Should vaccines be compulsory?

By Phil Plait | June 3, 2009 11:51 am

I was asked in a recent interview if I thought parents should be mandated by law to vaccinate their children.

I hesitated, knowing this was a thorny topic. I said I wasn’t sure, which was true. But I may be leaning toward a more definite answer now: yes.

There is a fine line between creating laws that restrict freedoms versus helping others. You don’t have the freedom to murder, of course, which is an extreme example. But what about mandatory vaccinations? Should you have the right to not vaccinate your kids?

We have seen cases lately — far too many — where ultrareligious parents have not sought medical attention for their children, and those children have been put at extreme risk and even died. I have no problem at all with having a court taking away those kids and giving them the medical attention they need to live. You have a right to believe whatever religion you want, up until that right interferes with the rights of others. And kids have the right to live.

You also have the right to believe in the antivaccinations movement’s nonsense, even when they lie. But that right ends when kids’ lives are at stake. And in this case, if we don’t have enough people vaccinated against diseases like measles, pertussis, and polio, we will see a resurgence of them and kids will die. It’s that simple. We have the evidence.

In the UK, the government is weighing compulsory vaccinations. I don’t envy their Herculean task, nor the public outcry they’ll have to endure. Steve Novella weighs in on this issue on Science Based Medicine, and as usual he is thoughtful, calm, rational, and makes a persuasive argument.

As Steve points out, using fear to get people to vaccinate may not be such a bad idea, because we should be scared. Logic isn’t working (as I’m sure the comments to this post will verify), so maybe showing parents what happens to their children when they believe people like Jenny McCarthy is the best way to keep kids from dying.

And if you still buy into the utter nonsense of the antivax mouthpieces, then I urge you to read this heartbreaking article by author Roald Dahl, whose daughter died of complications from measles four decades ago. Sadly, the only thing that’s changed since then is that the number of deaths from preventable diseases is now on the rise, not waning.

The bottom line here is that if you don’t vaccinate your children, you’re taking a big gamble where the stakes are disease and death… and you’re gambling the lives of children everywhere at the same time. Compared to the risk of disease, vaccines are overwhelmingly safe.

CATEGORIZED UNDER: Antiscience, Piece of mind, Science

Comments (193)

  1. http://factsnotfantasy.com/vaccines.html

    EDIT: Woot, I beat Todd. :) My mental health break was just at the right time.

  2. Proudhon

    The slippery slope argument is pertinent here. Of course all kids should be vaccinated, but the State should not be the entity that forceably coerces all children to be vaccinated.

    Kids shouldn’t eat McDonald’s or watch 8 hours of TV a day, and while this is NOT the same as what you’re suggesting, its a slippery slope from mandating vaccinations to mandating caloric limits (or insert another example here)

  3. Once again, before commenting, please take a read at the site linked by my name or at factsnotfantasy.com/vaccines.

    Phil, don’t forget the lives of HIV/AIDS patients, transplant recipients, the elderly, those with allergies to vaccine ingredients, and anyone else whose immune systems are susceptible to these diseases.

    I’m not certain about compulsory vaccination. If such a thing were to be instated, it would need to be done with careful consideration, and caveats put in place for those who cannot or should not be vaccinated due to pre-existing health conditions.

  4. Jason A.

    “Kids shouldn’t eat McDonald’s or watch 8 hours of TV a day”

    But a kid that eats nothing but McDonalds isn’t putting *other* kids at risk…

  5. Autumn

    I say that it’s a clear no, but all religious objections should be ignored, and vaccination should be cumpulsory without a medical reason. Some people are immuno-compromised, they should certainly not be forced to undergo vaccination, but it is for them and those like them that the idiotic religious exemptions need to be legally expunged.
    I think that it is even easy to construct a legal case for ignoring religion in medical cases importatnt to the larger community. In the case of vaccinations, allowing a religious sect to compromise herd immunity is legally the same as forcing a religious belief onto others in the community.
    If I live in a predominately Orthodox Jewish town, the prevailing religious beliefs can not force me not to sell ham.

  6. Ian

    I’ve got to go with no on this. I wish every single parent would get their children vaccinated wherever possible, but in no way should the government be forcing them to. I agree with proudhon on this that once you start mandating certain health-related choices it’s a slippery slope.

    Better education and information and better laws to stop those preaching medical mis-information would be the better option.

  7. eyesoars

    EDIT: FOUR decades ago, and nearly five.

  8. emote_control

    Look, I hardly think that they’re going to force people to be vaccinated who have legitimate medical reasons for abstaining. That’s fine. We don’t need to vaccinate that tiny minority in order to achieve herd immunity. I think it’s perfectly reasonable to assume that any law mandating vaccination will very carefully take into account the sort of exceptions that a doctor would argue are necessary to protect public health.

    Really, those at-risk groups of people stand to gain the most from mandatory vaccination. They’re at the greatest risk of death from the actual diseases.

  9. Ismael

    If you make vaccines compulsory, will you trust that the gigantic corporations giving you the vaccines won’t be corruptible? Doesn’t that seem like a really easy way to control people?

    Personally, I am trying to FIND Freedoms, not have them taken away by extremist-scientific thought. If you’ve had your shots, why are you worried about other people not taking them? That’s their decision, that they made of their own free will.

  10. I am on the fence here as well. Here in B.C. it is mandatory if your children are going to attend a public daycare that they are vaccinated (unless the child for medical reason cannot be vaccinated and they need a dr’s letter to that affect). And I think that is more than okay.

    @proudhon made the argument about kids and McD’s and TV, well guess what. Here in B.C. it is now mandatory that your child until they graduate school MUST participate in at least 1 hour of physical activity a day. Some may think that is a great idea but wait. The schools will be responsible for 15 minutes of that if they are in elementary, 30 minutes of that if they are in Middle School or HS. The rest of the time falls on the parents. Again, it is not a choice. So what does these mean, if you cannot prove that your child participates in at least 1 hr of physical activity a day, the state can intervene and remove your child. Yes, this is to combat childhood obesity and the first step they did was removal of all junk foods from schools.

    It becomes very scary when the government starts to make how your raise your children mandatory. Even so I agree with it, maybe a happy medium would be that if you want your child to go to daycare or public school, they need to be vaccinated unless they cannot for religious/medical reasons and the religious one poses a huge loophole but its a constitutional thing. If not they have to be home schooled, etc

    There is no easy solution here

  11. RL

    I’d say no to compulsory vaccintations. Generally, it should be up to the parents of a child to make these kinds of decisions. I also don’t think that the situation in the US warrants serious consideration of this.

  12. @emote control

    Look, I hardly think that they’re going to force people to be vaccinated who have legitimate medical reasons for abstaining. That’s fine. We don’t need to vaccinate that tiny minority in order to achieve herd immunity. I think it’s perfectly reasonable to assume that any law mandating vaccination will very carefully take into account the sort of exceptions that a doctor would argue are necessary to protect public health.

    While it seems like a no-brainer that such exceptions should be built in, it bears stating, and any legislation should be carefully reviewed that the exceptions do what they are meant to do.

  13. amphiox

    If it is justifiable to make seatbelts and bike helmets mandatory, then it is justifiable to make vaccination mandatory. If not, then not.

  14. jon

    I think that making all the vaccines mandatory is going along with the flow of the cooperate/medical dogma, which I’m afraid the lead commentator is akin to take. You notice that he discounted the “comments below” contradicting his view even before they were written. That is how science and discourse about matters should not take place. The fact is that science is always uncertain, their are hidden truths inside every set of data. Take the autism issue. Even though the data does not show a correlation, it could be that that there are subsets of the population who are susceptable and since they are not identified and lumped in with the rest of the data set, they end up still supporting the null. However, there are instances when things are clear cut, polio and measles may be candidates for stronger legal sanctions, but the myriad of other vaccines that they wish to inject our kids with almost right when they are born is where parents should have a choice.

  15. Jim

    Ismael:

    Individuals who have been vaccinated have plenty to be afraid of from people who haven’t. For one thing, a large unvaccinated population means that these diseased have more chances to mutate into vaccine and drug resistant forms. For another, a lack of herd immunity puts people at risk before they’re old enough to receive vaccines.

  16. Dan

    Phil’s bottom line: “..if you don’t vaccinate your children, you’re taking a big gamble where the stakes are disease and death… and you’re gambling the lives of children everywhere at the same time. Compared to the risk of disease, vaccines are overwhelmingly safe.”

    Phil’s “bottom line” way overstates/oversimplifies the case, and does so from a platform based on dismissive anti-religious rhetoric (as if slapping the “religious” label on the arguement satisfies all concerns) that is ill-informed about the poorly understood and unknown dangers of vaccines.

    I am not religious, Phil. I am a scientist.

    Our immune system is a wonderful thing, having evolved over millions of years to protect us from myriads of diseases. But it has it’s limitations, too, and sometimes goes haywire, as seen in the many debilitating autoimmune diseases which adversely affect millions of Americans. Vaccines certainly have their place, but they’re not the answer to everything and can cause problems with our immune systems. As such, vaccines should NEVER be compulsory. Rather, fully-informed consent based on proven scientific research is the solution. The CDC’s “vaccinate everyone for everything” approach is the unfortunately side-effect of their government mandate to eradicate infectious diseases. This of course ignores the fact that not all diseases are infectious, and that the long-term effects of vaccinations remains poorly understood.

    Have vaccines managed to minimize the spread of some infectious diseases and save millions of lives? Absolutely! And it’s a good thing, too! Are they the answer to everything? Absolutely not! And that is a good thing, as well. Studies have repeatedly shown the best preventative measure against the spread of disease is based on healthy a healthy body fed with a healthy diet and kept in good shape through a variety of regular and frequent exercise. Beyond that, vaccines can indeed be of good benefit to society as a whole, but they are NOT the end-all, be-all solution to infectious disease and should NOT be made compulsory.

    I find it rather disingenuous of you as a scientist to use your platform here to propagate these issues further, given that you’re not an immunologist and have little detailed understanding of the scientific, yet non-political details surrouding this issue.

  17. Caleb Jones

    @amphiox

    Bzzt. Wrong. There is a BIG difference between mandating by law that people strap a safety harness OUTSIDE their body when operating a vehicle and mandating by law that people inject a substance INSIDE their body.

    Should people get vaccines? Absolutely yes. But the government (or anyone else for that matter) has no right to demand you place (consume, inject, etc.) anything into your body.

  18. While I agree that, in principle, mandatory vaccinations would be a good thing, I urge commenters to really think about the issue and not offer a flippant, immediate “of course!”. What precedents would such legislation set? Are there ways in which such legislation could be used in the future to strip away the rights of others? Could other legislation arise following this which would have unintended consequences?

    What would the penalties be for violating the legislation? Just exclusion from public schools? If the goal is to increase overall immunization rates, then what about private schools? Will there be fines? If so, how much?

  19. MC

    Make it mandatory if the child is going to attend public school, and provide incentives to groups like Boy/Girl Scouts to require kids to be vaccinated before they can join up. Basically I think the law should be that any child that is going to be in close contact with anyone outside their immediate family is required to be vaccinated.

    That way the wacko religious fanatics who are opposed to modern medicine and the irrational anti-vaxxers can keep their kids unvaccinated but also have to protect the public by not letting them out of the house for any significant activity.

  20. Brian M

    THis is a tough one. But using the argument that, in the past, the courts have intervened with forced medical care doesn’t hold since those involved immediate danger as opposed to future risk.

  21. The government could take a WHO approach to vaccination: when a disease reaches pandemic level 6, vaccines are mandatory.

  22. LeoinNM

    I wonder how many of the ‘yes’ folks here have kids.

    Although I think the anti-vax folks are nuts, I do not want the government dictating to me what I should inject into my child.

  23. RL

    I’m going to amend my answer.

    I would add that many states, such as the one I live in, do require vaccinations for schools (public and private) and daycare. There are exceptions for medical conditions and there is also a religious exemption that can be granted and this can’t be a fivolous excuse (like I don’t believe in vaccinations). From the regulations: “General philosophical or moral objection to immunization shall not be sufficient for an exemption on religious grounds.”

    I very much hate aspects of the Nanny State that I live in (we’re protected from the dangers of undercooked eggs and from the great danger of pumping our own gas), but I will amend my answer above to state that I don’t have a real problem with this type of regulation as long as the vaccination list is reasonable. Not all vaccinations are equal. I don’t think this kind of power belongs directly in the hands of the federal government, though. At least at the state level, we can have some kind of say.

  24. Listen, this is just going to be another example of government putting our health at risk and kowtowing to big business in the process. The major corporations all want to make you think that you need their products and that you should put them in your children. Then they pay off all the corrupt useful idiots like the author of this blog and politicians to FORCE THEIR AGENDA DOWN YOUR CHILDREN’S THROAT! This is the definition of tyranny!

