Why are most doctors pro-vax? - Page 6

[Crisstiana]

Originally Posted by mamakay

So it's a mess.

Almost as always, I agree with Mamakay.

[Kokopelli-mana]

I took advanced graduate clinical pharmacology courses which included vaxes and only the efficacy and most common, mild reactions were mentioned. The focus was on the schedule.
When therapeutics are taught, every clinical trial is not critiqued. Indications, contraindications, mechanism of action, pharmacokinetics/ drug interactions, administration/ dosing are emphasized. Also comparisons among similar entities.

When I realized that I, among all people, was not properly educated on vaxes, I became very angry. I had always refused Varicella for my dd because thet taught us that boosters would be likely and I wanted her to have lifelong immunity. But she got doses of the others. I will ALWAYS think for myself from now on. So should every parent.

[giggleball]

I think that is my biggest issue (not a balanced view)..... OF COURSE you will come to the conclusion that vaccines are the best thing ever if that is what is taught. (I don't mean you, personally, just in general). I have NO PROBLEM with someone who comes to the conclusion that vaccines are necessary/great when they have evaluated all the material.....

It is ironic to me also that when I spoke to my friend (who is going to be a ped) about the vaccination issue, she had no words/evidence/etc. with which to speak to me. Her response was "where did you get your info, on the internet?" When I spoke to the doctor that we go to now, he was totally aware of the case against vaccinations and agrees w/ many (no need for the MMR, chicken pox, hepatitis) but believes in some. I respect his opinion as he respects mine (to not vax) because we both know that we have looked at both sides of this issue. Incidentally, he believes in a link between autism and vaccinations.....

[applejuice]

Originally Posted by JesseMomme

The other thing is that not much common sense is taught in college, traditionally.

Logic and ethics used to be taught in college, but I suppose now it would depend on who wrote and who published the texts and who pays the professors.

[lokidoki]

Originally Posted by Crisstiana

Some are worrisome. Of course, many people with polio will not get the paralytic form, but the risk is not worth it in my mind as there's very little that can be done for those who do. Measles can be mild or it can kill, and you can't always predict the course in any one given patient. Rubella may not be all that bad in kids - although it certainly can be - but I'm glad there's a vax in order to cut down on congenital rubella syndrome.

I appreciate your honesty and your opinion. My question is with regard to Rubella and this somewhat ties into another thread that was recently posted. When I went in and stated that we were going to claim religious exemption my ped had only one concern - CRS. He said that if I didn't give DS the MMR then he could get Rubella and transfer it to me if I were pregnant.

Now...it was laid out in another thread as we are all checked for immunity (or at least can request to be checked) prior to becoming pregnant and if we are not immune then we can get vaccinated at that time to protect us. Does that not make more sense than giving it to children? Seems logical to me that if it is extremely mild in children and the only risk is during first trimester pregnancy...then it is those of us getting pregnant that should be concerned with getting the vaccine. Furthermore...we would have more children raised with life-long immunity from having Rubella and less vaccines would be needed.

[Crisstiana]

Originally Posted by lokidoki

I appreciate your honesty and your opinion. My question is with regard to Rubella and this somewhat ties into another thread that was recently posted. When I went in and stated that we were going to claim religious exemption my ped had only one concern - CRS. He said that if I didn't give DS the MMR then he could get Rubella and transfer it to me if I were pregnant. And I'm all in favor of needing less vaccines.

Now...it was laid out in another thread as we are all checked for immunity (or at least can request to be checked) prior to becoming pregnant and if we are not immune then we can get vaccinated at that time to protect us. Does that not make more sense than giving it to children? Seems logical to me that if it is extremely mild in children and the only risk is during first trimester pregnancy...then it is those of us getting pregnant that should be concerned with getting the vaccine. Furthermore...we would have more children raised with life-long immunity from having Rubella and less vaccines would be needed.

In theory, that is a great idea. I would much prefer being checked for immunity to a VPD than getting vaxed for something I may already have protection against.

But I think there's a few problems with this. First, many women do not know they are pregnant until they are well along. As embarassing as this is to admit, I did not realize I was pregnant until week11/12. After nearly a decade of failed infertility treatments, I was told and believed that my chances for conception were zero. So I made a differential diagnosis for all my "symptoms", chalked up the extra appetite to the buckets of stress I was under, and remained clueless for quite a while. [I tell this story to nurses all the time so they can laugh at the stupid doctor .] While in my first trimester, I was around some very sick people, including some with VPDs, and am extremely glad I didn't get sick.

