Archive for 2008

« Older Entries
Newer Entries »

Vaccination Not Related to Mortality Decline in Elderly Say NIH, Other Government Researchers

Thursday, February 28th, 2008

Careful analysis of the data concerning flu-related mortality among the elderly makes it clear that although flu-related deaths are declining in that population, the decline is not related to vaccination. That is the conclusion of a team of researchers from the National Institutes of Health, National Institute of Allergy and Infectious Diseases and other prestigious institutions.
This important paper should be shared with internists and elderly patients along with their caregivers.
When coupled with the information () recently published by Russel Blaylock, MD, showing that flu vaccines put the elderly at special risk for inflammatory neuropathy, homicide and suicide, this draws a rather compelling picture mitigating against flu vaccination for the elderly.

Yours in health and freedom,
Dr. Rima

Rima E. Laibow, MD

Medical Director
Natural Solutions Foundation
www.HealthFreedomUSA.org
www.GlobalHealthFreedom.org

Impact of Influenza Vaccination on Seasonal Mortality in the US Elderly Population
Vol. 165 No. 3, February 14, 2005

Lone Simonsen, PhD; Thomas A. Reichert, MD, PhD; Cecile Viboud, PhD; William C. Blackwelder, PhD; Robert J. Taylor, PhD; Mark A. Miller, MD

Arch Intern Med. 2005;165:265-272.

Background Observational studies report that influenza vaccination reduces winter mortality risk from any cause by 50% among the elderly. Influenza vaccination coverage among elderly persons (≥65 years) in the United States increased from between 15% and 20% before 1980 to 65% in 2001. Unexpectedly, estimates of influenza-related mortality in this age group also increased during this period. We tried to reconcile these conflicting findings by adjusting excess mortality estimates for aging and increased circulation of influenza A(H3N2) viruses.

Methods We used a cyclical regression model to generate seasonal estimates of national influenza-related mortality (excess mortality) among the elderly in both pneumonia and influenza and all-cause deaths for the 33 seasons from 1968 to 2001. We stratified the data by 5-year age group and separated seasons dominated by A(H3N2) viruses from other seasons.

Results For people aged 65 to 74 years, excess mortality rates in A(H3N2)-dominated seasons fell between 1968 and the early 1980s but remained approximately constant thereafter. For persons 85 years or older, the mortality rate remained flat throughout. Excess mortality in A(H1N1) and B seasons did not change. All-cause excess mortality for persons 65 years or older never exceeded 10% of all winter deaths.

Conclusions We attribute the decline in influenza-related mortality among people aged 65 to 74 years in the decade after the 1968 pandemic to the acquisition of immunity to the emerging A(H3N2) virus. We could not correlate increasing vaccination coverage after 1980 with declining mortality rates in any age group. Because fewer than 10% of all winter deaths were attributable to influenza in any season, we conclude that observational studies substantially overestimate vaccination benefit.

Author Affiliations: National Institute of Allergy and Infectious Diseases (NIAID) (Dr Simonsen) and Fogarty International Center (Drs Viboud and Miller), National Institutes of Health, Bethesda, Md; and Entropy Research Institute, Boston, Mass (Dr Reichert).

Posted in Buy-Cott, Medical Hazards, Vaccination | No Comments »

Vaccine Dreams: the Myths of Safety, Science and Effectiveness

Thursday, February 28th, 2008

The United States Government has given itself the authority to declare a pandemic (at any time) and require mandatory universal
forced vaccination under Patriot I, Patriot II, Bio Shield I, Bio Shield II, Bio Shield III and various Homeland Security Directives, Executive Orders and Signing Statements. Under these Acts and authorizations you may be (legally) subjected to experimental drugs – drugs which have no track record at all – without any informed consent rights, without right of refusal (unless you are willing to go to a quarantine center for an indefinite period of time) so it is now more important than ever that the real truth about vaccines be widely and quickly disseminated. There are reported to be more than 200 new vaccines “in the pipeline”. If they, along with the ones in use now, are not safe, we, and our children, are not safe.
All of us have been carefully conditioned to believe that vaccines are safe. But the truth is ugly and more than a little frightening. Here are the cold, hard facts:
Cold, Hard Fact # 1: Vaccines are not safe: vaccines are dangerous. The evidence is abundant that the tragic cost of loading babies and children up with toxic brews of mercury, aluminum, formaldehyde, injected foreign protein, stealth viruses and, in the second generation vaccines, the deadly immune enhancer squalene, is unacceptably high. Lives are ruined and lost in these children when toxins overwhelm their immune systems and brains and cause tragic, totally preventable suffering and death. Autism(occurring in 4 children per 10,000 when I graduated from medical school in 1970) now afflicts a minimum of 1 child in 168 in the US. Children have not changed: the poisons we give them have. Gulf War Syndrome, a pervasive, progressive, deadly auto-immune disease afflicting over half a million US veterans, appears to be a deadly vaccine reaction to an experimental vaccine (Anthrax) which the US used on soldiers without their consent in clear violation of the Helsinki Declaration and the Nuremberg Protocols, international conventions and agreements which prohibit human experimentation without fully informed consent. Vaccinated people come down with the diseases they are supposedly vaccinated against with astonishing frequency.

The concept of informed consent, is, of course, is meaningless in the face of compulsory vaccination with secret ingredients and no manufacturer accountability.

Contaminants make vaccines tremendously dangerous. Swine flu (for a pandemic which never materialized) was contaminated with polio virus in 1976. Over 45 million Americans were vaccinated in just 77 days and although there were only 6 cases of Swine
flu in the entire country the vaccine reportedly caused at least 565 cases of polio paralysis (renamed “Guillain-Barre Syndrome” for the occasion), 60 deaths and other serious problems, including blindness and impotence. (There is no reason to feel reassured
because this particular disaster occurred in the past: every flu vaccine is capable of passing along Guillain-Barre (polio) and other unsuspected viral diseases.)

In February, 2008, the CDC announced that the seasonal flu vaccine being pushed, and required, of children, adults and the elderly was strikingly ineffective, missing more than 60% of the viruses circulating this flu season. That did not stop them, States, schools, hospitals, the New York City Department of Health, the American Academy of Pediatrics and myriad other “Health” organizations from continuing to insist on its use, despite its well characterized dangers.

Cold, Hard Fact # 2: Vaccines have not eradicated diseases: vaccines spread diseases. Attenuated viruses (infective, weakened versions of the dangerous ones) are commonly used in vaccines so that your body will develop an immune ‘memory’ for that virus. The next time your immune system meets that specific virus, it rapidly combats it by producing large numbers of antibodies. This practice and theory derive from the dawn of vaccination: Edward Jenner’s pioneering use of cowpox pus inoculations to eliminate
smallpox. This innovative and surprising medical treatment is touted as one of the triumphs of modern medicine. It makes a wonderful story but, in fact, inoculation not only spread smallpox, it caused well-documented epidemics of syphilis and leprosy in
inoculated people, especially babies (who have immature immune systems). In spite of the documented associated dangers of leprosy, syphilis, smallpox, death and blindness, England provided free vaccination in 1840, made it compulsory in 1853, and punished
lack of vaccination with seizure of property and imprisonment in 1857 (which should sound familiar). It took a British Royal Commission some 41 years more to put a stop to the deaths and disease that Jenner’s unproven technique caused. Finally, in 1898,
England’s compulsory smallpox vaccination laws were overturned.

