effective than preventing it with a vaccine.
"how about answering the question I actually asked"
I wasn't answering that question for very explicit and solid reasons. It's irrelevant. But if you insist.
If you "treat" a disease then you have treatments. If you cure it, then you can't sell any cures nor any treatments.
Buying a cure once is cheaper than buying a treatment for a lifetime.
Also note that if you eradicate the disease (smallpox anyone?), then not only are there no sales from the currently ill, but all future revenue/cost of healthcare for that extinct disease has disappeared.
I had thought this would be so obvious that it wouldn't require any explanation.
If you want it in Free Marketeer terms: is it cheaper to rent or buy your house in the long term?
Answer: Buy.
Where's your data? I said "I want numbers and data from actual sources." Was that unclear?
Show me the actual evidence that treating a disease is actually cheaper than preventing it through vaccination. If it makes it easier, just choose a disease like measles, Hib, or pertussis.
Also note I never said "cure." Some of these diseases do not have permanent "cures", especially if they result in death. Once you get chicken pox, you have it forever, which is how we get shingles later. And once you get pertussis, you have a chance to get it later much like most bacterial infections (it is the same for diphtheria, tetanus and even strep, the reason there is no vaccine for strep throat).
Plus, measles, Hib, rubella and mumps can cause permanent damage, for which there is no "cure." In the recent past measles and Hib were major causes of permanent neurological damage, along with congenital rubella syndrome: Impact of specific medical interventions on reducing the prevalence of mental retardation.
So stop hand waving, and let Joe answer the question.
@Wow
And how did smallpox get eradicated? How is polio being eradicated? I don't think your arguments support the point you are trying to make. You've just proven that
1. Doctors want to eradicate disease.
and
2. Vaccines are an effective way to do so.
With hand waving there is always a danger of hitting yourself in your own face.
But pharma doesn't. Therefore they don't mke or push cures, they prefer treatments.
And, being human, doctors are suceptiboe to advertising, and can also only offer what they have available.
Drugs in the USA are over prescribed. Partly as well due to the patient who "pays 1500 a month, so don't fob me off with 'it,ll get better on its own, I want drugs!!!" a doctor they think isn't prescribing 'their money's worth'.
And your data is...? Please limit your answer to diseases that have vaccines, and actually answer the question that was asked.
Plus, what vaccine in the current pediatric schedule costs $1500?
Perhaps you are getting two threads confused. The question is: How is it cheaper to treat for a vaccine preventable disease like measles, pertussis, tetanus, etc, than to prevent the disease with a vaccine.
For instance, a child who catches haemophilus influenzae type b will get very sick and require hospitalization (video of one family's experience). How is that better and cheaper than paying a total of $100 for the Hib vaccine series?
Again, please stop random hand waving and actually provide some real data for your answer.
Okay, I am trying to make it very easy for you now. This is a scientific paper with economic analysis for several vaccines: Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001. I am expecting Joe to come up with a similar bit of evidence.
In the results it says:
And it concludes that:
Now using actual data and evidence, please explain why they are wrong.
I cannot understand how anyone still believes that physicians who provide immunizations are making big-time money off them. Vaccines are, like any other medicine, expensive to develop and expensive to manufacture and the cost to the private physician and to the government are not cheap:
http://www.cdc.gov/vaccines/programs/vfc/cdc-vac-price-list.htm
When you add up the costs to a busy pediatric practice to maintain ample supplies of each vaccine, the costs to administer each vaccine, the "waste" factor and the cost to maintain a special biological refrigerator at the correct temperature...it is considerable. Pediatricians, rightly so, are disgusted with the snail's pace of reimbursement from insurance companies. Every pediatrician's nightmare is a prolonged power failure and the "tossing" of thousands of dollars worth of vaccines.
I worked as a public health nurse and I recall a specially-alarmed huge biologicals refrigerator, where the on-duty administrator would have to pack up thousands of doses of vaccines, vials of immune globulin, rabies vaccines/RIG and PPD vials to haul them to area hospitals for refrigeration powered by their generators.
Many years ago when my children were young I valued and respected the pediatricians who provided care to them. Why would anyone seek the care of an alternative practitioner or a pediatrician who lets the parent decide if and when they are going to vaccinate their children? (I knew only too well that my infants were vulnerable to devastating childhood diseases, prior to them receiving the complete series of vaccines.)
Now knowing how some credulous parents feel about immunizations and how some doctors "space out" vaccines or don't give some of the vaccines (Mommy intuition), I would definitely be asking the office staff about their vaccine "policy", even before I made the first appointment.
I would also seek another pediatrics practice, where the standards of care regarding immunizations are followed.
Sorry, Chris, what do you think you're proving?
That cures are cheaper than treatments? But you don't MENTION cures.
Get your head OUT of your butt and take a look at what's being posted, not what you see printed on your colon.
'K?
"And how did smallpox get eradicated? How is polio being eradicated?"
