Vaccine Safety Curriculum for Medical Residents - American Academy of Pediatrics - Page 4 - Mothering Forums

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Old 05-03-2012, 08:12 PM
 
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Rachel, I suspect you are using the words "conspiracy theory" in an attempt to discredit posters (non-vaxxers).  As you have said elsewhere, let it be about the ideas, not the people.   Conspiracy theory is a slur deliberately used by some pro-vaxxers to dismiss non-vaxxers, and I don't think it has any place in a discussion.  

 

Moreover, I read Taxi's post and she did not say "that there is a conspiracy to conceal cases of vaccine preventable diseases by calling them something else."  (your words).  She said that the diagnosis of polio changed and made it difficult to ascertain the real numbers of polio.  Heck, you said something very similar last week on autism - that diagnostic change could make it seems like there were more cases than there were.  You cannot have it both ways.  Diagnostic change - particularly if it happens at the same time a vax is introduced, is relevant when we are looking at numbers.

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Old 05-03-2012, 08:15 PM
 
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I may have misinterpreted her post. I interpreted it to mean she was saying the polio rate fell because we just call polio something else now (a theory I've seen plenty of places, but may have wrongly attributed here). That is in fact a conspiracy theory. Sorry, but words mean what they mean. If I wanted to discredit her I would have called her a conspiracy theorist.
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Old 05-03-2012, 08:17 PM
 
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And I have already acknowledged (three or four times now) the diagnostic change probably played a role, but unless someone can show me some numbers that say we have 30-40k more of those other diseases being diagnosed now than then, or that they suddenly went up in 56-60, I don't think you can use that to justify the entire drop (or even most of it), and you certainly can't use it to justify the fact that the polio rate is now ZERO. That is thanks to the vaccine!
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Old 05-03-2012, 08:25 PM
 
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Sorry, but words mean what they mean. If I wanted to discredit her I would have called her a conspiracy theorist.

 

spouting conspiracy theories or a conspiracy theorist?  Not much difference, but whatever.  ("thin" to quote you mischievous.gif)

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Old 05-03-2012, 08:27 PM
 
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Ok, you're entitled to your opinion. I didn't say she was spouting conspiracy theories, either. I called one particular thing a conspiracy theory, which it clearly is (well, what I thought she was talking about is, may not have been what she actually meant).
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Old 05-03-2012, 08:44 PM
 
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And I have already acknowledged (three or four times now) the diagnostic change probably played a role, but unless someone can show me some numbers that say we have 30-40k more of those other diseases being diagnosed now than then, or that they suddenly went up in 56-60, I don't think you can use that to justify the entire drop (or even most of it), and you certainly can't use it to justify the fact that the polio rate is now ZERO. That is thanks to the vaccine!

I am not trying to justify it.

 

I was trying to point out that Taximom did not say anything conspiracy-like and that what you were saying was inflammatory.

 

On topic:  I do think vaccines played a role in the reduction of polio.  

 

Some vaccines helped lower the chances of some diseases - and some diseases are scary and some are not.  Really, if I could discount the possibility of vaccine reactions, the selective and delayed crowd has it right in my book.  

 

Back to the OP - I scanned the initial link.  I am not sure what to think of it.  It look like "arguing with parents 101".  It is not the model of health care I like, or seek out.  I want a doctor who can answer my questions, give me lots of info, and does not pressure me to do something I am uncomfortable with.  

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Old 05-03-2012, 08:48 PM
 
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There are some interesting graphs here too. Doubt you will like the source. There are graphs of Polio cases and incidence 1870 - 1998 and 1912-1970.

 

http://www.vaclib.org/sites/harpub/pol_all.htm


Very interesting. I'm bookmarking this one.

Thanks!


 
 
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Old 05-03-2012, 08:55 PM
 
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It is a conspiracy theory, you can take it as pejorative if you want, but that's what it is. It's a theory that there is a conspiracy to conceal cases of vaccine preventable diseases by calling them something else. It's not worth responding to further, because the nature of conspiracy theories is that all evidence to the contrary is part of the conspiracy.
There is a lab test that can distinguish between polio related afp and non polio afp, by the way. I learned that when I was doing some reading as a result of the thread about India.

By your definition, pointing out that Merck buried negative evidence and distorted the safety/efficacy trials of Vioxx would actually be a conspiracy theory.

 

Furthermore, your asserting that "the nature of the conspiracy theory is that all evidence to the contrary is part of the conspiracy" is just a nasty little logic game.  Whoever comes up with that definition first traps the opponent, because no matter what the truth is, there is no way out.  It's like going first in TicTacToe.  It would be like saying,  "You're a liar, and I can prove it because if you say you are not, you are lying and therefore proving my point."

