How do you explain to family members that vaccinations aren't going to kill you.

[CavsFan2016]

I have several family members that are whako and keep going on about all of the "carcinogens" in vaccines. They are so adamant that my sister is considering not vaccinating my newborn nephew. I try to explain to them that literally all of the data over the past 20 years has shown that vaccines are, in fact, safe but they just dont get it. What do I say to them to help put their minds at ease???

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[SurfingDoctor]

Having done this for 10 years, you can't. Some people have a massive distrust of modern medicine. Only when their child is harmed, do they see the err of their ways. But I've never seen an effective way of teaching something to someone who doesn't want to be taught in the first place. This is why in places like California, they had to pass legislation to mandate vaccinations for children to be in public schools.

 

[Goro]

Throwing facts at them only increases the cognitive dissonance. For them, this is a belief system.

Try mentioning "if you don't vaccinate against, say, measles, your baby can die from encephalitis?"

I have several family members that are whako and keep going on about all of the "carcinogens" in vaccines. They are so adamant that my sister is considering not vaccinating my newborn nephew. I try to explain to them that literally all of the data over the past 20 years has shown that vaccines are, in fact, safe but they just dont get it. What do I say to them to help put their minds at ease???

 

[vendtex]

The anti vaccine groups have been very effective in their disinformation campaigns.


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[stepone2015]

I, once, tried to very gently say to an anti-vaxxer friend that she shouldn't trust everything she reads online. No personal attacks, nothing else. She immediately blew up, yelling/screaming/crying.

 

[chipwhitley]

You have done your part by giving them the facts. Now they have to make their own decisions and live with the consequences.

 

[escanoke]

I've seen the post, if vaccines protect people than why do they care if I don't vaccinate my child?


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[SurfingDoctor]

I've seen the post, if vaccines protect people than why do they care if I don't vaccinate my child?


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Interesting that people don't understand herd immunity, yet they act like sheep. Oh the irony.

 

[OnePunchBiopsy]

A physician once told me:

Logic cannot win in an argument rooted in emotion.


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[Terry Toma]

Just explain that autism isn't fatal.

 

[justin1390]

I really try hard to nail down the most dangerous diseases and tell them exactly which ones, if they are going to pick and choose, they REALLY need to have. For instance tetanus and pertussis are obviously a must right from the get go.

That said, I'd like to play a bit of the devil's advocate here and note that as providers, we can swing way too far the opposite direction. The fact is, many vaccines have not been around long enough to show life-long effects. Are they effective against infectious disease? Sure. But can they increase the risk of chronic disease? We really are just taking a shot in the dark. Medicine is constantly evolving to the point that it's very evident interventions we have pushed for a long time previously are drastically changing. Keep in mind that only 50-60 years ago we were performing lobotomies. I for one, am not so arrogant as to believe we know enough about long term physiology and immunity to believe that immune reaction to viruses may be considered perfectly safe (look at Zika virus, it is often a silent infection). In the same sense, I recognize the people who have the most to lose (pharma) will never stop the promotion of, or weaseling into the pockets of those who make the recommendations. I mean, good gracious people, we are trying to get babies to have Hep B vaccines at a very, very young age when they neither shoot up nor have sex. In fact, there is some evidence that the side effects from hep B vaccine have now surpassed the actual protection gained from getting it at an early age... And studies show immunity wanes after 5 years.... Does that add up to you? Nope, me neither.

My point is this:
- we aren't playing God here, we have our limitations in knowledge
- big pharma companies have proven themselves deleterious in the past for the sake of a dime
- we're medical professionals, not sheep to an industry. That means thinking critically for ourselves and analyzing what we know. The standard of care is a moving target, and just because "my attending does it," doesn't make it necessarily good medicine. Going back to Zika virus, there is emergency detection and funding pushed through by the CDC to get a vaccine done. I would practically bet my house on the fact that any trial expedited to rush that vaccine to public disposal will be vastly underpowered and confounded...
- patients have had bad experiences with medical professionals in the past and have valid reasons for being skeptics. I'm sure people were just as adamant about the safety of thalidomide and now Zofran in pregnancy as well. We may scoff, but so did the doctors back in the day

Just because a counsel or organization tells you to do something doesn't make it right, or make them free from bias. We are scientists, and you need to add this stuff up for yourself, while covering your butt and hopefully be understanding of patients' concerns. That's all I'm saying -- stay moderate and be a critical thinker. And I'll get off my soap box.

 

[raiderette]

I use my future physician scenarios on them. I have a cousin that I have already told that her kids can't be my patients if they aren't vaccinated. I have told my high school friends to ask about vaccinations and loaded guns before play dates and sleepovers.

 

[SurfingDoctor]

we're medical professionals, not sheep to an industry. That means thinking critically for ourselves and analyzing what we know.

You do recognize vaccination is probably the greatest contribution to medicine as far as number of lives saved ever, right? Maybe that and distilled water.

 

[67552931811]

I have a family member who always tries to stump me with incredibly bizarre medical questions. This individual sadly does not vaccinate his/her small child. Recently they tried to instigate an argument about another bizarre topic. When I told them that they should look up the info themselves and even directed them to things such as uptodate and clinical key they responded that they did do their own research and found reputable sources about it. When I inquired what such sources were, they responded...

"People's blogs...."

