Has anyone refused their school's vaccination requirement?

[NemoFish]

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Hi everyone,

I wondered if anyone, out of personal or medical reasons, has refused any or all of their medical school's vaccine requirements for entry. I'm wondering how easy it is to do this--i.e. if one objects for religious or personal reasons, etc.

What sort of documentation does a med school require that you have for vaccines and do they insist on checking titers for immunity--or will they accept a doctor's letter for refusal?

How does the whole process go, in general, for passing--or bypassing--this health screening?

 

[rxfudd]

My understanding is that it's pretty tough to bypass this. While your school may not have problems with immunizations (or lack thereof), the hospital(s) you rotate through probably will. At my school, they won't even let you step into the hospital without confirmation of your immunization status (and to answer your question, my school only wants titers on the Hep B - they were fine with my physician's signature for all others). If you have a known medical reason to not receive certain vaccinations (for example, if you're immunocompromised), that would probably be another story.

 

[Mutterkuchen]

If you have religious or other personal reasons against basic medical care, then I think that you should consider another profession other than medicine.

 

[Wednesday]

I think someone in my class has refused immunizations, but I don't know exactly how she did it. It seems to me that if you do that you are playing with fire. I can't imagine doing this, especially after seeing what some of these viruses do to you if you come down with them. Of course, I don't understand how anyone who went through med school could continue to smoke either, and that happens all the time.

Probably best to ask at your schools health center to see what their policy is.

 

[Vincristine]

If you have religious or other personal reasons against basic medical care, then I think that you should consider another profession other than medicine.

I think I have to agree with this. Are you willing to provide medical care to others that may be aginst your own practices?

 

[NemoFish]

I have no problems with basic medical care. I don't want to receive vaccines with questionable preservatives (i.e. mercury), that's all.

 

[Wednesday]

I have no problems with basic medical care. I don't want to receive vaccines with questionable preservatives (i.e. mercury), that's all.

Ever eat tuna?

 

[NemoFish]

I've been a vegetarian for 15 years, and no I never eat tuna because of the mercury levels. I'm also organic whenever possible, too. I.e. I'm very health-conscious.

 

[mlw03]

Immunizations, like many aspects of medicine, are risk versus reward. When a drug is prescribed that has known side effects, the physician is making the calculation that the risk and unpleasantness are worth the treatment. Vaccines are the same idea in my opinion. I don't claim to be an expert, but if the AMA is recommending a vaccine I have to think that it's because people who are experts feel that the risk is worth it.

Nemo posits a good question though, so I look forward to seeing what happens here.

 

[Whisker Barrel Cortex]

You're health conscious so you don't want to be immunized against diseases because of the theoretical risk of a small amount of mercury in a vaccine. Makes sense to me. Hopefully you won't be 40 years old with cirrhosis, massive ascites, and hepatocellular carcinoma because you didn't want the "unhealthy" Hepatitis B vaccine. Imagine the regret you would feel at that point.

 

[Super Rob]

Nemo,

Major thumbs up for your support of Organic produce! Vaccinations scare me because of all of the negative publicity they have received over the years. Those diseases also scare me, and as a med student I'll be in contact with a lot of them. And as a med student with not the best immune system in the world, I'll want some extra protection. Nonetheless, I think you have some legitimate concerns. Keep exploring and let us know what you come up with.

 

[LukeWhite]

Nemo,

An interesting argument. Maybe it will be easier to permit yourself vaccinations in good conscience if you consider it not only a benefit-risk ratio for yourself, as some have suggested, but for others. Herd immunity is pretty crucial, particularly among the people who are going to be giving the vaccines in the first place.

So the balance isn't just between risks to you and benefits you may gain...it's between risks to you and the risks to the others you'll be treating, many of whom, if not most, will have immune systems that are compromised in some way or another. Even if you go into a specialty that doesn't require you to deal with the issue of immunization, you'll have to go through rotations to get there, and regardless you'll be dealing with people who have a harder time resisting disease than most.

Perhaps it's best, then, to consider this as one of those times where you have to take one for the team, just as you do by going through four years of med school that are absolutely guaranteed to tax your health far more than any vaccine will.

 

[exmike]

i dont see how you can live up to your oath to "do no harm" as a physician if you refuse certain vaccinations. It is absolutly contrary to good medical practice to willfully expose your patients to illnesses preventable by vaccination.

As an aside, your chances of dying from a vaccination are far lower than your chances of dying without the vaccination. Otherwise they would never be approved.

 

[flighterdoc]

I've been a vegetarian for 15 years, and no I never eat tuna because of the mercury levels. I'm also organic whenever possible, too. I.e. I'm very health-conscious.

