Hacker News new | past | comments | ask | show | jobs | submit login
[flagged] Teen Gets Vaccines During Measles Outbreak, Despite Mom's Belief (npr.org)
82 points by evo_9 7 months ago | hide | past | web | favorite | 79 comments

Herd immunity is immensely important and an underrated benefity in modern society.

We lived near a large religious community in Ohio that does not practice vaccination while my children were too small to be fully vaccinated. Whenever measles or other outbreaks would occur, we had legitimate fears for our children's health.

I wonder if the benefits of non-compliance were offset with more certain negative impacts if more people would be vaccinated. Something like a tax levied for not being vaccinated set at compensating the ongoing care for people who can't (rather than choose to not) be vaccinated and get sick with things herd immunity would prevent.

It isn't just young children at risk. Some fraction of the people who were immunized are still at risk of catching the disease.

Getting an immunization doesn't guarantee immunity. There is a fundamental trade-off at play: make the immunization shot too strong and more people get harmed; make it too weak and fewer people actually get immunity.

The funny thing about the anti-vax crowd is they have opted to turn the dial to the maximum, and most dangerous, setting: use a full strength virus in order to gain future immunity.

Immunizations wear off over time that's why we get boosters, and even having the virus doesn't guarantee lifelong immunity. I had chicken pox as a child and recently was hospitalized for chicken pox as an adult twenty some years later.

There is an currently an outbreak of Measles in Washington.

Yet the anti-vaxers are still out in force, against any move by the government requiring vaxination.[1]

People with children too young to be vacinated are running scared[2].

its odd. I really wonder sometimes what is driving the anti vax movement. It seems like something that exists with nothing for anyone to gain. I'm all for questioning things, but it seems people aren't able to make the rational decisions and are endangering others.



> I really wonder sometimes what is driving the anti vax movement. It seems like something that exists with nothing for anyone to gain.

Likely answer: The Russian government.[1][2] It is yet another way to weaken their perceived rivals/adversaries by taking positions taken by fringe groups of insane people and amplifying their message thousandfold in order to sow social division.

[1] https://www.bbc.co.uk/news/world-us-canada-45294192

[2] https://www.telegraph.co.uk/news/2018/08/23/russian-trolls-b...


At first it seems like a crazy issue to sow discord about, and one with serious health consequences. But it worked, and the anti-vax movement which was probably pretty small and fringe now gets amplified. I wonder if its was just a test for other dis information campaigns.

I think the promise of social media was you could get information from networks you trusted, but it seems it doesn’t work like that. The amplification by anonymous sources seems to work.

Thanks for the articles

It's a great thing that the anti-vaxers are coming out in force. Ideally on a calm day.

What a lot of people seem to be missing is that the anti-vaxxers are actually pro-science. They are sacrificing to reproduce a result that the rest of us consider settled. The quicker they're able to draw a conclusion from their experiment, the better.

It's a good thing that these people's young children may contract violent whooping cough, or may die a miserable death, because their parents have freedom? It's good thing that others who can't vaccinate or otherwise benefit from herd immunity are getting sick while we let these parents play out their experiment?

I suspect you didn't mean that, but I think we need to take this more seriously, again, per the grandparent, given the broader public health risk that this movement plays, particularly outside its adherents.

Wow, HN, I can't help myself; why on Earth is this flagged? My post, even in the most critical light, says four things:

* Kids are getting sick in my state, from the measles, because parents refuse to vaccine kids that are perfectly capable of receiving the vaccination.

* Kids, across the country, in and near anti-vax communities, are contracting whooping cough. ITS A FACT. SORRY.

* Whooping cough is "violent". Maybe one of you can show me a video of a child with whooping chough that you wouldn't call "violent". How about one that you don't call "horrificly violent", even?

* That I could be misreading, though the parent commenter has indeed confirmed that my comment is an accurate read.

So? We just don't like having it pointed out, or what?

Also, big shoutout to HN for "rate-limiting" me from being able to reply to the undoubtedly good-faith commenter who is openly suggesting we let the children of anti-vaxxers just die; the one commenting in a subthread about herd immunity who clearly has no idea what herd immunity is. My comment remains positive, and there are no rule violation.

