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Although the press release talks about 20 to 25 suspected cases, it focuses on just 5 cases in their case report. Of these 5 children, it is important to note that:
they "experienced paralysis of one or more arms or legs that came on suddenly and reached the height of its severity within two days of onset" and their symptoms did not improve after six months of treatment the children do not have polio
they did not meet the criteria for Guillain-Barre syndrome or botulism
2 of the children tested positive for the non-polio enterovirus-68
I am not the one who has said that. Please re-read it.
Holy crap. Suzy is the one who is stating that hcps are only allowing spacing because they don't want to deal with parents but aren't willing to just deny treating them.
No. I said doctors who allow alternative vaccine schedules are only doing it because there are parents who want to do it. Some pediatricians do decline to have theses families in their practices. Some try to work with the parents.
It is not because there is a medical, scientifically supported reason to use alternative schedules, which is what you have implied. You said, "While I agree with your general point I think you are not giving health care providers enough credit. If they were concerned as a group with the dangers associated with spreading vax within their ranges, I think they would not be willing to spread them out."
They are indeed concerned about the dangers, which have been described in posts above. They yield to parental demand in hopes of eventually getting the kids at least some of the vaccines.
I believe this was previously mentioned, too. Perhaps you missed it. Note that it was published in Pediatrics, The Official Journal of the American Academy of Pediatrics:
I never said they wouldn't prefer to follow the CDC schedule. NEVER.
What I said and continue to say is that those physicians who are willing to accommodate spacing vaccinations out are not doing it just to avoid being frustrated by parents. I refuse to believe the majority of hcps are going to violate their hypocratic oaths just to avoid educating their patients. If they thought spreading it out was doing so much harm, I would expect them to refuse to do it.
Clearly those who are using alternative schedules believe spreading out vaccination is acceptable.
Now back to the things I never said.
I never said there was scientific evidence.
I am not anti-vax and I am not pro alternative schedule.
But when you paint someone who want to follow the alt schedule as being the same thing as the anti-vax crowd you are just going to alienate people.
Doesn't this prove that they are only doing it because patients --- based on bad information --- are demanding it? Being willing to do it does not mean they think it is best practice. They do it only because the alternative may be no vaccine at all. Unfortunately, it makes it appear that alternative schedules are somehow medically substantiated and encourages others to use them.
1. No, I'm ignorant! Isn't that what you mean? FYI, the table 3 in that link is a catch-up schedule for kids whose vaccines were delayed or interrupted. We do see a lot of this. People are going to come back in a month, and they get back 6-8 months later. That table in no way encourages anyone to spread out vaccination, in fact, it gives the information on how to catch these kids up as quickly as possible.
2. I was giving the most extreme case. A lot of the parents who spread out vaccines in our office will agree to two shots at a time, but most will NOT agree to a combination vaccine like Pentacel or Pediarix. Since you are so knowledgeable about vaccines, I do not need to tell you what's in these. If you think people don't try to get single antigen measles, mumps and rubella vaccines, you have another think coming.
3. Ask and you shall receive. You should know better than to challenge me. I don't post stuff I don't know anything about, like others on this forum. Ha! It didn't take me 30 seconds. Surely someone as knowledgeable about everything as yourself knew this stuff, NO? http://www.medscape.com/viewarticle/551272_5
**The major cause of the resurgence was a failure to vaccinate preschool children at the recommended age, 12 to 15 months.[31] Health services research identified the prominent factor to be the healthcare system failing to take advantage of the many opportunities it had to vaccinate children.[3,32] These missed opportunities occurred in physicians' offices and clinics where all vaccines for which children were eligible were not being provided simultaneously, where invalid contraindications were used to exclude otherwise eligible children, where immunizations were provided only in well child visits when there were other visits during which there were no contraindications and where children were referred out of physicians' offices to public clinics for free vaccines because the children's parents could not afford the costs. **
Now I really did not agree wholeheartedly with this "blame the provider" approach, as I have worked in immunization programs where we sent reminder after reminder and people did not return, etc. But one good thing that came out of it was a dropping of policies in many offices that vaccines could only be given at well checks, couldn't be given to kids on antibiotics (they usually can if the child is asymptomatic and afebrile), had to be split up due to office policy, etc. The CDC policy became "give everything you can at every visit possible".
Yes, I know you think flu vaccine is unnecessary, and I believe also HPV. Good luck with that!
ETA: Here is an article, appears to be from Sept. 2012, about a mom wanting to split MMR, also this: "Too often, an immunization delayed is an immunization missed," Vaccines: Fact and Fiction | Parenting
ETA #2: http://www.npr.org/blogs/health/2013...-declared-safe
**Preliminary research does show children who don't get vaccinated on time are hospitalized more often than children who are immunized according to federal guidelines. **
Not the healthy kids the anti-vax people want us to believe they are.
