Before Vaccinating Children, here's a form for your doctor to sign.

edited September 2012 in Parenting
@bahamamama4828, @homebirthadvocate
Thought you ladies would like this.

PHYSICIAN'S WARRANTY OF VACCINE SAFETY

I (Physician's name, degree) _______________ , _____ am a physician licensed to practice medicine in the State/Province of _________ . My State/Provincial license number is ___________ , and my DEA number is ____________ . My medical specialty is _______________ .

I have a thorough understanding of the risks and benefits of all the medications that I prescribe for or administer to my patients. In the case of (Patient's name) ______________ , age _____ , whom I have examined, I find that certain risk factors exist that justify the recommended vaccinations. The following is a list of said risk factors and the vaccinations that will protect against them:
Risk Factor __________________________
Vaccination __________________________
Risk Factor __________________________
Vaccination __________________________
Risk Factor __________________________
Vaccination __________________________

I am aware that vaccines may contain many of the following chemicals, excipients, preservatives and fillers:

* aluminum hydroxide
* aluminum phosphate
* ammonium sulfate
* amphotericin B
* animal tissues: pig blood, horse blood, rabbit brain
* arginine hydrochloride
* dog kidney, monkey kidney
* dibasic potassium phosphate
* chick embryo, chicken egg, duck egg
* calf (bovine) serum
* betapropiolactone
* fetal bovine serum
* formaldehyde
* formalin
* gelatin
* gentamicin sulfate
* glycerol
* human diploid cells (originating from human aborted fetal tissue)
* hydrocortisone
* hydrolyzed gelatin
* mercury thimerosol (thimerosal, Merthiolate(r))
* monosodium glutamate (MSG)
* monobasic potassium phosphate
* neomycin
* neomycin sulfate
* nonylphenol ethoxylate
* octylphenol ethoxylate
* octoxynol 10
* phenol red indicator
* phenoxyethanol (antifreeze)
* potassium chloride
* potassium diphosphate
* potassium monophosphate
* polymyxin B
* polysorbate 20
* polysorbate 80
* porcine (pig) pancreatic hydrolysate of casein
* residual MRC5 proteins
* sodium deoxycholate
* sorbitol
* thimerosal
* tri(n)butylphosphate,
* VERO cells, a continuous line of monkey kidney cells, and
* washed sheep red blood

and, hereby, warrant that these ingredients are safe for injection into the body of my patient. I have researched reports to the contrary, such as reports that mercury thimerosal causes severe neurological and immunological damage, and find that they are not credible.

I am aware that some vaccines have been found to have been contaminated with Simian Virus 40 (SV 40) and that SV 40 is causally linked by some researchers to non-Hodgkin's lymphoma and mesotheliomas in humans as well as in experimental animals. I hereby warrant that the vaccines I employ in my practice do not contain SV 40 or any other live viruses. (Alternately, I hereby warrant that said SV-40 virus or other viruses pose no substantive risk to my patient.)

I hereby warrant that the vaccines I am recommending for the care of (Patient's name) _______________ do not contain any tissue from aborted human babies (also known as "fetuses").

In order to protect my patient's well being, I have taken the following steps to guarantee that the vaccines I will use will contain no damaging contaminants.

STEPS TAKEN: __________________________
_______________________________________
_______________________________________
_______________________________________

I have personally investigated the reports made to the VAERS (Vaccine Adverse Event Reporting System) and state that it is my professional opinion that the vaccines I am recommending are safe for administration to a child under the age of 5 years.

The bases for my opinion are itemized on Exhibit A, attached hereto, -- "Physician's Bases for Professional Opinion of Vaccine Safety." (Please itemize each recommended vaccine separately along with the bases for arriving at the conclusion that the vaccine is safe for administration to a child under the age of 5 years.)

The professional journal articles I have relied upon in the issuance of this Physician's Warranty of Vaccine Safety are itemized on Exhibit B, attached hereto, -- "Scientific Articles in Support of Physician's Warranty of Vaccine Safety."

