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Old 10-31-2013, 10:10 AM - Thread Starter
 
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I am going to state right off the bat that I disagree with removing religious or personal belief exemptions for schools. Whether that be private or public or homeschooling. 

 

Having said that, I am not totally against requiring parents to sit down with a doctor or watch a video that discusses the benefits and risks of vaccines and the risks of diseases before being able to sign the exemption form.  I think this serves two purposes: The first one is that it will make parents who aren't against vaccines but have just been signing the waivers for convenience more likely to vaccinate their children since they have to go to the doctor anyway. Second, I think it is important that parents are truly informed. Making an informed decision means hearing from both sides of the issue.  It ensures that parents are at least listening to both sides. 

 

So for debate, I have read a lot of non vaccinating parents are against this bill and I just don't really understand why.  If the goal really is for parents to make an informed decision, shouldn't that include talking to a doctor about the benefits of vaccines?  

 

Here's part of the bill for those of you who aren't familiar with it. 

 

"

This bill would require, on and after July 1, 2013, the
above-described letter or affidavit to be accompanied by a form
prescribed by the State Department of Public Health that includes a
written statement signed by a health care practitioner, as defined,
that indicates that the health care practitioner provided the parent
or guardian of the person, or the person, if an emancipated minor,
who is subject to the immunization requirements with information
regarding the benefits and risks of the immunization and the health
risks of specified communicable diseases.

 

Things have been getting a little heated on this forum the last several days so lets please try not to turn this thread into a hole of ugliness.  I really am just curious.  And who knows? Maybe I'm the only one (even pro vaccine) who agrees with this kind of bill.  I'm open to changing my mind if someone brings up a point I hadn't considered. So I'd  really like to hear why you are against or in favor of the bill. 

 

Edit: I am also going to add that I think that only MDs should be able to sign off on the bill. No nurses, or PAs or homeopaths etc. 

 

Double Edit: Unless they are allowed to be primary care providers in your state. 


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Old 10-31-2013, 11:07 AM
 
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I do think it's important to be informed, however I feel like being forced to watch a video or talk with a doctor is a violation of my personal choice. It's really no one's business why I choose not to vaccinate. I have the right to refuse medical treatment regardless of the reason.

What's more important to me is that doctors are required to offer their patients informed consent. Meaning that when they speak to a patient about vaccinations, they must offer both the benefits and the risks. They must give patients a list of possible side effects including rare effects. And of course they can speak to patients about the disease that the vaccination prevents.

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Old 10-31-2013, 11:19 AM
 
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I just took PO's Coursera class because I am *sure* it is more informative & nuanced than anything the State would produce. I think as you make trickle down simplified info, it becomes more one sided & less actually informative.

It is not an issue on the West Coast to get a MD signature, I am sure I could get one, as I maintain great MD relationships. However, doctors on the East Coast & in the Midwest will IMO refuse to sign, as it will be seen as 'giving permission' even tho it is only certifying that you understand risk v. benefit.

IMHO: Certainly advanced practice nurses & PAs should be able to sign, ultimately NDs too, IF they are in a state where they are Primary Care Providers.

I also have a BFF who is uninsured & w/o transportation for her 5 children. They have insurance, but having to get to an actual MD in a non-emergent situation, creates an undue burden on some families, especially when the MD may refuse to sign.

In OR that is why the bill specified an Online Module. OR is the only state that has passed this type of bill w/o preserving a token RE.
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Old 10-31-2013, 11:37 AM - Thread Starter
 
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I do think it's important to be informed, however I feel like being forced to watch a video or talk with a doctor is a violation of my personal choice. It's really no one's business why I choose not to vaccinate. I have the right to refuse medical treatment regardless of the reason.

What's more important to me is that doctors are required to offer their patients informed consent. Meaning that when they speak to a patient about vaccinations, they must offer both the benefits and the risks. They must give patients a list of possible side effects including rare effects. And of course they can speak to patients about the disease that the vaccination prevents.

 

Well, if it is important to be informed, then that means hearing the other side of the issue doesn't it?  I agree that doctors should go through all the risks of the vaccine, including informing parents that vaccines are not always 100 percent effective.  They should also discuss the risks and complications of the diseases. 

 

"I have the right to refuse medical treatment regardless of the reason." 

 

I agree, but this isn't a medical decision you are making for yourself. You are making it for another person who has to live with the consequences of that choice one way or the other so I think that makes it even more important that parents receive information from both sides, ie an informed choice. 