I mean how does one even begin to have a discussion with such a non sequitur thought process.

 

[lymphocyte]

I have several family members that are whako and keep going on about all of the "carcinogens" in vaccines. They are so adamant that my sister is considering not vaccinating my newborn nephew. I try to explain to them that literally all of the data over the past 20 years has shown that vaccines are, in fact, safe but they just dont get it. What do I say to them to help put their minds at ease???

Keep the conversation going. Support their ego. Make them feel important. That's usually what it's about anyways.

Data likely won't get you far. Some people are just weak thinkers, and it is what it is. Mental hygiene is like physical hygiene; it takes time and effort. People sometimes let themselves go by indulging conspiratorial, extremist, or fantastical ideas.

Try this script:

"You seem to know a lot about this, and I know you want what's best. I want what's best for your child too. Measles is a terrible disease that's entirely preventable, and I watched a baby almost die of pertussis. It was terrifying, and I never want to see another family go through that again. What would convince you"? Now they feel affirmed and the ball's in their court to sound reasonable.

I don't want to argue. I don't want to tell them that they're wrong or erroneous or don't know what's what. I definitely don't want to mention autism, which is just a priming word for them. I want to focus on the risk of disease and making them feel important.

This is somewhat evidence-based: http://www.pnas.org/content/112/33/10321

 

[justin1390]

You do recognize vaccination is probably the greatest contribution to medicine as far as number of lives saved ever, right? Maybe that and distilled water.

Absolutely. But I think we need to think more critically about morbidity, and not just mortality. We also need to recognize the susceptibility of the system to fail to place safeguards against bias and manipulation. I'm definitely not arguing against vaccination, that's ludicrous. But I'm saying there's a reason patients are skeptical, and I understand that.

I guess here's my problem guys. It's not a problem with vaccines, it's how we study and use them.

If anyone tells me vaccines are perfectly safe and we've studied them enough to know that, I'd be pretty sure none of that information was anything but spoon fed them from their last attending or medical school. Evidence based medicine is a great example of how recommendations are constantly changing to fit what we know about risk vs benefit. I'm going to repeat it again in case anyone missed it, there's good evidence that Hepatitis B vaccine has a short immunity lifespan, may be given too early, and that we've crossed the border into doing more harm than good at the current recommendations. I've watched an attending pressure a mom into giving it because she had a friend whose baby got stuck with grandma's hep B needle in her purse. Puhleeeeeeze............ The incidence of hepatitis B in that age group, in ALL OF THE US, was 34 in 2013... Do you think I believe that story? Nope.

Have you ever used the VAERS database? The number of cases of reported deaths only (likely higher) is over 950 in the last 15 years alone (link below) due to vaccines with hep B in it (400 if you look at just Hep B [half the number in 1 out of 6 the vaccine]). We're all well trained, correct? Let's run some numbers: during the same time period there were ~63000 cases of acute Hep B. It is estimated that 1% of cases are in children less than 5 years old. Let's make it a generous 1.5%. That would be 946 new cases of AHB in these guys. Same number of deaths from the vaccine itself! And this doesn't include the over 15,000 cases of serious, debilitating effects from the vaccine. To further confound matters, 25% of new diagnoses are people born overseas. And to further confound it, only 25% of new AHB cases in perinatals will actually die from chronic liver disease complications.

To wrap it all up and put a bow on it, Johnson and Johnson poured millions into enforcement of vaccination. And guess what? They joined with Merck, the maker of the vaccines, years before doing so.

I'm just not sure I trust people in power who are lining their pockets with Johnson and Johnson dollars to do the right thing. It doesn't matter how many board certifications you have under your belt. You owe it to your patients to do the math and put two and two together. Parents are going to jail over this, and I quietly resent the health care professionals on board with that...


http://www.medalerts.org/vaersdb/findfield.php?TABLE=ON&GROUP1=AGE&VAX[]=6VAX-F&VAX[]=DTAPHEPBIP&VAX
=6VAX-F&VAX[]=DTAPHEPBIP&VAX []=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000'][]=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW
=6VAX-F&VAX[]=DTAPHEPBIP&VAX []=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000']AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000

https://www.cdc.gov/hepatitis/statistics/incidencearchive.htm

http://www.cdc.gov/hepatitis/hbv/perinatalxmtn.htm

 

[Ismet]

I have a family member who always tries to stump me with incredibly bizarre medical questions. This individual sadly does not vaccinate his/her small child. Recently they tried to instigate an argument about another bizarre topic. When I told them that they should look up the info themselves and even directed them to things such as uptodate and clinical key they responded that they did do their own research and found reputable sources about it. When I inquired what such sources were, they responded...

"People's blogs...."

I mean how does one even begin to have a discussion with such a non sequitur thought process.

Welcome to pediatrics. Mommy blogs and Dr. Google. Unfortunately the more reputable sources that we use for information is either inaccessible or too complicated for someone not in medicine to use. Those sources you suggested aren't free. People use whatever pops up first on a google search - wikipedia, webmd, medscape, and mommy blogs.

