Claims that childhood MMR vaccines cause autism are unfounded and irresponsible. As Ron Bailey notes, “study after study has debunked” the claim that MMR vaccines are linked to autism, and there are credible allegations that the study that prompted the initial scare was faked. As the BBC reports, British medical authorities have also concluded that the primary researcher promoting such claims, Andrew Wakefield, acted “dishonestly and irresponsibly” in conducting and promoting his research. More here from Discover‘s Bad Astronomy blog.
Despite the broad medical consensus on the importance of vaccination for many diseases, some prominent public figures, such as Oprah Winfrey and John McCain, continue to embrace or encourage the unfounded, unscientific charge that vaccinations cause autism. This could have very serious consequences as the rate of vaccination gradually declines. Childhood vaccinations are extremely important for public health. If vaccination rates drop below a certain point, herd immunity can be compromised, leading to widespread outbreaks of disease. Perhaps the latest report on Wakefield’s research will lead some to reconsider.
UPDATE: More from Orac at Respectful Insolence.
GW says:
I believe that there is a direct relationship between the decline in childhood vaccinations and the rise of an undifferentiated anti-big government theme in politics in the United States as well as other industrialized countries. The continuous disparaging of government programs in general has lead to significant distrust of even the best government programs. (You don’t like the FDA? — visit countries where Thalydamide/Contergan was an approved medicine for pregnant women!) The failure of small-government proponents to articulate a program in support of even the most minimal social contract while focusing almost exclusively on taxation, handguns, the flag, and the fetus, has potential for real dangers to both the cohesion and health of the American population.
January 30, 2010, 11:03 amlgm says:
The anit vaccine movement are just like the anti global warming movement. It is equally irresponsible.
January 30, 2010, 11:05 amzuch says:
Prof. Adler:
But what about the individual??? I want my free rides!!!
Cheers,
January 30, 2010, 11:27 amSenatorX says:
Why would anyone disparage vaccines and the industry/government marriage surrounding them? After look how well Swine Flu was handled. WHO is a reputable organization, they should get more power.
January 30, 2010, 11:41 amSenatorX says:
“But what about the individual??? I want my free rides!!!”
I think all citizens should serve in the military, otherwise they are free riding scum!
January 30, 2010, 11:43 amBrock says:
These Harvard researchers believe there is a vitamin d angle:
http://www.ncbi.nlm.nih.gov/pubmed/19699591
January 30, 2010, 11:45 amRoger the Shrubber says:
Not quite sure what you’re getting at here.
Are you claiming that what you call “the industry/government marriage surrounding” vaccines has produced deadly, unsafe, or unnecessary vaccines?
If so, which vaccines?
Do you think any vaccine causes autism? If so, what is your evidence for that claim?
January 30, 2010, 11:57 amTomB says:
What does the military have to do with communicable diseases?
And considering our military is already all-volunteer, I don’t get your point.
January 30, 2010, 12:11 pmmatt c says:
people used to say put tobacco smoke, tar and nicotine into your body wasn’t bad for you too.
honestly, this about common sense; putting abnormal levels of hard metals and other foreign chemicals into a child’s body all in one half hour setting several times over a few years does not make a health mind
January 30, 2010, 12:14 pmtarheel says:
My individual decision not to serve in the military does not have an impact on the either the effectiveness of the military or the safety of the country (the military does not need or want 10 million conscripts). The decision not to vaccinate decreases the effectiveness of the vaccines that everyone else gets. At their best, vaccinations are, let’s say, 95% effective, which is more than enough when everyone vaccinates. When a handful of kids in a school are not vaccinated, my kid is now at risk, even though we vaccinated him (and bore whatever minimal risks might accompany that decision . . . BECAUSE WE LIVE IN A SOCIETY).
January 30, 2010, 12:23 pmTomB says:
Yes, and then science did studies that looked at smokers and found they had statistically-significantly higher levels of some diseases. The same type of studies have followed people who have been vaccinated and haven’t found any evidence of higher levels of disease. Therefore, we can say scientifically, that vaccines are for the most part safe. But studies do continue.
Ah, the “common sense” argument. Unfortunately for you, science often times doesn’t follow common sense.
What are those “abnormal levels” of chemicals? Do you have specific numbers?
January 30, 2010, 12:29 pmdearieme says:
To put forward Global Warming as an argument for uncritically accepting what scientists say is daft. The Global Warming hysterics are, in my view, as much enemies of science as the anti-evolution chumps.
And as for the MMR jab, many people in Britain paid little attention to the fuss until our Prime Minister, the appalling Blair, publically prevaricated about whether he’d had his own child vaccinated.
January 30, 2010, 12:30 pmmatt c says:
common sense. science is constantly changing its position. hell dna evidence is now being discredited–by science no less. whoa–science…i thought dna evidence was full proof, too…
read ortega y gasset’s revolt of the masses
January 30, 2010, 12:34 pmtherut says:
We must add Robert Kennedy Jr. to the list of nuts in this country.
January 30, 2010, 12:34 pmRoger the Shrubber says:
Well said. I think he’s done real damage to public health in this country. And the threshold question goes unanswered: why should any of us care what Robert Kennedy Jr. has to say about vaccines?
January 30, 2010, 12:49 pmA. Criminal says:
Those who trust science, especially medical research, should keep in mind:
“Why Most Published Research Findings Are False”
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020124
It’s not a joke.
January 30, 2010, 1:02 pmMark Field says:
You and Robert Heinlein.
January 30, 2010, 1:05 pmA. Cooper says:
Are you aware that the total amount of “hard metals” (did you mean “heavy metals”?) in all the recommended vaccinations from age 0 to age 18 combined is significantly lower than anything that would be allowed in a child’s toy?
Of course it’s common sense not to inject kids with a bunch of heavy metals. That is precisely why nobody does it.
January 30, 2010, 1:09 pmRob Robinson says:
“common sense. science is constantly changing its position. hell dna evidence is now being discredited–by science no less. whoa–science…i thought dna evidence was full proof, too…
read ortega y gasset’s revolt of the masses”
Can you point to a link where DNA evidence–as opposed to say, a poorly managed crimelab–is being “discredited by science”?
Have you read Revolt of the Masses? Because while it has some interesting things to say about technology (that we come to take it for granted and thus lose the habits of mind that might keep the scientific edifice standing), I’m fairly certain it does not advocate for “common sense” divorced from scientific inquiry.
January 30, 2010, 1:14 pmChrisTS says:
I suspect that Matt C does not realize he is the kind of person of whom Ortega was thinking when he wrote:
The characteristic of the hour is that the commonplace mind, knowing itself to be commonplace, has the assurance to proclaim the rights of the commonplace and to impose them wherever it will.
The command over the public life exercised today by the intellectually vulgar is perhaps the factor of the present situation which is most novel, least assimilable to anything in the past. At least in European history up to the present, the vulgar had never believed itself to have “ideas” on things. It had beliefs, traditions, experiences, proverbs, mental habits, but it never imagine itself in possession of theoretical opinions on what things are or ought to be. To-day, on the other hand, the average man has the most mathematical “ideas” on all that happens or ought to happen in the universe. Hence he has lost the use of his hearing. Why should he listen if he has within him all that is necessary? There is no reason now for listening, but rather for judging, pronouncing, deciding. There is no question concerning public life, in which he does not intervene, blind and deaf as he is, imposing his “opinions.”
To have an idea means believing one is in possession of the reasons for having it, and consequently means believing that there is such a thing as reason, a world of intelligible truths. To have ideas, to form opinions, is identical with appealing to such an authority, submitting oneself to it, accepting its code and its decisions, and therefore believing that the highest form of intercommunication is the dialogue in which the reasons for our ideas are discussed.
January 30, 2010, 1:29 pmegd says:
For the same reasons that people care about which celebrity is endorsing which political candidate.
I do find it interesting that anti-vaccine groups tend to be almost equally represented on both sides of the political spectrum.
While I do agree that the Government should have no business requiring people to vaccinate, I have every intention of vaccinating my own children. If you’re unwilling to vaccinate your children against MMR, then it’s even more important for my child to have the vaccination.
January 30, 2010, 1:36 pmFedya says:
What I find interesting is the differing treatment of the anti-vaccine types and the anti-AGW types. Even though the scientific evidence against the “vaccines cause autism” position looks to be much stronger than the evidence against the anti-AGW position, the anti-vaccine people get treated with a respect they don’t seem to have earned.
January 30, 2010, 1:44 pmChrisTS says:
Feyda:
I suspect that, aside from faux ‘researchers’ and companies selling alternatives, we usually think of frightened or unhappy parents when we think of the anti-vaccine ‘type.’
January 30, 2010, 1:55 pmChrisTS says:
Sorry: Fedya
January 30, 2010, 1:55 pmVisitor Again says:
Common sense has been used to justify the most horrible things. I much prefer sense, common or not.
January 30, 2010, 2:03 pmgeokstr says:
And trial lawyers.
January 30, 2010, 2:04 pmTomB says:
Ouch Chris, that’s going to leave a mark…
January 30, 2010, 2:08 pmSergey says:
I do not know if vaccines actually cause autism – this condition is rare and poorly understood, and diagnostic criteria changed too often for longitudial studies be helpful. What I do know is that vaccines can cause cerebral damage, and I witnessed several episodes of this working in Moscow Gamaleya Institute of Epidemiology and Microbiology, the leading Russian center in vaccines development. Most of to-day vaccines still are prepared like in days of Pasteur, in chiken embrions or rodent brain tissue, and contain a lot of ballast proteins which can provoke autoimmune reactions against people’s brain tissue. What we really need is new technology of vaccine preparation using genetic engineering, without ballast proteins.
January 30, 2010, 2:09 pmOren says:
And perhaps unicorns will come flying out of my ears. The vaccine folks are long past the point where empirical evidence and reasoned analysis matter — they will simply dismiss the report as the product of some corrupt medical board that’s on the take from the vaccine makers.
January 30, 2010, 2:10 pmSuperSkeptic says:
This response by Senator X to Zuch was almost my thought verbatim. I apologize for bringing it back up, but it seemed to raise some visceral (and overly literal) reactionary criticism that missed it’s point. The point, I think, vaccinations aside – is that Zuch’s argument proves too much. It justifies a regime that (logically) subordinates the individual invariably in almost all things, as tarheel put it “BECAUSE WE LIVE IN A SOCIETY”. Yes, we do, thankfully and unavoidably so. Therefore, you should not (and indeed cannot) dismiss individualist arguments so quickly and easily. It is so thoughtless to simply cry “externality!”; like I always say – you can find one anywhere you look…
January 30, 2010, 2:45 pmChrisTS says:
Oren:
You have joined Leo Marvin as someone whose comments I must not read while drinking coffee (laugh back-up effect).
January 30, 2010, 2:47 pmChrisTS says:
TomB:
Remains to be seen. :-)
January 30, 2010, 2:47 pmA. Zarkov says:
Absolutely not. AGW deals with observational data and the very nature of the subject precludes the possibility of doing controlled replicable experiments. AGW is a little like astrophysics, which must deal with observational data guided by well-established physics. But the people who elect climate science as a career are on the whole not nearly as competent as those who go into astrophysics. In the case of vaccines, we can do controlled experiments, and these experiments show vaccinations don’t cause autism. Period. The benefits of vaccinations are immediate and observable. AGW deals with predictions of what might happen in 100 years from now based on models of uncertain veracity. In the AGW arena we cannot isolate cause and effect the way we can with vaccinations.
Your statement is in the nature of a political statement, not a scientific one.
January 30, 2010, 2:57 pmegd says:
I think ChrisTS hit the nail on the head here. It’s hard to disparage a parent who has a child suffering from autism.
January 30, 2010, 2:58 pmDan Lavatan says:
The problem with vaccines is the mandates lead to manufacturers jacking up prices so they are no longer cost-effective. The autism thing is just a negotiating tactic.
If you really want to increse vaccination rates, you need to deregulate to the point were people can buy self-vaccination kits for $5 at wal-mart.
January 30, 2010, 3:02 pmTomB says:
There is nobody forcing you to leech off of society. You can remove yourself and live outside society and as long as homeschooling is legal, you can remove your kids from school and keep them away from the rest of “society”.
January 30, 2010, 3:14 pmNickM says:
I think you have to differentiate people who are committed to the belief that vaccines cause autism from those who don’t know much about the subject, have heard the claims of the anti-vaccine movement, and don’t feel they can reject those claims on what they know.
On a scientific issue that doesn’t concern their day-to-day lives, many people are suspectible due to rational ignorance to accepting crackpot theories. Presenting evidence to them reaches them pretty well.
Nick
January 30, 2010, 3:16 pmTomB says:
Rare?
In the US now, with the expansive criteria, 1 in 150 kids are said to have Autism/Asperger’s.
The broadening definitions are why there is a boom in autism rates, not vaccines.
January 30, 2010, 3:20 pmChrisTS says:
TomB:
Yes, but please also keep them out of the pediatrician’s office, the park, the supermarket, and other places where those of us who do not want our children exposed to serious diseases might be present.
