Antivaccine activists rally around “Dr. Bob” Sears. Hilarity ensues.

As regular readers know, last Friday I was quite happy to relay the news that the Medical Board of California had finally acted against a rock star among the antivaccine movement, namely pediatrician “Dr. Bob” Sears. Dr. Sears (or Dr. Bob, as he likes to be called) rocketed to prominence among the vaccine-averse and downright antivaccine by writing a book called The Vaccine Book: Making the Right Decision for Your Child. It’s a book that Dr. Bob and his sycophants, toadies, and lackeys portray as being a “middle ground,” complete with an “alternative” vaccine schedule to the one recommended by the CDC that spaces out the vaccines, allegedly to lower risks (including the risk of autism). More recently, Dr. Bob has become one of the most outspoken opponents of SB 277, the recently implemented California law that eliminates nonmedical exemptions to school vaccine mandates, likening it to fascism and the Holocaust. More recently, Dr. Bob has decided to profit by selling dubious medical exemptions using an online form, which is part (but no means all) of the reason he now finds himself in trouble with the Medical Board. (For a more detailed description of Dr. Bob’s woes, check out my post and Tara Haelle’s news story.)

In reality, Dr. Bob’s “alternative” vaccine schedule is based on no science or on science misinterpreted and serves mainly to pander to the fears of the vaccine-averse and antivaccine, in reality making children less, not more safe. In the process, it repeats many antivaccine tropes, such as claims that doctors don’t understand vaccines, vaccine-preventable diseases aren’t so bad (misinformation that Dr. Bob recently doubled down on in the wake of the Disneyland measles outbreak in 2015), that regulatory agencies are corrupt, that “natural” immunity is better than vaccine-induced immunity, that vaccine safety testing is inadequate when vaccines are tested even more rigorously than most drugs, and that vaccines have eliminated disease but at the price of all sorts of chronic diseases, like diabetes, multiple sclerosis, eczema, and, yes, autism. In making such claims, Dr. Bob completely ignores the vast corpus of evidence that has failed to find a link between vaccines and these diseases. In the process, he ignores context, misunderstands risk, butchers science, and confuses correlation with causation. Even worse, in his book he basically tells parents who don’t want to vaccinate to “hide in the herd,” implicitly admitting the reality of herd immunity by telling them not to tell their neighbors about their fears of vaccines, lest those parents become afraid too and fail to vaccinate, leading to further degradation in herd immunity and increased risk of measles in the unvaccinated. Basically, Dr. Bob cynically urges vaccine-averse parents to mooch off the herd immunity maintained by those who do the responsible thing.

So Dr. Bob is in hot water with the Medical Board of California over his failure to do a proper neurologic examination on a toddler suffering headaches two weeks after reportedly being hit in the head with a hammer, for writing a letter supporting a medical exemption from vaccine mandates for that same child based on reasons that aren’t what any competent physician would call evidence-based, and for keeping crappy office records. Good. Predictably, however, even though the hard core antivaccine whackosphere views Dr. Bob as far too moderate in that he actually admits that vaccines can work (although he gains points for comparing SB 277 to the Holocaust), the usual suspects are circling the wagons, defending Dr. Bob, and lashing out at his critics in general and the Medical Board of California in particular. It looks very much like the tactics used by Stanislaw Burzynski’s followers.

That’s why it both did and didn’t surprise me to learn that Sears has engaged the services of Burzynski’s ex-lawyer, Richard Jaffe to defend him:

“I represent Dr. Bob Sears in the California Medical Board’s case against him for writing a medical exemption from vaccination.

We take the board’s accusation seriously. But this case is very clear: this child had two unusual and severe vaccine reactions and his situation warranted a medical exemption. To continue vaccination could have put the child at risk of further harm.

All physicians have an ethical duty to do no harm to a patient. This is no less true when a child suffers serious side effects from any medical intervention.

We anticipate this case will do much to further public education on the importance of recognizing severe vaccine reactions and providing informed consent for medical care. ”

Oh, goody. This will be at least entertaining. Jaffe, you’ll recall, is the guy who came up with Burzynski’s strategy for overcoming the FDA in the 1990s by having him apply for 72 clinical trials that allowed him to do whatever he wanted with antineoplastons. He also pioneered the cynical strategy of using patients as shields and weapons against authorities trying to bring Burzynski to heel. We can look forward, I’m sure, to the same tactics as were used for Burzynski, this time substituting autistic children for children dying of brain tumors. I’m not sure it’ll work.