I engaged in good faith (I certainly didn't think they were going to openly call for the deaths of anti-vax kids or act like it was a serious position to hold).

But hey, it's HN, so I should know that being offended at implicitly violent attitudes or calling out people's bullshit here would automatically land me in trouble.

What you have said is indeed the direct implication of what I said. And I did mean to say what I said.

I've got to wonder if the sensationalist panic of our times isn't simply due to people not being able to accept mild sarcasm in written form. Humor is a coping mechanism - read some horrible less-mediated truth, shake your head, sigh, and build some consensus based around calming rather than outrage.

What I am plainly sure of is that getting more and more worked up ("take this more seriously") about the actions of people I can't control isn't going to solve the problem either.

When multiple people misunderstand you the problem is with your writing, not with their comprehension.

I don't think the issue was with understanding, but rather with my comment detracting from the moral panic.

If you're not actually interested in debate and discussion, then why would you comment on here?

Where have I implied that I am not interested in debate or discussion? I reacted to what was basically grandstanding over the tone I made my points with.

Wooping cough vaccines have full effect for about 10 years. Adults get it, but a lot don't consider wooping cough since they assume the vaccines last forever.

Unfortunately, because vaccines aren’t 100% effective and not all people can handle them, their experiment is also sacrificing others, not just themselves.

I'm terrified by the idea that people like that are allowed to indoctrinate children's mins from early age on. Just because a child had the misfortune to be born to a crazy person shouldn't allow them to mess them up for good.

I don't know what the rules are for medicine, etc, but for education here in Japan teachers often trump parents. When I was working at the high school here, I can't tell you the number of times parents were brought in so that the teachers could yell at them for doing a poor job. The teachers even go to the house to ensure that the home environment is acceptable for the child. Personally, I like the system and if I had kids I would happily raise them here. However, I've talked to many expat parents who despise it and believe that the state should never be able to tell them how to raise their children. There are good arguments on both sides and probably there are balance points where it mostly works (and sometimes fails spectacularly) all across the spectrum.

herd immunity, very low density population count

pick one

This should explicitly be allowed under the law. Right now parents can exempt their children from lifesaving vaccines. Kids should be allowed to override that.

More broadly, kids should have some basic rights to self-determination well before 18. In the US, kids have astonishingly few rights.

Basically parents are allowed to let their children die this way and this way only. If they let them starve or without shelter, cps comes. Seems like a strange exception in our laws to allow a parent's stupidity and idiocy to kill their child. It also seems so out of place in a society that is so obsessed with controlling children's every move 24/7/365 till they are adults and beyond.

This is the real age discrimination issue in society.

Children get harmed with no recourse, while the adults responsible go free.

Measles is incredibly bad. What people have found is that the introduction of measles vaccination in a country inevitably leads to a significant decrease in all cause mortality, which doesn't seem to be explained by a reduction in measles cases alone. It has long been known that those recovering from the measles are effectively in an immunocompromised state for several weeks, there is now increasing research pointing to the measles basically knocking out existing acquired immunity and resetting a person back into an immunologically naive state. This "immune shadow" then leaves individuals vulnerable to secondary infections (flu, rotavirus, etc.) which take their own toll and show up in different columns in the statistics down the road. Additionally, a very rare form of encephalitis can develop up to a decade after having the measles and is invariably fatal.

Get vaccinated.

What I am really scared of is mutation of certain disease due to a lack of heard immunity. I thought it was logical that mutation of certain viruses poses a threat, even to vaccinated people within the heard, in a population where heard immunity is compromised?

As one who cannot get some vaccine shots. I am ever thankful to those that do.

Back in my day, the rebels just got tattoos when they were old enough. Maybe this generation will survive.

I think the only way to fix this is to create a counter-conspiracy theory. Maybe something like "the anti-vax movement was started by the lizard people to weed out the weakest people so they'd only have the healthiest slaves in their salt mines"

The CDC putting out notices isn't going to help. That just feeds into the rejection of authority at the heart of it. The only hope is to out-crazy them.

