A Vaccine Form You Can Give to Your Paediatrician

A Vaccine Form You Can Give to Your Paediatrician

Postby Veronica » Mon Jun 15, 2009 4:26 pm

Subject: Vaccine Form to give to Dr. this is GREAT!!!!!

Want assurances from your paediatrician about vaccines? Here's a form designed by Ken Anderson you can give them to fill out -- although there is no physician anywhere on earth who will sign it. (American, of course, but could fairly simply be converted to the UK)

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: ______________________
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Re: A Vaccine Form You Can Give to Your Paediatrician

Postby Farmer » Mon Jun 15, 2009 4:31 pm

This is excellent.
If you're scared of 'them' poisoning 'us' with some shit then maybe you haven't noticed the shit they are already poisoning us with.
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Re: A Vaccine Form You Can Give to Your Paediatrician

Postby IamallthatIam » Mon Jun 15, 2009 7:07 pm

Most execllent.

Copied, pasted, ammended and ready to go.

Ash is at the age where it is expected that he be poisened with the BCG vaccine and Tia will be handing these out to the parents that are due to get a leaflet urging them to immunise against Measels , Mumps and Rubella as it is doing the rounds in the nursey she is working in, so thank you very much for passing it on V!!
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Re: A Vaccine Form You Can Give to Your Paediatrician

Postby Veronica » Mon Jun 15, 2009 7:22 pm

Yes, Angie.

You will let me know if you can find a doctor to sign it ... won't you? :grin:

(Mandatory vaccinations? Not a fucking chance, mate!)
Freedom's just another word for: "Nothing left to lose" (Janis Joplin)
"There is no path to peace, peace IS the path" (Mahatma Ghandi)
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Re: A Vaccine Form You Can Give to Your Paediatrician

Postby Happydancer » Mon Jun 15, 2009 8:57 pm

I think this should have some slight changes done to it, so that it corresponds to
the British Isles.
Then upload it as a template.
I also have copied and pasted and will make the changes myself.
This is a great help to me as I have three kids.
Fantastic find V.
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Re: A Vaccine Form You Can Give to Your Paediatrician

Postby shemayah » Mon Jun 15, 2009 9:49 pm

This is what I Love about this Forum ....

Fantastic ... Thank you, Thank you, Thank you !!!!
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Re: A Vaccine Form You Can Give to Your Paediatrician

Postby free_spirit » Sun Jul 12, 2009 12:39 pm

Happydancer wrote:I think this should have some slight changes done to it, so that it corresponds to
the British Isles.
Then upload it as a template.
I also have copied and pasted and will make the changes myself.
This is a great help to me as I have three kids.
Fantastic find V.
Pete


Cool can you post it as changed for the less minformed of us ty.

James
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Re: A Vaccine Form You Can Give to Your Paediatrician

Postby free_spirit » Sun Jul 12, 2009 12:42 pm

Veronica wrote:Subject: Vaccine Form to give to Dr. this is GREAT!!!!!

Want assurances from your paediatrician about vaccines? Here's a form designed by Ken Anderson you can give them to fill out -- although there is no physician anywhere on earth who will sign it. (American, of course, but could fairly simply be converted to the UK)


Thanks for that Veronice, as a side note I'm reading the pdf version of your book,absolutely rivetting and exciting. I shall try and get my daughters to read it. I will also be ordering a hard copy.

Many Thanks Veronica

James
WAKE UP PEOPLE OR ELSE ON YOUR DEATH BED YOU WILL BE THINKING, WHAT THE F**K WAS ALL THAT ABOUT
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Re: A Vaccine Form You Can Give to Your Paediatrician

Postby Tom Bombadil » Fri Jul 24, 2009 2:04 pm

I have read the form and have noticed many spelling errors that need adressing before a uk doc or the like would even want to think of signing it.

Remember that some US words are spelt differntly from the uk ones.

Another form for your head master to sign would be nice too. They (the school) would need an insurance waver that does not bring blame to the school, given them by the gov. We need to get around this somehow too.


Hello all by the way. First time poster. Same tom bombadil as on 'other' fourums :8-):


I will try to get it right at all times. TRY! I said!
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Re: A Vaccine Form You Can Give to Your Paediatrician

Postby dognamedblue » Fri Jul 24, 2009 2:17 pm

fantastic stuff!

(I wouldn't mind a UK version for adults too)
many thanks
a-m:d
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