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  1. I find this troubling. I had this sense close to the beginning in mid-December, as I watched people without direct patient care posting selfies of their vaccine cards, that something might not be quite right. My hospital seemed to be doing the right thing, but then today I heard about vaccinations going to staff who are 100% telework and without other qualifying demographics. Just working for a healthcare institution does not justify a healthy young person without increased risk receiving this vaccine ahead of the elderly and high risk. I know for a fact that the nursing homes in my area haven’t been fully vaccinated. Even some of the inpatient nurses on non-Covid floors haven’t gotten shots yet, and they certainly qualify as “essential.” I don’t know where this communication breakdown began between the CDC, states, and institutions, and it’s enraging that this is being so poorly managed on such a wide scale. NYT article
  2. Please cite proof that a vaccine has ever saved a single life?
  3. First of all, I’d like to thank Rev Ronin for his thoughtful piece in the Feb 2020 issue of JAAPA about religious objections to vaccination (https://journals.lww.com/jaapa/Fulltext/2020/02000/Addressing_religious_objections_to_vaccination.10.aspx ), which gives three scenarios in which patients (or their parents) show vaccine hesitancy or refusal. I appreciate that the issue was acknowledged and taken seriously and that appropriate references were included. At no time did I feel like the author’s theoretical patients were caricatured or that his advice to medical practitioners was based on straw-man arguments as can so often happen concerning religious believers in journalism and the media. Though I disagree with some of the author’s positions (well, just one in particular), I feel like he showed respect and courtesy to people who hold beliefs similar to mine. I hope the same respect for all sides can permeate this thread—a thread that I’m starting with some hesitation because I know that, ironically, tempers can flare when religious considerations are brought up. I’ve read enough on this forum to know that forum members hold to differing viewpoints about many things and are a passionate bunch. I hope we can agree to be passionate about caring for our patients well and not tearing one another down. If you’re still trucking with me this far, thanks, and please chime in (after you’ve read the article!). The first two scenarios are of particular interest to me as both a soon-to-be-PA and a pro-life evangelical Christian. In the first one, I can see both sides of the issue but would in the end, I think, land exactly where the author does in encouraging the HPV vaccination for the reasons given. The second scenario is more tricky since there are two seemingly-competing ethical “goods” being espoused by the provider and the mother: the good of preventing disease (with a vaccine) and the good of respecting pre-born life (thus not giving/accepting a vaccine that was developed using the cell line of an aborted fetus). I hold the carefully-considered view that the end of potentially saving life and limb with a vaccine does not justify the means of using a cell line from an aborted fetus and that knowingly providing or using a vaccine so produced is at least partially a tacit endorsement of abortion. (Of course, most people have no idea how any meds/vaccines are made.) Though I do not have any kids of my own, if I did I would do the same thing as the mother in the second clinical scenario. My points for discussion are twofold: 1 1) As stated, I agree with the mother in the article’s second scenario. Thus, I as a PA also cannot in good conscience provide human fetal cell-derived vaccines to my patients. This includes MMR (rubella is the problematic part), varicella, and Hep A, as described in the article. How can I be honest and upfront with my patients without being confrontational or offensive? How about with potential employers? With fellow practitioners? 2 2) This scenario would be a non-issue if vaccines were all produced without using human fetal cells. It’s possible—there are some available in Japan, but they’re not available here in the U.S. How can physicians/PAs/other medical professionals play a role in the development, manufacture, and/or promotion of new pharmaceuticals? I’m talking both about alternatives to fetal cell-derived therapies and about other pharmaceutical issues as a whole. Writing to the CDC and drug companies to express one’s concerns is a start, but is there anything else in the medical world that can be done? Advice from anyone who has thought about or been involved in these things?
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