January 30, 2010, 3:25 pmTomB says:
Agreed. Perhaps my use of “society” will be interpreted too narrowly. I do indeed mean that if someone doesn’t want the responsibilities of living in a society, they shouldn’t leech off of us for the benefits of same.
January 30, 2010, 3:29 pmSuperSkeptic says:
TomB,
I suspect you are still missing my point. I don’t want to leave society. Moreover, it’s more of a symbiotic relationship (society and the individual). I would argue that every individual in society forcefully leeches off of me (and each other); and, of course, I individually utilize the benefits of society – despite those I might personally disclaim, if I could. Now, you can call that “leech[ing]” if you want, but I don’t call it leeching when a bunch of people give me a gift. I have no desire to go stand still in the woods with my children until we die of starvation. The question is what “society” demands of the “individual” – by virtue of society’s claim that it is entitled to call the shots because of the benefits the individual derives in part due to society’s very existence. My issue is that Zuch’s logic provides a win for “society” virtually every time that question arises. In my opinion, that’s no way to run a constitutional republic, let alone the hyperdemocracy its proponents typically endorse.
January 30, 2010, 3:45 pmAlast says:
Two problems with your statement.
One, replace “hard metal” (I think you mean “heavy” metal) with “poisonous gas.” In this case, chlorine. Chlorine is part of a compound you put into your child’s body all the time. Sodium chloride — aka table salt. But in the compound (salt) or as a disassociated ion (dissolves salt, i.e. the Cl- ion) chlorine is not poisonous. In thimerosal, the mercury is in a compound — not in elemental form. Elemental mercury, like elemental chlorine and elemental arsenic, are poisons. When those elements are in compounds or disassociated ions however, they may be quite harmless to the body.
Second, mercury has been eliminated from childhood vaccines since 1999 — so if it was the cause of anything, that “thing” should have seen a massive decrease since that time.
January 30, 2010, 3:45 pmSergey says:
These new criteria are so elastic that almost any mental development disturbance imparing social skills is now labeled “autism spectrum disorder”. There can be dozens of different underlying mechanisms with this effect, which automatically undermines any study proving or disproving vaccines/autism connection. I do not believe anybody stating that vaccines are perfectly safe, because I know how they are made. I was an immunologist (30 years ago); 10 years ago I was a scientific editor of Russian translation of the main WHO manual by Anderson&May “Infectious diseased of humans: Prevention and control”. Situation with vaccination is much more complicated than health officials want us to believe. I understand their position: they are afraid of mass rejection of vaccination if they told us the truth, and have excellent reason to be afraid. Basically, they ask us to put at risk our children health for public good. Tough sell. For parents, the best option is when all other’s people children are immunized, but their children are not. In some cases, risk for individual is less when he is immunized, but not always. And it depends on both coverage and severity of infection. But it is practically impossible for non-specialist to assess this risk. So we hear blanket assertion that vaccines are completely safe, which simply is not true.
January 30, 2010, 3:50 pmA. Zarkov says:
Phillip Roth, The Human Stain
Quoted at the top of Chapter 10, in Paul Offit’s book: Vaccinated.
Offit is not a journalist. He’s Professor of Pediatrics at the University of Pennsylvania and chief of the division of infectious diseases at Children’s Hospital of Philadelphia. His book is mostly about Maurice Helleman who developed most of the vaccines in use today. However Chapter 10 deals with the Autism controversy. Wakefield attacked Helleman’s MMR vaccine (three in one).
BTW Hilleman save more lives than anyone else in history. If anyone ever deserved a Nobel Prize in Medicine, it was Hilleman. He didn’t get it. According to Offit, the Swedish Academy did not want to give the prize to an employee of a pharmaceutical company. If this is true, then I have to blame the anti-business attitude so prevalent in government and academia.
January 30, 2010, 3:52 pmAlast says:
People confuse the term “autism” with “diagnosed with autism.” Many kids in the past, had “autism” but were never diagnosed. Today, many are diagnosed with autism, who do not have it.
Autism is a differential diagnosis — there is no test to prove it or disprove it. It is a spectrum disorder, from severe to mild, with many varied and different symptoms — symptoms that overlap with other mental, behavioral, and medical problems.
A recent study showed that if both parents were college educated, or a well-known autism treatment/therapy facility was nearby, autism diagnoses was much higher.
As a spectrum disorder, it may be that half the population has mild autism. Perhaps being warm and fuzzy and obsessively polite and making eye-contact is the defect, and mild “autism” should be the norm.
January 30, 2010, 3:54 pmTomB says:
What risk? There is a very small number of children who have severe reactions to certain vaccines, but that number is orders of magnitude lower than disease rates without the jab.
So we hear blanket assertion that vaccines are completely safe, which simply is not true.
Who says that?
Speaking of blanket assertions, you’ve made a few. Any proof to back them up?
January 30, 2010, 3:56 pmTomB says:
Of course you don’t. But as the rest of your post amply demonstrates, you do want the benefits while avoiding the responsibilities.
January 30, 2010, 4:02 pmSergey says:
Actually, most mercury compounds are much more toxic than elementary mercury. The same for arsenic. In any case, using conservants for vaccines is anachronism. This was done when dozen children were immunised by shots from the same bottle. Individual dozages make this unnecessary. Possible harm has another source: autoimmune reactions to neural tissue antigens. Another possibility – development of encephalomeningitus due vaccine strain reversal to virulent form, or in feeble succeptible individuals.
January 30, 2010, 4:08 pmChrisTS says:
To be fair to SuperSkeptic, it is not clear that s/he is making that claim. However, it does seem that many others are implicitly making that claim. They do want, and avail themselves of, all that a modern society has to offer. But, based on emotionalism and, perhaps as GW suggested, some vague anti-governmentalism, they also sometimes wish to be free of any responsibility to the collective good.
January 30, 2010, 4:11 pmSuperSkeptic says:
Who wants to pay taxes? I’m pretty sure everybody wants benefits without responsibilities. I want some benefits, sure, and there are others that I don’t – same goes for responsibilities. But, again, that’s not what I’m saying – you still don’t get it. (Note: I’m not arguing against vaccination – I’ve not weighed in on that at all here.) I’ve merely taken issue with the reflexive argument used by some in the Majority here because it undermines the case for Minority/Individual rights in every sphere or situation.
January 30, 2010, 4:15 pmPurple Koolaid says:
I’m not so sure about that. I just went to a talk by Barbara Loe Fisher of the Natl Vaccine Information Center–mostly all liberal. The folks at the mothering boards http://www.mothering.com/discussions/forumdisplay.php?f=47 have the largest anti-vaccine board that I know of and they are mostly liberal. Many say that govt just needs to be reformed w/ regards to vaccines. IT does make for interesting talk when I present a more libertarian view of govt.
January 30, 2010, 4:23 pmSergey says:
I personally know several cases when whole batches of vaccines caused small-scale epidemics of encephalitus. Our institute gathered statistics of this kind, and results were discussed among specialists. All these reports were classified, to avoid panic. But we know about these cases. My own son after smallpox vaccination got encephalomeningitus, and developed epilepsy afterward. Severe autoimmune reactions also can not be excluded, sometimes they are much worse than diseases which vaccination seek to prevent. This does not means that vaccination is bad idea, but there are inherent risks attached to it, and some children with known history of allergies or general bad health should be excluded from any vaccination programm. Only a specialist can say what is better for a child, on case-by-case basis. Vaccines are given to everybody, so the standards of safety in this case must be much higher than for drugs given to small percentage of actually ill; and there is no such thing as absolute safety.
January 30, 2010, 4:29 pmAnthony says:
Smallpox vaccine has always been notoriously dangerous, because it’s a live vaccine. It also hasn’t been given regularly since the 70s, so I suspect your experience is somewhat dated — vaccines have gotten safer with time (FWIW, a modern child may be vaccinated against more diseases, but the total quantity of vaccine he’s exposed to hasn’t gone up, because doses per disease have gone way down). Vaccines do have non-zero risk, but autism isn’t one of those risks, and even with herd immunity being generally retained that risk is probably lower than the associated disease, and absent herd immunity it’s vastly less risky.
January 30, 2010, 4:45 pmGuest12345` says:
I think all soldiers should be dentists, otherwise they are free riding scum!
January 30, 2010, 5:00 pmtarheel says:
Not true. This is a case where exercise of an individual right impacts every other person in society negatively. That is why the military example, or others like it, are bad analogies.
More importantly, in this case, the people exercising their “individual right” not to vaccinate do so with the warm comfort of knowing that they probably will suffer no consequences since almost every one else in society has done the responsible thing and vaccinated, despite the possible risks.
January 30, 2010, 5:06 pmTomB says:
Link?
Because it sounds more like bad batches, not bad vaccines. If you have a bad lab preparing the vaccine, you’re going to get bad batches, even though the vaccine itself is safe.
Was this incident in the old Soviet Union?
Severe autoimmune reactions also can not be excluded, sometimes they are much worse than diseases which vaccination seek to prevent.
And they are vanishingly rare.
This does not means that vaccination is bad idea, but there are inherent risks attached to it, and some children with known history of allergies or general bad health should be excluded from any vaccination programm.
They are, in all of the countries that I’m aware of. Is that not the case in Russia?
Only a specialist can say what is better for a child, on case-by-case basis. Vaccines are given to everybody, so the standards of safety in this case must be much higher than for drugs given to small percentage of actually ill; and there is no such thing as absolute safety.
No, vaccines are NOT given to everyone. There are specific, well-defined guidelines. As well as a mechanism for any physician to exempt a child if s/he feels the child is in danger.
Perhaps you should become more familiar with the protocols in the US before lecturing us.
January 30, 2010, 5:06 pmOren says:
I want you to be right about this. I really really do.
Or they may be far more dangerous than elemental form. Consider the difference between elemental mercury (causes brain damage and such like) and dimethyl-mercury (fatal at 0.1 mL level).
[ Not supporting the vaccine wackos here, just pointing out that you made an incomplete claim. ]
January 30, 2010, 5:16 pmPurple Koolaid says:
There may be well defined guidelines but I know of zero cases where a physician has exempt a child. My friend even had her baby at 32 weeks gestation and they gave her 3lb12oz baby hep b shot on her first day of life despite her mother not having hepb! I have friends that took their child in w/ a severe cold and the doctor said, “We have to do the shot today.” If you go over to the mothering.com boards you will read story after story of a mom who said her baby had a reaction and the doctor brushed it off as a mere coincidence and did not report.
Pro-vax doctors will even admit that there is underreporting to the vaers.
I would like to see a study of non-vaccinated children and see what their rates of asd, auto-immune diseases etc. Barbara Loe Fisher’s group (NVIC) is trying to raise money to commission a study. The govt isn’t interested in doing any such study.
January 30, 2010, 5:36 pmPurple Koolaid says:
ok, I know a few people w/ egg allergies that were exempt from certain vaccines, but this was after they were babies and they identified the egg allergy…should have amended my post
January 30, 2010, 5:42 pmSuperSkeptic says:
You are saying the argument is persuasive as-applied here. Perhaps. I’m saying it is a bad argument, generally.
January 30, 2010, 5:45 pmTomB says:
Well, in that case, I withdraw the assertion. I mean, if Purple Koolaid doesn’t know of anybody getting an exemption, then they must not exist!
I know of dozens. Your point?
The plural of “anecdote” is not “data”.
January 30, 2010, 5:49 pmLindsey Abelard says:
OK, lets run through this again. The autism rate has increased 20 times in less than 20 years. An increase of this magnitude in such a short period of time can only be due to environmental cause. A genetic explanation is not credible. There are three possible causes:
1) There is a new industrial pollutant that has emerged in the past 20 years. Perhaps a compound used in semiconductor processing. If so, then the rise of autism should be limited to areas where there are semiconductor plants. This is not the case. Also, there are fewer semiconductor plants in the U.S. today than in 1990 because the industry has largely moved to Asia. Perhaps there is a new compound that some other industry started using the early 90′s. However, there does not seem to be any evidence of this. The rate of autism seems to be increasing most in “white-collar” areas where there is no manufacturing industry whatsoever (Manhattan NYC, parts of the Bay Area where there is no manufacturing, etc.). This rules out the possibility of an environmental pollutant.
2) There is a new infectious agent that has appeared in the past 20 years that causes autism. If so, then the increases in autism would be most pronounced in places like Africa and South Asia, where there tends to be more infectious disease than anywhere else. This is also not the case. This rules out the possibility of a new infectious agent.
3) The autism is iatrogenic, that is, doctor caused. It is either the Thimerosol in the vaccines, the vaccines themselves, or some other treatment that kids are receiving from doctors. There is no other plausible explanation. Thimerosol is based on heavy metals (Mercury). There is never any reason, whatsoever, for any heavy metal to ever be used for medical application. It is worth noting that someone calculated that the amount of Thimerosol used in childhood vaccines exceeds by an order of magnitude the maximum level of Mercury exposure that is deemed safe by the EPA in industrial settings. This led to a bureaucratic turf war in ’99 between the FDA and EPA. Clinton resolved it in favor of the FDA.
