
Two L.A. universities quarantine hundreds students and staff in measles outbreak - pseudolus
https://www.washingtonpost.com/health/2019/04/26/two-la-universities-quarantine-more-than-students-staff-measles-outbreak/
======
austincheney
Those are both public schools. Why isn’t proof of immunity required at
registration?

It is likely I am just uniformed as to the California school system. Texas
schools require immunization records.

~~~
tapland
Could be visiting from elsewhere or somehow not enrolled. Requiring
immunization papers of anyone on campus would be very hard to do.

~~~
gonzo41
Probably easier to just roll in the vaccinations as part of the uni fee's.

~~~
microcolonel
Vaccinations are free of charge in most (all?) of the U.S, in California any
pharmacy can be reimbursed. This isn't an issue of funds, it's an issue of
unwillingness to vaccinate.

~~~
gonzo41
That's nice to know. I assumed that there would be a cost barrier too access
as with most US health care.

~~~
amluto
Last flu season, I walked into Kaiser and got a flu shot in about five minutes
total. I’m not a Kaiser member, and they didn’t even ask for billing info.

~~~
wemdyjreichert
That's one thing we've done pretty well, bringing down the cost of critical
vaccines. Others are expensive, but they are mostly elective. If you look at
the CDC price list [0] for kids, only 2 vaccines are over $200 for private
sector cost, and they're not too important (one is MMR/Varicella which covers
what would otherwise be two vaccines, and the other is HPV which is
unimportant). Even cheaper for adults. That's within the price range of pretty
much anyone.

~~~
bmalak
> HPV which is unimportant

Wrong. HPV vaccine is super important.

In 2018 nearly 580k women were diagnosed with cervical cancer. 70% of said
cancer is _caused_ by HPV (by two strains of it to be exact). So that is 406k
women each year getting cervical cancer which could have been prevented if
they were vaccinated, and that’s only counting people who were diagnosed. Now
consider that HPV is also known to cause cancers in other organs, both
reproductive and non-reproductive, and that these affect not only women but
men as well.

Granted only 14 of the 100+ strains are linked to cancer, but still. That’s a
lot of preventable cancer.

The CDC recommends the vaccine for basically everyone up to 26, and the FDA
has approved a vaccine for up to 45.

[https://www.who.int/news-room/fact-sheets/detail/human-
papil...](https://www.who.int/news-room/fact-sheets/detail/human-
papillomavirus-\(hpv\)-and-cervical-cancer)

~~~
wemdyjreichert
HPV is elective, because activities that cause it are elective. Cancer-causing
strains are transmitted largely by risky behavior, which is a choice. That is
why I called it elective. Being in a room with someone with measles can cause
you to get it; being in a room with someone with cancer-causing HPV cannot. It
requires a conscious choice.

Edit: down-voters care to explain why I'm wrong?

~~~
technofiend
>HPV is elective, because activities that cause it are elective.

This is patently absurd because if nothing else it's unfortunately a fact _not
all exposure to HPV is elective._ Did you miss the recent article about a baby
born with HPV nodes on her throat that damaged her vocal cords? By vaccinating
the mother and the father and preventing them from having HPV there's no
chance of in-vitro tranmission to the child. Just as vaccinating for tetanus,
measles mumps and rubella and all the rest building herd immunity prevents
current and future generations from passing on the disease.

And regardless of your implied moral judgements preventing a cancer-causing
disease is a net benefit to public health.

~~~
wemdyjreichert
> no chance

A 100% effective vaccination? Also, I didn't imply any moral judgement, I'm
simply stating it's not as important as others.

With respect to the baby story, was that a strain which was prevented by a HPV
vaccination?

I understand there is a benefit, and wasn't disputing that. All I was saying
was that it was elective and less important. There is a reason it is not
required for schools as MMR is, and that it is not standard.

~~~
technofiend
You're not implying that if people just abstained from sex they wouldn't need
the HPV vaccination? That's a judgement about people having pre-marital sex,
is it not? And your stance that it's "less important" is based on the idea
that simply abstaining from sex prevents all HPV exposure, correct? That is
not a science-based conclusion. HPV can be transmitted outside of sex by
walking barefoot across a bathroom floor.

But if you want a morality-driven argument it is IMHO undeniably imperative to
vaccinate the general public against disease including cancer causing disease
regardless of the mode of transmission of said disease and that imperative and
benefits outweigh any counter argument that simply abstaining from a given
behavior lowers that risk.

If I can find the citation for the article I mentioned (I did Google for it
but couldn't find it the first time) I'll happily address whether in fact it's
one prevented by Gardasil, etc.

