You ask why I am anxious, why i am depressed, let me list for you the reasons why:

Global warming
Melting glaciers
Heatwaves
Polar vertices
Category 6 hurricanes
F5 Tornadoes
Droughts
Desertification
Floods
Wild fires
Snowless winters
Ice free arctic
Antarctic ice shelf collapse
Greenland glacier melting
Perma forst thawing

Ocean warming
Ocean acidification
Coral bleaching
Sea level rising
Coastal erosion
Over fishing
Fisheries collapse
Plankton extinction
Fertilizer run offs
Chemical pollution
Raw sewage dumping
Red algae blooms
Vibrio explosions

Ozone layer depletion
Lack of fresh potable water
Acid rain
Top soil depletion
Dead soil
Deforestation
Banana palm tree cultivation
Evasive species
Overpopulation
Urban sprawl
Insect apocalypse
Animal extinction
Lower biodiversity
Bird apocalypse
Bee apocalypse
Bat apocalypse
Amphibian apocalypse

Aging nuclear power plants
Superfund sites
Radioactive contamination
Three mile island, Chernobyl, Fukushima
Endocrine disrupters
PBAs
Autism
***** count collapse
Effeminization of men

Noise pollution
Light pollution
Chronic stress
Diabetes
Metabolic diseases
Over eating
Obesity

Drug resistances
New and emerging diseases
Epidemics pandemics
Swine and bird flu
Genetic modification
Biotech tech
nano tech
Crispr
DNA
genetic testing
Designer babies
Aging population
Health care rising
Unaffordable medications
Uninsured
Medicare of all
Medical bankruptcy
Social security bankruptcy

Rise of terrorism
Rise of extremism
Far right
Alt right
Lack of education
Masculine identity crisis
Emasculation of men
Decline of boys
Rise of girls

Increasing depression and anxiety
Increase anxiety depression among young girls
Lack of human connection
Social isolation
Social awkwardness
Snowflake generation
Disintegration of the family
Suicides
Social media addiction
**** addiction
Drug addiction
Alcohol addiction

Lack of equality
Political corruption
Kleptocracy
Corporatocracy
Plutocracy
Oligarchy
New American aristocracy
Too big to fail
Privatize profits, socialize losses
Decline of democracy
Fascism
Terrorism
Religious extremism
Religious tension
Political divisiveness
National unity
Second American civil war
Helplessness of the common man

Big data
Data protection
Algorithms
Internet tracking
Lost of privacy
Artificial intelligence
Singularity
AI white collar job lost
AI automation
AI back office
Autonomous AI
5G supremacy
Quantum computer supremacy
Virtual reality
Augmented reality
Cybernetics
Chronophobia
Outsourcing
Off shoring
On shoring

Over education
Under employment
Skills gap
3rd world immigration
La reconquista
Cultural dilution
Status quo
Declining economies
Housing crisis
Housing cost
Homelessness
Illiteracy
Hunger
Unemployment
Full employment
Racism
Intolerance
Race relationships
Increasing crime
Student loans
Credit card debt
High mortgages
7 year car loans
Inverse yield curve
52 week high

Wars
Military interventions
Social uprisings
Dwindling resources
Resources conflicts
Rare earth metals
Depletion of helium
Peak oil
Fracking
Water wars
Climate refugees

pompeii runs through our veins,
hot with the taste of ash & decay.

some of us are fortunate enough to
become ruins; others are ruinous,
sepulchers of epidemics, air-born, contagious.
a disease that could make London a cemetery.

we dress ourselves up like relics, clothed
in silk and gold and gossamer,
as if they could one day be armor.
as if they could bring us safety.
as if we deserve such things when everything we touch rusts.

it takes only twenty-two years for the
average person to realize they are a weapon.
that words are knives and actions are razor blades,
as if to remind the living that we
came into the world screaming—
and we have never been silent since.

we are the Morrigans, the cursed women,
those whose destiny is entwined with death.
we court death, invite her to our dinner table every night,
let her sleep in the guest room, leave the doors and
windows unlocked for her.

death, we realize as women forced to bear
the weight of the dead on our shoulders,
never comes as a thief.
she comes as a lover, smelling of lilac, a grin
too white and too large to be human.

still, we invite her in,
because even death, regardless of form,
makes for better company than the empty dark.

Let's hear it for vaccines, my dears,
The 'anti' movement's  in full sway here,
Now there's measles in Melbourne, no cheers,
Summer epidemics, the parents' fears,
Let's hear it for vaccines, my dears!

Assisted suicide?
Physician Assisted Suicide is the process of a doctor providing the necessary sleeping pills/lethal dose to allow a terminally ill patient to perform the life ending act. In the United States, all but four states have made physician assisted suicide (PAS) illegal.When in a situation a terminally ill patient is in, they should have the right to commit a physician-assisted suicide.
In 1994, the state of Oregon enabled the Death With Dignity Act (DWDA). With 51% voting in favor of the act, it gives terminally ill patients access to PAS. Attorney General John Ashcroft challenged the act by saying it was not “real” and that allowing doctors to do perform that, violates the Controlled Substances Act (CSA). CSA protects the regulation of doctors from performing unauthorized distributions of drugs and drug abuse. If doctors are able to assist suicides, through Ashcroft’s claim, they would be using drugs as an abuse. In the Supreme Court, petitioner Paul D. Clement argued in the case about the violation of CSA, with 6-3, “we conclude the rule is not authorized by the CSA, and we affirm the judgment of the Court of Appeals” (Gonzales V Oregon).
Patients of irreversible illnesses often develop disorders that go underdiagnosed causing them to live a life that isn’t happy for them or their family members. According to Dr. Fine of the Office of Clinical Ethics, terminally ill patients usually get depressed when dealing with intense suffering. When the patient is depressed, they may not respond to treatment as expected. If the patient is not responding to treatment well, the doctor may up the dosage of medication or consider adding antidepressants, causing the patient to be reliant on medication for the rest of their life.
Patients who receive a terminal diagnosis usually experience high levels of anxiety.  According to Dr. Fine, anxiety can cause problems such as, agitation, insomnia, restlessness, sweating, tachycardia, hyperventilation, panic disorder, worry, or tension. Sleep deprivation plays a huge part in the anxiety the patients feel. The patient’s sleep is often interrupted many nights and several times to get their blood pressure checked, blood withdrawals, checkings of veins, etc. Because these medical requirements can not be withheld, many doctors may feel the need to heavily sedate the patient to make them feel lucid during the day time.
Studies have shown that patients of terminal illnesses fear that they’d burden their families. The patients feel, “grief and fear not only for their own future but also for their families’ future” (Johnson), researchers say. The feelings of being in the way can cause emotional, physical, social, and financial problems. In  doctors Johnson, Nolan, and Sulmasy’s research, they found that feelings of burden are most likely to affect emotional symptoms, quality of life, and patient satisfaction. Wanting to feel like they aren’t a burden to their families and society was most important to patients seen by the doctors. The research the doctors conducted found that out of a list of 28 qualities, the wish to not be a physical or emotional burden on family, 93% of respondents said that this was very or extremely important to them. The doctors made three categories of experiences that were related to “self-perceived burden” (Johnson). The first one being “concerns for other” (Johnson), then “implications for self” (Johnson), and last being “minimizing the burden” (Johnson). Feeling like a burden can cause “empathic concern engendered from the impact on others of one’s illness and care needs, resulting in guilt, distress, feelings of responsibility, and diminished sense of self” (Johnson).
To let a patient commit an assisted suicide means, they’re freed from pain. To force someone who knows that their time's coming to an end quickly when they do not wish to be in pain anymore should be a crime. In Epidemics, Book 1, it states, “practice two things in your dealings with disease: either help or do not harm the patient”, by allowing the patient to continue their life is harming them, all physically, mentally, and spiritually. Doctors take an oath, the Hippocratic Oath when practicing medicine. In the oath, there is a phrase that says “Also I will, according to my ability and judgment, prescribe a regimen for the health of the sick; but I will utterly reject harm and mischief”, if the patient has considered an assisted suicide, they’ve been in too much pain and wish for it to end. Refusing them the help causes them more physical and emotional pain; physical being the illness itself and emotional being the feeling of being a burden.
Patients with terminal illnesses have the right to commit assisted suicides because it allows them to end their life from something no drug would be able to fix. With the illness being irreversible, dragging it out will cause both suffering and financial problems. Terminally ill patients have the right to die with dignity. Dying by choice will let their loved ones know that they are ready and have accepted their fate, easing weight off their families shoulders. Having the ability to die will portray the patients as human beings who want to make one last decision before going rather than people who are laying in a hospital bed waiting to die. A patient knows that the doctor’s job is to relieve pain, with a doctor refusing their wish, only cause distrust in their relationship. Letting assisted suicide would allow their families to begin healing. By refusing the patient their right to die, forces them to live a poor quality of life no one would ever wish upon anybody. It is in everyone’s interest to let them go. Doctors have a responsibility to make the patient happy and to relieve them of any kind of pain, letting them go is relieving them of the pain they wish to no longer feel. PAS gives them the ability to go happily and contently.