Flu shots contain Thimerosol. This is why I will not take them. Whenever I visit a medical clinic, I routinely put down on my chart that I am allergic to all Mercury compounds, including Thimerosol. I consider any heavy metal compound to be poison and any medical professional who would attempt to inject me with them to be guilty of attempted poisoning.
The use of Thimerosol is a crime again humanity. Doctors are poisoning our kids.
January 30, 2010, 5:59 pmTomB says:
Then you have ethylmercury, which is what thimerosal breaks down to in the body. It is less toxic than elemental mercury and it rapidly excreted from the body.
In any event, since thimerosal was removed from childhood vaccines in 1999, the point is moot.
January 30, 2010, 6:05 pmtarheel says:
There are
threefour possible causes:4) Doctors, for whatever reason (standards have changed, detection is better, etc.), are diagnosing it in kids who would not have been called autistic 20 years ago.
January 30, 2010, 6:09 pmTomB says:
4. As discussed earlier, the diagnostic criteria for autism and ASD has become so nebulous, many more children are being diagnosed as autistic than 20 years ago.
There is no more thimerosal in childhood vaccines. There hasn’t been since 1999. And yet autism rates continue to skyrocket. Why is that?
I consider any heavy metal compound to be poison and any medical professional who would attempt to inject me with them to be guilty of attempted poisoning.
Uh, yea.
Do you like seafoood?
January 30, 2010, 6:13 pmTomB says:
Heh tarheel, great minds and all that…
January 30, 2010, 6:28 pmPurple Koolaid says:
TomB, can you give me dozens of examples of infants that were exempt from vaccines? I’m really interested to learn of them. Even if it is anecdote, I’m interested.
For example ACOG has explicit guidelines that mothers should not be induced for suspected macrosomia. Studies have shown doctors do this anyway. Just bc there is some guideline, doesn’t mean it is followed.
January 30, 2010, 7:12 pmTomB says:
-Serious allergic reaction (e.g., anaphylaxis) after a previous vaccine dose
-Serious allergic reaction (e.g., anaphylaxis) to a vaccine component
-Moderate or severe acute illness with or without fever
-Progressive neurologic disorder, including infantile spasms, uncontrolled epilepsy, progressive encephalopathy
-Guillain-Barré syndrome
-autoimmune disease
…..and so on. Those were cut-and-pasted directly from the CDC site.
January 30, 2010, 7:25 pmHarry Eagar says:
I second GW in the first post.
On the other hand, Dan Lavatan’s claim about prices is contradicted by everything I know about vaccines. Most vaccine researchers worry that returns are so low that nobody will develop them — unless, of course, BIG GUBMINT pays for the research.
January 30, 2010, 7:29 pmloki13 says:
As a side note, purple koolaid, last week we took our young son in to get vaccinated. He was running a very slight fever (only picked up by thermometer). We had to re-schedule the vaccination since the pediatrician will not vaccinate when there is any evidence of fever.
Again, just an anecdote.
January 30, 2010, 7:31 pmHarry Eagar says:
Lindsey Abelard loses the thread.
January 30, 2010, 7:36 pmsardonic_sob says:
I have a child suffering from autism. She’s been vaccinated against our ancient scourges. The vaccines, and their preservatives, had nothing to do with her autism. And I will laugh (and have) in the face of anybody who tries to tell me different without scientific evidence, whether they have an autistic child themselves or no. And if they tell me they won’t have their children vaccinated, I will tell them (and have) I think they’re criminally irresponsible.
Can you guess why I rarely get invited to parties?
January 30, 2010, 7:39 pmBarbara Skolaut says:
Every kid I knew was vaccinated for smallpox when I was young, and I never heard of any of them having a really bad reaction (the scab on the arm was expected). Mama was a nurse, so I’m pretty sure I would have heard of any since she often talked to me about medical subjects.
I was re-vaccinated twice in two years in the early 1970′s, once before leaving for Europe at my father’s insistance (he was a hospital pharmacist) and then again at the insistance of the U.S. Army, for whom I started working in Europe. Standard scab “reaction”; never heard of any bad reactions among those who got re-vaccinated.
What’s different today? What’s changed in the last 40 years (except smallpox was wiped out through worldwide vaccination)?
January 30, 2010, 7:45 pmsardonic_sob says:
Depending on your definition of “childhood vaccine,” and the geographical area to which you refer, this may not be entirely true.
However, it is entirely irrelevant whether it is true or not because absent an incredibly rare particularized metabolic sensitivity thimerosal is completely harmless at the levels found in vaccines. Furthermore, anybody who wants to claim that the levels of mercury found in childhood vaccines causes all manner of disease must first explain how the urban US was not decimated by, for instance, calomel.
January 30, 2010, 7:46 pmsardonic_sob says:
I think you mean that individual syringes make this unnecessary. That’s kind of an odd mistake for such an expert to make. Not all individual dosages come in preloaded syringes.
And besides, not all vaccines are distributed in individual dosages nor can all health care systems afford not to reuse syringes.
In any event, the preservatives have absolutely nothing to do with recipient cross-contamination, which is again a very odd mistake for such an expert to make. They are just that, preservatives. Thimerosal is just one example, and they serve several different related purposes. Thimerosal, for instance, ensures bacteriostatic conditions in the dosage during storage. The preservatives are quite necessary in many modern vaccine distribution systems.
January 30, 2010, 7:52 pmAlast says:
You are absolutely correct, and I did not intend to imply otherwise. Many compounds are indeed much deadlier than an individual component. I was simply trying to illustrate that the syllogism that “mercury is toxic therefore any compound with mercury in it is toxic” is false.
January 30, 2010, 8:00 pmsardonic_sob says:
Short version: You are a moron.
Long version: The diagnosis rate of autistic spectrum disorders has increased dramatically in the past few decades. This is not the same thing as the rate of autistic spectrum disorders increasing dramatically in the past few decades. Neither one requires the other to be true. Several people have already pointed out multiple potential reasons for this.
January 30, 2010, 8:02 pmAlast says:
No, the number of autism diagnoses has increased. That actual incidence rate may have remained constant, or even declined.
January 30, 2010, 8:04 pmBobDoyle says:
I’ve never quite understood the “free rider” logic of those who insist everyone should be vaccinated and that those who do not are free riders. Everybody who plays nice and gets the vaccinations has nothing to fear from those who do not. Only those who also choose not to be vaccinated are at risk from the others who have chosen not to vaccinate. If only those who opt not to vaccinate are at risk, how is that free riding?
Is the argument that those who choose not to be vaccinated avoid the small, but not zero, risk of complications attributable to the vaccination? If those “complication” risks were great enough, we probably would choose not to vaccinate everyone. So, assuming, in general, that the complication risks are quite small relative to the risk of the disease itself, why should anyone feel that people should be compelled by the state to be vaccinated? Virtually all the risk associated with NOT being vaccinated falls entirely on those who so choose. Why is that anyone else’s concern? Why do people feel they have the obligation and the right to tell others what is or is not good for them and to compel them to act in ways they do not wish? Admittedly, people who choose not to vaccinate may be “wrong” according to most people’s risk-return calculus, but isn’t that what it means to be free? They choose, and they bear the risk, not society (or those who are protected because they choose to vaccinate).
January 30, 2010, 8:26 pmAnatid says:
When they adhere to a certain pattern, yes. I view this as an excellent step towards approaching mental illness from a dimensional instead of categorical approach. It’s less useful to approach autism-related social ineptitude from a cut-and-dried “either you have it or you don’t” mentality than it is to acknowledge that some people will experience this spectrum disorder in varying levels of intensity. A person may have very mild ASD, not bad enough to warrant diagnosis by the DSM-IV-TR, but could still benefit from a bit of social coaching on how to work with their condition.
I’m still waiting on anxiety spectrum disorder, depression spectrum disorder, stress spectrum disorder, and a few others. A lot of ‘em will have overlap.
Our current system is trying to distinguish the healthy-sighted from the fully-blind and doesn’t want to give out eyeglasses to the millions of folks somewhere in between.
It could be magic. You know, science that is so sufficiently advanced beyond our present understanding that it resembles …
Sure. The $25 shot contains thimerosol, and the $30 shot does not.You can pick which you want. What, does this option not exist where you live?
Fun anecdote time: I know a young boy who was a fan of tuna fish. He would eat several cans of tuna every day, and he did so for several years. As a result, the mercury buildup in his system began to cause neurological problems, and he now has to carefully restrict the large fish in his diet to no more than one can a month. For these reasons, pregnant women are cautioned to avoid tuna and swordfish. That is heavy metal poisoning.
January 30, 2010, 8:27 pmTomB says:
You have no clue about how vaccinations work.
No vaccine is 100% effective. Therefore, your statement those kids who are vaccinated have “nothing to fear” is completely wrong. We depend on a high rate to protect those who aren’t fully immunized. You might want to look up the term “herd immunity”.
January 30, 2010, 8:30 pmsteve s says:
When I first started in practice, the diagnosis of reflux disease was rare. Now, every third patient has the diagnosis. Was this due to vaccines? No. We developed medicines that could treat it. Plus we got fatter. Diagnostic criteria changed.
Sort of odd that we had been vaccinating for many years, but autism only increased recently. other things that have increased recently include obesity, older mothers, extended use of antibiotics and hormones in our food. Smoking also decreased quite a bit.
What we do know is that multiple large scale epidemiological studies have failed to show a link between autism and vaccines. These have been done in other countries besides our own. These are the same kinds of studies that found an incidence of one in about 5,000, roughly, of a problem that was found when Lovenox was introduced. introduced. We are left with no evidence of the linkage other than some people’s feelings.
January 30, 2010, 8:30 pmAnatid says:
Here is your problem.
When there are trace amounts of a pathogen present, a vaccinated child is unlikely to be infected, while an unvaccinated child is likely to be infected. Once the unvaccinated child is infected, he becomes an incubator for the disease, dramatically increasing the amount of local pathogen. Even a vaccinated child is at risk for infection when a kid with measles is coughing at the desk next to him.
A vaccine is like a Kevlar vest. It’ll stop most of the smaller bullets, but it doesn’t make you immortal. A big chunk of shrapnel can still kill you.
Edit: Beaten by Tom.
January 30, 2010, 8:31 pmTomB says:
No, you bring up a valid, and different point.
Nevertheless, it still shows how wrong Bob was.
How embarassing, you write all that and base it on a completely false assuption.
Epic FAIL.
January 30, 2010, 8:38 pmBobDoyle says:
Lindsey Abelard:
Some years ago, AMTRAK improved their “on-time” record for arrivals at designate stops by over 100% in just one year. An incredible improvement, yes!
No! Amtrak redefined “on-time” from within 15 minutes of the scheduled time to within 45 minutes of the scheduled time and, VOILA, their on-time record improved by over 100%!
Anything is possible when one redefines terms!
January 30, 2010, 8:39 pmCPO_SW says:
And you prove that masterfully.
January 30, 2010, 8:41 pmmatt c says:
chris ts: methinks you don’t realize that the alleged expert, the specialist, the one whom makes a claim to science, is the mass man, which ortega y gasset exposes as a sophist and a primitive
January 30, 2010, 8:55 pmSuperSkeptic says:
For the record, I understand the free-rider logic. It’s just a tad bit overused is all.
January 30, 2010, 8:59 pmMichael Ejercito says:
Name one example, just one .
January 30, 2010, 9:02 pmmatt c says:
one last thing; i liked the idiocy of this obama statement at the gop retreat speech he just gave. notice the call to “experts”
OBAMA: Actually, I’ve gotten many of your ideas. I’ve taken a look at them… If you can show me and if I get confirmation from health care experts, people who know the system and how it works… I’m game…
January 30, 2010, 9:05 pmMichael Ejercito says:
This is true.
Back when the only health care was the local witch-doctor, the rate of autism diagnosis was zero.
January 30, 2010, 9:06 pmAlast says:
Non-Newtonian fluids.
January 30, 2010, 9:08 pmBobDoyle says:
Thanks TomB and Anatid.
First, I generally am in favor in vaccinations. Also, I agree there are second-order effects I did not address, such as the fact that some immunizations are less effective than others and some of those immunized may still face risk of infection as a result of the presence of the disease among those who were not immunized.
However, the risk associated with getting the disease even though one was vaccinate pales in comparison with the risk of getting the disease if one is not vaccinated. The question remains: how much should the state compel action and restrict individual freedoms when the risk associate with non-compliance is borne almost exclusively by those who would choose not to comply?
I don’t agree with those who would choose not to vaccinate, but is the risk associated with those who choose not to vaccinate so great to all the others who choose to vaccinate that the state should restrict freedoms and compel compliance?
Where does it stop? Do any of us have freedoms at all, when everything we do affects somebody else somewhere?
