Ask your doctor to sign this if he/she thinks Vaccines are safe

Ask your doctor to sign this if he/she thinks Vaccines are safe

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:
_____________________________________________________ ________________________
_____________________________________________________ ________________________
_____________________________________________________ ________________________
_____________________________________________________ ________________________
_____________________________________________________ ________________________
_____________________________________________________ ________________________
_____________________________________________________ ________________________
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
• 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
• sucrose
• 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. Reports to the contrary, such as reports that mercury thimerosol causes severe neurological and immunological damage, 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 give my assurance that the vaccines I employ in my practice do not contain SV 40 or any other live viruses. (Alternately, I hereby give my assurance that said SV-40 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 cells 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% 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% of patients who contract Hepatitis B develop no symptoms after exposure. I understand that 30% will develop only flu-like symptoms and will have lifetime immunity.

I understand that 20% will develop the symptoms of the disease, but that 95% will fully recover and have lifetime immunity. I understand that 5% of the patients who are exposed to Hepatitis B will become chronic carriers of the disease. I understand that 75% of the chronic carriers will live with an asymptomatic infection and that only 25% of the chronic carriers will develop chronic liver disease or liver cancer, 10-30 years after the acute infection. The following 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: ________________________


One thought on “Ask your doctor to sign this if he/she thinks Vaccines are safe

  1. Here is a correction to the sign this form made by very knowledgeable people in the know. I am not the one who found the mistakes, and I thank God there are people out there who look out and make sure the information provided is legitimate. I have XXXX the names and snipped identifying information because the last thing I want is anyone to be harassed for getting even more truth out there. *****Subject: Re: Physicians Warranty of Vaccine Safety.docDate: 4/22/2008 9:42:02 A.M. Pacific Daylight TimeFrom: XXXXReply To:To: XXXXCC:XXXXXXXXIn general, I enjoyed reading this and would be delighted to see a physician actually comply. 😉I noticed a few minor things and think the paragraph on hepatitis needs checked and possibly re-written.My nit-picks are posted below.XXXXphenoxyethanol (antifreeze) suggest you remove the (antifreeze) (see below)mercury thimerosol change to mercury in thimerosolSV 40 change to SV-40 (one place)50% of patients who contract Hepatitis B develop no symptoms after exposure. (check, think this is 90% and the other % in this paragraph???)Exhibit D , attached hereto, “Non-vaccine Measures to Protect Against Risk Factors.”Think this is Exhibit E not Dphenoxyethanol seems to be similar but not identical to Ethylene Glycol that is used in antifreeze. few names for 2-Phenoxyethanol# Ethylene glycol monophenyl ether# Ethylene glycol phenyl ether# Phenoxyethanol# Polyethylene glycol phenyl ether# Polyoxyethylene phenol ether# Polyoxyethylene phenyl ether# Spermicide 741 Safety data for 2-phenoxyethanolMolecular formula: C8 H10 O2 glycolMolecular formula C2H4(OH)2


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