What will work, I’m sure, is Dr. Sears’ fundraising. He (or Jaffe) has started a site, Stand With Sears, begging for money for his legal defense fund, the funds of which will be used thusly:

The time is now to help Dr. Sears! Please consider giving a monetary gift to help fund his legal defense. This fight will likely be time consuming and financially draining. Your support is greatly appreciated. Dr. Bob has never hesitated to stand with us for Health Freedom. It’s time for us to stand with him! #standwithsears

The best way to pledge your support is to send your gift payable by check to the address listed below. This is NOT a donation. It is a GIFT. Make your check payable to Dr. Bob Sears. Please make sure your return address is printed on the check or envelope so that acknowledgement of your gift can be mailed to you. All funds will be used for Dr. Sears’ legal defense. Any remaining funds will be applied to Health Freedom Issues to be determined at the sole discretion of Dr. Sears.

Now, I’m not an accountant or a lawyer, but this whole thing about how this is a “gift” and not a “donation” coupled with the emphasis on how a personal check sent to his personal address is the “best” way to help him raised red flags and got my skeptical antennae a’twitchin’. Maybe someone can fill me in here. I’m guessing that because Dr. Bob doesn’t have a charitable organization to give to and hasn’t set up a formal fund, he’s asking for direct gifts. The bit about how any remaining funds can be used however Dr. Bob wants to use them also caused a raised eyebrow. In any case, legal defense funds are usually set up for people who are not well off and for whom legal expenses of an action brought against them threaten their financial status to the point of the possibility of bankruptcy, such as when a blogger is sued for libel. I know Jaffe isn’t cheap, but Dr. Sears is loaded. He should be able to afford his own damned legal defense.

Be that as it may, it didn’t take long for that antivaccine quack defender of antivaccine quack defenders, Levi Quackenboss, the same woman who viciously went after a 12-year-old boy who posted a pro-vaccine video mocking the antivaccine movement and then retreated when things got to hot, to jump into the fray. First, she claims to “explain” the charges against Dr. Bob. Let’s just put it this way. It doesn’t take long for hilarity to ensue:

The board’s first allegation wraps up by saying that Dr. Sears screwed up by not getting a history of the vaccines the boy had in the past, as well as the reactions that occurred from those vaccines. We don’t know whether the mother brought in a shot card that wasn’t copied into the Sears file, and we don’t know if her previous doctor refused to document the vaccine reactions, as we all know happens all the time.

The second allegation says that Dr. Sears failed to conduct a neurological test on the boy two weeks after his father allegedly hit him with a hammer, in the incident that CPS closed . Does this mean Dr. Sears failed to see if the kids’ eyes tracked equally? How could they possibly know he didn’t do that?

The third allegation says that Dr. Sears failed to keep accurate medical records. Not just because there wasn’t a copy of the exemption letter on file, but because he didn’t document what exam he performed on the kid two weeks after being hit with a hammer.

And:

So that’s all they’ve got? That’s the whole charge? A two-year old case of loose record keeping? Clearly this is trumped up bullshit about a kid I’m guessing Dr. Sears could see was on his way to being on the spectrum and he wanted to lessen the severity of that diagnosis.

The Medical Board doesn’t know what testimony the mom gave to Dr. Sears, and they don’t know if Dr. Sears looked up his shot records in the California Immunization Registry. The Medical Board doesn’t know if Dr. Sears thought the hammer incident was fabricated, even though CPS obviously did, not that their opinion means anything. And what’s going on with the parents now? Are they divorced and the dad is going after the mom to vaccinate the boy, as we’ve seen hundreds of times in our circle? We’re supposed to believe that a mother who brought her son in for 5 sick child visits in 13 months waited two weeks for medical care after what the board thinks was a serious head injury? If the kid has got neurological damage now, my money is on it being caused by the vaccines, not the hammer.

Quackenboss seems oblivious to a rule in the medical field that was drilled into my head from my very first days on the wards as a third year medical student through my residency and even through to my career now as an established surgeon who’s been practicing independently since 1999: If it isn’t in the medical records, it wasn’t done. If it isn’t documented, it didn’t happen. Medical-legally, if you don’t document something relevant to a bad outcome it can come back and bite you in the posterior in court if the patient decides to sue for malpractice. As I was informed time and time again, one of the most common reasons physicians lose malpractice cases is inadequate documentation.

