
Infectious disease doesn't care why you're unvaccinated - RockyMcNuts
http://www.sciencebasedmedicine.org/i-refute-it-thus/
======
jared314
> Most people have not lived in a time of plagues or remember their effects.
> Most people do not read history or look at the morbidity and mortality of
> vaccine-preventable illnesses in the third world.

This is another great example of why people need to be taught actual history,
not the version censored "for their young minds". The people who change
curricula and edit textbooks to remove the unpleasant memories, or forward an
agenda, do a disservice to everyone[1].

[1] [http://www.huffingtonpost.com/2010/03/14/backstory-how-
the-t...](http://www.huffingtonpost.com/2010/03/14/backstory-how-the-texas-
t_n_496831.html)

~~~
jmadsen
The sad thing is, one of the worst pandemics in human history is fairly
recent:
[https://en.wikipedia.org/wiki/1918_flu_pandemic](https://en.wikipedia.org/wiki/1918_flu_pandemic)

There are (a few) people alive today who remember it.

It killed between 1.5 and 3 times as many people as the earlier WWI - but
isn't as sexy as war, so hardly anyone studies it (relatively speaking)

~~~
dhughes
Killing about 5% of the entire population of the world about 100 million
people, just imagine now with seven billion if a flu outbreak killed 350
million people.

Even people on remote islands in the middle of oceans died from the flu.

~~~
pyre
> Even people on remote islands in the middle of oceans died from the flu.

Without contact from the outside world?

~~~
dhughes
It was avian based influenza, birds spread it to remote areas of the world.

------
venomsnake
I saw a kid with polio deformed legs a few months ago. Something that I have
never seen while the immunization calendar was state mandated and I was young.

I have also never seen a case of autism.

In a few years we will have outbreak of something preventable. I just feel
poor for all the kids that had real reasons not to get the shots.

A friend of mine after very bad Hodgkin was with compromised immune system for
10 years. He was constantly sick and popping antibiotics like tic-tacs. If the
herd immunity was not so strong he would have been dead.

The stuff we vaccinate against is not harmless.

I would also recommend Ben Goldacre's "bad science" where he makes one of the
best analysis of the MMR scare insanity and its origins and development. It is
mostly the media's fault.

~~~
up_and_up
> I have also never seen a case of autism.

Not sure where you live.

There are two kids with autism on my block. Both young boys. Autism is a
common disease where I live in the midwest. We have 3 large organizations that
only work with Autistic kids.

My wife and I have 3 kids and vaccinate them selectively on our own schedule.
We vaccinate our kids for the same things that we received as children,
nothing more and nothing less.

> The stuff we vaccinate against is not harmless.

Our medical system wants to vaccinate for everything now, chicken pox etc.

~~~
minikites
Why not vaccinate for chickenpox? Helps reduce chance of scarring and reduces
the chance for shingles. When I was a kid I gave chicken pox to my mom who got
super sick. It would have been nice to have a vaccine back then.

[http://en.wikipedia.org/wiki/Varicella_vaccine](http://en.wikipedia.org/wiki/Varicella_vaccine)

I'm surprised at the number of comments on a tech site showing fear of
technology.

~~~
fnordfnordfnord
It isn't so much a fear of technology, as a distrust of the authorities. Like
the author said, some of it has a rational basis, and some does not. I know
vaccines usually work, and are mostly safe. I remain very skeptical though for
several reasons including: The difficulty of proving vaccine injury, and
inadequate remedies. The business incentives caused by the NVCIA[1] (no fault
vaccine court). Personal experience with doctors, pediatricians, and other
medical professionals. The lack of credible statistics for vaccine adverse
reactions.

It is nearly impossible to find authorities on the subject who can calmly and
rationally explain the risks and benefits, and help you evaluate the risk
properly. It is also nearly impossible to find objective impartial information
from any source. The "debate" on the subject is very polarized. Skepticism is
often treated as heresy or idiocy.

We still vaccinate our children, but not for everything[2], and not always on
schedule.

[1]
[https://en.wikipedia.org/wiki/National_Childhood_Vaccine_Inj...](https://en.wikipedia.org/wiki/National_Childhood_Vaccine_Injury_Act)

[2] We delayed the HEP-B at birth and opted not to take the rotavirus vaccine.

~~~
venomsnake
HEP-B is one of the vaccines that a person can take anytime. (It is actually
combined A+B 3 shot IIRC). HEP-B is transmitted by bodily fluid exchange so
the real danger kicks during puberty. But it is extremely virulent sadly.

~~~
fnordfnordfnord
>HEP-B is transmitted by bodily fluid exchange so the real danger kicks during
puberty.

Right, we determined the risk of contracting Hep-B was very low for infants.
The other risk factors are blood transfusions, medical malpractice. They will
get it before they start school. There is also very low chance for an infected
infant/toddler to spread Hep-B so, no ethical worries there, unlike MMR.

------
ronaldx
Please note first that I am pro-vaccination.

Vaccinations are a risk, which are designed to mitigate another (larger) risk.
With this in mind, we shouldn't look at vaccines uncritically.

The article points out that Japanese vaccinations were withdrawn because they
were believed to be causing aseptic meningitis - it's a shame that no numbers
are mentioned on that side of the coin.

The comparative risk of vaccination ought to be regularly and properly
assessed, e.g.
[https://www.ncbi.nlm.nih.gov/pubmed/8096942](https://www.ncbi.nlm.nih.gov/pubmed/8096942)

~~~
dalke
"it's a shame that no numbers are mentioned on that side of the coin"

Here you go: "The rates of virologically confirmed aseptic meningitis per
10,000 recipients were 16.6, 11.6, 3.2 and 0 for the standard MMR, Takeda MMR,
Kitasato MMR and Biken MMR vaccines, respectively." There were 38,203
recipients, and the vaccines "were arbitrarily given".

