News in brief: Bob Sears to face medical board over recommendation not to vaccinate and poor record keeping

The OC Register reports yesterday (8 September 2016) that Dr Bob Sears has to face charges over "medical negligence" when he failed to take a detailed medical history of a toddler before writing him an exemption from further vaccination (and other oversights). He is also facing charges of poor record keeping, because apparently, this letter was not on the child's file.

The consequence for Dr Bob can range from a reprimand to the loss of his medical license.

I am sure this decision will find a lot of attention, given the recent introduction of SB277 in California, which mandates vaccines for school attendance unless the child has a medical exemption and fears that some "vaccine friendly" doctors would distribute such exemptions liberally without clear cause, undermining the public health benefits intended by the law. Dr Bob, whose "The Vaccine Book" had been criticised as fuelling irrational, scientifically unfounded, and potentially dangerous fear of vaccines, has been among the vocal critics of this law.

Orac gives a more detailed description of the charges (with a side of Insolence), as does the Poxes blog.

I would hope that any verdict of the medical board would be 100% based on the charges at hand (and any extenuating circumstances, i.e. other instances of writing medical exemptions without rigorous examination of the child, or lapses in record keeping) rather than the notion of making an example of Bob Sears to discourage other doctors.

Addendum (9.13.16): Richard Jaffe is representing Bob Sears.

“I represent Dr. Bob Sears in the California Medical Board’s case against him for writing a medical exemption from vaccination.
We take the board’s accusation seriously. But this case is very clear: this child had two unusual and severe vaccine reactions and his situation warranted a medical exemption. To continue vaccination could have put the child at risk of further harm.
All physicians have an ethical duty to do no harm to a patient. This is no less true when a child suffers serious side effects from any medical intervention.
We anticipate this case will do much to further public education on the importance of recognizing severe vaccine reactions and providing informed consent for medical care. ”

Rick Jaffe

let the education process begin! community support appreciated.

rj

iPhone Apps for Vaccine Record-Keeping

Catherina posted an article about record-keeping and the importance of tracking our children's vaccinations.  Erroneous entries can be made, we move and records can be lost.  Michelle on NannyPro.com has listed several iPhone Apps that can be used to create, track and set reminders for immunisations.  Some are free and some are just a few dollars.  There are even apps for travel vaccinations and general vaccine information so go check them out.

Measles go to University

As British kids, not vaccinated in the 90ies due to the MMR media hysteria grow up, measles catches up with them - as seen yesterday:

 

Lovely Dr. S said that while he was happy to actually see a case of measles (young doctor in the post-vaccine era that he is), people would tend to forget that measles can be a very dangerous disease. And indeed, in Merseyside, where they have had over 200 cases of measles this year, 25% of over 15 year old patients (15 of 61) were hospitalised, the highest rate of all age groups (<1s: 24%, 1-5s: 20%, 5-9s: 4% 10-14s: 8%).

Apparently, University Health Service are also seeing lots of mumps and chicken pox, several cases of rubella and whooping cough. The nurse I saw was very impressed with the recent case of whooping cough - the first she had ever heard. She said she had heard a lot of coughs in her career, but the second she heard this one, she knew it as pertussis and "really something else" (in the sense of something much more severe that a normal cough). 

So here is a public service announcement to students in the UK and elsewhere where Universities may not check your vaccination record:

Make sure you are immune against measles, mumps, rubella, chicken pox, whooping cough and meningitis. 

If you don't have one of these, contact your GP, they should have your shots on file. It is your responsibility now.

You can still get the vaccines, if you didn't as a child. Talk to your GP - they'll be delighted to get you covered before you walk into their surgery with measles...

Keeping Track of Your Child's Vaccinations

One of the topics that come up often on the boards is shoddy book-keeping of the doctor's office, posts like

"My child is two years old and I am sure we had done all first year vaccines, but now we got called back for XYZ shots"

"I got a letter from the State saying that my child is not up to date, but s/he is"

"my child got his/her 4th DTaP at 12 rather than at 15 months and now we have to go back for a 5th, because the 4th doesn't count" *

"my child got his/her MMR too early and now it doesn't count" *

All of these are real life examples (2 from Dr. Bob's old board, 1 from Babycenter) and they illustrate one thing very clearly:

You have to keep a record of the vaccines your child get!

Now in an ideal world, your pediatrician hands you a vaccination schedule on your first well visit, including all info on the first vaccines, so you can read up ahead of time. S/he'll discuss with you whether you have any questions before the first shots and each time your baby is vaccinated, the little sticker on the vaccine vial that has vaccine name and lot number goes into a booklet like this:




that you get to keep. I have encountered such "best practice" with our second child - our first had 3 cards, one for each country she got vaccinated in, until we combined them into one. It is surprising, however, how often parents do not automatically get vaccination records to take him with them.

However, you need such records, so if you move or change doctors, you have proof of which vaccinations your child has had. These "Yellow Cards" exist world wide (the upper picture is an Ugandan one filched off the web, my daughter has one from California, my son one from Germany), they have been around for a really really long time - I have one, my original one is white though and I recently found my mum's and grandma's (proper record keeping during WWI and WWII, although mainly for smallpox).

It is even more important to keep your records if you are on an "alternative" schedule (for any reason - the European schedule my daughter had been vaccinated on for her first 9 months was very much "alternative" to what was recommended/required in the US).

As soon as your child is born, you can make up a vaccination schedule for him/her - the CDC has a handy tool, or find your country's National schedule and do it by hand. If you want to diverge from what is recommended, highlight this on the schedule. Take the schedule in to your doctor's appointment to double check you have done it right. Ask for the yellow card and then keep track of all shots. Also make sure that all vaccines are actually available in the combination that you want to give them - there are still parents out there who want to give monovalent measles, mumps and rubella, but they are no longer made by Merck - there are also periodic shortages in vaccines (in recent years for example the monovalent hib).

It needs a little planning, but it is very valuable, and, ultimately, your responsibility.


* that is actually a topic for another post