When I did my labor-and-delivery stint during med school, I repeatedly heard women say they drank, smoked, didn't eat right, took drugs, etc. before they realized they were pregnant. And we had one woman come into triage in full-blown labor who hadn't realized she was pregnant. That's extremely rare, but not knowing until well into the first trimester or early second is not.

The second problem is not everyone would get tested before getting pregnant or early in pregnancy. Most pregnancies are a surprise, so that takes out a lot of pre-preg testing. Not everyone receives medical care, for a variety of reasons, especially early in their pregnancies. Some are UCers who do their own care, but many are among the 44 million who have no insurance. If the person is in the US illegally (and in my far-from-the-borders state we see a lot of migrant workers who are not here legally), the chances are not good they will get care. Some folks, and I'm not pointing fingers at any here , just plain distrust and dislike doctors. Others would simply not see the need, even with public information campaigns. People are often in denial that bad things will happen to them, especially if the risk is much less than 100%. Lastly, others would not believe the risk was real. Again, not thinking of any MDCers in particular, but some folks seem to think positive thinking, intuition, and healthful living are shields against disease. They are not.

Ideally, everyone would plan each pregnancy and get tested. If it were true, I would agree, Lokidoki. But I just don't see that happening, I'm sorry to say.

[Deborah]

My biggest problem with the current rubella vaccine policies is vaxing women after they give birth. This exposes their newborn baby to rubella (even if they aren't breastfeeding) and this is just plain stupid!

On the subject of medical education and learning to critically read medical studies: the friend/doctor I mentioned is the same age as moi, which means that she was in medical school in the 1970s. It sounds as though some aspects of medical education have improved a lot since then...not all alas.

I notice that my comments on the problem of doctor's making decisions in favor of vaxes based on personal experience of bad disease outcomes rather than careful study of the data haven't gotten a lot of response

[LadyButler]

Originally Posted by Deborah

My biggest problem with the current rubella vaccine policies is vaxing women after they give birth. This exposes their newborn baby to rubella (even if they aren't breastfeeding) and this is just plain stupid!

:

I've often wondered the same thing. I know a ped told me once to keep my then about 4 month old away from her recently MMR vaxed cousins to keep from spreading the diseases.

[mamakay]

Well, they could do a preteen check-up (with a titre check) and vax for CP, rubella (girls), and mumps then (for boys).
The rubella vax has fewer side-effects in girls before puberty. (something about puberty makes weird arthritis stuff happen in females).

[Iolanthe]

Originally Posted by mamakay

No, I know for a fact that a lot of peds have no idea that a lot of flu vaccines still contain thimerosal.

Are you thinking of the "preservative-free" vaccines that still contain traces of thimerosal? If so, this is actually an example of what I mean. A doctor is going to interpret "trace amounts" as "zero, for all practical purposes" while someone else may say "small but non-zero is still non-zero!" It is a difference in attitude towards perceived risks.

[giggleball]

Actually, I believe the flu vaccine contains more than "trace amounts" of thermerisol.......

[Crisstiana]

Originally Posted by Deborah

On the subject of medical education and learning to critically read medical studies: the friend/doctor I mentioned is the same age as moi, which means that she was in medical school in the 1970s. It sounds as though some aspects of medical education have improved a lot since then...not all alas.

Med ed has changed quite a bit in recent years. My dad went to med school about when dinosaurs roamed the planet (no, no, I love my dad and he has a medical mind so sharp it is frightening, but it was a long time ago). He gave me his med dictionary from his school years, and we both laughed at it. Pretty much nothing on genes. It had a listing for "carrot" which described its use as a poltice to draw out infections or something like that. It defined the words "cretin" and "mongoloid" as perfectly good medical terms. "Evidence-based medicine" didn't exist as a set concept, and none of the terms relating to EBM were in there.

My dad was amazed at all the cultural sensitivity, active listening, and rapport buidling exercises I was required to do in med school. He initially thought it was the equivalent of holding hands and singing "Kum By Ya". After we talked about it, he finally got it and went on to learn Spanish in his 60s to better communicate with his Spanish-speaking patients.

It is continuing to evolve. There are more and more schools that are establishing formal policies to limit influence by drug companies. More schools regularly discuss commonly used supplements and non-drug treatments. The body-mind connection is being explored more. I'm sure I'll be surprised what is taught ten years from now.

[lokidoki]

Originally Posted by Crisstiana

Ideally, everyone would plan each pregnancy and get tested. If it were true, I would agree, Lokidoki. But I just don't see that happening, I'm sorry to say.

Well not everyone gets vaxed either...