Source is "Adverse events associated with MMR vaccines in Japan",
[http://www.ncbi.nlm.nih.gov/pubmed/8741307](http://www.ncbi.nlm.nih.gov/pubmed/8741307)
.

~~~
fnordfnordfnord
Shouldn't there be a _lot_ of very good data about this in the general case,
not just for widely recognized anomalous events? I suspect adverse reactions
are under-reported. A recent experience does nothing to dissuade me from that
notion. (I know, confirmation bias). But the sheer number of vaccinations that
take place would provide some very good data. Of course, that data would also
probably show at least some occasional quality control problems with vaccines.
No matter how much I may respect the science behind vaccination, I refuse to
simply have faith that there are never any QC problems with the mass
production of vaccines (or any product for that matter).

Our youngest developed a _very_ bad cough in the days/weeks after receiving
the DTaP. We called the pediatrician who gave us the standard advice, to
monitor the baby and bring her in if it worsened. We later did take the baby
in for the cough. The doctor began dissuading us from the idea that it was
Pertussis or related to the vaccination, before seeing the baby, and despite
local news reports indicating a local increase in Pertussis cases[1]. The
doctor had a look at the baby, and told us again it probably wasn't Pertussis,
everything was normal (except the cough and low grade fever), ran a blood test
for Influenza (tests confirmed that it wasn't Influenza), and told us to use a
humidifier. I asked what the procedure (WRT both treatment and reporting)
would be if it had been a possible or suspected vaccine adverse reaction. The
doctor said they had _never_ had any reportable cases of vaccine adverse
reaction and indicated a general lack of knowledge of adverse event reporting
requirements. The clinic where this occurred was right across the street from
the hospital that baby was born in, in the Medical Center in Houston, Texas,
and is part of a large and well respected practice. Considering the number of
patients that clinic has (it is a busy practice, with several clinics), even
considering the low expected rate of serious adverse vaccination events, it is
not possible that this clinic has never had a reportable event, and very
unlikely that there were no serious adverse events. Baby might not have had
Pertussis and baby is fine now. But, the experience turned my skepticism into
a lack of confidence, at least with that particular clinic.

[1] [http://www.chron.com/news/houston-texas/article/Whooping-
cou...](http://www.chron.com/news/houston-texas/article/Whooping-cough-on-the-
rise-in-Texas-U-S-3851973.php)

~~~
dalke
Umm, what makes you think there isn't a lot of very good data? Start with
[http://www.cdc.gov/vaccines/vac-gen/side-
effects.htm#dtap](http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#dtap) .
I linked to DTaP but there are many others on that page.

To report a problem, go to
[http://vaers.hhs.gov/index](http://vaers.hhs.gov/index) , which is the
Vaccine Adverse Event Reporting System.

Did you get any paperwork about the immunization? There should have been a
flyer or handout like [http://www.cdc.gov/vaccines/hcp/vis/vis-
statements/dtap.pdf](http://www.cdc.gov/vaccines/hcp/vis/vis-
statements/dtap.pdf) . This has information both about VAERS, as well as about
the National Vaccine Injury Compensation Program.

The "ap" in DTaP vaccine means "acellular Pertussis", which means it uses
antigens of the pertussis pathogen rather than whole cells. There should be no
infectious material that could cause a bad cough a week later. (It also has
fewer side-effects than, but is also less effective than the whole cell
vaccine.)

I read that newspaper article you mentioned. It said "Infants under 2 months
of age are at the highest risk, accounting for five of Texas' [six] deaths
this year" and "80 percent of those were children under 2 months old, who are
too young to be vaccinated against the disease."

This is a very different situation than what you are describing, where a cough
starts a week after the vaccination. I don't think you can make the inference
that it's a side-effect of the vaccination itself based on that article.

The article points out that the new vaccine formulation doesn't seem to be as
effective for as long as the old one. What's likely happening is that adults
whose immunity has worn off are acting as carriers for the disease, and
infecting babies and children who haven't received any immunization for the
disease.

This is probably one of the reasons that the Td immunization (DTaP is for
children) recommends "All adults should get a booster dose of Td every 10
years."

(While it doesn't confer a life-long immunity, the goal is to prevent
pertussis in children; they have the highest risk of death if infected.)

I don't know what to say to you, other than that I, some anonymous person on
the internet, agrees with your doctor that "it probably wasn't Pertussis."

> "even considering the low expected rate of serious adverse vaccination
> events, it is not possible that this clinic has never had a reportable
> event"

There are different styles of reporting. First off, 25% of the children who
receive the DTaP vaccine get a fever, 25% get redness or swelling where the
shot was given, and 25% get soreness or tenderness where the shot was given.
Your doctor has almost certainly seen those side effects.

But they aren't reported because they are expected. Again, they should be in
the handout you got as part of the information about immunization. No doctor
is going to report such mild problems.

Then there are the "moderate problems", like seizure, non-stop crying, and a
fever of over 105°F. These occur in less than 1:1000 children, which means
there should have been a couple of children in your clinic who have had these
reactions.

However, it's up to the doctor to decide if this is severe enough to report.
The VAERS guideline include "clinically significant adverse health events
following vaccination", "vaccination error [that] may pose a safety risk", "or
that the error would be preventable with public health action or education"
but "accepts all reports."