    How many people in the United States have died of starvation? NONE. Yet every other commercial is for food. There is another way of looking at the universe that tells us we can have all we need from the air and the ki circulating continuously. I see no reason to poison my child with vaccines or the so called “food” that is being promoted by big agro-business. The government can’t force me to either. I have a right and a freedom to raise my child as I see fit- no government can take that away from me. I vowed I would never set foot in a supermarket or doctor’s office, and no one can make me or my child do so!

  25. @Todd W If it reaches level 6, wouldn’t it be too late? You cannot be vaccinated if you are sick. At least that is the criteria here. If you have shown any sign of illness for a period of time before vaccination, you will not be vaccinated. The incubation period for these diseases vary, so how would one be able to tell who is already carrying the disease but not yet showing symptoms to those who are disease and vaccine free without carrying out a millions of blood tests that will cost millions of dollars where by the time the results come back, the disease is full blown?

    How are they going to herd the people who have not been vaccinated into clinics? Logistically waiting until level 6 would be a nightmare.

    In this case, it is so very difficult to find the line between respecting individual freedom and protecting the greater good. Unfortunately, like with many other things, you grant rights and freedoms to one group of people, it impedes the rights and freedoms of another group.

    The antivaxx movements scares the living *beep* out of me. I have Lupus and am allergic to vaccines so have never been vaccinated. My youngest had adverse reactions to his first two vaccines, so he was never fully vaccinated. Any time there is an outbreak of the smallest thing, I am not allowed to leave my house. It is not a nice way to live. That being said, forcing this upon people I think is too extreme on the other end of the scale.

  26. David D.

    Again, why are we still hearing from QUASAR? Phil?

  27. LT

    @Caleb Jone

    whats the difference, inside or out? Beyond the natural emotional reaction, i mean. something outside can be just as deadly as something inside of your body. If the government can regulate one, it can the other. There isn’t any logical difference.

  28. Pieter Kok

    It’s been mentioned before, but it is worth reiterating: There is a subtlety in the British case that makes the answer to the question posed in the title of this blog post an even more resounding “yes”: The proposition is to make vaccination compulsory for anyone who is to attend a state-sponsored school. Since there are alternatives to state-sponsored schools, vaccines per se are not made compulsory, and are therefore harder to argue against.

  29. @Jules

    I guess my point with the pandemic level 6 bit was that at that point, the entire population, whether they are attending public schools or not, would need to be vaccinated, barring medical exceptions. In other words, at that point, philosophical and religious exemptions would go out the window.

  30. Should vaccines be compulsory? YES. I agree that it is a difficult topic and there is no good way to go about insisting parents do what is best for their kids, but unless there is a valid medical reason for not vaccinating, kids should be vaccinated.
    Perhaps it would be as simple as once again insisting children are vaccinated before they are allowed to attend school. No religious exemptions, no personal belief exemptions, no idiocy exemptions. If your kid is not vaccinated, it is a risk to everyone else and other people’s kids should not be exposed to your kid.

  31. @Todd W

    Thanks for the clarification. Hopefully it will never come to that however, it appears to be a real possibility if this trend to not vaccinate continues.

  32. BMurray

    Maybe we could guarantee a decent education for all citizens instead of writing a law to forbid each and every act of potential stupidity. Who knows, there might even be positive side effects to a well educated citizenry beyond being able to understand simple explanations and derive appropriate actions from them.

  33. fos

    This is a very tough question. It would be easy if you could always count on government and bureaucrats to make the proper decision. In a few cases it is not always a black and white decision. I hesitate to say but the abortion issue is much the same.

    My children range in age from 35 to 18. I welcomed every new vaccine as it became available. My youngest children didn’t have to suffer through chicken pocks. As a parent, I wanted every protection available for my children.

    If children attend public schools, it is very difficult for a parent to avoid having their children immunized. It should be just as difficult for children that are home schooled. I feel a “REAL – MD type” doctor should have the final say if a parent want their children to opt out of the system.

    Should there be a religious option? ???

    Jeff

  34. David D.

    @Todd W.–

    As usual, thank you for your insightful and thoughtful comments on the issue. So many here are fond of the slippery slope argument. This is one slippery slope that has real potential to be destructive to our society.

    There are other ways to achieve a near-total coverage of the population with vaccines, some of which have been mentioned above. It should be kept in mind that even government enforced, compulsory vaccination will not achieve 100% coverage.

  35. @LT

    whats the difference, inside or out? Beyond the natural emotional reaction, i mean. something outside can be just as deadly as something inside of your body. If the government can regulate one, it can the other. There isn’t any logical difference.

    Generally speaking, the possible adverse events that could happen with an external device, like seat belts or bike helmets, is relatively limited. When something is injected into the body, there are numerous ways that it interacts chemically with the body, potentially leading to many more unforeseen reactions, as compared to the external device. There is a logical difference.

    Further, there is a legal precedence that the state does not generally interfere in the practice of medicine, nor with the right of the patient to determine what medical treatments they receive or refuse.

  36. BJN

    Fear is definitely not a sound basis for making decisions. “We should be afraid” doesn’t sound very rational and it’s very obnoxious after the last two presidential terms where fear was used to get us into all manner of irrational messes. Playing on fear to motivate the uninformed is what the antiscience folks do. If you want to counter that, you have to provide facts and motivate people to enlightened self-interest.

    I have no problem with making certain vaccines mandatory, but only when the science and actuarial data demonstrate a significant benefit to the overall population. But let’s not legislate based on fear.

    Don’t be afraid. Be informed.

  37. LukeL

    It isn’t just the religious who are anti-vax there are also many far left loons who think mother earth can heal everything.

  38. It could probably be argued that it is a parents right to put their children at risk by avoiding vaccinations… however because unvaccinated children could become carriers of severe preventable diseases that could harm or kill other children and adults as a result, the state does have a responsibility to step in and force vaccinations on everyone to protect the populace.

    That’s my opinion anyway

  39. Quiet Desperation

    But a kid that eats nothing but McDonalds isn’t putting *other* kids at risk…

    Unless he eventually has a heart attack while driving and runs someone over. Of falls down the stairs on someone. ;-)

    Silly, yes, but how many times have you heard some policy wonk advocating a multibillion dollar government effort and saying, “If it saves just one life, it’s worth it!” I always wonder how far people like that will go with that concept.

    Don’t know how I’d vote on compulsory vaccinations, although I think there are workarounds for people with allergies, yes?

    And you’re going to have a lot of people like this:

    “How does that coincide with your post-war Commie conspiracy, huh? It’s incredibly obvious, isn’t it? A foreign substance is introduced into our precious bodily fluids without the knowledge of the individual. Certainly without any choice. That’s the way your hard-core Commie works.” — General Jack D. Ripper from “Dr. Strangelove” :-)

  40. anna

    MMR vaccinations have been compulsory in my school system for a long time. Until there is some cold hard indisputable proof of Jenny McCarthy’s claims I would say keep them that way.

    HOWEVER. My answer to this question depends on the way in which the legislation is written. If it a specific, well-tested vaccine – Great! If all signs point to safe and no one has any reason to believe we’ll start making a bigger, long-term problem I’m fine with it. If this list includes something as poorly tested and shoved through the system as GARDASIL, I’d say absolutely definitely not. My problem with making these things across the board mandatory is that I know better than to trust in the altruism of Pharmaceutical companies and Congressmen. And corruption aside, there’s the problem of ignorance – just not knowing the harm that a particular new drug can cause because the proper time hasn’t been given to researching it.

    Since it could be abused or misused, I would like to reserve the right to deny any vaccine that wasn’t well documented, tested, and ABSOLUTELY necessary.

    And I think that fear is VERY RARELY (and this case is not one of the exceptions) an appropriate motivational tool. Effective, however it causes people to make emotional rather than rational decisions…And when it comes to Science and Health we should all be trying to make rational decisions. Not fear and anxiety based ones.

  41. @BJN

    The fear response is not useless, and we evolved it precisely because it can aid in survival. I’m reminded of the t-shirt on a nuclear technician from The Sum of All Fears,

    “I’m a bomb technician. If you see me run, try to catch up.”

    People who argue solely for “better education” forget that the brain is not wired to accept reliable information, only reliably packaged information. Refusing to use that fact is to fight a dragon with one hand tied behind your back and with a wooden sword.

  42. anna


    It isn’t just the religious who are anti-vax there are also many far left loons who think mother earth can heal everything.

    I’ve yet to hear of vaccines from outer space.

  43. Another thought, would mandatory vaccination legislation also impose mandatory quarantine for infected individuals and members of their household?

  44. No. No, no, no, no. Sorry, Phil, but this is one instance where your general science background fails to cover all the edge cases that would occur if you tried to legislate this.

    In the main, this will not work out the way you would want it to.

    There are too many vaccinations, too many exceptions, and too many possible legal loopholes and consequences that I would not want from making this sort of thing mandatory. Like Todd said, the number of details that would have to be covered make this just not a good venue for the law. Auditing it alone would be expensive, and those funds would be better served going to actual care and prevention programs.

    Certain types of behaviors cannot be well covered (either encouraging them or prohibiting them) by making them legal or illegal. Writing this law, auditing the process, and so on would be a gargantuan task, largely resulting in lots of money spent for little practical return. People that don’t want to get vaccinations aren’t going to get them. And if you think you can mandate them into doing it, you obviously haven’t spent any time paying attention to this sort of audit/security problem.

    I can get a document that will pass scrutiny (from anyone other than a law enforcement officer skilled in forgeries) as a legal state-issued California driver’s license in a little less than a day. Give me a week and I could probably arrange to get one that came directly from the DMV, and that will fool even a police officer trained in forgery detection, because it’s for all intents and purposes legit. This isn’t because I’m a crook, it’s because I’m pretty well read in the security field.

    Hundreds of thousands of people in this country have false identification papers; making “being unvaccinated” illegal isn’t going to make anti-vax people get vaccinated, it’s just going to make them find a forged certificate so that they can enroll their kid in public school. Now they’re unvaccinated and criminals, how is that better?

    It’s the flip opposite problem of making abortions illegal, or outlawing private gun ownership, or making recreational drugs illegal; you’re not going to stop the bad behavior, and you’re going to spend lots and lots and lots of money foolishly.

    In the realm of process-level thinking, audit is always expensive, and it’s the worst kind of expensive: completely unproductive expense. You’re not *doing* anything, you’re checking to make sure something is done, and that is done at a cost. The old security saw is that “Security is a tax on the innocent”; you do it when you get a *major* benefit from it or you prevent a *very significantly* risky outcome.

    Yes, the anti-vax movement has had consequences. The law is not the right tool to try and correct this erroneous behavior. Outside a pandemic, making vaccinations mandatory is a big waste of time and money.

  45. Let me rephrase one clause from the above: “you’re not going to stop the bad behavior” assumes that I think all those behaviors are bad.

    Change that to, “you’re not going to stop the behavior you want to stop”. My value judgments on private gun ownership, abortion, and drug is aren’t germane to the point, and I don’t want to give a false impression of them anyway :)

  46. Cheyenne

    I (with an unfortunate feeling) would vote no that we shouldn’t make vaccination mandatory at this point. I just don’t see how the government could enforce it effectively and I think it would open the floodgates to an even nastier battle over vaccination in the public arena (which could lead to an overall lower rate of vaccination).

    Basically, I don’t like the idea of the government enforcing it and I don’t think it would do a good job of it. I think there should be a combination of incentives and penalties (health insurance premiums, disqualification from attending public schools, government subsidies of vaccination, etc) that could collectively be used to try to increase the rate of vaccination.

    Another specific penalty could possibly be that all of the unvaccinated (those without a legitimate medical reason) should be forced to watch all of Pee-Wee Herman’s movies…with Quasar….once a year.

  47. Oh, all that said, if you don’t vaccinate your children, you’re very likely a doofus and you very likely have very poor risk analysis skills. Neither one of those things should be criminalized, though.

  48. I’m going to try to split the difference here:

    I think that it’s perfectly morally acceptable for a government to require its citizens to be vaccinated on principle. However, I think that under the United States Constitution, it is illegal and unconstitutional. violating the first amendment in religious cases and generally the penumba rights to privacy. And I don’t want to mess with those rights.

    So I’d take it in the UK, where the rights are less specific, but in the US, I think it’s bad news.

  49. anna

    @ The Chemist
    If that was true I would only remember really scary facts. As it turns out, I accept all kinds of information on a daily basis. So does my neighbor and my butcher and your mother and the president. It’s true that fear is a very effective way of getting a bunch of people to go along with an agenda (whether it be an altruistic or corrupt one, don’t jump to conclusions based on that word please) very quickly however it’s also a good way to get a bunch of people to do things they would otherwise think better of.