 

Sorry, we're not buying that garbage here. 

 

As for the lab test for polio, that was my point--the test was not used after widespread introduction of the polio vaccine, because all cases in those who were vaccinated were assumed to be something other than polio, and all cases in those who were not vaccinated were assumed to be polio.

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Old 05-03-2012, 08:57 PM
 
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Where's the evidence for that? If the vaccine don't work where are all those cases of polio now?
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Old 05-03-2012, 08:59 PM
 
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Where's the evidence for that? If the vaccine don't work where are all those cases of polio now?

 

With that logic, it's a good thing we had a vaccine for the black plague in the middle ages.  Oh wait...


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Old 05-03-2012, 09:04 PM
 
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Again, they did a random, controlled, double blind study and the vaccine reduced the incidence of polio. The polio vaccine works. It stops people from getting polio.

I give up. If we can't even agree the polio vaccine was worth it this conversation is really beyond hope.
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Old 05-04-2012, 06:50 AM
 
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Where's the evidence for that? If the vaccine don't work where are all those cases of polio now?

 

With that logic, it's a good thing we had a vaccine for the black plague in the middle ages.  Oh wait...


The black plague was carried by RATS. Directly related to cleanliness. NOT ALL DISEASES ARE RELATED TO CLEANLINESS.

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Old 05-04-2012, 07:00 AM
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The Black Plague was also devastating by every conceivable measure - economically, politically, socially, demographically, spiritually. 
 

How many Plague-style disease outbreaks do you think human civilization can weather?

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Old 05-04-2012, 07:25 AM
 
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My email is swamped with reports on this thread, from all sides. I appreciate you all giving me the heads-up on the line-crossing in here; and I really, really want to give you guys space to work this out and get it back on track. I don't like playing "mean mod," especially when there is good information hidden in here.

Quick tip: "conspiracy theory", "garbage", and "black plague" posts are not likely to take us to a good place.

Please pause and carefully review your post before hitting that submit button.

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R-E-S-P-E-C-T spells BRAND NEW User Agreement!!

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Old 05-04-2012, 07:38 AM
 
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The Black Plague was also devastating by every conceivable measure - economically, politically, socially, demographically, spiritually. 
 

How many Plague-style disease outbreaks do you think human civilization can weather?

The vast majority of diseases we vaccinate against are not the Plague, though.  Not even close.  

 

I think the discussion on the Black Plague brings up a valid point, though, on the rise and fall of diseases.  Diseases have a life cycle - they rise and fall.  Flu strains are another example.  

 

Do I think some vaccines might have contributed to a reduction in some diseases?  Absolutely.

 

Do I think it is possible some of the diseases or their severity might have gone away on their own - or with better nutrition, medication, sanitation, etc?  Sure.

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Old 05-04-2012, 07:48 AM
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Mosaic has asked that discussion of the Plague end now. 
 

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Old 05-04-2012, 07:55 AM
 
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Old 05-04-2012, 08:09 AM
 
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About the guide, one doctor stated "You've got parents out there arguing with their physicians because they are scared and they want to protect their child. That is healthy, but we have got to arm our physicians with good counseling tools and good statistics that will dispel the rumors."

 

http://www.aafp.org/online/en/home/publications/news/news-now/education-professional-development/20120409vaccinesafetycurriculum.html

 

Honestly, I don't see what the big deal is.  It's not "propaganda" as "The Refusers" claims. It's a guide to help residents communicate with parents about vaccine concerns they may have because of propaganda. The fact that autism is the biggest concern of parents indicates to me that that's true much of the time. 

 

I'm sure for parents that have done a lot of research and given the issue lots of thought, then these doctors are not going to change their minds. For parents who have concerns because they've seen Jenny McCarthy on Oprah and read some stuff on biased websites, then the discussion might be helpful. 

 

I'd certainly hope that if I was going to refuse standard medical care that could have great benefit for me or my child, then my doctor would challenge me and make sure I had complete understanding of my decision. Not to would be negligent. 

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Old 05-04-2012, 08:16 AM
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I feel like I can productively comment in re. the rise and fall of diseases as it relates to the Plague.  In the course of its rise and fall, the Plague took down an estimated 1/3 of the population of Europe.  In the process it undermined institutions and systems that people had liked - had thought provided for the best possible guarantees of collective survival and salvation.  The European population didn't recover to pre-plague levels until after the Industrial Revolution.  Outbreaks occurred every 7-15 years depending on the weather from 1348 on, and would still be occurring, had Europeans not changed their attitudes towards sanitation.  There are still plague outbreaks in some parts of the world, though the US and Europe are largely safe from the disease. 