You have a serious issue with making things up. Example, I am not anti-flu vax, I got it this year and will for the next few at least, at that time I will re-evaluate my decision based on my needs. The difference between you and I, is that I do not believe in just letting people stick any medicine in me for any reason they feel like it regardless of mine, my doctor, or my families wishes and needs. Same with my daughter and HPV. Which btw she got after speaking to her doctor, discussing her personal history and so on. Which is all I have ever advocated for.
1. Who cares about table 3? Table 2 is the one with the standard guidelines. I brought up the WHO recommendations to point out the fallacy that there is exactly one way to immunize. There is not. Most immunizations occur along schedules who are not always identical (see the WHO and CDC one) and even within those schedules they occur in ranges. For example WHO says DTP should begin around 6 weeks, CDC 2 months. Second dose 4-8 weeks depending on which one you use. That gives parents and doctors lots of wiggle room to space things out if they choose and to still be meeting the guidelines.
2. You can move the goal posts all you like. My posts were in response to people who jumped all over the poster who only stated she wanted to spread out her childs vax. She never said single fax, never said she was going to violate the CDC guidelines, never. But instead people jumped all over her and told her to go to the park. And this response is exactly why people who have not only the right but the moral obligation to have their questions answered, and met with out the vitriol are running to the anti-vax camp.
3. Your medscape link does not include a title, so it is impossible to look up. I only have access to pubmed. Care to give an actual citation?
I found this from the paper, specifically, about the 1989-91 resurgence, which by the way occurred primarily in school aged children (this point will be really important after the quotes).
"Instead, the major problem was primary vaccine failure—the failure to respond to the first dose. Questions were raised about whether measles was so contagious that it could persist among the 2% to 5% of persons who failed to mount an initial immune response to a single dose.2"
It appears that at that time, school aged children were only required to get one dose. Because the author goes on to say…."Before going to the expense of adding a second dose to the schedule….A small meeting in New York State broke the log jam on moving to a routine 2-dose schedule"
So this outbreak was not remotely from not following the schedule, they followed the schedule, it just did at that time, in that state, require a second dose. Additionally, it is not remotely about spreading apart vaccines. It was caused by school aged children never acquiring immunity from the first dose they did get, that is the "primary failure" and it does happen in a significant proportion of the community, hence the second dose of things like MMR becoming the norm now.
Also, given the 1 yr start, and 4 week minimum (and CDC has 12-18 month age as the time frame for completion) between MMR, it is probably the easiest of all vaccines to "spread apart" and still meet the schedule. That is six months over which you have to take second or third doses of Hib and pcv and both MMRs.
So your source isn't about spreading immunizations apart but rather the importance of a second dose of MMR. OK, I agree, everyone should get the second MMR. Absolutely.
Doesn't this prove that they are only doing it because patients --- based on bad information --- are demanding it? Being willing to do it does not mean they think it is best practice. They do it only because the alternative may be no vaccine at all. Unfortunately, it makes it appear that alternative schedules are somehow medically substantiated and encourages others to use them.
What is a "hypocratic" oath?
Sorry in the hospital, hard to pick up typos on the iPhone. I am assuming you realize it was an autocorrect and just want to feel superior. Is it working?
Ugh, I get it you know two doctors so are therefore able to speak for all of them. I will defer to your expertise about the internal though process of all doctors, in the entire world. Clearly, the actual studies done of doctors opinion are absolute bunk compared to your sample size of TWO.
If you choose to ignore my point, that is your business. But clearly, especially given the source I provided, most doctors who are giving are immunizations spread apart are fine with it. In fact:
"Washington State pediatricians are regularly being asked to use ACISs, and most of them are comfortable using them if requested"
But hey, you know better than the doctors do. Got it.
Doesn't this prove that they are only doing it because patients --- based on bad information --- are demanding it? Being willing to do it does not mean they think it is best practice. They do it only because the alternative may be no vaccine at all. Unfortunately, it makes it appear that alternative schedules are somehow medically substantiated and encourages others to use them.
What is a "hypocratic" oath?
Are you upset about the misspelling?
The hippocratic oath is the oldest medical ethics standard in existence. It has been rewritten many times to reflect different cultures and practices. The phrase "First, do no harm" is commonly attributed to it, but has never been part of the oath.
No. I said doctors who allow alternative vaccine schedules are only doing it because there are parents who want to do it. Some pediatricians do decline to have theses families in their practices. Some try to work with the parents.
It is not because there is a medical, scientifically supported reason to use alternative schedules, which is what you have implied. You said, "While I agree with your general point I think you are not giving health care providers enough credit. If they were concerned as a group with the dangers associated with spreading vax within their ranges, I think they would not be willing to spread them out."
