LDS Religious Exemptions from Vaccination

[pogi]

1 hour ago, ERMD said:

What is the evidence for this?  Are you a Mercola disciple?

Mercola?  Seriously?  This just proves my point that vaccines have an almost sacrosanct status in the eyes of the public.  "Anybody who acknowledges a potentially negative aspect of vaccine must be a Mercola disciple!"  Give me a break man, I am not anti-vaccine.

Quote

This research suggests that although individuals immunized with an acellular pertussis vaccine may be protected from disease, they may still become infected with the bacteria without always getting sick and are able to spread infection to others, including young infants who are susceptible to pertussis disease.

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm

Edited November 17, 2016 by pogi

[pogi]

1 hour ago, ERMD said:

You made the claim that having had a disease provides superior immunity to vaccinations and used a proof-text in an attempt to back up your point.  The rest of the article gave specific examples.  I post that part (from the article you cited) here again for your perusal:

You are straining at a gnat here.  Even if we completely removed the fact mentioned in the article that "it is true that natural infection almost always causes better immunity than vaccines" it doesn't really hurt my overall message.   The couple exceptions mentioned in the article does not detract from that fact.  Are you accusing the children's hospital of spreading false information, are you saying that they are contradicting themselves in the same article?  Perhaps you should write the Children's Hospital of Philadelphia and accuse them of "spreading a significant amount of misinformation."

1 hour ago, ERMD said:

Again, you are spreading a significant amount of misinformation.

Don't make accusations that you can't back up.

Am I wrong in assuming that you are an ER doc?

Edited November 17, 2016 by pogi

[ERMD]

1 hour ago, pogi said:

Why would you think I wouldn't know this after telling you what I do for work?  That is part of my job in international travel medicine.  I am updated daily with infectious disease reports from all over the world.

http://www.cdc.gov/polio/updates/

74 total cases worldwide in 2015, which was limited to 2 countries, out of 7.4 billion people worldwide and 196 countries (counting Taiwan).  I think it is safe to say that polio is "virtually non-existent".

I'm not questioning whether or not it is non-existent.  It is one of the many world-changing successes of vaccines.  Given what you are claiming about other vaccinations, it surprised me that you recognized it, your line of work notwithstanding.

 

[ERMD]

1 hour ago, pogi said:

You are straining at a gnat here.  Even if we completely removed the fact mentioned in the article that "it is true that natural infection almost always causes better immunity than vaccines" it doesn't really hurt my overall message.   The couple exceptions mentioned in the article does not detract from that fact.  Are you accusing the children's hospital of spreading false information, are you saying that they are contradicting themselves in the same article?  Perhaps you should write the Children's Hospital of Philadelphia and accuse them of "spreading a significant amount of misinformation."

Don't make accusations that you can't back up.

Am I wrong in assuming that you are an ER doc?

Multiple examples that refute your proof-text is hardly gnat-straining.  How many cases of epiglottitis have you treated (or even seen)?  How many cases of Hib meningitis have you treated (or even seen)?  

I think it is evident who is the one making claims here that cannot be backed up.

Yes, I am an Emergency Physician; residency-trained and board-certified for over 20 years.

[ERMD]

1 hour ago, pogi said:

Mercola?  Seriously?  This just proves my point that vaccines have an almost sacrosanct status in the eyes of the public.  "Anybody who acknowledges a potentially negative aspect of vaccine must be a Mercola disciple!"  Give me a break man, I am not anti-vaccine.

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm

This study was done in baboons.  Baboons are not human.  Additionally, the conclusion you quote uses the words suggests and may.  Those words are carefully chosen and do not represent the black and white assertion you make.

If you are not anti-vaccine, you are presenting them in an incredibly negative light, a light that is not supported by a preponderance of the literature, nor espoused by modern medicine.

[pogi]

 

2 hours ago, ERMD said:

Multiple examples that refute your proof-text is hardly gnat-straining.

The examples you mention come from the very source that made the claim, in case you still haven't noticed.  Listing the few rare exceptions is not a repudiation of the fact.  Again, write the hospital if you have a problem with it.

Edited November 17, 2016 by pogi

[pogi]

48 minutes ago, ERMD said:

How many cases of epiglottitis have you treated (or even seen)?  How many cases of Hib meningitis have you treated (or even seen)?  

