Statistics

The Vaccine Discussion: Update

Harvesting eggs for measles vaccine.

So. Vaccines. People are having trouble keeping separate matters scientific and ethical and moral. Let’s attempt a classification.

Scientific Vaccines protect against disease.

Disease The etiologies of diseases are understood at various levels. Measles is very well known, the human papillomavirus less so. The prognosis for any disease is variable and depends on patient characteristics. The same disease, say, flu, can range from annoying to deadly depending on the person. The exact course of a disease is usually difficult to predict for any individual.

Vaccines The efficacy of a vaccine depends on the drug itself, the disease, and the characteristics of the person receiving it. Allergies to components of vaccines are not uncommon. Not everybody receiving a vaccine is immunized, but by far most are. The efficacy rate varies by vaccine. Vaccines can cause side effects or allow entry of other diseases. For example, the flu vaccine depresses the immune system increasing the chance of contracting other diseases. The side effects also depend on patient characteristics: not every person will suffer the same side effects nor suffer to the same degree. For common vaccines such as MMR, the side effects are well studied and the risk for most is minimal. For other vaccines, such as Gardasil for HPV (an important case), less is known. There is always room for questioning, of course, but decisions should not be changed until any new evidence is solid.

Not every person should get every vaccine. The CDC maintains a useful list of the kind of people who should not receive various vaccines. For instance, pregnant women should not get the adenovirus vaccine.

Autism as side effect There is no substantial, reliable evidence showing how the components of any vaccine cause autism. There are many guesses, but all, so far as I can see, fall far short of plausible. This does not argue that biological causes should not be investigated. Perhaps they should. But the investigations must be “bench” style and not statistical. The possibility of false alarm, especially when using classical (frequentist or Bayesian) statistical methods is huge.

Tracking side effects The main problems are (1) an increase in “awareness”, leading more people to be examined for the side effects and other diseases, and (2) an expansion in the criteria for side effects and other diseases; more marginal cases are being diagnosed. Autism in particular is being checked more frequently and the criteria for its presence have expanded.

Herd immunity If everybody but you has been immunized for a disease, and the only potential carriers of the disease are humans, then you are very unlikely to develop the disease. The chance is not zero because not all vaccinated people will develop immunity. As more people around you are unvaccinated, the greater the chance you will contract the disease—even if you yourself have been vaccinated, because the vaccine might not have “took” or it “wore off” (think about “boosters”). Still, most common vaccines are known to be extremely effective. If the carrier of the disease is other than humans, and you yourself are vaccinated and it “took”, then it doesn’t matter whether those around you are vaccinated or not, you will not contract the disease.

Moral Science is not ethics nor can any scientific fact answer any moral question, though these facts might be helpful to any decision.

To vaccinate or not Every individual must balance the rewards of protection with the risk of side effects and changes to their immune system. Your risk-reward criteria will differ from another’s. There is no scientifically determined optimal; such a thing is impossible. You must decide for yourself and for those over whom you are responsible. Many misinformed people will base their decisions on incorrect information. But only puritans insist life should be perfect (and directed by experts). Every unvaccinated person must understand they have a very small chance of infecting others (for human-born diseases) who have been vaccinated but whose vaccines did not “take” or “wore off.” The unvaccinated person can also easily infect other unvaccinated persons (for human-born diseases only). There is a balance between watching out for yourself and caring for others.

Forced vaccinations That balance becomes important here. Should the government legally force parents to immunize their children? For every possible vaccine? This would set the precedent of allowing the government to dictate the healthcare of children. To some extent this already occurs, of course, but many vaccines are not life-and-death. And some are not necessary, and again, the risks of deleterious effect of some vaccines will outweigh any benefit (allergies, pregnant women, etc.). The government will soon begin the argument, weak as it is, that since they are paying for your healthcare they have a right to insist on vaccines. Saves money, you see. Money often trumps morals. But then the government will fell emboldened to also disallow you pop over a certain size for the same reason—and God knows what else. All experience proves the counter-argument is not a slippery slope.

Some people refuse vaccinations on religious grounds. The government, forbidden to encroach upon this area, will argue that the “greater good” demands it. The constant danger is a utilitarian (i.e. money) interpretation to that phrase.

The balance is between personal and religious freedom, the right for families, especially parents, to be superior to government, and the changes to society that comes with this freedom when some diseases might be particularly virulent.

Behavior There is no need for Gardasil if you (or your children) if they are going to be celibate or monogamous. The same would be true if there were a vaccine for HIV. Having protection from some sexually transmitted diseases would encourage promiscuity and open individuals to other dangers. This also changes society.

There. This isn’t everything, but I think most major items are covered. What have I missed? Each individual vaccine-disease-person requires its own discussion.

Update I had thought it obvious, but I see a lot of mistakes on the coercion argument. See this confusing (emotional) piece, for instance (from here). Here’s a clarification.

You and yours are vaccinated against disease X. Suppose that vaccine to be 100% effective. You and yours will then not develop X. Now another family may decide against not vaccinating for X. They are then susceptible; they might contract X. If X is transmitted by humans, it is from other non-vaccinated humans from whom they’ll get X. If X is transmitted by animals, it makes no difference whether any other person was vaccinated.

Now why would you insist that others are coerced into receiving a vaccination? It is true that as the proportion of non-vaccinated people increase, the greater the number of people who might contract X, and the easier X can spread if X can be spread via humans. But, still, you and yours will not contract X.

What you are doing in insisting on coercion is forcing people to do what they do not want “for their own good” (“What about the children!”), and not your direct good. There is an indirect benefit to you in that it is not good that more of your fellow citizens will fall ill. It is far from clear where to draw the line. That depends on how virulent X is and so forth, and it depends on how the vaccine was formulated as was pointed out in comments and in the linked autism article above. There is a difference between flu and smallpox.

