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#21
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"Beware of Vaccine Bullies"--Malkin column
"Roger Schlafly" wrote in message .net...
"JG" wrote Huh? Her "entire thesis" is that parents are pressured to get what, for them, are unnecessary vaccines! (A subthesis is that pediatricians are unthinking parrots.) She didn't say anything about "unfairness." And Mark's attitude supports her point. Mark is one of those peds who gets personally offended when a patient asks for the facts, instead of just shutting up and blindly taking his orders. Not at all. But when I give the facts and parents still refuse to protect their kids, I'm forced to think that they either think I'm lying to them, or they have preconcieved notions that no amount of "factual intervention" will affect. I have a patient whose Mom refused *all* immunizations because she had a younger brother who, 30 years prior, had contracted meningitis and died a month or two after having recieved his immunizations. I didn't kick the kid out of my practice, but I also never fail to mention vaccines when I see her. I also made her sign a paper stating that I had informed her of the risks of not immunizing her child, and that she understands she's putting him at risk. Mark, MD |
#22
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"Beware of Vaccine Bullies"--Malkin column
"Jonathan Smith" wrote
[quoting CDC article] We investigated two situations involving hepatitis B virus exposure among children in day care. In the first a 4-year-old boy who attended a day care center developed acute hepatitis B; another child at the center, who had a history of aggressive behavior (biting/scratching), was subsequently found to be a hepatitis B carrier. No other source of infection among family and other contacts was identified and no other persons at the center became infected. Possible, but not very convincing. Did the boy bite or scratch the kid who got infected? Did he draw blood? If others were bitten or scratched, why weren't they infected? Could the family have been concealing other contacts because it was suing the day care center? In the second situation a 4-year-old boy with frequently bleeding eczematous lesions was discovered to be a hepatitis B carrier after having attended a day care center for 17 months. Testing of contacts at the center revealed no transmission to other children or staff (representing 887 person months of exposure). So transmission is unlikely, I guess. Nationwide surveillance data showed that for the period 1983 to 1987, 161 children 1 to 4 years of age were reported with acute hepatitis B. After children with known hepatitis B risk factors were excluded, 25% (7 of 28) of children with known day care status were reported as day care attendees, a percentage comparable to national estimates of day care attendance by this age group. If HBV was being transmitted in day care, then we would expect that the set of kids with HBV would have a higher percentage of day care attendees. Instead, these figures suggest that HBV infection in uncorrelated with day care status. Notice how small the numbers are. This was before the universal HBV vaccination program was started, so the numbers are even smaller now. This is the first reported case of hepatitis B virus transmission between children in day care in the United States. Although it appears that day care transmission of hepatitis B is infrequent, further studies are needed to define the risk more accurately. IOW, the risk is too small and hypothetical to measure. |
#23
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"Beware of Vaccine Bullies"--Malkin column
"Mark" wrote
I also made her sign a paper stating that I had informed her of the risks of not immunizing her child, and that she understands she's putting him at risk. I had a physician once tell me that he had a similar policy for fat patients who refuse to cut back on dietary cholesterol. |
#24
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"Beware of Vaccine Bullies"--Malkin column
"Jonathan Smith" wrote in message
... "JG" wrote in message ... "PF Riley" wrote in message ... On Sun, 8 Feb 2004 10:32:03 -0700, "JG" wrote: Hep B is transmitted via body fluids; ergo, diligent parents will make sure their infant/child isn't engaging in unprotected sex, sharing needles, or being exposed to the body fluids of others (of unknown hep B status) in other ways. So they'll just go to the library instead the playground at recess? I dunno; someone here--D.C. Sessions, IIRC--used to claim that there were documented cases of transmission via paper cuts! g (If you, or anyone else, can provide such documentation, I'd love to see it. D.C., or whoever it was that made the assertion, never did when asked.) Just what goes takes place on your schools' playgrounds, PF? Orgies? Group piercings? Tattooing? Biting? A child who bites isn't ready for kindergarten. If you can find a verified, documented case of "recess transmission," please point me to it. Certainly if an instance of "blood swapping" did occur, post-exposure prophylaxis could be considered/initiated. http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract [...article excerpt snipped...] Close; day care isn't exactly school. ;-) (It would be interesting to know why the staff of the