June 20, 2008

AAP Decides that Insulting Parents Will Increase Vaccination Rates

The American Academy of Pediatrics now recommends (see update) that pediatricians tell parents who don't vaccinate their children that they:

Are "Selfish"
Are "Self-Centered"
Are "Complacent or Lazy"
Are often "Emotional" decision makers
Have "Unacceptable attitudes"


But they do not believe that insulting you like this is in any way coercing you to vaccinate your child.

Further, they kindly tell you that if you decide to only get one or two shots at a time, your child might die, but they are not trying to scare you into sticking to the full CDC schedule.

'Oh... and vaccinate or you are out of our practice and we won't recommend any other docs to you... but seriously... don't feel pressured.'

I have criticized the AAP in the past for making today's vaccine decisions based on the health threats that my father faced when he and his brother contracted polio, and lost their father to the disease, in the epidemic of the 1940's, rather than basing them on the modern heath threats my child, who contracted autism, faces a full sixty years later, in the current epidemic of developmental and immune disorders of the early 21st century.

But now they have topped themselves. In the letter that they are holding out to pediatricians as a model of what to tell their patients (from All Star Pediatrics), they are citing the small pox threat (which was eradicated 30 years ago) that Ben Franklin's son faced, and died from, in 1736!

They reiterate that they believe that neither vaccines nor thimerosal causes autism, or other any other developmental disabilities, and that "ALL children and young adults should receive ALL of the recommended vaccines according to the schedule published by the Centers for Disease Control." [emphasis mine]

This despite the multitude of research to the contrary, and in complete contradiction to the vaccine safety package inserts themselves that list contraindications and say that certain people should not receive certain vaccines.

All this is a part of the collaborative effort between the AAP and other organizations (yes of course Pharma and Paul Offit are among them, I can't believe you even asked) under their new "Childhood Immunization Support Program" or as they might as well call it, "We Know Everything and Parents Are Idiots Program".

Like pediatricians, and many of you reading this, I make my living by providing a service to people. I wonder how many of my clients and potential clients would still want to do business with me if I handed them a letter that in any way even remotely suggested that they were selfish, self-centered, complacent, lazy, emotional people with unacceptable attitudes if they didn't take my recommendations on which services of mine they should purchase? Any one of you wanna give it a try for a week in your business and see what happens?

By digging in and taking this increasingly absurd stance they are not just potentially damaging the vaccine program, they are putting at risk parents trust in their their statements about EVERYTHING. When you stand in front of your doc and hear him make the statement that vaccines have nothing to do with autism, then watch Hannah Poling get a million or so check from the Vaccine Injury Compensation Fund for her "autistic symptoms", then listen to the head of the CDC explain how vaccines cause autism in the presence of mitochondrial disorders on CNN, then go back and ask him about the whole thing and hear him reiterate that vaccines don't cause autism, but this time handing you a piece of paper that insults you, are you going to take his word about about anything else?

What do they plan on doing if the VCIP Omnibus Hearings find for the petitioners with Autism?

Do they understand that they are moving from shooting themselves in the foot to shooting themselves in an artery?

Two weeks ago Jim Carrey asked, "How stupid do you think we are?"

The AAP has answered, "You are so stupid that we can not only keep telling you obviously disprovable lies, but we can also insult you, and you will not only CONTINUE to entrust your children to us, you will pay us money to do it!"

Last April the AAP took the wise step of attending the DAN! conference. They said that they were impressed and thought we were on to something.

I wrote a piece on the AAP's chance to mend the widening rift between parents and pediatricians, and to regain the lost trust that was growing by leaps and bounds due to the obvious overstatements on vaccine safety that they were making to patients and their families.

I warned that they had a small window of opportunity to work to change course, work in good faith, and begin to make statements about the true risks of vaccination that abandons the now untenable assertion that vaccines don't cause autism or contribute to neurodevelopmental disorders. I warned that the window would only be open for a short time unless we saw real action, and would probably close around the time of the Green our Vaccines Rally if they didn't show up for us in some respect.

Well the AAP didn't show up for the rally and well... this certainly signals that the window is closed. They want it closed. And it looks like they may be locking it.


UPDATE:

An addendum to address critique that this post has received elsewhere.

-One person seems to have been concerned that I was personally insulted by the AAP and All Star Pediatrics. I want to assure that I am at peace on the matter. After having my son become sick due to AAP's bad policy, not much that they simply say about me, or people like me, hurts my feelings.

Insults given do not necessarily need to be received.

In my life, personally, I believe it is wise to work toward not being "insulted" by insults. Because really, either the person insulting you is right, and you need to do some self examination and change, or they are wrong, and (to be frank) who cares what they think about you.

In this case, I think that Dr. Dyer and his crew are wrong. Deciding not to vaccinate based on your best judgment is not selfish, self-centered, or a product of 'unacceptable attitudes'. (Come to think of it, how exactly does Dyer and company read minds to know what peoples motives are? Especially people he has never met, as the statement is a blanket one?) We are charged with making the best choices for our kids that we can given the information we have. Reducing that decision making process to the motives Dyer wants to believe are behind those decisions is just speculative bullying and communicates low regard for parents.

