Submitted by
Alice on July 28, 2014

The
average person that consents to a vaccine injection, either for
themselves or for their children, genuinely believes it is for the
betterment of health. What they are not aware of is that even their
doctor is likely unfamiliar with the toxic ingredients contained in
vaccines which can immediately begin to degrade both short- and
long-term health.
If your doctor insists
that vaccines are safe, then they should have absolutely no problem
in signing this form so that you may archive it for your own records
on the event of an adverse reaction.
The reality of vaccines is that they are a far greater risk to human
health than benefit and always have been. In fact, two centuries of
official death statistics show conclusively and scientifically that
modern medicine is not responsible for and played little part in
substantially improving life expectancy and survival from diseases
in developed nations.
In North America, Europe, and the South Pacific, major declines
in life-threatening infectious diseases occurred historically either
without, or far in advance vaccination efforts for specific
diseases.
Whenever I personally inform medical doctors of these realities,
many of them are quite shocked with the data. That’s not surprising
considering the fact that medical students are still brainwashed
that vaccines immunize which is a myth in itself, since natural or
“real” immunity can never be artificially induced by a vaccine.
Other misinformed educators also still rely on the myth of herd
immunity which is nothing short of medical fraud. It is a shame and
embarrassment that brilliant students are deceptively led down the
path of ignorance every single year at prestigious medical
institutions in the hopes of obtaining an education. These students
then become the physicians of a good percentage of the population.
One of the problems we have in a society filled with misinformation
about health, is that people sit on the fence. They want to conform
to the societal norms ingrained in our minds about conventional
medicine, but they also want to stand up for their beliefs and
conscience. These fence sitters are made up of those who understand
that current vaccination practices are unsafe, yet somehow also
believe you can make vaccines safer or more effective. That is where
we have to shift the opinions of those who are on the fence and have
them fall off on the side of natural health rather than conventional
medicine. See my article When It Comes to Vaccines, Don’t Sit On The
Fence!
I have previously written that if your doctor cannot answer these 4
questions, don’t vaccinate. Well, if your doctor does make an
attempt to answer these questions and a verbal response and
statement is not satisfactory for your own peace of mind, then your
doctor should be at least willing to provide you with his or her
personal declaration of the safety and efficacy of the vaccines he
or she (or attending physician or nurse) is about to inject in your
or your child’s body. Effectively, this becomes your doctor’s
warranty that the risk factors he or she has identified justify the
recommended vaccinations with the benefits exceeding the risks.
Physician’s Warranty of Vaccine Safety Form
The following form was adapted from Ken Anderson’s original. Perhaps
you can find a physician that will sign it because I have no record
of that ever happening:
Download PDF English
Physician’s Warranty of Vaccine Safety
Download PDF Espanol
Garantia Medica para la Seguridad en las Vacunas
PHYSICIAN’S WARRANTY OF VACCINE SAFETY
I (Physician’s name, degree)_______________, _____ am a physician
licensed to practice medicine in the State/Province of _________. My
State/Provincial 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 __________________________
I am aware that vaccines may contain many of the following
chemicals, excipients, preservatives and fillers:
* aluminum hydroxide
* aluminum phosphate
* ammonium sulfate
* amphotericin B
* animal tissues: pig blood, horse blood, rabbit brain,
* arginine hydrochloride
* dog kidney, monkey kidney,
* dibasic potassium phosphate
* chick embryo, chicken egg, duck egg
* calf (bovine) serum
* betapropiolactone
* fetal bovine serum
* formaldehyde
* formalin
* gelatin
* gentamicin sulfate
* glycerol
* human diploid cells (originating from human aborted fetal tissue)
* hydrocortisone
* hydrolized gelatin
* mercury thimerosol (thimerosal, Merthiolate(r))
* monosodium glutamate (MSG)
* monobasic potassium phosphate
* neomycin
* neomycin sulfate
* nonylphenol ethoxylate
* octylphenol ethoxylate
* octoxynol 10
* phenol red indicator
* phenoxyethanol (antifreeze)
* potassium chloride
* potassium diphosphate
* potassium monophosphate
* polymyxin B
* polysorbate 20
* polysorbate 80
* porcine (pig) pancreatic hydrolysate of casein
* residual MRC5 proteins
* sodium deoxycholate
* sorbitol
* thimerosal
* 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 thimerosal 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: ______________________
=================================================
I’m really anxious to hear back from any readers whose doctor
decides to sign this document in an effort to satisfy your peace of
mind. I also have a lengthy list of legal professionals who are very
curious as well.
Source(s):
preventdisease.com
Health Freedom Alliance
Health & Wellness Foundation
CHAD Foundation
http://www.
http://www.healthfreedoms.org/before-vaccinating-your-children-demand-your-doctor-sign-this-form/