Yesterday’s post ended up being quite long, to the point that I had considered not writing anything today. However, there is a vaccine-related news story that I became aware of yesterday that mandates at least some comment, mainly because it’s so bizarre. Regular readers who’ve encountered this story will understand why I feel I had to write about it. I’m referring, of course, to the case of a Chicago area pediatrician named Dr. Van Koinis who committed suicide last August and who was found dead of a self-inflicted gunshot wound in a forest preserve outside of Chicago. Why did this story attract my attention? It was headlines like this appearing in the news over the last three days:

The first story I saw about Dr. Koinis’ suicide was reported on Tuesday:

According to the report:

Investigators found a suicide note raising questions about his vaccination records. It was last September when Koinis was found dead from a self-inflicted gun shot wound. The Cook County Sheriff’s office said his suicide note indicates there might be a problem with records he kept regarding the vaccinations children received, or did not receive, at his office on West 95th Street in Evergreen Park. “The note was very short. It was a note where he expressed a lot regret and the note was solely driven at the fact that he did things he regretted as far as the vaccinations,” said Cook County Sheriff Tom Dart. He added Koinis also expressed regret in doctoring records. “He was incredibly regretful for what he did and it was the only thing he mentioned in the suicide note. It was this and only this,” Dart said. Dart said that the note mentioned a window spanning about 10 years in which he either doctored records or gave fake vaccinations. Koinis was a big believer in homeopathic remedies. The note didn’t express regret in those beliefs but “regrets in what he did.”

Of course, a physician who believes in homeopathic remedies and practices “natural” medicine is very likely to be antivaccine, or at least to have doubts about vaccines and/or believe that they cause autism and other health conditions commonly attributed to vaccination by antivaxxers, which leads to obvious questions. First, did Dr. Koinis actually do this at the behest of vaccine hesitant and antivaccine parents who were attracted to him because he practiced homeopathy and were seeking to avoid vaccination? Illinois only recognizes nonmedical exemptions to its school vaccine mandate based on religious objections, and since 2015 parents seeking a religious exemption to the Illinois school vaccine mandate must submit an official Certificate of Religious Exemption signed by a health care provider, who by signing the exemption form is certifying that he has counseled the parents on the benefits of vaccination as well as the risks to themselves and to the community of not being vaccinated. Presumably, Dr. Koinis wouldn’t have objected to signing such forms, given his focus on “natural” medicine and his apparent antivaccine slant. The situation now is all a confusing mess:

“Our thinking is that would mean that people who came there came with a purpose to get records phonied up, not have to take the vaccine and take the records to a school that would allow their child to be admitted even though their child never had a vaccine.”

Again, why wouldn’t such parents simply ask Dr. Koinis to sign the exemption form for their children? Falsifying medical records is a crime, and, if the crime were discovered, parents would be subject to prosecution if they were complicit in the crime by asking Dr. Koinis to fake the vaccinations. It doesn’t make sense:

“It was a little bit cryptic but in some places, very straightforward in the conduct that he was regretting,” Dart said, who noted the vaccine situation was connected to his suicide. “There seems to be an overarching depression that was driven by years of not vaccinating people properly. We were not able to nail it down any further,” Dart said. “That was the sole reason he gave for this.” It was those clues that led his office to investigate the doctor, his records and other connections to his practice. He was a solo practitioner and didn’t work with any other doctor. “He was an individual who practiced homeopathic medicine and was very much into holistic medicine and apparently a lot of individuals who are against vaccinations were attracted to him,” Dart added.

No doubt that is true. “Natural medicine,” naturopathy, homeopathy, and alternative medicine are very much associated with antivaccine views, both among practitioners and those who seek out such treatments:

Investigators found the possibility that in some cases Dr. Koinis did not provide vaccinations at their parents request. “Was this just the case where individuals who were against vaccinations came to him. He waived vaccinations and phonied up records or is this larger than that,” questioned Dart. “We feel that there was people who came to him purposely to get the sign-off on vaccinations that they did not get,” Dart said, who added that those people who got a phony sign-off could face criminal charges, including forgery.

Of course, there is another possibility, namely that Dr. Koinis, not believing in vaccination, thought he was helping children by faking the vaccinations and not telling the parents about it, which is, of course, malpractice. There’s no evidence that he did that, but one does wonder, given stories like this from parents who, unlike the majority of parents, did not gush over Dr. Koinis after his death had been reported:

But another parent, Mary Mullaney, said she’d had doubts about Koinis’ methods. “My oldest son now is 13, and when we went for his 12-year vaccinations, something was going on with him. He was just very different. He wasn’t the same doctor that I had been taking my kids to,” Mullaney said. She continued: “He had always been stuck on like the technology aspect of technology ruining children’s brains, but this visit, I mean I sat there for about 45 minutes and he kept going on and on and on. I was just there for the checkup and he actually ended up telling me that my son didn’t need the vaccines that the school had said, so I believed him and then my son’s school actually contacted me saying if he didn’t have these shots that he wouldn’t be able to come back, so when I went back to Dr. Koinis, he was kind of surprised. We got the shots. He gave it to him. I hope that’s what he gave him.” Mullaney said she went back another time when her son became sick. “Dr. Koinis kept telling me oh, it’s a virus, it’s a virus, but I knew something was wrong. I kept asking him to send us to a specialist or something and he wouldn’t. He told me it wasn’t necessary. He went back on the technology stuff,” she said. “So I actually ended up pulling my kids from the practice and found out my son actually ended up having like life-threatening food allergies.”