Especially parents who are earnestly struggling with the issue.

And it is not me being insulted that is the problem. It is the parents on the vaccine bubble. Treat their legitimate concerns with contempt and you only risk making complete vaccine refusal more widespread.

-Umbrage seems to have been taken at my use of the word "recommends" in the opening sentence, "The American Academy of Pediatrics now recommends that pediatricians tell parents who don't vaccinate their children that they..."

I am making the assumption, a reasonable one I think, that choosing only one medical practices vaccine policy letter to patients (one would think there are a thousand out there to choose from) and placing it prominently both on your newsletter and website whose purpose is to give guidance to pediatricians who are members of the AAP constitutes a 'recommendation'. If not a recommendation, it certainly represents a ringing endorsement.

For the sake of accuracy, I will contact the AAP on Monday and ask that they clarify if this was a 'recommendation' or an 'endorsement'.

But, if we can cut the crap and get real for a moment, it does not matter what semantics the AAP decides to play with this. They are holding it out for their members as an example to be followed and even if they DID run a disclaimer (which they didn't) that they don't recommended the letter at all, the message would still be loud and clear to peds.

'Feel free to insult your patients, use coercion to get them to fully vaccinate and dismiss them if they don't. We might 'have' to officially say don't do it, but really, you won't get any arguments from us! (wink)'

Kinda like the conversation I had with my seven year old yesterday, "Son, it is totally wrong to steal cars. Did I ever tell you about Jonsie "Zoom Zoom" Mcgillicutty? Man that guy was great at stealing cars. Here is what he did... now here is how you jimmy the lock to break in... and here is how you hot wire it... and once you have the car you..."

They can say all day they want their docs to 'work with' parents, but what they DO gives us the real message of what they are all about. And what they have DONE is tell peds how to treat patients with earnest vaccine concerns with contempt.

Addendum:

Links to the AAP Newsletter have disappeared, so I am copying the letter here in case the rest do as well:

"All Star Pediatrics’ Vaccine Policy Statement

Editor’s note: The following document is available for download on
the AAP Member Center at www.aap.org/securemoc/immunizations/
allstarpediatrics.doc, and may be adapted for use by practices.

We firmly believe in the effectiveness of vaccines to prevent serious
illness and to save lives.

We firmly believe in the safety of our vaccines.

We firmly believe that all children and young adults should receive
all of the recommended vaccines according to the schedule published
by the Centers for Disease Control and the American Academy
of Pediatrics.

We firmly believe, based on all available literature, evidence and
current studies, that vaccines do not cause autism or other developmental
disabilities. We firmly believe that thimerosal, a preservative
that has been in vaccines for decades and remains in some vaccines,
does not cause autism or other developmental disabilities.

We firmly believe that vaccinating children and young adults may
be the single most important health-promoting intervention we perform
as health care providers, and that you can perform as parents/
caregivers. The recommended vaccines and their schedule given
are the results of years and years of scientific study and data-gathering
on millions of children by thousands of our brightest scientists
and physicians.

These things being said, we recognize that there has always been
and will likely always be controversy surrounding vaccination. Indeed,
Benjamin Franklin, persuaded by his brother, was opposed to smallpox
vaccine until scientific data convinced him otherwise. Tragically,
he had delayed inoculating his favorite son Franky, who contracted
smallpox and died at the age of 4, leaving Ben with a lifetime
of guilt and remorse. Quoting Mr. Franklin’s autobiography:
In 1736, I lost one of my sons, a fine boy of four years old, by the
smallpox…I long regretted bitterly, and still regret that I had not given
it to him by inoculation. This I mention for the sake of parents who omit
that operation, on the supposition that they should never forgive themselves
if a child died under it, my example showing that the regret may
be the same either way, and that, therefore, the safer should be chosen.
The vaccine campaign is truly a victim of its own success. It is
precisely because vaccines are so effective at preventing illness that
we are even discussing whether or not they should be given. Because
of vaccines, many of you have never seen a child with polio, tetanus,
whooping cough, bacterial meningitis or even chickenpox, or known
a friend or family member whose child died of one of these diseases.
Such success can make us complacent or even lazy about vaccinating.
But such an attitude, if it becomes widespread, can only lead to
tragic results.
Over the past several years, many people in Europe have chosen
not to vaccinate their children with the MMR vaccine af ter publication
of an unfounded suspicion (later re tracted) that the vaccine
caused autism. As a result of underimmunization, there have been
small outbreaks of measles and several deaths from complications of
measles in Europe over the past several years.

Furthermore, by not vaccinating your child you are taking selfish
advantage of thousands of others who do vaccinate their children,
which decreases the likelihood that your child will contract
one of these diseases. We feel such an attitude to be self-centered and
unacceptable.