  50. Mo

    Have you heard about the Battlestar discussion at the World Science Fair? http://www.worldsciencefestival.com/2009/battlestar-galactica

  51. Wayne Conrad

    Any power you delegate to government to mandate what happens to your children cannot be restricted to doing only what you want, or only what is good, or only what is scientifically sound.

  52. Pfooti

    I don’t normally respond to these things, but I’m changing my policy here. I think there should be a simple rule: you’re not required to vaccinate your children, but if you want to enter any public space with them, you need to.

    For example, in order to apply to most universities, you need to show up-to-date vaccination records for some important diseases (dormitories can be bad for infectious diseases). So, if you don’t want to vax your kids, fine. Just don’t plan on bringing them to public school, the shopping mall, or the playground. Done and done.

  53. In the town where I live vaccinations are required in order to attend public school, and most private ones. Not sure about day-care facilities.

    Other than that I say NO to mandatory vaccinations.

  54. Phil,

    You bring up a compelling argument. I would agree with you under two conditions:

    1. The Citizens could be reasonably certain that the government(s) in question were relying upon verifiable scientific research/testing, and,

    2. The drugs being used in such mandatory vaccinations were coming from trusted and vetted sources open to scientific peer review free from the current processes we see in the American system of policial lobbying.

    With an eye towards the Bush Presidency (as just one example – there have been plenty of others) science being subverted by politics is not a conspiracy theory: it is a matter of record. Whether this would be used for something Orwellian or (as is more likely) graft-oriented, no-bid contracts, it would make me cautious about advocating any mandatory plan of vaccination without freeing it, as much as humanly possible, from what we’ve observed to be the current excesses of political and corporate corruption.

    Concerns over personal rights in exercising religious and philosophical freedoms are valid but, as you say, those end with the freedom of life. Minors have a right to live, first and foremost. They can worry about the dispensation of their immortal soul, later. I don’t know of any religion so strict that it doesn’t have a safety valve to allow for pennance arising from mistakes or things done beyond the power of parents … which the proposed vaccination program would fall into.

  55. Jeff

    @Jules: “In this case, it is so very difficult to find the line between respecting individual freedom and protecting the greater good. Unfortunately, like with many other things, you grant rights and freedoms to one group of people, it impedes the rights and freedoms of another group.”

    This is the eternal human problem probably since Cro Magnon days. Finding the line was and will always be the human condition. So I wouldn’t be too hard on Phil for taking a position. That’s what people do.

  56. @Jeff I am not hard on Phil at all. I respect his view on this fully. I have a habit of playing devil’s advocate from time to time and will look at all possible sides to any equation.

    Those were my first impressions and thoughts on this subject, they are not directed towards Phil or anyone else’s opinion.

    Like I said, in theory it would be so easy to say yes. However in practice, there is so much that can go wrong and end up causing greater harm.

  57. justcorbly

    @#2 Proudhon >> “The slippery slope argument is pertinent here. Of course all kids should be vaccinated, but the State should not be the entity that forceably coerces all children to be vaccinated.

    What slippery slope?

    Why not the state? Are you suggesting that another entity exists, or should exist, with the ability to mandate vaccinations for all children?

    Are you so ideologically inclined that you believe it is better for children to be stricken — unnecessarily — with potentially fatal ailments solely to avoid seeing the state exercise an authority it already has?

    Are you willing to explain to the parents of children who die because vaccinations are not mandatory that it was all done in the name of protecting them from the ravages of Big Government?

    This is not a matter for individual parents to determine for themselves because the children of those parents — parents who do not vaccinate their children — infect the rest of us when they get sick. My right to avoid getting some killer flu trumps my neighbor’s right to not vaccinate her kids. She doesn’t have the right to spray water dosed with a measles culture on me, so why does she have the right to allow her unvaccinated kid to sneeze on me?

  58. Mike

    A citizen has a responsibility to society at large. Given that vacination is necessary to protect society as a whole, I’ve got no problem with sanctioning those who won’t do so voluntarily. For those who won’t comply, perhaps we can find a big island to send them to where they can’t hurt others(Greenland is pretty big).

  59. John Powell

    It should be mandatory for EVERYONE to be vaccinated, unless there is a *medical* reason for them not to be. It is a public health issue that should be treated the same in law as using sanitary waste systems rather than defecating in the streets.

  60. Way ahead of you, Phil. As you may recall, I was endorsing compulsory vaccination on this blog some time ago.

    Vaccination isn’t a matter of personal choice. It’s a matter of public safety, and thus it is within the rights and is further the responsibility of governments to mandate it and to see that mandate carried out.

    How that would need to be done is a matter for scientists and policy-makers, which I am neither, but it needs to be done.

    As to the slippery-slope argument: Your right to swing your fist ends where my nose begins. That’s the classic determination of the extent of personal liberty, and the liberty to forgo vaccination crosses that line. There is no slope here, slippery or otherwise, merely a recognition that the freedom that has traditionally been allowed with regards to vaccination actually impinges in the case of its excersise upon the rights of others.

  61. Ryssa

    What would you say to anti-vax adovcates who claim that the FDA and CDC are not reliable because they make a profit from vaccines? I can quote statistics and facts to my anti-vax friends until I’m blue in the face, but the response I always get is that the FDA and CDC are evil, greedy corporations who are lying. Help?!

  62. Mike

    I have little patience with slippery-slope arguments. Because we do “A” in a given situation does not compel us to do “A” in all situations which have a passing similarity with the first case. Often, the slippery-slope argument is advanced in lieu of doing something which actully requires effort: thinking. We were given a brain. Why would some restrict us from using that brain to draw distinctions?

  63. Dr Plait, keep in mind that the congresscritters that make it so easy to ridicule them on their gathetic understanding of anything beyond grade school science would be the same idiots writing the laws… That may be a risk worse than non-vaccinated people!

    @E. Allen Banks, how can we take you seriously when you make a wild statement like this:

    How many people in the United States have died of starvation? NONE

    when it’s demonstrably FALSE. Granted, it’s a very small number (mostly elderly and poor), but it’s also not zero.

  64. I think people should make up their own minds, but if they opt against vaccination (obviously, absent a medical reason) they should not be allowed in public places. the public arena is a shared one that assumes each citizen is going to act as such, i think. if you choose to not be a responsible citizen, you shouldn’t be allowed out with the rest of us.

    what shape that takes, who knows. lock ‘em all up in a square state like carlin said?

  65. XI

    You think the vax backlash is bad now, just wait until someone’s kid “gets sick” from a gov’t mandated vaccine… I am 1000% pro-vaccine, but seriously, what is your hard-on for forcing people who don’t agree with you to act the way you want them to act? oh, right, its FOR THE CHILDREN! natch. isn’t it always?

  66. @anna,

    You’re confusing my statement. I didn’t say fear is the best and only way- but ONE way that in this case may work best. Pragmatic, no?

  67. Sir Eccles

    There are actually a shockingly large number of people in the US who live below the poverty line and/or end up skipping meals so their kids can eat.

  68. Mike

    “what is your hard-on for forcing people who don’t agree with you to act the way you want them to act? oh, right, its FOR THE CHILDREN! natch.”

    Screw the children. My hard-on, as you so crudely put it, is self-preservation.

  69. ChaosRu

    It should absolutely be mandatory. There is so little good science education and so much bad medical information out there that the public in general is not able to make this decision in an informed way. More importantly this has become a growing pubic health emergency.

    Compulsory vaccination for anything but a medical exemption is not akin to having to seat belt young children, it is more akin to not allowing them to drive.

  70. People are missing the point of E. Allen Blank’s statement. I know because I wrote it. He’s supposed to be a breatharian and imposing this practice on his child. The point was that if the government forced him to feed or relinquish the child because of a specific and certain risk, no one would bat an eye. Yet if someone places their child at a non-specific risk of disease, suddenly we’re talking about the parent’s rights without regard to those of the child. A child has a right to be free from the highly avoidable perils of some diseases.

  71. Radwaste

    Here’s a NO.

    1) This plan would be administrated by the people who brought you the Transportation Security Administration.
    2) If you advocate compulsory vaccination, please show me how you have determined that the process will NOT adversely affect me. Aside from violating the Constitution (threat to liberty absent due process), a person is genetically unique. Those of you who are going on about seatbelts or helmet laws are engaging in a “straw man” argument, because restraints and protective gear can be built to perform over a range of physical features when they are apparent. For the slow, “genetically unique” means that vaccines differ in effect from person to person, just as the severity of viral disease varies. Yes, there are both vaccines and virii that demonstrate similar effects on the bulk of humanity. That does not show that either safety or a test for it exists.
    3) As to establishing a “slippery slope” – the next step, immediately, would be ID implants, “for your safety”. Clearly, a powerful central government with many people to track will have to have a means of doing so; RFID could “prove” you were at the scene of a crime, and that clearly benefits all of society. Then, the people in charge of the database can claim anything they want; the individual doesn’t have a way to challenge such powers.

    One batch of bad poliomyelitis vaccine crippled and killed more people than antivax-related exposure has, yes, so far. Its production and distribution was approved and expedited by public health authorities. I’m sure that was a great comfort to those afflicted.

  72. Radwaste @71 said,

    If you advocate compulsory vaccination, please show me how you have determined that the process will NOT adversely affect me.

    Easy Radwaste, no one is talking about you (presumably you’re an adult, free and clear to make your own decisions). No one is talking about compulsory vaccination for adults but compulsory vaccination for children who are entering the school system.

    There is a very fine line between the slippery slope argument and the slippery slope fallacy and people are tromping all over it.

  73. justcorbly

    @#70 Radwaste: >>” Aside from violating the Constitution (threat to liberty absent due process)…

    Oh, that’s just nuts. The “due process” is the decision of a duly elected legislature. You cannot trot out the due process arugment every time a legislature does something you don’t like.

    Ditto the unconsititutional bit. Lame. Get a lawyer and take it to court

    Your argument could just as easily apply to anything the law requires us to do or not do. In the end, it’s an argument for anarchy.

    And, as I said earlier, what right have parents who oppose vaccinations to allow their kids to spread disease?

  74. Dan I.

    I think compulsory vaccines are fine, but I wholeheartedly disagree with those who say “no religious exemptions.”

    First of all, the amount of people with bona fide religious exemptions is going to be very small, we aren’t talking about some wacko new-age cult getting exemptions. State’s actually have lists of religious organizations that are allowed exemptions. The amount of kids not vaccinated for bona fide religious reasons is going to be so small that herd immunity will cover it.

    It’s also very easy for the non-religious, the atheist, or the “not that” religious to say “No Religious exemptions” because I don’t feel such people really appreciate how important a religion can be to people.

  75. @ JediBear

    > Vaccination isn’t a matter of personal choice. It’s a matter of public
    > safety, and thus it is within the rights and is further the
    > responsibility of governments to mandate it and to see that
    > mandate carried out.

    Respectfully, I wholeheartedly disagree. When it comes to matters of public safety, there are a great number of behaviors that we neither mandate *nor* allow the government to control. In some cases, this is a matter of personal liberty.

    That said, in my opinion *it is not germane in any way whether or not this is the sort of problem that government “ought” to tackle*.

    The real question is, can government tackle this problem *effectively*, and the answer is no.

    Sorry, they can’t. California has *mandatory automobile insurance*, for example, and one out of every three drivers still don’t have insurance. You’re not going to get above our existing 80+% vaccination rate coverage that way. It’s a giant waste of time and money. See my above comment; you’re not going to fix the problem, and any reasonably thorough method of trying to audit citizens getting vaccinations is still going to have too many gaps while costing way too damn much. *Any* money that you would spend enforcing this would be much better spent giving basic health care to people that don’t have any. I’d much rather give away vaccinations to uninsured people (or even give poor people adequate food and basic medical care) to improve herd immunity than start generating paperwork trying to force people to get vaccinations.

    > As to the slippery-slope argument: Your right to swing your fist
    > ends where my nose begins.

    This is a very bad counterargument to this *particular* slippery slope argument. I have a perfect right to swing my fist plenty of places. I just don’t have a right to force *you* to put your face in front of my fist. You, on the other hand, don’t have a right to expect that you can put your face in front of my swinging fist and then complain when my fist lands on your nose.

    General vaccination doesn’t map well to the fist swinging analogy. It doesn’t even map well to other more similar “freedom vs. public good” activities like smoking, where the activity is an active one (people smoke) vs a passive one (people refusing to get a vaccination).

  76. justcorbly

    @Dan: I know how important religion is to many people, but if we allow them exemptions then we need to look at alternative approaches to protecting society from their unvaccinated kids.

    Personally, I don’t think people have a right to permit their kids to be potential spreaders of disease when safe means to prevent that are available. That’s where the emphasis should be place, not on the state’s right to impose the mandate. The no-vaccine crowd should be compelled to explain why their alleged right to avoid vaccines trumps our right to stay healthy.

  77. Jefferson

    I say NO. Enough of our liberties have been trampled on already.