I think the only way to fix this is to create a counter-conspiracy theory.

Yes, we'll recruit from the Flat Earth Society, Moon Landing Deniers, Church of Scientology, Climate Change deniers, the Pizza Gaters, the 9/11 Truthers, Fluoridation haters, Shooting Victims are Child Actors group, Chemtrail worriers, Black Helicopter spotters, Blame George Soros fans, Illuminati Be Playin' 4D Chess Club, and every f'ing halfwit in a tinfoil hat.

It’s a complex issue. It’s a mix of crazy people and politically powerful religious groups.

You’ll never crack the religious people as communities that push this crap isolate people.

Naturopathic schools and doctors, too.

Those people have a strong financial incentive to remain wrong. Many of them may even know they're wrong but don't care because they enjoy money more than they enjoy the sensation of honesty. And since you can't differentiate the ones who are stupid from the ones who are sociopaths pretending to be stupid, there is a decent chance you'll be wasting your time trying to persuade somebody who already agrees with you and simply won't admit it.

Consider for instance practitioners of "psychic surgery." All practitioners of 'psychic surgery' know they are frauds because 'psychic surgery' is sleight of hand. With something like acupuncture or homeopathy, it's certainly plausible that some practitioners believe they are doing something real, but with 'psychic surgery' that form of self-delusion simply isn't a possibility. This demonstrates the existence of frauds who know they're frauds. There's no reason to believe similar personalities aren't operating in any other form of 'alternative medicine'.

Don't waste your time with nuts who've made careers out of being nuts.

>The only hope is to out-crazy them.

Or just outlaw all exemptions except medically necessary and block unimmunized children from attending school.

They'll homeschool them. In the worst case, you're punishing the kid, not the parent.

So be it. Fundamentalist Christians have the highest rate of home schooling now. At least the general public will be protected -- I'll take a slight uptick in home schooling for a huge increase in vaccination. And besides those truly committed to the cause the moms doing this because they're just followers will most likely not home school. Too much trouble.

I have blood relatives (not family) into this crap. Both the homeschooling and the fundamentalism. They "protect" their children from everything outside of their narrow worldviews, science being a chief villain. It's an incredible disservice to the kids. Who are alarmingly numerous and approaching voting age.

Unfortunately with the ease of forgery(my verification was a copy of a copy from 1990s when attending college) this is not exactly an easy solution. There is minimal to no verification process really in place.

> The only hope is to out-crazy them.

Or use the scientific method to determine what methods of persuasion have the highest success rates for promoting behavioural changes, such as motivational interviewing?



Or require parents to consult with local public health departments to obtain a waiver, which has significantly reduced vaccine exemptions in some cases?


You can't reason a person out of a position they didn't reason themselves into.

You have to have a genuine and open dialogue with them in the form of a socratic discussion. See examples of street epistemology to get them to lessen their confidence. The first step to lessening their confidence is to get them to recognize and understand that the methods they are using to recognize true things is unreliable. Often you can't get them to flip positions on it over one discussion, so you have to have multiple discussions taking their ideas seriously and being respectful with them before they can come around.

By presenting evidence, they'll be unconvinced and it will probably trigger the backfire effect and drive them deeper into their dogma. So I agree with what you're saying, street epistemology is like a form of motivational interviewing.

If states can force women to get medically unnecessary ultrasounds or listen to non-science-based "counseling" before an abortion it seems like they should also have the power to force parents to view videos of children who were maimed by polio or suffered brain damage from measles induced encephalitis before they opt out of vaccines.

In the American system it is often politically easier to force people to do something in order to get something - such as force people to get ultrasounds before having an abortion - than it is to force someone to do something in order to abstain from something else (note, I don't say it's impossible many examples do come to mind, just it's more difficult).

IIRC some places have tried to tie getting required vaccines to public school enrollment, but that is problematic because solu5ion is at state level and not national.

Is it from Ron Hubbard novel?