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Old 10-31-2013, 11:40 AM - Thread Starter
 
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I just took PO's Coursera class because I am *sure* it is more informative & nuanced than anything the State would produce. I think as you make trickle down simplified info, it becomes more one sided & less actually informative.

It is not an issue on the West Coast to get a MD signature, I am sure I could get one, as I maintain great MD relationships. However, doctors on the East Coast & in the Midwest will IMO refuse to sign, as it will be seen as 'giving permission' even tho it is only certifying that you understand risk v. benefit.

IMHO: Certainly advanced practice nurses & PAs should be able to sign, ultimately NDs too, IF they are in a state where they are Primary Care Providers.

I also have a BFF who is uninsured & w/o transportation for her 5 children. They have insurance, but having to get to an actual MD in a non-emergent situation, creates an undue burden on some families, especially when the MD may refuse to sign.

In OR that is why the bill specified an Online Module. OR is the only state that has passed this type of bill w/o preserving a token RE.

 

Maybe I am not understanding the bill correctly, but doesn't it just state that a doctor sign off that he discussed the risks and benefits of vaccines with you? He doesn't have to agree with your decision, in other words, he just has to sign something saying he discussed the issue with you. 


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Old 10-31-2013, 11:43 AM
 
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Should parents have to submit a paper saying they have discussed the pros and cons of breastmilk before they buy formula?


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Old 10-31-2013, 11:50 AM - Thread Starter
 
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Should parents have to submit a paper saying they have discussed the pros and cons of breastmilk before they buy formula?

 

The problem with using formula as an analogy is that it has to do with the rights of the mother, as well. They are her breasts. Breast feeding can be painful, time consuming, there may be a medical reason the woman can't breast feed etc.  So that is a decision that effects the woman herself.  With vaccines, you are making the decision for someone else. I certainly do not agree that  the average adult should have to talk to a doctor or sign any waivers before refusing a vaccine for themselves.


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Old 10-31-2013, 12:00 PM
 
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One, I _might_ be willing to consider a bill requiring a provider's signature that harms/benefits have been discussed, but NOT a bill that details what the provider must say. Two, I don't see why NPs and PAs wouldn't be appropriate providers to see. In many states NPs are licensed independent practitioners. If you have a pediatric NP as your kid's primary care provider then why shouldn't they be the one to offer counseling on immunization?


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Old 10-31-2013, 12:02 PM
 
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Right: the doctor only has to sign they have discussed risk v. benefit BUT then the parent can have an exemption. If doctors disagree fundamentally with the idea of exemptions (as *many* do) then nothing is requiring them to sign. Just like the AAP recommends continuing to work with Vax Hesitant/Vax Denying parents but in some states almost none will . . .
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Old 10-31-2013, 12:02 PM - Thread Starter
 
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One, I _might_ be willing to consider a bill requiring a provider's signature that harms/benefits have been discussed, but NOT a bill that details what the provider must say. Two, I don't see why NPs and PAs wouldn't be appropriate providers to see. In many states NPs are licensed independent practitioners. If you have a pediatric NP as your kid's primary care provider then why shouldn't they be the one to offer counseling on immunization?

 

Yes sorry I should edit. I hadn't thought about NP as being a primary care provider. So as dina said, if they are allowed to be primary care providers in your state then I'm fine with that. 


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Old 10-31-2013, 12:06 PM
 
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Another worry I have is that by signing or participating in a class, the parent is legally signing on to the worldview: that is, risks v. benefits ARE exactly what is being presented, when the parent may feel that the info is incomplete or inaccurate or one sided. This is more of an issue with a course.

The laws are all subtly different in WA, CA & OR: CAs is arguably the most liberal. WA did preserve a RE but you need a Religious Leader Signature, no idea if they have to be Ordained, have a Flock, or be from a recognized denomination?
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Old 10-31-2013, 12:06 PM - Thread Starter
 
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Right: the doctor only has to sign they have discussed risk v. benefit BUT then the parent can have an exemption. If doctors disagree fundamentally with the idea of exemptions (as *many* do) then nothing is requiring them to sign. Just like the AAP recommends continuing to work with Vax Hesitant/Vax Denying parents but in some states almost none will . . .

 

I am only OK with an exemption that requires that a doctor sign off that he discussed the risks/benefits with you. I do not think that getting an exemption should be based on whether or not the doctor agrees with your decision, just that he sign off that he discussed them with you. 


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Old 10-31-2013, 12:18 PM
 
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Right, but the law really hesitates the restrict certain rights of Physicans generally, so it would be difficult to make them sign legally . . .
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Old 10-31-2013, 12:24 PM
 
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I am concerned about the actual visit. Is this visit required for all children? What about parents who don't do well visits, or those who don't have insurance? What happens if you don't go to the visit, and therefore cannot have the form signed? Will there be a punishment or fine? Maybe for those who are uninsured, there will be a free class at the health department....just thinking out loud.