These moderate problems are likely not 'significant adverse.' The severe cases
seem to happen in 1:1 million cases or rarer for the vaccinations I looked at.
Even across all of the vaccinations, it's unlikely that your doctor's office
would have had that happen to one of their patients.

So, that's one style of reporting. Another style occurs when they get the
above statistics in the first place. In that case, they enroll doctors into
the program, and have the doctors report _all_ problems that arise after the
vaccination. This can be compared to a baseline reference from children who
haven't yet had the vaccine. (Eg, the three weeks before the vaccine compared
to the three weeks after.) That's used to weed out coincidental correlations.
After all, kids do get sick even with vaccines.

This second style of reporting is what's used to list the known risks of the
vaccine, with the first style of reporting use to get information about the
very rare cases.

What should the doctor have done to improve your sense of confidence? Run a
test for pertussis even though your child didn't have the symptoms for the
disease? Make a report even though it wasn't a severe adverse effect? The
information you wanted - what to do if there was a severe affect - should have
been information you already had. I'm somewhat surprised that the staff didn't
know that, since I (an anonymous stranger on the internet) knew it existed,
but I also only know your side of the story.

~~~
fnordfnordfnord
>Umm, what makes you think there isn't a lot of very good data?

Because there isn't. Good data on vaccine outcomes would mean that blood
samples would be taken and used to assess the effectiveness of vaccines. Good
data would require a follow-up tests post vaccination. Good data means I'd get
a report in the mail, and maybe every once in a while the report might say to
come and get another X because the test indicates that the last X vaccination
was ineffective. Thanks, I've been all over the FDA's and the CDC's websites.

>To report a problem, go to
[http://vaers.hhs.gov/index](http://vaers.hhs.gov/index) , which is the
Vaccine Adverse Event Reporting System.

Yes, VAERS is voluntary reporting system that is sporadically used by
practitioners, and may also be filled with reports from randoms, some of which
may be junk. It has some value, it is better than nothing; but, we certainly
aren't going to draw many conclusions from it. I was very dissatisfied with
baby's first pediatrician for failing to mention VAERS when I asked, as anyone
should be.

>Did you get any paperwork about the immunization?

Of course, parents are showered with CDC pamphlets; and showered with them
again every time you tick a box on forms that say your child isn't up to date
on ALL vaccinations.

>There should be no infectious material that could cause a bad cough a week
later.

I know there shouldn't! I described an experience as I remembered it. I did
not draw a conclusion, I cannot. I do not have my own immunology lab. But,
neither can I dismiss the possibility that the cough was related to the
vaccination (maybe baby was exposed in the waiting room). Nobody else should
draw a conclusion from a secondhand anecdote, either. Baby could have been
exposed several other ways, either to Pertussis or something else.

>I don't know what to say to you, other than that I, some anonymous person on
the internet, agrees with your doctor that "it probably wasn't Pertussis."

Nor do I know what to say to you other than, you're probably right. You'll
probably always be right because both Pertussis infection, and vaccine adverse
reactions are fortunately rare.

I didn't ask the ped to make a VAERS report over the visit. I asked what would
happen in the event of a serious problem, following a vaccination. If you're
my child's pediatrician, and your response to my question indicates a lack of
knowledge, or possible willingness to mislead me for your own convenience;
then you probably aren't going to be my child's pediatrician much longer.

> The severe cases seem to happen in 1:1 million cases or rarer for the
> vaccinations I looked at. Even across all of the vaccinations, it's unlikely
> that your doctor's office would have had that happen to one of their
> patients.

Unless death is the only thing you qualify as serious, you are mistaken. Even
with the shabby state of data collection, and the even shabbier state of
medical studies, severe adverse reactions are evidently more common than
1:1e6. Look at pretty much any vaccine label for evidence to support that. I
haven't access to our former ped's books, but I would expect them to have
given tens maybe hundreds of thousands of vaccinations per decade as a
conservative estimate. Consider the number of vaccines recommended by the CDC
schedule [http://www.cdc.gov/vaccines/parents/downloads/parent-ver-
sch...](http://www.cdc.gov/vaccines/parents/downloads/parent-ver-
sch-0-6yrs.pdf)

>What should the doctor have done to improve your sense of confidence? Run a
test for pertussis even though your child didn't have the symptoms for the
disease?

The child _did_ have the symptoms of the disease[1][2].

Additionally, as I stated, about that time, there was a "Massive Pertussis
(fear mongering) Outbreak" in the news, with periodic reporting and shaming of
vaccine refuseniks. Yes, absolutely, the ped. should have run a test. But the
main thing that any ped. can do to inspire confidence is not to be dismissive
of parents' concerns or questions. If instead of waving more CDC pamphlets at
us, she had mentioned VAERS, or anything resembling even a vague and non-
specific something like VAERS she would probably still be our ped.

Is it not enough that I vaccinate my kids for infectious diseases, despite my
suspicions that all may not be right in the world of vaccines[3], but you
expect me to do so with unreserved faith in the manufacturers of vaccines, and
the government?

[1] [http://www.cdc.gov/pertussis/about/signs-
symptoms.html](http://www.cdc.gov/pertussis/about/signs-symptoms.html)

[2] Pertussis symptoms are quite like the symptoms of Influenza, and many
other childhood ailments.

[3] I don't question the science of immunology or epidemiology. I question the
claim that in practice, vaccines are manufactured, distributed, and
administered with a near miraculous failure rate.

~~~
dalke
Yes, we have different definitions of "good data."

"Good data" for me is enough to establish if there's a public health need.
"Good data" for you is much, much higher.