Of course, we have to modify the argument assuming the vaccination is not 100% effective. See Katie’s comment below. This premise, ceteris paribus, is in the direction of favoring coercion, but it is not decisive.

Categories: Statistics

65 replies »

  1. I think you’ve separated the concerns properly. As I complained about in the last post, distinctions between normative and positive are not common enough. This post does a nice job of separating those concerns.

    We should be wary when talking with others about this because (1) it’s a highly emotional issue that will make discussion hard, and (2) that we’ll hear lots of “ought” and “should” that are predicated on value systems different than our own. Take care to listen, find common ground, and not jump to conclusions! Polarization will be the death of us.

  2. hawnito, you thing you,

    That link I have above collects a bunch of pictures like these.

    At second glance, they seem to show that things like improved sanitation and quality food—all the really bit public health areas—accounted for most of the decrease. And later that vaccines accounted for the drop to near 0.

    We must always remember that in any time series the previous points don’t cause the latter ones. Some thing or things caused measles not to be caught. What were those causes? Well, changes in cleanliness perhaps. Suppose it were sanitation and the like that were the primary cause of the drop. We then have to ask whether continuing improvements in sanitation would cause measles to drop to 0. Or would vaccines do a better job? We cannot just look at the chart and claim the answer is “sanitation” because, again, it’s not the previous points which cause latter ones. It’s things. We have to say how improved sanitation would work.

    Also don’t forget that the y-axis is rate, which is good, but the population has also increased dramatically. There were about 76 million in 1900 and there are about 316 million now. Lower rates in large populations can lead to a large number of cases.

  3. “But then the government will fell emboldened to also disallow you pop over a certain size for the same reason—and God knows what else. All experience proves the counter-argument is not a slippery slope.”

    Look to the UK for such an example. The voices of the ‘health’ zealots become louder by the week, commensurate with government spokesweasels taking up their causes.

  4. Apparently the bug bear in the US is the government. But what about peer pressure, community pressure? Government could not care less, but your neighbors want you either vaccinated, or out of town.

    Or the other way around. You want to vaccinate your children but the community feels vaccines are the spawn of the devil, or you taking the place of God. Over here we have a bunch of fundamental Calvinists who insist that everything that happens is the Will of God, so vaccination, or insurance is going against Gods Will.

    And the government doesn’t force them to vaccinate. Even though it is well known that the children of these people occasionally get very ill and need state-provided health care, sometimes for life.

  5. @Sander,

    If you choose to give your child a vaccination, and if they believe that everything that happens is the Will of God, then logically, shouldn’t you vaccinating your child be the Will of God? Calvinism is anti-rational.

  6. Briggs, you are right more often than not, but in this case you seriously overdid it. There are exclusion points in any discussion, namely fallacies. If you only scratch the surface of pro-vaccination argumentation you’ll find it largely fallacious.
    E.g. the very idea of herd immunity falls apart once you know the mechanism behind it. It is a horizontal contagion with vaccine strain that does it. Not the statistics. It is merely hijacking the statistics, and the way people perceive it. If you only consider that only a small portion of population – the youth – count in those statistics, you’ll see a gaping chasm lacking for the statistical approach to work.
    Don’t believe me – check it for yourself – there are conference proceedings confirming it: going for dead vaccines eliminates herd immunity. For example polio.

    As for a moral case – most of the bruhaha would simply vanish if the vaccines were truly voluntary. As a reality check, just see what diseases are fought with vaccines today, and weep – all the truly lethal diseases are left out. IMHO it is morally unsound to enforce only the profitable vaccines. Just saying.

    While WHO and such continue their thesis of no link between autism and vaccines, the courts in Italy and USA keep granting verdicts to the otherwise. Again, just saying.

    Maybe, just maybe it is the time to assess all the fallacies encompassing the holiness of the vaccines. I certainly was dumbfounded when I first scratched the surface. I’m not saying vaccines are downright bad, no. I’m simply dumbfounded that there is no such thing as a vaccine that is not marketed by enormous quantities of smoke and mirrors on every conceivable level.

    Simple enough example… gardasil… it is marketed as a cervical cancer vaccine, no less. Which it is not. A fallacy.

  7. http://www.abc.net.au/local/stories/2013/06/06/3776327.htm Interesting story about not vaccinating.

    Sander: I agree with your last statement. We have a problem with the “it’s my kid and my choice but if I’m wrong, then you people are going to pay to fix my mistake.” I would argue that you do not have to vaccinate your child, but if he contracts a disease that the vaccine could have prevented, you are responsible and you cannot write off the debt in bankruptcy. If you have the moral certainty that your decision is correct, you should be willing to pay for that certainty.

    Nate: You do not appear to be properly interpreting the belief. It’s not irrational, your interpretation is. (Okay, it may be irrational, but not in the way you are thinking.)

  8. With respect to freedom to vaccinate or not one’s children–let me put a question in ethics. If you believe in something false and harmful, do you have the right to inflict the consequences of that belief on another person, even if it is your child?

    And another point: kids undergoing treatment for cancer and some other conditions should NOT receive vaccinations because of lowered immunity. Would there be children with very low immune response that should not receive vaccines?

  9. Not every person should get every vaccine.
    I was in the navy and I think we were required to get every vaccine. I was even vaccinated for bubonic plague, Next time the black death sweeps over the US, I’m safe,

  10. Davor: A court case is not about science. If we went by court cases, virtually every single drug out there would be removed from the shelves (I mean that literally—watch daytime TV and see how many suits against every conceivable drug exist out there). Court cases are about money.

    What “truly lethal” diseases are left out?

    Bob: Parents always inflict the consequences of their beliefs on their children, no matter what the belief.