They are indeed concerned about the dangers, which have been described in posts above. They yield to parental demand in hopes of eventually getting the kids at least some of the vaccines.
I believe this was previously mentioned, too. Perhaps you missed it. Note that it was published in Pediatrics, The Official Journal of the American Academy of Pediatrics:
"In an effort to protect children from harm, Sears' book will likely put more in harm's way."
Nope they are comfortable.
And you keep bringing up things I have not mentioned. I specifically said "SPREAD OUT WITHIN THEIR RANGES". Hell, you even quoted it. For example, CDC says second doses of HIB and PCV should occur between 12- 18 months. That is a lot of wiggle room WITHIN THE RANGE. Give HIB at 15 months, and PCV at 18. Still completely within the ranges set forth by CDC, still "spreading immunizations apart", and nothing what so ever to do with Dr. Sears (someone neither I, nor the poster who brought up spreading fax apart, ever brought up anyway).
I think the biggest problem that the anti-vaccination group claims about spacing is that it just "feels right" and make up some pseudo-science. Baloney. Hard science is all you can go by, and the CDC and FDA have both endorsed studies by independent university researchers that conclude that vaccinations when spaced out will actually harm a developing immune system by continually bombarding it with cultures of the inactivated viruses. If you just did the research yourself, you would clearly see spacing out the vaccinations is not in the child's best interest.
Further, 50 years of data of vaccinations being clustered once a safe age is reached proves this.
Apparently there is a wide variety of what the term space out means. CDC does not say all vaccines have to be given at the same visit. They give ranges, so does WHO. It has just been historically convenient. It is completely possible to spread vaccines out to give fewer vaccines at one time, over more visits, and still meet the guidelines.
Second, vaccination schedules today look nothing like they did even 15 years ago. So that is not an apt comparison.
In the 60s, (fifty-ish years ago) DPT, MMR, polio and small pox were it. http://www.chop.edu/service/vaccine-...-schedule.html
Today, it is those, minus small pox, and add in rotavirus, hub, hep b, chicken pox, pneumococcus, flu, etc. That is more than twice as many vaccines, and more doses of some of them (apparently only one dose of MMR was the standard back in the day).
And apparently, kids only ever got one shot at a visit, which is all the poster who started all of this was advocating for.
"n the early 1950s, there were four vaccines: diphtheria, tetanus, pertussis and smallpox. Because three of these vaccines were combined into a single shot (DTP), children received five shots by the time they were 2 years old and not more than one shot at a single visit."
There is nothing wrong with people informing themselves. There is nothing wrong about actually take the time to discuss when to immunize with your doctor. People should be allowed to ask questions, it is hard to listen to the voice of reason when it is screeching with the knee jerk reaction so many of those who are blindly pro-vax.
Sorry in the hospital, hard to pick up typos on the iPhone. I am assuming you realize it was an autocorrect and just want to feel superior. Is it working?
Ugh, I get it you know two doctors so are therefore able to speak for all of them. I will defer to your expertise about the internal though process of all doctors, in the entire world. Clearly, the actual studies done of doctors opinion are absolute bunk compared to your sample size of TWO.
If you choose to ignore my point, that is your business. But clearly, especially given the source I provided, most doctors who are giving are immunizations spread apart are fine with it. In fact:
"Washington State pediatricians are regularly being asked to use ACISs, and most of them are comfortable using them if requested"
But hey, you know better than the doctors do. Got it.
So you believe that Washington physicians speak for all the doctors in the country?
More than a few docs are not comfortable with it. In case you missed this:
"The IOM report provides parents with 2 important pieces of information to inform their decision making: (1) Available evidence supports that the current vaccine schedule is safe and (2) any vaccine schedule that delays vaccines is less safe than the approved schedule because it places these children at risk of acquiring vaccine-preventable disease for a longer period of time.
Are alternate vaccine schedules obsolete? With this new report from IOM, they certainly should be."
ROFL!! Again, clearly your sample size of TWO was way more empirical than a sample size of two orders of magnitude larger. Yup, two vs. nearly 300. Got it. Still.
"The IOM report provides parents with 2 important pieces of information to inform their decision making: (1) Available evidence supports that the current vaccine schedule is safe and (2) any vaccine schedule that delays vaccines is less safe than the approved schedule because it places these children at risk of acquiring vaccine-preventable disease for a longer period of time.
Are alternate vaccine schedules obsolete? With this new report from IOM, they certainly should be."
Do you not understand the difference between an opinion piece or anecdotal evidence, and empirical studies?
BTW, once more, spreading out vaccines WITHIN THEIR RANGES (again you quoted me saying it) is not what they are talking about in the last opinion piece you posted.
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