I see, so now you are going to attempt to use your anecdotal evidence to refute the literature?  Your evidence will not change the rates of Hib nor will it change the rate of adverse reactions to the vaccine.

Edited November 17, 2016 by pogi

[pogi]

2 hours ago, ERMD said:

This study was done in baboons.  Baboons are not human.  Additionally, the conclusion you quote uses the words suggests and may.  Those words are carefully chosen and do not represent the black and white assertion you make.

From the link:

Quote

“This study is critically important to understanding some of the reasons for the rising rates of pertussis and informing potential strategies to address this public health concern,” said Karen Midthun, M.D., director of the FDA’s Center for Biologics Evaluation and Research, where the study was conducted. “This research is a valuable contribution and brings us one step closer to understanding the problem. We are optimistic that more research on pertussis will lead to the identification of new and improved methods for preventing the disease.”

The FDA certainly seems to be taking this study seriously.  To brush it aside as insignificant because it was performed in baboons would be careless and reckless.  Notice the carefully chosen words "critically important".

If I have used black and white language, it was unintentional.  I always try to report what I read accurately.  To defend myself, I did say this:

Quote

...studies suggest that the pertussis vaccine may be partly responsible for the recent increase in pertussis rates nation wide

Notice the use of the words suggest and may.

2 hours ago, ERMD said:

If you are not anti-vaccine, you are presenting them in an incredibly negative light, a light that is not supported by a preponderance of the literature, nor espoused by modern medicine.

I am only reporting the potential and known adverse events related to vaccination as reported by the CDC, WHO, and FDA. I compare that information with reported disease rates nationally and suggest that parents should be informed of the risks for disease and the risks of vaccination and be given a choice without compulsory means.   I welcome evidence of a "preponderance of literature" that refutes this information.

It may seem that I am portraying vaccines in a negative light because my only defense against accusations of being "selfish" and "immoral" is to shine a light on the mostly unknown negative side of vaccines to show that there is another side of the story.  Power to choose medical interventions should be in the hands of informed parents and medical professionals, not the government. That is my only argument. I am an advocate for parental choice and informed consent.  Vaccination is a large part of my occupation, I am obviously not anti-vaccine.

 

Edited November 17, 2016 by pogi

[ERMD]

1 hour ago, pogi said:

I see, so now you are going to attempt to use your anecdotal evidence to refute the literature?  Your evidence will not change the rates of Hib nor will it change the rate of adverse reactions to the vaccine.

The examples of Hib and it's consequences are illustrative of what the article you cite is really stating.

 

[Calm]

4 hours ago, pogi said:

Cause of death with rotavirus is severe dehydration due to diarrhea and vomiting.  You are right, it is not a good idea to say "always or never" in medicine, but I can say that early treatment with oral rehydration salts and IV hydration if it becomes severe, will put your chances of death from dehydration to near zero.  The already extremely rare deaths from rotavirus are almost always from malnourished children who did not receive proper treatment.  Again, I'll take my chances with the disease, but I respect the decision of anyone who chooses otherwise.

And those who lack the knowledge or access to the right treatment?  Not everyone makes the right decision when it comes to medical treatment, thinking they can weather an illness they have already had so many times before...only this time it is different and damage occurs because they wait one or two hours too long to get to the hospital.

I am a big fan of stats and making aware decisions based on the best research on costs and benefits.  Otoh, I think we need to take into account our often less than fully aware behaviour.  Maybe we will be on the ball most of the time, but illness can often hit when we are highly stressed and likely to make poor decisions, so decisions on preventative measures should have a huge cushion of caution included,. IMO.

Edited November 17, 2016 by Calm

[pogi]

1 minute ago, Calm said:

And those who lack the knowledge or access to the right treatment?  Not everyone makes the right decision when it comes to medical treatment, thinking they can weather an illness they have already had so many times before...only this time it is different and damage occurs because they wait one or two hours too long to get to the hospital.

You are absolutely right.  I have never argued that vaccination is never indicated or should never be recommended.  I have never argued that there are not potential risks with the decision to vaccinate or not vaccinate.  My argument is that vaccination should be seriously considered under the advise of a competent medical professional, especially where the risks (such as lack of knowledge or access to proper treatment) may be greater, but that it should never be the governments decision with a blanket mandate, except in times of serious epidemic activity.  Again,  I just want it to be known that there are other risks to consider besides the disease before making a choice to vaccinate.  We rarely hear about those risks and for some reason people seem to downplay the risk, as if dying from disease is somehow worse than dying from vaccination. 