    If there was a medical reason why a child could not take a vaccine, they should be excluded. I realize the government probably does not acknowledge this, so it could be a problem when the government steps in.

  11. I posted this on E.M. Smith’s blog, but it’s still waiting to be moderated so I’ll put it here too:

    In 2010 Finnish authorities tried to get everyone vaccinated for the H1N1 swine flu virus. The vaccine name was Pandemrix, and it was made by GlaxoSmithKline.

    GSK made EU authorities to sign an agreement that GSK would not be responsible for any side effects resulting from the vaccine.

    The authorities started an unprecedented scare campaign, where those suspicious of the untested vaccine were labelled as responsible for all those deaths that would occur if everyone would not take the vaccine. This was done even after it was obvious that the virus was not nearly as deadly as was first thought. In the end more than 50% of the population was vaccinated.

    35 people died with antibodies for the H1N1 virus in their system. Some 20+ of them had received the vaccine only days earlier, but it “did not have enough time to cause immunity”. All but one of those that died were already on their last legs.

    The death rate was much higher than in Poland (which did not vaccinate) or in Germany (which vaccinated only about 5% of the population).

    But then the fun started. It was discovered that the vaccine caused narcolepsy in children ranging from 5-19 years of age. Directly the vaccine caused more than 200 cases of narcolepsy in a country that usually has 1-3 cases of narcolepsy in children each year.

    Pandemrix has now been officially declared as the cause for the increase of narcolepsy in Finland.

    But it doesn’t end there. There were also a lots of reports of other cases of autoimmune diseases that appeared within two years after taking the vaccine. After it was revealed that Pandemrix caused narcolepsy, another study was started that was supposed to tell us whether other autoimmune diseases also had similar increases.

    They cancelled the study before it was finished.

    Here is something to read, although it was later revealed that more people got sick afterwards: http://www.thl.fi/fi/web/thlfi-en/-/increased-risk-of-narcolepsy-lasted-for-two-years-after-pandemrix-vaccination

  12. hannuko: The incidence of narcolepsy increases after having the flu (there studies out there on this). It’s an auto-immune disorder that can be triggered by anything. The kids may not have developed narcolepsy as early as they did with the vaccine, but they could very easily have developed it later after having the flu or a cold. Your assumption seems to be the children would never have developed narcolepsy if they had not received the vaccine. There is not sufficient understanding of auto-immune disorders to make that claim.

  13. @Sheri

    You are correct that the H1N1 also increased the risk of narcolepsy somewhat, but those that took the vaccine were still 12 times more likely to develop narcolepsy than those that didn’t.

    If it would have been the H1N1 -virus, wouldn’t that been the other way round – those that were protected by the vaccine would have developed narcolepsy much less often.

    The thing is that they noticed this connection only because narcolepsy was such a rare condition on children. There were usually only 1-3 cases per year in the entire country, but suddenly a single hospital had more than a dozen cases and a doctor there became suspicious. If the increase would have been on some more common autoimmune disease like type 1 diabetes, it is possible that the connection would never been made.

    Similar connection the vaccine Pandemrix was found on Sweden, so this is not just a Finland only thing.

    Just found this: http://www.reuters.com/article/2013/01/22/us-narcolepsy-vaccine-pandemrix-idUSBRE90L07H20130122

    “In total, the GSK shot was given to more than 30 million people in 47 countries during the 2009-2010 H1N1 swine flu pandemic. Because it contains an adjuvant, or booster, it was not used in the United States because drug regulators there are wary of adjuvanted vaccines.”

    I wonder why they are so wary. Finnish authorities told us that the adjuvant makes the vaccine even more safe…

  14. Dear Dr. Briggs:

    What have you missed? Well, the forest.. all of the issues you raise are easily dealt with if (and, I suspect, only if) all involved have both adequate information and sufficient reason to trust that information. Basically, the present dissension is a consequence of educational failure and does not reflect other moral, ethical, or scientific issues.

    Right now I know people who have refused measles vaccinations for their children because they believe the risk outweighs the rewards. For a very few kids this is true, but they’re not basing their decision on medical interpretation of a child’s unusual genome, they’re basing it on second and third hand reports passed from one scientific illiterate to another as capital T truth. That’s stupid on their part, amounts to unintentional child abuse, and is easily understood as a failure of those charged with ensuring that a sufficient proportion of the population has the knowledge and the faith needed to make sound decisions.

    On the other hand, I also know people who take the annual flu shot and don’t know or care that it pretty clearly doesn’t work. In this case, however, the immediate fault lies with the government agencies pushing this because they ignore the fact that the vaccine is a narrow spectrum technology aimed at a wide spectrum disease – and one that requires a direct hit to be effective at that. Indirectly, however, the fault is again one of population education: the people I know who take the shot generally haven’t the first clue what’s going on with it and are simply rationalizing their abdication of responsibility for their own health in bowing to public pressure as its own opposite: doing something for their own health.

    At both extremes, and most places between, the ethical and moral issues simply disappear if an educated population makes educated choices – and there is no scientific issue because what works , under what circumstances, and with what risks is generally well understood.

  15. hannuko: Yes, there is evidence of increased narcolepsy in children that took the vaccine. Causality? Some studies seem to say “yes”, others say more research is needed. There are studies in England and Brazil also. It is prudent to not use the adjuvant again, of course. I do note that only 50% of people in Finland actually were vaccinated, meaning this was voluntary. People did opt out.

