Washington State Law allows vaccine exemptions on the basis of religious, philosophical, or personal reasons; therefore, immunizations rates are considerably lower (85%) compared to states where exemptions rules are tighter. Immunization rates are directly proportional to the narrow scope of state vaccine exemptions laws. Immunization rates are used to “rate” the primary care physician despite the fact we have little influence on the outcome according to scientific studies.
After reviewing more than 100 EOB’s personally, a clear and definitive pattern of fraud emerges demonstrating GEHA makes every single patient responsible for $50-100 in out-of-pocket costs for immunizations. Language in our GEHA contract clearly states we must follow their specifications according to each EOB we receive.
How far should a medical director of a large scientific institution be allowed to veer off the path of mainstream medical science? A medical doctor employed at a large, prestigious medical institution has an obligation to his patients, his colleagues, and the general public at large.
So what does this mean exactly? Most likely the mumps portion of the MMR vaccine is less effective in the Marshallese population in particular due to some genetic difference in their immune response. It is also possible this virus is “drifting” by changing a protein here or there or an H or N molecule as similar to the influenza virus. So all in all, there are likely small changes in the natural mumps virus altering the landscape for everyone; however those with Marshallese background are naturally more susceptible.
Every year when this child comes in for an annual check-up, I think back to the moments when I seemed like both hero and villain. This fragile infant recovered and has grown into a young man. It is important that physicians be intelligent, caring, empathetic, and work hard, but sometimes timing can make all the difference. While I do hope my future holds more days as a hero than a villain, this young man is a constant reminder for me to be grateful to those parents who place their precious children in my loving hands.