So, from what I gather, is that Dr. Koinis had been deteriorating for some time, likely becoming more extreme in his antivaccine-views, if his encounter with Ms. Mullaney is any indication. Clearly, there also appeared to be mental health issues that were affecting his interactions with at least some parents.

Again, there’s no direct evidence that Dr. Koinis actually failed to vaccinate a child against a parent’s wishes that the child be vaccinated, but some of the stories coming out now are rather odd and do make one wonder. For instance, soon after Dr. Koinis’ death was reported, parents started complaining on local Facebook groups that they were having difficulty getting their children’s medical records, which were in disarray. Because Dr. Koinis was a solo practitioner, an increasingly rare beast in medicine these days, this was a serious problem for these parents, because there was no one to verify the records. In Michigan, this might not have been as large a problem, because here we have a centralized state database of all vaccination record and doctors’ offices and pharmacies (and any other entity where vaccines are administered) are required to enter the name of each patient and every dose of vaccine administered to each patient into the database.

Also, Dr. Koinis was apparently very popular and well-loved by his patients and their parents:

Koinis was wildly popular in the village of Evergreen Park, the suburban Chicago community where he maintained his practice. On Zocdoc, where he received over 1,000 glowing reviews and a five-star rating, parents praised him for being thorough, knowledgeable, attentive and caring. One reviewer also noted Koinis “doesn’t pressure you if you want to be more selective with shots!”

That last observation is unsurprising. AFter Dr. Koinis went missing, residents begged a local TV news reporter at WGN named Patrick Elwood to investigate:

The result:

…(The reporter, Patrick Elwood of WGN, responded that Koinis was his children’s pediatrician, too, “and a wonderful man.”) The news of his death on Sept. 10 inspired an outpouring of emotion from people who described him as “more than just your ordinary doctor,” including one mother who recalled driving all the way from Indiana so she could keep bringing her children to Koinis even after they moved. Another said Koinis once gave her money out of his own pocket to pay for a prescription.

So what to do now? Parents who have doubts over whether Dr. Koinis vaccinated their children are being asked to consult their children’s current pediatrician. For many vaccines, antibody titers can be drawn to see if the child has been vaccinated. This, of course, is not a prospect that parents will look forward to, given how children react to blood draws.

Not surprisingly, Kim Rossi at the antivaccine propaganda blog Age of Autism, were surprisingly negative about Dr. Koinis:

An Illinois pediatrician confessed to lying to parents that their children had been vaccinated. He in fact did not vaccinate them. My first thought is that he may have been committing financial fraud. There’s lots of speculation about his death. I think of the opiate epidemic and the money behind it. One theory, and just a theory, dear readers: money. He was being paid a bonus by the insurance companies for vaccination compliance. He was being paid for well visits – which are actually vaccination visits. But he was not vaccinating the patients. Surely purchasing records will show if he had brought in the product. And his nursing staff must have been aware of something going on? Anything is possible. My father was an orthodontist and he knew of a local doctor who kept two sets of books. One with far lower income that he presented for taxes than the true income. Fraudsters don’t care about the letters after their name. That said, suicide is always a lifelong pain for a family. Suicide with scandal is all the worse. Lying to patients, or in this case Mothers of patients, who trusted him to provide the medical care they expected, is onerous and wrong, no matter our position on vaccination. It’s cowardly too. Perhaps we’ll never know the true story.

That last part is, unfortunately, likely to be correct, and, of course, Ms. Rossi had to slip in a conspiracy theory that he was going for the insurance company “bonuses” for vaccinating children without actually buying vaccines. Unfortunately, that wouldn’t work, because of record keeping requirements to bill insurance companies. Of course, the denizens of the comment section are less circumspect. Some speculations found in the comments after Rossi’s post.