January 30, 2010, 9:08 pmSwan Trumpet says:
In 1994, the Clinton administration along with a Democrat controlled congress federalized most of the nation’s private vaccine production with the Vaccines for Children Program (VFC). Despite the name, it placed many adult vaccines such as influenza under government control. It also enacted price controls.
Vaccine manufacturers faced with government set low prices and soaring costs due to massive lawsuits closed up shop. Thirty years ago, the US had over 30 vaccine manufacturers. Today, we have three. Nearly all of our vaccines are imported from Britain, France, and Switzerland. When there’s an emergency pandemic, other countries take care of their own before selling to the highest bidders. President Bush eased the price controls but was unable to get tort reform passed in spite of the fact that US vaccine manufacturers are an integral part of our national security and a first line defense in the event of a biowarfare attack.
As far as the explosion of children diagnosed with autism – the numbers are inversely proportional to those who used to be diagnosed as mentally retarded.
January 30, 2010, 9:11 pmMichelle Dulak Thomson says:
Swan Trumpet,
As far as the explosion of children diagnosed with autism — the numbers are inversely proportional to those who used to be diagnosed as mentally retarded.
Now, there’s an idea I’d not seen broached before. (Not sarcasm; I really haven’t seen this raised, despite reading many discussions like this one.) Has someone attempted to document this? Have you (pardon the inevitable request) any citations or (better) links?
Because I’d never thought that this might be a thing like that famous graph (I forget whose) of incarceration rates and institutionalization rates against time, showing that the sum of the two was remarkably uniform over the whole period of massive deinstitutionalization. My half-formed guess was that kids who would formerly have been called “weird” or “socially maladjusted” or whatever were now being treated as ASD, due to changing diagnosis guidelines and greater awareness of the disorder. But, sure, it’s worth investigating whether some were just transferred from one diagnosis to another as knowledge of autism increased. It’s at least superficially plausible to a rank non-expert like me that some autistic children were formerly erroneously classed as retarded.
January 30, 2010, 9:32 pmMichelle Dulak Thomson says:
Ah, here’s a link to what I thought I was talking about. In the period of massive deinstitutionalization of people diagnosed as mentally ill, there’s a temporary drop in the combined mental hospital/prison institutionalization rate; our “massive increase in incarceration” from the 70s onward only gets us back to the total institutionalization level that pertained for the majority of the last century. We were locking up just as many people per capita from 1940-60 as we are now; but then the large majority were mental patients, whereas now nearly all of them are in jail/prison.
January 30, 2010, 9:43 pmMichelle Dulak Thomson says:
Man, I should just Google before writing. Here is (I think) what Swan Trumpet is writing about: A study by a UWisc/Madison researcher whose abstract says, among other things, that “higher autism prevalence was significantly associated with corresponding declines in the prevalence of mental retardation and learning disabilities.”
The whole paper is there (free) at the link, which is to the abstract.
January 30, 2010, 9:53 pmSwan Trumpet says:
Here’s one link and an excerpt. There are others, much better ones with actual graphs that I’ve seen, but I can’t locate them now. If I do come across a better one, I’ll return and post it. It’s a pretty well-known phenomenon in the medical community. The diagnosis of “mental retardation” is being phased out and viewed by many as a slur. Autism is more socially acceptable and easier for schools to design special education programs for. Prior to the 60s, many children diagnosed with mental retardation were thought of as unteachable and therefore, discouraged from attending school.
http://autism.suite101.com/article.cfm/autism_diagnosis_rates_not_on_the_rise
January 30, 2010, 9:56 pmTomB says:
Sure. Hold two sheets of paper by the top edges parallel about 3 inches or so apart. Now blow down between the two. What does your “common sense” tell you? That the air you are blowing will push the two papers apart. But that’s not what happens!
I’ll leave it to you to discover what happens, and why.
January 30, 2010, 10:00 pmSwan Trumpet says:
I’m glad you located some sources, Michelle.
I also think there’s another reason for the rise in autism diagnoses. Many women postpone childbearing until they are biologically senile, if you will. Approximately 90% of a woman’s eggs are gone by age 30. Those that remain are “old” and more susceptible to genetic defects and mutatations.
January 30, 2010, 10:01 pmDeezrightwingnutz says:
We have a “volunteer” army, but I put that in scare quotes, because people who say “I volunteer at the soup kitchen” don’t mean volunteer the way the army does. We have a professional army, not an army of conscripts. Anyway, I agree with those that brought up the national defense as an analogy to vaccination. People who aren’t in the army free ride every bit as much as those who don’t get vaccinated.
Isn’t the solution obvious? Rather than (or in addition to) appealing to our self-interest, our better angels, or our desire to send kids to public schools to have us get our kids vaccinated, why don’t we just set a vaccination target and pay people enough to get vaccinated at that rate?
Since vaccines are safe and most people think the benefits outweigh the costs, then it wouldn’t take a high price, I’d think. Did Milton Friedman ever issue pleas to end the vaccine draft?
January 30, 2010, 10:02 pmTomB says:
Quantum mechanics.
January 30, 2010, 10:04 pmTomB says:
False dilemma.
The fact is that we have had compulsory vaccinations for decades now, and it hasn’t directly led to any further erosions in our freedoms.
Liberty requires eternal vigilance, and we all need to be vigilant, but when that vigilance turns into stark-raving paranoia, its time to have a nice lie-down.
January 30, 2010, 10:16 pmAnthony says:
Having tried to beat an understanding of general relativity into the head of online skeptics, not only is it non-intuitive, it’s actively counterintuitive for most people; most people have difficulty with the concept that the order in which two events occur is not necessarily well-defined.
January 30, 2010, 10:26 pmRichard Nieporent says:
Name one example, just one
Theory of Relativity
January 30, 2010, 10:46 pmBobDoyle says:
You have not repudiated my argument, but you admit that we have had compulsory vaccinations. How is that, in itself, not proof of erosions of our freedoms? We’ve done it for decades so it is not now (or then) an erosion of freedom?
You ignore my point, which is that imposing your view (even though I agree with you) is a restriction of freedom. I think you are right on what should be done, but I disagree that the desired result should be compelled by government.
January 30, 2010, 10:52 pmChris Travers says:
There are a couple things that are generally missing from this debate.
The first is that the CDC is VERY aggressive about pushing vaccines on kids. According to the CDC, for example, ALL kids under 18 should get an annual flu shot. It is one thing to create too much panic about MMR shots. It is quite another to assume that the CDC is acting responsibly here. I will NOT give my kids annual flu shots, and I start to push back about some (though by no means all) childhood vaccinations. In general, I start asking hard questions beyond the basic vaccines (MMR, Polio, DTAP). Sometimes the answer is yes on other vaccines (TB,* Hepatitis B), and sometimes it is no (Flu shots).
* If the kids didn’t spend so much time in Indonesia, the answer would be different on that one.
The second thing is that, beyond clear serious epidemics or specific elevated risks, I really think the decisions need to be up to the parents. This means that by default, and absent objections of conscience or religion, kids should get MMR, DTAP, and Polio vaccines. I think that other vaccines should be discretionary. I get very nervous about a paternalistic government pushing dozens of new vaccines on kids.
So I suppose you can count me as a moderate. I think most vaccines are probably safe. I don’t want the government to mandate more than the minimum number needed to safeguard public health though.
January 30, 2010, 11:51 pmMartha says:
Many people don’t “choose” not to vaccinate. Newborns and young children who haven’t reached the right age for the vaccine, people who are immuno-compromised due to other illness, people who are allergic to eggs (for some vaccines), etc. cannot be vaccinated. Then there are people who did choose to be vaccinated but were unlucky enough to receive a weakened batch, plus no vaccine is 100% effective.
Widespread and deadly measles outbreaks in the late 80s began with unvaccinated Christian Scientists. They chose to refuse the vaccine, and their decision had serious consequences for many others.
I consider vaccine refusal to be selfish. “Gee, lady, sorry your baby was born deaf, but at least I didn’t have to compromise my principles.” Even worse is refusing the vaccine for your children. You make your children assume the increased risk so that you can enjoy the luxury of choice.
January 31, 2010, 12:01 amMartha says:
I’d have hedged that, but for some reason the edit window wouldn’t open and meanwhile I watched the timer counting down . . . .
Anyway, I don’t think it is selfish when parents review each vaccine and the timing thereof and then make modest adjustments. I’m talking about parents who ignore or reject the science, refusing all vaccines for religious or “conscience” reasons. It’s not right to martyr your children.
January 31, 2010, 12:09 amChrisTS says:
matt c says:
The odd Shakesperean language aside: No.
January 31, 2010, 12:32 amPurple Koolaid says:
Not quite. Our tax dollars pay for any injuries.
On October 1, 1988, the National Childhood Vaccine Injury Act of 1986 (Public Law 99-660) created the National Vaccine Injury Compensation Program (VICP). The VICP was established to ensure an adequate supply of vaccines, stabilize vaccine costs, and establish and maintain an accessible and efficient forum for individuals found to be injured by certain vaccines. The VICP is a no-fault alternative to the traditional tort system for resolving vaccine injury claims that provides compensation to people found to be injured by certain vaccines. The U. S. Court of Federal Claims decides who will be paid.
http://www.hrsa.gov/Vaccinecompensation/
January 31, 2010, 1:09 amBruce Hayden says:
I think that we try to simplify this too much.
Nevertheless, one of the problems that I have had with the theory that Autism, ASD, etc. can be caused by vaccines is that it appears that they result from the brain being wired differently, and that means pre-natal development.
I do think that part of the issue is the diagnosis. A good friend of mine, in her early 50s now, was diagnosed maybe 45 years ago as somewhat retarded and put in special ed as a result. Then, she was diagnosed as Autistic. But that too wasn’t really that close. The reality, it appears, is that she has Asperger’s (AS), which is still, to date, hard to diagnose in females. Retardation is still out there, just many fewer with some form of ASD are thrown in there.
With this friend of mine, no one figured out why she was so odd until she was in her mid-40s. By then, she had managed to get a college degree, get married, have, and raise children. All under the radar. But once you know what to look for, her symptoms have been there all her life.
But I think there is more to it than just over-diagnosis. Simon Baron-Cohen has theorized that there is a lot more of what he terms assortive mating going on now. You take two engineers or programmers working together in Silicon Valley. Both have brains that systematize very well. They may also be obsessive/compulsive, as that is a trait that is useful in those endeavors. They marry, have kids, and guess what? Autism or ASD.
The theory goes on that in the past, you married the girl next door, and getting all these geeks together just didn’t happen. Now that it does, possibly breeding them together may result in Autism and ASD children. Not always, of course (my ex and I met working together on a software project, and our kid is just fine in this regard – but definitely oriented towards math, science, and engineering). But statistically the chance goes up when you mate a lot of geeks together. Just a theory, but he makes a fairly persuasive case.
January 31, 2010, 3:10 amAnatid says:
The people who self-report the lowest rates of depression and anxiety are not the people who experience the lowest rates of depression and anxiety. Adults with a secure attachment type will report low rates of depression and anxiety – the normal amounts one would expect from a modern, stressful lifestyle – whereas adults with a dismissive attachment type will report no depression or anxiety whatsoever, even though they have higher rates than the securely-attached, because they are in denial about problems in their life.
This is why self-report data should always be treated with a raised eyebrow.
January 31, 2010, 3:11 amRicardo says:
That’s not correct. Few if any vaccines are 100% effective in any given individual. Vaccinated people are in fact put at risk by non-vaccinated.
January 31, 2010, 5:05 amtired of blogs says:
The non-vaccinated don’t just increase the prevalence of a virus. They also offer it more opportunities to mutate into a deadlier virus against which nobody is vaccinated. Flu viruses in particular are notorious for doing exactly this. In other words, the risk associated with non-compliance is NOT borne almost exclusively by those who choose not to comply.
January 31, 2010, 6:51 amSergey says:
TomB: Yes, this incident took place in Soviet Union. It was related to measles vaccine, which should be by protocol prepared in brain tissue of very young rats. In production lab they substituted these very young by more grown rats, which led to reverse of attenuated vaccine strain to more virulent variety and subsequent outbreak of measles encephalitus among vaccinated. Our Institute led an inquiry, and immunologist Svet-Moldavsky discovered the problem. But it does not means that using very young rats removes this danger completely, it only reduce incidence of vaccine-induced encephalitus to tolerable levels.
January 31, 2010, 7:02 amI know, of course, that some categories of children are exempt from vaccination in USA, and criteria for such exemption are discussed in the WHO manual which I edited. But rather few children in practice get this exemption, and this does not exclude neurologic damage to many who are not exempt.
In modern Russia there is a law that all medical services are strictly voluntary unless there is a court order of compulsary treatment. This was reaction to abuse of medicine for political purposes, like compulsary institutionalization of dissidents. This law encompass vaccination, too: it is a right, but not an obligation. Parents can opt out, without need to explain why. There is an aggressive propoganda campaign to persvade parents to vaccinate their children, but there is no coercion. As result, coverage is more or less satisfactory. Absence of coercion makes wonders to reduce paranoia.
