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  • Originally posted by FIREshrink View Post
    I want to vaccinate my kids and asked this group their thoughts from a legal, ethical, and medical standpoint about doing it two days early. Then met with all kinds of presumptions mostly incorrect as well as judgments mostly uninformed.

    Least judgmental way to have responded might be, do the benefits of early treatment outweigh the risks? Or perhaps that's how I should have asked the question.

    If the goal is vaccinate, vaccinate, vaccinate... Then is two days early a problem? Why/why not?
    My internet opinion, based on study of children over 12 is that there is no medical downside to vaccinating a small almost-12 year old. As has been alluded to, the ethics is a matter of opinion. And there would be no legal implication unless there is a vaccine reaction and the injured party sues to be made whole.

    You have a medical license and professional judgment. Prescribe your son his vaccination and enjoy your trip.

    Comment


    • Any chatter on the vaccine for kids under 5? 5-11 approval does not help us very much because that only gets 1/4 of my kids. My twins will not have to wait too long into next year but my 2 year old is going to keep us from completely vaccinated. He is on the big side though...

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      • Originally posted by CordMcNally View Post

        Like most financial posts, we can't give a complete picture because we never have all of the information. We only have the information that you have provided here. If you ignore all of your personal reasons to lie for your son to get a vaccination early then I guess you're mainly asking an ethical question for which many people have replied. Is it ethical to lie to obtain a vaccination that your son otherwise wouldn't qualify for? Is it ethical or moral to set a standard as a parent to let your child know that it's ok to lie if it benefits them or makes things more convenient? You're the only one here who those answers will affect so it's really your choice. We all have to live with the choices we make in life and the example we set for our children. Nothing changes that, especially strangers' opinions.
        You keep saying lie even though I have said, I won't lie.

        Comment


        • Originally posted by FIREshrink View Post

          You keep saying lie even though I have said, I won't lie.
          At some point somebody will not be honest with giving the vaccine and you will be condoning it. Is that better wording? Whether or not you fill out the vaccination card is irrelevant. I guess if it makes you feel better...

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          • You really make me want to bang my head on the keyboard! The entire point of this line of questioning is do ask about openly, not furtively, getting a vaccine. What part of that do you not understand? The pedi would willingly give the vaccine at age 11 and 363 days. Where is the not honest part?

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            • Originally posted by FIREshrink View Post

              Leisure, as opposed to... business? In that dichotomy, yes. My children are not going on a business trip. Bravo.

              Not worried about cost, don't need trip insurance. Have no idea why you are bringing up completely irrelevant information.

              Vaccine mandates serve to make life inconvenient for the unvaccinated, because the view is the unvaccinated are unprotected and serve as a risk to others. They are two sides of the same coin. How can you ascertain, from where you sit, what my motivation is for motivating my son? And what difference does it make at all? Are you saying the vaccine is less effective depending on the motivation or rationale of the recipient?
              If you’re not worried about cost then why not just shift the trip a few days. Buy new tickets for everyone (or just you and the kid, and meet up with everyone else a few days late) and go 2-3 days later.

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              • Originally posted by FIREshrink View Post
                You really make me want to bang my head on the keyboard! The entire point of this line of questioning is do ask about openly, not furtively, getting a vaccine. What part of that do you not understand? The pedi would willingly give the vaccine at age 11 and 363 days. Where is the not honest part?
                You can bang your head on your keyboard if you'd like but I don't think it will help you. My bottom line is that it isn't ethical. Getting somebody else to agree to go along with it doesn't make it any more or less ethical. Again, as I've pointed out, I don't think anyone here is going to alter your ultimate decision.

                Comment


                • Originally posted by CordMcNally View Post

                  You can bang your head on your keyboard if you'd like but I don't think it will help you. My bottom line is that it isn't ethical. Getting somebody else to agree to go along with it doesn't make it any more or less ethical. Again, as I've pointed out, I don't think anyone here is going to alter your ultimate decision.