Smallpox: Government intervention. http://www.who.int/mediacentre/factsheets/smallpox/en/
Polio: Governments again. http://www.polioeradication.org/
Not the drug companies.
Chris @51: Also note I never said "cure."
Chris @38: You could please give us the actual data that shows it is more cost effective to treat an illness instead of preventing it?
Now, forgive me if your personal dictionary says otherwise, but cures are how you prevent illnesses.
@Wow
I honestly don't understand your point. You are saying that vaccines shouldn't be administered to people because drug companies aren't the ones administering vaccines? That's like saying that chemistry teachers should be fired for not teaching music. The drug companies design vaccines. Doctors administer them. The government might subsidize the cost. They all have different roles. No one is arguing that drug companies are altruistic entities, but the point of this post is that people who refuse vaccines put others at risk and that doctors have to decide if the risk to their other patients outweighs his or her responsibility to the unvaccinated child.
What point are you trying to make? I wonder if you even have one. You seem more interested in completely unsubstantiated conspiracy theory.
Wow, you just proved my point. Vaccines are more cost effective by preventing the diseases when compared to treating the diseases. If you think you said anything contrary to my point, then work on your reading comprehension.
Vaccines are not cures. They are preventative measures that teach the body how to recognize and deal with the infections before they make a person sick. I never said "cure", that was all you with your odd interpretation of English.
And if you had read the article I posted on vaccine economics, you will see they were from the National Immunization Program, Centers for Disease Control and Prevention, a government agency. You will also notice that smallpox was not one of the vaccines listed as being used on children in the USA.
Also, most of the vaccines in the USA are bought and paid by the government and distributed to the states and counties. This is part of a program created to get children better immunized after the measles epidemic a bit over twenty years ago.
Now, I am still asking Joe (no, not you, Wow, you seem to be a bit lost) to show me how it is cheaper to treat for measles instead of paying for two MMR doses.
Chris, pediatricians make 90% of their revenue from well-baby visits. The only purpose of these visits is to vaccinate.
In 1962 I was in 2nd grade. Out of 300 kids, at one point over 250 were out with the measles. Not one kid went to the Doctor or hosp[ital. Now it costs $770.000.00 to contain one case. Mind boggling.
I am sorry, but I cannot verify your answer unless you provide actual data.
In 1962 almost every child in the USA had measles by the time they were fifteen years old. The data from the CDC Pink Book Appendix G shows that in 1962 there were 481,530 cases of measles, which resulted in 408 deaths.
What a coincidence, that is the year that Roald Dahl's daughter died from measles.
You were asked to provide actual data and evidence to show that it is cheaper to treat measles than to vaccinate with two MMR doses.
Perhaps you should tell the Europeans what they are doing wrong: European countries must take action now to prevent continued measles outbreaks in 2012:
Those numbers show that there are about about one quarter of the cases are being hospitalized, and at lease one death per 3000 cases.
So, really, Joe, tell us how much money France is saving.
Do tell us how Japan saved so much money as noted in Measles vaccine coverage and factors related to uncompleted vaccination among 18-month-old and 36-month-old children in Kyoto, Japan:
@Joe
Really, the only thing that happens at a well baby appointment is vaccination? I can be vaccinated by a nurse. In fact, all my vaccinations have been administered by nurses. It's hard to take you seriously when you make completely bogus claims without even a hint of irony.
Every minute spent on a child of an anti-vaxxer is a minute that could have been spent on a child whose parents will follow medical advice. It's unethical to keep accepting the money of people who think they know more about medicine than you - you are just giving them false peace of mind.
Oh: and they are also exactly the kind of person who wil blame you first if anything goes wrong with their health - regardless of the poisonous rubbish or stupid fad diets they have been subjecting themselves and their families to.
Chris, you are not providing data. You are providing propaganda from the vaccine manufacturer's trade groups, the CDC, WHO and the AAP. Why would anyone go to a hospital for measles? There's nothing they can do but run up your bill. You need to stay home for a week. Thats all my entire family (5 kids) had to do. Thank God for "Leave it to Beaver".
Marnie, don't be a total bimbo. Pediatricians do make %90 of their money from well baby visits. I don't care if their nurse administers the vaccines. If it wasn't for vaccines at every two month interval, their business would die.
12:13 of the video - Greg: "Boy this is the life isn't it?"
Marcia's response: "If you have to get sick you sure can't beat the measles."
Watch, this Brady Bunch episode (Is there a doctor in the house?) and you will see that back in the late sixties, early seventies, people were not panic-stricken over the measles, like they are now-a-days. I know it's just a television sitcom, but I grew up in the sixties, early seventies, and no one ever panicked over the measles. The threat wasn't exaggerated like it is today and measles certainly didn't make headline news.
http://www.blinkx.com/watch-video/the-brady-bunch-is-there-a-doctor-in-…
The brady bunch? Really? That's your evidence measles isn't harmful?
