Infectious disease doesn't care why you're unvaccinated • Hacker News Board

Re: Infectious disease doesn't care why you're unvaccinated

#111

Post by Nursie » Sat, Sep 07, 2013, 12:26 PM UTC

laughfactory wrote: post #33

sliverstorm wrote: post #18

Earlier quoted context omitted.

The folks who skip out on vaccination are (consciously or not) doing one or both of the following: 1) Counting on the herd immunity provided by everyone else to keep them safe 2) Pretending that the diseases which are being vaccinated against "really weren't all that bad" or maybe "didn't happen often"

Y'all are totally overlooking that there is a broad swath of the population that is intelligently selecting vaccinations based on current research indicating which vaccines pass the cost/benefit test. Not all vaccines are created equal--including some that are intended to solve for the same thing. And all too many who blab their opinion on pro-vaccine or anti-vaccine do so with a minimum of research and evidence to s…

Pretty much all the data points I've ever seen used by such people have been false, and little more than excuses for their irrational choices.

Re: Infectious disease doesn't care why you're unvaccinated

#112

Post by 6d0debc071 » Sat, Sep 07, 2013, 12:26 PM UTC

sitharus wrote: post #16

I've had the fun experience of debating with anti-vaccine people. Outside of the religious 'god will protect us' line, which I can't really argue with as it's a matter of faith, the vaccines cause autism line keeps coming up. Unfortunately for us a condition that we don't really understand is far more prevalent than the side-effects of preventable diseases. I've never met anyone who's experienced post-polio syndrome…

> Outside of the religious 'god will protect us' line, which I can't really argue with as it's a matter of faith

"God hasn't protected people of your faith historically, why do you think he's going to start now?"

Re: Infectious disease doesn't care why you're unvaccinated

#113

Post by pessimizer » Sat, Sep 07, 2013, 12:27 PM UTC

laughfactory wrote: post #33

sliverstorm wrote: post #18

Earlier quoted context omitted.

The folks who skip out on vaccination are (consciously or not) doing one or both of the following: 1) Counting on the herd immunity provided by everyone else to keep them safe 2) Pretending that the diseases which are being vaccinated against "really weren't all that bad" or maybe "didn't happen often"

Y'all are totally overlooking that there is a broad swath of the population that is intelligently selecting vaccinations based on current research indicating which vaccines pass the cost/benefit test. Not all vaccines are created equal--including some that are intended to solve for the same thing. And all too many who blab their opinion on pro-vaccine or anti-vaccine do so with a minimum of research and evidence to s…

>current research indicating which vaccines pass the cost/benefit test.

Citation needed, and also important to share if you really believe that unicorns like this exist.

>As in most things, vaccination is not an all or nothing proposition and it's a fallacy to suggest it is.

No, it's a fallacy to expect that the right answer must always be in the middle of two sides of an argument. The Law of Averages isn't really a law, it's a mistake.

Re: Infectious disease doesn't care why you're unvaccinated

#114

Post by marcelsalathe » Sat, Sep 07, 2013, 12:34 PM UTC

rbourke wrote: post #9

The effectiveness of vaccines rely on 'herd immunity', that is: you need more than 90% of a population immunised to stop a disease spreading (as vaccines are never 100% effective)(also varies according to vaccine types/adjuvants and disease contagiousness) So by not vaccinating your self/dependents you are actually extremely selfish as you are benefiting from herd immunity whilst at the same time avoiding the (small)…

Good points. I would just add two things. First, as you say, the percentage you need to reach herd immunity depends on a lot of factors. Broadly speaking, the vaccination coverage you need is 1 - 1/R0, where R0 is the basic reproductive number of the disease (http://en.wikipedia.org/wiki/Basic_reproduction_number). For diseases like measles, where the estimated R0 is above 10, you need at least 90% vaccinated, perhaps even more; for other diseases it may be lower.

Second, even if you reach herd immunity, it is a concept that completely relies on a random vaccination distribution. Say your R0 is 10, and you have attained a vaccination coverage of 90%, you may still get lots of outbreaks, because the 10% that are unvaccinated may not be randomly distributed. Indeed, it's becoming quite clear that in almost all cases unvaccinated people are clustered. This is why you get these sporadic outbreaks in under-vaccinated communities.

We (some of my colleagues at the Center for Infectious Disease Dynamics and I) are doing a MOOC this fall on exactly these topics: https://www.coursera.org/course/epidemics

Re: Infectious disease doesn't care why you're unvaccinated

#115

Post by raphinou » Sat, Sep 07, 2013, 12:34 PM UTC

nl wrote: post #104

raphinou wrote: post #72

Earlier quoted context omitted.