The professional journal articles that I have read which contain opinions adverse to my opinion are itemized on Exhibit C, attached hereto, -- "Scientific Articles Contrary to Physician's Opinion of Vaccine Safety."

The reasons for my determining that the articles in Exhibit C were invalid are delineated in Attachment D, attached hereto, -- "Physician's Reasons for Determining the Invalidity of Adverse Scientific Opinions."

Hepatitis B

I understand that 60 percent of patients who are vaccinated for Hepatitis B will lose detectable antibodies to Hepatitis B within 12 years. I understand that in 1996 only 54 cases of Hepatitis B were reported to the CDC in the 0-1 year age group. I understand that in the VAERS, there were 1,080 total reports of adverse reactions from Hepatitis B vaccine in 1996 in the 0-1 year age group, with 47 deaths reported.

I understand that 50 percent of patients who contract Hepatitis B develop no symptoms after exposure. I understand that 30 percent will develop only flu-like symptoms and will have lifetime immunity. I understand that 20 percent will develop the symptoms of the disease, but that 95 percent will fully recover and have lifetime immunity.

I understand that 5 percent of the patients who are exposed to Hepatitis B will become chronic carriers of the disease. I understand that 75 percent of the chronic carriers will live with an asymptomatic infection and that only 25 percent of the chronic carriers will develop chronic liver disease or liver cancer, 10-30 years after the acute infection. The following scientific studies have been performed to demonstrate the safety of the Hepatitis B vaccine in children under the age of 5 years.
____________________________________
____________________________________ _____________________________________

In addition to the recommended vaccinations as protections against the above cited risk factors, I have recommended other non-vaccine measures to protect the health of my patient and have enumerated said non-vaccine measures on Exhibit D, attached hereto, "Non-vaccine Measures to Protect Against Risk Factors." I am issuing this Physician's Warranty of Vaccine Safety in my professional capacity as the attending physician to (Patient's name) ________________________________. Regardless of the legal entity under which I normally practice medicine, I am issuing this statement in both my business and individual capacities and hereby waive any statutory, Common Law, Constitutional, UCC, international treaty, and any other legal immunities from liability lawsuits in the instant case. I issue this document of my own free will after consultation with competent legal counsel whose name is _____________________________ , an attorney admitted to the Bar in the State of __________________ .
_________________________ (Name of Attending Physician)
______________________ L.S. (Signature of Attending Physician)
Signed on this _______ day of ______________ A.D. ________
Witness: _________________ Date: _____________________
Notary Public: _____________ Date: ______________________
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Comments

  • Dang you go girl, I'd love to see a doctor dare and sign this!!!!
  • I have this posted in my notes on fb I'm not sure you've seen since were fb friends :)
    Aaaaaaand hba vaxxes....
  • I really doubt that any doc would sign this. It's like asking to be sued. A lot of the ingredients listed are used in a ton more medications than just vaccines, too. For example, the medicine we instill into micropreemie lungs (surfactant) is made from porcine/bovine fetuses. We know this and are happy to give it to the babies who would likely die without it. Yeah it's kind of gross to think of, but this is an instance where benefit absolutely outweighs the risk. This had nothing to do with vax or not...just that a lot of modern medicine comes from icky, unexpected places. I digress. Hah
  • The user and all related content has been deleted.
  • Thank you for that @captivated ill have to print this out :)
  • Oops. Yeah @rtmommy, fetus ingredients don't bother me in one way or the other. Of course if they were terminated and used for that purpose...but they aren't. Just as i am for stem cell research. Obviously no doctor would ever sign this :)
  • I find it very interesting just how many physicians do NOT vaccinate their own children.
  • Honestly my ped doesn't push either way, she gives her speech and then supports whatever the parent decides. She her self didn't vax her kids. Anyways I have been given the omg from other docs though! Like when my son was in the emergency room for a head injury, they asked if he was up to date on vax, when I said no the nurses and docs would freak out on me. I just told them that his ped supports me. It upset me, thier reactions but I didn't show it. @bexiewexie
  • @bexiewexie I know you didn't ask me, but this is always my response "we don't vaccinate, and it's not AT ALL up for discussion." that usually shuts them down. I find it's best to not even enter into a discussion with them..they will always think they are right abd u are wrong.
  • Exactly @Ashley_smashley. The reality of the matter is that they are not very educated upon the topic. My doctor could not win this argument with me simply because he was uneducated upon everything I brought up. He finally stopped, looked at me and said, "well, you seem very educated on the issue and looks like I need to do more research."
  • Here's the thing @bexiewexie : I vax'd Logan, but they'd want to do 4 to sometimes 5 shots at a time, so in that case I'd tell them that I only do 2 pokes at a time. I think it's mean to sit there and keep jabbing him. Plus, it gives his body a chance to deal with a couple things at a time instead of a barrage of them. I just made myself more selective to when he got them. If you don't know for sure how you feel, look up the CDC'd recs on shots before you go in to the office...then you can say you picked which were important to you, etc and kind of have your argument ready to go when you need it. As a parent, you have to be willing to be confrontational even if you never were before because now Markus depends on you for everything. Becoming a mommy made me a confrontational bitch :D haha And I don't feel bad about it at all. It's called being a tiger/dragon mom, and it's awesome :P