"the test indicates that the last X vaccination was ineffective"

And perhaps impossible. Do these tests even exist? In the various papers I
read, there are tests for given antibodies, but the only hard numbers I saw
are the infection rates. What's the false positive/false negative rate for
these tests? How much do they cost? Who should pay for them, and what's the
effective benefit?

Also, the test doesn't need to be 100% effective in everyone in order to be
useful. That's the logic behind herd immunity.

"Look at pretty much any vaccine label for evidence to support that."

I did look at the Vaccine Information Statements for several vaccines. I
pointed you to one as well.

DTaP: Severe Problems: 1) Serious allergic reaction (less than 1 out of a
million doses), 2) Several other severe problems have been reported after DTaP
vaccine ... These are so rare it is hard to tell if they are caused by the
vaccine.

Hepatitis B: Severe Problems: Severe problems are extremely rare. Severe
allergic reactions are believed to occur about once in 1.1 million doses.

MMR: Severe problems: 1) Serious allergic reaction (less than 1 out of a
million doses), 2) Several other severe problems have been reported after a
child gets MMR vaccine ... These are so rare that it is hard to tell whether
they are caused by the vaccine.

Then there's the ones that don't even have numbers, which I assume puts it in
the "greater than 1 in a million" probability.

Meningococcal: Severe problems: Serious allergic reactions, within a few
minutes to a few hours of the shot, are very rare.

Pneumococcal Conjugate (PCV13): Life-threatening allergic reactions from any
vaccine are very rare.

Haemophilus Influenzae Type b (Hib): The risk of Hib vaccine causing serious
harm or death is extremely small

Since I couldn't find one with < 1e6 probability of severe problems, perhaps
you can point it out to me?

If your clinic has done 100,000 shots, then that's still under a 10%
probability that any of their patients have had a problem. But the math
doesn't work out as simple as that. If someone isn't allergic to DTaP the
first time then that person likely isn't allergic to it the next 4 times. I
estimate more like a 2% rate.

> there was a "Massive Pertussis (fear mongering) Outbreak"

Which was an outbreak mostly among those who have not been vaccinated. Your
child had been vaccinated. (Well, you didn't say if this was after the 2
month, 4 month, or 6 month shot. If it started the day after the 2 month shot
then the immunization wouldn't have started being effective. I don't have
enough data to go on.)

> the main thing that any ped. can do to inspire confidence is not to be
> dismissive of parents' concerns or questions

Agreed. You have every right to make that decision. It is a proper one.

My argument is that your demands on the quality of the information you expect
- personalized tests after every vaccination, for example - is not possible.
It's expensive, even if feasible, and the major benefit seems to be that it
makes people like you more confident.

But that data will also have vague and uncertain parts. It won't be a simple
statement of "the last vaccine did not provide enough immunization" but "the
number of antibodies is 10% lower than the recommended level. This may
increase the risk that your child will be infected in the future by between 1%
and 15% compared to full immunization. Enough other children have been
immunized so the overall probability is very low, unless <list of
circumstances>. Should you wish a booster shot, please contact your
physician."

You complained about "waving more CDC pamphlets at us" \-- interpretation of
this additional data leads to still more CDC pamphlets.

"I question the claim that in practice, vaccines are manufactured,
distributed, and administered with a near miraculous failure rate."

Why do you think it's 'near miraculous' any more than having potable fresh
water come out of your tap? A clean water supply has probably saved more lives
than all the vaccinations ever done in the US. We bathe in drinking water!

The vaccines which have the higher failure rates, like anthrax, aren't part of
the normal schedule. The allergic reaction rate to the anthrax vaccine is
">100,000" so 10x higher than those children get.

The yellow fever vaccine lists "Severe allergic reaction to a vaccine
component (about 1 person in 55,000)" and "Severe nervous system reaction
(about 1 person in 125,000)" and "Life-threatening severe illness with organ
failure (about 1 person in 250,000). More than half the people who suffer this
side effect die." That's much higher than anything I saw on any of the
childhood vaccines.

Let's look at some less successful vaccines.

The RTS,S malaria vaccine only reduced the chance of infection in children by
31%, which it lower than the 50% that the researchers had hoped for, and much
lower than the 90+% from the best childhood vaccines.

The RV 144 HIV vaccine is estimated to be 31.2% effective, but "there is no
more than a 71 percent chance that the vaccine was effective at preventing
HIV." There are of course many AIDS vaccines which just plain didn't work.

The attenuated form of the polio vaccine would sometimes revert to a more
virulent form, which caused vaccine-induced polio in about 1 in 750,000 cases.
The US switched to the less effective inactivated form, because those rare
polio cases aren't worth the advantage.

And so on.

The first vaccine was for smallpox in 1796. The first compulsory vaccine law
was in England in 1853. The rabies vaccine was in 1885. The first polio
vaccine in 1955. There's a lot of work behind that "near miraculous failure
rate." Why are you so astonished?

For that matter, there are failure rates, just not at the level where you're
looking. People get the wrong shots, last year "160,000 doses of the Novartis
vaccine, Agrippal, [were] recalled after 'particles' were found in the vials",
and this year Merck recalled "1 lot [27,000 vials] of Recombivax HB hepatitis
B vaccine (adult formulation, 10 μg/mL) because some of the vials may be
cracked."

And so on.