First, of course, is a typical antivaccine conspiracy theory:

I am sorry but the cynic in me does not trust or accept the Cook County’s Sheriff office “interpretation” of the suicide note reportedly left after the suicide of Dr. Van Koinis. Consider … why would this doctor write a suicide note claiming to have ‘NOT VACCINATED CHILDREN” as their parents had requested him to do .. and not give the reason for so doing so? For instance .. if his intention was to confess misleading his patients .. for purely financial gain … wouldn’t it make sense for him to explain THAT as his MOTIVATION for doing so. Sheriff’s “interpretation”: “In his suicide note, he revealed he may not have administered vaccinations to children at their parents’ request. His note indicated he felt terrible guilt over the way he handled some children’s vaccinations going back a decade” Maybe the doctor did exactly the OPPOSITE … he DID administer vaccinations to children AGAINST their parents wishes … to GAIN THE FINANCIAL REWARD BASED ON COMPLIANCE RATE IN HIS OFFICE????? He just didn’t tell parents he had done so .. which would explain his “confession” that he may not have administered vaccinations as parents had requested??? Somewhere is the TRUTH in what this doctor did … whatever it was caused him great guilt .. and vaccinating children against the parent’s wishes would be a likely cause .. especially if ANY child so vaccinated against their parents wishes had a SERIOUS ADVERSE REACTION THE DOCTOR WOULD HAVE BEEN RESPONSIBLE FOR. In any event … we will never learn the TRUTH if that was the doctor’s cause of GUILT.

As conspiracy-laden as this commenter’s comment is, there is a grain of a good point there. The full text of the note has not been published. We are hearing only the Sheriff’s interpretation of what Dr. Koinis wrote before his death. The sheriff even admits that the note is rather cryptic in places. Without seeing the full text of the note, it’s hard to know how accurate the Sheriff’s interpretation is likely to be. Even so, wow. Of course antivaxxers would think it was guilt over vaccinating that led to Dr. Koinis’ suicide. Indeed, some even shared the article on social media saying just that.

Another AoA denizen didn’t think it was the doctor who was committing fraud, but rather that the revelation of the existence of a suicide note is a plot by the Illinois Department of Public Health to check up on patients who are likely not to have been vaccinated, given Dr. Koinis’ beliefs:

Another theory – has the suicide note been seen by the public? Is it genuine? This could easily be a scam by the authorities to check up on the patients. The doctor might even have been murdered – he wouldn’t be the first. Don’t believe anything you read.

I was surprised to discover one thing. I had figured that Erin Elizabeth of Healthnut News hadn’t yet added Dr. Koinis to her ongoing series of “mysterious deaths” of “holistic doctors” she’s been using to imply that there is some sort of plot to target holistic healers. She did report on it, though:

Koinis was found dead last September from what authorities say was a self-inflicted gunshot wound. Though he had no kids and wasn’t married, authorities state Dr. Koinis drove to a forest preserve that was some ways from his home and took his life. He was not discovered for weeks, prompting his patients to ask publicly (on our page no less) why he wasn’t found sooner during a popular time of year. We did a live video tonight to many thousands on our Facebook page and had dozens of his former patients (or parents of his patients) leaving comments as to what an amazing man and doctor he was.

Echoes of her “reporting” on the suicide of Jeff Bradstreet! Ms. Elizabeth might not have added Dr. Koinis to her list of victims of her postulated big pharma hit list…yet, but she sure does appear to be getting ready to add his name to the list. Otherwise, why would she make it a point to mention that Dr. Koinis wasn’t married and didn’t have any children before mentioning that he drove to a forest preserve and shot himself, while also “wondering” why it took so long for his body to be discovered. It’s a forest preserve, and it’s not uncommon for people looking for a place to commit suicide to find the most secluded area they can. When Elizabeth starts “raising questions” about whether Dr. Koinis really committed suicide or not, just remember, you read the prediction that she would do that here first.

In conclusion, I’ll just throw in a word of caution over this suicide note and its reliability about the actual reasons that Dr. Koinis killed himself. On Twitter, an actual expert in suicides wrote:

Suicidologist expert time!



Suicide notes are a mixture of truth, guilt, fiction, fantasy, projection, denial, and often the written "causes" turn out to be very much not true (or they can be, but we cant tell!).



They have been extensively studied and are of very poor value. — Tyler Black, MD (@tylerblack32) February 12, 2020

Certainly! But hopefully they look at other factors as well and don't see the note as "explanatory"! — Tyler Black, MD (@tylerblack32) February 12, 2020

This, of course, goes counter to common wisdom about suicide notes, which mistakenly views them as very truthful, as the person contemplating suicide unburdens himself before taking his life. Whatever the reasons that Dr. Koinis drove into a secluded forest preserve and shot himself, suicide is horrible, and its effects on family and friends are lifelong. I know this, unfortunately, from personal experience, as my brother-in-law committed suicide 13 years ago. I thus conclude by offering my condolences, as little as they likely mean at this point, to all of Dr. Koinis’ family, friend, and patients and their parents. I also hope that the investigation does ultimately turn up the truth regarding his vaccination practices, whatever that may be.

NOTE: Sorry this posted late. For some reason, WordPress’ Scheduled Post feature failed me this morning and I only just noticed.