I think all you need is a tax. Every unvaxed citizen is a (small) increased burden on the health system. It may be an individuals right to refuse but it should not be at the expense of others. (exemptions for real medical issues of course)

I'll bet that once there's a $50/year bill to remain unvaccinated, 95% of the problem will clear right up. For the remainder, great we've got the extra money to take care of it.

Just put the big fines on anti-vaxers and force them to vaccinate anyway (unless there are medical reasons of course). The only missing piece is a political will.

Yeah, I'm waiting to see if when a child dies due to a disease that could've been vaccinated against but parents refused if a state prosecutor will try to slap them with criminal negligent homicide. I guess that will be the real test.

I've seen a similar case. A kung fu instructor in New Jersey who didn't believe in the germ theory let his kid die of appendicitis instead of taking him to the hospital. Last I heard he was facing some pretty serious charges. I don't remember the final outcome, since I kind of disappeared from that circle.

I don't get it. If you don't feed your child, it's child abuse. Why is not providing vaccines any different? Why isn't this something you can make a CPS neglect case out of?

Refusing to vaccinate children should be considered abuse and endangerment. Other than some rare health conditions there are zero legitimate reasons to not vaccinate.

It certainly seems like CPS takes kids away from their parents for less already (e.g., independent play or travel).

The only, who are in charge (up to some law cases) in their child health are its parents; if they decide to vaccine or not it's their beef, not ours.

It is useless to talk to such people. You are using the scientific framework, they are not. Trust me, I tried.

Funny thing on the side:

Since a vaccination is rarely 100% effective but most people in the western world are vaccinated, more vaccinated people get sick than not vaccinated people. :-)

> "It is useless to talk to such people. You are using the scientific framework, they are not. Trust me, I tried."

It's possible to get through to these people if you're willing to argue in terms they understand, which means dropping "scientific framework". You might be unwilling to do that, but if you can stomach it, it works. Constructing persuasive irrational arguments for positions that are correct takes some practice, but it's not exactly difficult.

Good luck.


"It's possible to get through to these people if you're willing to argue in terms they understand"

No, because they would lose their feeling of superiority. On what kind of basis do you want to discuss with them? If you present a fact they will just say: "We don't believe this!"

If you present scientific evidence they will say: "We don't accept this! This is not proof! We want proof".

"Proof" is something that is not not inherent in the scientific method, requiring it shows a total lack of understanding of science.

> No, because they would lose their feeling of superiority.

Perhaps you've never gotten the hang of it, but it's possible to persuade people in ways that lead them to believe your idea was theirs. Learning this skill will improve your life, because most people you will encounter on your journey through life are not Spock impersonators.

> "God knows how I'm still alive," Lindenberger wrote on Reddit last November.

Seems a bit over-dramatic. "Thank God" for the good luck would make more sense if he wants to say something along these lines; it's not like he defied astronomical odds. Millions of people in poor countries are still surviving without vaccination. Living in Ohio, he also benefits from sanitation and the majority of the community being vaccinated. That last bit is part of the problem -- people see "nobody" is sick anymore and think vaccines aren't needed.

I have a Facebook friend who is fairly active in the anti-vaccine community. I don’t know much about the science, but the one thing she has posted that has concerned me is that insurers pay doctors significant sums (tens of thousands) if the super-majority or their patients are vaccinated on a certain schedule. She has posted printouts that allege this, and I’ve not seen any arguments that dispute this claim (there are lots of people disputing other claims of hers, just not this one).

Does anyone know if this is true? It resonated with me because when we were vaccinating our baby, we asked if we could slow down the vaccination schedule and spread out the shots a little. The doctor was very strongly against any spacing, even though she couldn’t articulate why. If she’s being measured/compensated based on having patients vaccinated on-schedule as my friend claims is the case, this would explain her reaction.

Note: we fully vaccinated our child, despite her having an adverse reaction to the chicken pox vaccine (which we never had as kids, since at that time everyone just got the chicken pox).