    But I have a question: is the scientific evidence on the safety of vaccines that reliable after all? I have read the following survey and I am beginning to wonder… http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0005738

    I agree that this is only one survey, and that more are needed, but I find the author makes some pretty compelling statements (not trying to cherry pick here; please read the entire survey and make your own opinion) e.g. :

    “…The image of scientists as objective seekers of truth is periodically jeopardized by the discovery of a major scientific fraud. Recent scandals like Hwang Woo-Suk’s fake stem-cell lines [1] or Jan Hendrik Schön’s duplicated graphs [2] showed how easy it can be for a scientist to publish fabricated data in the most prestigious journals, and how this can cause a waste of financial and human resources and might pose a risk to human health. How frequent are scientific frauds? The question is obviously crucial, yet the answer is a matter of great debate [3], [4]…”

    “…A popular view propagated by the media [5] and by many scientists (e.g. [6]) sees fraudsters as just a “few bad apples” [7]. This pristine image of science is based on the theory that the scientific community is guided by norms including disinterestedness and organized scepticism, which are incompatible with misconduct [8], [9]. Increasing evidence, however, suggests that known frauds are just the “tip of the iceberg”, and that many cases are never discovered. The debate, therefore, has moved on to defining the forms, causes and frequency of scientific misconduct [4]…”

    “…Once methodological differences were controlled for, cross-study comparisons indicated that samples drawn exclusively from medical (including clinical and pharmacological) research reported misconduct more frequently than respondents in other fields or in mixed samples. To the author’s knowledge, this is the first cross-disciplinary evidence of this kind, and it suggests that misconduct in clinical, pharmacological and medical research is more widespread than in other fields. This would support growing fears that the large financial interests that often drive medical research are severely biasing it [50], [51], [52]. However, as all survey-based data, this finding is open to the alternative interpretation that respondents in the medical profession are simply more aware of the problem and more willing to report it. This could indeed be the case, because medical research is a preferred target of research and training programs in scientific integrity, and because the severe social and legal consequences of misconduct in medical research might motivate respondents to report it. However, the effect of this parameter was not robust to one of the sensitivity analyses, so it would need to be confirmed by independent studies before being conclusively accepted…”

    The problem is that field researchers are often sponsored by big pharma corporations who have an interest in getting favorable reviews for their product. Will they go as far as threatening to disvest researchers who do not come up with favorable reviews? Are researchers blackmailed to the point they have to fudge the evidence to meet their sponsors’ requirements? I don’t know. But it’s a scary thought.

    I think the medical establishment has an “incestuous” relationship with the big pharma industry, and that can only be conducive to serious ethical issues.

    I’m not sure what or whom to trust anymore. If the government, Jenny McCarthy et al. and the scientific evidence can’t be trusted, then what’s left? My own judgment, I guess.

  78. Dom

    I do not believe vaccines should be compulsory for a few reasons. While we may be comfortable with the vaccines available today vaccines in the future may become radically different and we may wish to pick and chose which future vaccines we expose ourselves to without being forced to by some bureaucrats. Even if the vaccines remain relatively similar the number of them will increase; would it be compulsory to have every vaccine?

    Then there are economic concerns similar to our concerns regarding lobbyists in government. For example what if the government decides to start giving out government contracts to vaccine distributors; there will be incentive for vaccine creators to lobby government to get their vaccines added to the compulsory list.

    Finally there will be those who consider tinfoil to be appropriate apparel and will regard compulsory vaccines with extreme suspicion encouraging them to actively avoid them. Maybe going so far as to take their children out of the school system and children who would have otherwise had their vaccines and attended school may be lost to society.

  79. @ justcorbly

    > And, as I said earlier, what right have parents who oppose vaccinations
    > to allow their kids to spread disease?

    You’re conflating un-vaccinated people with typhoid Mary, which is obviously not a fair comparison. Most un-vaccinated people aren’t infected with anything worth worrying about.

    You can just as easily ask what right does a southern Californian have to drive a car when particulate pollution kills more people in a year in southern California than guns do nationwide? Or more generally why anyone should have a right to drive a car when automobile accidents kill ten times as many people in a year as terrorists did on 9/11?

    None of that matters, though, because the proposed solution won’t work. This isn’t like a helmet or seatbelt law (which are hard to enforce), it’s not relatively easy to audit *and* it’s hard to enforce. You’re not going to get the outliers that way, and it’s going to be too damn expensive.

  80. justcorbly

    @ Pat Calahan: The mandatory auto insurance analogy doesn’t work. No gatekeepers exist to keep uninsured drivers off the roads. The penalty for doing that is retroactive. Not so with mandatory vacinations. Children can be refused enrollement in public schools if not vaccinated. Private schools and homeschoolers can be strip of their authority to teach and to graduate students. Public and private health insurance premiums for the unvaccinated can be increased punitively.

    In other words, many effective disincentives for avoiding vaccination exist and can be brought to bear.

    And, to repeat, avoid vaccination is not a passive activity. The unvaccinated are more likely to get sick and spread disease than others. But, in any case, so what?

  81. Cairnos

    While I am very for vaccination I’d have to go a no on this one. One reason:
    LLQ@63 said ” Dr Plait, keep in mind that the congresscritters that make it so easy to ridicule them on their gathetic understanding of anything beyond grade school science would be the same idiots writing the laws… That may be a risk worse than non-vaccinated people!” …now if we go up to this level, who so you think will be able to generate more grassroots lobbying power, folk who are for vaccination to make them compulsory, or folk who follow those like Jenny Mccarthy who might (note I’m not saying would) prohibit them. I just wouldn’t want to risk seeing things reach that level.

    @ToddW@44 “Another thought, would mandatory vaccination legislation also impose mandatory quarantine for infected individuals and members of their household?” Given the results we’re seeing from current swine flu fears, even if the original legislation didn’t impose such controls (and there wasn’t a background power to do so anyway), the moment something nasty cropped up it would be imposed rapidly, and most likely badly, particular case from NZ, Man who was on plane with students suspected of having it was confined to his house. His wife however ws free to come and go from the house.

    @ E Allen Blank@24 “Then they pay off all the corrupt useful idiots like the author of this blog ” Proofs Phil is getting paid of please?

    “There is another way of looking at the universe that tells us we can have all we need from the air and the ki circulating continuously”
    Oh….never mind.

    Poe? Please be a poe…?

    I agree with the several commentors who have said that if it were to become mandatory, the list of mandatory vaccinations should be limited, very scrutinised, and quality control for those vaccines must be lifted to extreme levels (I’m already assuming that it’s normally quite high).

    I’m wary of the slippery slope argument, I have seen it applied well and seen it applied badly….and I mean really badly

  82. @ justcorbly

    Ah, no. There are gatekeepers for auto insurance; you need a certificate of insurance to register your car. And if you’re driving an unregistered automobile for more than 6 months in Los Angeles you’ll get nailed somehow… by a parking cop if not the Highway Patrol… and yet people still drive uninsured here. And that’s with maybe a dozen insurers who have electronic submission channels to the DMV, which are relatively “hard” to circumvent.

    I don’t want to be insulting, here, but I’ve studied security, identification, and authorization processes for a over a decade and your idea of gatekeepers is hopelessly naive. Any proposed document you would design to be a “certificate of vaccination” can be trivially forged to bypass a school admissions process unless you spend *scads* of money making the document hard to forge and making the people in charge of verification suitably un-subornable. Verification of that document requires a trusted authority and an established process, which is a hugely complex and expensive thing to design and maintain. Not to mention the fact that vaccinations are performed at nickel clinics at your local drugstore and by volunteers on vaccination drives, not just by physicians. A stack of those forms and a rubber stamp will be easy to obtain. People will get multiple vaccinations under false records and sell the certificates. There simply is no credible way for you to authoritatively determine that people are vaccinated without spending lots and lots and lots of money.

    If 12 million illegal immigrants can have sufficient documentation to live, work, and play in the U.S., it’s simply absurd to propose that you can devise a foolproof method to determine that 8 million children have had their shots.

    Put another way, write out your process. I’ll punch a couple thousand holes in it inside of a half an hour. I specialize in this sort of thing :)

    And vaccination *is* a passive activity. You’re also more likely to get sick and spread disease if you’re overweight, a smoker, a diabetic, an intravenous drug user, chronically stressed, chronically fatigued, have a generally bad diet, don’t exercise regularly… I can go on. Are you ready to mandate all that? I bike to work, eat three squares, have my shots, don’t smoke, don’t do drugs, go to the dentist twice a year and get my routine checkups… and I still don’t get enough sleep because I work and go to grad school and I have two kids. Are you going to mandate that I drop the school, the work, or the kids? Reducto ad absurdum aside, the main point is that you can’t make it work. Whether or not its “the right thing to do” or “unfair imposition on individual liberty” just doesn’t matter.

  83. Okay call me an ignorant Canadian here and this may be a bit of topic. Are vaccines not free in the States?

    Maybe that is one issue that should be tackled to raise vaccination rates.

    Off topic I know but if something should be mandatory by the government for any reason (such as having to be vaccinated for public school attendance as appears to be the case in some states) then the government should be footing the bill just like they have to provide free education as educating your child is law until they reach a certain age.

    Or just call me a Socialist wing nut.

    Now back to the topic at hand, some have raised a very valid point re: if it were law, how impossible of a task it would be to implement said law. Even here in Canada where vaccinations are free, it would be a huge ordeal. As I just recently stated on my own blog:

    […]Now that is just the tip of the iceberg when it comes to my thoughts on this subject. As I said, in theory it is so easy to say yes. However, in practice, there is so much that can go wrong and end up causing greater harm. Let’s just start with the logistics of carrying out such a program IF a law was drafted that would not leave it open for the government to start imposing all kinds of other medical treatment that some many feel does not fall under the life-threatening criteria and they feel it is their bodies, they should be able to choose which medical treatments they and their families should undergo.

    How exactly are they going to keep record of all of this? For instance, where I live, you do not go to your family doctor or pediatrician to get vaccinated. The program is carried out by the local heath authority aka the government. Before your child is of school age, you take them to your local health unit where the heath nurse administers the vaccine. When the child is of school age, the health nurse goes to your child’s school and administers them there. Now in other parts of the country, you go to your doctor to be vaccinated. Here, the doctors do not keep record of your child’s vaccines the health authority via the government does. Other places, it is up the parent and doctors to keep records. Now if it were nationally mandated to vaccinate, there would have to be a huge overhaul on the health system so that there is a central record of who and who is not vaccinated and how vaccination procedures will take place. That in itself would cost billions of dollars and would be a nightmare. Now that is just one small logistical nightmare I see in regards to this IF the logistical nightmare of how this law would be drafted is solved.[…]

  84. armando

    Here in Mexico (Third world) we have a “Cartilla Nacional de Vacunación”, Vaccination National Card. Every child has it’s own cartilla where doctors keep record on wich vaccines where taken and when.

    It also works as a reminder for parents because it has the ages in wich each vaccine most be applied to the child.

    When the child is subscribed in a nursery, kindergarden and latter, in school, he or she must HAVE TAKEN all the vaccines (according to the age). If not, is not allowed in school.

    By the way, vaccines are free for every child in Mexico.

    I’m an every day reader of your blog. Keep the good work.

  85. Gordon

    No, vaccination should not be compulsory. However, making the decision to not have your child vaccinated should come with the consequences for that decision. A child not vaccinated should be prevented from attending public school. The parent can home teach. The child should not be allowed to be in environments where the danger of communicating germs to others is exceptionally high. This might include not allowing an unvaccinated child to fly on a commercial airplane. There is likely a list of consequences that should apply for not having your child vaccinated. The parent should be free to prevent their child from being vaccinated and be responsible for the consequences of that decision.

  86. Mark Hansen

    @anyone replying to E. Allen Blank (comment 24)
    Do save yourselves a little time and typing by clicking on the name. Or alternatively, think a little harder about what is contained in his/her 2nd paragraph. All you need to know is there.

  87. Tony

    In the Australian state of New South Wales, and probably other Australian States – the following approach is taken:

    Vaccination is not compulsory, but children, for whom proof of vaccination has not been provided to the school or day-care etc., are not allowed to attend school or day-care during outbreaks of such a diseases in the community.

    To support this approach and to encourage vaccination, doctors report to the health department when they vaccinate a child, allowing records to be maintained. These records are available to Parents (to provide proof to the school) and are used to send reminders to parents for booster vaccinations.

    This is mostly about convincing lazy/too busy parents to get it done (since they will otherwise forget or won’t want the time off work), but has the benefit of taking a bunch of people without immunity out of circulation when highly contagious diseases and hence reducing the risk to those who are vaccinated.

    By simply applying reminders and a little pressure to ensure the lazy/too busy parents get it done – you hope to increase the vaccination rate significantly. Also – the flyers etc. produced by the government to explain the scheme provide a good opportunity to explain the benefits of vaccination.