    While we can, with 20-20 hindsight, declare this “should never have happened”, it’s “so horribly outrageous” and etc, we don’t get hindsight up front. It’s why they call it hindsight. Everything is perfectly clear after the fact. The reality of vaccines and drugs and all of medicine is there is a very real possibility of adverse reactions to things–I had a severe one to an antibiotic. Should I be calling for its removal? Should I blame the drug company? No–people are very different and there is no way possible foresee these outcomes. Except to remove all lifesaving drugs so no one ever adversely reacts. They die instead. I’m not happy with option. What we need is people who actually understand the science and realize the risks exist and deal with any bad outcomes. I realize the Finnish authorities told you the adjuvant made the vaccine safer. The doctor prescribing my antibiotic told me I needed it to cure an infection and it should be okay because it was not related to any of the drugs on my list of meds causing adverse reactions. I ended up sick for over 2 months. I don’t blame her. She couldn’t have known, nor could have I. Life is just not without risk.

  16. Here’s an interesting comment from Seth Minook, the author of “The Panic Virus: A True Story of Medicine, Science, and Fear”. (Those of you who watch Fox News will probably have heard it already.)
    Why the ‘Prius Driving, Composting’ Set Fears Vaccines

    California News Correspondent

    Email Greg
    By Greg Miller 31 January 2011 11:22 am 55 Comments
    Journalist Seth Mnookin’s new book, The Panic Virus: A True Story of Medicine, Science, and Fear, explores the public health scare over vaccines and autism. The 1998 paper in The Lancet by British physician Andrew Wakefield that sparked the panic has long since been debunked and retracted, and Wakefield himself has been barred from practicing medicine and accused of fraud. But that hasn’t stopped thousands of people from refusing to vaccinate their children out of fear that they could become autistic.

    Mnookin warns of grave consequences. Recent outbreaks of measles, whooping cough, and other preventable infections have sickened thousands of children and killed more than a dozen in the United States. Vaccine rates are falling below the level needed to prevent an outbreak in a growing number of communities, including ones with wealthy, educated populations.

    Last week, Mnookin spoke with ScienceInsider about why.

    Q: There’s a perception that vaccine refusal is especially common among affluent, well-educated, politically liberal parents—is there any truth to that?

    S.M.: It’s dangerous to make broad generalizations about a group, but anecdotally and from the overall data that’s been collected it seems to be people who are very actively involved in every possible decision regarding their children’s lives. I think it relates to a desire to take uncertainty out of the equation. And autism represents such an unknown. We still don’t know what causes it and we still don’t have good answers for how to treat it. So I think that fear really resonates.

    Also I think there’s a fair amount of entitlement. Not vaccinating your child is basically saying I deserve to rely on the herd immunity that exists in a population. At the most basic level it’s saying I believe vaccines are potentially harmful, and I want other people to vaccinate so I don’t have to. And for people to hide under this and say, “Oh, it’s just a personal decision,” it’s being dishonest. It’s a personal decision in the way drunk driving is a personal decision. It has the potential to affect everyone around you.

    Q: But why liberals?

    S.M.: I think it taps into the organic natural movement in a lot of ways.

    “I talked to a public health official and asked him what’s the best way to anticipate where there might be higher than normal rates of vaccine noncompliance, and he said take a map and put a pin wherever there’s a Whole Foods. I sort of laughed, and he said, “No, really, I’m not joking.” It’s those communities with the Prius driving, composting, organic food-eating people.”

    That’s a reasonably good description of the upper middle-class liberal left, who are also the AGW faithful. Again, education in what science is all about has failed.

  17. All,

    From The Daily Beast, getting it wrong:

    The problem is, when parents opt out of the [measles] vaccination regime, the rest of us can get infected. In recent days, more than 100 cases in 14 states have caught the measles—a disease all-but-eradicated years ago.

    As I said, “the rest of us” who are vaccinated almost surely (given the evidence we have) will not “get infected.”

    What a shame it would be if this (near) fallacy were used to create legislation mandating vaccines.

    Also, in the category of Morals, we have to ask if public and private groups can ban participation in certain activities for the non-vaccinated. Consider that question in relation to the error Daily Beast reporter made and thinking about clustering groups of non-vaccinated kids together, say in a school.

  18. I’m mainly for vaccination even more when it concerns diseases that have had vaccine for a long time..

    Although I also respect the parent liberty to choose if they want to vaccinate or not their kid.

    The problem is that when in a single place many people choose to not get vaccinated and diseases start to come back.

  19. @Sheri

    Actually there was the strongest pro-vaccination campaign that I have ever seen during the H1N1 vaccinations. There were skeptical voices about the matter and they indeed got some coverage in the media. Rokotusinfo ry (an NGO called “Vaccination Information”) criticized several issues with the campaign. For example:

    – The vaccine contains an adjuvant (squalene) that has been known to cause issues.
    – Other countries such as Switzerland decided that the vaccine was not safe enough to be given to children of to pregnant women.
    – GSK was given a immunity over side effects of the vaccine, which is a pretty bad sign.
    – The vaccine had not been tested enough to be given to an entire population.
    – H1N1 was not as dangerous as was first thought to be, so it is not worth the risk.

    This infuriated the establishment. The head of The National Institute of Health and Welfare called for criminal charges brought against the people at Rokotusinfo over every death that is caused by people listening to them. For a few months there was barely a day where those opposing the Pandemrix vaccination were not vilified. Researchers, experts, retired experts and officials all were constantly in the media assuring how safe the vaccine was: “everything that we know about vaccines assures us that there is not even a theoretical chance of any serious side effects”. All claims that the vaccine was not tested enough were said to be completely baseless and spawned only from dangerous ignorance.

    All this was crowned by the Finnish Skeptical Society (Skepsis ry), which gave Rokotusinfo the 2009 Scam Award for claiming that the vaccine was not safe even though all the experts said otherwise.

    All medical personnel were required to take the vaccine or be fired.

    Then it hit the fan.

    Suddenly all those experts disappeared from the media. The head of The National Institute of Health and Welfare gave a short interview saying it was unfair to blame them, because they had no way of knowing whether the vaccine was safe, since there had not been enough time to test it.