Have you ever been to Nairobi?
What did you see there?
Buildings, people and vehicles?
Uhmmm! Let me share with you my case
Hence I was there yesterday,
And I saw wonders of life;
Jubilant politicians clashing for tyranny,
At the Nairobi parliament,
Making anti-human laws,
Under faked canopy of de-terrorization,
With no tincture of surrender to open truth,
That; in juvenile states like Kenya,
Corruption is a minefield of terrorism,
Corrupt management of state organs;
The policemen and state spies,
Hired on full back-up of corruption,
Gives leeway to thriving of terrorism,
As a security agent hired nepotistic-ally,
Will never fight terrorism with a knack,
Leave police work to policemen with passion,
Not to your kinsmen and loyalists in politics,


I saw jubilant politicians high on nerves,
Excited like a swine on ****** heat,
Or they were possessed by the evil spirit,
Or crushed by the African cult of dictatorship,
Where humanity derives pleasure from political pains,
Scornfully viewing humane governance,
As dictatorship will fortunately give a bloom,
Of swift doors and windows of corruption,
Primitive accumulation of filthy wealth,
And apotheosification of the worthless self,
Into a lull of blind self-made god-ship

I saw a jubilant politician going pugnacious,
Forcefully restoring dark days of Toroitich arap Moi,
Making a law which a monkey cannot make,
Hitting a fellow politicians,
With all might and knack of a devil,
Shredding into laces the trouser of a colleague,
Exposing red lingerie of the fellow colleague,
Partially exposing the tools of child making,
Only to the positive chagrin of us all,
On discovery of the circumcised *****,

I saw jubilant dictator-maniac politicians,
Passing a law of shooting to death,
Him the police feels may be a terrorist,
Or detain at pleasure, without trial
Him that looks ugly like a terrorist,
A suspect is a snake to be crushed the head on sight,
But not all snakes are poisonous Mr. Politico-Jubilant,
Some are ornamental and others poisonously harmless,
Even snakes need fair trial,
Just like suspect of genocide,
Before the international criminal court,
Before a blow of hammer crushes their heads,
Let me ask you my dear reader,
A foolish question as usual;
What are snakes to the jubilant politics of Nairobi?
A political non loyalist who perhaps can chide,
The powers that be from their gusto of power,

I saw jubilant politicians in full gear of idiosyncrancies,
Passing the law to gag friends of the poor,
The NGO’s; the poor man’s uni-source of hope,
They have been relieving the poor man of Kenya,
From horrendous traditions of   epidemics,
In Turkana, Budalangi and marginalized Mandera,
Helping men and women of these areas to be free,
From tyranny of perennially missing basic needs,
This freedom is now thwarted,
Lest it gives these poor men right of speech,
Thwarted artfully in the **** of NGO’S,
Through false label of the time,
That they play *** with terrorist groups,
What a big a lie?

By
Alexander Khamala  Opicho,
Eldoret,Kenya

Merging the surges.
Converging the urges.
Surveying and delaying.
A brutally soft touch.
A swift tug.
Scramble to the rug.

Hop, twirl, stamp.
Intrinsic epidemics.
Employing harsh thoughts.
Enjoying warm laughs.
Instant confusion.
Undeliberate actions.
Sub-consciencely projected.

Magnified emotions.
Disrespectful conclusions.
Foundations laid, entrusted.
Irrigation failed, erupted.
Defied by fate.

I went for an X-Ray the other day. My name was called
and after the expected delay, I heard a nurse say
Right knee? I said Yep! She said “Come this way…
Can you get your trouser leg up to your thigh"?
I said “No… these skinny jeans don’t go that high”.
“In that case” she said looking me up & down... with a frown
Pop in that cubicle… and put on this gown!

For a start…it took me ages to get these trousers off…
and force the rest of my stuff into the carrier bag supplied
and then, when I saw the gown, I very nearly died!
It would have fitted me just fine if I’d been 18 again
but the gaps and bulges in the thing were a farce...
and allowed everyone in the corridor to see my fat 71 year old ****.

I said out loud when I sat down again in the queue
“You know…I had an inferiority complex before I met any of you.
But this has definitely taken me down a notch. And I apologise about the view”.
However, inside the X-Ray room with all the techie kit and Radiographer Rob,
I felt better… The pain in my knee had almost gone apart from a distant throb.
Then he said “You’re completely safe, just lie back calm, quite still…serene”.
Whilst he clicked the shutter from the other side of his lead lined screen. (So he was alright then!)

Well, I’m home again now, hobbling about… It’s bearable (not like childbirth ladies) but not great.
I’m sitting here with my leg up waiting for the letter that will let me know my fate.
Ah yes… men and pain! There is a well know fact about the differences between the sexes.
It’s proven that, with men, colds become flu…and ailments:- epidemics… (No really!)
So, here’s the letter… Now...will it be Ointment? Physio, to transform a permanent slouch?
Or a keyhole flush with a catheter? Or - Oh no!…
For me - it’s a titanium replacement knee!… Ouch!

Somebody pass me that gown!!!

There has to be more to life
than the elaborate mix
of endorphin, serotonin and dopamine.
There has to be more to this moment
than that seductive dance
between fight, flight and adrenaline.
There has to be more to each instance
than the tantalizing stroke of color on the palette of the eye
or the soothing spice of music that brings us to sighs.
More to it than the anticipation of a lover's caress,
or the murmur of a long forgotten scent.
More to it than the cringing from death,
the constant race from pain,
fear
of cigarette smoke, radiation,
gluten and epidemics.
More to it than tears and kittens,
Bougainvillea bushes and hot-rods.
Treasure hunts, graffiti,
date nights and shopping malls.
There has to be more,
for if there isn't,
Why are we so afraid to let "This" go?
Why are we so afraid to die?

Excuse me, if you must,
as the spinning causes seasickness.
Open the clouds as you continue on
in an aeronautical sarcophagus,
thirty-thousand feet
above broken land.
Grab your lover’s hair,
last resort to prepare for
the emergency crash landing
into mother earth’s disease,
or are they simply parting the seas,
causing darkness to spread
from the unfilled hole in their chest?
Stomachs turn as the
broken wings and sails
fall upon the shores.
An ocean of rage delivers
waves of hatred embraced.
The surf clears, exposing pain
and the premonition
of a cleansing blood red rain.
Shrieks of the banshee
and the howls of the hurt rise
to meet the clouds seeking
to brighten the days afar.
As thousands flee in terror
we make a toast in the French Quarter.
The chariots gain speed
and the wake gains mirth,
laughingly applauding
the approaching dark comedy.
The newly arrived antagonist
has forced the hero’s hand
and now she births forth
a wave of healing epidemics.
The wake’s in the wind
and the funeral’s imminent.
Its population’s been soothed
into a sedated slumber,
but our character has issued
too many warning,
and strikes deep at the heart
of this sinful city,
breaking apart the basin’s barrier,
and lulls its children back to sleep
with bloodstained lullabyes.

