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To vaccinate or not to vaccinate, that is the question

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by pat New Nurse

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after a cousin died of polio and seeing patients with shingles and other assorted diseases which could have been prevented with an injection  I and my children had all of their shots and no ill effects

 

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On 11/5/2019 at 9:59 PM, Elven_RN said:

I found out that my cousins just came down with chickenpox. I still remember my aunt asking my mother if she should vaccinate when she was a new mom looking for advice and worried about the potential of them contracting a disease if she didn't vaccinate. My mother was very anti-vax and helped convince her not to. The oldest child is 14 (which is a bad age to get this!). Now they have to face the risk of shingles when they're older. Just to think it could've all been prevented...but fears, nonfactual internet sources and friends/family who are not educated themselves get in the way of making rational decisions!

They would have been at risk of shingles if they had been vaccinated.

"About 91 percent of U.S. children are vaccinated against chickenpox, according to the most recent National Immunization Survey data, but that does not necessarily mean they cannot get shingles. The chickenpox vaccine is made with the live attenuated (weakened) varicella virus, so “not surprisingly, it can also become latent after vaccination,” explains Anne A. Gershon, a professor of pediatric infectious disease at Columbia University. “The virus has been altered so the vaccine rarely causes symptoms, but once you’ve been immunized and after the natural infection, you carry the virus in your neurons for the rest of your life

https://www.scientificamerican.com/article/two-for-one-chickenpox-vaccine-lowers-shingles-risk-in-children/

They could have avoided chickenpox had they received the vaccination.  Their risk of shingles would have been lower (after age 2), but they still could have shingles.

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10 hours ago, nursej22 said:

Except that the answers to many of the questions are available, but many just don't want to know or don't believe actual experts. The CDC pink book is available on line and is a wealth of information. Children's Hospital of Philadelphia has great informational videos. These sources explain among other things: why so many, so soon; why give Hep B at birth; adjuvants; and  thimerosal which was removed from single dose childhood vaccines in 2001. I mentioned it before, but the Advisory Committee  on Immunization Practices (ACIP) meets 3 times a year to review data and make adjust recommended vaccine schedules for children and adults. This committee is made of of experts: physicians (including pediatricians) researchers, immunologists, epidemiologists, nurses and lay persons. I trust their judgement about vaccines more than a solitary person with internet access. 

I want to start with saying I agree vaccines have improved and extended lives. I got my 2nd shingrix vaccine yesterday.

You have to recognize that a percentage of the population does not trust the CDC, so telling people to read the pink book and trust the experts is not going to convince them

People have legitimate reasons not to trust the CDC specifically and the medical community in general.  A few that I can think of include:

1.  The Tuskegee Syphilis Study run by the US Public Health Service and the CDC.  Black men were told they would be receiving medical care and instead were used to study untreated syphilis. 

The study began in 1932.  By 1945 it was clear that penicillin was the best treatment for syphilis.  They were not offered treatment.  Instead CDC and USPHS worked to prevent them from receiving treatment. 

In 1969 the CDC reaffirmed the need for the study and gained local medical societies’ support (AMA and NMA chapters officially support continuation of study).

The study wasn't halted until 1972 when someone leaked information about the study to the press.  Public outrage stopped the study.

There have been many, many studies published on the effect this had on trust in the medical community.  It's still affecting trust in the medical community.

2.  In 1955 200,000 children received the Salk (injected) polio vaccine.  4000 (20%) of them contracted polio from the vaccine.  The Salk vaccine was a killed virus.  There was a problem in the manufacturing process at Cutter Laboratories, so the virus wasn't killed. 

Many researchers trace the beginnings of vaccine hesitancy to this incident.

3.  From 1963 to 2001 the US used the Sabin (oral) polio vaccine.  This was a live, but attenuated virus.

One in 75,000 children receiving their 1st oral polio vaccine contracted polio from the vaccine.  That was 8-10 children each year.

The virus in the oral vaccine can revert to the wild type and cause polio.

The injectable vaccine was less likely to cause polio, but the oral vaccine was cheaper.

"When eight to 10 children a year contracted polio, and millions of others were protected, “my feeling was it was a small price to pay,” Walter A. Orenstein, who was director of the U.S. immunization program at the CDC from 1988 to 2004, recalled Friday in an interview."

The father (a lobbyist) of one of the affected children lobbied the CDC to use the injectable vaccine or at least use the injectable vaccine as the first dose.  Since 2001 the US has used the injectable vaccine.

4.  Then there is how you still can be enrolled into a research study without your knowledge or consent.

http://blogs.einstein.yu.edu/minnesota-case-demonstrates-continuing-erosion-of-informed-consent/

"A board that approves research at Minnesota's largest safety-net hospital failed to follow federal rules designed to protect patients when it fast-tracked studies on powerful sedatives, including ketamine, according to inspection reports from the Food and Drug Administration (FDA).

