Starting fresh - a pediatrician's perspective - Page 7

[pek64]

Originally Posted by WildKingdom 

Seriously.  You guys have been so warm and welcoming to him!  I can't believe that he lost patience.  After all, it's only required that he have an open mind right?  No one else on the forum should try to return the favor.

There's a frustration regarding this issue that one group acts like they have the right to take away freedom of choice from another. If we substitute 'life' (as in no abortion) for 'vaccination', I bet many on the pro side would be switching. The bottom line is -- do I have the right to choose my and my children's risks?

It sure seems like some want to take that freedom away.

Herd immunity or not, effective or not, safe or not, this country was founded on the idea of freedom. I want the freedom to do what I believe is right. And other than acts that *clearly* cause harm (such as shooting someone), I should still have those rights. And I will fight to keep them.

[emma1325]

Originally Posted by WildKingdom 

Seriously.  You guys have been so warm and welcoming to him!  I can't believe that he lost patience.  After all, it's only required that he have an open mind right?  No one else on the forum should try to return the favor.

If we were so bad, but he is "so right," then you'd think as a medically professional that he could keep his cool and answer a few specific questions, right?

Right?

[WildKingdom]

Originally Posted by emma1325 

If we were so bad, but he is "so right," then you'd think as a medically professional that he could keep his cool and answer a few specific questions, right?

Right?

Hmm.  Maybe.

A mere 14 posts in, Pek64 accused him of medical malpractice.

Quote:

And if she has the child vaccinated again and some serious, lifelong complication occurs, who will she blame?

YOU, because you gave the medical advise based on a few words in a post. How's your malpractice insurance?

I'm surprised he came back at all after that.

I think that pretty much set the adversarial tone for the rest of the thread.

[Bokonon]

Originally Posted by mgrella 

Please do not attempt to pursue this with me.  I'm thrilled to have a discussion with anyone and everyone discussing medical and scientific strategies, but you are trying to equate a personal decision made emotionally with religion (NOT) and/or medicine (again, NOT).  Many reactions can be avoided with pretreatment or managed with a predetermined strategy.  Your advice is instead to make a rash decision which might lead to a VPD that could damage a child (and then whom would YOU blame)? 

LOL, her post was in response to this already-adversarial one.  The OP set the tone very early on.

[kathymuggle]

nm - Bokonon beat me to it.

[AmandaT]

LOL @ "accusing him of medical malpractice" over the internet within a hypothetical situation. 

[WildKingdom]

Originally Posted by AmandaT 

LOL @ "accusing him of medical malpractice" over the internet within a hypothetical situation. 

Yeah.  It's hilarious.  Especially since he gave his real name and people here have already googled him.

Whatever.

I'm out of here.

Enjoy your echo chamber.

[AmandaT]

I'm not sure what him giving his real name and then people googling it (why give it if he did not expect that to happen?) have to do with a hypothetical situation but okay. 

Originally Posted by WildKingdom 

Enjoy your echo chamber.

THIS ^ is the problem. It seems to be the choice between being insulted or being in an "echo chamber". Someone who came on to "give a fresh perspective" did not answer any "tough" questions and its the fault of people who have questions or concerns?  He stated that "colleagues of his were scared away from forums like these because of rhetoric or perceived bullying, but I won't be" and then proceeded to spout rhetoric that we've all read/heard before and become a "bully" (insomuch as one can be a bully on the internet). 

*edited because I wasn't sure if it was a personal attack on OP. I assume restating what happened in this thread is okay? 

Edited by AmandaT - 10/3/12 at 8:15pm

[HappyHappyMommy]

Hi Everyone,

Please remember the following:

Originally Posted by Mosaic 
You are free to disagree with others and to passionately express that here; but you must remain civil and respectful and address the issues and not the poster. Review both the user agreement and the forum guidelines if you're unclear about the rules.

To those who have made a post with a personal attack or accusation, please edit your posts so they comply with the UA and the forum guidelines.

[Taximom5]

From September 9....

Originally Posted by mgrella 

Howdy all - I'm a (male) pediatrician and father in Brookline, MA; I work at a hospital in Boston and am pleased to be part of the community. My interests include ADHD (both sons have) and vaccinations (both sons have).

There's a LOT of information in this forum; much of it going very far back and likely not all of the opinions are still as they were.  I'd like to make myself available to answer general questions regarding vaccinations and to ask some in return.  I'm afraid a lot of my colleagues have gotten scared away from forums like this due to rhetoric and some perceived bullying; I promise not to be although I'm sometimes too busy to respond right away.  Anyway, reply away if you like; stay healthy!