[ERMD]

3 minutes ago, pogi said:

From the link:

The FDA certainly seems to be taking this study seriously.  To brush it aside as insignificant because it was performed in baboons would be careless and reckless.  Notice the carefully chosen words "critically important".

If I have used black and white language, it was unintentional.  I always try to report what I read accurately.  To defend myself, I did say this:

...studies suggest that the pertussis vaccine may be partly responsible for the recent increase in pertussis rates nation wide

Notice the use of the words suggest and may.

I am only reporting the potential and known adverse events related to vaccination as reported by the CDC, WHO, and FDA. I compare that information with reported disease rates nationally and suggest that parents should be informed of the risks for disease and the risks of vaccination and be given a choice without compulsory means.   I welcome evidence of a "preponderance of literature" that refutes this information.

It may seem that I am portraying vaccines in a negative light because My only defense against accusations of being "selfish" and "immoral" is to shine a light on the mostly unknown negative side of vaccines to show that there is another side of the story.  Power to choose medical interventions should be in the hands of informed parents and medical professionals, not the government. That is my only argument. I am an advocate for parental choice and informed consent.  Vaccination is a large part of my occupation, I am obviously not anti-vaccine.

 

"Studies"--one study

An animal study suggests something in animals, and many times are even species-specific.  When an animal study looks at a biochemical or organelle function/response, that result is more likely to have a human correlation; however, when organ systems or functions on a macro level are involved, the degree of reliability in humans suffers significantly.  Until a randomized, double-blinded, placebo-controlled study in humans, with significant statistical power is undertaken, there are nothing but more questions.  For example, fluoroquinolones were verboten in the pediatric population for years because of a study done in Beagle puppies that demonstrated potential growth plate complications.  FQs for different types of meningitis are now safely used in the pediatric population thanks to science that applies directly to medical practice.

In vitro is one thing, in vivo is another; just as animal research cannot be reliably extrapolated to humans.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2642860/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746847/

 

 

 

[pogi]

23 minutes ago, ERMD said:

"Studies"--one study

An animal study suggests something in animals, and many times are even species-specific.  When an animal study looks at a biochemical or organelle function/response, that result is more likely to have a human correlation; however, when organ systems or functions on a macro level are involved, the degree of reliability in humans suffers significantly.  Until a randomized, double-blinded, placebo-controlled study in humans, with significant statistical power is undertaken, there are nothing but more questions.  For example, fluoroquinolones were verboten in the pediatric population for years because of a study done in Beagle puppies that demonstrated potential growth plate complications.  FQs for different types of meningitis are now safely used in the pediatric population thanks to science that applies directly to medical practice.

In vitro is one thing, in vivo is another; just as animal research cannot be reliably extrapolated to humans.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2642860/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746847/

Take it up with the FDA who called this a "critically important" study.  Those are not my words, I am just reporting what the FDA reported.  This whole pertussis thing was kind of a side-point anyway and does not detract from my main argument.

Do you have any substantive arguments against my main points, or are you just a nitpicker?

Can you refute that the risk of vaccination is sometimes greater than the risk for disease. Let's focus on the meat of my argument here.  

Edited November 17, 2016 by pogi

[Calm]

It seems to me that probably everyone posting on the thread probably agrees there are times when the risks of a vaccine are higher than the risks of the disease (obvious example was the trial vaccine that killed off my friend's first grade class eons ago).

What is debated is where to draw the line.  I assume everyone agrees this should be different for each vaccine version and its accompanying disease (for example the line would be very different for the old polio vaccine of my friend's experience and the current one, though the disease is the same).

This kind of stuff is obvious, but not specifying can waste a lot of time.

A possible side debate is who is best to make that decision.  Currently in the US parents usually have the right if I understand the law correctly, though a decision not to may restrict a child's opportunities.  Considering that in my experience, parents rarely have sufficient information to make complicated medical decisions based on stats and often are not willing to be either educated or listen to criticism no matter what position they hold once a decision has been made, I am not certain that parents should have the final say.  Even if kids are homeschooled, there are infinite possibilities where they will be exposed to other kids without the other children's parents knowing the risk...such as on the playground, shopping in toy stores, libraries where books are shared by total strangers (hopefully most bugs don't last long enough for this to be significant), movie theaters, restaurants, etc.. Thus parents' decisions don't just affect their kid as say deciding whether to have a cavity filled or not does.