~~~
wemdyjreichert
> You're not implying that if people just abstained from sex they wouldn't
> need the HPV vaccination? That's a judgement about people having pre-marital
> sex, is it not?

No, because I said nothing about pre-marital anything. There is still a risk,
even in marriage, though people who take only one sexual partner are less
likely to contract such diseases. That's not a judgement, as I am not saying
whether anything is right or wrong, it is simply a fact.

> And your stance that it's "less important" is based on the idea that simply
> abstaining from sex prevents all HPV exposure, correct? That is not a
> science-based conclusion. HPV can be transmitted outside of sex by walking
> barefoot across a bathroom floor.

Correct. You are correct about some varieties, none of which are currently
known to cause caner.

> But if you want a morality-driven argument it is IMHO undeniably imperative
> to vaccinate the general public against disease including cancer causing
> disease regardless of the mode of transmission of said disease and that
> imperative and benefits outweigh any counter argument that simply abstaining
> from a given behavior lowers that risk.

Again, I didn't say that it was necessarily bad, I was pointing out that it
was less important than MMR or other such vaccinations, an assertion by which
I stand.

> If I can find the citation for the article I mentioned (I did Google for it
> but couldn't find it the first time) I'll happily address whether in fact
> it's one prevented by Gardasil, etc.

I couldn't find it through internet-searching either, which is why I made the
above point.

I still maintain that a HPV vaccination is less important than other
vaccinations. This is especially true for men, as the largest cancer risk by
far is for cervical cancer. You are unlikely to get major traction for people
being vaccinated against a disease that will most harm another at their
expense and pain. Why did you take such issue with a passing remark I made as
part of a broader, positive point? I am not saying anything that is _wrong_ ;
the risks are there and the benefits for a large part of the population that
would be required to achieve herd immunity are not.

Again, there is reason it is not standard or required. The herd immunity
argument is not as relevant because it is much less important for men
(especially because existing vaccines focus mostly on strains that cause
cervical cancer) and so a large portion of the population will remain
unvaccinated against it.

~~~
tapland
> I still maintain that a HPV vaccination is less important than other
> vaccinations. This is especially true for men

Yes. Because stopping cancers at disease spreading vectors is just silly,
right?

We don't vaccinate children and give boosters when they are young (at booster
time and have great immune systems) for them to not be kinda sick for a while.
We do it to prevent others, who are more vulnerable, from getting really sick
and/or dying.

How are you missing the simple fact that most women get the cancerous strains
from men?

How can you argue that virgins having sex with anything but another virgin and
having no other sexual partners for life is what is needed for non-risky
behavior? Because if any one has more than one partner and that partner is
allowed more than one partner we are going to have spread of cancerous
strains.

Moralistic arguments are what keeps us from mass-vaccinating against HPV-
strains.

Literally 2019 and arguing on the internet for abstinence only?

~~~
hooba
That guy is saying that 400k cases of diagnosed cancer per year is
“unimportant” because apparently[1] you can just choose not to have sex. They
doesn’t seem to grasp the fact that 100%[2] of the population are affected by
HPV, and that cervical cancer is just 2 of the 14 strains of cancer causing
HPV _that we know of_. Their judgement is indeed clouded by the whole “it’s a
SEX thing” whether they want to admit it or not.

[1] Of course you can choose to not have sex, and many people do, but my point
wasn’t literal. Abstinence is absurd, regressive, arcane, etc, and doesn’t
belong in 2019 nor does it work on 2019.