Sergey says:
The problem with MMR is ascribed primary to Rubella component. Measels and mummps are serious diseases, so in this case risk of disease is as a rule greater than risk of vaccination. But rubella is not serious in infants, complication are between extremly rare to non-existent. The only permanent damage from rubella infection is expected to fetuses, since in the first trimester of pregnancy it produces multiple congenital defects: deafness, blindness, malformation. So it is not wise, in my view, to combine rubella vaccination with measles and mummps. It is better to vaccinate against rubella only girls, but not boys, and do it in pre-pubertant age, when risk of complications is grossly reduced compared to vaccination of infants. Mumms, on the other hand, is dangerous only to boys and relatively harmless to girls (most frequent complication is orchitis). If I could choose, I would vaccinate both boys and girls in infancy against measles, only boys against mumms in infancy and only girls in pre-pubertat against rubella. Other parents are free to make their own choices, but my is at least founded in medicine and epidemiology.
January 31, 2010, 7:34 amHiggins says:
Sergey is the only one that has addressed this topic with authority. Sergey, thank you for your posts.
I live in Russia. There is no “coercion”, but there is a lot of pressure placed on parents by health care workers and teachers for kids to get the full battery of vaccinations.
January 31, 2010, 7:35 amJerry45 says:
Wasn’t Gulf War Syndrome caused by a vaccine given to military personnel? Over 150,000 still suffer from GWS. Yet the government swore up and down that it wasn’t the vaccine, but instead a nerve gas used by Saddam Husein. And there were studies proving that it wasn’t the vaccines that caused GWS. And everyone, outside those affected, was so sure that it wasn’t the vaccine.
January 31, 2010, 8:01 amSergey says:
There are lots of things in medicine and physiology that we simply do not know. One example is acceleration. In 1960 there was epidemic of early onset of pubertat in all developed countries, and average height of humans had rizen by several inches. Nobody still knows why. So epidemic of autism can be classified into the same category of inexplicable shifts of human population physiology.
January 31, 2010, 8:17 amVaccine safety is another problem, and in my view it still lacks adequate solution. Bold assertion of all of them being “safe” is political BS. What is needed is stop use all preservatives (they all are poisons, including merthyolate, and worse, they are cummulative poisons, especially harmful for babies, whoose brain development is still in progress); pre-filled individual syringes sterilized by gamma-irradiation is the best alternative. Incidence of allergic reactions now is many times or even dosen times higher than it was 30 years ago, due lack of breast feeding, and this another hurdle to vaccine safety. Here the best solution is recombinant DNA technology of vaccine production, which allows to stop using eggs or rodent brain tissue as substrate for breeding viruses. Gene engineered vaccines do not contain ballast proteins, the main cause of allergies.
TomB says:
Which, as I suspected, wasn’t with the actual vaccine, but with the production of it.
So your anecdote has almost nothing to do with vaccine safety. Other than using the proper lab to produce them.
“Tolerable levels” meaning “almost non-existent”?
There are only 2000 or so cases of encephalitis in the US each year by any cause.
On what do you base that assertion?
Could you please elaborate on the term “propaganda”, as used in this instance?
Well this it sheer idiocy.
And what, praytell, are we to do with all these young children when they are around their mothers!? Mothers, you know, the women who are most likely to be pregnant?
Sergery, do they not teach the concept of herd immunity in Russia?
January 31, 2010, 8:47 ambailey says:
So, this scientific fraud is inexcusable while the Global Warming scientific fraud is just boys being boys?
January 31, 2010, 9:12 amSergey says:
Of course, they do. But maintaining herd immunity is not the only goal of vaccination, and in many cases it is not even secondary consideration. It all depends on severity of disease, on its epidemical potential, and, in case of rubella, the goal is not epidemic prevention, but harm reduction by eliminating the most serious complications. There is a notion of “groop of risk” in epidemiology, and many vaccines are specifically designed to protect some narrow groop with high risk to pick up the disease. This include, for example, medical or veterinary personal, geologists working in taiga where encephalitus transmitted by mites is endemic. We do not vaccinate everybody against rabies, but only those who were biten by a stray dog, and when we can not exclude that the dog was infected. Obviously, herd immunity had nothing to do with this most classical use of vaccination.
January 31, 2010, 9:31 amTomB says:
I really hope you are pretending to be an expert from Russia. Because if you are, the good people of that country are in serious danger.
Herd immunity has everything to do with vaccination. You cannot separate one facet of disease prevention from another.
January 31, 2010, 9:47 amSergey says:
Medical propaganda in Russia is a special division of health service, with a big buget money spent on it. This includes placards, wall papers in every medical center, TV ads, billboards on the streets, special lessons in schools, ads in mass transit transport and many other forms. It is called “sanitary enlightenment”, or “Sanprosvet”.
January 31, 2010, 9:47 amSergey says:
Actually, you can. And in many cases you must. There is no herd immunity against rabies, and it is both impossible and not needed to create one. There is no herd immunity against plaque, cholera, smallpox, tuberculesis, and no country tries to create one.
January 31, 2010, 9:54 amTomB says:
“Propaganda” usually has a competely different meaning in english.
You are ignoring the issue here. We are discussing childhood vaccines and the diseases they prevent. With those, the idea of disease prevention depends largely on herd immunity. Bringing up rabies is nothing but evasion, seeing as how rabies is usually transmitted via animal bite. And there is no herd immunity from those.
January 31, 2010, 10:15 amsardonic_sob says:
If you are walking along a narrow path (say, trying to balance on one of those concrete parking-lot divider gizmos) and you start to fall to one side, one of two things will happen:
1) If you think, “I am falling to the right, I must shift to the left!” you will have followed your common sense.
2) If you let your body react naturally, even though you are falling to the right, it will shift to the right.
The kicker is that if you do the first thing, you will fall off the path, because your common sense is in direct contradiction to the laws of mechanics. (Your body knows this, and will do the correct thing. It is due to the fact that moving the top of your body one way results in moving the bottom of your body the other way.) Quantum mechanics is an excellent example but can be a little esoteric for some people. This example is from the macro world we all live in and it’s directly testable.
Logic, in this case as in so many others, is merely a means for arriving at the wrong conclusion with confidence.
January 31, 2010, 10:18 amSergey says:
Neurologic damage doesn’t necessary takes this extreme form, there are many milder, but still hardly acceptable variants, like meningitus, peripherial nerve system damage, cerebral palsy and, yes, autism, still suspectible for its association with MMR vaccine. The simple biological truth is that half of the viruses are neurotrophic, that is, brain and nerve tissue is their preferential site of reproduction, and that is why they are bred there for production of vaccines. Other preferential sites are embrionic tissues (another technique used in virology and vaccine production is using chicken embrions), liver, kidney and small intestine epithelium. They all can be targets of post-vaccination complications. This topics by understandable reasons are almost never discussed in mass media, but specialists know better.
January 31, 2010, 10:22 amsardonic_sob says:
There are multiple flaws in this logic.
1) Not all vaccines are effective for life, but by giving them to children and having them effective during the years when communicable diseases are most likely to be spread, we all benefit because children are the biggest vector. Block the vector, block the disease.
2) Many people, as has been pointed out, can’t take the vaccines. By immunizing everybody who can be immunized, it reduces the pool of potential carriers and minimizes the chance that those who can’t be immunized will be infected.
3) Not all vaccines are 100% effective: if a pathogen has a pool of nonimmunized people to work with, it can shift form enough so that a form which can elude the immunization in the immunized can appear.
I could go on.
January 31, 2010, 10:23 amsardonic_sob says:
I would, by the way, have suggested the immortal Galileo’s experiment with the balls of different density, but that requires more preparation – we don’t all have spheres of the same volume but differing masses just lying around. But for sheer elegance in destroying millenia of “everybody knows,” it still remains undefeated.
No matter what common sense tells you, everything falls together.
Young’s double-slit experiment which demonstrates the wave-particle duality of light (and other things) is yet another demonstration which is easily performed in the macro world and requires no interpretation of sophisticated data to observe. Again, I could go on. Most of what you think you know, ain’t necessarily so.
January 31, 2010, 10:41 amsardonic_sob says:
One last anecdote before I go my merry way this morning…
A relative of mine, who ironically enough is the head of the respiratory therapy department at a major teaching hospital, recently suffered from a prolonged case of pertussis (whooping cough.) And I use the word suffered in both a clinical and a subjective sense.
How did they get it? They’d had the vaccine! Oompossible!
Well, no. The effectiveness of the pertussis vaccine decreases greatly as we age. And my relative had recently married into an extremely conservative family which didn’t believe in vaccinations. They constituted, essentially, a large pool of the pathogen. Result? Two months of utter misery and isolation from most of the family – I certainly wouldn’t get anywhere near them, nor could they ethically visit my aged grandmother in her nursing facility. Fortunately no small children or infants were involved, or it could have been a lot worse.
January 31, 2010, 10:55 amSergey says:
Even when herd immunity is an issue, different rates of coverage are needed to prevent epidemic for different viruses. Many parameters of epidemiology are at play here: contagiosness, transmission mode, percent of underschool age children in day care centers, population densities, climate and so on. Sometimes only certain groops need to be vaccinated, and different quarantine measures are viable alternatives. But the most pressing issue here is the quality of vaccines. We live now in different world than in days of Pasteur, when infant mortality was dozen times higher and the main cause were children infections. But we still produce vaccines by essentially the same methods, which are obsolete and inherently dangerous. My idea of 21 century vaccine is preparation obtained by microbiological syntesis by gene engineering, which does not contain neither any live viruses nor ballast proteins, only purified target antigens, does not need preservatives and is supplyed in one-dose pre-filled syringes, sterilised by ultrafiltration or gamma-ray irradiation. This is not a pipe dream, all components of such technology are redily available, and such vaccines already exist. In mass scale production they can be cheaper than existing ones, because producing companies would not need to hedge against class suits, which now make a lion share of their price.
January 31, 2010, 10:59 amSergey says:
Someting obviosly went wrong with my last post, so I repeat it:
January 31, 2010, 11:08 amEven when herd immunity is an issue, different rates of coverage are needed to prevent epidemic for different viruses. Many parameters of epidemiology are at play here: contagiosness, transmission mode, percent of underschool age children in day care centers, population densities, climate and so on. Sometimes only certain groops need to be vaccinated, and different quarantine measures are viable alternatives. But the most pressing issue here is the quality of vaccines. We live now in different world than in days of Pasteur, when infant mortality was dozen times higher and the main cause were children infections. But we still produce vaccines by essentially the same methods, which are obsolete and inherently dangerous. My idea of 21 century vaccine is preparation obtained by microbiological syntesis by gene engineering, which does not contain neither any live viruses nor ballast proteins, only purified target antigens, does not need preservatives and is supplyed in one-dose pre-filled syringes, sterilised by ultrafiltration or gamma-ray irradiation. This is not a pipe dream, all components of such technology are redily available, and such vaccines already exist. In mass scale production they can be cheaper than existing ones, because producing companies would not need to hedge against class suits, which now make a lion share of their price.
Sergey says:
From epidemiological pespective, this story simply does not hold water. One family can not be a pool of pertussis virus. You need a city to allow a virus with long lasting immunity to circulate. Viral epidemics began only when human communities achieved this treshold size. By this reason, there were no viral epidemics earlier than 1500 years ago.
January 31, 2010, 11:20 amSenatorX says:
But Sergey, in America all vaccines are safe and the science is already perfected. One vaccination schedule fits all children and all children need the exact same vaccines (to be ever increased because there is no dangerous limit to the number of vaccines a child’s body can handle). If you disagree with this then you are science hating activist and probably have some greedy agenda too. The industry is already shielded from suits and a “few” broken eggs are acceptable to the government for the morally superior benefits of herd immunity. Our last hope for improvements are due to the free riders. While coercion is not complete and convincing free riders remains a desirable goal to achieve higher vaccination rates we still have some small motivation for improvement in creating a convincingly safe vaccination program. Unfortunately as the swine flu debacle shows there are other larger forces at work. My fear is it is going to take a large failure in a mass vaccination program or else the release of unknown data about an existing vaccine to shock the system into taking a good hard look vaccine safety.
January 31, 2010, 11:59 amSergey says:
What I see here in reaction of many posters is aggressive denial, impervious to facts, almost religious zeal to protect their cherished beliefs and demonization of opponents, in full witch-hunt mode. (Like this absurd claim that a single family can be a pool of pathogen). Phrases like “very conservative family who do not believe in vaccines” nicely express this attitude. Vaccines are not magic cures for all ills, in which you need to believe: they are human-made remedies, prone to errors, they can be dramatically improved if there is understanding of their limitations and dangers, and political will to do so.
January 31, 2010, 12:26 pmChris Travers says:
Actually I agree with Sergey.