Prior to vaccination measles caused hundreds of deaths a year. From the CDC:
People feel the same way about chicken pox. Familiarity breeds contempt. I got really sick from chicken pox, and developed ITP. A family member of mine was hospitalized at the same time for bleeding complications, also from ITP. I shudder to think what would have happened if I had needed a blood transfusion at that time given it was 1982. Got lucky. I only needed to be removed from school and all activities for 3 months with twice weekly platelet counts.
Rubella used to cause thousands of cases of birth defects a year. haemophilus influenza used to cause the majority of bacterial pneumonia in children prior to introduction of the vaccine. Thousands of cases a year.
Oh yeah. no big deal. Just because you haven't personally seen the complications of these illnesses doesn't mean they don't exist and can't be deadly.
Doctors and other health authorities often try to frighten parents about measles by exaggerating the risks. The CDC claim that 1 out of every 1000 children who contract measles will get encephalitis, an infection of the brain. The incidence of 1 in 1000 may be accurate for children who live in conditions of poverty and malnutrition (third world) but for just about everyone else "the incidence of true encephalitis is probably more like 1 in 10,000 or 1 in 100,000 and 75% of these cases will not show any evidence of permanent brain damage.
In the 1950's and 60's, most children in the United States and Canada caught measles (before the vaccination). Complications from the disease at this time were very unlikely because of improved living conditions and modern medicine. Previously healthy children usually recovered without incident.
Vaccinations against measles (decline to non-protective levels within 5 to 10 years of vaccination ). Measles was once an ordinary childhood disease. The MMR vaccine did not eradicate measles and it looks like it never will. All it did was shift the natural epidemiology of the disease from children, putting adults and infants at higher risk of catching it and an increased potential for more serious consequences, in these age groups. Infants who once had immunity until 12 months and young adults are now at much greater risk of contracting measles, when complications are more likely to occur.
Medical authorities like to give the impression that measles can only be kept under control by vaccination, but there is another side to the story. According to figures published in International Mortality Statistics, from 1915 to 1958 the measles death rate in the U.S. and U.K. declined by 98%. A chart illustrating the decline was published in a Public Health Report: âMortality in the United States, 1900-1950.â The measles vaccine was introduced a few years after the decline, in 1963. The decline was not due to the vaccine, so most likely it was due to better sanitation, nutrition, and standards of living in the U.S. and U.K. Today, measles is a mild disease in first world countries but can be more severe in third world countries and in impoverished populations in the first world.
Total nonsense. The numbers are real. There were thousands of deaths prior to introduction. Virtually none now. Such is the case with every other introduction of a vaccine. And the denialist response is always the same. It was improved sanitation yada yada. Even though each of the vaccines was introduced at different times.
There is no evidence kids are at a greater risk now because measles has been virtually eliminated with fewer than 100 cases a year.
The unbelievable inhumanity of the vaccine denialists who think the better state of health was prior to introduction of MMR, to polio vaccine, to smallpox, to tetanus, is shocking. Thousands died. Thousands had complications. Before polio vaccine parents were in terror every summer over outbreaks that would strike their children down from perfect health. This was better? This was more healthy? Being paralyzed? Children being born blind in the thousands? Deaths from measles and tetanus and diptheria and HiB?
Vaccines are one of the most effective health interventions in the history of humanity. Besides aseptic technique and antibiotics, what else has saved so many? Certainly not the vaccine denialists. They are disease advocates. Advocates of death.
The only people in denial are you guys!
Do you know that in the UK they don't even vaccinate for chicken pox. The chickenpox vaccine is not part of the uk routine childhood vaccination schedule because chicken pox is a common childhood infection. In most cases the symptoms are mild and complications are rare. Almost all children develop immunity to chicken pox after natural infection, so only catch it once.
Dr Shiv Chopra vaccine and drug regulator for Health Canada (equivalent of FDA in US) for nearly forty years points out that vaccination did successfully eradicate smallpox. The possibility of eradicating polio in the same way is open to scientific debate. However he also observes that all the other childhood diseases have been unsuccessfully fought with vaccination campaigns involving millions of children every year. Worst of all, these diseases are appearing with increasing frequency in the very populations that have been vaccinated for several generations. Clearly, something is wrong with these programs, the vaccines themselves, and he finds it alarming that âthe list of vaccines being administered to young children has been enlarged to include many more viral and bacterial infections with little or no scientific rationale.
http://www.kospublishing.com/html/speaking.html
"Informed parents know that hepatitis B is not like polio and that chicken pox is not like smallpox. They know the difference between taking a risk with a vaccine for an adult disease that is hard to catch, such as the blood-transmitted hepatitis B, and using a vaccine to prevent a devastating, highly contagious childhood disease such as polio.
