One physician comes back from the dark side, sort of, while another goes over, kinda

Remember that “pediatrician to the stars” that I mentioned to you a while back? The one that has his doubts about vaccines and has even used “The Brady Bunch” as his basis for the severity of mumps? He’s (probably) coming back from the dark side. He posted this summary on his blog of a study on the safety of vaccines. Is he coming back? Is he going to stop it with the questioning of the evidence of the safety of vaccines?

We’ll see. We’ll see.

On the other hand, we have this article from this physician about mandatory influenza vaccination of healthcare workers. Unfortunately, she hits a lot of the anti-vaccine talking points in her disagreement with hospitals’ policies on having their employees vaccinated against the flu:

“But I choose to take the flu vaccine realizing that the vaccine won’t necessarily protect me against all the different strains of the flu virus, and knowing too that I could suffer severe side effects.”

Ah, the “severe” side effects of the flu. You’ve probably heard about them and how “common” they are. (They’re not that common, and they’re not that severe.) The worst side effect from a flu vaccine in terms of mortality is Guillain-Barré Syndrome. It can be very severe and life-threatening, but you can also get it from a viral infection alone. This leads us to believe that it’s not the vaccine, per se, but the immune response to viral infection.

The article continues:

“I’ve always agreed with the general recommendation that people who work in health care should be vaccinated against the flu, but that still needs to be a personal decision, not a government mandate. Each person has individual responsibility to make decisions about safety issues of all kinds — whether or not to smoke, to eat that second piece of cake, to get the tires checked on the car before the road trip. While we acknowledge that bad decisions may put others at risk to a greater or lesser degree, in America we still believe that personal decisions are just that: personal.”

This is the “freedom gambit.” On its face, it makes sense that it’s up to us whether or not to make the decision to be safe. In this case, we’re not making a decision to be safe for ourselves. This is a decision that also affects the safety of others, i.e. the patients. Equate this to washing your hands. It’s your decision, but woe be unto you if you don’t wash your hands in a healthcare setting. You’re placing in jeopardy your safety and that of your patients. I’d say to Dr. Sibert that people who work in healthcare chose to be in a profession where their “freedom” can very well kill people. If she, or others in healthcare, cannot deal with that, they’re more than welcome to exercise their freedom in other professions.

She adds:

“If I should become ill with a strain of influenza that hasn’t been covered by this year’s vaccine, since I’ve been vaccinated I don’t have to wear a mask though I could be quite contagious for at least a day before I develop overt symptoms.”

Well, now we have a quadrivalent vaccine, Dr. Seibert, so you can take that to further reduce this theoretical situation of yours from happening. I mean, the odds of it happening are pretty low already because the way we select the strains to go into the vaccine have been very good for the Type A (and more severe) strains. The type B selection was tricky, I’ll admit it, but the quadrivalent vaccine takes care of it.

Issues of vaccine effectiveness aside, this argument of hers that there maybe, possibly, probably, in some weird situation be a strain that is not covered is hogwash. If there was some big problem with the vaccine not covering a strain, we epidemiologists would make it known to her and her colleagues so that everyone exercises the proper precautions at all times.

And then this:

“No hospital (to my knowledge) is requiring patients’ visitors and families to provide evidence of flu vaccination or wear masks, though they go in and out of patient care areas at will. If we are really to be logical and scientific about flu transmission, either we all should wear masks or none of us should bother.”

Wow! Just, wow! Replace masks with “hand washing” and see where she goes off the deep end on her argument. “None of us should bother?” Excuse me, doc, with all due respect, YOU CHOSE THIS PROFESSION. You also come into contact in a more direct way with a lot more patients that a visitor. And, if you look into isolation precautions, you’ll note that visitors to patient areas where there are severely sick and immune-compromised people are required to wear masks and gowns and gloves. You should have really consulted with your facility’s infection preventionist. You really should have.

Finally:

“Many of us in clinical health care have good reason to resent the obvious HIPAA violation that is taking place when health care workers are required to divulge whether or not they’ve been vaccinated against this year’s most likely influenza strains. Apparently, HIPAA only applies to some patients, not to all.”

What? Yeah, so her whole argument is that her private and protected medical information is being divulged to the public when she is required to either wear a badge that states she’s been vaccinated or wear a mask if she refuses to be vaccinated. You’ve probably seen this anti-vaccine argument before. It stems from the “sacred and impenetrable” relationship between a provider and their patient. However, there are two things at work here. Number one, she is not a patient. Whether or not she is vaccinated is not between her an a healthcare provider. It’s between her and her employer. And, number two, exclusions to HIPAA are allowed in matters of public health (as this so obviously is) and when the information needs to be divulged in order to operate the hospital in a better way. What do you think we, the public, think when we see someone with a cast over their arm? We think that they broke it. No HIPAA violation there. Why is it a HIPAA violation if we see your badge (if you got vaccinated) or your mask (if you’re not)?

If you feel like it, go read the article yourself, but, if you want to keep your sanity, stay away from the comments section. There’s even more anti-vaccine insanity there.

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12 thoughts on “One physician comes back from the dark side, sort of, while another goes over, kinda

  1. Lilady, I follow your posts on both RI and the SBM blogs.

    I must confess I have no idea how he can put you ‘On probation’ or block you from a blog he only comments on.