[ERMD]

43 minutes ago, pogi said:

Take it up with the FDA who called this a "critically important" study.  Those are not my words, I am just reporting what the FDA reported.  This whole pertussis thing was kind of a side-point anyway and does not detract from my main argument.

Do you have any substantive arguments against my main points, or are you just a nitpicker?

Can you refute that the risk of vaccination is sometimes greater than the risk for disease. Let's focus on the meat of my argument here.  

What is meant by "critically important study?"  What recommendations have been given?  What action has been taken?  Is it important in the sense that it gives answers or that it raises more questions?  There may be something to it, but until there is more information, we just don't know.

I am neither a nitpicker nor a gnat-strainer.  You are able to cite sources, but I question your ability to interpret the data you present.  When what I see as inaccurate or misleading medical advice is given, I will raise a flag every time.

The only vaccine in use today that would come close to being worse than the disease would be the childhood varicella vaccine.  Varicella for the most part is a benign illness, unless  it isn't (varicella pneumonia being the most frequent complication of the disease), or if a pregnant woman were to contract the virus and she is not immune.

[pogi]

19 minutes ago, Calm said:

It seems to me that probably everyone posting on the thread probably agrees there are times when the risks of a vaccine are higher than the risks of the disease (obvious example was the trial vaccine that killed off my friend's first grade class eons ago).

What is debated is where to draw the line.  I assume everyone agrees this should be different for each vaccine version and its accompanying disease (for example the line would be very different for the old polio vaccine of my friend's experience and the current one, though the disease is the same).

This kind of stuff is obvious, but not specifying can waste a lot of time.

A possible side debate is who is best to make that decision.  Currently in the US parents usually have the right if I understand the law correctly, though a decision not to may restrict a child's opportunities.  Considering that in my experience, parents rarely have sufficient information to make complicated medical decisions based on stats and often are not willing to be either educated or listen to criticism no matter what position they hold once a decision has been made, I am not certain that parents should have the final say.  Even if kids are homeschooled, there are infinite possibilities where they will be exposed to other kids without the other children's parents knowing the risk...such as on the playground, shopping in toy stores, libraries where books are shared by total strangers (hopefully most bugs don't last long enough for this to be significant), movie theaters, restaurants, etc.. Thus parents' decisions don't just affect their kid as say deciding whether to have a cavity filled or not does.

It is not as obvious to me that everybody agrees about the risks of vaccination vs. disease, I would be pleasantly surprised if you are right.  I have spent most of my time talking about the risks of vaccines, because when people become aware that the risks of vaccination are sometimes greater than the risk for disease, it opens a door to discuss the ethics of vaccine mandates.

I will have to finish my thought later... 

 

[pogi]

1 hour ago, ERMD said:

I question your ability to interpret the data you present.  

I am not the one asking for a p-value after being presented with a confidence interval...just saying. 

1 hour ago, ERMD said:

When what I see as inaccurate or misleading medical advice is given, I will raise a flag every time.

What medical advise have I given other than the following?

Quote

vaccination should be seriously considered under the advise of a competent medical professional

 

1 hour ago, ERMD said:

The only vaccine in use today that would come close to being worse than the disease would be the childhood varicella vaccine.  Varicella for the most part is a benign illness, unless  it isn't (varicella pneumonia being the most frequent complication of the disease), or if a pregnant woman were to contract the virus and she is not immune.

What I find misleading is this bunch of bologna!  It sure seems rather hypocritical of you for attacking me for making things seem so "black and white" when you do the same thing (without any supporting evidence I might add).  Based on what research can you claim that the varicella vaccine is the only vaccine that that may be worse than the disease?  Maybe you didn't know this, I wouldn't blame you because you are just an ER doc, but there were between 100-150 deaths from varicella each year in the early 90's.  That is 5 times the death rate of rotavirus pre-vaccine era.  100 deaths are prevented each year from the varicella vaccine.  Not to mention shingles from the dormant varicella virus which can come back later in life with a vengeance!

You clearly don't know what you are talking about, stick to the ER.

 

Edited November 17, 2016 by pogi

[ERMD]

6 minutes ago, pogi said:

 you are just an ER doc

I guarantee I have dealt with death many more times than you have.   As I said, you are good at citing references, but I question your ability to interpret the data, and I won't play the "you're just a nurse" card.