Just to clarify, what I meant by prior to getting pregnant was anytime prior to getting pregnant including pre-teen ages. My intent was that we need not be injecting it into our babies and young children but rather wait until their bodies can better handle a vaccine and/or reaction. I did not necessarily mean that one get tested just prior to pregnancy as I do realize there are unplanned pregnancies out there all the time. But I see it like I see Hep B -- give it when more of the risk arises and not as a young child so that the vaccine can damage and wear off immunity too prior to when the individual is truly at risk.

[Crisstiana]

Originally Posted by giggleball

Actually, I believe the flu vaccine contains more than "trace amounts" of thermerisol.......

Here's the ingredient list and partial preparation steps for some flu vaxes, with links to the labels. The amounts are per dose and the language regarding amounts (e.g., "trace" are from the label). Info regarding thimerosal is underlined:

Fluzone

45 micrograms hemagglutinin, in the recommended ratio of 15 g HA each, representative of the following three prototype strains: A/New Caledonia/20/99/IVR-116 (H1N1), A/New York/55/2004/X-157 (H3N2) (an A/California/7/2004-like strain) and B/Jiangsu/10/2003 (a B/Shanghai/361/2002-like strain)
0.05% gelatin (stabilizer)
25 micrograms of thimerosal per dose from a 5 ml vial (the 0.25 ml prefilled syringe dose for 6-25 months of age, the 0.5 ml prefilled dose for 26 months and older, and the 0.5 ml vial for 36 months of age and older do not contain a preservative and thimerosal is not used in the manufacturing process of these preparations)

- Influenza preparation: Propagated in embryonated chicken eggs.
The virus-containing fluids are inactivated with formaldehyde.
The virus is chemically disrupted using a nonionic surfactant, octoxinol-9, producing a “split virus.”

...

Fluvirin [information is for 2005-2006 formula]

Each 0.5mL contains the recommended ratio of 15µg each of A/New
York/55/2004 NYMC X-157 (A/California/7/2004 (H3N2)-like); A/New Caledonia/20/99
IVR-116; B/Jiangsu/10/2003 (B/Shanghai/361/2002-like) hemagglutinin antigens.
Trace thimerosal
0.98 mcg mercury
Polymyxin, neomycin, and betapropiolactone (used in manufacture) cannot be detected in the final product by current assay procedures.

Vaccine is prepared from the extraembryonic fluid of embryonated chicken eggs inoculated with an influenza virus suspension containing neomycin and polymyxin.
The fluid is inactivated with betapropiolactone.
Hemagglutinin and neuraminidase, two surface antigens, are obtained from the influenza virus particle in a process that involves nonylphenol ethoxylate and removes most of the internal proteins. The nonylphenol ethoxylate is later removed.

…

Fluarix

45 micrograms hemagglutinin
0.085 mg or less octoxynol-10
0.1 mg or less alpha- tocopheryl hydrogen succinate
0.415 mg or less polysorbate 80 (Tween 80)
Less than 1.24 micrograms mercury from thimerosal
Less than 0.0016 micrograms hydrocortisone
Less than 0.15 microgram gentamicin sulfate
Less than 1 microgram ovalbumin
Less than 50 micrograms formaldehyde
Less than 50 micrograms sodium deoxycholate
(no preservatives)

The influenza viruses used are propagated in embryonated chicken eggs. Three strains are used: 1) A/New
Caledonia/20/99 (H1N1), 2) A/New York/55/2004 (H3N2) (an A/California/7/2004-like strain), and 3) B/Jiangsu/10/2003 (a B/Shanghai/361/2002-like strain). The viruses are disrupted using detergent and inactivated with sodium deoxycholate and formaldehyde that leadis to the production of a “split virus.”

...

FluMist (influenza virus live, intranasal; 2003-2004 formulation)

Label appears to be incomplete

106.5-7.5 TCID50 (median tissue culture infectious dose) of live attenuated influenza virus
Less than 0.015 microgram per ml of gentamicin (limit of detection of assay)
(no preservatives)
0.47 mg buffer that contains sucrose, potassium phosphate, and monosodium glutamate


Vaccine contains three influenza strains recommended by the U.S. Public Health Service for the 2003-2004 flu season: 1) A/New Caledonia/20/99 (H1N1), 2)
A/Panama/2007/99 (H3N2) (A/Moscow/10/99-like), and 3) B/Hong Kong/330/2001. Each strain is attenuated and temperature-sensitives, with limited replication at body temperature.Each strain is a genetic reassortment of a master donor virus (A/Ann Arbor/6/60 and B/Ann
Arbor/1/66) and a wild-type virus. The master donor viruses were developed in chick kidney cells. The three viruses were inoculated into chicken eggs. After incubation, the allantoic fluid is harvested and stabilized with a buffer that contains sucrose, potassium phosphate, and monosodium glutamate. The virus harvests are diluted with uninfected eggs to produce buld vaccine.