                  I don't understand why you feel that it wouldn't be "ethical" if it didn't involve a lie. Now, totally different case if this conversation was happening in Feb when high risk patients couldn't find doses.

                  I didn't see any ethical objection from anyone to a different poster receiving a 3rd dose as a booster when that is not "approved" or recommended yet in America.

                  Comment


                  • Originally posted by FIREshrink View Post
                    I want to vaccinate my kids and asked this group their thoughts from a legal, ethical, and medical standpoint about doing it two days early. Then met with all kinds of presumptions mostly incorrect as well as judgments mostly uninformed.

                    Least judgmental way to have responded might be, do the benefits of early treatment outweigh the risks? Or perhaps that's how I should have asked the question.

                    If the goal is vaccinate, vaccinate, vaccinate... Then is two days early a problem? Why/why not?
                    There was another poster here (maybe he doesn’t want to be named, so I won’t) who gave the vaccine to his daughter when she was 17, early in the year. He didn’t seem to have qualms about it.

                    I can’t imagine the medical risk is more than negligible.

                    I’m also not entirely sure how other folks perceive the ethical issues. If you’re honest with your kid and his pediatrician and request the vax 2 days before he falls under EUA, I wouldn’t lose too much sleep over it. The slippery slope argument is mainly for his pediatrician to decide - every practitioner decides where they draw the line with patient requests. I guess one could make the argument that the vaccine is scarce and that it should go to one of the billions of adults in other countries who haven’t been dosed, but there are obvious pitfalls in that argument.

                    I’d just politely ask the pediatrician. They get paid to say no if they’re uncomfortable with it. Otherwise just postpone the trip like Anne said.

                    Comment


                    • Originally posted by Sampter View Post


                      I don't understand why you feel that it wouldn't be "ethical" if it didn't involve a lie. Now, totally different case if this conversation was happening in Feb when high risk patients couldn't find doses.

                      I didn't see any ethical objection from anyone to a different poster receiving a 3rd dose as a booster when that is not "approved" or recommended yet in America.
                      Unethical things don't have to involve lies. It is a huge issue? No, but again, it sets an example that their son will see. I don't have any horses in this race and I was just giving an opinion. I don't think the poster asking about the third dose was asking if it was ethical but I can't remember. Either way, I wouldn't get anything that wasn't officially recommended and without all the data but that's just me. I don't expect my words to change anyone's stance on ethics and morally nor would I hope they would.

                      Comment


                      • Originally posted by CordMcNally View Post

                        Unethical things don't have to involve lies. It is a huge issue? No, but again, it sets an example that their son will see. I don't have any horses in this race and I was just giving an opinion. I don't think the poster asking about the third dose was asking if it was ethical but I can't remember. Either way, I wouldn't get anything that wasn't officially recommended and without all the data but that's just me. I don't expect my words to change anyone's stance on ethics and morally nor would I hope they would.

                        FIREshrink also didn't ask our opinion if it was "ethical" or "moral", many just gave that opinion.

                        There was a fair amount of "holier than thou" thrown at OP.

                        Comment


                        • Originally posted by Sampter View Post


                          FIREshrink also didn't ask our opinion if it was "ethical" or "moral", many just gave that opinion.

                          There was a fair amount of "holier than thou" thrown at OP.
                          Though to be fair, later i did ask.

                          I'm still befuddled as to what the claimed ethical question is, the closest i can think of is that I'm putting the pediatrician in an awkward position and that could be unethical. But I'm with lithium here, patients ask all the time, say yes or no if you want, document your decision making, move on .

                          Comment


                          • Originally posted by FIREshrink View Post

                            You keep saying lie even though I have said, I won't lie.
                            “If the goal is vaccinate, vaccinate, vaccinate... Then is two days early a problem? Why/why not?”

                            1) In the host country, the protection they are seeking is the benefits of limiting activities of unvaccinated.
                            2) In our country, 12 is the limit.