I thought thymerosol wasn't used any more?

At any rate, I get all the vaccinations I can. I'd rather run the 1/million+ risk of a bad reaction than the 1/100+ risk of getting the flu each year.

 

[Ruban]

Hmm, I can't decide what would be more interesting:
1) you refuse to take the vaccinations, contract hep B, get cirrhosis, watch as your testicles shrink and become atrophic, and die of a massive hemorrhage from esophageal varices.
2) you refuse to take the vaccinations, get kicked out of med school, and end up waiting tables for the rest of your life.

Attention stupid people: quit applying to medical school. Thanks, that is all 🙂

 

[sambo]

Now I've seen everything! 😕 How can you expect to be a good advocate for your patients when you don't even believe in one of the basic tenets of health care and prevention of disease? Would you impose your wacked out beliefs on your patients, putting them at risk for all kinds of illnesses? Sounds like you need to give up medical school and become a naturopath. At least then your patients would be willingly subjecting themselves to your ignorance.

 

[exmike]

I.e. I'm very health-conscious.

for some reason i find this statment ironically hilarious consider you dont want to be immunized

Anyway, I usually refrain from such comments, but I'm starting to wonder about your fitness for the medical profession.

First you would forgo immunizations and put your patients at risk,

second you consider volunteer work a tremendous waste of time
http://forums.studentdoctor.net/showthread.php?t=101757

In fact you hated it enough to post two separate threads about how much you think volunteering is a waste of time
http://forums.studentdoctor.net/showthread.php?t=112141
especially with this telling quote "Of course, I'm going to keep volunteering until the day I turn in my AMCAS form, at which point I'm going to stop, never to volunteer again, but I was just wondering."

Third you've also state how you feel that it is absolutely OK to inflate your volunteer hours on AMCAS (i.e. lying)
http://forums.studentdoctor.net/showthread.php?p=1199106#post1199106
Which makes complete sense since you also feel that counting your transportation time to a volunteer event should be part of hours worked.
http://forums.studentdoctor.net/showthread.php?p=1437373#post1437373

I dont know..
😕

 

[flighterdoc]

for some reason i find this statment ironically hilarious consider you dont want to be immunized

Perhaps that "naturopathic" school that was being advertised might be a better choice.

Anyone catch the news about the measles outbreak in Iowa (?) earlier this year? Some college kids went to Eastern europe, into a known measles outbreak, and refused to be vaccinated. Got sick, came back to the states, and created a mini outbreak - spreading it to other people on the plane, etc.

BTW, they REFUSED to be vaccinated or treated even though they were sick, and deliberately spread the disease. They started feeling sick and just wanted to be home, and f-off to everyone else. Their carelessness cost over a million bucks that could have been used to provide vaccinations, staff ED's, etc.

I'm a big believer in religious freedom, but with freedoms come responsibilities - they shouldn't expect to have access to the rest of society if they're going to be contagious.

 

[NemoFish]

Exmike,

I think you have WAY too much time on your hands. But I did enjoy perusing my past posts. Yes, I do hate volunteering! But I am perfectly well-suited to the medical profession, and I feel that I adequately explored it with my shadowing. But no--the medical schools want to see "committment"--which I find ridiculous since it takes so long to do all the pre-med pre-reqs--so why doesn't just getting though all those classes count as your passion?

 

[NemoFish]

Anyhow, with regard to the vaccines, I do believe in patient CHOICE--thus, when I am a physician, I will offer vaccines to my patients, but also present them with extensive literature documenting the various risks...and let them make their own choice, because now, as it stands, it doesn't seem people have much of a choice--they do what they're told with regards to this issue.

Think of it this way--what is really the cost/benefit analysis for immunizing an infant against hepatitis B? Why not wait until the child's immune system is more developed and let them take it at 18 if they feel they'll be at risk? Why immunize an infant who will not be involved in any high risk behaviors when the vaccine is not 100% without risk? Vaccines are not without their risks and I feel that many doctors are not up on the latest indpendent studies done which document and explain these risks. I, however, will be and while I already have most of the vaccines required for med school due to my parents making the decision for me to have them as a child, I don't have one or two of them, and I will refuse to get those because I feel the risks outweigh the benefits (i.e. tetanus).

 

[Gleevec]

They dont use thimerosol (the mercury based vaccine preservative) anymore, and if you are still worried you can ask specifically about the vaccine to be administered. There is no evidence that it causes autism or any other disease, but the word "mercury-based" (its actually not mercury) scared people.