One thing I think we need to do is to reduce the number of vaccinations given to kids. This means prioritizing vaccines along lines of actual dangers. If rubella is neither a serious illness nor requires hospitalization in the vast majority of cases, then it is best to immunize only girls.
Measles and mumps are different.
The problem with relying only on herd immunity arguments is that one isn’t necessarily talking about what we are developing herd immunity from. It is only a small step from there to mandating that EVERYONE get a flu shot EVERY YEAR or pay a significant fine. And heaven forbid someone develops a vaccine from the common cold which must be given every month….. After all, herd immunity is good so we can’t let people get the cold!
Herd immunity arguments, IMO, must be backed up with solid public safety arguments. Otherwise there is no reason to compel folks to get vaccinated. Folks might still choose to be vaccinated for some things if they pose an elevated risk to that individual but mandates should be reserved for true threats to public safety.
For example, if you look at the CDC recommendations and the vaccinations my kids get, there is some overlap. However, my kids get some vaccines not routinely recommended and they don’t get others that are routinely recommended.
January 31, 2010, 1:28 pmChris Travers says:
Do you think flu shots should be mandatory for all minors? For everyone?
Where do you draw the line?
January 31, 2010, 1:31 pmChris Travers says:
Just as a note on autism rates: My suspicion is that there are probably a number of contributing causes and some of which may be outside our knowledge.
If Sergey thinks the rubella vaccine might be related, it is worth considering that as a possibility. However, I want to put forth here some other theories. Note that the rise in autism rates could be caused by any combination of these theories…. In general, few experts think it is just better detection, so we have to look at causes for the increase.
1) Geeks Bearing Gifts: There have been some arguments that the demographics of Asperger’s Syndrome suggest that one important factor may be that mildly autistic people who were previously less successful at finding mates may be reproducing more now. In essence the fact that geeks are now more desirable mates may be allowing for more reproduction than was possible in the past. This might account for some component of the increase in autism as well.
2) Blame the Teletubbies: Early exposure to TV has been shown in a number of studies to correspond with an increase in attention deficit disorder (another neurological disorder). This means that there is some evidence that the brain in early childhood may have its developing wiring changed by exposure to TV programming. It is quite possible that early exposure to TV programming could affect developing brains in other ways too.
I think it is clear that this issue needs a lot more research. We may find that each of these causes contributes but one of them is a dominant factor. But until we know it is hard to make public policy or provide proper outreach. It may even be that we are unable to address the real problem due to Constitutional issues. Certainly neither of the two theories suggested here could be addressed by changing laws.
Also a note on safety. We used to think that asprin was safe to give kids to reduce fevers too. When it was discovered that Reye’s Syndrome existed, it turned out it was extremely common. One problem with studying safety on things like mandated vaccines is that one cannot easily identify a valid control group. IMO all such vaccines should be presumed dangerous and that we should base policy decisions on the basis of weighing possible dangers.
January 31, 2010, 1:57 pmDrTJ says:
“Do you think flu shots should be mandatory for all minors? For everyone?
Where do you draw the line?”
The subject of exemptions is discussed in depth in the comments. Maybe you should check that out first.
January 31, 2010, 2:25 pmDrTJ says:
“One thing I think we need to do is to reduce the number of vaccinations given to kids.”
Why?
Do you have any specific information to support that?
January 31, 2010, 2:30 pmChris Travers says:
That was a gross misrepresentation of the question I asked.
The CDC recommends vaccinating every child under the age of 18 for influenza every year. Should this be mandatory, absent the exceptions listed? if so, why not require all adults to get vaccinated every year as well?
Why not make refusing to get a flu shot without a note from one’s physician detailing such an exception to be a misdemeanor? After all, this is compromising herd immunity….
Fortunately, every physician I have ever talked with thinks the CDC is out to lunch on that one. YMMV….
In short I am asking WHICH vaccines should be required and where lines should be drawn, not if…
January 31, 2010, 2:33 pmDrTJ says:
The CDC recommends vaccinating every child under the age of 18 for influenza every year. Should this be mandatory, absent the exceptions listed?
No. Why should it?
I’m not quite sure of your point here. The CDC “recommending” something is different from making it mandatory, no?
January 31, 2010, 2:42 pmChris Travers says:
AFAIK, the CDC doesn’t make vaccinations mandatory.
The question was directed at the argument that herd immunity against rubella is important. If we need herd immunity against Rubella, why not against influenza?
I am willing to bet that influenza is a much more serious public health risk than Rubella is….
January 31, 2010, 2:43 pmChris Travers says:
(As an addendum to my last post, there is a much greater chance that the report Orin Kerr cites will lead to cell-phone-use laws being repealed than there is that I or my kids will get annual flu shots. Heck I refused to get a swine flu shot and in my family, only my youngest son got one of those and only because of evidence showing unusually high risks for individuals in his age group. I don’t object to vaccines as a general rule and I doubt that MMR vaccines, even if they eventually are shown in rare cases to cause autism, are a major source of the increase.
However, I HIGHLY object to the increasing number of vaccinations forced on our kids. Mandatory vaccinations shouldn’t be meant to prevent everything from earaches to the chicken pox, and should be limited to serious, epidemic-prone public health threats.)
January 31, 2010, 2:57 pmDrTJ says:
The question was directed at the argument that herd immunity against rubella is important. If we need herd immunity against Rubella, why not against influenza?
I am willing to bet that influenza is a much more serious public health risk than Rubella is….
As was pointed out, Rubella can cause serious problems with pregnant women (well, actually the fetus). Since kids are the ones who are going to be spreading it, it makes sense to immunize them.
If you want to make an argument for making seasonal flu shots mandatory, go ahead. But it isn’t much of an argument against vaccines.
January 31, 2010, 2:58 pmChris Travers says:
Indeed, an argument against mandatory Rubella vaccination isn’t much of an argument against vaccines either.
That’s my main point.
IMO, mandatory vaccinations should be limited to cases of epidemic-prone, severe threats to public health. Do you disagree?
I object to giving my kids vericella vaccinations (which are required in my state), btw, but not to polio and dtap vaccinations. I am glad that all I have to do regarding school is fill out a form declaring a personal objection.
January 31, 2010, 3:08 pmDrTJ says:
IMO, mandatory vaccinations should be limited to cases of epidemic-prone, severe threats to public health. Do you disagree?
Yes. You cannot possibly hope to know where these threats are before they happen. Hence the idea behind childhood vaccines.
You said earlier:
“One thing I think we need to do is to reduce the number of vaccinations given to kids.”
Perhaps you could expand on this point?
January 31, 2010, 3:14 pmPurple Koolaid says:
I missed that one. Kids are the ones actually spreading it? Citation?
January 31, 2010, 3:18 pmDrTJ says:
I missed that one. Kids are the ones actually spreading it? Citation?
You want a citation that Rubella is a common childhood disease?
January 31, 2010, 3:34 pmChris Travers says:
True, but you can’t develop a vaccine for undiscovered ailments either. Once an illness is discovered, we can determine whether it is epidemic-prone, and whether it is a severe threat to public health.
The latter involves looking at how frequent deaths are, how severe the illness generally is, how fast it spreads, how easily other methods can mitigate the risk (for example, not sure if HIV vaccinations should ever be required even if they are properly developed since risk mitigation is possible, same with the HPV vaccinations which do exist.)
Measles, Mumps, Polio, Diphtheria, etc. qualify as epidemic-prone severe threats to public health.
Smallpox used to qualify, but does not qualify today.
Chicken pox, HPV, Rubella, and ear infections do not qualify.
Therefore, the first category of illnesses should have required vaccinations, and the second category should not.
At some point, ebola might become a severe threat to public health so developing a vaccine now might be a good thing. However, requiring it is probably premature.
My argument is that we need objective standards as to when vaccinations should be made mandatory. This should require:
1) An epidemic-prone illness that people cannot easily protect themselves from, and
2) A severe illness which causes substantial mortality, and
3) An illness for which other forms of treatment are fundamentally inadequate.
Basically we give kids a LOT of vaccinations and the CDC recommends far more than any state requires. In fact the CDC recommends far more vaccinations than any doctor I have ever met recommends.
At the same time, we are seeing reductions in the bars to requiring vaccinations. For example, Washington State now requires chicken pox vaccinations as a condition for attending school (as an alternative, parents can fill out a form saying they object, but this applies to all required vaccinations and no distinction is made in accepting this form between, say, polio vaccinations and chicken pox vaccinations).
One major issue here is that we don’t necessarily know for sure what the real risks of each vaccine are. If, for example, Rubella or some other vaccine caused one child to become autistic out of every 10000, we would never know (that would be statistical noise in autism diagnoses). By increasing the number of vaccinations we increase the risks of unintended side effects.
At the same time, there are families, such as my own, which often need non-routine vaccinations for good reason. Yet I hesitate to add EVEN MORE vaccines onto an already very heavy vaccination schedule.
For all the advances, pharmaceutical safety (and vaccination safety) is still something we know less about than we would like. There is a potential for undiscovered complications to come up years later, and some real controversies involving current medications have been ongoing for over thirty years (such as a possible, but as yet unproven and controversial, link between acetaminophen and Reye’s Syndrome). Because of this, I think that we need to reserve mandatory vaccinations for the most severe of public health risks and allow parents to choose which other vaccinations the child should have.
The best policy is to give infants the least amount of medicine and vaccinations necessary for their safety and the prevention of the most severe public health threats.
I am not anti-vaccination, btw. I just think we need to be very careful about what medications we give to infants whose brains and bodies are still rapidly developing. I wouldn’t even object to recommending rubella vaccinations for kids over, say, 7. However, unless it is absolutely required for the kid’s safety or a severe public health threat, it shouldn’t be given in early childhood.
January 31, 2010, 3:37 pmMartha says:
I’ve heard that the U.S. schedules vaccines earlier than other nations, in part because parents are much less likely to get regular medical care for their older kids, partly because so many are uninsured. So, for example, Canada recommends HepB (I think) at age 12, while in the U.S., the shot goes to preschoolers.
If that’s true, it’s a pretty sad comment on “the best health system on the planet.”
January 31, 2010, 4:25 pmAnthony says:
For rabies, the primary infection mechanism is not human-to-human, so herd immunity isn’t relevant (though it’s been proposed for the animal reservoirs that are primarily responsible for its transmission, and housepets are routinely vaccinated). Plague and Cholera are bacterial diseases with no vaccine, and in the case of plague, the primary reserve is animals (engineering plague-killing fleas has been discussed). Smallpox was wiped out through herd immunity — the immunity no longer exists because the vaccination is no longer done, because smallpox no longer exists. TB has no effective vaccine against the common adult form, herd immunity would be nice if it could be achieved.
January 31, 2010, 5:20 pmSwan Trumpet says:
You’re incorrect. Ronald Reagan signed into law the National Childhood Vaccine Injury Act to provide relief to US vaccine manufacturers threatening to shut down operations after a series of preposterous lawsuits winning huge awards. One was to the parents of Kevin Toner, who sued Lederle Laboratories claiming their pertussis vaccine caused Kevin to develop transverse myelitis. No evidence was shown at trial and no evidence exists today that there was any connection. But the jurors awarded the parents $1.3 million anyway. Lederle, whose profits averaged just 3 million annually, had to pay more than 1/3 their annual income to the parents of one handicapped child and lawyers were lining up more cases.
The funds for these remimbusements came – not from the taxpayers – but from excise taxes upon vaccine companies and went into a vaccine trust. This caused the pertussis vaccine to rise from $0.17 per dose to $11.00 per dose.
With the election of Bill Clinton and a Democrat-controlled congress, in order to reduce the sky-rocketing prices of vaccines the VFC law was enacted which placed roughly 65% of the nation’s vaccine supply under direct control of the federal government. Once in command of the majority of vaccines produced, price caps were slapped on, forcing vaccine manufacturers out of business and workers to lose good jobs.
January 31, 2010, 5:26 pmChris Travers says:
Anthony:
What level of herd immunity would we have against TB if everyone got the BCG vaccine?
January 31, 2010, 5:27 pmChris Travers says:
(I would point out that the US is one of few countries that doesn’t routinely administer vaccines against TB.)
January 31, 2010, 5:37 pmDeezrightwingnutz says:
I haven’t heard anyone respond to my proposal to pay people to get vaccines until the desired vaccination rate is achieved. Does everyone here who is generally pro-vaccination prefer compulsory vaccinations to a payment system?
January 31, 2010, 5:48 pmChris Travers says:
Too much governmental overhead.
January 31, 2010, 5:53 pmChris Travers says:
That’s not what I am finding with a little googling on vaccination schedules in Canada. Here is one site.
In the UK, things are a bit different. Hepatitis B is only given to those whose mothers test positive. BCG is given for infants at risk to TB but currently not given otherwise.