The Institutional Review Board (IRB) at Hennepin Healthcare expedited approval for at least four studies between 2014 and 2018 that did not require patients to consent beforehand, even though they included a likelihood of using "vulnerable subjects.""

http://www.startribune.com/fda-hennepin-healthcare-flouted-patient-safety-rules-in-sedation-studies/498891251/

Researchers are also using "passive consent."  The patient is handed some information to read.  If they don't object, they are enrolled in the study.  No one makes sure they understood the material.  They don't even make sure they can read.  An IRB can decide the risk is minimal, so passive consent is fine.

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11 hours ago, pat said:

after a cousin died of polio and seeing patients with shingles and other assorted diseases which could have been prevented with an injection  I and my children had all of their shots and no ill effects

 

I remember kids receiving the "sugar lump vaccine" in school for polio. I don't know a single person my age who had polio. I did work with a nurse older than me who contracted polio as a child. I saw her limping when I first met her and asked if she had an injury. She told me her story.

We see multiple shingles patients weekly. Most are younger than 50. I hope the CDC eventually lowers the age for the Shingrix vaccine.

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nursej22 has 30 years experience as a MSN, RN and specializes in med/surg,CV.

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10 hours ago, Anonymous865 said:

I want to start with saying I agree vaccines have improved and extended lives. I got my 2nd shingrix vaccine yesterday.

You have to recognize that a percentage of the population does not trust the CDC, so telling people to read the pink book and trust the experts is not going to convince them

People have legitimate reasons not to trust the CDC specifically and the medical community in general.  A few that I can think of include:

1.  The Tuskegee Syphilis Study run by the US Public Health Service and the CDC.  Black men were told they would be receiving medical care and instead were used to study untreated syphilis. 

The study began in 1932.  By 1945 it was clear that penicillin was the best treatment for syphilis.  They were not offered treatment.  Instead CDC and USPHS worked to prevent them from receiving treatment. 

In 1969 the CDC reaffirmed the need for the study and gained local medical societies’ support (AMA and NMA chapters officially support continuation of study).

The study wasn't halted until 1972 when someone leaked information about the study to the press.  Public outrage stopped the study.

There have been many, many studies published on the effect this had on trust in the medical community.  It's still affecting trust in the medical community.

2.  In 1955 200,000 children received the Salk (injected) polio vaccine.  4000 (20%) of them contracted polio from the vaccine.  The Salk vaccine was a killed virus.  There was a problem in the manufacturing process at Cutter Laboratories, so the virus wasn't killed. 

Many researchers trace the beginnings of vaccine hesitancy to this incident.

3.  From 1963 to 2001 the US used the Sabin (oral) polio vaccine.  This was a live, but attenuated virus.

One in 75,000 children receiving their 1st oral polio vaccine contracted polio from the vaccine.  That was 8-10 children each year.

The virus in the oral vaccine can revert to the wild type and cause polio.

The injectable vaccine was less likely to cause polio, but the oral vaccine was cheaper.

"When eight to 10 children a year contracted polio, and millions of others were protected, “my feeling was it was a small price to pay,” Walter A. Orenstein, who was director of the U.S. immunization program at the CDC from 1988 to 2004, recalled Friday in an interview."

The father (a lobbyist) of one of the affected children lobbied the CDC to use the injectable vaccine or at least use the injectable vaccine as the first dose.  Since 2001 the US has used the injectable vaccine.

4.  Then there is how you still can be enrolled into a research study without your knowledge or consent.

http://blogs.einstein.yu.edu/minnesota-case-demonstrates-continuing-erosion-of-informed-consent/

"A board that approves research at Minnesota's largest safety-net hospital failed to follow federal rules designed to protect patients when it fast-tracked studies on powerful sedatives, including ketamine, according to inspection reports from the Food and Drug Administration (FDA).

The Institutional Review Board (IRB) at Hennepin Healthcare expedited approval for at least four studies between 2014 and 2018 that did not require patients to consent beforehand, even though they included a likelihood of using "vulnerable subjects.""

http://www.startribune.com/fda-hennepin-healthcare-flouted-patient-safety-rules-in-sedation-studies/498891251/

Researchers are also using "passive consent."  The patient is handed some information to read.  If they don't object, they are enrolled in the study.  No one makes sure they understood the material.  They don't even make sure they can read.  An IRB can decide the risk is minimal, so passive consent is fine.

I do not think that most vaccine hesitant or resistant are even aware of the heinous Tuskegee Study, outside of the African American population. Nor do I think they have the polio vaccine debacle in mind. My comment about educating oneself was directed at members of this forum, not so much at the public. 

And by the way, it would have been nice if you had included the other part of Dr. Orenstein's quote: 
“Suddenly, the eight to 10 people were not just tiny numbers but were real people,” Orenstein said. “Just seeing how these people’s lives were ruined made a big difference. I went overnight from being an OPV hawk to being an IPV hawk.”https://www.washingtonpost.com/local/obituaries/david-salamone-who-contracted-polio-from-vaccine-and-helped-spur-changes-in-us-immunization-policy-dies-at-28/2018/09/15/5e86319e-b8f8-11e8-94eb-3bd52dfe917b_story.html

I have had the honor of hearing Dr. Orenstein speak twice. He is passionate about protecting children from vaccine-preventable diseases. 