Marc Grella, MD

...to October 4th:

Originally Posted by mgrella 

Your utter lack of a sense of scale is astounding.  Nothing is 100% safe.  This includes vaccines and cars and planes and crossing the street and eating lettuce and drinking water.  But we all fly and drive and walk and drink water.  Life does not guarantee a soft and fuzzy outcome, because life is inherently risky.  What allows humanity to move forward is to minimize risk with strategies that increase everyone's odds of living longer and healthier.  This is what vaccines do: decrease everyone's risk:benefit ratio.  There is no other math for those in public health.

Your strategy is rather to take case reports and try to generalize them to an entire industry.

Your strategy is to make a few misguided people into a massive conspiracy.

Your strategy is to equate a small percentage of side effects with the risk of massive epidemics. 

If we all stopped using measles (or pertussis, or H. flu, or pneumococcal) vaccine today, you would lose family and friends (that is, they would be dead).  And every person who reads your nonsense and defers an important vaccine and whose child gets a preventable illness is being harmed by your influence.

Again, feel free to not not vaccinate your kids - if we all did the same we'd be back to over 2 million deaths per year from measles.

Then there's HiB meningitis. 

Then there's polio (oh, but you AREN'T moving to Pakistan or Afghanistan with your unvaxed kids, are you?).

And did you actually say that our infant death rate is the highest in the world? 

 

I think the contrast is very interesting.

I'd also like to question his statement that "without vaccinations we'd be back to over 2 million deaths per year from measles."  And that was before we knew that vitamin A deficiency had a role in measles deaths (Oddly enough, when I checked the CDC website http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm,   they post that  "Before measles immunization was available, nearly everyone in the U.S. got measles. An average of 450 measles-associated deaths were reported each year between 1953 and 1963."

Hmmm.  Over 2 million deaths per year, vs. 450.  

Fear-monger much?

Well, maybe mgrella was referring to measles in developing countries?  Not that they would be affected by whether or not we vaccinate for measles here in the US, but just to give him the benefit of the doubt...

Of course, he seems to have ignored this 1993 article from American Academy of Pediatrics:

Vitamin A Treatment of Measles

http://pediatrics.aappublications.org/content/91/5/1014.abstract

"Several recent investigations have indicated that vitamin A treatment of children with measles in developing countries has been associated with reductions in morbidity and mortality."
 

RATIONALE FOR VITAMIN A

"Vitamin A is a necessary substrate for preserving epithelial cell integrity and in addition plays a role in immune modulation."

Well, gee, if this was known in 1993, shouldn't this have been applied to measles approaches in developing countries?  

As it turns out, that's exactly what they did in India.  According to http://wcd.nic.in/research/nti1947/7.11.2%20Vitamin%20A%20Deficiency%20pr%20map.pdf, 

"In an attempt to improve the coverage, especially of the first two doses, it was decided to link Vitamin A administration to the ongoing immunization programme during the Eighth Plan period. Under the revised regimen a dose of 100,000 IU of Vitamin A was administered to all infants at nine months along with measles vaccine and a second dose of 200,000 IU was administered at 18 months of age along with booster dose of DPT and OPV. Subsequently, the children were to receive three doses of 200,000 IU of Vitamin A every six months until 36 months of age."

In fact, vitamin A supplement programs have been done in over 40 developing countries: http://www.unicef.org/specialsession/about/sgreport-pdf/12_VitaminADeficiency_D7341Insert_English.pdf

"Most children in more than 40 countries are receiving at least one vitamin A supplement yearly, a remarkable achievement as only a handful of countries were reaching children with one vitamin A supplement in the mid- 1990s. Between 1998 and 2000, UNICEF estimates that about 1 million child deaths may have been prevented through vitamin A supplementation."

Yet we are told that our only hope of surviving the dreaded measles is the vaccine?

So why the fear-mongering?  Why the attempt to scare us into believing that if we don't give our children the MMR, they, our family, and friends will die of measles, and over 2 million people will die of measles?
 

[Jennyanydots]

I've been following this thread with interest, and I have to say I am really disappointed by the abusive tone the OP took after his assertions were met with questions. I really do have sincere questions about the safety of vaccines. If I thought they were safe, I'd vaccinate my kid. I don't know why intelligent, honest, concerned questions can't be answered thoroughly, and it is incredibly frustrating. It seems like no matter how deeply you dig trying to find reassurance that these drugs are a good idea for our babies, the official response is basically "because we say so." Oh, and "we know stuff you don't know (or wouldn't understand), so just trust us." Try me, please.

And here this guy is giving out controversial advice on something as basic and commonplace as tylenol. But refuses to explain himself.

How this could be good enough for anyone just blows my mind. I am tired of hearing non vax moms in this forum lumped together as conspiracy theorists or accused of being antagonistic bullies. I don't give a flying flip what medicines other people give their kids, I just want all the available information so that I can make an informed decision before giving my baby any drugs.

[japonica]

Not to generalize with the ped vs. GP angle, but this is why I adore our GP.

