"Beware of Vaccine Bullies"--Malkin column

JG wrote:

Ah, so you admit parents *do* have a say (even though you
apparently
still think it's subordinate to the doctors')! g

No, it is no that the parent's decision to immunize is
subbordinate to the doctor's. It is just that the doctor's
decision to continue treating the kid is not subordinate to
the parent's.

--
CBI, MD

Jonathan Smith wrote:

Just what goes takes place on your schools' playgrounds,
PF? Orgies?
Group piercings? Tattooing?

Biting?

Drooling, not washing hands after using the toilette,
getting cuts and scrapes and not immediately telling an
adult to have it cleaned and bandaged,.....

--
CBI,

"Mark" wrote in message
om...
"Roger Schlafly" wrote in message
.net...

"Jonathan Smith" wrote
In the case cited, the HBV+ kid *was known* to be "aggressive."
OK - so should we exclude this child from day care?

Yes. An HBV+ kid who goes around aggressively biting other
kids should *not* be in day care with others.

So should testing for HBV carrier status be mandatory for all children
before they are admitted to daycare?

If I ran a day care center (and were thus potentially liable for the
injuries inflicted by a "known-to-be-aggressive" attendee), I'd make it
a condition of attendance. This a decision that *individual day care
center owner/operators* are allowed to make, however. (You don't think
"society"--the public--should be allowed to make such decisions
regarding the operation of private businesses--as it has regarding
smoking in many locales--do you?) A parent doesn't like it? Tough!
He/she can find a laxer place in which to deposit his/her kid(s).

How often should this be
performed?

How ever often the owner/operator wants/requests. (A day care
owner/operator could, of course, decide to accept proof of HBV
vaccination in lieu of such testing.) Colorado actually considers day
care centers to be schools (C.R.S. 25-4-901), and as such mandates that
attendees be vaccinated against various diseases, including HBV, unless
the attendee's parent(s)/guardian(s) have had him/her exempted. (I'm
not aware of any case in which an owner/operator has sought to deny an
exemption allowed by the state, nor do I imagine that state public
health personnel regularly, if ever, check on small, home-based,
privately owned day care center operators to see if they have on file,
as required by law, either a copy of each child's vaccination record or
his/her exemption statement.)

Who pays for it?

The "responsible party" (parent/guardian) seeking admittance. (Seems
rather obvious...)

JG wrote:

The question was - are there any documented cases of
horizontal
transmission in children. The answer is - YES.

For heaven's sake, Jonathan, the proof/evidence in the day
care case
is strictly circumstantial. Don't you find it somewhat
odd that the
"documentation" doesn't show that the case patient was
ever bitten or
scratched by the HBV+ "aggressive" child? Gee, you'd
think *someone*
(parents, day care staff) would have made note of a
blood-drawing
assault.

Do you make a note of every scrape and bloody nose and track
them for months at a time?


You've cited *one* *suspected* case. Hardly convincing.
If it's a
widespread occurrence, surely more (and better)
documentation is
available.

Like live action electron micrographs showing the virus
travelling from one kid to the next? Or a child grown in a
sterile petri dish, briefly exposed to a single Hep B
positive kid, and then immediately put back into isolation?
I think yuo are setting an impossible burden of proof.

--
CBI, MD

"CBI" wrote in message
k.net...
JG wrote:

Ah, so you admit parents *do* have a say (even though you
apparently
still think it's subordinate to the doctors')! g

No, it is no that the parent's decision to immunize is
subbordinate to the doctor's. It is just that the doctor's
decision to continue treating the kid is not subordinate to
the parent's.

No one has said it is, or that it should be, despite Mark's attempt to
convince everyone that that's the Malkin's opinion.

JG wrote:

Why don't you do the math: Find out the (approximate)
number of
school-aged kids who are HBV+, then, taking demographics
such as
geographic distribution into account (no doubt there are
many more
"carrier kids" in urban areas, especially along the west
and east
coasts), calculate the chance of a given kid even being in
contact
with a (kid) carrier, let alone engaging in behavior(s)
with him/her
that could result in HBV transmission.