  88. justcorbly

    @Pat Calahan:

    You can just as easily ask what right does a southern Californian have to drive a car when particulate pollution kills more people in a year in southern California than guns do nationwide?

    And, indeed, I do ask that question.

    There are gatekeepers for auto insurance

    They’re all retroactive and come into play only after the damage has been done. Nothing is in place to keep an uninsured person from getting in a car and driving. We can prevent unvaccinated people from participating fully in society by keeping them out of public schools, de-sanctioning private schools that admit the unvaccinated, etc. All those gatekeepers come into play to prevent injury to others, unlike like state car insurance laws which come into play only after they are violated and others insured.

    It’s absurd to think vaccination is a passive activity. You go somewhere and get vaccinated. But, the issue of active versus passive is not relevant, to this issue or to smoking. Both activities — smoking and avoiding vaccinations — threaten the health of both the smoker and the unvaccinated and the health of the general public. The right to threaten the health of the general public does not exist.

    Put simply, smoking is stupid. Not getting vaccinated is stupid. People have a right to do stupid things. People do not have a right to do stupid things that cause harm to others.

    It’s also absurd to think we should avoid this just because some people might be able to forge documents. One obvious remedy is to digitize and secure all such records. Your argument suggests that we ought not to require drivers licenses, etc., because they can be forged. And that’s just as obviously nonsense. Rational societies do not avoid advancing the general welfare just because a few outlaws will misbehave.

    Make vaccinations mandatory. Don’t let kids who haven’t been vaccinated into public schools. Don’t legally sanction private schools and home schoolers who admit or teach unvaccinated kids. (I.e., make them essentially unemployable.) Encourage health insurers to refuse coverage for treatment of illnesses that could have been avoided with vaccination, and to jack up premiums for the parents of unvaccinated kids. Don’t let unvaccinated people into the military.

  89. Scenario Dave

    In response to Pat at 83.

    I agree that it would be fairly easy to get a fake certificate but what percent of people would do it? Car insurance vs vaccine is not a good comparison. How much does car insurance cost per year vs how much does it cost to get a vaccine?

    The cost of a vaccine when covered by insurance is $0, the cost of a fake certificate, a lot more. The cost of car insurance, $1,000+ a year, the cost of a fake certificate, a lot less. With vacines, most parent will choose the easier, cheaper way out unless they’re very dedicated.

    I do agree that cost is a major issue, especially if your looking for near 100% compliance. But isn’t 80 or 90 percent compliance better than 40 or 50 percent compliance?

    Vaccines are a health issue. They go under the same category as preventing people from dumping raw sewerage in the river, if a few people do it its harmless but if a lot of people do it, people will die.

  90. re: auto insurance gatekeepers

    > They’re all retroactive and come into play only after
    > the damage has been done.

    They’re not, but continuing this argument isn’t germane, so for the sake of saving my forehead I’ll just concede the point to move on.

    > It’s absurd to think vaccination is a passive activity

    Certainly. That’s not what we’re arguing. We’re arguing that *not* vaccinating is a passive activity. And it clearly is. If you can’t differentiate the difference, you’re not a process-level thinker and your design is not going to work.

    > It’s also absurd to think we should avoid this just because
    > some people might be able to forge documents.

    That’s not what I’m saying. What I’m saying is that you cannot do it cost effectively. In fact, you’re being counterproductive; you can improve your overall society’s health by spending the money elsewhere, on basic care and heath issues.

    > One obvious remedy is to digitize and secure all such records.

    Dear sir, you are digging yourself a greater hole when it comes to displaying poor knowledge of the security domain. Digitizing and securing all such records is a massive undertaking, making it more expensive, harder to design, and subject to class breaks.

    > Your argument suggests that we ought not to require drivers
    > licenses, etc., because they can be forged. And that’s just as
    > obviously nonsense.

    My argument does not suggest this, in fact. It does suggest that the cost of designing, implementing, deploying, and auditing the driver’s license process should not be significantly greater than the cost of not having a driver’s license system to begin with, however. Licensing a driver is different from carrying a driver’s license, in any event.

    > Rational societies do not avoid advancing the general welfare
    > just because a few outlaws will misbehave.

    Absolutely.

    Rational societies also do not undertake activities that have no chance of having a reasonable outcome in a cost benefit analysis. This doesn’t.

    > Make vaccinations mandatory. Don’t let kids who haven’t been
    > vaccinated into public schools.

    So in addition to being un-vaccinated and susceptible to disease, we remove their access to an education where they can learn why this is stupid?

    > Don’t legally sanction private schools and home schoolers who
    > admit or teach unvaccinated kids.

    Okay. I’m a private school. I say that the student brought in a signed document from a doctor that said they’re vaccinated. How do you propose I authoritatively prove that the signature is valid, that the doctor exists, or that the document itself doesn’t indicate a falsehood to begin with? (Hint, you can’t)

    > Encourage health insurers to refuse coverage for treatment of
    > illnesses that could have been avoided with vaccination

    Sure. Violate your Hippocratic oath and your professional ethical standards. Not to mention, again, that you’re punishing the child for the fact that their parent is an idiot.

    > and to jack up premiums for the parents of unvaccinated kids.

    Given the fact that a third of the nation doesn’t have health coverage, I’m not thinking that this will do much except exacerbate this problem.

    > Don’t let unvaccinated people into the military.

    The military is *one* place where vaccinations *can* be made mandatory.

    I’m sorry; while I sympathize with the desire for a healthier society, I flatly reject the possibility that your solution will meet that goal.

  91. Radwaste

    “In the end, it’s an argument for anarchy.”

    No. It’s an argument against an agency working its own agenda without regard for due process. And we have lots of evidence already in the behavior of existing government agencies. You can be strip-searched for wanting to fly on an airplane. You can be denied access to commercial air travel by means beyond your ability to challenge. This is the real face of government actions today. I am appalled that people meekly bend over, sometimes literally, to agents who are ineffective.

    In other news, I am so thrilled to learn that children adversely affected will not grow up to become adults whose health was stolen absent due process. /sarcasm

    I am not anti-vaccination: I am merely against government coercion. And you are…?

  92. @Pat Calahan:

    What percentage of California drivers would have auto insurance were it not mandatory? In case it’s not obvious, the answer is “considerably fewer.” Perhaps “nearly none.” The law must be effective, therefore, since it’s clearly having an effect.

    You’re never going to get complete compliance with a law. That’s asking too much, and it’s fallacious to argue that a lack of complete compliance with a law makes that law useless.

    My argument was that there’s no place for you to swing your fist where it won’t connect with someone’s nose, and it’s not like anyone can move out of the way.

    Perhaps the fist-nose analogy doesn’t map well, but the impingement of a useless individual liberty is almost certainly outweighed by the considerable potential benefit to public safety.

    As to the cost — that’s actually a matter of implementation. We don’t need to perform extensive audits, nor do we need to come up with a foolproof method of record-keeping. We need only to impose penalties for failure, and it will compel the majority to either get vaccinated (easy/cheap, especially with well-funded vaccination programs) or obtain forged records (expensive/difficult.)

  93. Diko

    The answer is obviously NO. Vaccines have negative effects and the individual should choose weather to potentially harm themselves or their child. Considering what happened after the 76 swine flue ‘pandemic’ there is no way we should be forced to vaccinate.

    Most of you seem to say yes. Why do you want your freedoms taken away after each crisis we have. You can’t eliminate all risk from life, enjoy it and stay free.

    Look into some of Sherri Tennpennys research on vaccines, then make an educated decision for yourself. If all you have is media hype, we’re doomed.

  94. @ JediBear

    > What percentage of California drivers would have auto insurance
    > were it not mandatory? In case it’s not obvious, the answer is
    > “considerably fewer.” Perhaps “nearly none.”

    (cough cough) Citation needed. I simply will not accept this statement without substantive evidential support. In point of fact, the uninsured rate in California has been between 30 and 25% for the last 30 years in spite of multiple attempts to increase compliance. I am unable to find a reliable source indicating the rate of uninsured driving prior to the passage of the original mandatory insurance law (I’ve looked for about a half hour). Since you’re making the claim, you’re going to have to back it up :) I certainly don’t believe that “nearly none” is close to accurate. Damn it, you’ve got me beating my forehead again.

    > The law must be effective, therefore, since it’s clearly having
    > an effect.

    Ah, no. No, no, no. This is the same logical process of, “If it saves only one child, it’s worth it!” Having an effect != effective. Effective is a measurement of cost to benefit of a process, when compared to other likely processes. I can dig ditches with dynamite, a backhoe, or twenty guys with shovels. They all have an effect. Which one is effective is problem-specific.

    > You’re never going to get complete compliance with a law.

    Absolutely.

    > That’s asking too much, and it’s fallacious to argue that a
    > lack of complete compliance with a law makes that law useless.

    I did not say that. Lack of complete compliance with a law makes that law useless if the cost of getting the law passed (really, good luck with that one in the first place, you’re looking at years of court challenges at a huge cost), plus the cost of implementing the process to support and audit the law’s observance increases compliance with the underlying behavior of the law in a manner consistent with its cost.

    In other words, let us assume that a 95% vaccination rate is sufficient, and that our current rate of vaccination is at 80%. Let us assume that making vaccinations *mandatory* will produce a net gain of 15% in the vaccination rate (it won’t), at a cost of $N dollars. If I can produce that net gain at a cost of $N-1 dollars, the law is inefficient. If I can produce that gain with $N dollars, and eliminate externalities in the process, the law is counterproductive.

    > My argument was that there’s no place for you to swing
    > your fist where it won’t connect with someone’s nose, and
    > it’s not like anyone can move out of the way.

    On the contrary, if you’re that worried about disease there are several steps you can take to make yourself “out of the way”. Why is my right to refuse a vaccination of less value than your existing freedom to wear an NBC suit (or, for non-silly sake, a mask), if you’re that worried? But I’m going to drop this line of reasoning altogether, again, because the “right” in this discussion is NOT GERMANE. It doesn’t matter whether I’m a raging libertarian, a complete socialist, or a religious nutbar. Making vaccinations mandatory is a stupid waste of resources, period.

    > As to the cost — that’s actually a matter of implementation.

    You betcha.

    > We don’t need to perform extensive audits, nor do we need to
    > come up with a foolproof method of record-keeping.

    That’s an interesting position.

    > We need only to impose penalties for failure, and it will compel
    > the majority to either get vaccinated (easy/cheap, especially
    > with well-funded vaccination programs) or obtain forged
    > records (expensive/difficult.)

    No, it won’t. You’re completely ignoring the fact that the majority (80%+) already get vaccinated, with no compulsion (note, this means all the money you spend auditing those people, which you of course must, is completely wasted money – right off the top 4/5ths of your process is utter waste).

    So the people whose behavior you’re attempting to modify are those who aren’t vaccinated. Some of those are because of cost (giving the vaccinations away for free handles that). Some are because they have medical reason (not much you can do about those). Some of them are because they *do not believe that vaccines are safe, or worth the risk*.

    Look, I understand that you have no particular reason to accept my bona fides as a self-proclaimed security expert. I can’t distill the last 15 years worth of reading about security processes, human safety engineering, and psychology any more than I already have in this thread without writing a couple research papers, and quite frankly I don’t have the time or the inclination.

    I’m simply telling you that your underlying assumptions are incorrect. You can’t make this work with the law, any more than making drugs illegal has stopped the recreational drug trade (in fact, by and large, there’s little evidence that making drugs illegal even cuts down significantly on their use). It ain’t gonna happen.

  95. MartyM

    I don’t know if it’s been stated in these comments or not, but I’ll say it (again if so be it). I’m for vaccinations that are proven and tested thoroughly. What I’m afraid of is a mandatory vaccination opening the door to untested, flash-in-the-pan vaccines hot off the centrifuge. We already see this in other medications that get yanked from the market because of damage to recipients due to insufficient testing It doesn’t matter if its 1 in 1000, it’s still too many. We all know the FDA can not keep up and regulate completely.

    I think we need vaccinations and I remember having to get tetanus shots before entering school as a kid, and don’t we have requirements for traveling overseas too? So I’m not opposed to “forcing” them to a degree, but what I don’t want is ever major pharma-conglomerate rushing out their new miracle cure in time for the Christmas rush like it’s the next X-Box. This is where business trumps science. That’s always a bad thing.

  96. @ Scenario Dave

    Sorry, I missed you in the middle there.

    > I agree that it would be fairly easy to get a fake certificate
    > but what percent of people would do it?

    That’s a very good question.

    > I do agree that cost is a major issue, especially if your looking
    > for near 100% compliance. But isn’t 80 or 90 percent
    > compliance better than 40 or 50 percent compliance?