The CDC schedule is designed to minimize the risk of infants contracting preventable diseases during periods when they are highly vulnerable. In addition, clinical research and experience is based on the recommended schedule, so once you’re off the schedule you’re in terra incognita. Since research hasn’t shown any clinical benefit to going off-schedule, and because of infants’ extreme vulnerability, pediatricians aren’t generallly going to volunteer to change vaccination frequency, as it would contravene the patient’s best interests (medically speaking).

As far as payers are concerned, your insurance may incentivize certain physicians based on overall (covered) patient immunization rates; this isn’t anything new, going back at least a few decades. From the insurance perspective, immunizations are a financial firewall — vaccinated kids means fewer seriously ill (read: expensive) kids. However, there’s no evidence that financial incentives materially change vaccination rates, just the quality of documentation (less of an issue with EMRs these days).

I don't know if this is true or not but either way why would anyone want to refute this? Insurance companies paying doctors to make sure patients are vaccinated according to the recommended schedule is a ringing endorsement of vaccination.

Insurance companies would in effect be saying with their wallet that vaccinations are safe and effective. Effective enough that paying doctors ten's of thousands is cheaper than paying for the increased costs of care resulting from a significant number of patients not being vaccinated. Since insurance companies would also bear a significant part of the cost of care for patients that were negatively affected by vaccines, this also implies that the rate of and impact of negative effects from vaccination are low.

Financial incentives don't make something automatically wrong.

Google provides this explanation about a Blue Cross incentive program similar to what you describe that sounds modest, benign, and completely justified: https://vaxopedia.org/2017/09/24/that-3-million-vaccine-bonu...

My insurance program gives incentives for people to achieve a healthy weight, quit smoking, and get regular checkups.

I understand the financial incentives, but presumably a couple people in the firm think they might be helping people too.

Even insurers can't be sinister all the time.

I'm happy to believe they're sinister 100% of the time. What they clearly aren't is stupid. If they are spending money to incentivize behavior, it's because that is in their financial best interest. In this case, it just so happens that their best interest (not wanting to pay for care) aligns with mine (not wanting any more care than I have to have).

Sounds like general doctor's resistance against picking another schedule, even if it can't be articulated well. See [1] for considerations among pediatricians.

Insurance companies may indeed pay more or less for 'well designed' vaccinations programs, and may incentivize vaccination in general in some locales as a long-term cost reduction program [2].

[1] https://seattlemamadoc.seattlechildrens.org/pediatricians-co...

[2] https://vaxopedia.org/2017/09/24/that-3-million-vaccine-bonu...

Having taken schedules of medicine myself, what resonates with me is the balance between strength and consistency of whatever the medicine is supposed to do. Think about alleviating pain. You want to take as much pain reliever as you can to take effect but not too much at once to overdo it, but you should continue over period of hours to sustain its fever / pain reducing effect.

I've heard the spacing idea from a number of people, saying it's somehow easier on the kid's system. It doesn't really work that way. All you do by spacing it out is take your kid to the doctor's office to be jabbed by needles more times than necessary and expose them for longer to preventable diseases.

There are lots of examples of programs where payers (insurance companies, medicare, etc) pay doctors who are meeting various measures. This could be anything form ensuring patients who are at risk for various diseases (cancer, diabetes, etc) get screened for those diseases, to making sure high blood pressure is well controlled, to making sure patients are getting vaccinated. Check out CPC+ as just one example.

There is nothing inherently bad about these incentive models (they are trying to address a number of issues with the current fee-for-service model). If anything, they are proof of the efficacy of these actions. The "evil" insurance company's primary goal is spending less money on care, so if they're willing to pay doctors to vaccinate at the recommended rate, then clearly it's in their financial interest to do so (i.e. vaccinated patients cost the insurance company less money, which is a pretty good proxy for "vaccinated patients have fewer health issues").

Can you articulate why you would want to "slow down" the vaccination schedule? The current guidelines are based on a significant body of research. What evidence are you basing your decision on?

> we asked if we could slow down the vaccination schedule and spread out the shots a little. The doctor was very strongly against any spacing, even though she couldn’t articulate why

You aren't wrong to question, because most professionals seem to just apply a rubric deductively rather than spending thought analyzing every situation. But if you would seriously like to understand / check her advice, then you need to do research on this specific subject and come up with your own informed opinion. Likely there is some debate in the medical community on timing, and the doctor either made that decision and doesn't seem the need to revisit it or is simply following a colleague.