All diseases and all vaccines are not the same and neither are children. Parents understand the qualitative difference between options freely taken and punishing dictates. They are calling for enlightened, humane implementation of state vaccination laws, including insertion of informed-consent protections that strengthen exemptions for sincerely held religious or conscientious beliefs. This is especially critical for parents with reason to believe that their child may be at high risk for dying or being injured by one or more vaccines but cannot find a doctor to write an exemption."
http://www.whale.to/m/fisher8.html
Canada has been experiencing a large measles outbreak. More than half of the cases may be among people who have been âfullyâ vaccinatedâthat is, they had received all the mandated doses.
Measles is supposed to be a disease of the past, one thatâs been wiped out by vaccines. What went wrong?
All sorts of excuses are being made, from blaming the unvaccinated to blaming immigrants to suggesting that the vaccine schedule isnât aggressive enough to wondering if a pool of âsusceptiblesâ has been building up over the years.
http://gaia-health.com/gaia-blog/2011-10-27/canadian-measles-outbreak-h…
You just cited whale.to.
You are a crank.
There is no reasoning with cranks. We are done here.
And you a what I call a clever/fool...a little bit of book sense, but absolutely no common sense; just believe everything you are fed. I am quoting an article by Barbara Loe Fisher, President and co-founder of National Vaccine Information Center and someone who had a child injured from a vaccination.
Rachael @ 79:
Fixed that for ya.
Barbara Loe Fisher, President and co-founder of National Vaccine Information Center and the mother of three grown children, her oldest son suffered a convulsion, collapse and brain inflammation within hours of his fourth DPT shot in 1980 when he was two and a half years old and was left with multiple learning disabilities and attention deficit disorder.
http://www.nvic.org/about/barbaraloefisher.aspx
Joe:
You have absolutely no evidence for that bit of conspiracy mongering. Was Roald Dahl also providing propaganda for pharmaceutical companies when he hid a notebook about his feelings after his daughter's death?
And you actually get medical advice from a television sit-com? Now that is delusional!
Rachael, even though you invoked Scopie's Law, I will ask one more question. I am sure you will answer it honestly and with real data. I am going to post some data from a large document that has lots of tables of census data from 1912 to the late 1990s. Now, look at it closely and answer the following question:
Why did the incidence (morbidity) in measles drop 90% between 1960 and 1970 in the USA?
Answer the question as it was asked. Do not provide data from another country, another decade nor mention deaths (mortality). Please provide actual scientific documentation for your answer. Thank you.
From http://www.census.gov/prod/99pubs/99statab/sec31.pdf
Year.... Rate per 100000 of measles
1912 . . . 310.0
1920 . . . 480.5
1925 . . . 194.3
1930 . . . 340.8
1935 . . . 584.6
1940 . . . 220.7
1945 . . . 110.2
1950 . . . 210.1
1955 . . . 337.9
1960 . . . 245.4
1965 . . . 135.1
1970 . . . . 23.2
1975 . . . . 11.3
1980 . . . . . 5.9
1985 . . . . . 1.2
1990 . . . . .11.2
1991 . . . . . .3.8
1992 . . . . . .0.9
1993 . . . . . .0.1
1994 . . . . . .0.4
1995 . . . . . .0.1
1996 . . . . . .0.2
1997 . . . . . . 0.1
"In most cases the symptoms are mild and complications are rare. "
Usually. Except when they aren't. And mild refers to 7-10 of an intensely itchy rash with some fever, with quarintinme. Oh, the death rate is only 1 n 20K, so a lot better than the measles.
Meanwhile, the vaccine has maybe a day of low-grade fever, with some soreness and redness at the injection site (as opposed to all over). And no one has died from it, despite millions of doses.
As for the "life long immunity" nonsense, aside from the fact that it can occur, what's the point of having immunity if you've already had the disease? With vaccination, you get immunity with a ca 90% chance of not even getting sick! What good is immunity. If it doesn't stop you from getting the disease?
I tell you, the "I'd rather kids get chicken pox than be vaccinated" really piss me off. I just usually assume theymust not be parents, because if they are, they are bloody abusive monsters. Jeez, my kids currently have colds, which are mild by any definition, and still they are bloody miserable, and I would do anything to make them not have to deal with it. If it were as simple as a vaccine, I'd be all over ir. But instead we get crap about taking a bunch of stupid supements and how we have to avoid daycare.
There is no comparison between chicken pox and the vaccine. There just isn't any reason not to vaccinate, and no reason to prefer getting the friggin disease. Anyone who would intentionally choose the chicken pox over the vaccine are guilty of intentionally subjecting their children to misery and risk of something serious. Who aside from a monster would do that?
"There is no comparison between chicken pox and the vaccine. There just isn't any reason not to vaccinate, and no reason to prefer getting the friggin disease."
CHICKEN POX: Chicken Pox is a mild disease which was dangerous only for vulnerable populations (eg. cancer victims). Merck Laboratories, the exclusive maker of chicken pox vaccine, persuaded the federal government to mandate the vaccine for all children based on economics. It presented evidence that businesses would save $400 million if parents did not have to take time off to care for children with chicken pox. However, there are many side effects of the chicken pox vaccine which have health care costs associated with them which were not taken into account for the economic analysis. These include: 1 - 27 reasons. Read more:
http://curezone.com/forums/fmp.asp?i=745370
Rachael, my children have all had chicken pox, including a six month old baby. I think that those who think children spending two weeks with dozens to hundreds of itchy open wounds is a very mean, cruel and evil person. Obviously the Curezone is full of mean, cruel and evil people.
