New AANP position paper on vaccines 3

RE: [NaturopathicChat] AANP Immunization Position - Thank you
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peaceandjustice2
Message 1 of 14 , Aug 1 4:08 PM
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Thank you Eric Blake and Jared Zeff for speaking out about this issue. It is extremely unfortunate and disheartening on the almost eve of our first AANP convention in my native Northern California that the AANP would take a position that so clearly and obviously does not reflect the attitudes and opinions of the rank and file AANP member. It was/is very possible to take a more nuanced position that represent the members of our beloved ND profession. The AANP position does not have to be in complete support of the CDC schedule or completely opposed. The current AANP position could tell the truth and represent our profession, be prophetic, provide some support to the parents of the children that support our profession, and let the chips fall where they may. Anything else will be our downfall.


Dennis Godby, MA, ND
Sacramento, CA



Anne Van Couvering, ND
Message 2 of 14 , Aug 2 12:00 AM
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Thank you Dennis, Eric and Jared for speaking up. . .

I suggest we simply shut up until the issue isn't such a political hot potato - no one is demanding we issue a position paper.  But I certainly can't support this one that would make me out of compliance  with our "professional standards" to delay or not administer certain vaccinations, and I think many many NDs feel this way.

Anne Van Couvering, ND, LMT, CNS
Berkeley, CA




Mona Morstein
Message 3 of 14 , Aug 2 1:22 PM
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I have been invited to be on a focus panel at the AANP. I will be focusing on this information during my hour. I am in support of Dr. Zeff’s positions. Everything the AANP tries to convince us it is moving forward positively and openly, more of this kind of crap comes out.

For everyone else also on a focus panel, if you are of the same opinion, please also bring it up.

Mona Morstein, ND, DHANP
Tempe, AZ



Nancy Dunne Byington
Message 4 of 14 , Aug 2 1:33 PM
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I am so glad to hear Jared's reminder of our earlier process. He reminds us that we made an earlier decision to hold back landing on a position on immunization, and now here again, maybe by hook or by crook, maybe because it is significant unfinished business, we are being forced to our feet on once again. Our patient's well-being demands that we grapple with a difficult choice. A commitment. It reminds me that every federal administration since Eisenhower talked about healthcare reform. We have the ACA finally because of a confluence of influences of course, but also because it was committed to, and it got done. I wonder if the ND community is getting closer to being willing and able to take a fundamental stand.

Managing the use of vaccinations in real life is hard work. It takes know-how and attention to detail; it presumes resources and an educated, collaborative and motivated patient population.  NDs either enjoy this kind of patient population, or fervently believe all patients can be educated into collaboration and motivation on their own behalf.

The conventional system experiences patients differently. They have to treat everyone, not just the self-selected who come already motivated. The well-educated are very vocal and demanding but the majority of patients are passive and remain so throughout their health care experiences. The conventional system is getting slick at doing lip service to lots of PC-like window-dresssing, but bottom line they have mostly figured out how to get patients to sign a form declaring they have been given the opportunity to be educated, collaborative in their own care and able to access informed consent and engage preventative services, and can't sue anyone if things don't work out. It would be hilarious if it weren't so sad. And, realistically, there is a LOT of education that people will need, if a prevention-based health care system is to work. And education is expensive, the outcomes much harder to quantify than counting how many vaccine doses have been administered in a community and then deluding ourselves into thinking we now have a predictable, knowable outcome as a result.

But since economics is what will always win, there is a potential for a future health care system that looks more like true naturopathic medicine. Prevention simply is the least expensive way to go. If we decided to do it, we could change it all in a generation. It's just about teaching and giving resources to kids. But that's another story!

I think what we need to do right now with the vaccination issue and with every other issue in which the question is do we become more or less like traditional naturopaths, is that we should do it the hard way. I think we should insist on the truth, which is that medicine is complex, health care decisions must be made on a patient by patient basis and legally mandating treatment of any kind is real, real weird in the land of the free and the home of the brave.

SOME body is going to have to know how to teach and treat patients who choose - what ever they choose. We already have a kind of division among us, those who were educated before a certain time and those educated afterward. Diversity of skill sets, specialization is all good- but if WE don't teach how to walk a family through experiencing pertussis, who will? How many of us are confident of our ability to manage measles?  I will bet a few of us are and most are not. Logically; when does one have the opportunity anymore?