In 1854, the first year of British compulsory vaccination, deaths from syphilis in infants under 1 year increased by 50% and continued to rise steadily after that. In 1802 Jenner was paid 10,000 pounds by the House of Commons. Shortly afterwards, it became clear
that vaccines did not work. Rather than lose face, the House of Commons granted Jenner another 20,000 pounds in 1807 and 3,000 pounds a year thereafter.

Jenner knew that milk maids who milked with active pus-filled sores on their hands transmitted pox to their cows. Local superstition held that the cow’s pus was a preventive against small pox. Jennings learned from a local farmer, Benjamin Jestey, that he had inoculated his wife and 3 children with cowpox pus by jabbing them with a darning needle and they did not contract small pox. Jenner assumed that this meant they were protected against smallpox. To the modern ear this is absurd. In Jenner’s day, neither methodology nor the scientific method were part of the culture.

Jenner, a village apothecary who purchased a University of Edinburgh MD for 15 pounds, was a showman who made much of his “discovery” and hastened to induce Sarah Nelmes, a young milk maid with a fresh lesion on her finger, to allow him to collect pus from her sore. He inoculated an 8 year old named James Phipps who developed a fever and a pustule on his skin. Seventeen days later he inoculated the boy again, this time with small pox. Since the boy did not develop smallpox, Jenner concluded that “protection was complete”.

Jenner hawked his inoculation but people started to complain because they were developing smallpox (and syphilis) after vaccination with Jenner’s cowpox. Jenner switched to infected material from horses’ heels instead (“Horse-grease”). John Baker, the child he inoculated with horse-grease, however, died before he could expose him to small pox. Undeterred, he inoculated 6 more children, including James Phipps, with horse-grease and was so convinced that the results would be positive that he rushed to London to publish them before there were any results. The [untested] “success” of James Phipps’ inoculation and his London paper established Jenner’s method and his success. Revolted by the idea of horse-grease inoculations, people demanded cowpox inoculations again. Jenner
complied.

But just what is cow pox? In tropical countries it is cutaneous smallpox plus leprosy (a non-lethal disease often present along with leprosy) while in more moderate climates the milk maids were transferring syphilis to the cattle along with their cutaneous smallpox.
Jenner was making his brew from the cowpox pus and the results were nothing short of disastrous for untold numbers of people.

Modern small pox vaccines are produced in much the same way: lesions are induced on the skin of calves and, after they are “sacrificed” [and sold for veal?], the harvested material from their lesions is cultured in eggs and prepared as vaccines.

However, although immunity fails to develop more than 80% of the time, serious side effects are distressingly common from the modern small pox vaccines: At least 52 people out of every million will have life threatening events and 1-2 will die. Permanent damage to heart, brain, skin and GI effects are also well known side effects. The Center for Disease Control (CDC) notes that serious side effects and dangers probably occur much more often since many people can be harmed by live virus vaccines: immune compromised people (on steroids, with eczema or psoriasis, nursing babies, pregnant women and their fetuses, people with HIV/AIDS, transplant patients, chemotherapy and radiation patients, people with auto-immune diseases, young children, asthmatics, etc.) are at serious risk for contracting the same disease that the inoculation is designed to prevent or worse.

In the US, the CDC classifies more than 60 million people as immune compromised. People who are re-inoculated after many years are particularly susceptible to severe and life threatening reactions. Those who are ill are likely to develop sever effects as well.
In fact, Tommy Thompson, former Health and Human Services boss, said that he would not take the vaccine although the US is stock piling “a dose of smallpox vaccine with every American’s name on it”. Perhaps the one with his name has been changed so it
reads, “To Whom It May Concern”.

Emergency vaccinations for a Homeland Security emergency, that is, a pandemic, will allow absolutely no exemptions
for medical conditions or personal conviction. None.

Dr. Mike Lane, former director of the CDC’s so-called “smallpox eradication program” in the 1970’s, is a proponent of mass vaccination with no exemptions saying, “Medical contraindications would not apply… there would be NO exceptions. [In India] I’m sure that we killed a few people, but we did the best that we could….If the person is exposed there will be no exemptions, medical or otherwise.”

When a live virus is used in the vaccine, infective virus is shed for anywhere from 4 to 21 days (or more) and, during that time, inoculated persons can give the disease, or the side effects of the inoculation, to any vulnerable person they come into contact with.

So, while it may be true that vaccines have spread disease, isn’t it true that vaccines have eliminated the epidemic diseases of the past? No, actually they have not. Neither Jenner’s cowpox inoculation nor modern smallpox inoculation did anything to eliminate
smallpox (quite the contrary). The fact is, Dr. Charles A. R. Campbell discovered that smallpox is transmitted by the flying bedbug, Cimex lectularius, and that eliminating this parasitic insect from human habitation eliminates smallpox, too. Personal hygiene and
better housekeeping eliminated the deadly scourge. (Dr. Campbell also discovered that the disfiguring pocks of the disease could be prevented by a diet high in Vitamin C.)

When the World Health Organization (WHO) declared the planet “smallpox free” in 1980, they did so administratively, not medically: small pox incidence was reduced, but not gone, despite nearly universal vaccination. What to do? WHO solved the problem
cleverly: they renamed the disease “cowpox” and “monkey pox”. Shazam: a smallpox free planet, quicker than you can say, “Junk Science!”

Other epidemic diseases were in sharp decline at the end of the 19th and early 20th centuries as a direct consequence of improved hygiene and other life-style changes. Measles, Diphtheria, Whooping Cough, Polio and Hepatitis B were all in sharp decline
long before vaccines were introduced. The contribution to the decline made by vaccines, however, was negligible or non-existent. Scarlet Fever, typhoid fever and cholera, for which inoculation either did not exist or was never wide-spread, declined on the same
sharp curve for the same reasons. So do we need inoculations because of the public health hazard? Despite the considerable hype, in fact, there is no unbiased evidence which connects disease prevention with inoculation.