Confucius- inequality is fundamental to humanity

Relationships of inequality
Parent-child
Elder-younger
Husband-wife
Ruler-minister
Friend-friend

Philoso­phy known as Ren

Household (Jia)
-patriarchal
-patrilineal
-having sons was the most important thing
-ancestor worship-having sons was essential for carrying on the family name and therefore honoring the ancestors
-partible inheritance- each son would inherit equal shares of the family wealth

Sage emperors –Yao, Shun, Yu- each passed on rule to the best man instead of their son
-Yu was the first emperor to form a dynasty with his son Xia after being asked by the people to do so, this is followed by the Shang and eventually by the Zhou dynasty
-all of this is essentially myth and the only thing that is actually known is that the Zhou dynasty existed.

Zhou Dynasty (1050-250 BCE)

Qin-Han (221 BCE- 220 CE)

Sui-Tang (587-907)

Command economy

Society order of rank-

-scholar-most valuable because they bring knowledge and order
-peasant-are higher than artisans because they actually create rather than manipulate
-artisan-higher than merchant because they at least contribute skilled work and goods
-merchant-the lowest rank because they only sell goods and do not contribute anything to society.



Three teachings

Confucism  

Daoism-a system created by a small group of elites in china. Accepted a kind a view of getting along in the world by essentially rolling with the punches. Became a sort of religion based on the texts of Laozi

Buddhism

Sui Dynasty (589-618)

Tang Dynasty  (618-907)

-Up until the tang dynasty nobody owned land besides the emperor. This changed after the tang dynasty was weakened. During this period salt became the new revenue stream for the empire. This allowed merchants to control certain areas of the market and become very wealthy.

Song Dynasty (960-1276)

Yaun Dynasty- Mongol dynasty- did not run china in a chinese way

Ming dynasty- return of chinese order, second peasant emperor Zhu yaunzhen, he distrusted the gentry and the bureaucracy as well as his revolutionary allies, he punished and executed many previously noble families inadvertently making room for many new families to gain prominence.

-boom in population and wealth lead to many families having the ability to educate their sons and participate in the examination system. The quotas however went unchanged which lead to a general dissatisfaction with the system.

-global climate change lead to high frequency of crop failure leading to famine and strife.

Wanli 1572-1619- had a long rule, which is known as the beginning of the decline of the Ming. During his reign china becomes more and more wealthy and with wealth comes decadence. When he dies he is followed by his son who dies soon after and then his grandson who has little interest in ruling and allows Wei ZhonXian, a ******, become the defacto ruler.  Meanwhile crops begin to fail around the country and epidemics soon follow. By the mid 1640’s things are falling apart for the Ming.

li Zicheng- Rebel leader, started as rider in the royal postal service, was fired and turned into a bandit eventually becoming a rebel leader and taking the city of Beijing and declaring himself as the head of a new dynasty.

-At the same time the Manchus are also beginning to take over militarily northeast of the great wall. They ally with one of the few remaining Chinese generals and take Beijing from Li Zicheng. This begins the Qing dynasty.

There are pandemics,
epidemics,enmity,
earthquakes, floods,
famine, wildfire,
volcanic eruptions,
cyclones,simoom,
tornadoes,hurricanes,
peril, disease, death,
war,weapons,moreover,
oppressors in this planet
Do you want and love peace?
Earth is not the suitable place to live
for you.

I use to see you in the sunlight.
Until the sun died,
Growing so dim,
The earth was forced to dwell,
In eternal night.

The sky blazed with angry stars.
Glittering and glinting with,
Malice and envy because they will never rest again.
Men would expect to much of them.
Making wishes on their fallen,
Leaving gaps in the sky open,
Hating the sun for being so selfish.

The earth becomes,
Cold and Ice blue.
Frozen.
Desolate.
A wasteland of hate.
And Plants wither and die,
Loathing the moon.

Chaos expels,
Gushing from the wounds.
Hurricanes, Oozes from gashes,
Tipped and ripped from its roots,
Because of the imbalance in the universe.

The sun went out like candle light,
From the winds that came from your lips
As you blew it out with a smile.
Leaving the world to die slowly.

Setting off wars,
Threatening extinction,
Causing epidemics,
Brewing disasters,
And Hunger...
Existence relies on your power.
But you are to ignorant to see it.
Everything revolves around you.
Everything suffers because of it too.

On a deadly day
Air-locked lungs
Severed air-links
By tyranny of time

Yester beauty lost in pesters
In the travail travel of life
Deeds, deals are doomed
Solo soul slipped out sad
Of static veins, bones and blood
Body is now nobody to anybody

Unlocked fast food counter;
The paradise of parasites
The stray dogs’ dish delight
The flying hawk’s eye-catch
Wholesome diet for the day

Stinking corpse threatened
Endangered epidemics
World worried and buried
The Esquire in a square
Of engraved box in a grave

Soul in hunt of sprouting seeds
Of vibrant hygienic genes
For long sustained body’s succor
Of its own make – sane or sin,
Of heaven’s choicest justice

This is long, but go through it.  It’s worth it.      it was originally called "Words That Changed Our Lives", being inspired by the  connection between pandemonium and pandemic.  

           Pandemonium

Words that show lives but a tribe:
There to scribe, describe our lives.
Words that come from health or sickness: mind and body:
Prowess, fearless, speechless, endless;
Dangerousness, selfishness, childishness - nothing escapes;
Sowing seeds of mental shapes
That come from mind-to-mouth.

Now’s come the time to learn some new:
Epidemic and Pandemic,
Plus another word to view: Endemic.
Just a few, but whew!
Hoping that it’s not titanic - the Titanic!
Let me help you.

First came epidemics:
Measles, smallpox, influenzas…
How to conquer, name and aim,
How could and could we control the sum?  
Sometimes.  Some.
Coming back to hit us all the same,
But vanquished?  Germs and viruses not dumb -
Survive  anti-biotically (the foe of symbiotically).

Year twenty-twenty,
Epidemic now pandemic,
Plentiful and more than plenty;
Too, too many - far too many.

Struck by the invisible;
Questionable, susceptible,
Humans daring not to touch,
Wondering, asking when will it become too much?
And thus we come to the last word:
Endemic: background sound
Though underground many a year
Alive and well and waiting for…
Pandemonium 5. 14. 2020 Nature Of & In Reality; Circling Round Experience; Our Times, Our Culture II; Arlene Nover Corwin

pandemonium | ˌpandɪˈməʊnɪəm |
wild and noisy disorder or confusion; uproar: there was complete pandemonium—everyone just panicked.
ORIGIN mid 17th century: modern Latin (denoting the place of all demons, in Milton's Paradise Lost), from pan- ‘all’ + Greek daimōn ‘demon’.
pandemic
(of a disease) prevalent over a whole country or the world.
an outbreak of a pandemic disease: the results may have been skewed by an influenza pandemic.
ORIGIN mid 17th century: from Greek pandēmos (from pan ‘all’ + dēmos ‘people’) + -ic
endemic
1 (of a disease or condition) regularly found among particular people or in a certain area: complacency is endemic in industry today.
[attributive] (of an area) in which a particular disease is regularly found: the persistence of infection on pastures in endemic areas.
epidemic
1 an epidemic of typhoid: outbreak, plague, scourge, infestation; widespread illness/disease; Medicine pandemic, epizootic; formal recrudescence, boutade.
2 he's a victim of the county's joyriding epidemic: spate, rash, wave, explosion, eruption, outbreak, outburst, flare-up, craze; flood, torrent, burst, blaze, flurry; upsurge, upswing, upturn, increase, growth, rise, mushrooming; rare ebullition, boutade.
adjective
a widespread occurrence of an infectious disease in a community at a particular time: a flu epidemic.
• a sudden, widespread occurrence of an undesirable phenomenon: an epidemic of violent crime.

have you picked your poison?
look at us
look at all of us
pathetic
bags under our eyes,
lifeless and gaunt,
maxing out at three hours of sleep per night
what keeps you awake?
demons?
yes
skeletons?
yes
depression? war? weather? abuse? addiction? epidemics? heartache? heartbreak? stress? worry? scars? acceptance? lack of money? ******? despair? pending approval? family? illness? the future? disaster? pain? friends? tragedy? guilt? hatred? work? secrets? anger? anxiety? sadness? curiosity?

somewhere along the way
we forgot how to be happy
I mean, /h a p p y/
we forgot that we are only going to inhabit this place
one time, for any given (or taken) amount of minutes
and to remedy this
we pick a poison
so, tell me
what's yours?