[mamakay]

Originally Posted by Iolanthe

Are you thinking of the "preservative-free" vaccines that still contain traces of thimerosal? If so, this is actually an example of what I mean. A doctor is going to interpret "trace amounts" as "zero, for all practical purposes" while someone else may say "small but non-zero is still non-zero!" It is a difference in attitude towards perceived risks.

No.

A lot of the manufacturers make single dose flu vaccines (no or trace thimerosal) and multidose versions (full strength ***aka-NOT 'trace' amounts***). Most of them this year were full strength.

http://www.cdc.gov/flu/about/qa/vaxprioritygroups.htm

Like this :

http://www.novartis-vaccines.com/pro...luvirin_pi.pdf

INFLUENZA VIRUS VACCINE
(FLUVIRIN®)
Purified Surface Antigen Vaccine
2006-2007 FORMULA

Thimerosal 0.01% (mercury derivative, 24.5 mcg mercury per 0.5 mL dose) is added as a preservative.

[mamakay]

Crisstiana....lol...you have that same typo there for Fluzone again...
(I only notice that because I know flu shots aren't adjuvanted, but wonder if some aluminum might actually make them work...lol...)

[Crisstiana]

Gah, you are right again, Mamakay. I forgot to correct it in my Word doc I pasted this from.

Fixed. And fixed in Word. Thanks one more time.

[mamakay]

Yer welcome.

[ericswifey27]

Originally Posted by kate3

Yes, people do die from mumps and rubella. It is not common but it can and does happen. Not every case is mild and not everyone is able to recover.
I have seen people die from respiratory failure from chicken pox.

Again, this is not to change opinions. Just to increase awareness that there is not always a "happy ending". You are forever changed by holding a dying child. It is something you never really get over.

Kids DIE from vaccines too. And suffer seizures, and all kinds of other reactions. And it's not a secret. It's right there on the vax inserts, although doctors don't tend to offer that up to the parent to read.

[mamaverdi]

Originally Posted by JesseMomme

The other thing is that not much common sense is taught in college, traditionally.

I think that's true with any profession. And one problem is, you can't teach common sense. My dh is freaky smart. He's a scientist. But man, he just has no common sense. Well, maybe trace amounts.

Originally Posted by Iolanthe

This I don't believe at all. I think it is more reasonable to assume that a) doctors know what ingredients are in vaccines and simply don't have a problem with it, and b) they have weighed the risks of adverse reactions against the risk of complications from disease and found that the stats favor vaccines. In other words, I don't believe that the disconnect between doctors and non-vaxers is an issue of ignorance; I believe it reflects different tolerance for certain types of risk and the use of different sources to assess those risks.

In my experience, peds have NOT read the inserts for the vaccines. We have a friend whose small child has cirrhosis. People with cirrhosis are not supposed to have neosporin products. The ped did NOT know that this was a common additive to vaccines. She went, got the insert, read it, and was SURPRISED.

Originally Posted by Crisstiana

People are often in denial that bad things will happen to them, especially if the risk is much less than 100%. Lastly, others would not believe the risk was real. Again, not thinking of any MDCers in particular, but some folks seem to think positive thinking, intuition, and healthful living are shields against disease. They are not.

Just like I hear, well, I'm healthy. I ate well while I was pregnant. My family has no history of genetic problems. So my child couldn't possibly have a metabolic disease.

This makes me :

But honestly, I can't say that the doctors we have spoken to about metabolic disease have much more information than the regular people one meets.

One geneticist said with a straight face mind you, "What you eat has nothing to do with metabolic disease."

Originally Posted by ericswifey27

Kids DIE from vaccines too. And suffer seizures, and all kinds of other reactions. And it's not a secret. It's right there on the vax inserts, although doctors don't tend to offer that up to the parent to read.

I don't think most of the doctors I have encountered have ever read the inserts.




I wanted to comment on something I didn't actually quote. :

Someone made the comment up-thread about risk and calculating risk.

We consulted a GI doc recently about our son. He said the most brilliant thing I've heard in a while. He said, well, this test detects about 98% of cases, but if you're in that 2%, it's 100% to you.

It *is* binary when you are faced with that 2%.

Still, sometimes you accept the risks, and sometimes you don't.