Nemofish, as a physician you have an implicit moral obligation to be vaccinated, because otherwise you become a very active transmitter of the virus. The number of patients you see, many of whom are sick already, will be severely affected by any pathogens you may pass on. Iatrogenic infections are a big deal, and I doubt the hospital board will let you practice knowing that people could get even sicker perhaps leading to a lawsuit. Can you imagine the public relations disaster a hospital would face if the headline reads "Doctor refusing to be vaccinated leads to death." As future physicians, we need to set a good example about things like vaccination, which has gotten a bad name by some nutcases-- the public health consequences are immense. If the moral aspect does not appeal to you, Im sure the institutional policy aspect will.

Anyhow, with regard to the vaccines, I do believe in patient CHOICE--thus, when I am a physician, I will offer vaccines to my patients, but also present them with extensive literature documenting the various risks...and let them make their own choice, because now, as it stands, it doesn't seem people have much of a choice--they do what they're told with regards to this issue.

Think of it this way--what is really the cost/benefit analysis for immunizing an infant against hepatitis B? Why not wait until the child's immune system is more developed and let them take it at 18 if they feel they'll be at risk? Why immunize an infant who will not be involved in any high risk behaviors when the vaccine is not 100% without risk? Vaccines are not without their risks and I feel that many doctors are not up on the latest indpendent studies done which document and explain these risks. I, however, will be and while I already have most of the vaccines required for med school due to my parents making the decision for me to have them as a child, I don't have one or two of them, and I will refuse to get those because I feel the risks outweigh the benefits (i.e. tetanus).

 

[exmike]

Anyhow, with regard to the vaccines, I do believe in patient CHOICE--thus, when I am a physician, I will offer vaccines to my patients, but also present them with extensive literature documenting the various risks...and let them make their own choice, because now, as it stands, it doesn't seem people have much of a choice--they do what they're told with regards to this issue.

Think of it this way--what is really the cost/benefit analysis for immunizing an infant against hepatitis B? Why not wait until the child's immune system is more developed and let them take it at 18 if they feel they'll be at risk? Why immunize an infant who will not be involved in any high risk behaviors when the vaccine is not 100% without risk? Vaccines are not without their risks and I feel that many doctors are not up on the latest indpendent studies done which document and explain these risks. I, however, will be and while I already have most of the vaccines required for med school due to my parents making the decision for me to have them as a child, I don't have one or two of them, and I will refuse to get those because I feel the risks outweigh the benefits (i.e. tetanus).

Hep b is mostly a disease of poor sanitation. I wonder how many babies contract it from poor infant formula preparation hygiene. Babies love putting things in their mouths. I wonder how many babies got HepB from that?

Also, infantile HepB is MUCH MUCH MUCH more likely to progress to chronic hepatitis and liver cancer than adult HepB (the adult HepB patient is much more likely to completely resolve). It is because of this that babies are recommended for HepB vaccination. But I guess you would rather your baby contract HepB, resolve, then turn out to be a chornic carrier later on and die from liver cancer right?

I am leery of these "independent" studies by dubious "health organizations". Vaccines are such a low margine industry that the companies really have little incentive to fudge their data. This is exactly why there are may vaccine shortages nowadays. Also, vaccination programs are costly to the government. What incentive does the gov't have to push vaccines besides to ensure the health of the population.

I feel particulary strongly about this issue as a MPH seeking a MD. There are too many old wives tales spun by naturopaths that result in the unecessary death of thousands of children.

 

[merlin]

NemoFish,
I'm going to echo what the last person said in that there has been no scientific study showing any association with mercury in vaccinations and adverse health consequences. And, I fully support being healthy, living in the bronx here, I have organic produce shipped to my apartment, but I think you are taking it a little too far...just do some reading in the medical literature and you will see that you may be overreacting.

Now, if you had a positive PPD and you didn't want to take the prophylaxis treatment, then that may be another debate, as you won't be able to spread TB unless it was active, but in this instance, you protect your patients, not just yourself by getting vaccinated. There are better battles to fight out there...

 

[lotanna]

I do believe the schl has every right to deny u continue in their program. As there are laws and being vaccinated for certain diseases is 1 of them. Since ur not willing to comply with it, then they have every right to say NO!!

 

[NemoFish]

Why don't you read this article, one of the many on the National Vaccine Information Center, and decide for yourself. Those who say there are no risks, or very small risks associated with the mercury in vaccines, may change their minds.

http://www.insightmag.com/news/573542.html

 

[lorarp]

This is unbelievable (enough to make post, which is rare). I just hope to God you don't become a pediatrician because you would actually endanger kids lives on a daily basis by not strongly recommending vaccination. No parent wants to have their kids stuck with needles, but they are guided by their doctor who tells them it is for their child's best interest - which it is. Smallpox, polio, measles, pertussis, and many of the more serious H. flu type B diseases which caused many deaths and serious morbidities are now eradicated or at least rare in the US - ALL DUE TO VACCINATIONS!