And I have no idea what an ethical breach by a hospital  in obtaining consent has to do with this issue. 

I remember the sugar cubes, and I got at least one in grade school. I can imagine if you need to immunize a hundred children, popping a sugar cube in their mouth is much easier than drawing up a 100 injections. 

By the way, oral polio vaccine is used in many countries outside of the US. And it was just announced that a second strain has been eliminated. WhooHoo!

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On 10/31/2019 at 2:24 PM, Cowboyardee said:

I think you took my post to be argumentative or sarcastic when it was meant to be earnest. A lot of this thread has been so argumentative and meandering that it's difficult to separate the wheat from the chaff, so to speak. You seemed impassioned enough that I hoped you wouldn't mind citing (or re-citing) the studies that led you to your conclusions, for the sake of clarity. Of course I can do my own research, but I'd be less likely to miss part of the argument if you'd kindly lay out your sources. 

Fwiw, I'm familiar with the link between GBS and vaccinations. Less so with other autoimmune complications. It would seem to me that data on the actual incidence of vaccination-related complications would be pretty important to perform a reasonable risk-benefit analysis of various vaccinations and vaccination schedules. 

https://www.frontiersin.org/articles/10.3389/fpsyt.2017.00003/full

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caffeinatednurse has 3 years experience as a BSN, RN and specializes in Med-surg, telemetry, oncology, rehab, LTC, ALF.

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Please vaccinate your kids and yourself, unless you have a legitimate medical reason for which your physician has advised you to avoid vaccines. Vaccines do not work the way they're intended to if most people refuse to get them.

Please do your research and understand that the studies that claimed autism have been disproven several times over.

Who do you really trust more...Jenny McCarthy or the CDC and the many physicians and scientists that stand behind them?

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On 11/4/2019 at 10:13 AM, LibraSunCNM said:

 My child's pediatrician and I had a long discussion about how she talks to parents who have fears about vaccines and how she presents the facts.  She acknowledges that there are some parents who she can tell right away are never going to agree with her, and then the rest, she just works with them as much as possible and she says they generally end up getting on the regular schedule if she's flexible with them in the beginning and they realize their children are fine. (And they feel respected)

Smart person.

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LibraSunCNM has 10 years experience as a MSN and specializes in OB.

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3 hours ago, JKL33 said:

Smart person.

She's the best.  I know a lot of pediatric practices have a hard and fast rule about not accepting patients who don't vaccinate on schedule, and I can understand their frustration, but in the long run I doubt such a stance is actually helping to increase the rates of vaccination.

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54 minutes ago, LibraSunCNM said:

She's the best.  I know a lot of pediatric practices have a hard and fast rule about not accepting patients who don't vaccinate on schedule, and I can understand their frustration, but in the long run I doubt such a stance is actually helping to increase the rates of vaccination.

A lot of pediatricians, especially in California, are refusing patients not utd. I understand their reasoning but at the same time believe it does more harm then good. The ultimate goal is keeping kids healthy and if parents don’t have a pediatrician or don’t trust their pediatrician they will avoid taking their kids in for care. I saw a pediatrician with my kids a few years ago who told me he tells parents why he believes vaccines are important and that he will work with them on a schedule because he rather help their kids when they are sick then have them avoid him. I wish more pediatricians did that. Some parents will be swayed but not like that and the others won’t be swayed at all. 

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Sensibility has 17 years experience as a BSN, RN and specializes in Pediatrics.

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I think it is total foolishness to discredit the people who have had children or loved ones that died or became impaired after receiving a vaccination. On the other hand, the advocates for vaccinations make great points. I have seen a baby die of pertussis caught from mommy who wasn’t vaccinated.  So what we should be investigating is why those people who have adverse reactions do so and then screen them from the group. Parents don’t want to take the chance that their son or daughter might be that one baby. They have no trust in us when we dismiss these credible testimonies of severe reactions.  

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nursej22 has 30 years experience as a MSN, RN and specializes in med/surg,CV.

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On 11/14/2019 at 7:37 AM, Sensibility said:

I think it is total foolishness to discredit the people who have had children or loved ones that died or became impaired after receiving a vaccination. On the other hand, the advocates for vaccinations make great points. I have seen a baby die of pertussis caught from mommy who wasn’t vaccinated.  So what we should be investigating is why those people who have adverse reactions do so and then screen them from the group. Parents don’t want to take the chance that their son or daughter might be that one baby. They have no trust in us when we dismiss these credible testimonies of severe reactions.  

I don't know of any healthcare professional who discredits people who have had loved ones with a verified adverse reaction to a vaccine. The key word is verified. Just because a payment has been made by the vaccine court, does not equal a verified reaction. The so-called vaccine court has a very low bar for ruling on on an adverse reaction. And autism is not caused by MMR. 

I am not sure why you assume that adverse reactions are not investigated. And I am speaking about more than "I get the flu every time I get a flu shot" adverse reaction. The whole reason there is a VAERS (Vaccine Adverse Event Reporting System) is so that adverse reactions can be investigated. 

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