    That’s part of my point. We have > 80% compliance now. Some of those don’t vaccinate because of cost; make ‘em free and it goes up more. Some of them don’t vaccinate for health reasons, they’re not going to get vaccinated in any event and I don’t think anyone would seriously argue that we ought to target them. What you’re left with is about 10% rejecting vaccinations for spurious reasons, give or take (slightly more in some areas, slightly less to much less in others). These people, for the most part, are going to be highly motivated to continue to reject vaccinations for those spurious reasons. The overall cost of making vaccinations mandatory, with all of the legislative, judicial costs, deployment costs, lost manhour filling out paperwork costs, etc., etc. is entirely to change the behavior (if not the attitude) of that 10%… but your process must apply to everybody. That’s a huge mountain of red tape. Imagine if you’re one of those people who *can’t* get a vaccination for health reasons. How do I go about opting-out? The easier you make it for me to opt-out, the easier it will be for that 10% to take advantage of the process. The harder you make it for me to opt out, the more burden you put on me, when I can’t get the vaccination in the first place. Ick.

    > Vaccines are a health issue. They go under the same category
    > as preventing people from dumping raw sewerage in the river,
    > if a few people do it its harmless but if a lot of people do it,
    > people will die.

    No, they don’t. It’s close, but the distinction is important. Preventing me from dumping sewage in the river is preventing an action. Forcing someone to get a vaccination is forcing an active behavior. The entire process of authenticating, authorizing, and auditing is vastly more complex.

  97. Yay! I was ahead of the curve for a change. :) I wrote about this very issue back a few months ago. Check this link: http://wilybadger.wordpress.com/2009/02/09/should-parents-be-forced-to-vaccinate/ For real fun, check out the comments, including one left by someone who claims to be a doctor and a scientist!

  98. knutty knitter

    They did the fear thing on one vaccination here. The result was a high rate of vaccination and 200 bad reactions including several with permanent after effects. The actual disease was limited to one small area and affected about 9 people one of whom died. The one who died wasn’t even in the target group! The disease carried on as usual because the vaccination only covered half the known cases anyhow. And you think these things are good!

    viv

  99. Anthony

    “but the State should not be the entity that forceably coerces all children to be vaccinated.”

    Why not?

  100. Anthony

    “I wonder how many of the ‘yes’ folks here have kids.

    Although I think the anti-vax folks are nuts, I do not want the government dictating to me what I should inject into my child.”

    A child is not a piece of your property. You have no right to put its life at risk.

  101. Daniel J. Andrews

    My friend casually mentioned in passing he and his wife had not vaccinated their children (ages 3 and 5) because they didn’t think vaccines were safe, and didn’t trust what was in them. I chatted with him a bit on the phone then on email I linked them to Todd’s site, sent them some information from the CDC, showed them the risks versus benefits. He said he and his wife would read it. This was about 3 weeks ago.

    Tonight I received an email saying they just started the children on their vaccinations today. The oldest thought it was cool, the youngest put up a bit of a fuss but was okay.

    A big thank you to Phil, Todd, and other posters, as well as other bloggers like Orac, who over the past few months have taught me where to find this information, and have made it readily available through their links. I’m grateful.

  102. Correction; we have over 90% compliance now, according to the CDC. With those who cannot be vaccinated for legitimate medical reasons, and those who don’t for poverty reasons, we have at the very worst 8% rejecting vaccinations for spurious reasons. So now we’re talking about imposing costs on over 92% of those people who are already getting vaccinations or unable to for the sake of imposing vaccinations on 8% of the rest.

    Here’s some number-scratching. I do not propose that the below is accurate, but it illustrates the point rather well…

    Let’s say we have 8 million children who are of an age for mandatory vaccinations, under a proposed enforcement plan. Let’s say each one of those now needs to have an actual doctor perform the vaccination and sign the paperwork (loss of license threat makes it pretty unlikely that they’ll cheat, compared to a vaccination clinic run by someone who passes a few community college courses). 5 minutes of doctor time per form – let’s cut a doctor’s salary and G&A to $60/hr and we’re looking at $5 for each child. For the 90% who would get vaccinated anyway (7,200,000 children), that’s a nice hefty $36 million. Let say 0.5% need medical exceptions (that’s 40,000 kids), which requires a set of forms in triplicate and a couple of extra blood tests for justification. Ballpark this at a laughably low $100 per child, there’s another $4 million. Each form needs to be processed by some clerk at the school, let’s say that takes again a laughably short 2 minutes per child, at a ridiculously low $7.25/hr for the clerk… that’s $1,933,333 dollars right there. We’ll have to have some sort of audit procedure done by the local school board, spot checking. Let’s say they check 1.5% of the records, the same as the IRS audits taxpayers, and each audit costs $50 (another laughably tiny amount)… that’s another $6 million. We’ll say for the sake of argument that making vaccinations mandatory is going to make a whopping 80% of the anti-vaxxers change their mind (working off of our 8% figure) that means we still have 128,000 people trying to game the system. Assuming random distributions of our audit process, we’ll catch 1,280 of them. Some of those will challenge the results, either procedurally or in the courts, let’s just throw another laughably low number of $2,000 to resolve those cases in administrative time, legal costs, etc. There’s another $2.56 million right there.

    So far we’ve spent (in our *crazily* conservative number assumptions) over $50 million dollars. Our net advantage here has added 640,000 antivaxxers who voluntarily got vaccinated, plus another 1,280 who got caught. We still have 126,720 holdouts. We’ve spent $50 million dollars to get 641,280 vaccinated (the likely dollar figure here in the real world is at *least* an order of magnitude higher, probably two, and we’re not even counting the aggravation, technical costs, court cases when some school’s database gets hacked and HIPAA regulatory penalties come into effect, etc.) Hm, that doesn’t seem so bad, does it? $70 some odd dollars per vaccination? But wait, there’s more…

    I can think of a lot of things I’d rather spend $50 million dollars on, let alone the much more realistic $500 million – $5 billion figure. Not to mention the fact that if 640,000 of the antivaxxers are so uncommitted that they’ll just give up because it’s the law, we can probably convince them using something much, much cheaper… like blogging… so the delta between this program and that something is…

    … a grand total of 1,280 additional vaccinations (or a grand total net benefit of 0.016% of our 8 million). Whoo, we just bumped our vaccination rate from 90-something percent to 90.016% for $500+ million or more.

    If that’s not irresponsible and stupid, I don’t know *what* is.

  103. Oh, keep in mind, that all of those above costs are *per vaccination cycle*. If you get a total of 20 cycles of shots during the 14 years you’re in the mandatory coverage period (making this up out of whole cloth, I don’t know what the cycle is as my wife handles the chillin’s and the doctor visits, and I’ve spent too much time on this thread already to go look it up), that multiplies a good chunk of the costs above by a factor of 20. We’ll not mention the fact that none of the above covers children not in school (say, for reasons of severe poverty or the very young, those who would be most adversely affected by an outbreak)… auditing *those* kids is actually much, much harder, and therefore much, much more expensive.

    The upside is with 20 audit cycles, you’ll catch more than 1,280 of the 640,000 antivaxers; not quite 20 times as many, but within a reasonable amount for the sake of argument.

    I leave the math as an exercise to the reader, the dollars get *really* ugly.

    What are you going to cut to fund this? No more observatories? The NSF? The NCEA? Just raise taxes?

    When do you stop? Do you ever stop?

  104. Vaccines compulsory? Hmm.

    Those that do not want (bad idea) their kid vaccinated should fill out a form where they agree that in case their kid gets ill with (one of) that particular disease/s the vaccine is for, they should pay 100% for all the treatment/hospital expenses to cure that disease.
    And if their kid’s (contagious) disease can be proven (???) to be the cause of someone else’s death, they should be held responsible in court. I believe one’s kid death due to the parent’s negligence or ignorance is enough of a punisment.

  105. Gary Shavit

    Definitely YES! We don’t let the parents decide whether their children need seat belts and booster seats in the car. When the child’s safety (and in this case, also the safety of other children in the community) is at risk, the government has the duty to impose regulations that may infringe on the parents “freedom of choice”.

  106. Attila

    In lots of european countries, vaccination is mandatory. I remember there was an issue recently with a local couple who refused to have their kids vaccinated – the law prohibits the kids from being admitted to school, and prescribes monetary fines for parents, as well as potential imprisonment if they repeatedly refuse to conform. Social authorities can even take away the custody of the children in extreme cases, on basis that non-vaccination is a criminal negligence towards the child (this is in Hungary).

  107. Dan I

    I understand what some people have said about “Why should we let religious people make our kids sick?”

    But I don’t think that’s a valid argument. First, the VAST majority of religious people have absolutely no objection to vaccines on religious grounds. It’s a few outlying and particular sects that object.

    Many of those sects will not be considered bone fide religions by the government or courts, hence they won’t qualify for an exemption. So the number of people exempted from compulsory vaccines for religious reasons would be incredibly small. So small in fact that I would wager they would not appreciatively alter the number of people vaccinated for other reasons (health, compromised immune system, allergies).

    In other words, the danger posed by this small religious population would be the same as the danger posed by those left unvaccinated for other reasons. Should we apply the same logic to that group.

    Herd immunity would cover here.

    Secondly, in the United States, for the government to infringe upon a First Amendment right, like free exercise. The burden is on the government to prove a compelling interest. The second we switch that burden for one right, we open the door to switching it for others. Oops, sorry its now on the CITIZEN to prove why the government can’t infringe on freedom of assembly, or freedom of speech. We don’t want to switch or lower the burden on the government.

    Now the government can certainly articulate a compelling interest in public health, but is that interest still compelling when you take into account herd immunity and the small number of people who would qualify for an exemption? I don’t think so.

  108. All people should be vaccinated.

    The day the government tells me that it knows better than me what I should put into my body and tries to force its view on me is the day that we need revolution, war, and blood in the streets.

    I’m no crazy anti-vaxxer, just someone who knows that GOVERNMENT POWER STOPS WITH MY BODY AND MY CHILDRENS’ BODIES.

    Government can recommend, government can suggest. In special cases, government can incentivize, but if GOVERNMENT TRIES TO PUT THINGS IN MY BODY, IT IS TIME TO START SHOOTING AT IT. Plain and simple.

  109. p1gnone

    I just listen to your interview in the SETI institute podcast “Skeptic Check” and would comment that whether obligatory or not one should consider innoculation as a social duty, perhaps borne more heavily by those of good health. I have fully vaccinated kids and am myself innoculated against all standard significant illnesses. However as there is a small risk to any vaccination, and cost to self, cost to society through the burden shared via insurance, and as the risk of strong health imapct if ill is reduced by my general healthy lifestyle I have avoided flu vaccination. So the computation considers whether my acting as vector in some ‘flu’ has significant social cost drive the decision to vaccinate. That is, if mild, with statistically few suffering major consequence with falling ill then perhaps I can still avoid the “costs” of vaccination, but if many are deeply impacted by the illness, and even if my own likely depth of illness would be shallow then I should feel it a social responsibility to protect my neighbors and roll up my sleeve.

  110. justcorbly

    @105:

    Opposition to mandatory vaccinations on ideological grounds doesn’t cut it. People who avoid vaccinations are puting the health of others at risk. They are acting in an irresponsible and dangerous manner. People who behave like that in other areas are routinely brought up on charges, as expected.

    Parents of unvaccinated children pose a threat to the health of their children. Would we not stop a parent who deliberately placed a known disease culture in her child’s food? Wouldn’t that parent be subject to criminal charges? What is the difference, then, between that action and the action of deliberately leaving the child unprotected from diseases she is certain to encounter?

    Being responsible enough to take the actions needed to prevent your children from culturing and spreading deadly diseases is part of the price of living in a community. Is it a loss of freedom? Of course, but every responsibility imposed by society is a loss of freedom compared to anarchy. The ideological argument in support of the non-vaccinators is equivalent to arguing that we all have a right to drive down the wrong side of the street or to burn piles of arsenic in a backyard bonfire.

  111. @Daniel J. Andrews

    May I add your account to the feedback section of my site?

  112. Some other thoughts about the mandatory vaccination thing. Some have offered up the opinions that the children of parents who refuse to vaccinate their kids should be denied an education, making them unemployable. Others have suggested increased cost (insurance rates or no insurance coverage for treatment) for parents who refuse to vaccinate their kids.

    My question to those who hold those views: how do you keep these people from then becoming a burden upon society. If the kids do not receive a proper education and become unemployable, they tax the welfare system or end up homeless. Those who cannot afford insurance to cover medical costs put a burden upon hospitals providing care regardless of insurance coverage and, consequently, insurers and the insured who do get their kids vaccinated.

    I hope that people can see, at least from my posts, that while in principle it is good to require vaccination for everyone (except those with contraindicated medical conditions), it is not a simple matter and has numerous ramifications, not only for general health care, but seemingly unrelated areas.