    • Peebs, you must have missed this exchange between Jay Gordon and me on the SBM blog. It starts here with Jay’s comment about polio vaccines:

      http://www.sciencebasedmedicine.org/antivaccine-use-the-law-when-science-fails-you/#comment-137365

      Several of the SBM commenters replied and so did I. Scroll down to see how Dr. Jay took me “off probation” and “banned me”.

      http://www.sciencebasedmedicine.org/antivaccine-use-the-law-when-science-fails-you/#comment-137459

      “Lilady–You have called me a liar at least twice in your post above. You are off probation and banned instead. You are not worth one more minute of my time. Good bye.

      No, I did not fabricate the Israel-bound travelers and residents of Israel and (*) yes, the vaccine was available to both hospitals and private practitioners for compassionate use long before it was in universal use.

      I visit polio eradication.org every single day, by the way.

      David, you’re proud of your incivility, rudeness and name calling? Good for you. You have turned into a caricature. You’re the Bill O’Reilly of SBM.”

      *The “compassionate use vaccine” which Dr. Jay refers to, is the Varicella vaccine, which Dr. Jay claimed was available for children undergoing cancer therapies. I caught Dr. Jay in an out and out lie. During the time frame that Dr. Jay references, the Varicella vaccine was still undergoing clinical trials in Japan, where it was developed and NOT available for compassionate use in the United States. Post-exposure prophylaxis was available; Varicella Zoster Immune Globulin (VZIG) on a very limited basis and it was dispensed by local health departments.

      • My apologies Ma’am, because I usually use my mobile phone to read posts I sometimes don’t click on links purely for the reason I have a fairly aged telephonic device.
        I confess to those of you that, unless I’m at home I trust your collective wisdom.
        And I can confirm that collective wisdom has rarely let me down!
        Many thanks for taking the time to reply. I shall now go silent and continue to stalk you all!!

  2. I don’t think he has come back from the dark side. He’s merely trying to play both ends against the middle.

  3. I will only agree that Dr. Jay is coming back from the dark side if he deletes the entire section of his blog dedicated to “alternative medicine.” Nothing he recommends there looks particularly dangerous, but I doubt many of his recommended herbs and/or supplements are more effective than a placebo, particularly since he provides no supporting evidence for them.

  4. It’s clear from later in the paragraph what you mean, but I don’t think this is what you wanted to say:
    “Ah, the “severe” side effects of the flu. You’ve probably heard about them and how “common” they are. (They’re not that common, and they’re not that severe.)” I believe you mean (and she meant) “the “severe” side effects of the flu vaccine,” no? Just don’t want some anti vax nut to jump on that…

  5. I am wondering which specialty the physician practices in. I most certainly do wish to avoid her!
    “…since I’ve been vaccinated I don’t have to wear a mask though I could be quite contagious for at least a day before I develop overt symptoms.”
    So, the “good” physician doesn’t bother with masks if she was vaccinated against influenza, as influenza is the *only* reason to don a mask?! Not to protect a immune challenged individual, not to avoid all manner of other URIs, naw, it’s only for influenza.
    Add in the remainder of blather, I’ll be frank, I’d not trust this professional to carve a turkey, let alone care for myself or a loved one.

    In the immortal words of Bugs Bunny, “What an ultra-maroon!”

  6. I don’t know about Dr. Jay “coming back” from the dark side. He still is not following the CDC/AAP/California Department of Public Health Recommended Childhood Vaccine Schedule.

    I’ve been a thorn in Dr. Jay side, every time he posts on Orac’s blog. The advice he formerly had on his own website was to give MMR vaccine at age 5 before entering school, give chicken pox vaccine at age eight or nine (if the child hasn’t already contracted the disease), and Prevnar vaccine (12 years after it was licensed) was “too new for (him) to recommend”.

    I shamed him into taking down his “opinions” and in their stead, Dr. Jay linked to references about each of the Recommended Childhood Vaccines, which appeared on whale.to. Those whale.to links have disappeared from Dr. Jay’s website now…but he steadfastly refuses to link to the California Department of Public Health or the CDC vaccines pages for current and accurate information for each childhood vaccine.

    Dr. Jay *put me on probation on Orac’s blog, then *banned me on Orac’s blog, because I caught him telling porkies about the varicella vaccine which Dr. Jay claimed was available under a “compassionate use protocol” for children with leukemia and certain cancerous solid turmors. (The varicella vaccine was still undergoing clinical trials in Japan and only VZIG was available in the United States, in very limited doses, for post-exposure prophylaxis for those at extreme risk for contracting the virus).

    * Being put on probation, then being banned by Dr. Jay, on Orac’s blog and on the Science Based Medicine blogs, is a badge of honor for me.

  7. Another reason there’s no HIPAA violation: it’s completely unclear that this is, in fact, a disclosure. Health Care Workers may work a mask for a variety of reasons besides being unvaccinated.

  8. The good Doctor also missed the fact that if you had an accident because you didn’t get the tires checked, you may find yourself liable in negligence. Similarly: if your behavior involved not taking simple precautions in a way that put others in risk, you may have to pay for it in a tort case.

  9. I run this article by two health law professors that teach HIPAA. They both agreed she is simply wrong.

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