We are losing what makes us unique. The easy bits have been scooped off and are incorporated in some fashion into very very conventional practices. I wonder if we were to engage in a massive public campaign of SELF-assessment, in which we very publicly describe in a horrified, dramatic fashion, what a huge mistake we have almost made, and what we stand to lose if we don't start practicing more traditional naturopathic medicine again, I wonder if that would engender a corresponding increase in public awareness and commitment to retaining freedom of choice in health care. It seems like that's how people want to engage- a scandalous drama, confession, redemption... I think we have a convincing campaign just about ripe!

I'm kind of kidding but mostly not.  The current vaccine hysteria is not about human well being, it's about profits and it's hard hard hard work to effectively combat forces of greed that use powerful and effective scare tactics and manufacture controversy where people are going for each other's throats rather than looking at the source of the problem. Oh well. Did we think we were gonna be able to just practice medicine? We can continue to avoid making a commitment, or, we can do it now.

This vaccine postion paper draft represents a potential decision that makes us less deniable by the conventional system. We want to be incorporated into the national healthcare system and it's a good idea for many reasons. I am not sure we have to give up who we are however. We do not have to presume we have to change shape to be incorporated. Rather than spotlight where we are not different from conventional practitioners, we could claim our uniqueness as our strength, as what is so very valuable about naturopathic medicine; as what the conventional system "wants", to meet it's commitment to patients. If our patients want naturopathic medicine, it's our responsibility to help them effectively demand our inclusion as naturopathic practitioners.  As is, and not as MD-dilute. I prefer a position paper that calls for a legal opportunity to practice, and our patient's option to choose a naturopathic solution to communicable disease and vaccinations.

Nancy E. Dunne Byington, RN, MA, ND
    Counseling, Consultation, Education



Emily Kane
Message 5 of 14 , Aug 2 2:03 PM
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Thank you Mona!
Our forum is ever more vital to keeping the Vis alive in our medicine. Of course we all need to make a living. But we, the rank and file of natural primary care providers, have nothing to gain from losing our roots. It remains a mystery to me why some of our leadership has abandoned our true purpose. Are the schools raising money from Big Pharma? Are legislators signaling better scope expansion if we cave to AMA demands?  Really, I'm clueless about this steady shift away from teaching true Naturopathic Medicine in our schools. I'm so grateful I was at Bastyr when standard allopathic protocols and pharmaceuticals would never be first choice on clinic shifts. Now they often are. I don't get it.  If anyone (Jared, Mona, Pam, Thom, anyone?) could enlighten us then we could push back more effectively.
In health
Emily Kane ND
Juneau AK




Eric Blake
Message 6 of 14 , Aug 2 7:13 PM
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Thank you Mona

I really do believe the issue at hand is not about vaccination.  The position paper could be about UFOs.

The issue at hand is position paper development and the manner in which this has been handled.

Knowing that it is a controversial departure that does not accurately reflect the professions large breadth of opinion and pushing it through quietly is the issue.

Justifications center around 'it's good for the professional image and job opportunity' are all irrelevant.

 If there is no formal process by which positions are adopted then that is where the association needs to begin.

 If there is and the process has been compromised to push through a position not in alignment with the actual survey of what the profession ACTUALLY practices and believes then the leaders who did this have upside down ethics.

If the leaders who did this believe that misrepresenting the profession to employers legislators future students and the public is appropriate they have also mistaken dictation for leadership.

This type of leadership creates divisiveness upset and mistrust.

Sincerely
Dr. Blake




Sheila Frodermann
Message 7 of 14 , Aug 3 8:46 AM
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Thank you, Mona. I'm delighted that you will be on the panel at the AANP and will be sharing perspectives from members on natchat. I am not in favor of the position in the paper. I find many statement not in alignment with our naturopathic tenants, my training as a naturopathic physician (I was taught philosophy by Dr. Zeff, for which I am grateful), and my clinical practice.

I learned of the new AANP Vaccine position paper, not from the AANP, but from a survey posted by OncANP and requested of it's members.