Cold, Hard Fact # 3: Flu vaccines do not protect people from flu-related deaths. The CDC claims that an astonishing 36,000 people die from flu in an average year. But according to the former Secretary of Health and Human Services, Tommy Thompson, 68 people under 65 die from flu each year in the US. The truth i,440 people, mostly elderly, died from flu, no where near the CDC’s touted 144,000 deaths. While that figure is great for flu vaccine sales, it derivers not from reality but
from the CDC’s industry-friendly statistical trick of classifying all pneumonia-related deaths, despite any lack of evidence, as flu deaths. Discussing this nonsense, Lone Simonsen of the National Institute of Allergy and Infectious Disease/NIH, writes in The
Archives of Internal Medicine “We could not correlate increasing vaccination coverage after 1980 with declining mortality rates in any age group. Because fewer than 10% of all winter deaths were attributable to influenza in any season, we conclude that observational
studies substantially overestimate vaccination benefit.”1

Cold, Hard Fact # 4: Potential pandemic viral diseases like the Bird Flu do not have safe and effective vaccines to prevent them and there are no drugs to treat them effectively. Despite that fact, on September 15, 2005 the US purchased $100 Million of a French experimental flu vaccine designed to protect against bird flu. It’s so experimental, in fact, that although we have purchased megabucks worth of the stuff, the French manufacturer, Sanofi-Pasteur, is planning to experiment with adjutants (immune response enhancers) to rev up human response to it. Perhaps the adjuvant is the same one that the Army used in the deadly Vaccine A against anthrax: squalene. The purchase is real, but there is currently no such thing as a vaccine for pandemic bird flu. None the less, the US has announced recently that it has stock piled enough “Avian Flu Vaccine” to inoculate every man, woman and child in America. With what? Against what?

Unfortunately, even if vaccines did work (they don’t) and were safe (they’re not), a virus has to actually exist before you can make a vaccine that can control the disease. The pandemic version of the latest bird flu does not yet exist. Vaccines are very specific: they
train the immune system to make antibodies to a particular protein sequence. Because those antibodies are highly specific, guessing wrong on which flu strain is coming soon to a droplet near you has led to an embarrassing history, year after year, of ineffective flu
shots against the wrong strain of virus. People developed side effects, but the shots did not ward off the flu since the vaccine misfired with regard to the virus it was supposed to be protecting people against. And, oh by the way, experimental vaccines are not even
alleged to be safe. No one knows what effects they will have. Now that the FDA, the Courts and Congress have relieved vaccine and drug manufacturers from any consumer liability whatsoever once their product has been approved by the FDA for any use whatsoever, the entire question of receiving compensation from a manufacturer for vaccine damage is moot. Vaccine damage is an uninsurable risk because no insurance underwriter in the world wants to bet that you (or your child) will NOT be damaged by the vaccines tampering with your immune, neurological and other systems. The US has paid out over 2 billion dollars through its Vaccine Injury Compensation system and recently announced in a concession that vaccines could have precipitated the autism in a child who received 9 shots on one day and then collapsed into autism. Another 49,000 cases making their way through the same Court system may be settled in the same way because of this decision. But if the damage is not autism, but, for instance, encephalitis, cancer, sterility or death, there is no system of compensation for you.

Allegedly, the bird flu pandemic version has not yet mutated and therefore does not exist so there is no way whatsoever to make a vaccine against it. Not even the US Government can make a vaccine against an imaginary virus. But that is just what the government
wants us to believe they can do. Clearly, the French experimental flu vaccine purchase is a political, not a public health one. IF the bird flu mutates and becomes pandemic, it would take between 4 and 18 months to gear up to make commercial quantities of the vaccine.1 (http://archinte.ama-assn.org/cgi/content/abstract/165/3/265) In the meantime, anyone getting the bird flu and surviving it would have natural antibodies to the disease. But right now, unless the already-mutated pandemic H5N1 virus is being stock-piled in a laboratory for convenient release at an opportune moment
(which is certainly possible), the virus needed to make a real bird flu vaccine exists only in fearful imagination. So what would the government inoculate you with? Who knows? A nanochip to track you, perhaps? The technology exists. An experimental drug, maybe? Something that someone wants to test on huge numbers of people whether they like it or not? An FDA approved sterility vaccine already used in sub Saharan Africa by the WHO and in South and Central America? Squalene? Perhaps. Perhaps not. Only the government would know. You won’t.

The US government has set itself above the law and beyond investigation. Consider: the anthrax vaccine currently being tested on US 2nd and 3rd graders contains squalene. The experiment is therefore not about anthrax (the vaccine is only approved for cutaneous anthrax, a non- life threatening disease highly unlikely to be used, therefore, as a bio-weapon) but rather about what happens to children given a deadly substance which stimulates their immune systems to destroy their bodies over time. After World War II, the managers of IG Farben, the vast German industrial combine, were imprisoned for Crimes Against Humanity for precisely this kind of activity. Who will be convicted this time? The head
of the FDA? The Secretary of Homeland Security? The Secretary of Health and Human Services? On what secret evidence? This is what the US government/pharmaceutical cabal is setting up in full view of the public and of Congress under the false flag of Homeland Security. Can you imagine what would happen if there were no public scrutiny at all and no legal liability for any ill deeds whatsoever? Only if you can imagine medical fascism – and it is no dream.

Under the banner of Homeland Security the US government has established a medical Gestapo. It has given itself the power to initiate a medical marshal law from which the only escapes would be prison, death, fleeing the country or rebellion.

Vaccines are unscientific (but highly profitable), dangerous and forced vaccinations represent a violation of personal self determination and the inalienable rights enumerated by the Declaration of Independence: Life, Liberty and the Pursuit of Happiness.

Visit www.HealthFreedomUSA.org for the latest in health freedom news. Sign up for
our Health Freedom eAlerts (http://www.healthfreedomusa.org/index.php?page_id=187) and disseminate them widely. The action steps listed in them, and on the Natural Solutions Foundation website, www.HealthFreedomUSA.org, allow you to make your voice heard. Health freedom and freedom are indivisible.

And don’t forget to donate (http://www.healthfreedomusa.org/index.php?page_id=189) generously. Your donations are fully tax deductible and are our life blood. Recurring donations are especially helpful to us.
The other side has more money than God. We depend totally on your support for our ability to continue bringing you information and meaningful health freedom strategies.

Thanks for your support and your activism.

Yours in health and freedom,
Dr. Rima
Rima E. Laibow, MD

Medical Director
Natural Solutions Foundation
www.HealthFreedomUSA.org
www.GlobalHealthFreedom.org

Posted in Activism, Disinformation, Medical Hazards, Privacy, Vaccination | No Comments »

Am. Acad. Ped. Immunization Reccomendations

Wednesday, February 27th, 2008

POLICY STATEMENT

PEDIATRICS Vol. 119 No. 4 April 2007, pp. 846-851 (doi:10.1542/peds.2007-0164)

POLICY STATEMENT
Prevention of Influenza: Recommendations for Influenza Immunization of Children, 2006–2007
Committee on Infectious Diseases

ABSTRACT

The purpose of this statement is to update recommendations for routine use of influenza vaccine in children for the 2006–2007 influenza season. The American Academy of Pediatrics recommends annual influenza immunization for (1) children with high-risk conditions who are 6 months and older; (2) healthy children 6 through 59 months of age; (3) household contacts and out-of-home caregivers of children with high-risk conditions and all healthy children younger than 5 years; and (4) health care professionals. Other children, adolescents, and adults can be immunized to decrease the impact of influenza as indicated in the Red Book: 2006 Report of the Committee on Infectious Diseases.