 

[oldanddone]

in clinic, i remember a family asking me what my opinion was on vaccination. i got the sense that theirs might be different from medical opinion, as they had non-verbal language that seemed a bit hesitant and oppositional. i prefaced by saying that i was trained in western medicine, and so could only tell them what I knew from that perspective. i picked an example, pertussis, which has been going around in the community. i wanted to play them a video of the pertussis cough, and accidentally clicked on a very sick baby, which I had clicked on before and knew had died. I quickly clicked off and told them I was sorry, that was not the one I was searching for, it was too upsetting, and I did not want them to see it. then i went ahead to another video, to play the sound of the cough, just getting them familiar with how pertussis works, and what is dangerous about the oxygenation in the paroxysms of cough. what was interesting is that they shifted in the process. they felt i didn't want to scare them. at the same time they saw the impact long enough that we were all moved by the little babies, that little baby, who are most at risk. i think that combined with me distancing myself from 'western medicine' gave me more of a 'neutral'/'emotional' position in this polarized debate, and they were able to hear me more. the power of anecdote and image when a person has their guard dropped and feels in alliance. they did get the vaccinations. i remained apologetic for having opened the video, and told them that although i was happy that they were getting the vaccination, i hadn't wanted to scare them. something about that encounter stays with me, and moves me to write it up here.

 

[VA Hopeful Dr]

Absolutely. But I think we need to think more critically about morbidity, and not just mortality. We also need to recognize the susceptibility of the system to fail to place safeguards against bias and manipulation. I'm definitely not arguing against vaccination, that's ludicrous. But I'm saying there's a reason patients are skeptical, and I understand that.

I guess here's my problem guys. It's not a problem with vaccines, it's how we study and use them.

If anyone tells me vaccines are perfectly safe and we've studied them enough to know that, I'd be pretty sure none of that information was anything but spoon fed them from their last attending or medical school. Evidence based medicine is a great example of how recommendations are constantly changing to fit what we know about risk vs benefit. I'm going to repeat it again in case anyone missed it, there's good evidence that Hepatitis B vaccine has a short immunity lifespan, may be given too early, and that we've crossed the border into doing more harm than good at the current recommendations. I've watched an attending pressure a mom into giving it because she had a friend whose baby got stuck with grandma's hep B needle in her purse. Puhleeeeeeze............ The incidence of hepatitis B in that age group, in ALL OF THE US, was 34 in 2013... Do you think I believe that story? Nope.

Have you ever used the VAERS database? The number of cases of reported deaths only (likely higher) is over 950 in the last 15 years alone (link below) due to vaccines with hep B in it (400 if you look at just Hep B [half the number in 1 out of 6 the vaccine]). We're all well trained, correct? Let's run some numbers: during the same time period there were ~63000 cases of acute Hep B. It is estimated that 1% of cases are in children less than 5 years old. Let's make it a generous 1.5%. That would be 946 new cases of AHB in these guys. Same number of deaths from the vaccine itself! And this doesn't include the over 15,000 cases of serious, debilitating effects from the vaccine. To further confound matters, 25% of new diagnoses are people born overseas. And to further confound it, only 25% of new AHB cases in perinatals will actually die from chronic liver disease complications.

To wrap it all up and put a bow on it, Johnson and Johnson poured millions into enforcement of vaccination. And guess what? They joined with Merck, the maker of the vaccines, years before doing so.

I'm just not sure I trust people in power who are lining their pockets with Johnson and Johnson dollars to do the right thing. It doesn't matter how many board certifications you have under your belt. You owe it to your patients to do the math and put two and two together. Parents are going to jail over this, and I quietly resent the health care professionals on board with that...


http://www.medalerts.org/vaersdb/findfield.php?TABLE=ON&GROUP1=AGE&VAX[]=6VAX-F&VAX[]=DTAPHEPBIP&VAX
=6VAX-F&VAX[]=DTAPHEPBIP&VAX []=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000']=6VAX-F&VAX[]=DTAPHEPBIP&VAX []=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000'][]=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW
=6VAX-F&VAX[]=DTAPHEPBIP&VAX []=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000']=6VAX-F&VAX[]=DTAPHEPBIP&VAX []=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000']AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000

https://www.cdc.gov/hepatitis/statistics/incidencearchive.htm

http://www.cdc.gov/hepatitis/hbv/perinatalxmtn.htm

I seriously question your resident status if you honestly believe much of what you're saying in this thread.

First, VAERS is purely a self-reported database. If anything happens to a kid that a parent thinks (not can prove, just believes) was related to the vaccine, the report goes in and is included in the stats.

Now to address your previous post's highlights...

My point is this:
- we aren't playing God here, we have our limitations in knowledge
- big pharma companies have proven themselves deleterious in the past for the sake of a dime
- we're medical professionals, not sheep to an industry. That means thinking critically for ourselves and analyzing what we know. The standard of care is a moving target, and just because "my attending does it," doesn't make it necessarily good medicine. Going back to Zika virus, there is emergency detection and funding pushed through by the CDC to get a vaccine done. I would practically bet my house on the fact that any trial expedited to rush that vaccine to public disposal will be vastly underpowered and confounded...
- patients have had bad experiences with medical professionals in the past and have valid reasons for being skeptics. I'm sure people were just as adamant about the safety of thalidomide and now Zofran in pregnancy as well. We may scoff, but so did the doctors back in the day

In order:

-Duh, but many of these vaccines are older than lots of attendings. Polio and measles, for example, are the same age as my parents. If we haven't seen anything major in half a century, I feel OK saying that its safe.

-Skepticism towards new vaccines I can understand, but no one is making a fortune on 99% of the routine childhood vaccinations.