We are making you aware of these facts not to scare you or coerce
you, but to emphasize the importance of vaccinating your child.
We recognize that the choice may be a very emotional one for some
parents. We will do everything we can to convince you that vaccinating
according to the schedule is the right thing to do. However,
should you have doubts, please discuss these with your health care
provider in advance of your visit. In some cases, we may alter the
schedule to accommodate parental concerns or reservations. Please
be advised, however, that delaying or “breaking up the vaccines”
to give one or two at a time over two or more visits goes against
expert recommendations, and can put your child at risk for serious
illness (or even death) and goes against our medical advice as
providers at All Star Pediatrics. Such additional visits will require
additional co-pays on your part. Furthermore, please realize that
you will be required to sign a “Refusal to Vaccinate” acknowledgement
in the event of lengthy delays.

Finally, if you should absolutely refuse to vaccinate your child
despite all our efforts, we will ask you to find another health care
provider who shares your views. We do not keep a list of such
providers, nor would we recommend any such physician. Please recognize
that by not vaccinating you are putting your child at unnecessary
risk for life-threatening illness and disability, and even death.

As medical professionals, we feel very strongly that vaccinating
children on schedule with currently available vaccines is absolutely
the right thing to do for all children and young adults. Thank you
for your time in reading this policy, and please feel free to discuss
any questions or concerns you may have about vaccines with any
one of us.

Sincerely,
Bradley J. Dyer, M.D.
Jennifer Melnychuk, M.D.
Robert C. Duncheskie, M.D."

7 comments:

nhokkanen said...

We parents suspected that the AAP officers were fools, and now they've opened their mouths and removed all doubt.

Out goes the care and in comes the bullying. Next they'll be rewriting the Hippocratic oath on a web page with ads from their Pharma donors.

As I've noted elsewhere, the press release writer made 3 grammatical errors in the first paragraph alone. Shooting themselves in the foot yet again. Nitwits.

Kathi said...

Actually, the AAP doesn't recommend insulting parents. If you read all the links, they recommend informing, listening to, and respecting parents.

The one letter under the link "pediatricians tell parents" is from a single doctors office, as a sample if others want to use it. It is one of several links on the page, with every other link being about educating and respecting parents, and NOT kicking them out of their practice.

http://www.cdc.gov/vaccines/pubs/providers-guide-parents-questioning-vacc.htm

Excluding patients from your practice whose parents decline immunizations is not deemed the best public health strategy. Remember, unimmunized young children did not decide for themselves to forgo vaccination. If you don’t care for them, who will?

I personally don't believe vaccines cause all autism. I do believe there are cases of autism due to vaccine reaction. I also really believe in and understand the importance of vaccines, especially in our community. We have a very large illegal population in our area, which is often unvaccinated. I know of people who have come to our community from out of the country carrying TB and measles. If your child is exposed to children who have not been vaccinated and possibly carrying these diseases, you would want them protected. Two years ago, my husband caught whooping cough, the "P" in the DPT shot. It was very scary to see him have coughing spells, and wonder if I would have to call 911. It lasted for months, and is something I wouldn't wish on anyone. He was vaccinated as a child, but obviously that one has worn off.

Please understand that I'm not saying these things to "SCARE" anyone into vaccinating, or as racist devisive remarks. It's just the way it is.

Ginger Taylor, M.S. said...

Kathi,

The AAP printed said letter on the front page of their newsletter. They have endorsed the letter and the practice of turning patients away.

If that is not holding it out as an example to be followed, then nothing is.

As it DOES violate their previously stated policy that patients should not be turned away, I can only assume that they have reversed their policy.

Or else why would they not have an asterisk next to it saying that it went against their current policy? Or simply have written their own version of a sample letter of their own using the All Star letter as a template to work from, leaving out anything they didn't recommend or endorse?

Twice publishing that letter, first in their newsletter an then on their web site, is recommending it.

Jim said...

"the AAP didn't show up for the rally and well... this certainly signals that the window is closed. They want it closed. And it looks like they may be locking it"

Why did they do it in the first place I wonder? Because they think we are idiots? (apparently..)

As for whooping cough, is it one of those diseases that are more serious to adults than to children? Does the immunity incurred by the DTP (or DTaP) shot lifelong? If so, getting a DTP shot as a child would not necessarily protect an adult. However, devloping immunity the old-fashioned way (by getting the disease) might. It's also possibly that waning DTP-induced immunity might be strengthened by exposure to wild-type bacteria (just as protection against VZV-caused shingles is strengthened by exposure to chicken pox HHV virus).

Lynna Kay said...

Wow. Just when I thought I had seen or heard it all...that is definately on my top 10 list now as one of the most stupid things I've heard about ever. I cannot believe the audacity of the AAP - though by now nothing they do ought to surprise me. Good grief. Thank you for posting this story. I'm going to pass it along.

Kathi said...

Whooping cough is actually much more serious in young children than in adults. When my husband had it he literally couldn't breath during coughing fits. We became very educated on whooping cough and he learned to stay calm, and his breath would return. A small child doesn't have that ability.

http://www.siumed.edu/news/releasesFY05/WhoopingChaud.htm

Kathi said...

Ginger, point well taken!

I investigated further and found where you could leave feedback regarding articles they publish.
http://aapnews.aappublications.org/cgi/feedback

I left feedback regarding the sample letter/policy and encourage others to do the same.