                            I don’t know the motivation of either country. I do know you are rationalizing violating the intent of both policies. The host country really wants safe and effective vaccinations which by your point won’t be in place for your child for 10 days per your post. Are you considering following the restrictions for 10 days? That to me would be good faith.

                            Ethically, omission and commission intentionally lead to the same conclusion. The difference between right and wrong is easy.
                            You have two options:
                            1) Get your kid vaccinated one month early. Both shots and be done with it. This requires you to reject the FDA 12 year old limit and rely on the judgement of you as a parent and the pediatrician. In this case, the host country receives full compliance.
                            2) Don’t get the child vaccinated and comply with the restrictions.

                            I have no problem with asking for a waiver due to extenuating circumstances. No deception, technicalities, or omissions. The right process is to get a physician to grant the waiver.

                            The only problem is for policies to be effective they have to be consistent. Everyone has a reason, maybe your pediatrician will fully vaccinate your kid. Maybe not. You tried to follow the process with full disclosure. That to me is more important to your child than playing games with a 2 day plan. Two wrongs don’t make a right. One month dude, fully vaccinated.
                            Maybe you can doctor shop. It’s not the same with opioids is it? It is different, the intent and full disclosure.
                            BTW, I don’t blame you one bit. Go for full vaccination before the trip. I would state it carefully, IF you agree, let’s “git-r-done”. Both shots. Just an example why Fauci’s approach allows no room for judgement. It is your kid, you are putting at risk one month early.


                            Comment


                            • Interesting recent conversation. I believe there's a heck a lot more ethical delimas that happen daily in our offices. Give Prednisone,. Antibiotic stewardship, that narcotic or benzo. Or the housestaff or fellow physician colleague asking for something without being assessed directly for some diagnostic. We bend the rules daily.


                              ​​​​​​The harder one part of this question isn't whether to give early two days, but the question of changing the dosing. Now you're asking to alter an EAU dosing schedule that doesn't have guidance.

                              As a clinician who's asking a fellow clinician to cross knowing the greyness, it's a bridge that one should consider closely and to me a bit higher than asking for Xanax for the flight for your wife. Just my opinion.

                              If you want to get the shot early. Go to CVS. They won't double check anything . Buy a pint of ice cream and travel meds to give them a boost to ease your guilt and pad their bottom line if one feel the guilt.

                              Comment


                              • Originally posted by Bdoc View Post
                                I have seen 1 covid patient in the past 3 months. Currently there are 19 in the hospital(this includes the chronically intubated ones that cannot be dispo)

                                curently there is an outbreak among the residents/students this week. So far mild symptoms bc all are vaccinated.

                                I know the what the news says, and how bad the numbers are but im just not seeing it as hospitalized patients.

                                Do i have to mentally prepare for January again? IDK if I can do n95s again.
                                Right now it is indoor season where I’m at. 85 degrees at night, 90s and very humid during the day, raining every day. Vaccination rates are sometimes 10% lower on average in the south, than areas in the north, where it’s currently outdoor season. I wonder what will happen up north as they transition to indoor season.

                                We are seeing the highest case numbers of the pandemic so far and the highest ED volumes ever recorded here. Not like the previous waves where it was low volume with lots of covid.

                                Delta seems to move very fast. We went from nothing to tons very quickly.

                                Many of our residents and students have had covid and all did fine with mild symptoms. They were catching it on ICU rotations, in ortho rotations, and in acute care settings in early 2020 with heavy exposures, before anyone was really even doing PPE or aware of what they were seeing at the time, or knew covid was here.

                                It’s just an opinion, but I think delta is going to burn through the south, and hopefully burn out, like it did in India. Then the North will have its turn, especially as temps drop, windows close, and school resumes. Delta infects vaccinated people and can be spread by them….

                                Next up though, Lambda variant. We’ll see how the current vaccine does against that. They say so far, not well.

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