By. Lauren

To all the girls I've loved,
My love for you dug into my veins like a shard of glass searching for any resemblance of blood left in me. After you shattered like mirror that I looked into, my heart broke too.
Our love was stronger than words could speak until you took the last bit of my innocence and discarded of me like a plastic bag. To you I was a game just waiting to be won. If only I had wiped the hazy fog from my eyes soon enough to see that you were just the devil taking a hold of me. Boy was I wrong when I discarded the advice of others. They spoke truth. Our love was merrily a puzzle piece in the complex puzzle we call life. Every which turn I take I am faced with the same reality. The blunt truth indeed. Our love was more toxic than all the skull labeled barbells I surrounded myself with.  You were just a chess master waiting to call checkmate on me. If only I had left before we got so far. Our love was a monster under my bed waiting to pull me under and call me crazy. I was crazy. Our love was crazier than the epidemics we see on TV. To all the girls I've loved, there is no need for apology. For our love was far too complex to simplify into one poem.

There is an anger inside me
Burning
Like the crashing trees of the Amazon

There is rage inside me
Roaring
Like the hurricanes of the Atlantic

There is sadness inside me
Pouring
Like the torrents of the flood waters of Southern Spain

There is dis-ease inside me
Spreading
Like the epidemics of the Congo

On a deadly day
Air-locked lungs
Severed air-links
By tyranny of time

Yester beauty lost in pesters
In the travail travel of life
Deeds, deals are doomed
Solo soul slipped out sad
Of static veins, bones and blood
Body is now nobody to anybody

Unlocked fast food counter;
The paradise of parasites
The stray dogs’ dish delight
The flying hawk’s eye-catch
Wholesome diet for the day

Stinking corpse threatened
Endangered epidemics
World worried and buried
The Esquire in a square
Of engraved box in a grave

Soul in hunt of sprouting seeds
Of vibrant hygienic genes
For long sustained body’s succor
Of its own make – sane or sin,
Of heaven’s choicest justice

On a deadly day
Air-locked lungs
Severed air-links
By tyranny of time

Yester beauty lost in pesters
In the travail travel of life
Deeds, deals are doomed
Solo soul slipped out sad
Of static veins, bones and blood
Body is now nobody to anybody

Unlocked fast food counter;
The paradise of parasites
The stray dogs’ dish delight
The flying hawk’s eye-catch
Wholesome diet for the day

Stinking corpse threatened
Endangered epidemics
World worried and buried
The Esquire in a square
Of engraved box in a grave

Soul in hunt of sprouting seeds
Of vibrant hygienic genes
For long sustained body’s succor
Of its own make – sane or sin,
Of heaven’s choicest justice

Our feet are in the water, we exhale the semester away, and kiss the moon goodnight.

A sporadic membrane of white motion paves the way for daybreak...a moonset for the books that feigns the horizon's onlookers for a thirsty tangerine.

We tread back...slow and steady. Music sets the mood, too loud perhaps, but we are outside after all, so who cares.

I settle heavy upon the sweet and salty cushion. I fell the tremble as the earth inhales and exhales.

I look up, that endless span of spilt milk prompting reflection--my gaze upon a picture that my brother, a thousand years gone by, too admired.

We think that we are so much smarter now. How often we laugh at our naive predecessors and how quick we are to praise our clever selves. Isn't it so much easier now? To cook? To sleep? To dance?

But we are no better off now than ever before. We fail to recognize the relative ailments that ******* our generation same as plague and epidemics past.

We must humble ourselves...must realize how truly insignificant our little speck of an existence is in the grand scheme of happenings and play things.

To compare the human condition on earth with that of the blink of an eye, on universal terms, is only to begin to understand how little our time here matters. So get over your affliction, you poor you-you. Stop your anger. End your sadness. Feel greatful that your person was important enough to matter to you for a moment. Feel even more greatful if yours was the genuine concern of another.

Mind your gaze, please and thank you, find the sun, and say your prayers.

and noticing that much
is enough to remind me that
all of this only amounts
to meteoric chances and happenstances,
so even the worst of it will come to its end—
and maybe that just has to do
with the optimistic sap in me.

But even then, you greet me
“Good morning,” and I hear you,
and you sound like you're of the Sun
touching through the barricades of Woodbury,
where the undead ******* can't touch us.

And you buffer the cold of the wind
and the wet of the rain
when the kindling is too soaked
to start a fire big enough
to counter the draft
coming from under the doors,
or dry our jackets by the fireplace.

Which probably sounds like naivety,
but even after Woodbury rots from the inside out,
and we lose the car and our last can of beets
somewhere during our escape, and the rest of the way,
we're joking about the way things were
before they got worse, while hypothesizing
about the fall of man, epidemics and expiration dates
to forget the endless hills aching our feet, I could tell you:

“Sure, I mean, there are ten-thousand ways
the world can go to **** (and it probably has,)
and I might not live to one-hundred-three,
but if the world's gonna burn on me now,
it's always better watching with you.”