Racheal, why was incidence of measles in 1970 only 10% of what it was in 1960 in the USA.
Before the inception of the measles vaccine (1963), from 1915-1958, a 95 percent decline took place in measles death rate (see figure 3). That is, the measles death rate dropped from approximately 13.3 deaths per 100,000 population in 1900 to 0.03 deaths per 100,000 in 1955. Moreover, post-vaccination death rates for measles in the mid-1970s are similar to those of the pre-vaccination years in the early 1960s.(5)
Journal of the American Physicians and Surgeons
http://www.jpands.org/hacienda/article36.html
There is no question of the great benefit of general immunization for such mankind scourges as poliomyelitis, diphtheria, smallpox, etc.; but can we say the same for greatly self-limited rotavirus diarrhea and chickenpox for children, or for the sexually transmitted hepatitis B for infants?
http://www.jpands.org/hacienda/article39.html
Again you cite denialist rags! JPANDS? Really? Don't you know those cranks deny HIV causes AIDS? Whale.to? Your crank clearing house for everything from HIV/AIDS denialism to chemtrails to the conspiracy of reptilians to rule the world? They cite Andrew Wakefield, one of the greatest scientific frauds of the last century per Time magazine, as a great doctor. These are your sources of information? Do you understand how stupid this makes you appear to normal rational human beings?
See this people? This is classic crankery. Rachael shows a complete inability to judge the legitimacy of sources of information, overestimates her competence in judging merits of medical interventions, and in true crank fashion, just goes on, and on, and on, saying the same crap over and over again while ignoring countervailing evidence.
Next she'll compare herself to Galileo and say we're persecuting her. Just wait.
So, it ends now. Stop engaging with her. She's broken. There is no changing the mind of a crank. You might as well argue with the spam bot that posts links to buy Uggs.
Interesting. Chris gave you the data and asked you for an explanation. She explicitly told you NOT to change the subject to death rates. As if she knew that is what you would do.
As for your curezone nonsense, simply repeating the claim that chicken pox is mild doesn't address my post at all, even if you throw in vague references to "serious side effects" of the vaccine.
Yes, the chicken pox is usually relatively mild from a serious disease perspective. But by the same measure, the vaccine is trivial. Moreover, at all levels the complication rates of the vaccine (from mild to moderate to severe to death) are better than those of the disease. It is completely disingenious to compare "the chicken pox is usually mild" to "the vaccine can have severe side effects.". Actually, that's not just disingenious, it's bullshit.
Answer the question as it was asked. Remember I said "Do not provide data from another country, another decade nor mention deaths(mortality)."
I should have added no other diseases.
@Joe #68
Calling me a "bimbo" doesn't make your argument stronger, it outs you as someone who cannot disagree with a woman without resorting to to misogynist ad hominem attacks. Thanks for saving me the trouble of wasting any more of my time talking to you.
What do you call a 1,000 vaccine pushers anchored to the bottom of the Atlantic Ocean? A good start! Bye boys!
Marry Me, Mindy: Why aren't children in the UK vaccinated against chickenpox?
The chickenpox vaccine is not part of the UK childhood vaccination programme, because experts think that introducing a chickenpox vaccination for children could increase the risk of shingles in older people. It is used to protect people who are most at risk of a serious chickenpox infection.
Chickenpox is usually a mild illness, particularly in children. The condition is so common in childhood that 90% of adults who grow up in the UK are immune to the chickenpox virus because they have had it before.
http://www.nhs.uk/chq/Pages/1032.aspx?CategoryID=62&SubCategoryID=63
Sorry, MarkH.
I knew I should not, but I was curious if she was going to give a new contortion. While she threw in the "death" bit, she at least did not try to bring up England and Wales (or Japan), or switch decades, all of which I have seen. She did try to change the disease. I'll add to the limits the next time I ask that question.
It is one of many I have gathered that cranks refuse to answer.
I did think of a way a pediatrician could work with parents who do not vaccinate, and protect vulnerable populations, like babies, in the waiting room. It would be to set up a separate waiting area where both the parents and children will have to don masks and use the alcohol gel. The staff would also be masked, and keep them separated from the rest of the patients.
Yes, it is a bit more expensive, but the children get real medical care. And it is a reminder that the pediatric practice takes infectious disease seriously.
Marnie@91:
Actually, he told you not to be one. Good advice. Take it.
Rachael@92:
Such strong words! Fortunately for "vaccine pushers" if there were such a thing, it doesn't appear you could find your own backside with two hands and a map, let alone a nearby ocean.
Perhaps you should consider heeding Joe's advice to Marnie...