-Why do you assume that those of us who fervently believe in vaccination are just sheep? This may surprise you, but most doctors actually know what they are talking about in their area of expertise.

-Thalidomide was never approved in the US, the FDA stopped that as its supposed to. As for zofran, let's try to keep up with the literature... http://www.sciencedirect.com/science/article/pii/S0890623816300910

 

[67552931811]

Welcome to pediatrics. Mommy blogs and Dr. Google. Unfortunately the more reputable sources that we use for information is either inaccessible or too complicated for someone not in medicine to use. Those sources you suggested aren't free. People use whatever pops up first on a google search - wikipedia, webmd, medscape, and mommy blogs.

Well I offered my account to them to use lol. But yeah . It's sad to me.

Have you, or anyone really, found a useful way to discuss these things with people? And by useful I mean get the child the proper health it needs and deserves. I feel like I've never met an anti vaxxer whose open to the conversation :/

 

[Furan]

I definitely don't know **** about vaccines, and probably shouldn't even be contributing to the discussion, but in my experience I think the weird distrust with western medicine sometimes stems from the lack of full disclosure by healthcare providers. For example, instead of pushing vaccines as something that are 100% good with no negatives, just be honest about the potential consequences and explain why the benefits far outweigh the risks. This way when the one infant that died from anaphylaxis gets on the news, people don't immediately jump to conspiracy theories.

That's how mommy blogs work, they find the 7 out of 4 million cases where something bad happened and it was published, then use those cases as proof against western medicine. Instead of denying it and/or calling them stupid, just embrace it and acknowledge that these are unfortunate casualties of a necessary process. If they choose to ignore it then, well, darwinism -- we have population issues anyway.

 

[Ismet]

Well I offered my account to them to use lol. But yeah . It's sad to me.

Have you, or anyone really, found a useful way to discuss these things with people? And by useful I mean get the child the proper health it needs and deserves. I feel like I've never met an anti vaxxer whose open to the conversation :/

I think a good approach is starting from the parent's point of view. Ask what they know about the vaccine. You need to understand their mindset before you can try to educate and change that mindset. And if it doesn't happen at the 12 month visit and they refuse the MMR or varicella, give them patient-friendly information to read and revisit the discussion at the 15 month visit. I really don't like "scare tactics" but it's important to discuss the dangers of having the diseases that the vaccines prevent against.

The biggest kickback I get is with Gardasil, which is still somewhat understandable as it is a relatively new vaccine, but there are a lot of misconceptions about it. I've had several parents agree to get it for their kids after I sat down and explained all the benefits, the actual risks, and debunked the stupid articles that are floating around FB. Some parents of boys don't know that it protects against cancers other than cervical cancer. Some parents don't understand that we vaccinate so "early" so that they can be protected before they start being sexually active, instead of waiting until they're older. And some parents just believe the junk articles their friends post on Facebook.

But really, you can't win them all. There are always going to be parents who refuse despite your best effort.

 

[vendtex]

I definitely don't know **** about vaccines, and probably shouldn't even be contributing to the discussion, but in my experience I think the weird distrust with western medicine sometimes stems from the lack of full disclosure by healthcare providers. For example, instead of pushing vaccines as something that are 100% good with no negatives, just be honest about the potential consequences and explain why the benefits far outweigh the risks. This way when the one infant that died from anaphylaxis gets on the news, people don't immediately jump to conspiracy theories.

That's how mommy blogs work, they find the 7 out of 4 million cases where something bad happened and it was published, then use those cases as proof against western medicine. Instead of denying it and/or calling them stupid, just embrace it and acknowledge that these are unfortunate casualties of a necessary process. If they choose to ignore it then, well, darwinism -- we have population issues anyway.

No one pushes them as "100% good"


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[Psai]

I think a good approach is starting from the parent's point of view. Ask what they know about the vaccine. You need to understand their mindset before you can try to educate and change that mindset. And if it doesn't happen at the 12 month visit and they refuse the MMR or varicella, give them patient-friendly information to read and revisit the discussion at the 15 month visit. I really don't like "scare tactics" but it's important to discuss the dangers of having the diseases that the vaccines prevent against.

The biggest kickback I get is with Gardasil, which is still somewhat understandable as it is a relatively new vaccine, but there are a lot of misconceptions about it. I've had several parents agree to get it for their kids after I sat down and explained all the benefits, the actual risks, and debunked the stupid articles that are floating around FB. Some parents of boys don't know that it protects against cancers other than cervical cancer. Some parents don't understand that we vaccinate so "early" so that they can be protected before they start being sexually active, instead of waiting until they're older. And some parents just believe the junk articles their friends post on Facebook.

But really, you can't win them all. There are always going to be parents who refuse despite your best effort.

They'll figure it out when little Billy gets hpv in his throat

 

[SurfingDoctor]

And some parents just believe the junk articles their friends post on Facebook.

Gotta have a license to go fishing, but not to have children. Go figure.

 

[Furan]

No one pushes them as "100% good"

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We've had 3 lectures on vaccines and not a single one mentioned any negatives

 

[vendtex]

We've had 3 lectures on vaccines and not a single one mentioned any negatives

Never heard of Vaccine Information Sheets?