Why does any of this require you have "unreserved faith in the manufacturers
of vaccines, and the government", any more than you have faith in the builders
of your car, the maintainers of the traffic lights, or the pilots and builders
of the plane you fly?

~~~
fnordfnordfnord
For a start "Good data" is data from independent sources, not merely clinical
trial data provided by manufacturers. The need to collect "Good Data" doesn't
stop after the clinical trial ends because there are many opportunities to
screw up between the end of clinical trials and mass vaccination.

>what's the effective benefit?

It closes the loop. Researchers and manufacturers get data with which to
improve their products. Patients get more confidence in the products they are
administered. Increased confidence means more vaccinated people, and better
herd immunity.

>Which was an outbreak mostly among those who have not been vaccinated.

It was also mostly fear mongering, and there were a fraction of those who
contracted Pertussis who were vaccinated. Ped's shouldn't be surprised if this
sort of thing biases the opinions of worried parents. I think baby's cough
happened after the first or second of the series. Can't remember exactly,
doesn't really matter. Baby is doing fine.

>Why do you think it's 'near miraculous' any more than having potable fresh
water come out of your tap?

Because manufacturing and distributing pharmaceuticals is more complicated
than digging a hole, pumping water through sand filters and adding Chlorine, a
task that is routinely accomplished by people without even a high school
education.

> A clean water supply has probably saved more lives than all the vaccinations
> ever done in the US.

Yes, I know, isn't it great? But vaccines often get the credit.

>We bathe in drinking water!

The significance of this isn't lost on me. I have visited developing
countries, and lived in China, where tap water is usually not considered safe
to drink.

>My argument is that your demands on the quality of the information you expect
- personalized tests after every vaccination, for example - is not possible.
It's expensive, even if feasible, and the major benefit seems to be that it
makes people like you more confident.

It probably is too expensive to achieve 100% testing, that's a high bar.
Continuous sampling? I think it not too big a challenge or too expensive. I'd
bet that some people would even pay extra for it if they had too.

>the major benefit seems to be that it makes people like you more confident.

Do you want herd immunity or don't you? It's not as though I am the last
doubter.

>But that data will also have vague and uncertain parts. It won't be a simple
statement of "the last vaccine did not provide enough immunization" but "the
number of antibodies is 10% lower than the recommended level. This may
increase the risk that your child will be infected in the future by between 1%
and 15% compared to full immunization. Enough other children have been
immunized so the overall probability is very low, unless <list of
circumstances>. Should you wish a booster shot, please contact your
physician."

We need some meeting place between the raw data in .csv vs "Just Take, All The
Vaccines" Maybe I'd trust Nate Silver to tell me, if he showed me some pretty
charts. It needs to be understandable by a lay-person.

>You complained about "waving more CDC pamphlets at us"

Well, obviously, they aren't effective on everyone. Why would more of them be
more effective?

>For that matter, there are failure rates, just not at the level where you're
looking. People get the wrong shots, last year "160,000 doses of the Novartis
vaccine, Agrippal, [were] recalled after 'particles' were found in the vials",
and this year Merck recalled "1 lot [27,000 vials] of Recombivax HB hepatitis
B vaccine (adult formulation, 10 μg/mL) because some of the vials may be
cracked."

No, that's exactly the sort of thing that worries me. And no amount of
historical safety data can prevent a mishap like those you mentioned from
occurring.

>Why does any of this require you have "unreserved faith in the manufacturers
of vaccines, and the government", any more than you have faith in the builders
of your car, the maintainers of the traffic lights, or the pilots and builders
of the plane you fly?

Cars are not a great example, I can choose not to buy a crappy car because
they performed poorly in crash tests. Planes are a little better, and you know
what? I don't really want to ride in a 787 until they fix those batteries, and
I can choose not to fly Northwest because of their maintenance problems (well
before they went under). But in general, I am mostly unimpressed with the FAA.
But, I have very small latitude WRT my choices of vaccines. A gov't agency
purposefully crashes example cars to prove their safety, it is unethical to
try the same thing with people. But neither the FDA nor the CDC appear to take
much interest in providing better oversight. I expect more. Sorry if you think
it is too expensive or not worth it. I don't agree.

------
rbourke
The effectiveness of vaccines rely on 'herd immunity', that is: you need more
than 90% of a population immunised to stop a disease spreading (as vaccines
are never 100% effective)(also varies according to vaccine types/adjuvants and
disease contagiousness)

So by not vaccinating your self/dependents you are actually extremely selfish
as you are benefiting from herd immunity whilst at the same time avoiding the
(small) side reactions each vaccine may have. This is one of the most selfish
things you could ever do.

~~~
ChrisAntaki
From my research, people who avoid vaccines are usually afraid of (big) side
reactions, like infertility or autism.

~~~
jlgreco
Oh, those are "big" (as in, serious, though rare; or serious, but doesn't
fucking happen...) but do you know what is bigger? Somebody who could not get
immunized dying because you refused to get immunized.

That is why it is selfish. _Incredibly_ selfish.

~~~
rentAchop
If one was forced to immunize their child, that child then dies from a
reaction to that vaccine. Is that the "unselfish" act? You might of well have
said it's against your "morals". Your full of it, might as well say we should
cull the autistic kids from the herd, you know to protect the herd.

~~~
jlgreco
Vaccines save _millions_ of live. If, in your personal system of morality, the
_veeery_ slight chance that your child will die takes priority over the
benefit vaccines present to society, then while you are entitled to that
viewpoint, I have the right to call you a selfish monster who embodies much
that is wrong with modern society.

Furthermore, neither autistic kids nor eugenics have fuck all to do with
vaccinations. Quit peddling this bullshit.

------
laurent123456
I love this argument, "reality doesn't care". I often have semi-arguments with
family members when they tell me that they "believe" that X is true or Y is
false when it comes to medical or scientific stuff. Then I tediously argue
that science is not a matter of beliefs but facts, but that doesn't really hit
home because some random guy on a random website wrote something they wanted
to hear.

I thought about forwarding this cool article but then realized that, just like
reality doesn't care about us, there's a category of people who doesn't really
care about reality.