What you can't do is take her lack of explanation as if she's hiding something, and then backpropagate and conclude that she must be doing it for nefarious reasons. That is essentially equating laziness with malice.

> What you can't do is take her lack of explanation as if she's hiding something, and then backpropagate and conclude that she must be doing it for nefarious reasons. That is essentially equating laziness with malice

Note that I didn't do that. I asked a question, which is whether anyone has information on whether such payments are made.

The US is not the only country in the world -- all my vaccinations were free and there was no profit motive built into the system for it.

Presumably your physician was still paid, and there are plenty of programs in various countries that compensate physicians for following best practices like this (this is generally a good thing).

My physician is paid for any sort of checkup. I'm sure every one of them would happily poison their patients for the visit fee. /s

This should be a pro-vaccination point. Insurance companies can only be benefited from this if they make short/long term return on it. i.e. people fall less sick reducing insurance claim. Isn't this what vaccines are for? Or, is there some theory that companies are in bed with NSA/Illuminati to make the world impotent?

Completely false. Doctors push vaccines because they work very well, and don't want to see you get sick. (I married a pediatrician.)

Any financial incentives that exist are because insurance companies are incentivised to have everyone vaccinated for very obvious reasons.

If you don't understand what the obvious reasons are, think about how much it costs to take care of someone hospitalized, versus the cost of a shot.

> chicken pox vaccine (which we never had as kids, since at that time everyone just got the chicken pox)

If you get chicken pox, your chances of getting shingles later in life is much higher. It is not pleasant. Also, chicken pox can be deadly. That's why we have a vaccine now.

For what it's worth, I typed "vaccination schedule rationale" into a search engine and received many interesting results, several which did not seem to have been paid for by the insurance industry.

This is what I hate the most about this anti-vax thing. They've gotten so much publicity and are so wide-spread, that even people who know vaccines don't cause autism, wind up getting trapped into this game where they think they have to compromise for the anti-vax viewpoint.

All they have to do is throw handwavey bullshit out there until enough people doubt and do stupid made-up stuff like spacing out the vaccines for some unknown, unmeasurable benefit.

There are people in my state, in the "best country on Earth", dying from preventable diseases because of OTHER PEOPLES' pseudo-scientific crap and "beliefs". I just can't take it. When are we going to drop what we're doing and pour the billions we need into public education? - funding, reform, curriculum, emphasis on personal finance and logical reasoning skills. Pick a topic - climate change, flat earth, vaccines/autism, all of this irrationality starts with education.

Also, insurance companies go out of their way to incentivize and encourage proactive health measures, especially for younger groups; given all credible scientific research and data, and barring some other weird conspiracy, it seems reasonable to think they're encouraging vaccines because they keep people from getting preventable diseases and suffering miserable deaths.

> When are we going to drop what we're doing and pour the billions we need into public education?

Anecdotal, but most of the anti-vaxxers I know are relatively highly educated.

Same here. I'm not antivax myself, but in those I know who are, they don't lack education. It seems more to do with distrust of authority in my observation.

In my experience it tends to both extremes...

Anti-vaccination isn't exclusively an American phenomenon. It just seems like it because most commenters would be Americans or foreigners who live in bubbles. I remember in high school in Australia about a decade ago, there was one kid who was said innoculations were akin to "injecting garbage into your bloodstream".

I also frequently give blood in Australia and there are also more and more warnings about measles and stuff (interestingly regarding neighbourhoods that tend to vote very progressive).

Anecdotal evidence, however!

I'm really close to my mom. The difference between us is that I'm a militant atheist (not agnostic, there is a logical reason for that but it's off topic) and she's a hard core jehovahs witness. Imagine the conversations we have.

Applications are open for YC Winter 2020

Guidelines | FAQ | Support | API | Security | Lists | Bookmarklet | Legal | Apply to YC | Contact