Example.
http://www.immunize.org/vis/dtap.pdf


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[Ismet]

We've had 3 lectures on vaccines and not a single one mentioned any negatives

That doesn't mean that the negatives aren't discussed in clinical medicine. I'm assuming you're still in your pre-clinical years. If your school isn't teaching it to you, look it up. We always inform patients and parents about side effects to watch for, especially of the live attenuated vaccines that are given starting at 1 year old.

 

[justin1390]

I seriously question your resident status if you honestly believe much of what you're saying in this thread.

First, VAERS is purely a self-reported database. If anything happens to a kid that a parent thinks (not can prove, just believes) was related to the vaccine, the report goes in and is included in the stats.

Now to address your previous post's highlights...

My point is this:
- we aren't playing God here, we have our limitations in knowledge
- big pharma companies have proven themselves deleterious in the past for the sake of a dime
- we're medical professionals, not sheep to an industry. That means thinking critically for ourselves and analyzing what we know. The standard of care is a moving target, and just because "my attending does it," doesn't make it necessarily good medicine. Going back to Zika virus, there is emergency detection and funding pushed through by the CDC to get a vaccine done. I would practically bet my house on the fact that any trial expedited to rush that vaccine to public disposal will be vastly underpowered and confounded...
- patients have had bad experiences with medical professionals in the past and have valid reasons for being skeptics. I'm sure people were just as adamant about the safety of thalidomide and now Zofran in pregnancy as well. We may scoff, but so did the doctors back in the day

In order:

-Duh, but many of these vaccines are older than lots of attendings. Polio and measles, for example, are the same age as my parents. If we haven't seen anything major in half a century, I feel OK saying that its safe.

-Skepticism towards new vaccines I can understand, but no one is making a fortune on 99% of the routine childhood vaccinations.

-Why do you assume that those of us who fervently believe in vaccination are just sheep? This may surprise you, but most doctors actually know what they are talking about in their area of expertise.

-Thalidomide was never approved in the US, the FDA stopped that as its supposed to. As for zofran, let's try to keep up with the literature... http://www.sciencedirect.com/science/article/pii/S0890623816300910

You obviously have many more years experience than I, but that doesn't mean that any one of us can't use the tools at our disposal. To doubt a resident status due simply to not siding entirely with mainstream medicine is perhaps . . . presumptuous. To respectfully disagree on some points:

I'm talking about chronic disease implications, not just acute immunologic reactions. For example, we know even silent Zika infections can cause microcephaly or lasting neurological deficits. We also know most chronic diseases are on the rise. There are, unfortunately a myriad of confounding factors influencing these. All I'm saying is if you claim that there is no way there may be a connection, you are probably outside the bounds of the scientific and clinical knowledge we have from an evidenced based medicine standpoint, anecdotal experience aside. There was a study that simply compared the number of adverse events reported for Hep B vaccine, and it was twice as much as other common vaccinations given with much higher frequency throughout a lifetime: http://aop.sagepub.com/content/36/3/370.short

If the 4,000,000 kids born each year are worth just $20 in a 3 series HepB vaccine, that's $80,000,000 in established, low overhead income. That sounds like enough to pad a research budget on new vaccines quite nicely.

A 2014 study found that there was an increased risk of septal defects. It was adjusted for confounding, which I'm not seeing in the new study. But I could see a scenario where there was a sicker population in the newer study as it was supported in part by the Hyperemesis Education and Research Foundation, allowing for increased complications in those untreated. That's why all research needs appraisal for application to patient population, bias, confounding, etc. http://www.ncbi.nlm.nih.gov/pubmed/25450422

As I said before, I'm in the office every week ordering PCV13s, influenza, etc. And I do recommend them, that's not going to change anytime soon. But I think the mindless hating on those questioning and doing a little research is ridiculous, because as a health care professional who was very well trained in EBM at my medical school, it is my humble (if not slightly outspoken) opinion that these may not be as safe as we always slate them to be, and I think more high quality research is needed. And thus I choose to give the patient a little more benefit of the doubt.

 

[FBurnaby]

Welcome to pediatrics. Mommy blogs and Dr. Google. Unfortunately the more reputable sources that we use for information is either inaccessible or too complicated for someone not in medicine to use. Those sources you suggested aren't free. People use whatever pops up first on a google search - wikipedia, webmd, medscape, and mommy blogs.

This is one of the key reasons. Science literacy has plummeted to the point that people have no idea what evidence is, let alone evaluate it. The real science that does exist is quite poorly communicated to the public, if communicated at all.

So you've done your research from elitist journals that are bought and paid for? They're done their research too, read every article on the first page of google search from "mercola" to "alternativemediatruthseekerz.wordpress" so I guess your opinions cancel out...

The humble and skeptical nature of science, which some are spouting here for vaccines, are only taken as weakness to these anti-vaxxers. Their "research" will always show their "alternatives" to be 100% safe with no side effects. To hypothesize potential links to chronic illness or point to anomalies in the ocean of vaccine data just confirms to them that modern medicine is evil and their kids will be fine without immunization.

Sadly, I think the only thing that will change the mind of a true anti-vaxxer is when a wonderful kid in their community dies from a vaccine preventable disease.

 

[Goro]

NO medical intervention is perfectly safe. Hell, walking down the street isn't perfectly safe, nor is walking across your living room

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591732/

The risk to benefit ratio for vaccination more than justifies their use.