He signed my kids' Conscientious Objection form. We talked at length. He told me at the time that he wished I'd reconsider on one or two "important" vaccines (every HCP has a favorite) and I said, "Well, let's wait and see."

Fast forward three years. I told him I was considering the dT for my eldest kid (since there's no childhood DT manufactured here in Australia). He listened to my reasoning. And guess what? He didn't try to upsell me. He didn't tell me to get the Tdap instead. Or tell me that while I was at it to add the MMR and Men C and IPV and Hep B and anything else he felt she needed. He didn't tell me that my kids would be dead next week from not being up to date.

He simply said, "Okay, dT it is. Give me a call when you've decided and you want to schedule it." He didn't try to pressure me into anything else.

THAT is a decent health care provider. Even in public health, I guess he doesn't share mgrella's sense of math. But then his kids had mumps. And chickenpox. And whooping cough. And he's from the generation that didn't have a vaccine for measles. 

Some health care professionals could take a lesson from him. More flies with honey, people. Anyone getting hardline with me means that I walk--right to the office of someone willing to listen and answer questions honestly.

Edited by japonica - 10/4/12 at 4:59am

[nia82]

Hmmm Flumist has an admitted shedding rate in their package insert, yet the military routinely gives it to service members with newborns, preemies and immunocompromised individuals at home.

To add: there is hope. Our family doctor, while in favor of vaccines, admits that there are severe risks to them. He never pesters me, patronizes me or shows other indecent and unprofessional behavior. I don't have to sign a "bad mommy form". When we have our vaccine appointments (we delay and select, quite a bit) he goes over all the possible reactions and we are always advised to go to the ER if anything isn't right to get treatment and monitoring straight away. I think overall our doctor shares my view and experience (since I have had bad reactions) of critical thinking of vaccines and all medications, to never discredit reactions; he knows to try to do without meds most of the time (he has never once suggested antibiotics, steroids or whatever else many kids I know take like candy for every sniffle to us). I value him as a true professional. He also stays on top of new research, which I think is great - and he is open to suggestions and has great discussions with me, from which we both took away new perspectives. So.... those docs are out there!

I forgot: he e.g. does not vaccinate when my kids are sick or recently were sick. He agrees we wouldn't do it if they are on meds. We agreed not to vaccinate a day before we left for a vacation as he felt it's a bad idea to deal with a reaction on the road/plane... He knows not to give Tylenol before shots as it has shown to lower the response to it... He read up that the supine position is the most painful for kids, so we don't do that during administration of the vaccine... And so on, stuff like that - knowing those things, knowing a pop of Tylenol won't stop severe reactions, that is what makes me comfortable with him. Working with us, not against us.

[prosciencemum]

This thread got pretty adversarial pretty early on I would say. Mgrella asked not to talk about philosophical or religious exemptions, but stick to medical questions, then it got pretty nasty. 

Mgrella - try again with a second fresh start thread? Some of the questions early on which you responded to I found really interesting. Remember lots of people might be reading these threads who aren't posting. :) 

[Taximom5]

Originally Posted by prosciencemum 

This thread got pretty adversarial pretty early on I would say. Mgrella asked not to talk about philosophical or religious exemptions, but stick to medical questions, then it got pretty nasty. 

Mgrella - try again with a second fresh start thread? Some of the questions early on which you responded to I found really interesting. Remember lots of people might be reading these threads who aren't posting.  

Actually, those of us who asked mgrella direct questions and/or directly refuted some of his points would appreciate direct answers from him, HERE, on the thread that HE started.

I think it's very telling that he has not dared to directly address the many difficult questions and arguments addressed to him, yet you leap to his defense (can he not handle this himself?) and then suggest he "start again," thereby avoiding those discussions--and the real issues.

[kathymuggle]

Originally Posted by prosciencemum 

This thread got pretty adversarial pretty early on I would say. Mgrella asked not to talk about philosophical or religious exemptions, but stick to medical questions, then it got pretty nasty. 

Mgrella - try again with a second fresh start thread? Some of the questions early on which you responded to I found really interesting. Remember lots of people might be reading these threads who aren't posting. :) 

I disagree.  I think it turned here:

" Many reactions can be avoided with pretreatment or managed with a predetermined strategy.  Your advice is instead to make a rash decision which might lead to a VPD that could damage a child (and then whom would YOU blame)? " Mgrella.

He can come back if he wants. I  would love to pick the brains of a health care provider who really is sel/delayed (which is what this forum is).  I don't see much point in coming back if he refuses to discuss vaccine side effects or safety.  The entire medical vaccine debate comes down to risk assesment of VPD's  and vaccines. 

[japonica]

Originally Posted by prosciencemum 

This thread got pretty adversarial pretty early on I would say. Mgrella asked not to talk about philosophical or religious exemptions, but stick to medical questions, then it got pretty nasty. 