  113. Daniel J. Andrews

    @Todd. Yes, you can add that to the feedback section. It’s a great site you have. My location is Sudbury, Ontario, Canada, job title is Wildlife Biologist, if you need a bit more info.

  114. @ justcorbly

    > People who avoid vaccinations are puting the health of others at risk.

    Again, there are lots and lots and lots of behaviors that put the health of others at risk, directly or indirectly.

    > They are acting in an irresponsible and dangerous manner.

    And they can just as easily say that if you don’t wear an NBC suit and live in a clean room, *you* are the one acting in a dangerous and irresponsible manner. It is not necessarily always the responsibility of the community to modify their behavior for the maximal “safety” of everyone in the community.

    > People who behave like that in other areas are routinely
    > brought up on charges, as expected.

    This is a ridiculous and gross over-generalization.

    > The ideological argument in support of the non-vaccinators
    > is equivalent to arguing that we all have a right to drive
    > down the wrong side of the street or to burn piles of arsenic
    > in a backyard bonfire.

    No, it’s not equivalent. It’s not even close.

    Why am I letting myself get drawn into this again? I need to take more patience lessons from Todd. Your ideology (which is marginally relevant here, because quite frankly the chance of you successfully imposing your legislation is within epsilon of zero) is not relevant. Look at the numbers. You’re talking about a criminal waste of funds that could be better used *anywhere*.

  115. Scenario Dave

    In response to 102 Patrick Cahalan:

    I believe that some of the costs you have listed are somewhat exagurated.
    The cost assumes that new people have to be hired in order process the paperwork.

    When I registered my children for kindergarten, I had to provide several pieces of documentation such as the childs birt certificate,and proof of residency. Adding one more document on top of the 7 or 8 other documents will not generate that much more work. I doubt that they would need to hire extra people to process one more piece of paper.

    Since there is little or no verification in the process it will be easy for people who wish to avoid vaccination to get forged papers but I believe that most won’t have the incentive. Of the 10 to 15 percent of people who could but don’t vaccinate, how many are hard core and how many just follow Oprah? If someone is mildly against vaccination, how many would be willing to submit fradulent documents in order to avoid it?

    Making vaccines free and legally required the could raise it from 80 to 90 percent compliance. I do agree that setting up an elaborate system to insure compliance would be a total waste of money since it would probably result in raising compliance levels one or two percent at a high cost.

    A simple sytem that is easy to get around would be a lot cheaper and still gain you a high percentage of the gains that a much more secure system would give you. With a computerized system, a simple form letter would take five minutes or less to prepare.

    The problem is that most people don’t look at cost benifit. If the rate is currently 80% and just having doctors or clinics submit one form letter will raise compliance to 90%, it is probably worth it. Having an elaborate system to raise it from 90 to 92% is not.

  116. Cheyenne

    @Todd-

    It’s annoying how cogent you are on this topic…… Kidding!

    Do you think kids should be barred from attending public schools if they don’t have their vaccinations (but again, just the ones that don’t have a valid medical reason)? Right now I feel like they should but honestly, this is such a complicated and difficult topic I could change my mind in the next two minutes.

    The law of unintended consequences is saturating this topic.

  117. @Daniel J. Andrews

    Thanks for the permission and the added info!

  118. @ Scenario Dave

    > I believe that some of the costs you have listed are
    > somewhat exagurated.

    They’re massively exaggerated. Hugely exaggerated. On the simplicity side.

    > The cost assumes that new people have to be hired in order
    > process the paperwork.

    No, it doesn’t. People still need to do the work. If they’re doing this, they’re not doing something else. This is how you make a budget.

    > Since there is little or no verification in the process it will be
    > easy for people who wish to avoid vaccination to get forged
    > papers but I believe that most won’t have the incentive.

    Before you start proposing that we legislate this and spend money on it, I respectfully ask that you do some research to support your belief.

    > If someone is mildly against vaccination, how many would
    > be willing to submit fradulent documents in order to avoid it?

    If someone is mildly against vaccination, I posit it is simple and straightforward to remove that mild objection without resorting to adding more paperwork to the school system. I don’t want my teachers acting like INS agents, and I don’t want them acting like CDC agents. I want them teaching.

    > Making vaccines free and legally required the could raise it from
    > 80 to 90 percent compliance.

    As I pointed out, we (the U.S., that is) already have over 90% compliance, so by this measure we don’t need to do anything :)

    > A simple sytem that is easy to get around would be a lot cheaper
    > and still gain you a high percentage of the gains that a much
    > more secure system would give you.

    That’s only true in certain circumstances. Note the system I describe above is stupidly simple (it doesn’t even come close to solving the problem)… and while it’s not all that expensive “per capita”, it’s still a lot of money. Persuasive systems shouldn’t be implemented to change behaviors without a very careful analysis of what you’re trying to change. This is a whole research field in itself.

    > With a computerized system, a simple form letter would take
    > five minutes or less to prepare.

    … and the computerized system needs to be backed up. Synchronized. Secured. Maintained. Distributed. Designed. Maintained some more. People will bypass it and use paper if it’s too much bother. People will bypass it and use paper when its down. Then it needs to be reconciled. Again, if it gets hacked, you’re looking at FERPA and HIPAA violations, double whammy. It has to be audited. I build these sorts of things for a living; it’s *not* going to be cheap… not to mention the fact that fully half of IT systems fail when they’re deployed, so it’s a coin toss that you’ll have to scrap the whole thing and start over after you blow the initial budget. With administrative staff and programmers to run the back end; trainers and technical writers to interface with the users, etc., you’re still looking at gobs of money. Note, this is a system that would just add money to the scenario I described above, the forms still need to exist for the doctor to sign. Someone needs to input the form into the computer. You can’t scan these and expect a computer to run OCR on a doctor’s handwriting :)

  119. @ Cheyenne

    > The law of unintended consequences is saturating this topic.

    The law of unintended consequences is pretty much the entire problem with this topic. Certain problems can be handled within the framework of the law very well. Certain others quite frankly cannot. This is one of those :)

  120. Gary Ansorge

    Vaccinate or sequester. Those are the options. If one doesn’t vaccinate their child, that child cannot be admitted to school, allowed access to other children or adults who might be at risk.

    I see no problem with this approach,,,

    GAry 7

  121. Yojimbo

    Seems to me that Patrick Cahalan make a strong and cogent argument. We should be able to keep immunization levels high enough by offering vaccines free (or nearly so) and continuing to try to educate. A mandatory program might make sense if the rates of immunization fell drastically, but at this point the public health gain would be small. It would be akin to using a nuke to kill a mouse.

    The outbreaks of diseases like measles that we have seen lately are disturbing, but we have not seen enough to know whether dropping immunization rates are really a trend that will continue, or just inertia and complacency brought on by the recent low incidence of disease. Have vaccination rates increased, decreased or remained the same in the areas that have had outbreaks as a reaction to them? I don’t know, but it would not surprise me to find that rates had increased in reaction.

    In any case, though it is something that should raise concerns, the problems in bringing in a mandatory system just don’t seem worth it right now. I am visualizing the battles in federal and state legislatures, years of court decisions, organized protests, and a probable increase on the anti-vax side from publicity alone, all to try to get, what – a 5% increase in vaccination levels? If overall immunization rates were, say, 70% and clearly falling, then it might be time to consider a mandatory program. I have no ethical problem with making it mandatory, but if you’re going to fight a war it had better be worth the sacrifice.

    As for those who think the government has no right to tell you what to put into your body, remember that they already have the right to tell you what not to :)

  122. Cheyenne

    I agree with Patrick Cahalan and Yojimbo.

    The comments on this blog are all the evidence one needs to see that vaccines won’t be made compulsory by the government in the United States (barring a high-level pandemic of something in particular). Most of the people commenting here are pretty educated on the topic and believe in the value of vaccination – and yet there is not much agreement on mandating laws enforcing it. If there isn’t consensus in a blog like this I don’t think that Congress and the public in general would go for compulsory vaccination.

  123. Eduardo Padoan

    After thinking a little, I agree with you Phil and will research if there is any initiative here on Brazil to make vaccinations compulsory.

  124. kid cool

    I can see both sides of this arguement also, but my inclination is to say no.

    Look at the recent outcry of the cervical cancer vaccine. Yes it saves lives, but the state mandates were becoming a marketing tool for the drug company that developed the vaccine. Does anyone really believe that corporations would resist the urge to lobby states and the federal government to mandate their vaccines as a way of increasing profits. Set aside the issues of safety.

    Unfortunately, freedom means the freedom to make mistakes, or be just plain stupid.

  125. Dan I.

    @ Gary Ansorge

    Perhaps we should create some kind of “camp” in the middle of nowhere. A place where these unvaccinated children should be confined for the safety of others?

    Again folks, herd immunity will likely cover those children unvaccinated for religious reasons. Most religious people are not anti-vaxx nutjobs.

    Secondly, let’s not forget that when we’re talking about “sequestering” children we’re talking about punishing children for decisions that were not theirs.

  126. Wayne

    I took my daughter for her four-month vaccines today, and I am infuriated by the anti-science nonsense that tells people not to vaccinate their kids, but I say NO to mandatory vaccination. I’d go along with making it very inconvenient to have your kid unvaccinated (no school attendance, no govt. aid, etc) but to completely remove the choice here is not the direction we should be going and will open up a serious can of worms.

    I agree with you most of the time Phil, but I think you’re wrong on this one.

  127. Eli

    Vaccines are another medication designed to fit around our lifestyles and education. Those who live a healthy life, and educate themselves about other options, require no vaccinations. My father cured himself of Stage 4 Terminal brain cancer in 3 months, rejected chemo, radiation, and all medications, changed his diet and took supplements and food that specifically helps with his condition. He is completely cancer free now, and his brain cells are growing back. This is the case with most ANY medical condition. Your body has the equipment at its disposal to fight off any outside intrusion. you just gotta give the body what it needs. NOT what is convenient for your lifestyle. If people would stop being lazy, exercise and eat right, the need for vaccination would drop dramatically. There are few things in life we ourselves dont have the ability to combat naturally.

    And for those who think I or my father are nutjobs, I beg you to come visit us. You’d be surprised what can be done without the evil pharma compaines and medical/commerical complex.

    And anyone that says that there isnt something seriously wrong with current Doctor-Pharma relationship and the kickbacks they make for giving out scripts for various brands of drugs, that only treat symptoms and NOT illnesses, are the nutjobs. How you can even say some of the things you believe with a straight face is beyond me.

  128. @Eli: Documentation, please. Other than your blog.

  129. @Eli

    This is the case with most ANY medical condition. Your body has the equipment at its disposal to fight off any outside intrusion.

    Citation please. Let’s see the science that supports your claim. Anecdotes, unfortunately, don’t count.

    If people would stop being lazy, exercise and eat right, the need for vaccination would drop dramatically.

    Are you suggesting, then, that the germ theory of disease is wrong? What about those people whose immune systems are compromised (e.g., because they received an organ transplant to save their life or they have HIV/AIDS)? What about those whose immune systems are not yet fully developed (i.e., babies)? Your approach puts these people at risk for serious disease.

    While exercise and proper diet do go a long way toward making a person healthy, many bacteria and viruses really aren’t affected. They will still infect quite happily. In fact, there are some viruses that have worse effects in those who are healthy (e.g., certain flu strains).

    At any rate, show us science, not personal stories.

  130. @ Eli

    Best wishes to your father in dealing with his stage 4 terminal cancer.

    > My father cured himself of Stage 4 Terminal brain cancer in 3
    > months, rejected chemo, radiation, and all medications, changed
    > his diet and took supplements and food that specifically helps
    > with his condition. He is completely cancer free now, and his
    > brain cells are growing back.

    Google “post hoc ergo proper hoc”. In the unfortunate event that your father’s cancer comes out of remission, will you then blame his diet and supplements for allowing the cancer to come back?

    Some cancers spontaneously go into remission… with or without chemo, prayers, power crystals, diet, vitamins, homeopathy, alien intervention or virgin sacrifice.

    There is preliminary data to suggest that diet can affect both your odds of getting cancer and your survival rate (say, http://archinte.ama-assn.org/cgi/content/abstract/158/11/1181 for example), but the efficacy of this in comparison to chemo is not comparable.

  131. @Eli Not to be rude here, but what you are suggesting is dangerous. Yes, in some places there is a huge problem with over-prescribing medication for whatever reason. Not all countries though have these kickback programs that you speak of as one point.

    Now I live with a few conditions that severely compromises my immune system. I live with a condition that without rhyme or reason attacks all organs in my body.

    Thankfully, my team of medical doctors are very well versed in both natural things that will help with my immune system (that have been tested) and pharmacological remedies.