 
 
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Old 10-31-2013, 12:34 PM - Thread Starter
 
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I am concerned about the actual visit. Is this visit required for all children? What about parents who don't do well visits, or those who don't have insurance? What happens if you don't go to the visit, and therefore cannot have the form signed? Will there be a punishment or fine? Maybe for those who are uninsured, there will be a free class at the health department....just thinking out loud.

 

There should definitely be a free option. Either a free class at a health department or a place where a parent or guardian can watch a 45 minute video discussing the risks and benefits. 

 

I also do not think that parents that homeschool should have to get any exemptions at all. I think it should be up to the individual private schools whether they want to require this or not. I have to think a little bit more about that. I think it should definitely be required for all public schools, though.  


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Old 10-31-2013, 12:55 PM
 
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Right now it is required in most states for HS to maintain exemptions. And school is compulsory after 7/8.

The law does not protect the rights of parents to 'skip well visits' entirely. It can be & is called medical neglect to do zero well visits & have no primary care doctor for a child. Most states insure children to a very high income limit . . .

Dr. Offit made a distinction between compulsory & mandatory Vax in his course. He called 'holding you down & making you get a shot' compulsory & 'you need a shot to do XYZ' mandatory.
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Old 10-31-2013, 01:05 PM - Thread Starter
 
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Right now it is required in most states for HS to maintain exemptions. And school is compulsory after 7/8.

The law does not protect the rights of parents to 'skip well visits' entirely. It can be & is called medical neglect to do zero well visits & have no primary care doctor for a child. Most states insure children to a very high income limit . . .

Dr. Offit made a distinction between compulsory & mandatory Vax in his course. He called 'holding you down & making you get a shot' compulsory & 'you need a shot to do XYZ' mandatory.

 

Well even if you aren't getting your child vaccinated I think well baby check ups are important. The doctor could pick up on something you might miss or might not realize is a symptom of something serious. 


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Old 10-31-2013, 01:06 PM
 
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The problem with using formula as an analogy is that it has to do with the rights of the mother, as well. They are her breasts. Breast feeding can be painful, time consuming, there may be a medical reason the woman can't breast feed etc.  So that is a decision that effects the woman herself.  With vaccines, you are making the decision for someone else. I certainly do not agree that  the average adult should have to talk to a doctor or sign any waivers before refusing a vaccine for themselves.

So the womans desires trumps the infants?  I am not so sure…..  That being said, if parental desires trump infant health, then there is no argument for the law.  Parental desire (no vax or selective vax) trump infant health concerns.

 

__________________________

 

 

I think it is a good idea that people talk to their care provider about vaccine decisions.  I imagine most do, btw. I am just not sure we should legislate it.

 

There are lots of things parents should do, but may not, and they do not need to get a doctor to sign off on it.


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Old 10-31-2013, 01:14 PM - Thread Starter
 
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So the womans desires trumps the infants?  I am not so sure…..  That being said, if parental desires trump infant health, then there is no argument for the law.  Parental desire (no vax or selective vax) trump infant health concerns.

 

__________________________

 

 

I think it is a good idea that people talk to their care provider about vaccine decisions.  I imagine most do, btw. I am just not sure we should legislate it.

 

There are lots of things parents should do, but may not, and they do not need to get a doctor to sign off on it.

 

The difference is that breast feeding involves using the body part of another individual. It can be painful, cause infections etc.  Since there is a good alternative to breast feeding the rights of the woman in this case trump the rights of the newborn. 

 

Most states recognize that the health of a child trumps the religious or personal beliefs of the parent. For instance, you can't just not give your diabetic child insulin because you don't want to or your religion forbids it.  But there isn't good alternative to giving insulin and giving insulin doesn't require the parent to relinquish parts of their body or put them at risk for infections or other issues. 


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Old 10-31-2013, 01:38 PM
 
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The difference is that breast feeding involves using the body part of another individual. It can be painful, cause infections etc.  Since there is a good alternative to breast feeding the rights of the woman in this case trump the rights of the newborn. 

 

Well, I disagree that formula is a good alternative to breastmilk.  Still, it is not my call, as I am not the mother.

 

I agree that sometimes people cannot establish breastfeeding or cease breastfeeding due to physical issues.  I actually came back to edit, but you are fleet of fingers and beat me to it, Lil.