 

 

[Yirgacheffe]

12 hours ago, pogi said:

oral rehydration salts and IV hydration if it becomes severe, will put your chances of death from dehydration to near zero

And doesn't that require hospitalization? I this the best way to spend health care dollars, skipping vaccines and going with hospitalization instead?  Would you willing to accept insurance companies refusing to pay for treatment of disease if a vaccine was available to prevent it and there was no medical reason to refuse?

[Yirgacheffe]

8 hours ago, pogi said:

but that it should never be the governments decision with a blanket mandate, except in times of serious epidemic activity. 

An epidemic seems more than a little late to party to prevent illness and death.

[Yirgacheffe]

7 hours ago, ERMD said:

What is meant by "critically important study?"  What recommendations have been given?  What action has been taken?

Totally aside from the discussion at hand.  But considering today's climate there is a cynical little center of me that asks, do you attribute the same gravity, if said government agency says something contrary to your belief?  Do you hold all government letters (USDA, DOE, DHUD, DHSS, DOI) in the same high regard and respect when they say something is of critical importance? 

[pogi]

17 hours ago, ERMD said:

I guarantee I have dealt with death many more times than you have.   As I said, you are good at citing references, but I question your ability to interpret the data, and I won't play the "you're just a nurse" card.

With my history of hospice nursing, I think your comment about death is debatable, either way, I fail to see the point.  More anecdotal evidence?  You do tend to question me a lot.  So far, you have been wrong on every point that you have questioned me on.  First, you question my ability to interpret statistical analysis.  I asked "P value???" and you responded:

Quote

That's what I thought.  If you're going to try to use statistics to prove a point, you need an understanding of statistics.  You are claiming that data state something that is contrary to what it is actually stating

You were wrong. I question your ability to interpret the information.

Second, you questioned me after I stated that natural acquired immunity to rotavirus gives better immunity than vaccination. 

You stated:

Quote

If you're going to cut and paste, use the entire quote.  Again, reality is different from the point you are trying to make.  I don't know what your background or area of expertise is, but it is certainly not medicine, and you are promulgating some very bad information.

The link stated that "natural infection almost always causes better immunity than vaccines".  It listed a couple exceptions, and guess what...rotavirus wasn't one of them. Rotavirus immunity is better from natural infection then from vaccination.  So, who is promulgating bad information here?

I was right, you were wrong.

Third you question me on pertussis, and guess what, I did use the words "suggest" and "may" when I suggested that it may be responsible for increased pertussis rates in the last few years.  And contrary to what you might believe, I do understand that studies on animals are not as solid as studies on humans (I never said otherwise), however, the study suggests that it may be responsible (not me), so you can't blame me for misinterpreting the information.

Forth, you state that there is a "preponderance of literature" that refutes the figures I have listed as reported by the CDC, WHO and FDA.  I am still waiting to see that literature.  Who is being misleading here?

Based on my experience with you so far, I question your ability to question my ability!  When it comes to being an ER doc, I am sure you are great.  But when it comes to vaccines, you are the one who is "out of his league" here.  I had to pass the exact same test that physicians have to pass in order to become certified with ISTM.  I am specialized and you are not.  Physicians come to me for expert advise.  I said, "just an ER doc" because you are not specialized like I am...and because I am tired of your condescending and patronizing rhetoric.

 

Edited November 18, 2016 by pogi

[Kenngo1969]

Pogi,

What, exactly, is your position with respect to vaccination?  Are you concerned about the purported link between vaccination and autism (I think there's more than enough evidence that that alleged causal link is suspect, myself; I just want to know more about where you're coming from)?  Do you think that, generally, vaccinations are a good idea, but that government shouldn't mandate them?  As I say, it would help to know more about where you're coming from.

[pogi]

Oops

Edited November 18, 2016 by pogi

[pogi]

14 hours ago, Yirgacheffe said:

And doesn't that require hospitalization? I this the best way to spend health care dollars, skipping vaccines and going with hospitalization instead?  Would you willing to accept insurance companies refusing to pay for treatment of disease if a vaccine was available to prevent it and there was no medical reason to refuse?

Cost effectiveness is debatable.  https://www.ncbi.nlm.nih.gov/pubmed/17403839