I was disappointed that the same survey was not offered directly to AANP members.I understand it has been offered to state associations via a representative in the House of Delegates. I am very appreciative of Jared (thank you!) alerting this group to the history and the complicated politics of the proposed paper on this forum.

I am in agreement with the concerns stated by Jared, as well as with the comments summarized by Eric Blake. Unfortunately, I am once again questioning my membership with the AANP. I look forward to a more ethical and truly representative AANP in the future.

Thank you.

Sheila M. Frodermann, MS, ND, DHANP, CCH
Naturopathic Doctor



Michael W Whitney NMD DC FABNO
Message 8 of 14 , Aug 3 9:21 AM
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Hi Folks,

I am neither here  or there with vaccination as an individual prevention community health strategy.  I am sure the schedule and dogma of vaccination is flawed.  However, are all vaccines "the devil" or is there a more  moderate position?  For instance, we see  emerging evidence that certain vaccines may be useful in cancer therapy.  Does this extend to prevention of common childhood illness?  If so, which ones should we support and on what schedule.

Having treated in excess of 500 spectrum children, about 10% report " not same since vaccination".   Often the regression appears within hours or days of the vaccine event.  As onset of autism  is often 24-30 months from birth, an altered schedule may be better without completely giving up the entire "herd immunity" concept.

If we were  not to throw out the vaccine program all together what would that look like?  Is there potential support for moderation?  We have vaccine experts among us maybe we can  hear from them?

It seems as though vaccination programs are  either a big pharma "money machine" and an allopathic control vehicle or equally plausible there is benefit in vaccination in certain individuals and in certain circumstances.

searching for a better construct to herd immunity....



Michael W Whitney NMD DC FABNO



mjcronin13
Message 9 of 14 , Aug 3 11:54 AM
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I appreciate the concerns shared on the proposed Vaccination Paper. This is an important issue in the growth of our profession.
Getting new states licensed is the #1 priority of the AANP to which we dedicate our best attention and resources. We face organized and well funded opposition to licensing.  Vaccination is one of their most effective issue to blocking our progress.
In 2013 the Colorado ND licensing law was passed that prohibited ND’s from treating infants under 2 due to the vaccination issues. The Maryland ND law was passed in 2014 without that restriction. In 2015 the Colorado restriction was lifted after intense lobbying and the skillful use of compromise. It had been over 10 years since California began licensing. Certainly because of licensing it has seen huge advances in its 10 years and the public has benefited  The Vaccination Position Paper in discussion was written by an AANP Vaccination working group lead by Matt Baral ND over 2 years, with input from many including the Scientific Affairs Committee and including those involved in state licensing. Input continues in the HOD process.
I hope folks recognized that the political process is less about truth and justice and more about finding compromise.  I believe this position paper describes a compromise that describes how ND’s advise their patients including adjusted vaccination schedules while it includes language that neutralizes our opposition sufficiently.  That language recognizes that  the “CDC vaccination schedule should serve as a primary guidance on vaccine administration” but then clearly describes that ND’s use alternative schedules when indicated in the best interests of their patient. The paper describes this in several ways that are not in bold type but provide appropriate ND judgement and latitude in treating patients individually. Primary guidance is not a mandate when individual ND judgement is allowed!
There are many other effective groups active working on vaccine reform and against additional mandatory vaccinations. AANP has limited bandwidth and we leave to those other groups the vaccination work. AANP’s priority is new state licensing without the restrictions imposed and then removed by Colorado.
I include a comment by Denise Clark ND who lead the Colorado licensing effort and the successful effort to removing the 2 year old restriction and allow ND’s to treat those under 2. ND’s in Colorado are able legally give their patients their very best advice.
The House of Delegates process on position papers has been followed and is in process. It is not an fast process and is one that allows for much member input which is and has been occurring in a vigorous manner.
I would add that dispersions against AANP, its leadership and the ND volunteers working on this difficult issue is hurtful and does not help our process.
Mike Cronin, ND
Past President, AANP



erikakrumbeck
Message 10 of 14 , Aug 3 12:53 PM
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I just want to weigh in briefly,

Even as someone who vaccinates a LOT of kids (on an alternate vaccine schedule), this position paper makes me uncomfortable.