~~~
dgallagher
The nice thing about reality is that it continues to exist regardless if you
believe in it or not.

The thing is, what we perceive as reality might be wrong sometimes.
Fortunately the scientific method is a pretty good algorithm whose purpose is
to expose it whether we like the answer or not. Our species doesn't know
everything yet, and we're limited by the capabilities of our bodies,
knowledge, technology, and other things.

Many people like to create a worldview in their heads which they become
comfortable with. That's fine, but trouble arises when it's challenged and
they fail to question or adjust it. Those who stubbornly defend against,
dismiss, or demonize contradictory evidence significantly increase their
probability of being wrong. A great technique to avoid this trap is to ask
yourself, and answer, the following question for any subject, no matter how
uncomfortable or taboo:

What facts or evidence would it take for you to stop believing in what you
currently believe?

It's an excellent self-check, and a tool no open minded person should be
without.

------
auctiontheory
Yes, I think we should all be vaccinated, as the powers that be confidently
tell us.

And as a consumer of medicine, I observe that doctors are equally confident
when they really don't know what they're talking about, and when their
opinions aren't substantiated by science. (The command to wear padded running
shoes, for instance.)

And I know that the CIA organized a fake "vaccination drive" to get Osama bin
Laden.

So I understand why people who might not have a scientific education choose
not to believe the vaccination story they're given by their government.

Saying it louder and more often won't help.

~~~
ewoodrich
So as to not provide any more baseless evidence against vaccines under the
guise of impartial reasoning, the CIA led vaccination drive actually did
provide vaccines in a poorly developed region, but the data collected led to
the capture of Bin Laden.

In and of itself, the vaccination drive wasn't some sort of hoax, and it had
legitimate doctors and results. It had just been co-opted by the CIA for
covert intelligence gathering.

~~~
Steuard
That doesn't actually make it better. The point is that we want people in
those communities to be able to trust that the doctors who come to their door
don't have an ulterior motive. It's not a question of whether the vaccines are
real (though faking that would of course have been far worse).

------
pdkl95
I've been thinking about "Herd immunity" a lot recently, but not with respect
to /biology/. The concept that if we easily become overpowered by a threat if
do not maintain an active defence against it is true in most _political_
issues, too[1].

In the current NSA drama, for example, we are fortunate enough to HAVE a
"vaccine" against many of the problems: encryption. It's not always something
that can be used (just like vaccines), but if those are rare enough most of
the abuse-of-power problems wouldn't even be attempted.

When a certain critical mass of people start skipping that protection, a
tempting target is created and the problems com back, often much faster than
expected. If I could just think of a clever epithet similar to "antivaxxers"
to use when referring to someone who think they can skip encryption because
"they aren't doing anything wrong" ("won't get $DISEASE").

[1]: insert traditional speculation about meme-vs-gene here

------
sitharus
I've had the fun experience of debating with anti-vaccine people. Outside of
the religious 'god will protect us' line, which I can't really argue with as
it's a matter of faith, the vaccines cause autism line keeps coming up.

Unfortunately for us a condition that we don't really understand is far more
prevalent than the side-effects of preventable diseases. I've never met anyone
who's experienced post-polio syndrome or given birth to a child with
congenital rubella. Alas I had measles myself, but I was too young to have
been vaccinated.

This coupled with our odd perception of risk leads to people abandoning
something that demonstrably saves lives because of the minor risk of side-
effects. Having done some minor work with autistic children it's certainly not
as bad or as certain as the documented outcomes of disease.

I don't think much will change people's minds until the diseases return, but I
will be keeping up on the pro-vaccination side.

~~~
joshuahedlund
Why would God protect from the measles but not the autism? (And I say this as
a Christian who believes in healing) Yet while 'vaccine denialism' is often
associated with the Religious Right, it's certainly not a prerequisite,
because you can certainly find the same sentiments among the all-natural anti-
GMO fringe Left, and before we had stories about Texas mega churches we had
stories about affluent Californians[1]

[1][http://scienceblogs.com/insolence/2010/08/26/vaccine-
exempti...](http://scienceblogs.com/insolence/2010/08/26/vaccine-exemptions-
in-california-threate/)

~~~
nl
_Why would God protect from the measles but not the autism?_

That's a wonderful line.

~~~
joshuahedlund
Well, when your mind is made up you can explain anything - perhaps the autism
is a punishment for not trusting in the original protection, etc, etc

~~~
jlgreco
Indeed. If you want talk to them with their terms, you might have better luck
with _" God helps those who help themselves"_, though I doubt that will work
in practice either.

~~~
joshuahedlund
Sure, but it's not like they're consistently anti-medicine, happily 'helping
themselves' to cancer treatments and the rest (well, except for the oddly
named Christian Science sect, but not the broader Bachmann-style evangelicals
that are found overlapping with the anti-vaccine movement these days). It's
almost like existing biases helped them succumb to the original fraud and
helped them get stuck in it, so now they just truly believe that most medicine
helps but vaccines cause autism. Fortunately it doesn't seem to be spreading
across evangelicals as a whole.

------
contingencies
The notion that we can secure ourselves from disease through immunization is
clearly valid for the subset of known treatable diseases.

With pure untamed conjecture, I suspect, however, that the behavioural and
psychological effects of the greater population's immunity to such diseases
serve primarily to reinforce the modern 'medical miracle' that may, longer
term, in fact leave us in a state of reduced immune performance and an 'immune
monoculture', due to unnatural lifestyles and living environments, relaxed
psychology, and a lack of exposure within the general population to the range
of natural challengers that we once had.