Rachael, why do you consider it acceptable to vaccinate against some diseases but you balk at others? What is your concern? Why wouldn't you want to protect your children from a disease they may not be exposed to until they are adult? Why do you prefer a child go through weeks of measles or chicken pox instead of just avoiding the risk? Why wouldn't you want to contribute to possibly eradicating diseases as we have with smallpox and polio?
Like insurance for your car or home, you may never need either but the little investment up front protects you from something horrible. The same is true of vaccines. Your children may never be exposed to hepatitis or pertussis, but if they are, they are protected. How is that a bad thing?
Sorry, can't resist. The reason the UK does not vaccinate for chicken pox is the same reason it introduced an MMR in 1988, almost two decades when it was introduced in the USA: it is a different country. They make their own rules.
Okay, I will stop. I'll now go find a ruler and rap my own knuckles.
"Rachael, why do you consider it acceptable to vaccinate against some diseases but you balk at others? What is your concern?"
I understood why we vaccinated for polio and smallpox because of the seriousness of these illnesses, but the risk/benefit for vaccinations against Hep B, chicken pox, rotovirus are not the same. As someone with an autoimmune illness (up-regulated immune system) I don't know why we are treating everyone the same. Should I suggest that people start taking immune-suppressants, just in case they develop an autoimmune illness in the future. I, and many people like me, never get flues or colds. There is no cancer in my family. So, why do they treat everyone the same, like their own immune system couldn't possibly defeat a virus or cancer? What are you doing to my immune system and people like me by injecting us over and over again with vaccinations we are not in need of.
As I said post #28 Who determines that every child needs the same amount of vaccinations to achieve immunity? One size does not fit all in any other area of medicine except vaccinations. Universal vaccination recommendations don't take into account that we are not all one and the same.
Some people are genetically more susceptible to cancer, colds, flues and infectious diseases than others (suppressed immunity). Some are more genetically susceptible to inflammatory conditions, allergies and autoimmune disorders, such as rheumatoid arthritis and lupus (over-active immune response).
One of a patient's greatest complaints with the medical system is that doctor's do not listen. They know better. But, we are not cookie-cut-outs of each other. We are individuals who all react differently to medications (including vaccinations) and we 'present' differently with different illnesses. Their blindness to these facts are hard to understand.
Marnie - the dumb thing is that the people who don't vaccinate against the chicken pox are not playing the risk they won't get the disease. Instead, they are fully intending their kids to get soick!
That's mental.
@Rachael,
What is the risk of vaccinating or the benefit of not vaccinating in this risk/benefit analysis? I wear a seatbelt whether I'm driving on surface streets to a store 5 miles away or when I am driving cross country, sometimes upwards of 70 mph on highways. The risks in each case are different, but I still use a seatbelt both times because in both cases the seatbelt can protect me from unnecessary harm.
Vaccines protect against becoming infected by a diseases. Immune suppressants are a treatment for a disease. They are taken for vastly different reasons. If there is a way to prevent a disease, that seems like a good thing. Please explain how it is not.
Well, there is no vaccine for colds or cancer so those are not valid arguments in this case. Flu vaccines are totally optional but just because you haven't gotten a flu, doesn't mean you or other family members cannot get one, just as having never been in a car accident, doesn't make it impossible for you to be in one at some point.
It sounds to me like you don't have a valid argument against vaccinating. It sounds like you resent the fact that you feel that medicine is patriarchal and that you are pushed to do something you are not 100% comfortable doing, namely, vaccinating.
I will say this, you have a legitimate argument about some doctor's bedside manner and one of the reasons non-medical professionals like homeopaths, resonate with people is because they make people feel heard and cared about. I think if you listen to a lot of medical professionals, they consider this a legitimate issue to discuss. However, the answer is not to reject solid scientific findings, treatments and preventative measures. Putting yourself and your children at greater risk doesn't fix the issue. You cannot predict whether or not you will be exposed to a pathogen that will harm or even kill you. The risks of vaccinations are incredibly low, lower than even the most mild symptoms of any of the diseases. If you are genuinely interested in making a real risk/benefit analysis, you should really do so. Chickenpox may be largely fairly mild but 2 weeks of discomfort and pain is far greater than a day or two with a sore arm. The risk of shingles when you are elderly is even worse and once you've had chickenpox, that is a real risk. Preventing both, outright is the least risky option.
@Marry Me Minday
I just don't understand it. I can't understand how a 2 second jab and maybe a sore arm for a couple days, is worse than any disease it can prevent.
My last comment to Rachel is in moderation, but I'm not sure it matters what I say. When you believe that the risk of vaccines outweigh the risks of disease and you don't care how sketchy your sources are, some random person on the internet isn't going to change your mind.
And vaccines are your scape goat for these, apparently. Correlation is not causation. Show me studies where unvaccinated individuals get these diseases at a statistically significantly lower rate than individuals that do get vaccinated. Where are these studies published and how were the studies structured. That is how you begin to identify a cause of a problem. The brain is incredibly good at leaping to conclussions, but the scientific method helps us weed out bias and fraud.