 

I know a number of people who did not try to breastfeed for goodness knows what reason.  I know, for some of them, it was because they "wanted their body back" thought is was "not for them" and a few other non-physical reasons.  They have the right to pass of trying breastfeeding without discussing it with a doctor.  Once again, this would not be my call, but they have the right to say to a doctor "I am going to use formula and I do not want to discuss it." I don't see how this differs much from vaccines.   I imagine some would could come along and say "but breastfeeding only affects your baby - not others; vaccines affect others" but this would be an oversimplification. 

 

1.  Some vaccines do not affect others - tetanus, pertussis ( pertussis vaccine prevents or lowers clinical signs of pertussis, it does not prevent transmission) .

 

2.  formula fed babies, are, on average, sicker.  People who get sick more often are more likely to pass on said sickness to others.

 

 

 

Most states recognize that the health of a child trumps the religious or personal beliefs of the parent. 

 

Vaccines do not make people healthy.  At best, they may help prevent a child from getting something if they are exposed.  Vaccines carry risks. 

 

 


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Old 10-31-2013, 02:22 PM - Thread Starter
 
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I guess we are going to have to agree to disagree that vaccinating is comparable to breast feeding.  One involves a risk and directly effects the mother, the other doesn't. For example, mastitis can require hospitalization, surgery and antibiotics. All affect the mother. 

 

Breastfeeding usually only protects against diseases for a few months.  An unvaccinated breast fed child is MUCH more likely to get measles or polio or diptheria or chickenpox or Hib or pertussis than a vaccinated formula fed one if exposed, for example.  

 

I don't care how healthy you eat or how much you exercise, an unvaccinated child is almost guaranteed to get measles if exposed. Breastfed or not. 

 

The fewer number of cases of pertussis going around in a community, the less likely a person is to get exposed.  That's how herd immunity works.  The pertussis vaccine isn't as effective as others, but studies have consistently shown that unvaccinated children are many many times more likely to get pertussis than vaccinated ones. 


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Old 10-31-2013, 07:51 PM
 
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I guess we are going to have to agree to disagree that vaccinating is comparable to breast feeding.  One involves a risk and directly effects the mother, the other doesn't. For example, mastitis can require hospitalization, surgery and antibiotics. All affect the mother. 

 

Breastfeeding usually only protects against diseases for a few months.  An unvaccinated breast fed child is MUCH more likely to get measles or polio or diptheria or chickenpox or Hib or pertussis than a vaccinated formula fed one if exposed, for example.  

 

I don't care how healthy you eat or how much you exercise, an unvaccinated child is almost guaranteed to get measles if exposed. Breastfed or not. 

 

The fewer number of cases of pertussis going around in a community, the less likely a person is to get exposed.  That's how herd immunity works.  The pertussis vaccine isn't as effective as others, but studies have consistently shown that unvaccinated children are many many times more likely to get pertussis than vaccinated ones. 

 

Actually the "breastfeeding only protects for a few months" chestnut has been addressed here before specifically with Hib and the protection dependent on the duration of breastfeeding. I don't have the study link, but I know many of the other members here have referenced it before. I think personally that Jack Newman's observation that breastmilk does not automatically turn into water at the minute a baby turns 12 months is apt. The white cells, immune factors, are all still available in it past the one year mark.

 

As for pertussis, *anecdote alert* one of my unvaccinated children got it (from his UTD father) and the other didn't. Yet, both live in the same house. We got a firsthand view of exposure not equalling infection. 

 

The proposed law sounds similar to the hoop jumping for a CO here in Australia. We had to sign a form that we'd discussed the risks of not vaccinating with a GP (who also had to sign it) and then file it with Medicare. In our case, it wasn't much of a lecture besides, "What are your concerns?" and then a bit of discussion and the GP conceding that he could see our point and in his opinion, he'd only strongly recommend a handful of the vaccines on the schedule anyway. I can see how it might be problematic though in states where GPs will refuse to have unvaccinated children as patients. 


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Old 11-01-2013, 10:22 AM - Thread Starter
 
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Actually the "breastfeeding only protects for a few months" chestnut has been addressed here before specifically with Hib and the protection dependent on the duration of breastfeeding. I don't have the study link, but I know many of the other members here have referenced it before. I think personally that Jack Newman's observation that breastmilk does not automatically turn into water at the minute a baby turns 12 months is apt. The white cells, immune factors, are all still available in it past the one year mark.

 

As for pertussis, *anecdote alert* one of my unvaccinated children got it (from his UTD father) and the other didn't. Yet, both live in the same house. We got a firsthand view of exposure not equalling infection. 

