For all you people on the fence about vaccines. Your GP won't sign

[MorelCabin]

Do you think your physician thinks vaccines are safe enough to take the risk of signing this?






Physician"s Warranty of Vaccine Safety

I (Physician"s name, degree)_________________________, _____ am a physician licensed to practice medicine in the State of ________________. My State 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 ___________________________________________

Risk Factor ____________________________________________

Vaccination ___________________________________________

Risk Factor ____________________________________________

Vaccination ___________________________________________

Risk Factor ____________________________________________

Vaccination ___________________________________________



I am aware that vaccines typically contain many of the following fillers:

* aluminum hydroxide

* aluminum phosphate

* ammonium sulfate

* amphotericin B

* animal tissues: pig blood, horse blood, rabbit brain,

* dog kidney, monkey kidney,

* chick embryo, chicken egg, duck egg

* calf (bovine) serum

* betapropiolactone

* fetal bovine serum

* formaldehyde

* formalin

* gelatin

* glycerol

* human diploid cells (originating from human aborted fetal tissue)

* hydrolized gelatin

* mercury thimerosol (thimerosal, Merthiolate(r))

* monosodium glutamate (MSG)

* neomycin

* neomycin sulfate

* phenol red indicator

* phenoxyethanol (antifreeze)

* potassium diphosphate

* potassium monophosphate

* polymyxin B

* polysorbate 20

* polysorbate 80

* porcine (pig) pancreatic hydrolysate of casein

* residual MRC5 proteins

* sorbitol

* 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 thimerosol 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: ______________________

 

[freemotion]

Holy carp!

 

[PamsPride]

I just wrote out a letter stating the "beacause of religious reasons" and sited the case law that allows that and the school never gave me a problem. It was less than two sentences.

 

[farmerlor]

Yeah, my doctor would probably sign it.

 

[hobobrando]

no more shots
no more shots

 

[patandchickens]

I do understand that this is rhetoric, not a serious form.

However, for pretty much the same reason, I would say you might wonder how many people (getting OR not getting their kids vaccinated, makes NO difference) would THEMSELVES be willing and able to sign a comparable form.

For instance a quiz about what a given vaccine being suggested/considered contains, and what are the likely and unlikely outcomes of those *amounts* of taking in those particular ingredients.

A statement of having actually researched the subject (and I mean researched; append your journal references at the end of the form, as the original one asks) and a summary of one's understanding of the numerical risks of vaccination and of the disease it's designed to prevent in different relevant circumstances.

A statement saying that I, the undersigned, understand that the point of vaccines is NOT to be 100% safe (as NOTHING in life is 100% safe), but to be used in circumstances where the risk they guard against is greater than the risk that they themselves pose.

And a statement saying that I, the undersigned, understand that it is impossible for every last thing in the world to have been already fully and fairly tested, enumerated and documented before a decision is made about something, and I, the undersigned, take personal responsibility for making my decision under the certain knowledge that some of where I'm extrapolating or filling-in-the-blanks will turn out to be mistaken.

Something like that.

It is the *person's own* responsibility to educate themselves.

And it is, pardon my bluntness, SILLY to expect that anything in life is 100% fully understood and risk-free (as the above piece implies is possible). We all, every one of us, do things all the time in life that are neither of the above; vaccination decisions are no exception.


Pat, who lies somewhere in the middle of the continuum from "vaccinations are terrible" to "vaccinate for everything", and a proponent of informing yourself and making your own risk-tradeoff-based decisions on the subject.

 

[me&thegals]

Well, it probably would make a physician sit up a little straighter and think an extra thought or two

 

[patandchickens]

Honestly, I think what it would do is get you dropped from the GP's list of patients

Pat

 

[MorelCabin]

My doctor wouldn't drop me...he has this way of laughing at me and saying "I think you've been spending too much time online..." LOL! But the things on that form are so true, and nothing I want n my body

 

[Big Daddy]

I don't think our pediatrician would sign it. However I would never request it. I feel that the vaccines pose less of a risk than the diseases they protect against. We have 8 children that have all gone through their vaccinations and all boosters. So far so good.