    @captivated I honestly don't know the process they use...but I imagine the stuff would cost a whole lot less if they were slaughtering the fetuses for supply/demand. (?) And yay stem cells. ;)
  • Love this! I had to argue at our last well baby visit and wish I'd had everything printed out like this to politely let him know I know they are not ALL safe and not ALL necessary. Not that it would have gotten through his thick skull...I just smiled and told him I'd done the research and although there are two sides, I am postponing at this time. Hate being made to feel like it's reckless endangerment trying to protect my child from the harmful side effects of excessive vaccinations.
  • I love how respectful you are @mom2ing. It is refreshing! And how respectful everyone else was!
  • We are all trying to protect our kids, regardless of which viewpoint we have. I don't see why we should attack each other for it. :)
  • Agreed @rtmommy and @mom2ing I'm provax but only certain ones at certain times and don't judge any parents for choosing all or none!
  • At my lo's 1 year checkup (new Dr) she asked if she will be getting her 12m shots. I got ready to defend myself after I said no -- and I started to - but she didn't even seem to care! I wonder if she vaccinates her son (he's a month older than my lo) I totally should have asked!
  • Absolutely! @bexiewexie (sorry this is long!) I consulted the CDC's schedule and chose MMR (measles, mumps, and rubella) and Polio, as they are painful diseases eradicated in the US only within the last couple generations. Since other countries still have those diseases, I wanted to make sure we did our part to keep those illnesses at bay. I also had them as a child and trust more that they've stood the test of time from a safety standpoint than some of the newer vaccines. I would have consented to Hep B only because my son had surgery at 4 days old and required a blood transfusion, but we didn't have time before he was transferred. Normally I say no Hep because my *babies* won't have risk factors like being sexually active, using intravenous needles, or working in the health care system. I was pushed to accept Whooping Cough and RSV vaccinations, but declined as I didn't feel he is at risk: he's at home with me, I exclusively breastfed and believe that boosted his immunity, my husband and I are never sick, and I'm a little germ obsessed and tend to keep him very protected. ;-) MMR and Polio aren't administered until 12 months, but I'm waiting until 2 years old so we can talk about it with him and prepare him for the "ouch". If we ever go to a foreign country, I'll reevaluate and see if there's anything else I think he needs, too.
  • No problem @bexiewexie :-) I support whatever you decide for your little man! :-)
  • Did you get added to the fb group @bexiewexie?
  • Aww. Some of them come off a bit too strong and over the top on specific issues, even for a tinfoil hat kinda gal like me, but there is great info.
  • @captivated bwahaha! Are you talking about 'great mothers..'
  • Yes @Ashley_smashley! Some of the stuff is slightly far fetched to me. But that's just me. I'm still learning.
  • I hear ya...but I am finding that the shit that is the farthest out there that my mom says actually turns out to be true! @captivated lol
  • I've got to inch in to it little by little ;)
  • Lol don't blame ya!
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