As for the newborns getting the HepB. Why not? They're in the hospital and it easier. You save the parents a trip to the vaccine clinic.

Absolutely. But I think we need to think more critically about morbidity, and not just mortality. We also need to recognize the susceptibility of the system to fail to place safeguards against bias and manipulation. I'm definitely not arguing against vaccination, that's ludicrous. But I'm saying there's a reason patients are skeptical, and I understand that.

I guess here's my problem guys. It's not a problem with vaccines, it's how we study and use them.

If anyone tells me vaccines are perfectly safe and we've studied them enough to know that, I'd be pretty sure none of that information was anything but spoon fed them from their last attending or medical school. Evidence based medicine is a great example of how recommendations are constantly changing to fit what we know about risk vs benefit. I'm going to repeat it again in case anyone missed it, there's good evidence that Hepatitis B vaccine has a short immunity lifespan, may be given too early, and that we've crossed the border into doing more harm than good at the current recommendations. I've watched an attending pressure a mom into giving it because she had a friend whose baby got stuck with grandma's hep B needle in her purse. Puhleeeeeeze............ The incidence of hepatitis B in that age group, in ALL OF THE US, was 34 in 2013... Do you think I believe that story? Nope.

Have you ever used the VAERS database? The number of cases of reported deaths only (likely higher) is over 950 in the last 15 years alone (link below) due to vaccines with hep B in it (400 if you look at just Hep B [half the number in 1 out of 6 the vaccine]). We're all well trained, correct? Let's run some numbers: during the same time period there were ~63000 cases of acute Hep B. It is estimated that 1% of cases are in children less than 5 years old. Let's make it a generous 1.5%. That would be 946 new cases of AHB in these guys. Same number of deaths from the vaccine itself! And this doesn't include the over 15,000 cases of serious, debilitating effects from the vaccine. To further confound matters, 25% of new diagnoses are people born overseas. And to further confound it, only 25% of new AHB cases in perinatals will actually die from chronic liver disease complications.

To wrap it all up and put a bow on it, Johnson and Johnson poured millions into enforcement of vaccination. And guess what? They joined with Merck, the maker of the vaccines, years before doing so.

I'm just not sure I trust people in power who are lining their pockets with Johnson and Johnson dollars to do the right thing. It doesn't matter how many board certifications you have under your belt. You owe it to your patients to do the math and put two and two together. Parents are going to jail over this, and I quietly resent the health care professionals on board with that...


http://www.medalerts.org/vaersdb/findfield.php?TABLE=ON&GROUP1=AGE&VAX[]=6VAX-F&VAX[]=DTAPHEPBIP&VAX
=6VAX-F&VAX[]=DTAPHEPBIP&VAX []=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000']=6VAX-F&VAX[]=DTAPHEPBIP&VAX []=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000'][]=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW
=6VAX-F&VAX[]=DTAPHEPBIP&VAX []=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000']=6VAX-F&VAX[]=DTAPHEPBIP&VAX []=DTPHEP&VAX[]=HBHEPB&VAX[]=HEP&VAX[]=HEPAB&VAXTYPES[]=Hepatitis B&DIED=Yes&WhichAge=range&LOW AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000']AGE=&HIGHAGE=10&SUB_YEAR_LOW=2000

https://www.cdc.gov/hepatitis/statistics/incidencearchive.htm

http://www.cdc.gov/hepatitis/hbv/perinatalxmtn.htm

 

[Ophthoseidon]

 

[VA Hopeful Dr]

You obviously have many more years experience than I, but that doesn't mean that any one of us can't use the tools at our disposal. To doubt a resident status due simply to not siding entirely with mainstream medicine is perhaps . . . presumptuous. To respectfully disagree on some points:

I'm talking about chronic disease implications, not just acute immunologic reactions. For example, we know even silent Zika infections can cause microcephaly or lasting neurological deficits. We also know most chronic diseases are on the rise. There are, unfortunately a myriad of confounding factors influencing these. All I'm saying is if you claim that there is no way there may be a connection, you are probably outside the bounds of the scientific and clinical knowledge we have from an evidenced based medicine standpoint, anecdotal experience aside. There was a study that simply compared the number of adverse events reported for Hep B vaccine, and it was twice as much as other common vaccinations given with much higher frequency throughout a lifetime: http://aop.sagepub.com/content/36/3/370.short

If the 4,000,000 kids born each year are worth just $20 in a 3 series HepB vaccine, that's $80,000,000 in established, low overhead income. That sounds like enough to pad a research budget on new vaccines quite nicely.

A 2014 study found that there was an increased risk of septal defects. It was adjusted for confounding, which I'm not seeing in the new study. But I could see a scenario where there was a sicker population in the newer study as it was supported in part by the Hyperemesis Education and Research Foundation, allowing for increased complications in those untreated. That's why all research needs appraisal for application to patient population, bias, confounding, etc. http://www.ncbi.nlm.nih.gov/pubmed/25450422

As I said before, I'm in the office every week ordering PCV13s, influenza, etc. And I do recommend them, that's not going to change anytime soon. But I think the mindless hating on those questioning and doing a little research is ridiculous, because as a health care professional who was very well trained in EBM at my medical school, it is my humble (if not slightly outspoken) opinion that these may not be as safe as we always slate them to be, and I think more high quality research is needed. And thus I choose to give the patient a little more benefit of the doubt.