[2] Just to pre-emptively cover my base against pedantic people: I’m sure that
the number isn’t 100% because of genetic mutations but those are exceptions
not the rule.

~~~
wemdyjreichert
> Abstinence is absurd, regressive, arcane, etc, and doesn't belong in 2019
> nor does it work on 2019.

Why do you call it these things? Your opinion is not a source. I think both of
us can agree it is 100% effective with respect to disease prevention. We're
running into antibiotic-resistant STDs because people won't stop sleeping
around. From the CDC: "Gonorrhea has progressively developed resistance to the
antibiotic drugs prescribed to treat it." [0]

> cervical cancer is just 2 of the 14 strains of cancer causing HPV _that we
> know of_.

"The main type of cancer linked to HPV infection is cervical cancer. Virtually
all cases of cervical cancer are caused by HPV." [1] Yes there are risks of
other cancer, but they are very small unless you are gay.

[0]
[https://www.cdc.gov/std/gonorrhea/arg/default.htm](https://www.cdc.gov/std/gonorrhea/arg/default.htm)

[1] [https://www.cancerresearchuk.org/about-cancer/causes-of-
canc...](https://www.cancerresearchuk.org/about-cancer/causes-of-
cancer/infections-eg-hpv-and-cancer/hpv-and-cancer)

------
deweller
Classification of the event in the headline: "Measles Outbreak"

Actual number of confirmed measles infections: 1

~~~
jostmey
And diseases spread exponentially. Anything that exhibits exponential growth,
whether it be disease or Moore's law, requires a different mindset

~~~
dsfyu404ed
1^N is not the kind of curve most people think of when you say "exponential
growth"

Edit: You people have no sense of humor.

~~~
mnl
I don't know how you came to model anything about this with "1^N" (I don't
recognize that either). A nuclear chain reaction for instance starts with a
single fission event, and if it's supercritical neutron population grows
exponentially.

Edit: wasn't expecting idiosyncratic notation.

~~~
dsfyu404ed
1^N is "1 raised to the N". The one measles case so far growing exponentially
where N is the exponent. It's still 1 for all values of N though. Nothing is
actually increasing even though it's "growing exponentially". There is one
measles case so far. Even if it "spreads exponentially" you would still only
ever have one case if you intentionally misunderstand how disease spreads and
model the number of cases with the function X^N where X is your starting
number of cases.

Jokes aren't funny when you have to explain them though

------
jdougan
[http://archive.is/qHgaz](http://archive.is/qHgaz)

------
largespoon
[https://outline.com/ABYcdE](https://outline.com/ABYcdE)

------
tomohawk
Anyone know what the chance of being infected is if you've been exposed to
someone with measles and had both measles vaccinations?

As best as I can gather, the probability of being protected is 97%, but that
seems to be a general probability during the average persons lifetime. I can't
seem to find a number for when its known you've been exposed.

------
0b0001
Whenever I travel somewhere, my yellow WHO vaccination card comes with me. It
fills me with some pride that humankind set up a worldwide organization to aid
health of both individual /and society/. It's a good feeling to be protected
and protect others.

Is the yellow booklet popular in the US?

~~~
jayess
I've never heard of a yellow booklet.

~~~
0b0001
It's the WHO document that keeps track of your vaccinations.

[https://en.m.wikipedia.org/wiki/Carte_Jaune](https://en.m.wikipedia.org/wiki/Carte_Jaune)

------
lordnacho
Vaccination is one of those things that's presented as a choice, and so some
people will think about whether to do it. And out of those, some will decide
it's not for them. With all the misinformation on the internet it's probably
quite easy to get the wrong impression of how it works.

I really hope this anti-vaxx thing is a passing fad. We're at a point where we
can't live without it. People aren't spread out on farms anymore, we all jam
together on public transport every day now.

~~~
0815test
I don't think it's _just_ a fad, sadly. It's a kind of post-modern hipsterism
that borders on the quasi-reactionary, of a sort that seems to be weirdly
popular as of late, and it might stay around for a while whether we like it or
not. Yes, crowded environments will definitely be an issue. Hopefully wearing
face masks in public will become more popular, much like we see happening in
East Asia.

~~~
sixothree
How are religious conservatives considered post-modern hipsterism?

~~~
TomVDB
Many anti-vaxxers are not religious conservatives but progressives who live in
rich enclaves of Marin county etc.