HIGHLIGHTS OF PRESCRIBING INFORMATION
These highlights do not include all the information needed to us e
M-M-R II safely and effectively. See full prescribing information
for M-M-R II.
M-M-R® II (Measles, Mumps, and Rubella Virus Vaccine Live)
Suspension for subcutaneous injection
Initial U.S. Approv al: 1978
-------------------------------INDICATIONS AND USAGE-------------------------------
M-M-R II is a vaccine indicated for active immunization for the
prevention of measles, mumps, and rubella in individuals 12 months of
age and older. (1)
-------------------------- DOSAGE AND ADMINISTRATION--------------------------
Administer a 0.5-mL dose of M-M-R II subcutaneously. (2.1)
• The first dose is administered at 12 to 15 months of age. (2.1)
• The second dose is administered at 4 to 6 years of age. (2.1)
------------------------DOSAGE FORMS AND STRENGTHS -----------------------
Suspension for injection (0.5-mL dose) supplied as a lyophilized
vaccine to be reconstituted using accompanying sterile diluent. (3)
---------------------------------- CONTRAINDICATIONS ----------------------------------
• Hypersensitivity to any componentof the vaccine. (4.1)
• Immunosuppression. (4.2)
• Moderate or severe febrile illness. (4.3)
• Active untreated tuberculosis. (4.4)
• Pregnancy. (4.5, 8.1)
-------------------------- WARNINGS AND PRECAUTIONS --------------------------
• Use caution when administering M-M-R II to individuals with a
history of febrile seizures. (5.1)
• Use caution when administering M-M-R II to individuals with
anaphylaxis or immediate hypersensitivity following egg ingestion.
(5.2)
• Use caution when administering M-M-R II to individuals with a
history of thrombocytopenia. (5.3)
• Immune Globulins (IG) and other blood products should not be
given concurrently with M-M-R II. (5.4, 7.2)
----------------------------------ADVERSE REACTIONS----------------------------------
See full prescribing information for adverse reactions occurring duri ng
clinical trialsor the post-marketing period. (6)
To report SUSPECTED ADVERSE REACTIONS, contact Merck
Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., at 1-8 7 7 -
888-4231 or VAERS at 1-800-822-7967 or www.vaers.hhs.gov.
-----------------------------------DRUG INTERACTIONS----------------------------------
• Administration of immune globulins and other blood products
concurrently with M-M-R II vaccine may interfere with the
expected immune response. (7.2)
• M-M-R II vaccination may result in a temporary depression of
purified protein derivative (PPD) tuberculin skin sensitivity. (7.3)
-------------------------- USE IN SPECIFIC POPULATIONS--------------------------
• Pregnancy: Do not administer M-M-R II to females who are
pregnant. Pregnancy should be avoided for 1 month following
vaccination with M-M-R II. (4.5, 8.1, 17)
See 17 for PATIENT COUNSELING INFORMATION and FDA
approv ed patient labeling.
Rev ised: 06/2020
FULL PRESCRIBING INFORMATION: CONTENTS
1 INDICATIONS AND USAGE
2 DOSAGE AND ADMINISTRATION
2.1 Dose and Schedule
2.2 Preparation andAdministration
3 DOSAGE FORMS AND STRENGTHS
4 CONTRAINDICATIONS
4.1 Hypersensitivity
4.2 Immunosuppression
4.3 Moderate or Severe Febrile Illness
4.4 Active Untreated Tuberculosis
4.5 Pregnancy
5 WARNINGS AND PRECAUTIONS
5.1 Febrile Seizure
5.2 Hypersensitivity to Eggs
5.3 Thrombocytopenia
5.4 Immune Globulins and Transfusions
6 ADVERSE REACTIONS
7 DRUG INTERACTIONS
7.1 Corticosteroids and Immunosuppressive Drugs
7.2 Immune Globulinsand Transfusions
7.3 Tuberculin Skin Testing
7.4 Use with Other Live Viral Vaccines
8 USE IN SPECIFIC POPULATIONS
8.1 Pregnancy
8.2 Lactation
8.4 Pediatric Use
8.5 Geriatric Use
11 DESCRIPTION
12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action
12.6 Persistence of Antibody Responses After Vaccination
13 NONCLINICAL TOXICOLOGY
13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility
14 CLINICAL STUDIES
14.1 Clinical Efficacy
14.2 Immunogenicity
15 REFERENCES
16 HOW SUPPLIED/STORAGE AND HANDLING
17 PATIENT COUNSELING INFORMATION
Sections or subsections omitted from the full prescribing info rma tion
are not listed.
2
FULL PRESCRIBING INFORMATION
1 INDICATIONS AND USAGE
M-M-R® II is a vaccine indicated for active immunization for the prevention of measles, mumps, and
rubella in individuals 12 months of age and older.
2 DOSAGE AND ADMINISTRATION
For subcutaneous use only.
2.1 Dose and Schedule
Each 0.5 mL dose is administered subcutaneously.
The first dose is administered at 12 to 15 months of age. A second dose is administered at 4 to 6
years of age.
The second dose may be administered prior to 4 years of age, provided that there is a minimum
interval of one month between the doses of measles, mumps and rubella virus vaccine, live {1-2}.
Children who received an initial dose of measles, mumps and rubella vaccine prior to their first
birthday should receive additional doses of vaccine at 12-15 months of age and at 4-6 years of age to
complete the vaccination series [see Clinical Studies (14.2)].
For post-exposure prophylaxis for measles, administer a dose of M-M-R II vaccine within 72 hours
after exposure.
2.2 Preparation and Administration
Use a sterile syringe free of preservatives, antiseptics, and detergents for each injection and/or
reconstitution of the vaccine because these substances may inactivate the live virus vaccine. To
reconstitute, use only the diluent supplied with the vaccine since it is free of preservatives or other
antiviral substances which might inactivate the vaccine.
Withdraw the entire volume of the supplied diluent from its vial and inject into lyophilized vaccine vial.
Agitate to dissolve completely. Discard if the lyophilized vaccine cannot be dissolved.
Withdraw the entire volume of the reconstituted vaccine and inject subcutaneously into the outer
aspect of the upper arm (deltoid region) or into the higher anterolateral area of the thigh.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to
administration, whenever solution and container permit. Visually inspect the vaccine before and after
reconstitution prior to administration. Before reconstitution, the lyophilized vaccine is a light yellow
compact crystalline plug, when reconstituted, is a clear yellow liquid. Discard if particulate matter or
discoloration are observed in the reconstituted vaccine.
To minimize loss of potency, administer M-M-R II as soon as possible after reconstitution. If not used
immediately, the reconstituted vaccine may be stored between 36°F to 46°F (2°C to 8°C), protected from
light, for up to 8 hours. Discard reconstituted vaccine if it is not used within 8 hours.
3 DOSAGE FORMS AND STRENGTHS
M-M-R II vaccine is a suspension for injection supplied as a single dose vial of lyophilized vaccine to
be reconstituted using the accompanying sterile diluent [see Dosage and Administration (2.2) and How
Supplied/Storage and Handling (16)]. A single dose after reconstitution is 0.5 mL.
4 CONTRAINDICATIONS
4.1 Hypersensitivity
Do not administer M-M-R II vaccine to individuals with a history of hypersensitivity to any component
of the vaccine (including gelatin) {3} or who have experienced a hypersensitivity reaction following
administration of a previous dose of M-M-R II vaccine or any other measles, mumps and rubellacontaining vaccine. Do not administer M-M-R II vaccine to individuals with a history of anaphylaxis to
neomycin [see Description (11)].
4.2 Immunosuppression
Do not administer M-M-R II vaccine to individuals who are immunodeficient or immunosuppressed due
to disease or medical therapy. Measles inclusion body encephalitis {4} (MIBE), pneumonitis {5} and death
as a direct consequence of disseminated measles vaccine virus infection have been reported in
3
immunocompromised individuals inadvertently vaccinated with measles-containing vaccine. In this
population, disseminated mumps and rubella vaccine virus infection have also been reported.
Do not administer M-M-R II to individuals with a family history of congenital or hereditary
immunodeficiency, until the immune competence of the potential vaccine recipient is demonstrated.
4.3 Moderate or Severe Febrile Illness
Do not administer M-M-R II vaccine to individuals with an active febrile illness with fever >101.3F
(>38.5C).
4.4 Active Untreated Tuberculosis
Do not administer M-M-R II vaccine to individuals with active untreated tuberculosis (TB).
4.5 Pregnancy
Do not administer M-M-R II to individuals who are pregnant or who are planning on becoming
pregnant within the next month [see Use in Specific Populations (8.1) and Patient Counseling Information
(17)].
5 WARNINGS AND PRECAUTIONS
5.1 Febrile Seizure
There is a risk of fever and associated febrile seizure in the first 2 weeks following immunization with
M-M-R II vaccine. For children who have experienced a previous febrile seizure (from any cause) and
those with a family history of febrile seizures there is a small increase in risk of febrile seizure following
receipt of M-M-R II vaccine [see Adverse Reactions (6)].
5.2 Hypersensitivity to Eggs
Individuals with a history of anaphylactic, anaphylactoid, or other immediate reactions (e.g., hives,
swelling of the mouth and throat, difficulty breathing, hypotension, or shock) subsequent to egg ingestion
may be at an enhanced risk of immediate-type hypersensitivity reactions after receiving M-M-R II vaccine
.The potential risks and known benefits should be evaluated before considering vaccination in these
individuals.
5.3 Thrombocytopenia
Transient thrombocytopenia has been reported within 4-6 weeks following vaccination with measles,
mumps and rubella vaccine. Carefully evaluate the potential risk and benefit of vaccination in children
with thrombocytopenia or in those who experienced thrombocytopenia after vaccination with a previous
dose of measles, mumps, and rubella vaccine {6-8} [see Adverse Reactions (6)].
5.4 Immune Globulins and Transfusions
Immune Globulins (IG) and other blood products should not be given concurrently with M-M-R II [see
Drug Interactions (7.2)]. These products may contain antibodies that interfere with vaccine virus
replication and decrease the expected immune response.