Mgrella - try again with a second fresh start thread? Some of the questions early on which you responded to I found really interesting. Remember lots of people might be reading these threads who aren't posting. :) 

I thought many of the questions asked, that he has yet to answer, were medical questions. Many of the members posted published studies that contradicted several of the general points he was making. I would think, as a pediatrician and making the claims he did (like 25% of us would be dead now without being vaccinated as children, yet as a child I had a fraction of what's on the schedule now--and no boosters because back in the 70s, doctors told us we had "lifelong immunity" from them), that he would be able to critique these studies and using said peer-reviewed published materials, show us where we have misinterpreted the data.

But he hasn't. Yet. We get told that we'll be back to two million measles deaths, that our kids are at imminent risk of polio, but there's nothing to back it up. No links from him, no studies or articles, nothing but a bit of empty rhetoric. I know most of us usually get called out for posting opinion without anything tangible and credible as support.

I hope he comes back and answers the questions that were asked of him. Otherwise, ignoring them and changing the subject--how is that "starting fresh"? From what I've read in this forum, many peds do this now as a matter of practice.

Finally, I respectfully inquire if this is the best forum for a physician whose opinion of the "most important vaccines" includes everything on the schedule for kids up to six years old, along with HPV and Men C.

HiB (can be fatal or disabling and used to be a frequent cause of meningitis, blood infection, deafness and seizure disorder prior to vax)

Strep pneumoniae (aka PCV13 or Prevnar; similar to above)

MMR (because measles is wildly contagious and can be fatal; in some states we are approaching dangerously low levels of herd immunity)

DTaP/Tdap (in the US mostly for pertussis prevention, because pertussis can kill newborns)

Influenza (very contagious, 30,000 deaths per year in US, vaccine moderately effective)

Hep B (once acquired, no cure and can lead to liver cancer and/or cirrhosis)

Polio - still around and very disabling

Varicella (very common, very contagious, hospitalization rate ~1%, death rate ~1/10,000 in the US)

HPV - VERY common, can lead to cervical (and anal and throat) cancer

Menigococcal (MCV) - less common but very serious and sometimes fatal

Rotavirus (prevents a very common but rarely fatal (in the US) disease

Hep A (fairly common but rarely fatal or disabling)

Selective and delayed does not mean, "Select all without delay." His recommendations for the "most important" means following the standard, mandated CDC schedule. Funny, when I asked my GP what he considered the "most important vaccines," his list only had three items.

Edited by japonica - 10/4/12 at 5:17pm

[emma1325]

Originally Posted by japonica 

I thought many of the questions asked, that he has yet to answer, were medical questions. Many of the members posted published studies that contradicted several of the general points he was making. I would think, as a pediatrician and making the claims he did (like 25% of us would be dead now without being vaccinated as children, yet as a child I had a fraction of what's on the schedule now--and no boosters because back in the 70s, doctors told us we had "lifelong immunity" from them), that he would be able to critique these studies and using said peer-reviewed published materials, show us where we have misinterpreted the data.

But he hasn't. Yet. We get told that we'll be back to two million measles deaths, that our kids are at imminent risk of polio, but there's nothing to back it up. No links from him, no studies or articles, nothing but a bit of empty rhetoric. I know most of us usually get called out for posting opinion without anything tangible and credible as support.

I hope he comes back and answers the questions that were asked of him. Otherwise, ignoring them and changing the subject--how is that "starting fresh"? From what I've read in this forum, many peds do this now as a matter of practice.

Finally, I respectfully inquire if this is the best forum for a physician whose opinion of the "most important vaccines" includes everything on the schedule for kids up to six years old, along with HPV and Men C.

Selective and delayed does not mean, "Select all without delay." His recommendations for the "most important" means following the standard, mandated CDC schedule. Funny, when I asked my GP what he considered the "most important vaccines," his list only had three items.

In his defense, I do believe he was asked to list vaccines in order of importance, which he did.  I don't think he was asked to pick some out.

[japonica]

Originally Posted by emma1325 

In his defense, I do believe he was asked to list vaccines in order of importance, which he did.  I don't think he was asked to pick some out.

Okay, if we give him the benefit of the doubt, I would like to know then why the HPV vaccine is more important than Men C. The HPV doesn't even appear on the schedule until much, much later.  

[prosciencemum]

Originally Posted by japonica 

Selective and delayed does not mean, "Select all without delay." His recommendations for the "most important" means following the standard, mandated CDC schedule. Funny, when I asked my GP what he considered the "most important vaccines," his list only had three items.

But it can. That came up a while ago on a thread about if a new board was needed for Mothering Mamas (and Dads) who do thoughfully choose all vaccinations with no delay. We are supposed to respect all points of view here right. :)