s Vaccination Warfare - With Already High Rates What is the Issue? | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Vaccination Warfare - With Already High Rates What is the Issue?

Neil Johnston

articles by this author...

Neil Johnston is a pharmacist who trained as a management consultant. He was the first consultant to service the pharmacy profession and commenced practice as a full time consultant in 1972, specialising in community pharmacy management, pharmacy systems, preventive medicine and the marketing of professional services. He has owned, or part-owned a total of six pharmacies during his career, and for a decade spent time both as a clinical pharmacist and Chief Pharmacist in the public hospital system. He has been editor of i2P since 2000.

Warfare has escalated between anti-vaccination groups and GP’s, as a significant number of doctors are refusing to sign forms to enable people to collect government tax benefits while their children remain unvaccinated.
In NSW it is a legal requirement for a parent to have a GP signature on a “vaccine-refuser” form before their children can be enrolled in childcare establishments.
Doctors are claiming that their patients are adopting bullying tactics while patients are claiming that doctors are showing disrespect towards their conscientious objection, and that they will report non-cooperating doctors to the relevant authorities.

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It is a bit like the predicament that some pharmacists experienced when asked to supply the “morning after” pill when unprotected intercourse put women at risk of an unwanted pregnancy.
That process was also a matter of conscience, but was resolved when pharmacists began to issue referrals to other pharmacists who were willing to make supply.
GP’s do not seem to be programmed to be able to create this simple procedure within their own practices, which represents a simple solution.

And compounding the process is the fact that the patients who complain the loudest are usually intelligent and articulate people who ask questions that health professionals don’t have the capacity to fully answer.
Questions like is the proposed vaccine safe?
Will the preservatives and antiseptics contained in vaccines cause serious side-effects?
Will multiple doses of different vaccines have an additive effect that can cause issues such as autism spectrum disorders?
Also, given the fact that major Pharma’s have a history of generating fraudulent evidence, can you point to specific safety information that is not tainted?

Dr Michael Vagg, a Clinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist at Barwon Health, published an article recently in The Conversation regarding second opinions and patient dealings with their doctors.
He is also a supporter of the Friends of Science in Medicine and a member of the Skeptics Society.
He wrote:
“In order to get the best outcome from a second opinion, it’s important to first negotiate the issues of power and autonomy in your relationship with your treating health professional.
As a patient, it is your absolute right to seek advice and to be in charge of what happens to your body.

Respect for autonomy is drummed into health professionals, because the power balance in the clinician-patient relationship is generally with the clinician. Too little autonomy, and you will feel like you are being patronised or given no say.
You should expect to be treated as a partner and collaborator in the process.
And your opinions and preferences should be respected and honoured, regardless of the option you choose to take.”

It is going too far for doctors to mandate their personal feelings in contentious issues and still maintain a trusting doctor/ patient relationship.
It is also going too far for government to legislate against patient or parental wishes.
As Dr Vagg clearly states “it’s your absolute right to seek advice and to be in charge of what happens to your body”.

Because of the complexity surrounding some medical issues it is probably time for consumers to negotiate a code of conduct with the medical profession, through their representative organisation.
Too many issues fall, on balance, in the favour of doctors and basic patient autonomy needs to be clearly spelled out.

Recent polling on this issue indicated that 54% of doctors will refuse to sign the anti-vax form on presentation to them, but 27% would sign if they had the opportunity to counsel the patient on the benefits of vaccination.

But is the rate of vaccination of children declining?
“No”; according to, representatives from the Commonwealth's Office of Health Protection, who told a recent Senate Estimates hearing that vaccinations were "very high in Australia".

* Rates were between 91% and 92% for kids aged one, two and five years.

* Just 1.4% of children had parents who had recorded a conscientious objection.

So if the number of parents that actually register as not wishing to have their children vaccinated is quite small as a proportion of all the children that are vaccinated – what is all the fuss about?

Return to home

Submitted by Peter Kennedy on Tue, 25/06/2013 - 14:18.

Jarrod is right, this article is grossly ill-informed and irresponsible to say the least.

Vaccination rates are plainly NOT high enough to prevent the outbreaks of diseases such as whooping cough which have repeatedly occurred in australia recently.

It is not compulsory for children to attend a child care centre. If you don't want your kids immunised, don't send them to a child care centre. Simple, there should be no dodgy excuses. The government certainly shouldn't be paying parents NOT to have their kids vaccinated and bullying doctors to support this monstrous idea. Even in the USA, home of 'small government" and the rugged individualist, if a child is not fully immunised, he is not allowed to enter any school. No ifs, buts or exceptions except for the extremely rare medical grounds.

Every one of the anti-vaccination myths/objections/questions the article mindlessly parrots, and many more, is fully and clearly answered/refuted by the Health Department's excellent booklet "Immunization: Myths and Realities", which is freely available to everyone at the click of a mouse. And any competent GP should know these facts off by heart anyway without having to look them up.

Some (not all) pharmacists who decline to supply the morning after pill may refer enquirers to another pharmacy, but they are not COMPELLED to do so, nor should they be. Nor should doctors who don't believe there are valid reasons for non-vaccination of a patient be compelled to sign vaccination exemption forms nor to refer people to another less principled doctor who will sign anything anyone asks him to as long as he gets his consultation fee from Medicare.

Submitted by Jarrod McMaugh on Tue, 18/06/2013 - 19:15.

Neil, the fuss is that while the average vaccination rate is high, in some areas of Australia, vaccinations rates are not high at all. This fact is hidden by country-wide reporting of statistics rather than regional reporting of statistics.

In addition, you are misrepresenting a few things here.

Firstly, the government is not legislating that children must be vaccinated, only that they cannot participate in government subsidised child care if they are not.

Secondly, doctors are not being over-bearing in their aim to vaccinate children, or to refuse to sign vaccination-refusal forms. They are in fact following their duty of care to ensure that patients are fully informed about their choices, and in most cases signing a form just because the parent demands it is not fulfilling their obligation to their patient.

Lastly, including a comment about Autism in an article about vaccination is beyond irrelevant, with the links to this condition from vaccination well and truly debunked. Including it in your article demonstrates that you are actually out of touch on this issue

Submitted by Neil Johnston on Fri, 28/06/2013 - 22:28.

Hi Jarrod,
Thank you for commenting on this article.
Re the vaccination rate - I well understand that there are a few pockets of low vaccination rates, because I actually live in one of them (Northern Rivers, NSW), home of the AVN.
Not that I belong to that group or have any contact with them - but they area an example of educated and articulate people who are capable of thinking for themselves, and as such are very much involved in vaccine refusals.
So the question I asked as to why the fuss still remains because their right to refuse is being attacked.
That is not democratic and on those grounds they have my sympathy.
I take your point that I have erred in respect of government legislating for mandatory vaccination. This is not the case but difficulty is created for patients by legislating for removal of government benefits in areas of childcare.
More discriminatory than mandatory.
A recent doctor survey indicated that a majority would not sign a "refuser form" but if the opportunity occurred to interview and "educate" the patient the figure became 29 percent would sign.
That indicates that some (not all) are following a duty of care.
And finally, if you review my article regarding the question of autism you will note that this is one of the questions asked of me as a practicing pharmacist, not me pushing this line to fellow-pharmacists.
However, that question still has some unsatisfactory professional elements, but I will address that in another future article that will address "beyond irrelevance"
Thanks anyhow for opening up some rational comment on these issues.
Regards, Neil.

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