[https://www.sfgate.com/local/article/kindergartens-
vaccines-...](https://www.sfgate.com/local/article/kindergartens-vaccines-
medical-exemptions-calif-13085811.php)

~~~
tzs
In fact, there is no major religion that is against vaccination [1].

Even religions that you might expect to have a problem because of some of the
ingredients in the vaccine, such as Hindus with vaccines that include bovine
components, or Muslims and Jews with vaccines using porcine components, are
fine with them even with if they include those components.

Jainism you might expect to have a problem because they are against violence
against any life, including microorganisms. But vaccines are allowed, with
regrets, as necessary to protect other lives. (The same reason they allow soap
and cooking).

Scientologists are OK with vaccination.

Among Christians, most denominations are fine with vaccines. Catholics,
Eastern and Oriental Orthodox, Amish, Anglican, Baptist, Mormons,
Congregational, Episcopalian, Jehovah's Witness, Lutheran, Mennonite,
Methodist, Quaker, Pentecostal, Presbyterian, Seventh-Day Adventist, and
Unitarian-Universalist...all fine with vaccination.

The Christians against vaccination are the Christian Scientists, the Dutch
Reformed Congregations, and the faith healing denominations. (Christian
Scientists think vaccinations are unnecessary because they think they can cure
disease with prayer, but they don't have a religious problem with getting
vaccinations if they are required to enroll in school or travel or things like
that).

[1] [https://www.vumc.org/health-wellness/news-resource-
articles/...](https://www.vumc.org/health-wellness/news-resource-
articles/immunizations-and-religion)

~~~
droithomme
Is Catholicism a major religion?

The Vatican issued an official statement about the morality of using,
administering, allowing and requiring vaccines which include aborted fetal
cells.

[http://www.immunize.org/talking-about-
vaccines/vaticandocume...](http://www.immunize.org/talking-about-
vaccines/vaticandocument.htm)

~~~
tzs
The document you cite concludes that it is OK for Catholics to use such
vaccines on their children if there are no vaccines not derived from such
cells available because the moral necessity to protect the health of your
children and those they come in contact with outweighs the mild, remote
passive material cooperation with abortion doing so provides.

That was from 2005. They updated their position in 2017 [1]. The two abortions
that provided the cell lines used for vaccines were more than 50 years ago.
That removes even that mild passive material cooperation concern:

> the cell lines currently in use are very distant from the original abortions
> and no longer imply that bond of moral cooperation indispensable for an
> ethically negative evaluation of their use

...

> The technical characteristics of the production of the vaccines most
> commonly used in childhood lead us to exclude that there is a morally
> relevant cooperation between those who use these vaccines today and the
> practice of voluntary abortion

They also say that there is a "moral obligation to guarantee the vaccination
coverage necessary for the safety of others".

[1] [https://cruxnow.com/vatican/2019/03/20/vaticans-academy-
for-...](https://cruxnow.com/vatican/2019/03/20/vaticans-academy-for-life-
encourages-parents-to-vaccinate-children/)

------
tibbydudeza
What year is this again ... why is US society pandering to the most stupid
among them ???.

~~~
briffle
There is a large group of people starting to frame this a "personal freedom'
issue. Some people in my circle are family members, or old classmates, etc.
Some view it as a moral issue, because they are afraid of what 'the state'
might mandate as a vaccine. (and what might get added in the future. For
example, a few of them are VERY opposed to gaurdasil, since in their minds
(not mine) that helps promote promiscuity, and the downfall of good moral
choices, etc.

Overall, the people that I know that are opposed are all successful, in
industries without strong education requirements (ie, realestate, the trades,
etc) But have a VERY strong distrust of government, and the medical industry.
They frame it as a personal 'freedom' but really, they seem to be worried that
the corrupt state will push barely tested shots on our kids, that will cause
who knows what.