Marnie, the "autoimmune" epidemic is another contortion that they use to try to say vaccines are bad. Most of them are because more people actually grow old enough to get arthritis and Type 2 diabetes.
They ignore that the diseases themselves caused neurological diseases, and seizures. While there was a claim that DTP caused seizures, it is has been shown that often there was another reason (like Dravet syndrome). My kid had seizures because of a now vaccine preventable disease. And unlike Ms. Fisher's son who turned out okay, my son is still permanently disabled.
So another one of my questions the cranks cannot answer is which vaccine causes more seizures than the diseases? It is usually accompanied by these cites:
Vaccine. 2011 Nov 12. [Epub ahead of print]
Lack of association between childhood immunizations and encephalitis in California, 1998-2008.
Pediatr Infect Dis J. 2006 Sep;25(9):768-73.
Encephalopathy after whole-cell pertussis or measles vaccination: lack of evidence for a causal association in a retrospective case-control study.
And for the diabetes claim there is this:
Pediatrics. 2001 Dec;108(6):E112
Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus.
They ignore that diabetes, ADHD, arthritis and learning diseases affected children before there was much of a vaccine program. They are just more recognized, and in the case of juvenile diabetes: don't die as children.
Some of those studies are part of the Vaccine Safety Datalink. This is a program that uses information from several health maintenance organization to evaluate some of the spurious claims made by people like Barbara Loe Fisher (like diabetes, seizures, etc). It gets cute when folks like Joe then try to claim that the insurance companies are in cahoots with the pharmaceutical companies. In my experience health insurance tries to get the cheapest pharmaceuticals, or avoid paying for them.
That is why we see so many comical crank contortions.
@Chris, you don't have to tell me, I just wanted to point out how a hypothesis like "vaccines cause diabetes" could be tested and the type of evidence I would require to accept that claim. Someone just saying, "there's a correlation" isn't evidence.
Frankly I was done after she started citing Whale.to. If you are linking the same page promoting the Reptilian conspiracy, I'm just going to label you a crank and be done with it. There really is no point arguing with cranks, and here we are at 106 comments, on a post about whether doctors should fire patients from a practice, discussing whether or not vaccines even work.
Sigh.
I'd probably lose my license on the first day if I were a physician; I'd refuse to treat the sufficiently scientifically illiterate.
Well, Mark, one of the comic cranky contortions is to try to explain that pediatricians should not dismiss families because they know better than someone who has been through medical school and residency. They think they know better because they actually believe a former football/soccer player who may hit the ball with his head too often. Sorry for trying to get them to answer a couple of my questions they never actually answer.
I still kind of like my idea of making those who ignore public health measures having to come through a separate door, use the gel and wear a mask in order to get any kind of medical care. Make the use that is voluntary in many hospitals mandatory.
I have unfortunately been at too many appointments with a kid at the university medical center. And one time I found that the hospital gift shop was selling the "Autism File" magazine. As an example of how bad a rag it is, Andrew Wakefield is part of its advisory board. I complained, and it was removed (they claimed the supplier included it by mistake).
I suggest anyone who enters a hospital to check to make sure its gift shop is not selling the anti-science "Autism File."
A little bit of book sense, but absolutely no common sense is a way of describing many of you know-it-all personalities; who in actuality really know nothing. We have a distorted picture of true intelligence now-a-days because our current measures of intelligence are limited to just one dimension (technical intelligence) and ignores important areas of intelligence like wisdom, common sense, social skills and practical knowledge. Common sense usually produces the right answers in the social domain; something you supposed know-it-alls are completely lacking in. Otherwise, you would be able to see that a one size vaccine schedule does not fit all.
"Intelligent people with high levels of technical ability are seen (by the majority of the rest of the population) as having foolish ideas and behaviours outside the realm of their professional expertise. In short, it has often been observed that high IQ types are lacking in âcommon senseâ â and especially when it comes to dealing with other human beings."
Google: Clever Sillies - Why the high IQ lack common sense
@Rachael,
In other words, you reject any evidence that doesn't agree with your predetermined conclusion. That's called, "dogmatic faith."
Common sense would suggest that the sun travels across our sky from east to west. Scientific inquiry tells us that we are rotating around the sun.
Common sense told us the earth is flat. Scientific inquiry revealed that the earth is round.
Common sense has limits and the scientific method is a tool for determining which hypotheses are valid and which are not. If you are going to make a claim, you have to back it up with fact. If you are asked to provide proof and you tell everything they are big dummies and that common sense matters more, you clearly have nothing further to add to the discussion.
Marnie, all Rachael can do from now on is provide entertainment, especially since she is clueless on the limits of "common sense" (something it seems she lacks). It would be best to ignore her, though commenting on her behavior (like her off topic fact free comments) should be okay.