Key Words: influenza • vaccine • immunization • epidemiology • children • adolescents

Abbreviations: TIV—trivalent inactivated influenza vaccine • LAIV—live-attenuated influenza vaccine

KEY POINTS RELEVANT FOR THE 2006–2007 INFLUENZA SEASON

1. The recommended age range of children for annual influenza immunization has been expanded to include all healthy children 6 through 59 months of age. Studies indicate that healthy children younger than 24 months of age and children of all ages with chronic heart and lung conditions are hospitalized for influenza infection and its complications at rates similar to those experienced by the elderly. This recommendation was extended to include healthy children 24 through 59 months of age, in part, on the basis of documentation of the significant morbidity in this age group, which results in additional office and emergency department visits and increased use of antimicrobial agents. This preschool-aged cohort is also an important potential source of transmission of influenza to household members and others in the community.
2. Household contacts and out-of-home caregivers of either high-risk children and adolescents or all healthy children younger than 5 years should also receive influenza vaccine each year. To reduce the risk of exposure to influenza, especially in infants younger than 6 months, who are too young to be immunized, it is essential that all contacts of high-risk children and all children younger than 5 years be immunized each year.
3. All high-risk children of any age, all healthy children 6 through 59 months of age, and all healthy 5- to 18-year-olds who are contacts of either high-risk persons or children younger than 5 years should be identified, and their parents should be informed that annual influenza immunization is due (Fig 1).
* Previously unimmunized children 6 months to younger than 9 years of age should receive 2 doses of influenza vaccine to maximize protection during the influenza season.
* Available data suggest that children younger than 9 years who did not receive the second dose of influenza vaccine in the initial year that influenza vaccine was given may not be adequately protected with only 1 dose the next influenza season. In this group, levels of protection can be suboptimal, especially if the antigenic specificity of the predominant strains has changed from the previous year. Thus, the American Academy of Pediatrics recommends that 2 doses be given to these children the following influenza season.* This recommendation applies only to the influenza season that follows the first year that a child younger than 9 years receives influenza vaccine.

4. Two of the 3 strains in the 2006–2007 influenza vaccine are different from last year’s vaccine. On the basis of global surveillance of influenza virus isolates, the influenza vaccine formulated for this season contains new components to match the strains expected to circulate this year.
5. Amantidine and rimantadine should not be prescribed during this influenza season. Widespread resistance to these antiviral medications now exists among influenza A viral strains. Therefore, the only antiviral therapies available for chemoprophylaxis or treatment of influenza in children this year are the neuraminidase inhibitors (ie, oseltamivir or zanamivir), which should be prescribed as recommended in the Red Book: 2006 Report of the Committee on Infectious Diseases.
6. Influenza vaccine should be offered throughout the influenza season, well into late winter and up to May 1, 2007. Because the influenza season peaks in January and February and often extends into March and beyond, administration of influenza vaccine later in the season can still offer protection to recipients during that specific influenza season. Therefore, if a child requires 2 doses of the influenza vaccine this year, the second dose can still be given later in the season. There may be more than 1 peak of activity during an influenza season, so later immunization may still help protect from a later peak caused by a different strain of the influenza virus that season (Fig 2).
7. Outreach and infrastructure to immunize more children should be developed. All health care professionals, influenza campaign organizers, and public health agencies should work together, especially if prioritization for administering influenza vaccine is indicated when vaccine supplies become delayed or limited.

INFLUENZA VACCINES

Tables 1 and 2 summarize information on the 2 types of influenza vaccine used to immunize both children and adults—trivalent inactivated influenza vaccine (TIV) and live-attenuated influenza vaccine (LAIV)—as well as the licensed age group of each available preparation. Both vaccines contain 3 virus strains (2 strains of influenza A [subtypes H1N1 and H3N2] and 1 strain of influenza B) that are selected annually on the basis of the viruses anticipated to be circulating during the upcoming influenza season. Children with serious allergies to chicken or egg proteins should not receive these vaccines, because both TIV and LAIV are developed with embryonated hen eggs. Inactivated influenza vaccine is preferred for close contacts of very severely immunosuppressed people.

TIV is an inactivated vaccine, administered intramuscularly, that contains killed viruses and, therefore, cannot produce signs or symptoms of influenza caused by active virus infection. The most common symptoms associated with TIV administration are soreness at the injection site and fever. Fever, usually occurring 6 to 24 hours after immunization, affects approximately 10% to 35% of children younger than 2 years. Mild systemic symptoms such as nausea, lethargy, headache, muscle aches, and chills also can occur with TIV injection.

TIV is administered intramuscularly into the anterolateral thigh of infants and young children and into the deltoid muscle of older children and adults (injection-site recommendations are outlined in the Red Book: 2006 Report of the Committee on Infectious Diseases). Recent concerns about thimerosal have prompted some parents to reconsider influenza immunization. However, the benefits of protecting children against the known risks of influenza far outweigh the theoretic risks associated with the small amounts of thimerosal in some currently available forms of influenza vaccine. In addition, certain types of TIV without thimerosal can be obtained, including single-dose Fluzone (sanofi pasteur, Swiftwater, PA) and Fluvirin (Novartis Vaccines, Emeryville, CA), but the latter is not licensed for children younger than 4 years.

LAIV is a live-attenuated vaccine that is administered intranasally and is licensed by the Food and Drug Administration for healthy individuals 5 through 49 years of age. LAIV has the potential to produce mild signs or symptoms related to influenza virus infection. The cold-adapted formulation that is licensed in the United States must be stored at –15°C or colder. LAIV may be stored in frost-free freezers without using a freezer box. When the vaccine is warmed to room temperature for intended use, it must be used within 30 minutes. It should not be refrozen after thawing because of decreased vaccine potency.