 

Thus, plague is NOT a good example of a disease that would burn itself out. 

- it hasn't burned out yet.

- it's easily controlled by sanitation measures, which many other diseases are not.

- The initial outbreak killed 1/3 of the population of Europe.  I don't have stats on subsequent outbreaks, but death rates remain high among people who cannot access treatment.

- The survivors tended to be people with genetic resistance to the disease.  Essentially, the first survivors got lucky and the survivors of subsequent waves tended to be the descendants of the survivors of the initial wave.  Which is great for them, but deeply unfortunate for those who didn't win the genetic lottery - it's these people who are the intended beneficiaries of vaccination.  Some diseases might burn themselves out - but at horrible and tragic costs for the people who aren't genetically resistant.  Guns, Germs, and Steel by Jared Diamond examines the consequences of disease outbreaks for populations that lack genetic or acquired resistance at length. 
 

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Old 05-04-2012, 08:18 AM
 
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Good point. I also think its important to realize that this IS a public health issue. All the (mainstream) research points to not vaccinating puting not only your child but other children at risk. Doctors have a responsibility I be a source of accurate information and try to get as many people as possible to vaccinate.

That being said, they also have an obligation to really listen to concerns parents have and reliably recognize legitimate medical objections and adverse reactions. I do wish doctors had more training in recognizing truly serious adverse reactions, no matter how rare they are.
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Old 05-04-2012, 08:44 AM
 
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Honestly, I don't see what the big deal is.  It's not "propaganda" as "The Refusers" claims. It's a guide to help residents communicate with parents about vaccine concerns they may have because of propaganda. The fact that autism is the biggest concern of parents indicates to me that that's true much of the time. 

 

Bolding mine.  I don't think that is true. Non-vaxxing mothers on MDC have repeatedly said they do not vax for a variety of reason - for many of them autism does not even crack the top three.  

 

I agree it (the link in the OP) is not propaganda.  It is "talking points."    Talking points are not evil or propaganda…but they are not very genuine either.  They focus more on what to say than listening to what the patient has to say.  

 

I'm sure for parents that have done a lot of research and given the issue lots of thought, then these doctors are not going to change their minds. For parents who have concerns because they've seen Jenny McCarthy on Oprah and read some stuff on biased websites, then the discussion might be helpful. 

 

All or almost all website are biased.  Some more so than others.  Raw numbers are the way to go. 

 

I'd certainly hope that if I was going to refuse standard medical care that could have great benefit for me or my child, then my doctor would challenge me and make sure I had complete understanding of my decision. Not to would be negligent. 

 

I have issues with the word "challenge."   I think it is the doctors job to make sure you have all the information you need to make the decision, but it is not their job to challenge the decision, or convince you one way or the other.  You are the parent - you are the one who needs to make the decision (without pressure) and live with the consequences.  Anecdote:  I am about to change dentists because the dentist has challenged me 3 times on my refusal of routine X-rays.  At some point "challenging"  comes across as not respecting a boundary.

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Old 05-04-2012, 08:51 AM
 
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Bolding mine.  I don't think that is true. Non-vaxxing mothers on MDC have repeatedly said they do not vax for a variety of reason - for many of them autism does not even crack the top three.  

Kathy, I was not talking about non-vaxxers here but rather referring the number one reason doctors said parents gave for having concerns.  It's in the link I provided.

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Old 05-04-2012, 08:59 AM
 
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Good point. I also think its important to realize that this IS a public health issue. All the (mainstream) research points to not vaccinating puting not only your child but other children at risk. Doctors have a responsibility I be a source of accurate information and try to get as many people as possible to vaccinate.

I can appreciate that doctors believe it is a public health issue and that they think they should convince as many parents as possible to vaccinate.  That  is the public health POV.  I do think heavy-handedness and forcefulness has little place in this issue…and respect for parents as the decision makers and the word "no" does.  

 

My primary job, however, is not public health - it is the safety of my child.  

 

I don't think doctors are villains (indeed I am very grateful for them some of the time!) but when it comes to vaccines, they have a different mandate than I do.  

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Old 05-04-2012, 09:02 AM
 
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Kathy, I was not talking about non-vaxxers here but rather referring the number one reason doctors said parents gave for having concerns.  It's in the link I provided.

Thanks for clarifying.

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Old 05-04-2012, 09:04 AM
 
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Right. That was what I was pointing out. To be fair, I vaccinate because I believe it is best for my child. I believe I would unethical for a doctor to push me to vaccinate if it was for the greater good only and not also in my child's best interest.