The ACIP has specific recommendations for intervals between administration of antibody containing
products and live virus vaccines.
6 ADVERSE REACTIONS
The following adverse reactions include those identified during clinical trials or reported during postapproval use of M-M-R II vaccine or its individual components.
Body as a Whole
Panniculitis; atypical measles; fever; syncope; headache; dizziness; malaise; irritability.
Cardiovascular System
Vasculitis.
Digestive System
Pancreatitis; diarrhea; vomiting; parotitis; nausea.
Hematologic and Lymphatic Systems
Thrombocytopenia; purpura; regional lymphadenopathy; leukocytosis.
Immune System
Anaphylaxis, anaphylactoid reactions, angioedema (including peripheral or ****** edema) and
bronchial spasm.
Musculoskeletal System
Arthritis; arthralgia; myalgia.
4
Nervous System
Encephalitis; encephalopathy; measles inclusion body encephalitis (MIBE) subacute sclerosing
panencephalitis (SSPE); Guillain-Barré Syndrome (GBS); acute disseminated encephalomyelitis (ADEM);
transverse myelitis; febrile convulsions; afebrile convulsions or seizures; ataxia; polyneuritis;
polyneuropathy; ocular palsies; paresthesia.
Respiratory System
Pneumonia; pneumonitis; sore throat; cough; rhinitis.
Skin
Stevens-Johnson syndrome; acute hemorrhagic edema of infancy; Henoch-Schönlein purpura;
erythema multiforme; urticaria; rash; measles-like rash; pruritus; injection site reactions (pain, erythema,
swelling and vesiculation).
Special Senses — Ear
Nerve deafness; otitis media.
Special Senses — Eye
Retinitis; optic neuritis; papillitis; conjunctivitis.
Urogenital System
Epididymitis; orchitis.
7 DRUG INTERACTIONS
7.1 Corticosteroids and Immunosuppressive Drugs
M-M-R II vaccine should not be administered to individuals receiving immunosuppressive therapy,
including high dose corticosteroids. Vaccination with M-M-R II vaccine can result in disseminated disease
due to measles vaccine in individuals on immunosuppressive drugs [see Contraindications (4.2)].
7.2 Immune Globulinsand Transfusions
Administration of immune globulins and other blood products concurrently with M-M-R II vaccine may
interfere with the expected immune response {9-11} [see Warnings and Precautions (5.4)]. The ACIP has
specific recommendations for intervals between administration of antibody containing products and live
virus vaccines.
7.3 Tuberculin Skin Testing
It has been reported that live attenuated measles, mumps and rubella virus vaccines given individually
may result in a temporary depression of tuberculin skin sensitivity. Therefore, if a tuberculin skin test with
tuberculin purified protein derivative (PPD) is to be done, it should be administered before, simultaneously
with, or at least 4 to 6 weeks after vaccination with M-M-R II vaccine.
7.4 Use with Other Live Viral Vaccines
M-M-R II vaccine can be administered concurrently with other live viral vaccines. If not given
concurrently, M-M-R II vaccine should be given one month before or one month after administration of
other live viral vaccines to avoid potential for immune interference.
8 USE IN SPECIFIC POPULATIONS
8.1 Pregnancy
Risk Summary
M-M-R II vaccine is contraindicated for use in pregnant women because infection during pregnancy
with the wild-type viruses has been associated with maternal and fetal adverse outcomes.
Increased rates of spontaneous abortion, stillbirth, premature delivery and congenital defects have
been observed following infection with wild-type measles during pregnancy. {12,13} Wild-type mumps
infection during the first trimester of pregnancy may increase the rate of spontaneous abortion.
Infection with wild-type rubella during pregnancy can lead to miscarriage or stillbirth. If rubella infection
occurs during the first trimester of pregnancy, it can result in severe congenital defects, Congenital
Rubella Syndrome (CRS). Congenital rubella syndrome in the infant includes but is not limited to eye
manifestations (cataracts, glaucoma, retinitis), congenital heart defects, hearing loss, microcephaly, and
intellectual disabilities. M-M-R II vaccine contains live attenuated measles, mumps and rubella viruses. It
is not known whether M-M-R II vaccine can cause fetal harm when administered to pregnant woman.
There are no adequate and well-controlled studies of M-M-R II vaccine administration to pregnant
women.
5
All pregnancies have a risk of birth defect, loss or other adverse outcomes. In the US general
population, the estimated background risk of major birth defects and miscarriage in clinically recognized
pregnancies is 2% to 4% and 15% to 20%, respectively.
Available data suggest the rates of major birth defects and miscarriage in women who received
M-M-R II vaccine within 30 days prior to pregnancy or during pregnancy are consistent with estimated
background rates (see Data).
Data
Human Data
A cumulative assessment of post-marketing reports for M-M-R II vaccine from licensure 01 April 1978
through 31 December 2018, identified 796 reports of inadvertent administration of M-M-R II vaccine
occurring 30 days before or at any time during pregnancy with known pregnancy outcomes. Of the
prospectively followed pregnancies for whom the timing of M-M-R II vaccination was known, 425 women
received M-M-R II vaccine during the 30 days prior to conception through the second trimester. The
outcomes for these 425 prospectively followed pregnancies included 16 infants with major birth defects, 4
cases of fetal death and 50 cases of miscarriage. No abnormalities compatible with congenital rubella
syndrome have been identified in patients who received M-M-R II vaccine. Rubella vaccine viruses can
cross the placenta, leading to asymptomatic infection of the fetus. Mumps vaccine virus has also been
shown to infect the placenta {14}, but there is no evidence that it causes congenital malformations or
disease in the fetus or infant .
The CDC established the Vaccine in Pregnancy registry (1971-1989) of women who had received
rubella vaccines within 3 months before or after conception. Data on 1221 inadvertently vaccinated
pregnant women demonstrated no evidence of an increase in fetal abnormalities or cases of Congenital
Rubella Syndrome (CRS) in the enrolled women {15}.
8.2 Lactation
Risk Summary
It is not known whether measles or mumps vaccine virus is secreted in human milk. Studies have
shown that lactatingpostpartum women vaccinated with live attenuated rubella vaccine may secrete the
virus in breast milk and transmit it to breast-fed infants.{16,17} In the breast-fed infants with serological
evidence of rubella virus vaccine strain antibodies, none exhibited severe disease; however, one
exhibited mild clinical illness typical of acquired rubella.{18,19}
The developmental and health benefits of breastfeeding should be considered along with the mother’s
clinical need for M-M-R II, and any potential adverse effects on the breastfed child from M-M-R II or from
the underlying maternal condition. For preventive vaccines, the underlying maternal condition is
susceptibility to disease prevented by the vaccine.
8.4 Pediatric Use
M-M-R II vaccine is not approved for individuals less than 12 months of age. Safety and effectiveness
of measles vaccine in infants below the age of 6 months have not been established [see Clinical Studies
(14)]. Safety and effectiveness of mumps and rubella vaccine in infants less than 12 months of age have
not been established.
8.5 Geriatric Use
Clinical studies of M-M-R II did not include sufficient numbers of seronegative subjects aged 65 and
over to determine whether they respond differently from younger subjects.
11 Description
M-M-R II vaccine is a sterile lyophilized preparation of (1) Measles Virus Vaccine Live, an attenuated
line of measles virus, derived from Enders' attenuated Edmonston strain and propagated in chick embryo
cell culture; (2) Mumps Virus Vaccine Live, the Jeryl Lynn™ (B level) strain of mumps virus propagated in
chick embryo cell culture; and (3) Rubella Virus Vaccine Live, the Wistar RA 27/3 strain of live attenuated
rubella virus propagated in WI-38 human diploid lung fibroblasts. {20,21} The cells, virus pools,
recombinant human serum albumin and fetal bovine serum used in manufacturing are tested and
determined to be free of adventitious agents.
After reconstitution, each 0.5 mL dose contains not less than 3.0 log10 TCID50 (tissue culture infectious
doses) of measles virus; 4.1 log10 TCID50 of mumps virus; and 3.0 log10 TCID50 of rubella virus.
Each dose is calculated to contain sorbitol (14.5 mg), sucrose(1.9 mg), hydrolyzed gelatin (14.5 mg),
recombinant human albumin (≤0.3 mg), fetal bovine serum (<1 ppm), approximately 25 mcg of neomycin
and other buffer and media ingredients. The product contains no preservative.
6
12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action
M-M-R II vaccination induces antibodies to measles, mumps, and rubella associated with protection
which can be measured by neutralization assays, hemagglutination-inhibition (HI) assays, or enzyme
linked immunosorbent assay (ELISA) tests. Results from efficacy studies or effectivenes s studies that
were previously conducted for the component vaccines of M-M-R II were used to define levels of serum
antibodies that correlated with protection against measles, mumps, and rubella [see Clinical Studies (14)].
12.6 Persistence of Antibody Responses After Vaccination
Neutralizing and ELISA antibodies to measles, mumps, and rubella viruses are still detectable in 95-
100%, 74-91%, and 90-100% of individuals respectively, 11 to 13 years after primary vaccination. {22-28}
13 NONCLINICAL TOXICOLOGY
13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility
M-M-R II vaccine has not been evaluated for carcinogenic or mutagenic potential or impairment of
fertility.
14 CLINICAL STUDIES
14.1 Clinical Efficacy
Efficacy of measles, mumps, and rubella vaccines was established in a series of double-blind
controlled trials. {29-34} These studies also established that seroconversion in response to vaccination
against measles, mumps and rubella paralleled protection. {35-38}
14.2 Immunogenicity
Clinical studies enrolling 284 triple seronegative children, 11 months to 7 years of age, demonstrated