    The head researcher at THL cried at an interview apologizing for her previous claims. She said she thought what she said was best for everyone. I bet those 200 kids with their lives ruined felt much better when they saw that.

    Nobody got into trouble for intentionally lying to everyone. They didn’t even get fired.

    And now they wonder why people no longer trust them: “It must be because people are confused about all this false information on the internet!”

  20. One objection that some parents have with MMR is that it is manufactured with tissues culled from fetuses. According to the Vatican, there is responsibility “to use alternative vaccines and to make a conscientious objection with regard to those which have moral problems”; the problem arises when there isn’t an readily available “alternative”. More here: http://www.immunize.org/concerns/vaticandocument.htm

    The economics, politics, and availability of “alternative vaccines” need to part of the bigger discussion.

  21. Governments should not force individuals to do most things. (Paying taxes, regrettably, is probably one of those exceptions.) However, any group on a case by case basis has a right to mandate a requirement. For example, a child may not be permitted to attend a school unless they can show a vaccination record. (A reasonable request so long as it’s decided by the school and not the federal government.) There is no libertarian infringement here because if your child doesn’t get a public education, you can be home schooled. This is a question of how valuable is your freedom versus your personal convenience.

    The so called ‘ethical’ question has to be looked at this way: Does the overall benefits exceed the risks? If you’re in lower probability of danger than prior to the vaccination, all your other ‘ethical’ concerns demonstrate failures of thinking. Of course, this doesn’t mean that calculating the risk-benefit is going to be a simple process in many situations.

    Regarding the ‘rest of us’ approach–yes other people are put at risk, even those already vaccinated, because the efficacy of a vaccination varies between individuals. If you got vaccinated and in your case it was not effective, then you did the right thing but you are still being exposed to risks by individuals who may be suffering from failures of thinking.

  22. My hubby was at the local gas station yesterday and a Prius parked next to him. It had the usual “save the planet” stickers. The driver was an older woman. She came out and got into the Prius about the same time my hubby got into, and started, his very ancient, oil-burning, muffler-lacking V8 car. 🙂

    Briggs: I’m okay with separating kids into non-vaccinated groups. Not to stop the spread of illness, but because the kids are not subjected to associating with those kids whose parents probably don’t buy organic food and were cruel enough to vaccinate their kids.

    hannuko: Again, the fact that the outbreak did not actually occur is not justification for being angry at vaccine side effects. This CANNOT BE KNOWN at the time (I’m using caps because you keep ignoring that “hindsight” thing.). You are blaming people for what COULD NOT BE KNOWN. Most flu viruses are not tested fully because flu changes so often. The only way to have complete safety with flu vaccines is to NOT vaccinate for flu at all. Then flu can kill people and we’ll all be happy. Natural death and incapacitation from disease is okay, just not from vaccines.
    Sorry, but “they picked on us” if we didn’t want to vaccinate means nothing to me. Those who are skeptical of climate change are threatened with death and one media article went so far as to say a “denier’s” children should kill him for his beliefs. These individuals don’t back down. People made a decision about a vaccine, it didn’t turn out the way they wanted it to and now they want to blame others for their choice. Not buying it.
    People don’t trust because, again, they don’t understand risk and if they don’t get the perfect outcome they demand of science (an impossibility), they then blame everyone but themselves. You don’t have to trust them. You could have opted out as long as the vaccines are not mandatory. (If industry did lie, then there should be some consequences. Unfortunately, there are few consequences for government/industry malfeasance and I don’t see that changing unless people take action. That generally doesn’t happen—people just complain and do nothing else.)

    Katie: Good point.

  23. ” H1N1 was not as dangerous as was first thought to be, so it is not worth the risk.”

    A statement like this regrettably demonstrates enormous ignorance. Even a so called ‘average’ flu will kill between a quarter and a half million people around the world with each outbreak. Yes, most of the people who will die are in older age groups, have compromised immune systems, or are young children. Of course, you might point out that being a young healthy male or female, your risk of death is relatively low. That doesn’t stop you from sneezing on an older person or having contact with a young child, perhaps even before you know you’re infected. But their deaths aren’t your problem, is it?

  24. “The government will soon begin the argument, weak as it is, that since they are paying for your healthcare they have a right to insist on vaccines. Saves money, you see. Money often trumps morals”

    Happening here in Australia already!

  25. Briggs —

    A couple points are telling:

    “Every unvaccinated person must understand they have a very small chance of infecting others (for human-born diseases) who have been vaccinated but whose vaccines did not ‘take’ or ‘wore off.'”

    As you note, even the vaccinated have a chance of infecting others. So the comment holds for both the vaccinated and the unvaccinated. Why did you only indict the unvaccinated?

    “And some are not necessary, and again, the risks of deleterious effect of some vaccines will outweigh any benefit (allergies, pregnant women, etc.). ”

    Hmmm. That sounds like an appeal to the collective. Risks are individual, though they can be aggregated in the form of statistics. But I hope your are not confounding my risk with the supposed risk aggregated to the collective.

  26. “Risks are individual, though they can be aggregated in the form of statistics.”

    Risks impact individuals and groups. If you want to be reductionist then risks are not to individuals, but to the organs in your body, or the cells in your body. If you think that’s silly, contemplate what you wrote about groups.

  27. Will,

    Hmmm. If a disease affects an organ, I am concerned with my organ, not some aggregate of that organ. The risk is to me, or you, or any other individual in whatever group you imagine.
    Briggs correctly notes that individuals have their own risk, effected by allergies and other very personal condition, but there is a slight ring of utilitarianism and appeal to the collective in his response. I may be wrong – it might just be my tin ear.