~~~
ghshephard
Vaccines do the precise opposite of what you just wrote - they expose you to
huge numbers of viral particles ramping up your immune system so a state of
enhanced immunity performance.

When you travel to foreign countries, you tend to take a number of vaccines
just so that your body is ready to fight off the endemic diseases that are
prevalent in the region you are traveling to.

~~~
contingencies
_Vaccines do the precise opposite of what you just wrote..._

Yes, but only for one specific disease.

~~~
lovemenot
I believe your parent was arguing that vaccines facilitate travel and that
globalisation is anathema to monoculture. So vaccines indirectly attack the
monoculture which you both think is a risk to our civilisation.

~~~
ghshephard
I wasn't - but I really like the point you are making. It had never occurred
to me that the globalization of of travel is the antitheses of monoculture
disease pools - But it's true - the Flu in China last year, quickly becomes a
worldwide phenomenon six-nine months later.

~~~
lovemenot
That wasn't really my point so much as an attempt to clarify. In all
likelihood globalisation at best buys time against the monoculture issue. If
and when that hits, with globalisation, it will be commensurately larger than
it would have been otherwise.

------
altero
There is also other side of vaccination when pharma industry pushes untested
and ineffective serum. Mostly it is for viruses (hint: virus mutates too fast
and vaccination is practically useless).

Great example is bird/pig flu, serum was untested and used only thanks to
massive hype. More people died from vaccination than actual flu. And best part
are doctors which refused to have themselves vaccinated :-)

disclaimer: I am well educated and my children got full vaccination.

~~~
tjogin
How do you know that bird/pig flu wouldn't have had more severe impact if it
wasn't for the vaccinations?

~~~
tsotha
Last year the flu vaccine was only about 35% effective in my area and the
world didn't end. In a normal year you're in no danger from the flu unless
your pulmonary or immune systems are compromised.

Of course that's not true every year.

~~~
ceejayoz
> In a normal year you're in no danger from the flu unless your pulmonary or
> immune systems are compromised.

As the parent of twins born three months early, that sort of attitude is
distressing. Vaccination protects more than just the person vaccinated.

~~~
tsotha
Don't misread me. I'm not saying people shouldn't get vaccinated. All I'm
saying is we have a pretty good idea what a "normal" non-vaccinated flu season
looks like.

Of course getting vaccinated is the right thing to do, even if it's only
partially effective. My dad has emphysema, so I know where you're coming from.

------
azakai
> Combined with a little luck (nothing quite as beneficial as being a white,
> middle class male in the US) you might have a reasonably healthy health.

Hard to take an article seriously that starts out like that. On every axis
mentioned there, there is a significantly healthier alternative group (and all
but one - the alternative to middle class - are large).

------
yuhong
Personally I recommend keeping vaccine exemptions but not encourage people to
use them.

~~~
toomuchtodo
There is no reason to have a vaccine exemption unless there is a legitimate
health reason (allergic reaction, etc.).

~~~
hitchhiker999
You have spoken, all interactions within biological sciences are decided.
Thanks for that.

~~~
toomuchtodo
If you have valid, replicatable evidence where vaccines cause harm, I'm all
ears.

But if you're going to rely on anecdotal evidence, GTFO. I'm tired of hearing
people not vaccinating their children and causing public health issues because
they believe they're more informed than the CDC.

~~~
Patrick_Devine
Here's an example where vaccines cause harm:
[http://www.cbc.ca/news/canada/british-
columbia/story/2012/09...](http://www.cbc.ca/news/canada/british-
columbia/story/2012/09/10/flu-shot-pandemic.html)

By and large though, vaccines are amazing. Just the fact that we have a
vaccine which can protect against influenza is pretty fantastic. Life
unfortunately always throws you spanners, so even though I think the people
who live in the vaccine autism universe are bat shit crazy, it's still good to
have people taking both sides of the issue. This is despite how freaking
frustrating it can be when one side is arguing with opinion and the other is
arguing with facts.

~~~
mpyne
Well it's still possible to be pro-vaccine in general but against a specific
vaccine that does not hold up its end of the risk/reward bargain.

There aren't simply two sides where 1 is always pro-vaccine and the other is
always quoting Wakefield.

~~~
Patrick_Devine
Absolutely. I wasn't trying to paint it as a black and white argument at all,
and in fact, quite the contrary.

The people who are against vaccinations are mostly idiots, however, scientists
are not infallible. Sometimes they lapse into politics too.

------
rspeer
What happened to sciencebasedmedicine.org?

Does anyone else see an auto-generated placeholder spam page linking to
"Naturopathic Nutrition", "Faith Healing", and "Homeopathic Treatment" when
they go there?

------
tomjen3
Way to miss the point. This is so much bigger than just vaccines, encompassing
distrust of authorities, misunderstandings about the existence of god, etc.

But sure lets focus on vaccines.

~~~
merraksh
I'd rather think his point is precisely that: distrust of authority,
misunderstanding about the existence of god are just distractions from
reality, and the wrong tools to face it. When disease=reality hits, he says,
vaccines are the right weapon.

------
flagnog
It's interesting (scary) to see all the anti-biotic resistant diseases on the
rise. I wonder how long until the diseases vaccinated against evolve enough to
bypass the antibodies produced by the vaccine?

------
newobj
Spend some time in the autism community, as a parent of a child with autism,
and meet other parents of children with autism, and you might have a different
opinion about whether children can be vaccine injured after you hear the same
stories over and over again.

~~~
jostmey
Man, I wish I could down-vote this idiotic comment.