that M-M-R II vaccine is immunogenic. In these studies, a single injection of the vaccine induced measles
HI antibodies in 95%, mumps neutralizing antibodies in 96%, and rubella HI antibodies in 99% of
susceptible individuals.
A study of 6-month-old and 15-month-old infants born to mothers vaccinated with a measles vaccine in
childhood, demonstrated that, following infant and toddler vaccination with Measles Virus Vaccine, Live
(previously US-licensed, manufactured by Merck), 74% of the 6-month-old infants developed detectable
neutralizing antibody titers while 100% of the 15-month-old infants vaccinated with Measles Virus
Vaccine, Live or M-M-R II vaccine developed neutralizing antibodies {39}. When the 6-month-old infants
of immunized mothers were revaccinated at 15 months with M-M-R II vaccine, they developed antibody
titers similar to those of toddlers who were vaccinated previously at 15-months of age.
15 REFERENCES
1. General Recommendations on Immunization, Recommendations of the Advisory Committee on Immunization Practices, MMWR
43(RR-1): 1-38, January 28, 1994.
2. Measles, Mumps, and Rubella — Vaccine Use and Strategies for Elimination of Measles, Rubella, a n d Co n g e nita l Ru b e lla
Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practice s (ACIP), M M WR
47(RR-8): May 22, 1998.
3. Kelso, J.M.; Jones, R.T.; Yunginger, J.W.: Anaphylaxis to measles, mumps, and rubella vaccine mediated by IgE to gel atin , J.
Allergy Clin. Immunol. 91: 867-872, 1993.
4. Bitnum, A.; et al: Measles Inclusion Body Encephalitis Caused by the Vaccine Strain of Measles Virus. Cl i n . In fect. Di s. 2 9 :
855-861, 1999.
5. Angel, J.B.; et al: Vaccine Associated Measles Pneumonitis in an Adult with AIDS. Annals of Internal Medicine, 129: 1 0 4 -1 06 ,
1998.
6. Cecinati V, et al. Vaccine administration and the development of immune thrombocyto pe ni c p urp u ra i n ch i ld re n. Hu m an
Vaccines & Immunotherapeutics 9:5, 2013.
7. Mantadakis E, Farmaki E, Buchanan GR. Thrombocytopenic Purpura after Measles-Mumps-Rubella Vaccination: A Systematic
Review of the Literature and Guidance for Management. J Ped 156(4): 2010.
8. Andrews N, Stowe J, Miller E, Svanstrom H, Johansen K, Bonhoeffer J, et al. A collaborative approach to investigating th e ri sk
of thrombocytopenic purpura after measles-mumps-rubella vaccination in England and Denmark. Vaccine. 2012;30:3042‐6.
9. Rubella Prevention: Recommendation of the Immunization Practices Advisory Committee (ACIP), MM WR 3 9 (RR-1 5 ): 1 -1 8 ,
November 23, 1990.
7
10. Peter, G.; et al (eds): Report of the Committee on Infectious Diseases, Twenty-fourth Edition, American Academy of Pediatri cs,
344-357, 1997.
11. Measles Prevention: Recommendations of the Immunization Practices Advisory Committee (ACIP), MMWR 38(S-9): 5-22,
December 29, 1989.
12. Eberhart-Phillips, J.E.; et al: Measles in pregnancy: a descriptive study of 58 cases. Obstetrics and Gynecology, 82(5): 797-801,
November 1993.
13. Jespersen, C.S.; et al: Measles as a cause of fetal defects: A retrospective study of ten measles epidemics in Greenland. Acta
Paediatr Scand. 66: 367-372, May 1977.
14. Yamauchi T, Wilson C, Geme JW Jr. Transmission of live, attenuated mumps virus to the hu m a n p l ace n ta . N En g l J M e d .
1974;290(13):710‐712.
15. Rubella Vaccination during Pregnancy —United States, 1971-1988. JAMA. 1989;261(23):3374–3383.
16. Losonsky, G.A.; Fishaut, J.M.; Strussenber, J.; Ogra, P.L.: Effect of immunization against rubella on lactation products. II.
Maternal-neonatal interactions, J. Infect. Dis. 145: 661-666,1982.
17. Losonsky, G.A.; Fishaut, J.M.; Strussenber, J.; Ogra, P.L.: Effect of immunization against rubella on lactation products. I.
Development and characterization of specific immunologic reactivity in breast milk, J. Infect. Dis. 145: 654-660, 1982.
18. Landes, R.D.; Bass, J.W.; Millunchick, E.W.; Oetgen, W.J.: Neonatal rubella following postpartum maternal i mm un izatio n , J.
Pediatr. 97: 465-467, 1980.
19. Lerman, S.J.: Neonatal rubella following postpartum maternal immunization, J. Pediatr. 98: 668, 1981. (Letter)
20. Plotkin, S.A.; Cornfeld, D.; Ingalls, T.H.: Studiesof immunization with living rubella virus: Trialsin children with a strain culture d
from an aborted fetus, Am. J. Dis. Child. 110: 381-389, 1965.
21. Plotkin, S.A.; Farquhar, J.; Katz, M.; Ingalls, T.H.: A new attenuated rubella virus grown in human fi bro b la sts: Evi d e n ce fo r
reduced nasopharyngeal excretion, Am. J. Epidemiol. 86: 468-477, 1967.
22. Weibel, R.E.; Carlson, A.J.; Villarejos, V.M.; Buynak, E.B.; McLean, A.A.; Hilleman, M.R.: Clinical and Labo ra tory Stu d ie s o f
Combined Live Measles, Mumps, and Rubella Vaccines Using the RA 27/3 Rubella Virus, Proc. So c. Exp . Bi ol. M e d. 1 6 5 :
323-326, 1980.
23. Watson, J.C.; Pearson, J.S.; Erdman, D.D.; et al: An Evaluation of Measles RevaccinationAmong School-Entry Age Ch i ld re n,
31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Abstract #268, 143, 1991.
24. Unpublished data from the files of Merck Research Laboratories.
25. Davidkin, I.; Jokinen, S.; Broman, M. et al.: Persistence of Measles, Mumps, and Rubella Antibodies in a n M M R -Va ccina ted
Cohort: A 20-Year Follow-up, JID 197:950–6, April 2008.
26. LeBaron, W.; Beeler J.; Sullivan, B.; et al.: Persistence of Measles Antibodies After 2 Doses of Measles Vaccine in a
Postelimination Environment, Arch Pediatr Adolesc Med. 161:294-301, March 2007.
27. LeBaron, C.; Forghani, B.; Beck, C. et al.: Persistence of Mumps Antibodies after 2 Doses of Measles-Mumps-Rubella Vaccine,
JID 199:552– 60 , February 2009.
28. LeBaron, W.; Forghani, B.; Matter, L. et al.: Persistence of Rubella Antibodies after 2 Doses of Measles-Mumps-Rubella
Vaccine, JID 200:888–99, September 2009.
29. Hilleman, M.R.; Buynak, E.B.; Weibel, R.E.; et al: Development and Evaluation of the Moraten MeaslesVirusVa cci n e , JAM A
206(3): 587-590, 1968.
30. Weibel, R.E.; Stokes, J.; Buynak, E.B.; et al: Live, Attenuated Mumps Virus Vaccine 3. Clinical and Serologic Aspects in a Fiel d
Evaluation,N. Engl. J. Med. 276: 245-251, 1967.
31. Hilleman, M.R.; Weibel, R.E.; Buynak, E.B.; et al:Live, Attenuated Mumps VirusVaccine 4. ProtectiveEfficacy as Measure d i n
a Field Evaluation, N. Engl. J. Med. 276: 252-258, 1967.
32. Cutts, F.T.; Henderson, R.H.; Clements, C.J.; et al: Principles of measles control, Bull WHO 69(1): 1-7, 1991.
33. Weibel, R.E.; Buynak, E.B.; Stokes, J.; et al: Evaluation Of Live Attenuated Mumps Virus Vaccine, Strain Jeryl Lynn, First
International Conference on VaccinesAgainst Viral and Rickettsial Diseases of Man, World Health Organization, No. 147, M a y
1967.
34. Leibhaber, H.; Ingalls, T.H.; LeBouvier, G.L.; et al: Vaccination With RA 27/3 Rubella Vaccine, Am. J. Dis. Child. 123: 133-1 3 6,
February 1972.
35. Rosen, L.: Hemagglutination and Hemagglutination-Inhibition with Measles Virus, Virology 13: 139-141, January 1961.
36. Brown, G.C.; et al: Fluorescent-Antibody Marker for Vaccine-Induced Rubella Antibodies, Infection and Immunity 2(4): 360-363,
1970.
8
37. Buynak, E.B.; et al: Live Attenuated Mumps Virus Vaccine 1. Vaccine Development, Proceedings of the Society for
Experimental Biology and Medicine, 123: 768-775, 1966.
38. Hilleman M.R., Studies of Live Attenuated Measles Virus Vaccine in Man: II. Appraisal of Efficacy. Amer. J. o f Pu b l ic He a lth ,
52(2):44-56, 1962.
39. Johnson, C.E.; et al: Measles Vaccine Immunogenicity in 6- Versus 15-Month-Old Infants Born to Mothers in the Measles
Vaccine Era, Pediatrics, 93(6): 939-943, 1994.
16 HOW SUPPLIED/STORAGE AND HANDLING
No. 4681 ⎯ M-M-R II vaccine is supplied as follows:
(1) a box of 10 single-dose vials of lyophilized vaccine (package A), NDC 0006-4681-00
(2) a box of 10 vials of diluent (package B)
Exposure to light may inactivate the vaccine viruses.
Before reconstitution, refrigerate the lyophilized vaccine at 36°F to 46°F, (2°C to 8°C).
Store accompanying diluent in the refrigerator with the lyophilized vaccine or separately at room
temperature (68° to 77°F, 20° to 25°C). Do not freeze the diluent.
Administer M-M-R II vaccine as soon as possible after reconstitution. If not administered immediately,
reconstituted vaccine may be stored between 36°F to 46°F (2°C to 8°C), protected from light, for up to 8
hours. Discard reconstituted vaccine if it is not used within 8 hours.
For information regarding the product or questions regarding storage conditions, call 1-800-
MERCK-90 (1-800-637-2590).
17 PATIENT COUNSELING INFORMATION
Advise the patient to read the FDA-approved patient labeling (Patient Package Insert).
Discuss the following with the patient:
• Provide the required vaccine information to the patient, parent, or guardian.
• Inform the patient, parent, or guardian of the benefits and risks associated with vaccination.
• Question the patient, parent, or guardian about reactions to a previous dose of M-M-R II vaccine
or other measles-, mumps-, or rubella-containing vaccines.
• Question females of reproductive potential regarding the possibility of pregnancy. Inform female
patients to avoid pregnancy for 1 month following vaccination [see Contraindications (4.5) and
Use in Specific Populations (8.1)].
• Inform the patient, parent, or guardian that vaccination with M-M-R II may not offer 100%
protection from measles, mumps, and rubella infection.
• Instruct patients, parents, or guardians to report any adverse reactions to their health-care
provider. The U.S. Department of Health and Human Services has established a Vaccine
Adverse Event Reporting System (VAERS) to accept all reports of suspected adverse events
after the administration of any vaccine, including but not limited to the reporting of events required
by the National Childhood Vaccine Injury Act of 1986. For information or a copy of the vaccine
reporting form, call the VAERS toll-free number at 1-800-822-7967, or report online at
https://www.vaers.hhs.gov.
For patent information: www.merck.com/product/patent/home.html
Copyright © 1978-2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
All rights reserved.
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It's a downer to express the largest-scale tragedy of my lifetime