January 31, 2010, 6:00 pmOwen H. says:
I am convinced that the rise in anti-vaccine mentality is a direct result of the success of vaccination. Few of us remember a time when we wondered if all of our friends would be back at school in the fall, or if someone would contract polio and die or be paralyzed. Few of us know anyone that has died from measles or small pox. I was vaccinated against small pox as a child, but we don’t have to do that anymore. Two hundred years ago, if small pox was making the rounds, people risked the rather significant chance of developing it from the then state-of-the-art preventative, inoculation with living pus. They didn’t complain, because the alternative, 30%+ mortality, was far worse. And now people want to avoid the one in a million risk of any negative outcomes, because they no longer have any conception of what we left behind.
January 31, 2010, 6:16 pmSwan Trumpet says:
I’m sure you’re right in part. My Dad had polio as a child and spent nearly a year in a hospital in an iron lung. He was lucky; he survived. He went on to join the Navy and in college he was a champion swimmer. He was fanatical when it came to making sure all of his children were always vaccinated.
More and more, we live in a society that believes when things go wrong, they are entitled to get payment. Not so long ago there was a story in the news about a judge suing a dry cleaner for losing his pants. Merely offering to reimburse the judge a reasonable cost to purchase a replacement wasn’t enough. The judge sued for several million dollars. That’s a sad epitaph for the modern mindset.
January 31, 2010, 6:57 pmMartha says:
@Chris Travers: Thank you for googling that site. It states that “hepatitis B vaccine can be routinely given to infants or pre-adolescents, depending on the provincial/territorial policy.” Since HepB is transmitted by blood-to-blood or sexual contact, preschoolers would seem to be at lower risk than adolescents . . . but I don’t claim to be an expert on HepB.
@Owen H., I’m sure you’re right. Most people don’t know anyone who has been damaged by vaccine-preventable disease. Let’s hope that we continue to have the luxury to be cavalier about vaccination.
January 31, 2010, 7:44 pmChris Travers says:
Sure. But I think it is fair to ask whether being vaccinated against polio or smallpox is really the same thing as being vaccinated against chickenpox and rubella. The benefits to a lot of vaccines which are routinely required in our society do not belong in the same category as measles, mumps, smallpox, and polio.
So I think I would go further than you do and say that another contributing factor to the anti-vaccine rhetoric is that the success of vaccination programs have lead to a lower threshold for determining when a disease should be vaccinated against.
There’s room for a position between “Don’t hesitate! Vaccinate!” and “vaccines are solely responsible for the massive increase in autism over the last few decades.” I have had folks try to tell me that it is morally necessary for me to get a flu shot every year, and that, morally, I must ensure my kids get them. I see this as no more rational than the other side. I didn’t even get either a standard flu shot or an H1N1 vaccine this year (one of my two kids got an H1N1 shot due to other risk factors).
We should be encouraging parents to make informed decisions.
January 31, 2010, 8:04 pmOwen H. says:
Martha- although far lower in mortality than other, more serious diseases, chicken pox killed between 50 and 100 children a year in the US alone prior to universal vaccination. It also cost in excess of $400 million annually due to lost wages and medical costs.
Also, blood transfer is easy for small children. They play rough sometimes. As an aside, I am vaccinated for Hep a and B because of my work.
January 31, 2010, 9:13 pmOwen H. says:
Not really. No correlation whatsoever has ever been shown in a credible study.
January 31, 2010, 9:14 pmMartha says:
It’s Chris Travers who is skeptical about the chicken pox vaccine, not me. I’m aware that vaccines are recommended when the risk from the vaccine is judged to be lower than the risk from the disease. My kids have had the chicken pox vaccine, and they regularly get their flu shots too. (And last flu season, my 9yo got the shot and STILL got flu A–complete with a 105.7 degree fever which was pretty scary. If that was vaccine-mitigated flu, I don’t want to see an unmitigated flu.)
Thanks for the info about blood-to-blood transfer. I’m pretty confident that my own small children have never exchanged blood with other children, but it’s quite possible that I shelter them too much. Anyway, my spouse and I considered asking to delay the HepB until they were older, but then we decided we didn’t really have any objections to their getting it on schedule. The pediatrician told us that we should also get the vaccine, since we both work in a university setting, but we haven’t done it yet.
January 31, 2010, 9:30 pmMartha says:
I think you’re right that such a perception is out there. I personally don’t consider any of the diseases on the schedule to be trivial, but I can envision a future in which we have eradicated the most serious disease and thus can focus on more trivial disease. Assuming that the vaccines remained less risky than the disease, why would that be a bad thing? Or is your point that we can’t do a good enough job of judging risk to be sure that the vaccines are less risky than the disease?
Anyway, I assume that other factors also affect a public vaccine schedule, e.g., how to deliver the vaccine most efficiently, with lowest cost, when most people will take advantage of it, how quickly the vaccines can be produced, or whatever. No public schedule can possibly focus only on the situation of one child. So I agree that parents should make informed decisions. Like schooling–it’s ok to homeschool, not ok to deny schooling; it should be ok to make some reasonable adjustments to the vaccination schedule but not ok to deny vaccines.
January 31, 2010, 10:39 pmSergey says:
Every mandatory medical or sanitary measure is infringement of personal freedom, let be honest about it. Nevertheless, in some cases it is necessary (Typhoid Mary is an example). To what extent we are ready to sacrifice our freedom to common good? There isn’t and can’t be general answer to this question which can satisfy everybody. Libertarians would reject almost every measure, totalitarians would accept any infringement if it promisses some highly hypothetical and uncertain “public good”. Reasonable people seek some compromiss. So the ussue is highly ideologically and politically charged. We can not allow Typhoid Mary serve us in “Macdonald”, but eugenics, the purest form of “public good”, is also inacceptable. Where the line should be drawn? My answer is simple: restrictions of personal freedom are acceptable only if there is a clear and serious danger to public safety, and only to extent that is absolutely necessary to remove this danger. Mandatory flu vaccination do not pass this test. Mild children infection which do not leave permanent damage also do not pass.
February 1, 2010, 4:39 amSergey says:
Homeless wanderers also are medical danger, they transmit drug-resistant strains of TB, syphilis, and most of them are mentally ill. If we lock all them in mental institutions, as was a custom before 60-s, this will significantly improve epidemiological situation. But the same people who promote mandatory vaccination against even mild infection would protest against this measure as “fascistic”, while it certainly would do more to public safety. What about locking up HIV-positive homosexuals, the most dangerous transmitters of HIV-infection? All homosexuals? Advocates of mandatory vaccinations should be more consistent in promoting public good at expense of individual liberties.
February 1, 2010, 5:12 amsardonic_sob says:
You know a lot of big words – more than I do, which is no small feat. However, while my statement about the family being a pool of pertussis was oversimplification – it was the large community of conservative anti-vaccinators to which the family belonged which was the “pool” – your statement that there were no viral epidemics more than 1500 years ago is simply nonsensical. You’re either a cut-and-paster or a highly educated lunatic. I’m done talking to you now.
February 1, 2010, 10:05 amsardonic_sob says:
The chickenpox vaccine hasn’t been administered in large enough quantities for long enough to really know, but it should be pointed out that since the chickenpox virus is the same virus that causes shingles – which is incredibly debilitating and occasionally fatal in older people – reducing the reservoir of chickenpox in the population may also greatly reduce the incidence of shingles.
February 1, 2010, 10:11 amChris Travers says:
In those cases, let’s recommend the vaccination to those at risk. It isn’t serious enough to mandate vaccines for everyone.
Two things:
1) There are a lot of illnesses out there with the same symptoms of the flu. The vaccine only protects against the typical flu of a given year. Other variants are not covered and other look-alike illnesses are not covered.
2) The standard flu shot didn’t protect against H1N1. That required a separate vaccination.
In my state, parents (fortunately) can refuse any vaccines and still send their kid to school. It takes some extra paperwork to opt out, but the “requirements” are not really “requirements.”
This is a good thing. It allows for reasonable discussion and debate over which vaccines we really should be giving our kids and when.
February 1, 2010, 11:18 amChris Travers says:
There are two major concerns on my part:
I personally think that prior to the age of two, no unnecessary medicines should be given internally to children (that includes even things like acetaminophen, but does not prevent treating, say, diaper rash with topical remedies). In your question, these aren’t necessary so they certainly shouldn’t be given to infants. In that age range, I am not sure we can ensure a level of safety that can be ensured later.
The second thing is that I don’t think that the dream of a world without even moderate disease is a reason to require vaccination. As I say, vaccination should be required only for diseases which pose the particularly severe threats to public health. Otherwise we are asking people to sacrifice liberty for progress, which is not something that works well.
In general, I only want me kid to get vaccines which:
1) Are necessary for the prevention of serious threats to public health (such as measles, mumps, polio, etc)
2) Are fundamentally necessary for the safety of the child (tetanus, and because of the amount of time we spend in Indonesia, Hepatitis A and TB).
I expect that every vaccine administered to my child must be defended on such grounds. Why do you think I am wrong?
February 1, 2010, 11:42 amA. Cooper says:
That’s the meat of it. “Necessary”, “serious”, and “fundamentally necessary” are all judgment calls. Your judgment appears to be that chicken pox is not “serious”. Others think it is. I suspect many people who disagree with you on the policy would agree with your criteria 1) and 2) above.
For me, the definition of “serious” is intrinsically tied to a society-wide cost-benefit analysis. A virus is serious enough to be vaccinated against if the negative outcomes from the vaccine (pain of the injection, injection-site swelling, fever, and then the much-rarer more severe reactions) are less than the negative outcomes from not vaccinating (sick days, deaths, etc.).
Under this standard, the better we get at making vaccines, the more diseases will be serious enough to vaccinate against. If we were doing pus-inoculations against chicken pox, of course it’s not worth it. But we’re not, and that’s relevant, isn’t it?
February 1, 2010, 12:27 pmChris Travers says:
Ok, so for many people it is worth getting an annual flu shot. Should we require it?
I disagree. My viewpoint on chicken pox is give it at age 10 if the kid hasn’t gotten the illness yet. If a friend has chicken pox, send the kid over to play!
There is a difference between having a disease which we might allow vaccination for (I put flu, rubella, and chicken pox in that category) and ones we should require a vaccination for (polio, measles, mumps).
February 1, 2010, 12:35 pmAnthony says:
Though a shingles vaccine is available, and is recommended for most adults age 60+ (if you grew up pre-vaccine, there’s a 99% chance that you were exposed to enough chicken pox to be vulnerable to shingles). Note that this is a perfect case where requiring a vaccine does not make sense; shingles isn’t directly transmissible, so all the vaccine does is reduce your personal risk.
What defines ‘serious’ and ‘necessary’? Plenty of diseases are harmless for the vast majority of victims but cause serious problems or death to a small minority. For example, influenza and chicken pox.
February 1, 2010, 12:41 pmAmiable Dorsai says:
True, and the most obvious change has been that people, especially the well-educated people whose children are much more likely to be diagnosed with autism, have stopped smoking. Stripped of the protective powers of secondhand smoke, the developing brains of children become much more vulnerable to the emotional trauma inflicted by such “educational” television programs as Sesame Street.
The evidence is irrefutable. When Sesame Street was first aired, smoking was still quite common, so there were very few cases of autism diagnosed. However, as smoking decreased, autism diagnoses increased dramatically.
The only reason this is not better known is that Big Medicine is in the pocket of Big Bird.
February 1, 2010, 12:43 pmChris Travers says:
Actually, there are some credible arguments that watching a fair bit of tv prior to the age of 2 can cause neurological problems. Smoking isn’t an issue, though you raise it in jest, and Sesame Street is aimed at older kids. Hence the “Blame the Teletubbies” theory. Most of the research has involved ADD, but ADD is a neurological problem, like autism, and I am not sure there has been any research on correlation between early childhood tv exposure and autism.
In general, my money though is on a combination of factors (in order of importance):
1) Increased diagnosis and detection
2) Increase in mildly autistic parents (natural selection at work), and increased desirability of mildly autistic people as mates….
3) Teletubbies and other early-childhood tv programming.
As Sergey has pointed out, there are reasons to wonder if vaccines might cause autism as a rare side effect. But I have trouble believing that this would show up as anything more than statistical noise compared to the above factors.
Also, I wonder if environmental factors in early childhood day care environments may be a factor.
February 1, 2010, 12:56 pmChris Travers says:
If it is only a small minority that suffers serious complications, it isn’t serious enough to require everyone get a vaccine. It is a reason to vaccinate those at risk.
You seem to be in favor of requiring that everyone get a flu shot every year, right? Would you want it to be punishable if someone doesn’t?
Note that some targetted requirements may be good. I am in favor of requiring that health care workers get flu shots. I just don’t think we need to require it for everyone.
February 1, 2010, 12:58 pmPurple Koolaid says:
The hep b shot is given the day a baby is born, or two days after if the hospital stay is longer.
February 1, 2010, 1:08 pmIT is true that many families are uninsured, but a study from wsj showed that 1/3 of families that are uninsured qualify for their state’s medicaid and do not sign up for it.