I agree heavy handedness or bullying does no one any good in this scenario.
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Old 05-04-2012, 09:15 AM
 
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I have issues with the word "challenge."   I think it is the doctors job to make sure you have all the information you need to make the decision, but it is not their job to challenge the decision, or convince you one way or the other.  You are the parent - you are the one who needs to make the decision (without pressure) and live with the consequences. 

 

I don't really want to get into a debate about semantics. Of course doctors should treat people with respect and not shove things down their throats and ultimately medical decisions are not up to doctors. But they have an obligation to make sure people are making fully informed choices. I think that training guide offers some good insight for doctors on how to have respectful conversations about the issue rather than just dismissing concerns out of hand.  As a matter of fact, it stated specifically not to just dismiss concerns. While of course it's biased, it seems like step in the right direction. Better than just telling people this is the way it is, just deal. It opens a dialogue.

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Old 05-04-2012, 09:26 AM
 
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I have issues with the word "challenge."   I think it is the doctors job to make sure you have all the information you need to make the decision, but it is not their job to challenge the decision, or convince you one way or the other.  You are the parent - you are the one who needs to make the decision (without pressure) and live with the consequences. 

 


Kathy, while I see your objection to "challenge", I think many doctors would disagree with you regarding their job description. 

 

Most doctors view their information-providing function as non-neutral.  It is *not* their job simply to give you the information and let you draw your own conclusions from it.  In fact, many patients would find that approach confusing, unproductive, and unsatisfying.  If you had diabetes, you would not expect your doctor to simply tell you what he knows about the condition and let you figure out how to deal with it.

 

Most of us do not approach all aspects of our health with the zeal and interest that would enable us to seek, absorb, and act on all the relevant information regarding them.  (I was a PITA to my OBs during pregnancy - and they were quite obliging about dealing with my concerns - but I am currently being treated for a minor skin problem and I have asked almost no questions, beyond "why does this hurt, and what should I do about it?"  One of the most common questions that doctors are asked is the functional equivalent of "what should I do?"  Patients want recommendations, and (IMO) are badly served by health care providers who will not make them.

 

Most doctors view it as part of their jobs to filter and summarize information for patients, AND to convince patients to act in their own best interests.  Since they can be sued for failing to make those best interests (and the risks of not acting in them) clear, they tend to be active in making recommendations.

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Old 05-04-2012, 09:42 AM
 
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Most doctors view their information-providing function as non-neutral.  It is *not* their job simply to give you the information and let you draw your own conclusions from it.  In fact, many patients would find that approach confusing, unproductive, and unsatisfying.  If you had diabetes, you would not expect your doctor to simply tell you what he knows about the condition and let you figure out how to deal with it.

 

Actually, I would.  I would expect him to tell me what he knows, lay out options, and let me decide on a plan.   

 

Most of us do not approach all aspects of our health with the zeal and interest that would enable us to seek, absorb, and act on all the relevant information regarding them.  (I was a PITA to my OBs during pregnancy - and they were quite obliging about dealing with my concerns - but I am currently being treated for a minor skin problem and I have asked almost no questions, beyond "why does this hurt, and what should I do about it?"  One of the most common questions that doctors are asked is the functional equivalent of "what should I do?"  Patients want recommendations, and (IMO) are badly served by health care providers who will not make them.

 

I hear you.  There have been times where I just want to be told what to do.  However, if a patient is coming to you and saying "no" to vaccination,  they are not asking to be told what to do.  Some of it probably comes down to reading your patient.  

 

Most doctors view it as part of their jobs to filter and summarize information for patients, AND to convince patients to act in their own best interests.  I do not want to be told what is in my best interest.  It is a little patronising.  I can figure it out for myself.  If I cannot or do not want to, I will ask for further information or ask to be told what to do.  

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Old 05-04-2012, 09:57 AM
 
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Most of te people I know irl who don't vax do NOT do it because they are well educated. They do it because they have "heard too much stuff" and they see it as erring on the side of caution since thy are protected by herd immunity. I think doctors absolutely need to challenge that attitude.
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Old 05-04-2012, 10:03 AM
 
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      Quote:

Originally Posted by MeepyCat View Post

Most doctors view it as part of their jobs to filter and summarize information for patients, AND to convince patients to act in their own best interests.  Since they can be sued for failing to make those best interests (and the risks of not acting in them) clear, they tend to be active in making recommendations.

 

I totally agree. I have refused medical treatment for myself before, and while it would have been nice for me if the doctors had just shut up and gone with it since I had done my research (and had a strong gut feeling I was right shy.gif), I knew they had an obligation to make sure I understood what I was doing and what all the risks were and that I was going against their recommendation.  They would have had to deal with the consequences too if I had been wrong. 

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