But I also want to correct a few statements here.  For some reason Hepatitis B is often cited by members of our profession as a vaccine that is inappropriate for childhood (given that it is sexually transmitted, etc, etc.).

Please remember that there is a reason why the CDC advises giving vaccines to certain age groups!

Here's a little back history: Hep B used be relatively common: 13.8 cases/100,000 people.  The cases in children numbered in the tens of thousands alone.  CHILDREN, not sexually active adults.   That is because children CAN get this infection - usually from Mom, but sometimes even from sloppy kisses from other caregivers as well.  Transmission can be through saliva, any fluids including menstrual blood, seminal fluids, through surgical or dental procedures, needles, tattooing, etc.   Scratches or abrasions in the skin, burns, etc, may lead to contraction.

At first they recommended the vaccine ONLY to high-risk populations (Mom was a known IV drug user, prostitute, etc), and they didn’t notice a significant reduction in Hep B in the population.  Then they switched to recommend it to ALL babies and noticed a huge reduction in cases.  This was a 89% reduction over a decade.  So before it was 13.8 per 100,000, now it is less than 0.02 cases per 100,000.

If Mom has Hep B 70-90% of infants will be infected, and 90% of infected babies will be chronically infected.   Chronically infected infants are virtually guaranteed to get cirrhosis or hepatocellular carcinoma later in life.

So remember - perhaps our patients are less likely than the general public to have Hep B, and if we know that all caregivers are Hep B negative then perhaps it is fine to refuse/delay Hep B.  BUT, if we translate that to the general public then undoubtedly we would see huge increases in Hep B cases.  Remember that there are areas of the world where >7% of the population has Hep B.  High risk groups in US: Alaskan natives, Pacific Islanders, children of immigrants from endemic countries.

Erika "Vaccine Information" Krumbeck.

(a.k.a. Erika "Informed consent means ALL information about vaccines, both good and bad" Krumbeck)

Missoula, MT



jacobschor
Message 11 of 14 , Aug 3 4:50 PM
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Well this sure promises to be an interesting aanp conference given all the heat discussion about vaccinations is generating.  It's impressive to me that we put so much energy into this position paper.  I'm not sure why we have decided to invest our time in trying to create it as I'm not so sure there is a good outcome.

If we create a position paper that reflects the views of a more traditional naturopathic worldview that immunizations are dangerous, then we will further hobble the legislative efforts of our unlicensed states at passing bills and our newly licensed states at expanding scope.  If we pass a position paper swearing allegiance to whatever CDC schedule comes our way, it may help these colleagues succeed in passing legislation and furthering our profession but it will be a rather disingenuous act.

Whatever position the AANP takes will probably not change things in licensed states, no matter what the final statement says.  The range of opinions is so broad regarding this issue, any document that tries to encompass our full spectrum of views will still hurt our legislative efforts.

My suggestion is that we table any discussion of a position paper on this topic for a solid five years and at that time see if either the science is clearer or our profession's opinions are more consistent.  To do anything otherwise will leave us in disarray.  It would be far more productive for the HOD to find issues that we are all in agreement about and can collectively feel comfortable publicizing.

Jacob Schor
Denver CO



Jonathan Light
Message 12 of 14 , Aug 3 7:38 PM
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I agree with Jacob and think a position paper for our profession at this time is foolhardy.
Jonathan B Light, MD, ND
Tucson, AZ



Emily Kane
Message 13 of 14 , Aug 3 8:37 PM
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www.DrEmilyKane.com



laurarepola
Message 14 of 14 , Aug 3 9:06 PM
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My state organization was notified of the request for input. It went into the trusted hands of Dr. Katie Carter who tried to get input from us. I unfortunately fell in the non participating percentage on this topic at that time. So I am voting in now with Dr. Whitneys opinion. Why shan't all participants in this debate agree that there is some missing data, epidemiology, and personal accounts that make this a true controversy?
I live in a state with religious exemption that just mandated chicken pox. As a mother, which is not the opinion I present to the AANP, I would freak out and go great distances to avoid the current vaccination schedule. I also support the individual right choose.
I also believe that a vaccine for HSV II would have been better received than the varicella which was a dumb idea. I'd rather have CP than HSV for life. Maybe a vaccine by vaccine review is the best way to understand our position.
Laura Repola
Butterly MT