Then multiply it by every possible opportunity for exposure
to come up with a total risk.

--
CBI, MD

JG wrote:

Just what goes takes place on your schools' playgrounds,
PF? Orgies?
Group piercings? Tattooing?

Biting?

A child who bites isn't ready for kindergarten.

Maybe - but they are there none the less.

--
CBI, MD

"CBI" wrote in message
k.net...
JG wrote:

The question was - are there any documented cases of
horizontal
transmission in children. The answer is - YES.

For heaven's sake, Jonathan, the proof/evidence in the day
care case
is strictly circumstantial. Don't you find it somewhat
odd that the
"documentation" doesn't show that the case patient was
ever bitten or
scratched by the HBV+ "aggressive" child? Gee, you'd
think *someone*
(parents, day care staff) would have made note of a
blood-drawing
assault.

Do you make a note of every scrape and bloody nose and track
them for months at a time?

I'd ask a school-aged (5+) child about any skin-breaking injuries; I'd
check a day care attendee myself and ask the operators about any
questionable injuries. (I wouldn't be surprised if day care operators
documented any/every wound of which they're aware, regardless of
how/where/when/by whom they were caused; I know that's the practice in
every SPED room in which I've worked.)

You've cited *one* *suspected* case. Hardly convincing.
If it's a
widespread occurrence, surely more (and better)
documentation is
available.

Like live action electron micrographs showing the virus
travelling from one kid to the next? Or a child grown in a
sterile petri dish, briefly exposed to a single Hep B
positive kid, and then immediately put back into isolation?
I think yuo are setting an impossible burden of proof.

The bottom line is that horizontal transmission between/among
schoolkids, assuming it does occur, is extremely rare--so rare that
using it as a rationale for mass vaccination is ridiculous.

"CBI" wrote in message
k.net...
JG wrote:

Just what goes takes place on your schools' playgrounds,
PF? Orgies?
Group piercings? Tattooing?

Biting?

A child who bites isn't ready for kindergarten.

Maybe - but they are there none the less.

And I bet every school district has policies regarding aggressive
behavior (such as biting) that apply to all students, regardless of age.

On 10 Feb 2004 14:45:32 -0800, (abacus) wrote:

Ma'am,

Just curious; why are you 'ma'am'-ing me? I don't see you do that to
female posters with whom you appear to agree.

this thread started with an account of a pediatrician who
had discharged the patient because the parents objected to a
single vaccination - specifically the Hep B vaccination for their
newborn - not to any and all vaccinations.

I said 'particular vaccination, maybe.' I have no way to know if the
parent's characterization of the threat (get all or get out) is an
interpretation of a discussion or a quote. Possibly the doctor actually
said the office could not accommodate her request because they weren't
stocking anything other than Pediarix (though I don't think that make
sense, but who knows?), so the parent would have to get vaccines
elsewhere, and the parent is exaggerating. But possibly the doctor is a
control-freak asshole and the family is better off out of that practice.
None of us can know what was really discussed.

In particular, I can understand parents wanting to delay Hep B given the
age when infections typically occur, though I also understand the public
health push to catch the kids when the data show visits happen most
regularly, and vaccinated my youngest accordingly.

Is the response of the pediatrian described above the kind of
behavior that encourages patients (or parents of patients) to
learn about more about medical procedures and make up their own
minds regarding the risk and benefits or is the the kind of
behavior that encourages patients (or parents of patients) to
simply obey their doctors orders without question?

The characterization provided of the doctor is very unflattering, and
not what I would look for or accept in a physician. When selecting a
pediatrician for our youngest, we sought a recommendation from our
family practice doc and interviewed her (including discussing her
practice's philosophy on a variety of topics, such as vaccination); if
we had not 'clicked' immediately, we would not have initiated care with
her. Also, a doctor would not be given an opportunity to treat me in a
disrespectful way twice.

I have no way to know if that particular practice actually did what was
claimed, and no way to know which specific sources the parents used to
obtain their information about vaccines. Maybe the only data sources
the parent provided in discussions with the doctor were quacky and the
parent is a loon. I'm not about to accept the parent's characterization
as the only correct interpretation of the events in question.