Changes in the brains of infants who later developed Autism have been observed
_before_ those infants ever received their vaccinations.

~~~
lotharbot
> _" Changes in the brains of infants who later developed Autism have been
> observed before those infants ever received their vaccinations."_

I'd love a citation, if you have one.

(Disclaimer: I am pro-vaccination, and the father of an autistic child. I'm
interested in the "changes in the brain" thing, not the "link with vaccines"
thing.)

------
raphinou
I am not against vaccines, it saves lives, but sometimes i have the feeling we
may not get sick anymore, with all proposals for inefficient vaccines against
benign affections. Sadly both camps (pro and anti vaccines) have too extreme
positions to have a constructive debate.

~~~
raphinou
I do not understand the downvotes here,especially with no argumentation. It
only illustrates my opinion: people have too extreme opinion on the subject. I
maintain that being unconditionally pro or anti vaccines is a bad approach.

~~~
dalke
You have made an implication, without basis, that the immunization policies in
the US are "unconditionally pro", or at least that the people here are
"unconditionally pro."

This is not the case. Read any of the CDC, NIH, or WHO history of vaccinations
and you'll see the reasons for the decisions. You'll see the numbers of how
much it costs to vaccinate, how much it costs to treat, the likelihood of
disease, the likelihood of death, and the effect of side-effects. You'll see
research to reduce those side-effects, like improved treatment methods for
those with egg allergies.

You'll see treatment policies change over time. The polio vaccine in the US
use to be the more effective Sabin vaccine, which used attenuated vaccine
strains that occasionally mutated to a more virulent form that gave 144 known
cases of vaccine-associated paralytic polio (VAPP) between 1980 and 1999.

Since polio doesn't exist in the US, we switched to the deactivated form in
2000. This isn't as effective, which is why there's now one more shot in the
vaccination series, but the old treatment, if continued, would have been
deadlier.

There has always been a policy to allow people to opt out of vaccines, usually
for religious reasons. (The last outbreak in the US was among Amish groups.
The virus came from the Netherlands.) A reason why is because there will
always be resistance to any mandate, and vaccines don't require 100% coverage
to be effective in a population. It's better to let a few not be vaccinated
than to use the indiscriminate and blunt threat of government intervention
against them.

This means the CDC and others have to be very cautions and sensitive. For
example, even though there's no evidence that mercury preservatives in
vaccines cause side effects, you'll see that the vaccines were reformulated to
remove thimerosal. The general policy is to minimize objections to the
process, and not to force people to comply.

This is absolutely not an "unconditionally pro" policy, so you are downvoted
because you're speaking out of ignorance and a blithe appeal, as jlgreco
rightly points out, to an argument to moderation.

~~~
raphinou
> You have made an implication, without basis, that the > immunization
> policies in the US are "unconditionally pro", > or at least that the people
> here are "unconditionally pro."

You have interpreted this. Read my comment without considering me as anti-
vaccines and maybe you'll understand you over-reacted....

My reflection was about pushing administration of vaccines against for example
stomach ulcers (vaccine in development) or rotaviruses in developed countries.
Would you be for mandating, in high-income countries, the administration of a
vaccine against rotaviruses knowing their efficiency is only 45%? Rotavirus is
evaluated at 1% of children deaths in these countries [1] (from CDC, a source
you mention yourself). Will you also push for a vaccine for the 99 other
percent?

[1]
[http://wwwnc.cdc.gov/eid/article/9/5/02-0562_article.htm](http://wwwnc.cdc.gov/eid/article/9/5/02-0562_article.htm)

~~~
nl
_Would you be for mandating, in high-income countries, the administration of a
vaccine against rotaviruses knowing their efficiency is only 45%? Rotavirus is
evaluated at 1% of children deaths in these countries [1] (from CDC, a source
you mention yourself). Will you also push for a vaccine for the 99 other
percent?_

Where to start with this?

45% is a pretty low effectiveness rate. I'd prefer to see it higher, but
nevertheless 45% success should improve herd immunity, right?

 _Rotavirus is evaluated at 1% of children deaths in these countries_

If that is correct, then that is a _HUGE_ death rate. Anything to reduce that
seems sensible.

 _Will you also push for a vaccine for the 99 other percent?_

Well.. can you predict in advance which are the 1% who are going to die? If
you can then vaccinate them! If not then it would seem sensible to vaccinate
everyone to develop her immunity. That will (a) directly decrease the death
rate by making some who would have died immune, and (b) indirectly decrease
the death rate by making it less likely to be transmitted.

Edit: Reading a bit, I believe your numbers are incorrect - or at least the
way you have phrased it. 1% may be the rate in _developing_ countries, but it
isn't in developed countries.

The Wikipedia article on Rotavirus[1] makes the vaccine seem pretty
compelling: _In Mexico, which in 2006 was among the first countries in the
world to introduce rotavirus vaccine, diarrhoeal disease death rates dropped
during the 2009 rotavirus season by more than 65 percent among children age
two and under.....In the United States, rotavirus vaccination since 2006 has
led to drops in rotavirus-related hospitalizations by as much as 86 percent.
The vaccines may also have prevented illness in non-vaccinated children by
limiting the number of circulating infections._

So yes, in my opinion - based on 10 minutes of research only - it should be
mandatory.

[1]
[http://en.wikipedia.org/wiki/Rotavirus#Prevention](http://en.wikipedia.org/wiki/Rotavirus#Prevention)

~~~
raphinou
Just to be sure we agree: it is 1% of deaths, not of children. Maybe the
efforts should focus on bigger death causes of children. My opinion of course.

Your example talks about mexico, which is not a high income country, and the
US, which has amongst the worst life expectancy amongst developed
countries....

