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Tag: adverse events

Real Time Censorship of case report on HPV vaccine associated with ADEM

Real Time Censorship of case report on HPV vaccine associated with ADEM

Most pediatricians receive in the mail Pediatrician News. The most recent issue contained an interesting case report discussed in “Pearce-ings” by columnist Francine Pearce, M.D. It discusses a teenage girl who presented to an orthopedist with back pain of unknown etiology, who then had a seizure of unknown origin, according to the neurologist. The patient had more seizures and developed tics. She was hospitalized. A spinal tap and MRI confirmed ADEM (acute disseminated enchaphalomyelitis).

She had been healthy and athletic, and her medical history was unremarkable except that two weeks before the onset of the symptoms, she had the HPV vaccine.

Dr. Pearce noted the reported negative association between the HPV vaccine and ADEM, but did say that the evidence on the association between ADEM and other vaccines is “varied” and that ADEM following vaccination “was infrequent but not rare.”

She hypothesized about a possible mechanism of action, and noted that the aluminum in the Gardasil vaccine was associated in changes in behavior in a mouse study, which offered further support that vaccines might be associated with ADEM.

Her recommendation was that clinicians consider ADEM as a differential diagnosis with new onset seizures, especially if there was a recent vaccination event.

She concluded with her opinion that although vaccines are considered safe, AE’s do occur, and that discussing this and other possible adverse events with patients will “build trust and confidence with your patients.”

Not really all that controversial to openminded practitioners.

Here is a image of the case report.

The reason I need to give you an image rather than a URL link is because the case report has already been pulled by the journal from its online edition, due to intense negative feedback. Big surprise? Not really, but what is surprising is how fast it happened, it was just a matter of a few days.

Would it shock anyone if this was Dr. Pearce’s last column?

We’ll see.

Wouldn’t hurt if some folks wrote the editor of Pediatric News and expressed support for the doctor and the valuable information she provided to clinicians.

The journal is published by  Frontline Medical Communications Inc. and headquartered at 7 Century Drive, Suite 302, Parsippany, NJ 07054-4609. Telephone: (973) 206-3434. For information: www.frontlinemedcom.com.

The editor is Catherine Cooper Nellist. Her email address is: cnellist@mdedge.com

Rick Jaffe, Esq.

rickjaffeesquire@gmail.com

Cali. Medical Board makes it official: Docs who write non- standard-of-care medical exemptions will be prosecuted, (but maybe not)

Cali. Medical Board makes it official: Docs who write non- standard-of-care medical exemptions will be prosecuted, (but maybe not)

vaccineimage
The elimination of the PBE (personal belief exemption) via SB 277 has put a lot of pressure on vaccine concerned California pediatricians to write medical exemptions for the children of vaccine concerned parents. The recently dismissed San Diego federal anti-SB 277 lawsuit showed that at least one school board is collecting information about the docs who write these medical exemptions and will forward the information to the medical board for prosecution.

Based on some non-binding legislative history, and some personal discussions with legislators, the vaccine concerned community was hoping that the medical board could not or would not assert jurisdiction over docs who write these exemptions. That seemed completely unrealistic to me based on my experience dealing with medical boards. These guys just don’t give up jurisdiction on their licensees’ conduct.

In case you had any doubts, the board has made it official in its recent executive summary. Here is its position which couldn’t be clearer:
“The passage of two legislative bills increased the Board’s authority to investigate allegations of misconduct. * * *
In addition, SB 277 (Pan and Allen, Chapter 35) effective January 1, 2016, deleted the personal belief exemption from the existing immunization requirements. The Board will investigate any complaints in which a physician may not be following the standard of care in these two new areas.”
(From page 6: http://www.mbc.ca.gov/Publications/Annual_Reports/annual_report_2015-2016.pdf)

So there you have it. It’s basically open season on docs who write full vaccine exemptions, because according the pediatrician groups and the CDC, there are almost no medically justifiable reasons to excuse a child from all childhood vaccinations.

So what can be done about it? In the very short term, nothing really. Many pediatricians will probably be wary of writing medical exemptions.

Still, here are a couple hints. If your child had some prior vaccinations and had a serious adverse event associated with (not necessarily provably caused by) a prior vaccine, you may be able to obtain an exemption from the right doc, which decision would be literature supported. Make sure you bring documentary proof of the prior adverse event(s). The doc will need it for his records. Prior auto immune problems in the child or family members? That might help as well. Again, bring documentation. Help your pediatrician make the case and help him document the exemption. That’s the best protection for you and your doc. Admittedly, right now there is no medical board authority indicating that this would justify or exculpate a doc who writes an exemption on this basis, but I hope to change that within the next six months, in connection with my work on the current medical board case I’m working on, so stay tuned.

Next, an obvious mid-term solution is to amend SB 277 by making medical exemption decisions unreviewable by the medical board. As stated, there is some legislative history indicating that SB 277 was not intended to have the medical board second-guess the decisions of docs who write these medical exemptions. Realistically, passing such an amendment is a long-shot, but it’s time, energy and money better spent that filing another frivolous SB 277 constitutional challenge. (By the way, whatever happened to the dismissed San Diego federal lawsuit which was supposed to be refiled October 1st?) My suggestion: start working your legislators to get some feedback on whether it’s a possibility. If it is, that’s where the community should put its efforts and money.

Finally, there’s a soon-to-be publicly announced group of vaccine concerned docs, which is open to the public. It’s called Physicians for Informed Consent.

Check out their Facebook page at https://www.facebook.com/search/top/?q=physicians%20for%20informed%20consent.

Here is their web site. www.physiciansforinformedconsent.org

These folks have done more good for the vaccine concerned community even before they’ve officially started than all the lawsuits combined, but I can’t talk about that now. Go to their Facebook page, sign up and support them. They have and will continue to make a difference.

Rick Jaffe, Esq.
Rickjaffeesquire@gmail.com