CURRENT RECOMMENDATIONS

Immunization with TIV is recommended for the following groups (Fig 1):

* Healthy children 6 through 59 months of age
* High-risk children 6 months and older and adolescents with underlying medical conditions, including:

-> Asthma or other chronic pulmonary diseases such as cystic fibrosis
-> Hemodynamically significant cardiac disease
-> Immunosuppressive disorders or therapy
-> HIV infection
-> Sickle cell anemia and other hemoglobinopathies
-> Diseases requiring long-term salicylate therapy, such as rheumatoid arthritis or Kawasaki disease
-> Chronic renal dysfunction
-> Chronic metabolic disease such as diabetes mellitus
-> Any condition that can compromise respiratory function or handling of secretions or can increase the risk of aspiration, such as cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders

* Any female who will be pregnant during influenza season

To prevent additional cases of influenza and transmission from these patients to at-risk individuals, influenza immunization with TIV or LAIV is recommended for the following persons, unless contraindicated:

* Healthy household contacts and out-of-home caregivers of either high-risk children and adolescents or children younger than 5 years; immunization of close contacts of children younger than 6 months is especially important, because influenza vaccine is not licensed for use in these infants
* Healthy contacts and caregivers of other children or adults at high risk of complications from influenza infection
* Close contacts of immunosuppressed people
* Health care professionals or volunteers in hospitals or medical offices

Children or adolescents should not receive TIV if they

* Had a severe allergic reaction to a previous dose or vaccine component, including eggs
* Are younger than 6 months
* Have a moderate-to-severe febrile illness (minor illnesses, with or without fever, do not contraindicate use of TIV, particularly among children with mild upper respiratory tract symptoms or allergic rhinitis)
* Had Guillain-Barré syndrome within 6 weeks after a previous dose of influenza vaccine

Children or adolescents should not receive LAIV if they

* Are younger than 5 years
* Have a moderate-to-severe febrile illness
* Received other live-antigen vaccine(s) within the last 4 weeks
* Had a severe allergic reaction to a previous dose or vaccine component, including eggs
* Are receiving salicylates
* Have a known or suspected immunodeficiency
* Have a history of Guillain-Barré syndrome
* Have asthma or reactive airways disease
* Have other conditions traditionally considered to place them at high risk of severe influenza (chronic pulmonary or cardiac disorders, pregnancy, chronic metabolic disease, renal dysfunction, hemoglobinopathies, or immunosuppressive therapy)

PRECAUTIONS

Consideration of the potential risks and benefits of administering influenza vaccine to any child with known or suspected immunodeficiency is discussed in the Red Book: 2006 Report of the Committee on Infectious Diseases.

Precaution also should be taken when considering LAIV administration to persons with minor acute illness such as a mild upper respiratory tract infection with or without fever. Although the vaccine can most likely be given in this case, LAIV should be temporarily deferred if nasal congestion will impede the delivery of the vaccine to the nasopharyngeal mucosa until the congestion-inducing illness is resolved.

LAIV or TIV can be used to prevent influenza in those who are in close contact with most immunosuppressed individuals. People who are in contact with severely immunosuppressed individuals, such as those being cared for in a protective environment after hematopoietic stem cell transplantation, should not receive LAIV. For such individuals, TIV is recommended.

Committee on Infectious Diseases, 2006–2007

Joseph A. Bocchini, Jr, MD, Chairperson

Robert S. Baltimore, MD

Henry H. Bernstein, DO

John S. Bradley, MD

Michael T. Brady, MD

Penelope H. Dennehy, MD

Margaret C. Fisher, MD

Robert W. Frenck, Jr, MD

David W. Kimberlin, MD

Sarah S. Long, MD

Julia A. McMillan, MD

Lorry G. Rubin, MD

Liaisons
TOP
ABSTRACT
KEY POINTS RELEVANT FOR…
INFLUENZA VACCINES
CURRENT RECOMMENDATIONS
PRECAUTIONS
Committee on Infectious…
Liaisons
Ex Officio
Consultant
Contributors
Staff
IMPORTANT RESOURCES

Richard D. Clover, MD

American Academy of Family Physicians

Marc A. Fischer, MD

Centers for Disease Control and Prevention

Richard L. Gorman, MD

National Institutes of Health

Douglas R. Pratt, MD

Food and Drug Administration

Anne Schuchat, MD

Centers for Disease Control and Prevention

Benjamin Schwartz, MD

National Vaccine Program Office

Jeffrey R. Starke, MD

American Thoracic Society

Jack Swanson, MD

Practice Action Group

Ex Officio
TOP
ABSTRACT
KEY POINTS RELEVANT FOR…
INFLUENZA VACCINES
CURRENT RECOMMENDATIONS
PRECAUTIONS
Committee on Infectious…
Liaisons
Ex Officio
Consultant
Contributors
Staff
IMPORTANT RESOURCES

Larry K. Pickering, MD

Red Book Editor

http://aappolicy.aappublications.org/cgi/content/full/pediatrics;119/4/846

Posted in Medical Hazards, Vaccination | No Comments »

Am. Acad. Ped. When Parents Refuse to Immunize Their Children

Wednesday, February 27th, 2008

This is an official document of the American Academy of Pediatrics discussing what to do about/with/to parents who refuse immunizatin for their children. Note that the document asserts that decision-making about the health care of the child should be shared between the parent and physician and that parents who do not agree with pediatricians to immunize their children are evaluating information less well than doctors. None the less, more than 4% of all pediatricians refuse to immunize their own young children.

CLINICAL REPORT

PEDIATRICS Vol. 115 No. 5 May 2005, pp. 1428-1431 (doi:10.1542/peds.2005-0316)
* Abstract of this Article
* PDF Version of this Article
* Email this article to a friend
* Similar articles found in:
AAP Policy Online
ISI Web of Science
PubMed
* PubMed Citation
* This Article has been cited by:
other online articles
* Search Medline for articles by:
Diekema, D. S.
* Search for citing articles in:
ISI Web of Science (8)
* Download to Citation Manager
CLINICAL REPORT
Responding to Parental Refusals of Immunization of Children
Douglas S. Diekema, MD, MPH and the Committee on Bioethics

ABSTRACT
TOP
ABSTRACT
OVERVIEW OF THE PROBLEM
PARENTAL REFUSALS AND THE…
COMMUNITY INTERESTS AND PUBLIC…
RESPONDING TO PARENTS WHO…
Committee on Bioethics, 2003…
Liaisons
Staff
REFERENCES

The American Academy of Pediatrics strongly endorses universal immunization. However, for childhood immunization programs to be successful, parents must comply with immunization recommendations. The problem of parental refusal of immunization for children is an important one for pediatricians. The goal of this report is to assist pediatricians in understanding the reasons parents may have for refusing to immunize their children, review the limited circumstances under which parental refusals should be referred to child protective services agencies or public health authorities, and provide practical guidance to assist the pediatrician faced with a parent who is reluctant to allow immunization of his or her child.

