

Book Is Rallying Resistance to the Antivaccine Crusade - scott_s
http://www.nytimes.com/2009/01/13/health/13auti.html

======
mdasen
This is one of the reasons I love game theory. So, if no one gets vaccinated,
lots of people die preventable deaths. If everyone is vaccinated except me (or
my child in this case), no one will die because there are no carriers. So, in
the face of the vast majority being vaccinated and wild claims about autism (I
agree with the author), parents decide "well, my child has no chance of
getting one of these diseases if all their classmates are vaccinated and I've
been reading trumped up news reports that make me scared so i'll just not have
my kid vaccinated!"

The problem becomes that there's a tipping point. If 5% aren't vaccinated,
that's a lot of potential carriers. Then it becomes a fight of "i don't want
my child vaccinated, but i want your child vaccinated to protect my child."
It's not hard to imagine parents of immunized children then saying, "well,
screw you trying to get us immunized while not taking the risk for your kid!"

Ah, the rights of the individual and the rights of the society! It's really
fun to think about.

~~~
ConradHex
>"...and I've been reading trumped up news reports that make me scared so i'll
just not have my kid vaccinated!"

That's a fairly biased representation of those parents' viewpoint, isn't it?

~~~
mdasen
Totally! I mean, whether that's the reason why or because they have some
secret knowledge, the game scenario is the same (and I'm way more interested
in that). If you're in that camp, I meant no offense and I'm sorry if I
offended you. Mostly, I like to make fictional people sound funny whether I
agree with them or not because it makes the harsh reality that can be life
more fun.

No one would claim that vaccination = autism. It's more like 0.001 *
vaccination = autism if you're in that camp (1 in 1,000 times vaccination
causes autism for those that might not understand my quasi-programmer speak).

For a lot of things in life, belief and reality are the same thing. Whether or
not vaccinations cause autism, the belief that some have that it does cause
autism alters behavior. Whether or not the economy is going to crash, if
everyone believes it will and stops spending so they have money when it does
crash will cause it to happen (since if everyone stops spending money, very
soon businesses will have no money coming in). There is reality, but from a
game theory perspective it often doesn't matter since people's behavior will
be altered by perception of reality probably as much as by reality.

So, let's say it's real that vaccines cause autism in 1 out of 1,000 cases. If
everyone looks at that and says, "no way my kid's getting vaccinated," we have
a huge public health problem. On the other hand, if most submit to the social
good, there will be large resentment of those who don't and are relying on the
vaccination of others not to become infected.

We're not anywhere near the levels where it becomes a big issue in society,
but if more parents go down this road there might be more heat to force them
not to (for the public good). I'm not saying that's good or bad. Morality is
better left to people better than me. I'm just saying it'd be interesting (I
guess in the way a car wreck is interesting) to see how it played out
socially.

~~~
timr
_"We're not anywhere near the levels where it becomes a big issue in society,
but if more parents go down this road there might be more heat to force them
not to (for the public good)."_

Actually, this _is_ a problem. California has had several measles outbreaks in
past few years -- a deadly disease that was effectively eradicated a few
decades ago:

<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e222a1.htm>

Not vaccinating your child should be classified as abuse. There is no personal
liberty argument that overwhelms the public good in this situation.

------
Scriptor
This got me thinking. I am otherwise normally in favor of health care for
everybody, but that would also mean health care for those who chose not to get
vaccinated because of their own or their parents' beliefs. That would mean
that when they get sick it's the public that has the further burden of
supporting them.

~~~
blurry
There is an interesting proposal out there related to organ donation which
could be adopted for this type of situation.

The proposal is to separate people into two groups: those who agree to donate
their organs, and those who decline. Later on, when people happen to need
organ transplants, they receive them according to their group priority, i.e.
if you decline to donate, you turn comes up only after everyone in the first
group received their organs.

I think that is a fair system, and could be applied in this case also. If you
choose to vaccinate, you are covered, and if you do not, you pay out of
pocket.

~~~
showerst
Part of the problem with respect to applying this to vaccinations is that
vaccines have a low but non-zero chance of failure.

If everyone gets vaccinated, and 1% fail (that's just an arbitrary number),
it's no big deal because there isn't enough of a population to carry an
outbreak.

But if 1% of vaccinated patients are vulnerable, and 5% of people choose not
to get vaccinated, then now there's a potential for outbreak, and even some
people who vaccinated get sick.

In economic terms, by not vaccinating you're introducing a negative
externality into society that you're not paying for, so the true cost to non-
vaccinators is artificially low.

~~~
blurry
I don't understand how this affects the system. If the vaccine fails and you
need urgent care, you are covered because you did get vaccinated, right? What
am I missing?

~~~
showerst
You're still covered, but you're paying a cost (missing work, being sick) and
so is the insurance provider/govt, that you wouldn't otherwise have paid, and
it's the non-vaccinator's fault, and they aren't paying for that damage under
your system.

Not really a flaw in your system as much as just something interesting to
think about.

------
Tichy
Isn't there a way to settle this discussion scientifically?

~~~
arockwell
Yes, it more or less has been settled. I have not heard of a reputable study
showing that vaccines cause autism. The problem is that if you try hard enough
you can stretch/fake/politicize scientific results to show just about
anything. There is at least some causal link between giving the vaccines and
autism (there has been a large rise in autism cases that coincide with the
usage of certain vaccines).

Since no one can explain why the incidents of autism are increasing so rapidly
there's a ton of crackpot theories which desperate parent's latch on to.

~~~
Tichy
What is a sensible person to do, get hold of some of the actual studies by
oneself? Without prior knowledge of the problem, I feel inclined to believe
the "no causation" camp. But I can also imagine that it is easy to select the
proper studies to prove just about anything. For the book in question, how can
I be sure that the author didn't chose to only quote the "no causation"
studies, and not other ones that might come to other conclusions?

As I said, I would tend to believe the "no causation" camp, but I also don't
have 100% faith in doctors...

Recently I was in a heated discussion with a friend about "The China Study",
which claims that animal protein causes most of the worst "civilization
diseases" like cancer and heart disease. At face value it sounds absurd,
because it seems as if people have always been eating lots of meat (not sure
if they really have, 150 years ago). So my friend completely rejected the
possibility. The book sounded convincing to me, though - but at the end of the
day, it is just one guy... At least I tried to Google for articles debunking
the book and found none, but there is still a nagging feeling that one might
fall for yet another diet scam (although as I said, the book really made a
very solid impression on me). Just saying it is a similar problem, who is one
to believe?

~~~
arockwell
I think this is one of the problems with so called "un-biased" reporting in
the media. They tend to give equal time to competing theories as if they were
equals. Vaccinations causing autism in the media has been really hyped up in
the media because its an extremely interesting, link-bait type story.

The vaccination story gets so much media attention I'm sure there are many
people who believe that its true simply because its in the news so frequently.