Oooh, Chris, I think you are right, she just let out with a little slut shaming while she's at it. You know, only sluts get HepB so they probably deserve it. WON'T SOMEONE THINK OF THE CHILDRENZ!
Sorry guys, I'm done with having the thread overrun by this crank. I'm spam-listing further comments from her. She had her chance to make her point, then like all cranks do just went on, and on, and on, ignoring countervailing evidence and linking the reptilian conspiracist site whale.to. There is no arguing with cranks.
Just for your entertainment (because it is a wee bit off topic):
Marnie, yes that is what "common sense" claims. Though you must see the geocentric video discussed here. It contains some incredible cranky denialism. Though to preserve more brain cells I suggest turning off the sound and listen to something else.
Great googily moogily, Chris. I cannot even...This is just more proof that there is no theory so irrational that it cannot be embraced by someone.
Medicine Man probably won't see this, but the VA state legislature is all set to approve a bill that will mandate, in many cases, transvaginal sonography of all women who seek an abortion in that state. It would be mandatory on both patients and their physicians, and there is no medical justification for it, or even the pretense of such a justification. In post #16 Medicine Man castigates liberals, saying:
"I was also referring to grown ups, not children. A grown man or woman does NOT have to accept any form of treatment or operation that he/she does not want. If one denies chemo then it is their own personal private sovereign right to do so and no one on this planet has the authority to over rule it. They may think that they have such authority, butthis type of thinking is what invented the word asshole. Morons who think they can control someone else are usually pretty useless."
I wonder if he feels that the folk pushing this bill are also assholes? I'm betting he does not. As Yoda might say, "The Hyprocracy is stong with this one."
@Immunologist,
Not to be pedantic but I believe you are paraphrasing Darth Vader, there.
Otherwise, I agree completely. :)
There really shouldn't be any conflict here. If it's in the child's best interests to get vaccinated, and the parents won't, the question is not 'should they be allowed to visit the doctor and potentially spread their diseases', the question is 'should the state forcibly vaccinate the children'.
Pediatricians should at the very least be strongly encouraged to reject families that don't vaccinate their kids. Why should anyone else's kids be forced into exposure? They're the ones that innocently suffer in that case.
"63
@Wow
Smallpox: Government intervention. Polio: Governments again. Not the drug companies.
I honestly don't understand your point. You are saying that vaccines shouldn't be administered to people because drug companies aren't the ones administering vaccines?"
No.
My point is that drug companies will prefer treatments to cures. Therefore vaccines have had to come from government programs, where profits aren't the reason for existing.
I've not said anything at any time in any way that could possibly be inferred to be "vaccines can't be administered".
I have said NOT ONE THING about how non-treatment is cheaper than treatment overall.
The closes I've come to is that drugs are over-prescribed because the doctor is as amenable to marketing as anyone is. But this is ALSO a problem in the USA specifically since you all pay for it, therefore since you paid, YOU WANT YOUR MONEY'S WORTH!!!
So you demand drugs when just reassurance that there isn't an actual problem would be cheaper.
But if you have measels, or don't want your child to get them, then vaccines (a cure) are cheaper than skin ointment (a treatment) and should be taken.
"64
Wow, you just proved my point. Vaccines are more cost effective by preventing the diseases when compared to treating the diseases."
I know.
I meant to.
Do you have any inkling WHY????
I shall tell you: because vaccines (A CURE) is cheaper than treatments (keeping kids at home so as not to infect other kids).
Now, given that I WAS ALWAYS AGREEING THAT CURES ARE BEST, do you know why I said, right at the beginning that your question was irrelevant to my comments?
Can you think?
I'll give you a pretty strong hint: since I agree cures are good, and never said that not treating (never mind curing) was better, your petulant DEMAND that I prove why not treating was better than treating had nothing to do with my post.
OK, that was more "an answer" than "a hint" but I believed you'd miss anything that didn't reverse several times over you before you get it.
Wow, MarkH has decided that off topic comments are not welcome.
Good. Since that post there at 122 wasn't on topic, and you knew of the censure, you're going to apologise to Mark, right?
I was answering the accusations or misunderstandings. But you'd prefer to pretend that you "won" by ignoring the answers you demanded when given.
And Schenck at 119 gets the same position as I hold on the subject of the thread. The only extent to which the doctor is at fault here is in not lobbying the government to force kids to be vaccinated. And since they're supposed to represent the will of the populace, that the doctors can't vaccinate means they're allowed to refuse (and hence "fire") their patients.
To do otherwise would be enforcing one person's paranoia on the rest of us by vector of their doctor.
OMG, whale.to is the best site ever! Is it a joke? Who is in charge of it? Are they suffering from some delusion? Maybe a delusional disorder? Or is it not a disorder and just stupidity and/or culture?
I, for one, welcome my reptilian overlords! (Which, includes, Sophie Ellis-Bextor, apparently!)
See, here's an example of someone who is refusing their medication from their doctor and is a minor nuisance to everyone else because of their inanities.