Key Words: immunization • parental refusals • medical neglect • vaccine refusal

Abbreviations: AAP, American Academy of Pediatrics

OVERVIEW OF THE PROBLEM
TOP
ABSTRACT
OVERVIEW OF THE PROBLEM
PARENTAL REFUSALS AND THE…
COMMUNITY INTERESTS AND PUBLIC…
RESPONDING TO PARENTS WHO…
Committee on Bioethics, 2003…
Liaisons
Staff
REFERENCES

The immunization of children against a multitude of infectious agents has been hailed as one of the most important health interventions of the 20th century.1–3 Immunizations have eliminated smallpox infection worldwide, driven polio from North America, and made formerly common infections like diphtheria, tetanus, measles, and invasive Haemophilus influenzae infections rare occurrences. By one account, pediatric immunizations are responsible for preventing 3 million deaths in children each year worldwide.3 Despite this success, some parents continue to refuse immunizations for their children. The number of pertussis cases has increased steadily in the United States over the past 20 years, and Web sites critical of immunization are prominent on the Internet, a source that many parents rely on for health information.4 It is ironic that the remarkable success of vaccine programs has resulted in a situation in which most parents have no memory of the devastating effects of illnesses such as poliomyelitis, measles, and other vaccine-preventable diseases, making it more difficult for them to appreciate the benefits of immunization.

According to a periodic survey of fellows of the American Academy of Pediatrics (AAP) on immunization-administration practices, 7 of 10 pediatricians reported that they had had a parent refuse an immunization on behalf of a child in the 12 months preceding the survey.5 Measles-mumps-rubella vaccine was refused most frequently, followed by varicella vaccine, pneumococcal conjugate vaccine, hepatitis B vaccine, and diphtheria and tetanus toxoids and pertussis vaccines. Four percent of pediatricians had refused permission for an immunization for their own children younger than 11 years. When faced with parents who refuse immunization, almost all pediatricians reported that they attempt to educate parents regarding the importance of immunization and document the refusal in the patient’s medical record. A small number of pediatricians reported that they always (4.8%) or sometimes (18.1%) tell parents that they will no longer serve as the child’s physician if, after educational efforts, the parents continue to refuse permission for an immunization.5

The AAP strongly endorses universal immunization. However, for universal childhood immunization programs to be successful, parents must comply with immunization recommendations. The problem of parental refusal of immunization for children is an important one for pediatricians. Parents may have many reasons for refusing immunization. Some parents may object to immunization on religious or philosophical grounds, some may object to what seems to be a painful assault on their child, and others may believe that the benefits of immunization do not justify the risks to their child. Many commonly held beliefs about the risks of immunization are not supported by available data, and they frequently originate from the unsupported claims of organizations that are critical of immunization. These antivaccine information sources not only propagate unproven claims regarding vaccines but also may undermine the physician-family relationship by challenging the parents’ trust of the medical profession.

What should the pediatrician do when faced with a parent who refuses to consent to immunizations for a child? The goal of this clinical report is to provide guidance to the pediatrician faced with this difficult situation. The physician faced with a parent who refuses to immunize a child faces 3 important and distinct issues that will be addressed in this report. First, are there situations in which parents who withhold immunizations from their children risk harming them sufficiently that their decision constitutes actionable medical neglect and should be reported to state child protective services agencies? Second, are there situations in which a parental decision to withhold immunization from a child puts other individuals at risk of harm sufficient to justify public health intervention? Finally, how should the pediatrician respond to a parent who refuses immunizations for his or her child?

PARENTAL REFUSALS AND THE BEST INTERESTS OF CHILDREN

Health care professionals and parents are bound by the duty to seek medical benefit for and minimize harm to children in their care. When faced with the decision to immunize a child, the welfare of the child should be the primary focus. However, parents and physicians may not always agree on what constitutes the best interest of an individual child. In those situations, physicians may need to tolerate decisions they disagree with if those decisions are not likely to be harmful to the child.6 Although decision-making involving the health care of children should be shared between physicians and parents, parental permission must be sought before children receive medical interventions, including immunizations.7 Parents are free to make choices regarding medical care unless those choices place their child at substantial risk of serious harm.

Whether parents place their children at substantial risk of serious harm by refusing immunization will depend on several factors, including the probability of contracting the disease if unimmunized and the morbidity and mortality associated with infection. The results of such an analysis will also vary depending on the prevalence of disease in the community in which the child resides or the areas in which the child is likely to travel. The balance between the risks and benefits to a given individual favors immunization most strongly when rates of immunization in the community are low and disease prevalence is high. In most cases, however, as immunization rates increase and disease prevalence decreases, the balance may tip the other way.8,9 Although the benefits of a measles-vaccine program, for example, clearly outweigh the risks at a population level,10 an unimmunized child living in a well-immunized community derives significant indirect protection from herd immunity.11 Even in a community with high immunization rates, the risk assumed by an unimmunized child is likely to be greater than the risks associated with immunization. However, the risk remains low, and in most cases the parent who refuses immunizations on behalf of his or her child living in a well-immunized community does not place the child at substantial risk of serious harm.

The role of the physician in these situations is to provide parents with the risk and benefit information necessary to make an informed decision and to attempt to correct any misinformation or misperceptions that may exist. For example, in a national survey of parents, 25% believed falsely that their child’s immune system could become weakened as a result of too many immunizations.12 Exploring and addressing parental concerns may be an effective strategy with reluctant parents. Only in rare cases in which the decision of a parent places a child at substantial risk of serious harm may the health care professional be obligated to involve state agencies in seeking to provide the necessary immunization over the parents’ objections. For example, for the situation in which a child has sustained a deep and contaminated puncture wound, it might be justifiable to challenge the decision of a child’s parents to refuse treatment with tetanus vaccine. In these situations, the health care professional would involve the appropriate state child protective services agency because of the concern about medical neglect. It would be up to the state agency to decide whether immunization would be required. Although this role of the state has been recognized as constitutionally valid in the United States, courts have closely examined such actions, showing reluctance to require medical treatment over the objection of parents “except where immediate action is necessary or where the potential for harm is rather serious.”13

COMMUNITY INTERESTS AND PUBLIC HEALTH
TOP
ABSTRACT
OVERVIEW OF THE PROBLEM
PARENTAL REFUSALS AND THE…
COMMUNITY INTERESTS AND PUBLIC…
RESPONDING TO PARENTS WHO…
Committee on Bioethics, 2003…
Liaisons
Staff
REFERENCES

The benefits provided by most vaccines extend beyond benefit to the individual who is immunized. There is also a significant public health benefit. Parents who choose not to immunize their own children increase the potential for harm to other persons in 4 important ways.14 First, should an unimmunized child contract disease, that child poses a potential threat to other unimmunized children. Second, even in a fully immunized population, a small percentage of immunized individuals will either remain or become susceptible to disease. These individuals have done everything they can to protect themselves through immunization, yet they remain at risk. Third, some children cannot be immunized because of underlying medical conditions. These individuals derive important benefit from herd immunity and may be harmed by contracting disease from those who remain unimmunized. Finally, immunized individuals are harmed by the cost of medical care for those who choose not to immunize their children and whose children then contract vaccine-preventable disease.