So tell me, what chronic diseases do you think vaccines are causing?

 

[MeltingIceCube]

Interesting that people don't understand herd immunity, yet they act like sheep. Oh the irony.

Ohhh I like this. When I use it I will quote "SurfingDoctor".

 

[SurfingDoctor]

Ohhh I like this. When I use it I will quote "SurfingDoctor".

Patent pending...

 

[unsweetened88]

Remember the good old days when 4 or 5 public health workers made house calls? They'd break down the door and hold you down while the other guy gave you the vaccine.

 

[Taco Time]

20th century: 300-500 million people died of smallpox. For comparison, today's population of all of South America is ~420 million people; Europe is at ~730 million, & North America is at ~500 million.

1979 (with still a couple decades left in the 20th century): smallpox is considered eradicated--with the last reported case being in 1977.

I have a buddy whose parents went to great lengths to shell him and his siblings through private schooling from pre-K to 12th grade. For some reason, they're the well-off family, typical of anti-vaxxers, who are skeptical but without inquisition. They're strong skeptics against the utility of vaccinations and the science behind treating cancer cells with chemo and radiation. It irks me because every time I have a couple of conversations with him on vaccines, I am always amazed at the notions he has. Are some vaccines overkill? Maybe. But, why take a bigger risk (stopping immunizations for diseases) to avoid a potential smaller risk that does not have a strong scientific basis?

If there ever is another smallpox type bug that comes up--hopefully there isn't--and kills millions, these people will be in line to receive a vaccine if/when it's made available. I doubt their skepticism would persist. Until then, I think it's best to not get too contentious with family, friends, and neighbors all while stating clearly that vaccines aren't part of some conspiracy but are actually beneficial.

 

[Dr. Janitor]

Try this putting it this way.....

 

[Microshaft]

Try this putting it this way.....

MM AHhhhhhhhhh vaccine

 

[unsweetened88]

Did you know Dr. Oz doesn't vaccinate his kids? Just sayin'.

I read it in a magazine at my doctor's office. I was early for my appointment. lol

 

[Cara Delevingne]

Well, you'd be lying if you said that vaccines will not kill you. There's no way you can make the guarantee that they will 100% live or have zero adverse effects
http://www.who.int/vaccine_safety/i...enza_Vaccine_rates_information_sheet.pdf?ua=1

However, the incidence of these AEs occurring is so low that the benefits completely outweigh the risks. As is the case for literally anything in the world.

 

[Goro]

The anti-vaxxers were notably quiet during the 2009 swine flu pandemic. When it hits home, they start rolling up their sleeves for their shots. If Zika becomes widespread in the US, just watch for this to happen.

I don't know the exact psychology, but it has something to do with threat perception. is, if something is more real, they'll perceive it more realistically. I guess measles and rubella are too abstract, much less smallpox and diphtheria.

If there ever is another smallpox type bug that comes up--hopefully there isn't--and kills millions, these people will be in line to receive a vaccine if/when it's made available. I doubt their skepticism would persist. Until then, I think it's best to not get too contentious with family, friends, and neighbors all while stating clearly that vaccines aren't part of some conspiracy but are actually beneficial.

 

[Psai]

The anti-vaxxers were notably quiet during the 2009 swine flu pandemic. When it hits home, they start rolling up their sleeves for their shots. If Zika becomes widespread in the US, just watch for this to happen.

I don't know the exact psychology, but it has something to do with threat perception. is, if something is more real, they'll perceive it more realistically. I guess measles and rubella are too abstract, much less smallpox and diphtheria.

Made me feel so validated when I read those stories about the cali parents whose kids got super sick because of their parents' ridiculous beliefs. Poor kids though, I'm glad that the government stepped in to protect them.

 

[justin1390]

NO medical intervention is perfectly safe. Hell, walking down the street isn't perfectly safe, nor is walking across your living room

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591732/

The risk to benefit ratio for vaccination more than justifies their use.

As for the newborns getting the HepB. Why not? They're in the hospital and it easier. You save the parents a trip to the vaccine clinic.

So tell me, what chronic diseases do you think vaccines are causing?

Of course I agree with both of you on this point, but I think where we really diverge is in the idea that it needs further studying. I am an evidenced-based medicine stickler, and I also view myself as a healthy skeptic of any system I'm in because I want to push the boundary of cutting edge improvement. And I think that's perhaps why I go against the grain on some of these things.

All I'm saying is that if we are practicing truly cutting edge medicine, which if it hasn't really clicked yet, I don't think we do very well at all, then we would attempt to find a crossover between when and how much vaccination we are pushing and where that mortality/morbidity intersects the benefit.

And I think that, given my own literature review and appraisal of articles, there is a justification for parents being skeptical about some vaccines.

Furthermore, it's quite evident even from the responses on this post that the medical community as represented here is quite close-minded to even the possibility there may be better alternatives (or that pharmaceutical bias exists), and that bothers me ... a lot. That kind of mindset really kills the ability of the medical community to openly research better alternatives.