Quackenboss also seems oblivious to basic responsibilities of a physician taking on a new patient. Confronted with a new patient whose mother claims she had a serious vaccine reaction, the description of which by Sears in his records was described in the Board’s complaint as “shut down stools and urine” for 24 hours with 2 month vaccines that the girl went limp “like a ragdoll” lasting 24 hours and not himself for up to a week after 3 month vaccines. What would a competent and responsible pediatrician do, faced with this story? Would he take it at face value? Certainly not, and not because a clinician shouldn’t trust the medical history as related by the parent. It’s because you can’t assume how well any parent understands what’s going on, and whether she’s correct attributing whatever happened to her child to vaccines. Just because she believed vaccines caused whatever happened to her child does not mean that they in fact did. The responsible thing to do when accepting a new patient like this is to get a hold of the patient’s records from the previous pediatrician and examine them himself, particularly before altering medical management. Heck, ignore the question of vaccine reactions. It’s just good practice in general, when taking over as the primary care doctor of a patient, to get the patient’s previous records if at all possible from the previous doctor. If a woman comes to me and says she has breast cancer, I don’t disbelieve her but I can’t even begin to treat her without her records, including the biopsy report, her mammogram and ultrasound reports, as well as a disc with all her mammograms, ultrasounds, and other imaging studies. Even then, we not infrequently request the tissue slides for our pathologist to look over in order to make sure that we concur with the diagnosis. It’s just good medical care.

As for the head injury, Quackenboss, as usual, is full of it. In fact, her attempt to defend Sears by asking how the Board could know whether Sears did a proper neurological examination on the child when he saw her for her headache and learned the history is risible in the extreme. Basically, if it’s not in the chart, it is assumed that he didn’t do it, and no one would (or should) trust Dr. Sears’ memory of one patient among likely hundreds or thousands that he’s seen since then. That’s not a knock on Dr. Sears (although there is much to knock him for); it’s just the fallibility of human memory, that fallibility being the reason we need good record keeping in medicine in the first place.

The next part of Quackenboss’ defense is equally silly. (It is Quackenboss, of course.) She basically goes back to testimony during the debate in the legislature over SB 277 in which it was pointed out repeatedly that no one, including Dr. Arthur Pan, the California state senator who co-sponsored the bill, knew of any physician facing Board action over writing a letter supporting a medical exemption. Of course, the assumption was that these doctors were writing exemptions based on reasons that were at least close to being evidence-based. Dr. Sears, of course, was not, and he was sloppy about documenting the medical history and findings behind even his dubious reasons.

Finally, Quackenboss wrote one of the most hilarious things I’ve ever seen her write. It’s a post entitled Done playing nice. I laughed out loud when I read the title, given that Quackenboss has never played nice. But what does she mean this time? Something truly abusive:

Here’s the plan: if you’ve got a kid who became autistic, allergic, epileptic, or diabetic after childhood vaccines, you’ve got to file a complaint against that doctor. Gone are the days of being told it was a coincidence. No more will we quietly find a like-minded physician and transfer care. Today is the day to take the first step to standing up and saying, “What happened to my child was unacceptable, and it’s time they answer for it.”

So this is what Quackenboss wants antivaccine parents to do. First, she wants them to get their child’s medical records and go over them. Then:

Your child’s vaccine reaction is not documented? You don’t say! No mention of high pitched screaming? No concern about the blank stare? No neurological exam when the head circumference rocketed to the 90th percentile?

Did your doctor file a VAERS complaint like they are obligated to? Of course not.

All of this will go in your complaint to your own state’s medical board.

First of all, VAERS is not mandatory. It’s a voluntary reporting system. No one is “obligated” to report anything. Actually, that’s not quite true. Doctors are required to report so called “Table Injuries” (injuries on the Vaccine Injury Table used by the Vaccine Court for which reimbursement is basically automatic). Here’s a hint: Autism, diabetes, multiple sclerosis, and eczema are not Table Injuries, because the scientific consensus is that vaccines do not cause these conditions and diseases. So a physician is not obligated to report them, and no state medical board will discipline a physician for not reporting to VAERS conditions that are not on the Vaccine Injury Table. Just because Quackenboss thinks that autism, diabetes, multiple sclerosis, eczema, and whatever other conditions antivaccine activists blame on vaccines are “vaccine injuries” does not mean that they are, and just because she thinks these conditions must be reported to VAERS doesn’t mean that they must.