  28. Jim: Sadly we cannot separate ourselves from the rest of society. What you do does affect others. Whether or not there is a risk to the collective, I don’t know. However, what if we were talking polio and not measles? Smallpox maybe? Typhoid Mary visiting Disneyland? I don’t know. Where do individual rights end and the need to protect society begin? A tough question.

    Briggs: I have no problem with ending the “personal belief” exemption. People have every right not to vaccinate their children. The state also has every right to protect the collective (public schools) if alternatives are available. Children can be home-schooled or go to school over the internet. Public school is not the only option. Yes, it requires the parents to take extra time and effort to raise their children, but if parents truly believe vaccines are bad, I can’t see why they would not make the effort to protect their children. Society does not owe every individual accommodation for their beliefs.

  29. @Shery, you just could not confirm my point more beautifully, a fallacy upon fallacy. The worst of all a propter nomen fallacy. It is so common to trust any concoction that sells as a vaccine to actually have effect on the disease it is sold for.
    – What “truly lethal” diseases are left out?
    How about TB? There is no such thing as TB vaccine, and BCG is a perfect example of propter nomen usage when sold as TB vaccine. The largest ever population in any vaccine statistics (in India) showed it nicely, yet some people still find excuses.

    I’m not a real skeptic regarding vaccines, but I find it truly appalling how gullible people must be to fall for every con trick of the market. It is so akin to climate alarmism: zero substance, all hype, too much scientivism. And rape of statistics.

    Regarding denying medical services to the unvaccinated, please be amazed that all recent outbreaks of (not only) mumps happened among the fully vaccinated populations of college youth. Point is that you can’t guarantee that vaccines will actually work when needed even when coverage is 100%. You simply have no moral high ground with vaccines when all the facts are observed.

    In short: you can do only so much with vaccines, and everything else is a deception.

    @Briggs, check the flu studies for flaws in statistics – you’ll have fun – with all of them. Pay special attention to conclusions drawn from those statistics. I do not expect you to change your trust in vaccines, but I’m sure you’ll lose it for the people peddling them 😉

  30. Davor: Are you saying the flu vaccine did not prevent the flu? That would be necessary for my comment to be proper nomen fallacy, would it not?
    I am not familiar with BCG. Wikipedia (that totally reliable source–NOT) says it’s a TB vaccine. It’s not used in the US.
    How can you say that failure to vaccinate is the same thing as vaccine failure? If a person had the vaccine but got the mumps anyway, it’s not their fault. They took the vaccine. There’s no guarantee that an antibiotic will cure an illness, so why bother trying one? It may not work in some people, so again, why bother? Same for cancer treatment–why bother? It fails as often as it works in many cases. So don’t bother to treat cancer. That seems to be your argument–if we can’t have 100% certainty, then forget it. That’s not a very scientific argument.
    You say you are not a real skeptic regarding vaccines, then turn around and say gullible people fall for every con trick on the market. That’s true of all markets–we wouldn’t be so inundated with commercials if they didn’t work. We need a smarter population, yes.

  31. Jim,

    “The risk is to me, or you, or any other individual in whatever group you imagine.”

    Again, your claim that group risk is imaginary is itself imagery. If a group is at risk of disease an individual in that group is at risk. There is no distinction here. You can even have group risks that don’t affect individuals. If a neighbouring country wants to invade your country (say Ukraine/Russia situation), their army will put you at risk as an individual and as a group. If you were an individual living there alone, they would not bother invading. Individuals are not at risk of military invasion.

  32. Will,

    If you are going to be pedantic, you will need to tighten up your language. To say my claim is “imaginary” is nonsense.

    “…their army will put you at risk as an individual and as a group.”

    I am at risk as an individual. However, to claim I (referencing a singular individual — aka “me”) am at risk as a group (some collective that includes more than me) is nonsensical.

    Read that to yourself a few times and you will understand – I hope.

  33. Will,

    A little levity …

    After hearing your first sentence, “Again, your claim that group risk is imaginary is itself imagery,” I keep hearing this from Karl Marx, “I can only answer you: Your question is itself a product of abstraction.”

    Different words, similar timing.

    Or it could just be my tin ear.

  34. “I am not familiar with BCG. Wikipedia (that totally reliable source–NOT) says it’s a TB vaccine. It’s not used in the US.”

    Yes BCG(Bacillus Calmette Guerin) is a TB vaccine, I had to have three of the suckers over 5 years before my Heaf test result was consistently satisfactory.

    It used to be offered to all schoolchilden in GB between the ages of 10 to 14. The universal vaccination program was run down in 2005 in favour of selective vaccination of high risk groups.

  35. My sister, who was fully vaccinated, came down with a case of the measles in the mid-1970s. The doctor–older, genial man from central casting, told my mother that he wished he could some medical students to see my sister, as measles was so rare, and the younger generation likely had never encountered it.

  36. @Mike Ozanne, @Sheri,
    The BCG is a perfect example of wishful reasoning, because it apparently does nothing useful, and the only thing it does is interfere with PPD skin test. Therefore it is abandoned in USA. Of all countries the most vaccinated one is USA, and of all countries they abandoned BCG as it is useless against TB.
    So yes, it is sold to the gullible as TB vaccine, and it does not work as such. A perfect example of propter nomen fallacy.
    Now, once you know a vaccine does not work, and you still insist on vaccinating large portions of population with it on some bogus moral (head) case – what does it make you? A bigot?

    As for flu vaccines, pay attention on the way those are composed for each season using 3 strains, and be amazed how often those strains are a miss. Beside the poor hit/miss ratio, it is well established that flu vaccines work poorly for the very young and the very old, even when composition is good. Again, how about a moral case when you know the vaccine is a miss? Or the target population is a miss.

    My point is that you can’t dispense the moral gospel in the case of vaccines, as more often than not they all are a miss (for various reasons), and you simply have no firm moral high ground.