I don't agree with them, but I figured I would state their points, because
just calling them idiots doesn't solve the problem

~~~
BeetleB
>For example, a few of them are VERY opposed to gaurdasil, since in their
minds (not mine) that helps promote promiscuity, and the downfall of good
moral choices, etc.

Not disagreeing with the message of your comment, but I would be quite careful
with relating what happened regarding Gardasil. While a lot of people opposed
it on promiscuity grounds, there were many other reasons people opposed it,
and they tend all to erroneously get lumped into the same category. Probably
the most common reason was that the manufacturer was very strongly pushing to
make it a mandatory vaccine for school, and was charging a huge amount for it.
The cost at the time was a lot more expensive (order of magnitude) compared to
other mandatory vaccines. So people felt it was mostly a money grab by the
manufacturer. Additionally, at the time there were studies suggesting that
were it to become mandatory, it would be a net negative for the overall health
of society - because it cost so much. Money would be diverted to this vaccine
from treating other health issues. There were studies indicating that the cost
of mass vaccination was significantly more than the cost of the disease
(relatively rare in the US).

(The years since have likely shown the studies to be inaccurate, but they were
out there).

On top of that, they put in a ton of money on marketing. They paid a large
number of physicians to go on speaking tours about the benefits of Gardasil.
These physicians were sometimes touted as experts, but most were just regular
physicians who had no particular expertise on the matter.

In that kind of environment, you can understand that people will not trust the
motives of the company, and thus by proxy their claims on the effectiveness of
the vaccine. The manner in which they pushed for that vaccine likely hurt the
vaccine movement overall.

(And on the side, I always suspected that the whole "promotion of promiscuity"
argument was merely a strategy by those who don't believe in mass medication
by the government - so they put out the morality propaganda to help their
cause).

------
linuxboxer
Vaccination is criminal assault. Measles is not deadly, it was a normal part
of childhood before people had weak and compromised immune systems.

------
wemdyjreichert
I've always struggled a bit with the whole vaccination issue. Those who don't
want them are obviously idiots, and unfortunately most are parents who are
refusing to vaccinate their children. I generally lean more toward the
libertarian "do what you want until it hurts me" stance, but it's obvious that
a disease epidemic hurts me. At the same time, I have trouble with the idea of
the government rounding people up and sticking needles in their arms.

It's a tough question, and I'm not quite sure how to solve it. We will likely
face many more issues of disease in the years to come, with antibiotic
resistance becoming a growing threat. The idea of a society where a small nick
very well may cause a fatal infection is not a pleasant one.

Also, fungi are a rising threat:
[https://news.ycombinator.com/item?id=19590180](https://news.ycombinator.com/item?id=19590180)

------
wjn0
It seems like vaccination info is not kept at the state or federal level. This
information is no doubt extremely dangerous - imagine if a malicious actor
could get ahold of the "non-vaccinated list." But right now, it's stored at
high schools, universities, and workplaces around the country with standard
HIPAA-grade security. As an example of what kind of government oversight I'm
talking about: in Canada, there are reporting requirements for certain STD
infections (including treatable ones: think chlamydia, or gonorrhea). I think
some US states have reporting requirements as well.

In cases like this, where there's already an active quarantine, if the CDC or
the state kept track of non-vaccinated people, they could be quarantined as
well. The idea being, even if they're not showing symptoms, they're at high
risk for carrying the disease. This seems like a reasonable trade-off for
choosing not to vaccinate yourself, and my guess is people who can't be
vaccinated for medical reasons would be glad to consent to quarantine.

~~~
sneak
The reporting requirements make anonymous testing impossible, which
discourages some people from getting tested at all.

~~~
wjn0
True, it's not a perfect system. But that would likely not be the case for a
vaccination database, anyway.

------
linuxftw
Seems illegal to quarantine people for measles. They don't quarantine people
for the flu, and that's a much deadlier disease.

~~~
overcast
No, what seems illegal is forgoing vaccination. You want to forfeit a proven
system to prevent widespread disease, then you should give up your right to
live in the country. How vaccination isn't a mandatory thing by law, is beyond
me.

~~~
gnu8
Where would you deport them to? Whatever your answer, I can assure you that
the people over there don’t want measles people either.

~~~
overcast
I guess the answer is that it should be required by law then? You either get
vaccinated, or you go into permanent quarantine until you do. I don't
understand how in this case, the needs of the few outweigh the needs of the
many.

~~~
ccallebs
I appreciate your desire to solve the problem, and I'm certainly pro-
vaccination. However, I really don't want to set another precedent of allowing
the state to permanently detain people because of perceived public danger
(real or otherwise).

Imagine if this kind of thinking prevailed in the HIV hysteria of the
80's/90's. It's relatively easy to follow this approach to its logical
conclusion. When you order authoritarianism, it's very likely you'll get it.
And not simply in the places you want it.

~~~
overcast
The HIV scenario is not equivalent. It was new, people were frightened and
ignorant. There is no cure, no vaccination. Measles is a well understood
disease that had been eradicated. Openly putting others at risk because of
some nonsense belief should not be tolerated.

Are you good with a HIV+ person knowingly infecting others because it's their
right to refuse antiviral medication? Measles and other highly contagious
diseases can infect large populations without anyone knowing before it's too
late.

~~~
ccallebs
I don't disagree with you and I trust you to make the distinction between the
two things. However, I don't trust lawmakers/police/military to have the same
sense of nuance.