Also, anyone can report anything as a vaccine injury. (Remember the pro-vaccine parent who reported that a vaccine had turned him into the Incredible Hulk.) Parents don’t need a physician to report a suspected vaccine injury. If their doctor disagrees that their child’s illness or condition, whatever it is, is a result of vaccine injury, nothing’s stopping them from reporting it themselves. Perhaps Quackenboss is confusing child abuse with reporting to VAERS. In most states, physicians and other medical personnel are mandatory reporters. If they see evidence of child abuse they are legally mandated to report it. The same is not true of vaccines, although most physicians who see what they suspect to be a real vaccine reaction will likely report it. There’s the rub. What Quackenboss and her fellow antivaccine wingnuts believe to be vaccine reactions, such as autism, allergies, epilepsy, and diabetes are not vaccine reactions. We know this because, you know, science. It’s just that Quackenboss and her ilk don’t accept the science, which is why she urges her fellow antivaccine activists to file bogus complaints against their children’s pediatricians thusly:

Detail how your child reacted to vaccines, how you dutifully brought your child in only to have your concerns swept under the rug. Maybe more vaccines were given. VAERS was not contacted. If you asked your doctor to file with VAERS and they refused, include it. MAKE SURE TO MENTION HOW POOR THE MEDICAL RECORDS ARE IN REFLECTING THE DETAILS OF YOUR CHILD’S HEALTH. Then, the kicker. Tell them this doctor caused your child’s autism. Tell them the doctor caused your child’s food allergies. Tell them the doctor caused the epilepsy, caused the diabetes. They recklessly administered vaccines without an examination for vaccine fitness, and they violated the standard of care by continuing to vaccinate, failing to perform proper examinations, and giving terrible medical advice. Did you get kicked out when you tried to save your child’s life by stopping the vaccines? Tell the board your story.

I didn’t know whether to laugh or to cry when I read this paragraph. Quackenboss has it exactly backwards (as usual). It is not the standard of care to assume vaccines cause diabetes, epilepsy, autism, or food allergies, because there are mountains of evidence that have failed to find a link between vaccines and any of these things. The most parsimonious explanation for this is that there is no such link. Just because Quackenboss believes there’s a link does not mean there is one, and it does not mean that a physician who does not attribute a child’s autism to vaccines is guilty of practicing so far below the standard of care that the Board will act. Yet, Quackenboss hopes to get 5,000 complaints submitted against various pediatricians throughout the country by Christmas. I’d be surprised if she got many more than 50 or 100.

Even that, however, would be bad. Even though the first reaction of most state medical boards to such obviously bogus complaints will be to laugh at them, the law still mandates that they investigate. I know. A Burzynski fan once wrote a complaint about me to the Michigan Board of Medicine over a blog post I did discussing her case based on what she had posted about it on public forums. I got a letter from the board saying there was no reason for action, of course. Unfortunately, though, even though there was no action against me, that Burzynski fan’s letter at least wasted someone’s time. The complaints Quackenboss is soliciting are so obviously from cranks and so clearly dubious that they are highly unlikely to result in the action of any state medical board against any pediatrician or primary care doctor. They will, however, waste the time of an unknown number of people working for state medical boards, who are obligated to do at least an initial investigation to determine if a complaint has merit, time that could be better spent investigating real cases of physician malfeasance.

Hilariously, Quackenboss’s fans have taken up the challenge. One of them has started a website called Neglect report, which redirects to a Facebook page run by Educate: Advocate, based on the contact address listed in one of the comments:

Unlike the case with patients supporting Stanislaw Burzynski, all of whom were either patients with deadly cancers or their family members, where activism and complaints could turn public opinion against the FDA and regulatory agencies trying to protect the public, I rather suspect that Quackenboss is actually doing far more harm than good to Dr. Sears’ defense. The doctors and employees of state medical boards are human, and, like all human beings, they don’t take kindly to threats or to people retaliating against them for their doing their job. Quackenboss, in her anger, ignorance, and arrogance, is proposing a strategy far more likely to backfire spectacularly than to help Dr. Bob.

Such are the delusions of antivaccinationists.