> You have made an implication, without basis, that the > immunization policies in the US are "unconditionally pro", > or at least that the people here are "unconditionally pro." You have interpreted this. Read my comment without considering me as anti-vaccines and maybe you'll understand you over-reacted.... My reflection was about pushing administration of vaccines against for example stomach ulcers (vaccine in dev…

Would you be for mandating, in high-income countries, the administration of a vaccine against rotaviruses knowing their efficiency is only 45%? Rotavirus is evaluated at 1% of children deaths in these countries [1] (from CDC, a source you mention yourself). Will you also push for a vaccine for the 99 other percent? Where to start with this? 45% is a pretty low effectiveness rate. I'd prefer to see it higher, but neve…

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

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

Re: Infectious disease doesn't care why you're unvaccinated

#116

Post by Steuard » Sat, Sep 07, 2013, 12:36 PM UTC

bowlofpetunias wrote: post #82

robbiep wrote: post #43

Earlier quoted context omitted.

in a few years there will be an outbreak of something preventable There's an outbreak of preventable childhood measles in England at this very moment

Same thing in the Netherlands. No surprise: all in the Bible Belt. This is a map of the Dutch Bible Belt: http://en.wikipedia.org/wiki/Bible_Belt_%28Netherlands%29 , and this is a map of the epidemic: http://www.nrc.nl/wp-content/uploads/2013/06/ANP-23877900-56... And just for clarity: these are areas with a low population density.

At least in the US, my impression is that vaccination refusal is more common among left-wing anti-corporate types than among fundamentalist Christians. It thrives any time there are non-rational beliefs, but it doesn't seem to be too picky about which kind.

Re: Infectious disease doesn't care why you're unvaccinated

#117

Post by bayesianhorse » Sat, Sep 07, 2013, 12:37 PM UTC

route66 wrote: post #99

bayesianhorse wrote: post #89

Earlier quoted context omitted.

In theory maybe. The data suggests that the same companies are providing vaccines and drugs. Competition in the US Health System certainly doesn't do a good enough job at driving costs down... I don't like to use these strong words, but I do find it dangerous and reckless when people with nearly no medical knowledge want to reason against proven methods on the basis of costs and the hatred of "evil, profit seeking co…

I don't believe what I'm reading here: You suggest that the medical industry is more or less a monopoly / oligopoly with lack of competition and at he same time barf at people dependent on that system to keep out of the discussion? Maybe you (or I) missed a sarcasm tag ... Otherwise it might be the place to remind you that the medical industry does not operate on a free market because sick people mostly don't have mu…

Your retort is baseless since I didn't say anything of the nonsense you are trying to make me say.

There is an economic aspect to health care. I am accusing those who want to make recommendations on (extremely weak) economic grounds without any medical and scientific reasoning.

Baseless anticapitalist conspiracy theories should not play a role in healthcare.

Re: Infectious disease doesn't care why you're unvaccinated

#118

Post by Steuard » Sat, Sep 07, 2013, 12:37 PM UTC

up_and_up wrote: post #97

venomsnake wrote: post #23

I saw a kid with polio deformed legs a few months ago. Something that I have never seen while the immunization calendar was state mandated and I was young. I have also never seen a case of autism. In a few years we will have outbreak of something preventable. I just feel poor for all the kids that had real reasons not to get the shots. A friend of mine after very bad Hodgkin was with compromised immune system for 10…

> I have also never seen a case of autism. Not sure where you live. There are two kids with autism on my block. Both young boys. Autism is a common disease where I live in the midwest. We have 3 large organizations that only work with Autistic kids. My wife and I have 3 kids and vaccinate them selectively on our own schedule. We vaccinate our kids for the same things that we received as children, nothing more and not…

I had a friend in college who used to talk about how she almost died as a kid due to complications of chicken pox. She was very vocally thrilled when the vaccine was announced.

Re: Infectious disease doesn't care why you're unvaccinated

#119

Post by pessimizer » Sat, Sep 07, 2013, 12:42 PM UTC

altero wrote: post #30

bayesianhorse wrote: post #25

Earlier quoted context omitted.

Knowing some of the details on vaccination, I can't agree. There is profit to be made in vaccines, sure. But it's hardly the same as in patented drugs. Competition is usually harder. I wouldn't call the bird/pig flu story hype. There was a wide consensus that these viruses were a threat and might have the potential for a pandemic. It killed a lot of people, and as far as I remember it had a higher mortality rate than…

> There is profit to be made in vaccines, sure. But it's hardly the same as in patented drugs. But there is also good chance to convince government to buy huge quantities. Flu kills and becomes pandemic nearly every year. Bird/pig flu was just a bad year. There are more effective measures to fight flu. For example closing schools for couple of weeks. Also employers should allow tele-commuting during flu seasons.

>just a bad year.

1918 was just a bad year, too.

https://en.wikipedia.org/wiki/1918_flu_pandemic

>It infected 500 million people across the world, including remote Pacific islands and the Arctic, and killed 50 to 100 million of them—3 to 5 percent of the world's population at the time—making it one of the deadliest natural disasters in human history.

Re: Infectious disease doesn't care why you're unvaccinated

#120

Post by Steuard » Sat, Sep 07, 2013, 12:45 PM UTC

ewoodrich wrote: post #91

auctiontheory wrote: post #31

Yes, I think we should all be vaccinated, as the powers that be confidently tell us. And as a consumer of medicine, I observe that doctors are equally confident when they really don't know what they're talking about, and when their opinions aren't substantiated by science. (The command to wear padded running shoes, for instance.) And I know that the CIA organized a fake "vaccination drive" to get Osama bin Laden. So…

So as to not provide any more baseless evidence against vaccines under the guise of impartial reasoning, the CIA led vaccination drive actually did provide vaccines in a poorly developed region, but the data collected led to the capture of Bin Laden. In and of itself, the vaccination drive wasn't some sort of hoax, and it had legitimate doctors and results. It had just been co-opted by the CIA for covert intelligence…

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