If your reasoning is based on "not wanting to be exposed to mercury" then you are clearly exposing your ignorance as it was pointed it that it is no longer used, even though no studies have shown it to be harmful. Read some real journals and then reevaluate.

As an almost third year med student who is probably destined for peds, I am really angered by your cavalier and uninformed attitude that would greatly harm patients.

 

[Stinger86]

Whether you can or can't all depends upon state law

 

[NemoFish]

Check out the article I put a link to a few posts before and look around the National Vaccine Information Center web site--you'll learn that mercury IS still used in SOME vaccines. There was a recommendation made by some pediatric association that all mercury be removed from vaccines in 1999, but this has not happened yet. Most routine childhood vaccines have had mercury removed, but there is still mercury in non-routine childhood vaccines and in many adult vaccines. It has not been eliminated completely. There are actual facts and statistics on this. So check out these stats, future pediatricians.

 

[exmike]

Why don't you read this article, one of the many on the National Vaccine Information Center, and decide for yourself. Those who say there are no risks, or very small risks associated with the mercury in vaccines, may change their minds.

http://www.insightmag.com/news/573542.html

I've read this article before, and the study is fraught with inconsistencies. I believe a recent norwegian study just came out studying the same thing that found not linkage between thimersol and autism. Its nice of you to link an article that supports your claim when more recent studies have disproven it.

Lets think about DTaP.

We'll just assume for a second that DTaP causes autism. Do you think that if we stopped DTaP immunization, the number of autism cases avoided would surpass the number of babies that die or are permantly disfigured by diptheria, tetanus and pertussis? FYI before vaccination 10,000 people died a year from pertussis, 13,000 died from diphteria.

Is the yearly incidence of autism greater than 23,000? And at least the autistic kids are alive.

I dont find your argument very compelling.

 

[Gleevec]

Why don't you read this article, one of the many on the National Vaccine Information Center, and decide for yourself. Those who say there are no risks, or very small risks associated with the mercury in vaccines, may change their minds.

http://www.insightmag.com/news/573542.html

That's some BS and propagates a lot of myths.

http://www.immunize.org/catg.d/4038myth.htm

 

[group_theory]

It is definately your right not to get vaccinated. However, it is not your right to be a physician. Whether you like it or not, the school and hospitals WILL NOT let you practice on site because you pose a HUGE liability to them. If you were to contact a disease (that could have been prevented w/ vaccination) and give it to your patients who are immunocompromised, the hospital and your school can be held liable in civil court for negligence.

Also, in science, you must prove your claim. Besides the original paper, there have been no randomized control trials to prove the link. If you want to be a physician, you can start by practicing evidence-based medicine.

No internet websites or news articles will convince me. That is not how science works. What will convince me - well-design studies published in peer-review journals (the more reputable the better) that can be duplicated.

Anyway, below are some articles that you might be interested in reading. While there may be some controversies with the authors, I have yet to see a good paper to support the Hg/autism claim.

Madsen KM, Lauritsen MB, Pedersen CB, Thorsen P, Plesner AM, Andersen PH, Mortensen PB. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics. 2003 Sep;112(3 Pt 1):604-6.

Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen P, Olsen J, Melbye M. A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med. 2002 Nov 7;347(19):1477-82

Stehr-Green P, Tull P, Stellfeld M, Mortenson PB, Simpson D. Autism and thimerosal-containing vaccines: lack of consistent evidence for an association. Am J Prev Med. 2003 Aug;25(2):101-6

Verstraeten T, Davis RL, DeStefano F, Lieu TA, Rhodes PH, Black SB, Shinefield H, Chen RT. Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases. Pediatrics. 2003 Nov;112(5):1039-48

 

[flighterdoc]

Why don't you read this article, one of the many on the National Vaccine Information Center, and decide for yourself. Those who say there are no risks, or very small risks associated with the mercury in vaccines, may change their minds.

http://www.insightmag.com/news/573542.html

How about that little scandal at the lancet a few months ago, when it became known that the author of the only "authoritative" study linking vaccination to autism was found to be fradulent, and it was retracted?

Turns out the physician who wrote the report was being paid by a so-called "indiependent public science organization".