    If you wish to remove any freedoms from the vaccine skeptics lot, you’ll have to establish immaculity of vaccines, and you can’t. As long as vaccines are incapable of removing specific diseases in 100% rate, and simultaneously introduce side effects that include death, your moral case is very poor.

  37. Davor: So your “moral high ground” is to not vaccinate, allowing flu, measles, tetnus, small pox, polio and a myriad of disease kill people because we can’t get 100% effectiveness? Same for drugs? Let millions die because drugs can’t deliver 100% either? What you seem to be advocating is doing absolutely nothing and letting people die because the alternative is a vaccine that might fail or cause harm. As previously noted, I would then have to demand that many medications be removed from the market because they failed to work for me or tried to kill me. How is that in any way a “moral case”. It sounds monstrous and uncaring and I really cannot fathom how the deaths of millions is better than a vaccine that is not 100% effective. Your claim that vaccines lack a moral case is actually quite disturbing. Why do you think people dying in huge numbers because we can’t guarantee certainty of outcome is somehow the preferred outcome?

  38. Sheri,

    Are you suggesting that vaccination at the point of a gun is moral, even when the vaccine itself is dangerous?

    Why not force everyone to have multiple vaccinations so that the collective can be certain that all are immunized — regardless the risk to individuals?

    Why let those who may suffer adverse reactions to NOT be vaccinated since ever exception puts the reified collective at risk?

  39. No, Jim, I am not suggesting we vaccinate at gun point. I didn’t suggest that anywhere. I am not trying to protect the collective, impose medical treatment on those who do not want it or cannot take it. I don’t get a flu vaccine even though I am in what is considered a “high risk” group. I have a natural immunity to the flu and a very bad reaction to my last flu shot. I would not impose treatment on anyone. That being said, I also believe that people who are not vaccinated or cannot be vaccinated can be excluded from things like schools and day care.

    Davor stated “As long as vaccines are incapable of removing specific diseases in 100% rate, and simultaneously introduce side effects that include death, your moral case is very poor.” My objection was that demanding 100% effective and no side effects deprives people of medical treatment they may want and would spell the return of diseases like polio and small pox. I don’t believe we should demand people vaccinate and I don’t believe that depriving people of vaccines is correct either. I consider the “moral case” to be allowing people to choose on vaccinations, either way. There are consequences to both choices. It’s up to the person.

  40. Sheri,

    I would agree except …

    School, at least for many (those who do not homeschool), is close to be coercive itself. Private daycare? Certainly. But school is different.

  41. @Sheri, as expected, you distorted everything that I wrote.
    That’s precisely why vaccine zealots are dead wrong. We have a cabal of vaccine zealots that are perfectly happy with semi-effective vaccines, and no real development other than marketing and scientivism.
    Well, thanks, but no thanks. We do not need mandated vaccines at this state of the art.
    True scientist looks for opportunities to improve the grasp of things. Briggs is obviously aware of the other side of the vaccine dogma and seeks answers, but sadly, Sheri, you are not.
    Thanks for the effort.

  42. Jim: Not much can be done for a country whose parents signed their children over to the government. We won’t be having these discussions soon because parents don’t care to stand up to anything to protect their kids. They just say they are helpless to act. Helpless has very bad consequences and those are becoming apparent. I am tired of people saying “the government made us do it”. No, apathy and fear did. Schools only do what parents let them do.

    Davor: Okay, Mr. Conspiracy theory, apparently never reads what someone writes–I’m finished here. I have said I am not for mandatory vaccines, yet you keep saying I said that. It”s impossible to have conversation with someone who wants to revive polio and small pox–it’s irrational. So, have nice conspiratorial existence and keep looking around every corner for the evil folks who want to keep polio at bay. You’re a real humanitarian.

  43. @Sheri, I’m a bit surprised at your attempt on improving your position, but hey, we are all humans. On two occasions you kind of distanced yourself from being a mandated vaccine zealot, but in a conditional form, which I translated to the opposite, as I always do:
    “I would argue that you do not have to vaccinate your child, but if he contracts a disease that the vaccine could have prevented, you are responsible and you cannot write off the debt in bankruptcy.”
    – so unless everyone jumps your high hoops they must vaccinate, ergo mandated vaccination.

    Again:
    ” I would not impose treatment on anyone. That being said, I also believe that people who are not vaccinated or cannot be vaccinated can be excluded from things like schools and day care.
    – now, the vaccinated are supposed to be safe because they are vaccinated, and not because the others are ostracised into quarantine.

    I’m also glad you pulled the “conspiracy theorist card” as it speaks volumes on its own. It helps when you pull a real argument instead 😉

  44. Davor: I’m not trying to improve my position, I’m trying to figure out how a person could advocate for death and illness over prevention, as you seem very content doing.

    Your translation skills need a whole lot of work there. Mandated means you have NO choice, not that there are consequences that you are trying to worm out of. Check the meaning of the word. Very few, if any, countries have truly mandatory vaccination requirements.

    How would you know about a real argument? I have yet to see you produce one. (You have definitely made all kinds of conspiracy type comments–“We have a cabal of vaccine zealots that are perfectly happy with semi-effective vaccines, and no real development other than marketing and scientivism.” which read like a quote from many of the Big Pharma conspiracy sites. I’m just relating what you say to what I read. If you want to disagree with conspiracy theory, you’ll need go to their sites and argue against them.)

    Why do you get to “translate to the opposite?”. How does that work? Other than to annoy people and avoid the actual subject?