day care center in the first instance cited didn't control the behavior of a known-to-be-"aggressive" attendee, though.) Nevertheless, there's no proof that the "passive" child contracted HBV from the "aggressive" child; heck, the article doesn't even state whether the passive child was even bitten or scratched! (I'd hope a wound serious enough to break the skin--esp. a bite, which would have left a distinctive mark--would be noticed by his parents, at least. Even if not contemporaneously investigated, you'd think they'd recall it when questioned by doctors/health officials about possible sources of their kid's infection.) The second instance cited--the fact that no one with whom an HBV+ kid had regular contact became infected--just highlights how (relatively) difficult it is to transmit HBV. |
#25
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"Beware of Vaccine Bullies"--Malkin column
"Jeff" wrote in message
... "JG" wrote in message ... (...) If you can find a verified, documented case of "recess transmission," please point me to it. Certainly if an instance of "blood swapping" did occur, post-exposure prophylaxis could be considered/initiated. If the kids or adults present realized the danger of the situation, the doctors involved agreed, ... In the type of scenario described (e.g., one kid somehow transferring blood into another's open wound), it would, first and foremost, be the *parents'* call. I can't imagine any doctor refusing to provide treatment (e.g., administering hep B immune globulin [HBIG] and/or the initiating the "regular" hep B vaccine series) to an otherwise healthy, though w/o "adequate" HBsAb levels, child (assuming the "source" kid is HBsAg+, of course). You're grasping, Jeff. ....and weighed the benefits and risks of the post-exposure prophylaxis and felt that the benefits outweight the risks. Unless HBIG or HBV vaccine were contraindicated for the kid, I can't imagine any physician believing the benefits *wouldn't* outweigh the risks. And then, only if the parents agreed and consented. Ah, so you admit parents *do* have a say (even though you apparently still think it's subordinate to the doctors')! g I doubt this would happen much. Why? Who'd balk? I doubt many parents, knowing that their kid's blood has been contaminated by that of a HBV+ classmate, would refuse treatment. |
#26
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"Beware of Vaccine Bullies"--Malkin column
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#27
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"Beware of Vaccine Bullies"--Malkin column
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#28
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"Beware of Vaccine Bullies"--Malkin column
"JG" wrote in message ... "Jeff" wrote in message ... "JG" wrote in message ... (...) If you can find a verified, documented case of "recess transmission," please point me to it. Certainly if an instance of "blood swapping" did occur, post-exposure prophylaxis could be considered/initiated. If the kids or adults present realized the danger of the situation, the doctors involved agreed, ... In the type of scenario described (e.g., one kid somehow transferring blood into another's open wound), it would, first and foremost, be the *parents'* call. I can't imagine any doctor refusing to provide treatment (e.g., administering hep B immune globulin [HBIG] and/or the initiating the "regular" hep B vaccine series) to an otherwise healthy, though w/o "adequate" HBsAb levels, child (assuming the "source" kid is HBsAg+, of course). You're grasping, Jeff. No I'm not. The odds that a parent will recognize a potential tranmission of hep B and do something about it, other than clean a wound is next to nil. ...and weighed the benefits and risks of the post-exposure prophylaxis and felt that the benefits outweight the risks. Unless HBIG or HBV vaccine were contraindicated for the kid, I can't imagine any physician believing the benefits *wouldn't* outweigh the risks. In the situation where you know that a kid has been exposed, but how often does a kid prsent to a doctor with a complaint of exposed to Hep B? And then, only if the parents agreed and consented. Ah, so you admit parents *do* have a say (even though you apparently still think it's subordinate to the doctors')! g No, I don't think it is subordinate to the doctors'. However, a physician would not offer at treatment a treatment unless he thought it was in the best interest of the patient. For example, if a doctor thought that a patient had a viral infection and there was no need to give antibiotics, he would not offer antibiotics. I doubt this would happen much. Why? Who'd balk? I doubt many parents, knowing that their kid's blood has been contaminated by that of a HBV+ classmate, would refuse treatment. Yet, how often do think that: 1) A parent knows that another kid in class is Hep B+? 2) A parent knows that his kid's blood has been contaminated by that blood? This would be a very rare situation. Jeff |
#30
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"Beware of Vaccine Bullies"--Malkin column
"Jeff" wrote
Yet, how often do think that: 1) A parent knows that another kid in class is Hep B+? Very rare. There are only a handful of hep B+ kids in the USA. |
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