A parent’s refusal to immunize his or her child also raises an important question of justice that has been described as the problem of “free riders.”14–16 Parents who refuse immunization on behalf of their children are, in a sense, free riders who take advantage of the benefit created by the participation and assumption of immunization risk or burden by others while refusing to participate in the program themselves. The decision to refuse to immunize a child is made less risky because others have created an environment in which herd immunity will likely keep the unimmunized child safe. These individuals place family interest ahead of civic responsibility. Although such parents do reject what many would consider to be a moral duty, coercive measures to require immunization of a child over parental objections are justified only in cases in which others are placed at substantial risk of serious harm by the parental decision.

Compulsory immunization laws in the United States have been upheld repeatedly as a reasonable exercise of the state’s police power in the absence of an epidemic or even a single case.17,18 They also have been found to be constitutional even for cases in which the laws conflict with the religious beliefs of individuals.19

When others are placed at substantial risk of serious harm, the range of choices of the individual may be restricted. With regard to immunization, the key question becomes whether the harms associated with unimmunized individuals are great enough to make restrictions permissible. In times of epidemic disease, when an effective vaccine can end the epidemic and protect those individuals who have not yet contracted the disease, the answer clearly is yes.

In a highly immunized population in which disease prevalence is low, the risk of disease from the small number of children who remain unimmunized does not usually pose a significant-enough health risk to others to justify state action.20 Diseases with very high morbidity and mortality (such as smallpox), however, might create a situation in which even a single case of infection would justify mandatory immunization of the population. For most routine vaccines, less forcible alternatives can be used justifiably to encourage parents to immunize children because of the public health benefit. In the case of vaccines routinely recommended for children, the AAP supports the use of appropriate public health measures, education, and incentives for immunization.7 Because unimmunized children do pose a risk to other children who lack immunity to vaccine-preventable infections, the AAP also supports immunization requirements for school entry.

RESPONDING TO PARENTS WHO REFUSE IMMUNIZATION FOR THEIR CHILDREN
TOP
ABSTRACT
OVERVIEW OF THE PROBLEM
PARENTAL REFUSALS AND THE…
COMMUNITY INTERESTS AND PUBLIC…
RESPONDING TO PARENTS WHO…
Committee on Bioethics, 2003…
Liaisons
Staff
REFERENCES

What is the pediatrician to do when faced with a parent who refuses immunization for his or her child? First and most important, the pediatrician should listen carefully and respectfully to the parent’s concerns, recognizing that some parents may not use the same decision criteria as the physician and may weigh evidence very differently than the physician does.21 Vaccines are very safe, but they are not risk free; nor are they 100% effective.22 This poses a dilemma for many parents and should not be minimized. The pediatrician should share honestly what is and is not known about the risks and benefits of the vaccine in question, attempt to understand the parent’s concerns about immunization, and attempt to correct any misperceptions and misinformation.23–25 Pediatricians should also assist parents in understanding that the risks of any vaccine should not be considered in isolation but in comparison to the risks of remaining unimmunized. For example, although the risk of encephalopathy related to the measles vaccine is 1 in 1 million, the risk of encephalopathy from measles illness is 1000 times greater.22 Parents can also be referred to one of several reputable and data-based Web sites for additional information on specific immunizations and the diseases they prevent (see pages 52 and 53 of the Red Book25 for a list of Internet resources related to immunization).

Many parents have concerns related to 1 or 2 specific vaccines. A useful strategy in working with families who refuse immunization is to discuss each vaccine separately. The benefits and risks of vaccines differ, and a parent who is reluctant to accept the administration of 1 vaccine may be willing to allow others.

Parents also may have concerns about administering multiple vaccines to a child in a single visit. In some cases, taking steps to reduce the pain of injection, such as those suggested in the Red Book,26 may be sufficient. In other cases, a parent may be willing to permit a schedule of immunization that does not require multiple injections at a single visit.

Physicians should also explore the possibility that cost is a reason for refusing immunization. For a parent whose child does not have adequate preventive care insurance coverage, even the administrative costs and copayments associated with immunization can pose substantial barriers. In such cases, the physician should work with the family to help them obtain appropriate immunizations for the child.

For all cases in which parents refuse vaccine administration, pediatricians should take advantage of their ongoing relationship with the family and revisit the immunization discussion on each subsequent visit. As respect, communication, and information build over time in a professional relationship, parents may be willing to reconsider previous vaccine refusals.

Continued refusal after adequate discussion should be respected unless the child is put at significant risk of serious harm (as, for example, might be the case during an epidemic). Only then should state agencies be involved to override parental discretion on the basis of medical neglect. Physician concerns about liability should be addressed by good documentation of the discussion of the benefits of immunization and the risks associated with remaining unimmunized. Physicians also may wish to consider having the parents sign a refusal waiver (a sample refusal-to-immunize waiver can be found at www.cispimmunize.org/pro/pdf/RefusaltoVaccinate_2pageform.pdf). In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child. However, when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists, the pediatrician may encourage the family to find another physician or practice. Although pediatricians have the option of terminating the physician-patient relationship, they cannot do so without giving sufficient advance notice to the patient or custodial parent or legal guardian to permit another health care professional to be secured.27 Such decisions should be unusual and generally made only after attempts have been made to work with the family. Families with doubts about immunization should still have access to good medical care, and maintaining the relationship in the face of disagreement conveys respect and at the same time allows the child access to medical care. Furthermore, a continuing relationship allows additional opportunity to discuss the issue of immunization over time.

Committee on Bioethics, 2003–2004
TOP
ABSTRACT
OVERVIEW OF THE PROBLEM
PARENTAL REFUSALS AND THE…
COMMUNITY INTERESTS AND PUBLIC…
RESPONDING TO PARENTS WHO…
Committee on Bioethics, 2003…
Liaisons
Staff
REFERENCES

Jeffrey R. Botkin, MD, MPH, Chairperson

Douglas S. Diekema, MD, MPH

G. Kevin Donovan, MD, MLA

Mary E. Fallat, MD

Eric D. Kodish, MD

Steven R. Leuthner, MD, MA

Marcia Levetown, MD

Liaisons
TOP
ABSTRACT
OVERVIEW OF THE PROBLEM
PARENTAL REFUSALS AND THE…
COMMUNITY INTERESTS AND PUBLIC…
RESPONDING TO PARENTS WHO…
Committee on Bioethics, 2003…
Liaisons
Staff
REFERENCES

Christine E. Harrison, MD

Canadian Paediatric Society

Marcia Levetown, MD

American Board of Pediatrics

Arlene Morales, MD

American College of Obstetricians and Gynecologists

Staff
TOP
ABSTRACT
OVERVIEW OF THE PROBLEM
PARENTAL REFUSALS AND THE…
COMMUNITY INTERESTS AND PUBLIC…
RESPONDING TO PARENTS WHO…
Committee on Bioethics, 2003…
Liaisons
Staff
REFERENCES