    The Autism groups in the US are now urging parents via ads and news articles to vaccinate and let go of the belief that autism and vaccines are connected. Yet you insist we don’t need to go there……

  45. @Sheri, this is going to be fun 😆
    If you really researched the subject you’d know that mandated vaccination is a norm, not an exception. Only the select first world countries have completely voluntary vaccination programs that are financially covered by state, say Austria, Germany, UK, etc. However, of 29 EU countries studied in 2012, some 14 do have mandatory vaccinations, see http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20183
    If it was not nearly 50% for the select first world countries (and more for the rest of the world), and if 50% ever counted as few, you’d be completely right.
    Similar digests are not readily available, not even at WHO, so if you are truly interested in the subject, you’d have to dig a little deeper than just dispense the big pharma conspiracy theory gospel. If such gospel was not a clear sign of malice, you’d have won this discussion with flying colours.

    BTW, if the Autism Speaks (singular) was not a sock-puppet of CDC with sole purpose of undermining the vaccine-autism link (ergo propter nomen fallacy again), and so far the only autism group advocating vaccination, your claim on the autism groups (plural) would be well substantiated. If the idea catches only in a single other autism group, you’d be completely right 🙂

    Who knows, maybe there is no such link after all? Or maybe we’ll know more if the story of a whistleblower pans out to be true: http://dailycaller.com/2015/02/03/obama-admin-grants-immunity-to-cdc-scientist-that-fudged-vaccine-report-whistleblower-plans-to-testify-before-congress/

    Poor CDC is in a rough patch with measles that spreads among the fully vaccinated right now, and more vigorously than previous years, also among the fully vaccinated. Their solution is (marketing) science and more jabs, rushing heedlessly to another fiasco, I guess. If only they tackled the ebola fiasco properly. Or the swine flu… They did however announce that this season’s flu vaccine is a miss, and therefore you should vaccinate 😆

    In any case, it is always fun seeing pro-vaccination freaks wallow in dishonesty, and you’d disappoint me if it was any different at this place. Thanks 😉

  46. Davor: Your definition of “fun” is also problematic.

    Yes, they use the word mandatory, but it is not a proper usage. I researched this just as you did. First, If it truly were “mandatory” the vaccination rate would be100%. Finland is reported to be at 99%.

    “than just dispense the big pharma conspiracy theory gospel” I’m done here. You most certainly are a conspiracy theory believer and that type of behaviour is irrational and definitively immune to any kind of learning or changing. Flat out, you’ve wasted enough of my time spreading conspiracy nonsense.

    You have not read or paid attention to anything I type.

  47. Quite on the contrary, I did, and you are right about one thing – I do have a problematic sense of humour. Guilty as charged 🙂

    BTW, the reported vaccination rates mostly anecdotal as they mostly depend upon the reporting scheme, and not so much on the actual vaccinations. And they are mostly ridiculous, as they cover only a certain portion of population. Mostly the old are omitted, yet they claim 99% (of vaccinated youth on record).

    I’m not against vaccination, sorry to convey that impression. I only find the mind-rape about it appalling. And I detest state mandated health procedures. Electroconvulsive “therapy”, castration, genital mutilation, vaccination … all of them.

  48. Ugh – seriously! Young women should be receiving the Gardisil vaccine. I have HPV and I am a 30 year old virgin. I likely got it traveling in South Africa during a college service trip – unfortunately the rest of the world isn’t as “sanitary” as Western Europe and the US. HPV can be transmitted in other ways beyond just sexually transmitted – and it is the leading cause of cervical cancer. If you love your daughters, you will vaccinate them.

  49. Thank you for this article. I found a link to it in the National Catholic Register.
    I’m perfectly fine with ethically manufactured vaccines.Vaccines save lives. The problematic part for me is the use of fetal remains in several vaccines, including the MMR.
    Since 2009, the separate measles & mumps vaccines are no longer being offered by Merck.Previously, this was an alternative for parents wishing their children to be protected from those 2 diseases while avoiding the rubella component in the MMR which utilizes fetal cell lines.
    You’d imagine that if pharmaceutical companies & health authorities were serious about measles prevention, they would again offer the separate measles vaccine to those who have conscientious objections to the MMR.
    I think sadly, it boils down more to economics & compliance rigidity than sincere public welfare concern. Parents, like me, who want their children & grandchildren to be vaccinated against measles are being denied the vaccine.

  50. Contrary to false belief; a good number of people who choose not to vaccinate whether themselves or a child are more informed compared to those who favor vaccines. If you are really interested in the truth take the time to do the research.

    This book may interest those interested in the history of vaccines. If you believe vaccines ended the polio epidemic for example, then you may be interested in reading about why this is not true or a myth. The book is titled Dissolving Illusions: Disease, Vaccines, and The Forgotten History by by Suzanne Humphries MD (Author), Roman Bystrianyk (Author)

    Also, Dr. Russell Blaylock has written and talked about the subject of vaccines that may be of interest.

    Vaccinations are and should always be a choice. America is supposed to be the land of the free.

  51. Hello Briggs,
    I want to ask if you would be willing to revisit the question of childhood vaccines & autism based on some what seem to be first-of-a-kind studies that have been done after you wrote your blog entries on this topic. This new data seems very intriguing, here a few of the papers:

    Mawson et al. (2017) Pilot comparative study on the health of vaccinated and
    unvaccinated 6- to 12-year-old U.S. children
    https://www.oatext.com/pdf/JTS-3-186.pdf

    Mawson et al. (2020) Multiple vaccinations and the enigma of vaccine injury
    https://www.researchgate.net/publication/347799128_Multiple_Vaccinations_and_the_Enigma_of_Vaccine_Injury

    Hooker & Miller (2021) Health effects in vaccinated versus unvaccinated children, with covariates for breastfeeding status and type of birth
    https://www.researchgate.net/publication/352773611_Health_effects_in_vaccinated_versus_unvaccinated_children_with_covariates_for_breastfeeding_status_and_type_of_birth

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