 

[LukeWhite]

But Nemo, it's not about you. Choice is great, but by refusing to be vaccinated, you're in a very real sense making a choice for your patients that they may not like. Now, I don't know about anyone else, but when I see a doctor, I go with the expectation that the doctor has all the proper immunizations. If he didn't, that alone would be a dealbreaker. Not worth the risk.

So. When you go into practice, will you advertise this prominently in such a way that the patients see this before they get anywhere near you? If so, more power to you, if you can manage to somehow skip rotations. If not, you're essentially acting as a big germ sink, with those from 30+ patients a day going in and then out to every subsequent patient you see. Talk about a nocosomial nightmare.

 

[musicman1991]

I have no problems with basic medical care. I don't want to receive vaccines with questionable preservatives (i.e. mercury), that's all.

As someone who was stuck with a needle, i'm glad i had my hep B shot. wish they had HIV and Hep C vaccines too. Don't get it is fine with me just don't come crying when you get your first risky exposure, it is likely to happen at somepoint. i was nervous enough.

I hope you aren't one of those crazy parents who refuses vaccines for their kids and end up with a kid with measles or more likely HIB ear, sinus, and lung infections. They already proved MMR doesn't cause autism in the NEJM study.

 

[Mirror Form]

I have no problems with basic medical care. I don't want to receive vaccines with questionable preservatives (i.e. mercury), that's all.

Oh christ, are you kidding me? Stop reading newsweek and read some real medical literature on vaccines.

 

[merlin]

i have to say that that is a fairly weak article to link to. on this board, if you are going to try to make a point, it would benefit you to do a search in the real medical literature. if you go to the NEJM and do a search on mercury and vaccination, you will see that there have been no convincing studies that show a linkage between vaccination and autism.

AND, there has been a skyrocketing of autism cases recently mainly due to the redefinition of autism and so the Autism spectrum of disorders has become more inclusive and so many cases are now being included that previously weren't.

 

[Mirror Form]

How about that little scandal at the lancet a few months ago, when it became known that the author of the only "authoritative" study linking vaccination to autism was found to be fradulent, and it was retracted?

Turns out the physician who wrote the report was being paid by a so-called "indiependent public science organization".

Yep, fortunately Lancet is pressing charges on the researchers who wrote the paper. That won't bring back the number of kids who DIED b/c their parents decided to not get them vaccinated based on the paper though.

Furthermore, getting immunized isn't just about yourself. There are many people who have real medical reasons that cause them not to be able to be immunized. For them, herd immunity usually stops them from getting the diseases. But if everybody else didn't get the vaccinations, the diseases would surely come back.

 

[Earth]

While I truly do agree with the pros of vaccinations, it is necessary to point out the cons. Some children, while a low risk do get sick from the vaccines, and one posted earlier how some diseases are "eradicated", so basically getting vaccinated is now just purely for peace of mind then for any other reason. But who am I to talk, I just got my tet and hep c vacc today.

 

[Earth]

also there are those who do not consume pork or porcine products, which does include medications and contact lens enzyme cleaners. It is imperative as a physician to have a specific sensitivity to these issues and be prepared to offer alternatives. We cannot allow our egos to become larger than our intellect.

 

[Robz]

They showed us!!!!

http://www.newsday.com/news/nationw...88907.story?coll=sns-ap-nationworld-headlines

 

[Wednesday]

While I truly do agree with the pros of vaccinations, it is necessary to point out the cons. Some children, while a low risk do get sick from the vaccines, and one posted earlier how some diseases are "eradicated", so basically getting vaccinated is now just purely for peace of mind then for any other reason. But who am I to talk, I just got my tet and hep c vacc today.

Only small pox is technically eradicated and we don't get vaccinated for that anymore (and I sure hope we won't have to start).

 

[edmadison]

But who am I to talk, I just got my tet and hep c vacc today.

I would love to get a hep C vaccination -- where did you get yours?

There are two things that have greatly improved health in the past 100 years: public sanitation and vaccination. From a public health standpoint we'd be much better off getting rid of every physician than getting rid of vaccination.

Ed

 

[Jaded Soul]

Hep b is mostly a disease of poor sanitation. I wonder how many babies contract it from poor infant formula preparation hygiene. Babies love putting things in their mouths. I wonder how many babies got HepB from that?

Um...none? Hep B is transmitted parenterally and vertically. I think you're getting it confused with Hep A, which is fecal-oral and associated with poor sanitation.

I'm on the side of getting vaccinated, but I think it's important to have the facts straight.

 

[Seaglass]

I would love to get a hep C vaccination -- where did you get yours?

Yeah, I was gonna let that slide but if I can get me some Hep C security, I'm all for it.

C

 

[Hillbilly]

Hey nemofish, I sent you a pm.