Alison Baker, MS

FOOTNOTES

The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

REFERENCES
TOP
ABSTRACT
OVERVIEW OF THE PROBLEM
PARENTAL REFUSALS AND THE…
COMMUNITY INTERESTS AND PUBLIC…
RESPONDING TO PARENTS WHO…
Committee on Bioethics, 2003…
Liaisons
Staff
REFERENCES

1. Centers for Disease Control and Prevention. Impact of vaccines universally recommended for children—United States, 1990–1998. MMWR Morb Mortal Wkly Rep. 1999;48 :243 –248[Medline]
2. Centers for Disease Control and Prevention. Ten great public health achievements—United States, 1990–1999. MMWR Morb Mortal Wkly Rep. 1999;48 :241 –243[Medline]
3. Bonanni P. Demographic impact of vaccination: a review. Vaccine. 1999;17(suppl 3) :S120 –S125
4. Davies P, Chapman S, Leask J. Antivaccination activists on the World Wide Web. Arch Dis Child. 2002;87 :22 –25[Abstract/Free Full Text]
5. American Academy of Pediatrics, Division of Health Policy Research. Periodic Survey of Fellows No. 48: Immunization Administration Practices. Elk Grove Village, IL: American Academy of Pediatrics; 2001
6. Buchanan AE, Brock DW. Deciding for Others: The Ethics of Surrogate Decision Making. New York, NY: Cambridge University Press; 1990
7. American Academy of Pediatrics, Committee on Bioethics. Informed consent, parental permission, and assent in pediatric practice. Pediatrics. 1995;95 :314 –317[Abstract/Free Full Text]
8. Pertussis vaccine. Br Med J (Clin Res Ed). 1981;282 :1563 –1564
9. Vaccination against whooping cough. Lancet. 1981;1(8230) :1138 –1139[CrossRef]
10. Hinman AR, Koplan JP. Pertussis and pertussis vaccine. Reanalysis of benefits, risks, and costs. JAMA. 1984;251 :3109 –3113[Abstract]
11. Fox JP, Elveback L, Scott W, Gatewood L, Ackerman E. Herd immunity: basic concept and relevance to public health immunization practices. Am J Epidemiol. 1971;94 :179 –189[Free Full Text]
12. Gellin BG, Maibach EW, Marcuse EK. Do parents understand immunizations? A national telephone survey. Pediatrics. 2000;106 :1097 –1102[Abstract/Free Full Text]
13. Wing KR. The Law and the Public’s Health. 3rd ed. Ann Arbor, MI: Health Administration Press; 1990
14. Veatch RM. The ethics of promoting herd immunity. Fam Community Health. 1987;10 :44 –53[Medline]
15. Menzel PT. The pros and cons of immunisation—paper four: non-compliance: fair or free-riding. Health Care Anal. 1995;3 :113 –115[CrossRef][ISI][Medline]
16. Ball LK, Evans G, Bostrom A. Risky business: challenges in vaccine risk communication. Pediatrics. 1998;101 :453 –458[Free Full Text]
17. McMenamin JP, Tiller WB. Children as patients. In: American College of Legal Medicine. Legal Medicine: Legal Dynamics of Medical Encounters. 2nd ed. St Louis, MO: Mosby Year Book; 1991:282–317
18. Dover TE. An evaluation of immunization regulations in light of religious objections and the developing right of privacy. Univ Dayton Law Rev. 1979;4 :401 –424[Medline]
19. Jacobson v Massachusetts, 197 US 11 (1905)
20. Ross LF, Aspinwall TJ. Religious exemptions to the immunization statutes: balancing public health and religious freedom. J Law Med Ethics. 1997;25 :202 –209, 83[ISI][Medline]
21. Meszaros JR, Asch DA, Baron J, Hershey JC, Kunreuther H, Schwartz-Buzaglo J. Cognitive processes and the decisions of some parents to forego pertussis vaccination for their children. J Clin Epidemiol. 1996;49 :697 –703[CrossRef][ISI][Medline]
22. Maldonado YA. Current controversies in vaccination: vaccine safety. JAMA. 2002;288 :3155 –3158[Free Full Text]
23. Wilson CB, Marcuse EK. Vaccine safety—vaccine benefits: science and the public’s perception. Nat Rev Immunol. 2001;1 :160 –165[CrossRef][Medline]
24. Pattison S. Ethical debate: vaccination against mumps, measles, and rubella: is there a case for deepening the debate? Dealing with uncertainty. BMJ. 2001;323 :840
25. American Academy of Pediatrics. Parental misconceptions about immunization. In: Pickering LK, ed. Red Book: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2003:50–53
26. American Academy of Pediatrics. Managing injection pain. In: Pickering LK, ed. Red Book: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2003:20–21
27. American Medical Association, Council on Ethical and Judicial Affairs. Termination of the physician-patient relationship. In: Code of Medical Ethics: Current Opinions. 2002–2003 ed. Chicago, IL: American Medical Association; 2002:110

http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/5/1428

Posted in Medical Hazards, Privacy, Vaccination | No Comments »

Letter on Immunization from Am. Acad. Pediatrics President

Wednesday, February 27th, 2008

Dear Parents,

Most parents associate immunizations with school and day care requirements, filling out those dreaded forms every year and you ask yourself why. Well, the Web site you’re about to see tells you why.

Prior to the creation of many of the vaccines available today, thousands – and sometimes millions — of children became infected with diseases that often resulted in lifelong disabilities or, even worse, death. These diseases were contagious, meaning they were easily spread between children. Thankfully, we now have the ability to immunize children and adolescents against contagious, preventable and sometimes deadly diseases.

Immunization success stories, however, can lead parents to think that diseases like polio, whooping cough, and measles no longer exist…but they do. Because many parents today have never seen a child with whooping cough, for example, they mistakenly may think of it as simply a mild childhood disease. According to the National Foundation for Infectious Diseases, whooping cough causes coughing that lasts for weeks, even months. Coughing spells can lead to problems breathing, eating and sleeping. In serious cases, coughing may cause broken ribs or hospitalization. In 2005, 8 infants died in a whooping cough outbreak in Texas.

Whooping cough is on the rise in the United States, across all age groups. More than 20,000 cases were identified in the U.S. in 2005, but the vast majority go unreported. Experts estimate there may actually be up to one million cases every year. That’s why we have to be diligent about vaccinating our children and adolescents against illnesses. The fact that we don’t see certain diseases anymore doesn’t mean they no longer exist…it simply means the vaccines are working. They will continue to work, however, only as long as we continue to immunize our children.

Unfortunately, there’s a lot of misinformation on the Internet about vaccines, so I commend you for finding your way to this reliable Web site. We’re pleased to provide you with the information you’ll need to make an educated decision about immunization. And, of course, you’ll also want to discuss this issue with your partner in your child’s health…your pediatrician.

Sincerely,

Signature

Renée R. Jenkins, MD, FAAP
President
American Academy of Pediatrics

Posted in Medical Hazards, Vaccination | No Comments »

« Older Entries
Newer Entries »