You don’t even have to be poor to get medicaid in my state. My family qualifies and I do not consider us poor.
I can’t speak for every city, but our public health dept offers all childhood vaccines.
Purple Koolaid says:
GOod points Sergey. I appreciate your comments.
QUestion to the others: do you not think there are ANY risks to vaccines? And that is why they should be given to everyone? Even the package inserts tell you there are risks! My friend’s son was diagnosed w/ type 1 diabetes at 3 years old and w/ no famlial history, the doctor even admitted it was probably from the mmr vax.
As to autism, I am keenly interested in more research on the vitamin d deficiency causation. Dr.Cannells of the vitamindcouncil.org hypothesis is compelling.
February 1, 2010, 1:14 pmPurple Koolaid says:
Yes, that is mainly transmitted from children to adults. I just read in one of my baby magazines that whooping cough is mainly transmitted from adults to children bc it is a milder cough, w/out the “whoop” and adults don’t realize how sick they are and unknowingly give it to children. If this is the case, then all adults should be vaccinated against it. Make it mandatory to leave your front door w/out the vaccine.
And, as for whooping cough, it is given at age two, not two months, which is the starting schedule in the us.
February 1, 2010, 1:20 pmA. Cooper says:
Sergey, are you seriously equating mandatory vaccination (small pain plus a *risk* of further harm) with involuntary commitment (which is *certain* deprivation of liberty)?
One of those is a much greater threat to individual liberty, which is precisely why we no longer use it. If you can’t see this, your perspective is seriously warped.
February 1, 2010, 1:23 pmPurple Koolaid says:
sorry for my error about our tax dollars paying for it. I do find it odd that the govt is so involved w/ our vaccine system and vaccine companies are making so many donations to our legislators. The Gov of Texas said it was just a coincidence that he and 8 other lawmakers sizable donations from Merck days before mandating the hpv vaccine for 12 year old girls.
February 1, 2010, 1:29 pmAnthony says:
If vaccines worked 100% you might have a valid point. Since they don’t, the only way to protect those at risk is to prevent communal transmission, and the only way to do that is mass vaccination. Also, the ‘at risk’ population can be quite large, potentially most of the population.
I’m in favor of universal vaccination requirements if we can reasonably and effectively achieve herd immunity. Influenza vaccine at the moment doesn’t really qualify (though I get annual flu shots).
February 1, 2010, 1:37 pmChris Travers says:
Such a plan is clearly not driven by a need for herd immunity but only damage reduction.
After all, who do girls get HPV from? If one wanted herd immunity, one would require the vaccine for everyone.
Once again, I don’t think HPV constitutes a severe enough public health risk to require vaccination. This is one area where people should make the decisions themselves on an individualized basis.
February 1, 2010, 1:43 pmChris Travers says:
Yet the CDC recommends that every child be vaccinated against the flu every year. The flu shot, if everyone got it, might provide a short-lived herd immunity.
February 1, 2010, 1:45 pmChris Travers says:
But this is only a hop a skip and a jump from the folks who tell me that I am being irresponsible for not getting a flu shot (after all, I might accidently give the flu to some elderly person who could die) and not having my kids get it.
I really think one needs to save mandatory vaccines for measles-class threats.
February 1, 2010, 1:48 pmAnthony says:
Well, you are being irresponsible; the issue is whether or not it’s a degree of irresponsibility which justifies legislation.
February 1, 2010, 2:02 pmChris Travers says:
I disagree. I don’t think it is irresponsible at all. Most years, the people most at risk from influenza are also most at risk from any number of other ailments. Such people could just as easily develop pneumonia as a secondary infection from the common cold. There is no reason to assume that one is necessarily adding a significant amount to the life of elderly people by getting a flu shot, even if everyone gets one.
We all eventually die. The sooner we come to terms with that, the better.
I WOULD get a shot against any form of the flu which looks like it has a mortality profile similar to the 1918 pandemic. Other than that, nope.
February 1, 2010, 2:08 pmPurple Koolaid says:
WHy shouldn’t moms be forced to breastfeed? Solely breastfeeding would eliminate 700+ US baby deaths per year.
February 1, 2010, 3:05 pmMartha says:
Several people have talked about mandatory vaccines. As far as I’m aware, some vaccines are required for students to enroll in public schools. The public schools (at least around here) don’t even ask about flu shots.
Currently, most states make it pretty darned easy for parents to skip all shots and still enroll kids in school. Homeschoolers are free to incubate whatever viruses they so desire. And even during the measles outbreak with which I’m most familiar, during which three people died, the dept of public health did not require anyone to become vaccinated.
So is it just the school enrollment requirement that is upsetting people?
February 1, 2010, 3:52 pmChris Travers says:
It is here in Washington. Though if there is an outbreak, the kids who are not vaccinated are sent home (where they will probably get sick anyway).
A lot of people object to this sort of allowance though.
February 1, 2010, 4:06 pmChris Travers says:
Why not just make infant formula a prescription drug?
February 1, 2010, 4:23 pmSergey says:
My assertion about viral epidemics and critical size of human communities is not my invention, it is directly from Anderson&May WHO manual. This is also follows from the basic equations of epidemiology describing dynamics of epidemic outbreaks. Most, probably all, human viruses can be transmitted only from human to human and do not have natural pools in animals. And almost all make those who fell ill immune for life. That is why only infants are succeptible to such infections, and population in which a virus circulates must be large enough to have many infants. “Many” means new crop of infants can arise before the virus made previous crop of children immune. This estimated to be several hundred thousand people contacting each other closely enough. Aztecs reached this treshold when Pissaro arrived, and almost half of them perished from smallpox in weeks. Before this all known epidemics were bacterial, not viral, like Black Death in 14 century.
February 1, 2010, 4:40 pmChris Travers says:
Please define a “viral epidemic” for purposes of that statement.
Also every year new flu variants arise in part because new flu viruses jump species. Are you including newly introduced viruses in that definition? If you are, then wouldn’t the population threshold be substantially smaller for a newly introduced virus?
February 1, 2010, 4:48 pmChris Travers says:
The reason I am asking is that there are credible theories about periodic, nonendemic epidemics of Smallpox during the Roman Empire and Middle Ages, but the population may not have been large enough to support an endemic population of infected people, meaning that each epidemic would have meant a new introduction. The model you are describing is specific to maintaining endemic populations of infected people and doesn’t necessarily preclude other epidemic models.
February 1, 2010, 7:05 pmKent G. Budge says:
I am a parent of a child with mild autism. The notion that vaccination causes autism has been thoroughly debunked, and I resent any further expenditure of resources pursuing this scientific dead end.
So how come it’s the parents still pushing the debunked vaccine/autism connection who get all the press?
February 2, 2010, 1:30 pmPurple Koolaid says:
I don’t know if anyone is still on here, but I get the vitamin d council newsletter. In today’s letter he unequivocally refutes the vaccine theory and places it all on “sunscare” tactics of spf and no sun, hence the dangerously low vit d levels. He also talks about the “geek theory” of geeks getting married and having asd babies. He writes: The main finding was that college educated parents, especially women, had an increased risk of having a child with autism. Actually, this is not a new finding. As I discussed in my 2007 autism paper, this has been known since the early 1980s but was dismissed as being caused by ascertainment bias, or how you pick your samples. Dr. Van Meter’s findings correlated well with CDC researchers who found a similar risk for the well-educated, findings that are difficult to dismiss as being entirely due to ascertainment bias.
February 2, 2010, 2:58 pmBhasin TK, Schendel D. Sociodemographic Risk Factors for Autism in a US Metropolitan Area. J Autism Dev Disord 2007;37(4):667-77.
What is known is the relationship between sun-avoidance and sun-block use, which is strongly correlated with higher education and socioeconomic achievement.
Robinson JK, Rigel DS, Amonette RA. Summertime sun protection used by adults for their children. J Am Acad Dermatol 2000;42(5 Pt 1):746-53.
Hall HI, Jorgensen CM, McDavid K, Kraft JM, Breslow R. Protection from sun exposure in US white children ages 6 months to 11 years. Public Health Rep 2001;116(4):353-61.
He has links to all the articles the website vitamindcouncil.org
Sergey says:
Chris Travers:
Viral epidemic is epidemic caused by virus, an obligatory intracellular parasite lacking its own molecular apparatus for syntesis of proteins or nucleic acids (ribosomes, mitochondria and lots of other organels which all bacteria and cellular parasites possess). New flu variants arise not because of jumping species (such events are extremely rare, they occure 2-3 times in a century), but because of genetic drift (mutations), which happen each 2-3 year, and reassortation (an unique form of genetic recombination, which happen once in 10-20 years.
February 2, 2010, 3:23 pmSergey says:
It is hard to determine which virus or bacteria caused some epidemic 2000 years ago, but you are right that a community not big enough to maintain permanent virus circulation can be occasionally struck by a small-scale epidemic outbreak from infection reintroduced to it from some other source population. Exactly this happen now in small, relatively isolated communities. But this means that such source community exist and is large enough for virus persistence. Rome was the largest city of its epoch, the first megapolis, that is, had more 1 mln citizen. From where it could import infection? Smallpox is a strictly human infection, without natural sources outside human populations. That is why in 1970 it was declared “eradicated”, that is, non-existent outside virological labs. That is why we do not vaccinate anymore against smallpox.
February 2, 2010, 3:48 pmChris Travers says:
Sergey: I know what a virus is.
My question though has to do with model dependencies.
In your discussion of smallpox hitting the Aztec communities, you seem to be confusing the number of susceptible people in the community with one where the disease might be endemic. In such a model, the virus is introduced, causes an epidemic, and in the process eradicates itself from the area it was introduced in. After a sufficient time has lapsed, the process could repeat. This may be the cause of the Augustine Plague (definitely earlier than 1500 years ago).
This model doesn’t depend on enough children being born in the community to keep the virus living in the community. Instead it requires a long enough incubation and infectious stage where the virus can spread among a target population which is in contact with a culture where the disease is endemic. After a period of time, herd immunity drops, and the disease can be re-introduced. In this model, the disease does not need to remain endemic in the community.
There is a third model for epidemic as well that I think is shown by HIV (where the disease is never “cured” but where a portion of infected persons become long-term carriers of it— in HIV that is probably around 10%). Over time, this can lead to an “immune” population of carriers spreading the virus to neighboring populations. Also very slow-acting viruses like HIV might require a much lower population to become endemic (consider non-human dynamics of FIV and BIV in Africa, for example).
I guess what I am trying to say is that I think there may be types of viral epidemics beyond the model you are citing. Not that this has a great deal of relevance for the modern world (with the exception of questions like long-term HIV-carrying populations in sub-Saharan Africa), but it is worth keeping in mind.
As for the vaccine issue, I find a lot of really unsavory things happening on the extremes of the debate. This article pretty much describes why I see the “more vaccines are better” crowd as fascist nuts.
February 2, 2010, 3:53 pmChris Travers says:
(As a side note, I am a firm believer that ALL medical treatment, whether prophylactic, supportive, or curative, should require informed consent. Any law which abridges that requirement I am fundamentally opposed to. I see little difference between forcing kids to have vaccines and forcing women to have C-sections. Both are, in the absence of consent, an assault and should be actionable. The courts and the states have no right to mandate assaults on the population in my view, and a narrow exception where competent consent or refusal is neither possible nor where an acceptable proxy exists, like parental consent, spousal consent, and the like. This may be extremist to some, but it is my view.)
February 2, 2010, 4:06 pmA. Cooper says:
They may, as you assert, be of the same kind; but differences of degree matter, too. Would you rather be stopped on the street by a police officer and questioned without due process, or locked up for ten years without due process? Both are improper detentions. But one is clearly worse from a personal-liberty perspective. And the difference between a mandatory C-section and a mandatory vaccine is far far greater than that between ten years and a stop on the street.
If your philosophical bent doesn’t allow for input about how bad the bad things are, something’s bad-wrong with it.
February 2, 2010, 4:13 pmSergey says:
For viral diseases without natural reservoir of virus (that is, strictly human to human transmission) there must be at least one human community where virus is endemic. Then some communities have enough susceptible people to support epidemic when virus is introduced into it, and some have not. Is it big enough to allow virus to persist or not, is another question. And I completely aggree that ideological attitude “the more vaccination, the better” is fascistic and has not scientific basis at all. For example, herd immunity for flu require coverage >90%, which is impossible goal, and can not achive anyting worthy because flu virus is constantly changes and effect of any vaccination last only 2-3 year. Here the only reasonable goal of vaccination is protection of the most vulnerable (schoolchildren, for example, and elders) and should be strictly voluntary. But some categories of public servants could be required to get vaccination (teachers and medical personal), because they are the most likely spreaders, and this restriction of their personal freedom is a job requirement. The same for military servicemen: public service can suppose some restrictions for those who volunter for it.
February 3, 2010, 6:45 amCourtney Lloyd says:
I got mumps last year and it was really very painful. I have to take some pain killers to ease the pain. `
April 29, 2010, 11:14 am