You say "why not give it to kids while they are in the hospital?" The majority of adverse reactions are in children under 4. Who also happen to be in the lowest risk category. Who also happen to represent the lowest categories of new diagnoses... More and more early environmental exposures to a whole host of different things are showing increasing correlation to chronic disease: http://www.webmd.com/asthma/news/20160826/early-virus-raises-asthma-risk-in-certain-kids-study But if a mom comes into the office and asks to wait until their child is a bit older to avoid a possible reaction, she gets labeled an anti-vaxer. Is anything I have mentioned above sounding unreasonable to people? If anything, a stubborn medical community and hardline anti-vaxers begin to look like two groups playing tug-of-war, and what they really need is ref to call foul...

I maintain what I feel is a progressive stance on vaccination:
-I'd respectfully remind people that diverting from the normal vaccination schedule is not anti-vaccination, just a modification of something we already know to be beneficial
-To say there isn't a chance of correlation with acute or chronic disease is quite simply out of the scope of knowledge we have now in any comprehensive capacity
-We'd do right by our patients and ourselves to, at the very least, keep an open mind in a field where standard of care is a moving target

 

[vendtex]

Of course I agree with both of you on this point, but I think where we really diverge is in the idea that it needs further studying. I am an evidenced-based medicine stickler, and I also view myself as a healthy skeptic of any system I'm in because I want to push the boundary of cutting edge improvement. And I think that's perhaps why I go against the grain on some of these things.

All I'm saying is that if we are practicing truly cutting edge medicine, which if it hasn't really clicked yet, I don't think we do very well at all, then we would attempt to find a crossover between when and how much vaccination we are pushing and where that mortality/morbidity intersects the benefit.

And I think that, given my own literature review and appraisal of articles, there is a justification for parents being skeptical about some vaccines.

Furthermore, it's quite evident even from the responses on this post that the medical community as represented here is quite close-minded to even the possibility there may be better alternatives (or that pharmaceutical bias exists), and that bothers me ... a lot. That kind of mindset really kills the ability of the medical community to openly research better alternatives.

You say "why not give it to kids while they are in the hospital?" The majority of adverse reactions are in children under 4. Who also happen to be in the lowest risk category. Who also happen to represent the lowest categories of new diagnoses... More and more early environmental exposures to a whole host of different things are showing increasing correlation to chronic disease: http://www.webmd.com/asthma/news/20160826/early-virus-raises-asthma-risk-in-certain-kids-study But if a mom comes into the office and asks to wait until their child is a bit older to avoid a possible reaction, she gets labeled an anti-vaxer. Is anything I have mentioned above sounding unreasonable to people? If anything, a stubborn medical community and hardline anti-vaxers begin to look like two groups playing tug-of-war, and what they really need is ref to call foul...

I maintain what I feel is a progressive stance on vaccination:
-I'd respectfully remind people that diverting from the normal vaccination schedule is not anti-vaccination, just a modification of something we already know to be beneficial
-To say there isn't a chance of correlation with acute or chronic disease is quite simply out of the scope of knowledge we have now in any comprehensive capacity
-We'd do right by our patients and ourselves to, at the very least, keep an open mind in a field where standard of care is a moving target

What diseases are you suggesting that kids under 4 are at lower risk for?


Sent from my iPhone using Tapatalk

 

[justin1390]

What diseases are you suggesting that kids under 4 are at lower risk for?


Sent from my iPhone using Tapatalk

I've been knocking on Hepatitis B. It's typically blood borne and kids under 4 have the lowest rate of infection.

 

[vendtex]

I've been knocking on Hepatitis B. It's typically blood borne and kids under 4 have the lowest rate of infection.

The rationale for giving it early was based on the ineffectiveness of reducing the disease by the strategy of only giving it to high risk groups. If I'm not mistaken wasn't your "evidence of adverse effects" a study of adult hepatitis B vaccine?


Sent from my iPhone using Tapatalk

 

[justin1390]

The rationale for giving it early was based on the ineffectiveness of reducing the disease by the strategy of only giving it to high risk groups. If I'm not mistaken wasn't your "evidence of adverse effects" a study of adult hepatitis B vaccine?


Sent from my iPhone using Tapatalk

I don't disagree with what you've noted above. Perhaps you can point out where discrepancy lies? I'm only trying to note that there is likely a point at which time a vaccine's effectiveness at reducing incidence crosses over with its harm. And that perhaps the rigorous recommendation of vaccination of infants may have an increase mortality/morbidity benefit vs vaccinating those same children when they are a year or two old.

In regards to adverse effects, to which evidence are you referring? The sources I have listed in prior posts primarily deal with children <10 years of age.

 

[lymphocyte]

This thread seems like an appropriate place to celebrate the news.

"Before a separate, worldwide vaccination drive against measles began in the 1980s, the disease caused 2.6 million deaths a year worldwide - 12,000 of them in the Americas. Measles is the fifth vaccine-preventable disease to be eliminated in the Americas--after smallpox in 1971, poliomyelitis in 1994, and rubella and congenital rubella syndrome in 2015."

http://www.scientificamerican.com/article/the-americas-are-now-measles-free/

 

[njtrimed]

It's so easy to be relaxed about this when you don't have kids who are directly affected by this mentality. My daughter is 2 and is healthy, so I'm not that worried. However, she contracted varicella recently, despite her MMRV vaccine a year ago. She had the vaccine, so her case was mild, with a mostly asymptomatic rash. My next kid may not be so lucky- mumps or measles in a newborn can be lethal, as can pertussis. This refusal to vaccinate is a serious and life-threatening epidemic, and all med students need to be aware of it and the potential repercussions.