 

The proposed law sounds similar to the hoop jumping for a CO here in Australia. We had to sign a form that we'd discussed the risks of not vaccinating with a GP (who also had to sign it) and then file it with Medicare. In our case, it wasn't much of a lecture besides, "What are your concerns?" and then a bit of discussion and the GP conceding that he could see our point and in his opinion, he'd only strongly recommend a handful of the vaccines on the schedule anyway. I can see how it might be problematic though in states where GPs will refuse to have unvaccinated children as patients. 

 

It's not that it turns into water, but at some point it does stops providing sufficient immunity which is why I said a breastfed unvaccinated child is more likely to get a VPD if exposed than a formula fed vaccinated one.  I think we can all agree that a kindergartner is not going to be immune to VPDs from their mother's breast milk anymore.  


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Old 11-01-2013, 10:57 AM
 
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Unless they are still nursing. wink1.gif As a mama who puts the extended in EBF, I think neither/both of you are right. Mothers IMO, seem to make antibodies & transfer in a dynamic way. Like based on what the mama is currently exposed to . . . The issue is that many of today's mamas have weak or non-existent immunity to the theoretically VPDs b/c they have likely never had them & the Vaxes for them are not kept up to date . . .
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Old 11-02-2013, 06:30 PM
 
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Non-vaccinating parents have more provider options than vaccinating ones. Some see chiropractors, some see naturopaths, and still others see pediatricians and family physicians who tolerate their choices and provide care for them regardless.

But Well Child Visits are the lifeblood of any pediatric practice. So how objective will pediatricians be if their counseling could make or break future clientele? I know, I know. Leave it to me to point out the COIs. ;-)

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Old 11-02-2013, 06:42 PM
 
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Why do you think non-vaxing parents have more provider options?  I'm pretty sure I could see a chiropractor or naturopath if I were so inclined.


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Old 11-02-2013, 06:55 PM
 
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Point well taken, but as a vaxxer, you will ALSO have to see someone who administers vaccines. Some naturopaths might (???), but overall, non-vaxxers can opt out of the conventional pediatric WBVs.

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Old 11-03-2013, 10:43 AM
 
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Vaccinations can be obtained from a public health clinic by a nurse or even, in my state, a medical assistant or a pharmacy tech in any random pharmacy. You do not have to establish care anywhere.


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Old 11-03-2013, 12:40 PM
 
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Here is the new vaccine exemption form for California, to be used for new exemptions starting January 1, 2014.

http://eziz.org/assets/docs/CDPH-8262.pdf

 

Most California students with an exemption already in place will NOT need to use the new form, unless they are advancing to 7th grade.

"All students newly admitted to a California school, kindergarten through 12th grade, students advancing to 7th grade, and children newly admitted to a childcare facility, who wish to be exempt from one or more required immunizations because of their personal beliefs must provide this form to their school or childcare facility.

Children transferring from one grade school in California to another school in California, and not starting kindergarten or the 7th grade for the first time, do not need to provide a new exemption form. Exemptions from the prior schools should be part of the records transferred to the new schools."

http://www.immunizeca.org/wp-content/uploads/2012/01/PH13-051-New-PBE.pdf

 

I disagree with the law because theoretically, a parent could go to 100 health care providers and still not get the required signature. There is nothing in  the law requiring any health care provider to sign the form.

 

I also do not think that parents are legally required to agree to the following statement on the form:

"An unimmunized student and the student’s contacts at school and home are at greater risk of becoming ill with a vaccine-preventable disease."

I read the text of AB 2109, and I do not see where a parent is required to agree to that statement.

http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml;jsessionid=f80932d87a8e7fbfd7738d9d4a6e 

 

I might cross out that part, or, instead of using the form, AB 2109 allows "a letter signed by a health care practitioner that includes all information and attestations included on the form." Or, a parent can write above that statement, "I acknowledge that I have read the following statements made by the CDPH." (That way, they are not agreeing to the statements).

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Old 11-05-2013, 01:44 PM
 
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Quote:
Originally Posted by Katie8681 View Post

Vaccinations can be obtained from a public health clinic by a nurse or even, in my state, a medical assistant or a pharmacy tech in any random pharmacy. You do not have to establish care anywhere.


 



I don't know of any state that allows small children to get vaccinated at pharmacies . . . .

I share the concerns about doctors refusing to sign off on the form. Also, federal law already requires providers to give information on vaccine risks and benefits, so the law is redundant. For those few parents who never see physicians, I have serious issues with the government mandating any kind of paid, contractual relationship with a private entity.

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