over and over again.

I've combed through 10,014 medical malpractice reports of young people who had been strong and without complication up until receiving the one-eyed technocratic snake bite that supposedly has nothing to do with their suspicious deaths,

I've gone through 25,117 autopsy reports (not every report: I scanned bunches of 250 reports in 10 groups of 25 reports or 25 groups of 10 reports at a time for very specific details, though I've read some of the reports 5 or more times) of elderly people who had survived world wars, epidemics, pandemics, and many outbreak and spikes, only to succumb within 72 hours of receiving whichever junk SGT inoculations that have nothing to do with their untimely deaths—

that occurred in North America
over a 2 week period.

I'm not supposed to talk about it.

I'm not supposed to express anything
other than expressions of agreement
that Delta variants and the unvaccinated
are killing the vaccinated

or express nothing at all.

I'm not supposed to express that I know the ingredients, and the processes involved to source ingredients, on chemical, molecular, cellular levels; that I know the MSDS and LCSS documentation, and patents, involved.

But, I do express it, just as I did again above.

When someone claims that their significant other didn't die from the shot that they had received within 24 hrs of dying,
I'm supposed to agree with the cheap, disloyal, dumbed-down, brainwashed, bootlicking, unscientific, pseudo-intellectual, spineless coward

who is hurting from losing a loved one.

I'm sorry.

I'm not supposed to express that we've known since 1991 that the synthetic chemical digitized mRNA, that isn't really mRNA, causes the host to spin-off variants of multi-drug-resistant and multi-vaccine-resistant super microorganisms—subtype variants of virions and bacteria that are often variants of variants of variants.

I'm supposed to stay zipped-up
or—encourage!—offer support
and congratulations to people
who are suiciding and committing
****** and euthanasia

without proper informed consent.

Be positive about it. Smile. Nod.

Have it be whatever you want it to be.
Use mockingbird skills to make it real— abracadabra!—it's en vogue, all the rage
to parrot percentages of efficacy,
to virtue signal over standing with
trillion $ industries and special interest
against Earth and humanity.
Insert cash money and mirages
into the soul-******* jukebox, baby.

Rage With The Machine.
Rage For The Machine.

Yesterday's false-positive
is today's false-negative.

Thomson Reuters will fact check you
into a cancer case to vindicate delusions, stubbornness, and negative pride.

I'm not supposed to express that within the principles and disciplines of medical ethics and the Hippocratic Oath, it's ethically corrupt and illegal to use political and emotional coercion, especially while simultaneously dangling fear over the intended target, to enforce/push any drug treatment, regardless of situation.

I'm supposed to use dope and *****
and a movie
to switch tracks
from my passionate obsession.

I watched a movie that included
a medical health scam to entrap the people
in a fashion similar to when the Germans believed that they were receiving vaccines
that helped to defend against typhus.

If we ever find ourselves in opposite sides
and positions as we are currently,
please offer proper informed consent
to the people.

It started quietly, as most epidemics do.
A few victims, holes in the crowd; no one really notices them even when they're gone.
The same was true for me.

They saw that I was weak; they targeted me for pretending that I wasn't. It was a challenge to their superiority, and any rebellion must be culled.
This rebel could have caused an uproar, so they slipped a virus in my mouth
pressed my lips together
force-fed me poison
made me swallow
and watched my insides burn.

It locked onto my vocal cords, strangled me from the inside.
It gathered my heartstrings into angry fistfuls and knotted them together- made every heartbeat a struggle,
every beat beat beat a fight.
It burned my veins and severed my arteries, bleeding me out to the last aching drop.

They didn't understand the extent of the suffering they put me through.
I don't believe they would care either way.
I was silenced.
I was broken.
They broke me to pieces.

They dug my grave and left me at the precipice without the power to even stand or cry for help.
What was I supposed to do?
My knees buckled; I fell in.

They broke me, but they did not bury me.
I collected those pieces from the toiled, raw ground where they were meant to stay,
pick pick picked until my fingertips bled,
and put myself back together again.
After all, they'd bled all the sickness out with the rest of me.

The question became:
Who am I now?