    Are you aware that there are some things that are “natural” and as a whole are safe but for some will cause their conditions to become worse? I cannot eat foods that contain Vitamin K. Eating those foods will kill me. Yet Vitamin K is an essential thing for most people. The list can go on, but I am afraid it will fall on blind eyes.

    There is such a thing as being too extreme on both the natural side of things and the pharma side of things.

    As others have said, proof please.

  132. Eli

    The problem with proving these things with substantial evidence, via academia, or other sources, is lack of sponsored research in these fields, While I have admitted that there a some things in nature that we need medical assistance with, Most things that occur commonly are completely reversible by natural means.

    I can provide sources of research performed outlining the effectiveness of supplements and diet vs. pharmaceuticals. But to give you a source that outlines ALL forms of ailment is nearly impossible. It is easy to find sources that depression/stress/anxiety can be easily remedied via use of St. Johns Wort, Passionflower extract, 5HTP, Iron and Vitamin B. You can find many research studies on the effectiveness of Echinacea, Vitamin-C, oregano oil, Flaxseed oil, and omega-3 fatty acids with Immune System boosting.(Which have cured many a early feeling of a cold or flu in me) There is research out there that shows the efficiency of natural medicine, but modern medicine makes those who even mention naturopathy, or alternative medicine, look like crackpots. But the fact remains that many people who have struggled with ailments and disease have found a solution that your average doctor would never recommend, because he doesn’t make money with natural. Especially with mental issues like stress, anxiety, and depression.

    Harrer. G, and Sommer.H., Treatment of Mild/Moderate Depressions With Hypericum, Phytomedicine, Vol. 1, 1994, pp 3 – 8.

    Dr. James Belanger has an interview here on the topic of naturopathic treatments of cancer

    http://stanford.wellsphere.com/patient-empowerment-article/dr-james-belanger-the-naturopathic-treatment-of-cancer/360170

    Curezone.org is an excellent resource for any and all ailments. Had it not been for this website, my father may be dead or debilitated.

    I’m not trying to tell you what you should do, because the decision is ultimately yours to make, and that decision is no business of mine. All I want to do here is make people aware that there ARE alternatives that work as well as vaccines that DO NOT. I’m not saying ALL vaccines are ineffective, but even the best of vaccines available, are Pharmaceuticals are not good for you. They are chemical and synthetic concoctions that do not cure disease. Symptoms can be alleviated and thus make for better quality of life. But the disease remains, and ultimately the side effects and the disease itself can still kill you. I have seen people diagnosed with minor depression and doctors said take this pill. and then when the pill stops working as well, the doctor says, hey its ok, we got this better pill and the cycle continues, then someone you know and love is a walking zombie for the rest of there latter years. But if the doctor would have recommended some natural options paired with mental exercise, diet and physical exercise the person could have been cured in the very beginning. But again, there’s money in pills not nature. And people don’t want to give up the easy lifestyle they have. They would rather take pills that mask the symptoms, continue eating daily McDonalds, and drinking nothing but soda, and stuff high in sugars, than work harder to cure the disease.

    In summary, I disagree. It should be NO ONE’s choice other than the parent to decide what’s right for his/her child. And any subsequent legislation requiring me to vaccinate my children is in violation with basic human rights.

  133. > The problem with proving these things with substantial evidence,
    > via academia, or other sources, is lack of sponsored research in
    > these fields

    (cough). Uh, horsefeathers.

    Why do you propose that this is the case? The National Center for Complementary and Alternative Medicine (which gets its money from the NIH, not from coporations) funded over 250 research centers last year (http://nccam.nih.gov/research/extramural/awards/2008/). The success rate for these studies was 15.8% (http://report.nih.gov/success_rates/index.aspx). Not unreasonable to fund, but less than half of the NIAAA’s success rate, (which is funded at the same rate) for example.

    On the other hand…

    Dietary supplements and vitamins, being unregulated in the United States and most other places, made up a whopping $68 billion dollar market worldwide (http://www.glgroup.com/News/Overview-of-the-Nutritional-Supplements-Market-20182.html). The *worldwide* market for vaccinations was $11.2 billion in 2006 and won’t hit $50 billion until 2013.

    So, pray tell, why is it that you are positing that “medical research is dominated by Big Pharma”? One would think that if Big Pharma was spending a ton of money on proper clinical trials (as they are required to do so by the FDA) to prove that their piddily little $11.2 billion dollar market’s products actually work, dietary supplement makers might be willing to spend a ton of money on proper clinical trials (to show that they are as effective as pharmaceuticals) to show that their $68 billion dollar market’s products actually work.

    And yet, they don’t. Obviously one reason is that they are not required to do so; they tack the “this claim has not been tested by the FDA” on the label and people buy it anyway.

    However, it’s disingenuous to claim that there is some massive conspiracy by Big Pharma and medical researchers to fund only FDA-approved drug studies and ignore natural remedies and alternative therapies.

    The money is there, for supplements and vitamins… the manufacturers choose not to perform the studies. It’s that simple.

  134. Cairnos

    First, the next time someone on this blog says that pro-vaxxers are either corporate shills or sheeple blindly following the dictattes of authority, someone should kindly point them to this thread.

    Do most people here believe childhood vaccination a good thing? Yes the vast majority

    Add one more question (should it be mandatory) and we all continue to follow the same line…..NOT.

    We’ve got for, we’ve got against, we’ve got different reasons for and against. So far it looks like the majority actually disagree with Phil, for wide and varied reasons.

    My personal favourite is the number of us ‘corporate shills’ who have expressed concerns that they wouldn’t want it mandatory because they don’t trust the companies THAT much :-)

    @ Eli
    “but even the best of vaccines available, are Pharmaceuticals are not good for you. They are chemical and synthetic concoctions that do not cure disease. Symptoms can be alleviated and thus make for better quality of life. But the disease remains, and ultimately the side effects and the disease itself can still kill you.”

    Um….thats….thats not even wrong. I can’t even begin….

  135. Yojimbo

    Um… it is unlikely Eli even knows what it means to be “not even wrong” Or that he would care if he did – he asks if people even read what he wrote but clearly doesn’t read what is written in response to him.

    Face it – you’re dealing with a human diode :)

  136. Charlie Young

    When the government is paying for your healthcare as in Canada, UK, France, etc., you might expect mandatory vaccination, obesity control, well checks, and other interventions necessary to improve the general health and welfare of the populace. As one early poster from BC stated, they have mandatory vax for public preschoolers and 1 hour mandatory exercise. The Soviet Union before the break up had the same situation.

  137. G Williams

    Legislation should not be used as an alternative to education. not only would this (as others here have already said) take away rights, but you can’t expect that parents who think these vaccines cause autism are going to quietly surrender and start vaccinating just because the nanny-state tells them to (or any other government for that matter).

    Using Legislation in place of education doesn’t actually change anything, even if you happen to keep most of these parents from keeping their children unvaccinated, the basic anti-scientific attitudes that led to that are still their, you may have vaccinated their children, but the next time a harmful public health myth comes along, they’ll just jump right on it without a second thought.

    If instead, you educate these parents, give them the rational, scientific basis and a basic understanding that they were wrong and why, then you have a population that will be more skeptical of later health scares and generally more resistant to anti-scientific bias.

  138. Diko

    I think those of you who think that we anti vaccine protectors are criminal, stupid or selfish should consider the recent ‘mistake’ made by Bayer early this year…or possible late last year.

    Bayer sent out a flu vaccine to a bunch of countries in Europe that was accidently contaminated with a ‘live’ bird flu. If it wasn’t picked up by some of the lads that recieved it we could be in real trouble.

    I dont think anyone can dispute the damage that could have caused.

    Another case like I mentioned earlier is the 1976 swine flue scare where they started a mass vaccination procedure that ended up killing 24 people while the flu only killed 1.

    Research these events in history and then ask yourself if we should just accept and let the drug companies pump us full of vaccines against our will.

  139. Diko

    Protectors should read Protestors and Bayer should read Baxter.

  140. @Diko

    Bayer sent out a flu vaccine to a bunch of countries in Europe that was accidently contaminated with a ‘live’ bird flu. If it wasn’t picked up by some of the lads that recieved it we could be in real trouble.

    Glad you corrected your post to say Baxter, not Bayer. However, you fail to mention that it appears that the materials that were sent out were for lab use only, not vaccines and not for use in humans. Second, the samples were sent to one of Baxter’s contractors which does lab work for them. There was no real danger, then, to anyone.

    Another case like I mentioned earlier is the 1976 swine flue scare where they started a mass vaccination procedure that ended up killing 24 people while the flu only killed 1.

    There were a number of issues that made the ’76 swine flu scare a poorly handled case. First, fears were still fresh from the recent, very deadly outbreaks of the 1918 and, IIRC, another outbreak in the 50s, in which the flu killed thousands. Second, the strain of flu that was discovered at Fort Dix had not been seen before, but was similar to the strain that caused the 1918 epidemic, which raised those fears even more. The government understandably wanted to act quickly to prevent a recurrence of those type of outbreaks and ordered vaccines to be produced post haste. Therefore, the government issued a mandatory vaccination program, which was welcomed heartily by the people, who also feared this flu. So, we have the government and general populace pushing hard for a vaccine. The company producing it went through proper protocols and testing and had the vaccine ready to go. A change was made to the formulation (I can’t recall at the moment the reason), but due to increasing pressure from both sides, the vaccine was distributed to market without further testing. Millions of doses were administered. After a short time, there were reports of a few elderly patients dying, and cases of Guillain Barre syndrome (GBS) started popping up, which were linked in the media to the vaccine. The vaccination program was halted. The elderly deaths were investigated and found not to be due to the vaccine. The cases of GBS totaled around 500, with approx. 25 of those dying. So, we have about 40 million doses administered, with ~500 GBS cases and ~25 deaths. That gives us a risk of GBS of 1.25/100,000 and a risk of death of .0625/100,000.

    Meanwhile, the flu strain had not yet been fully studied. After the news of the adverse reactions started coming in, it was discovered that the flu strain was not as virulent as first thought. So, there was an overreaction by both the government and the public.

    Your quoting the vaccine as killing 24 and the flu killing 1 is disingenuous, since you do not disclose how many people were actually infected with the flu, nor how many were not infected due to the vaccine.

    Was the 1976 incident poorly handled? Yes. Does it completely indict all vaccines or vaccination programs? No. The circumstances were rather unique and so it cannot serve as an analog to vaccines in general. Furthermore, the media and public at the time grossly distorted and exaggerated the problems.

    For more, here is a paper looking back at the 1976 issue: http://www.cdc.gov/ncidod/eid/vol12no01/05-1007.htm

    Stop using unique cases that have no bearing on vaccines in general. It is intellectually dishonest, at best, and dangerous propaganda at worst.

  141. I started to write a reply and it became the length of a blog post, so I turned it into a blog post:

    Compulsory Vaccinations

    Check it out.

  142. Diko

    Todd,

    It’s not propaganda, just a couple of cases that give me reason to be cautious. There are many more cases of adverse side effects regarding vaccines. And there’s too much money in pharmacuticals for me to have total trust in them.

    If you want to be injected with dead viruses and mercury then go ahead, I just don’t agree with compulsory vaccination. I actually don’t get it, if you get vaccinated, then why doe it matter if I don’t?

  143. Angelica

    The only reason I am against mandatory vaccinations enforced by the government can be summed up in one question: what next?

    By making getting a vaccine a law, you would be in an arena where precedence rules. So her is the scenario:

    1. Vaccines are compulsory (the gov’t cites public safety)
    2. Fast food restaurants closed (Pulic safety)—not happening in this century
    3. Mothers under the age of consent or not yet at their majority can’t keep their children (safety of mother and child)
    4. Parents that make below minimum wage can’t keep their children unless they earn better wages (safety of the children)
    5. etc…

    So, you see where I’m going with this.

    By the way, vaccinating every child in the world will not eradicate all infectious diseases.

    CIM

  144. Mark Hansen

    Diko, it’s very simple. If not enough people are vaccinated, that otherwise could be, then those that cannot be vaccinated because of compromised immune systems (i.e. transplant patients), those allergic to ingredients in the vaccine (eg. Eggs), and others such as those too young to be immunised are at risk from the diseases. Herd immunity works when enough of the herd is immunised. Herd immunity (a better name needed; group immunity? community immunity?) builds barriers to the diseases. The barrier will have gaps but not enough to let the diseases take hold. But if people such as yourself start opting out, the gaps increase, and problems arise.

    Incidentally, the mercury angle is as dead as a doornail. The only vaccine that has any Thimerosal in it is the flu vaccine.

  145. Diko

    I’m aware that mercury is only in the flu vaccine. Thats also the driving force behind this discussion. I don’t want any of it.

    The thing I find interesting is that kids that don’t receive all these vaccinations are often healthier than the rest of them. If you start paying attention to all of this it doesn’t take long before you hear about friends or family having an adverse reaction to a vaccine.

    Vaccine science isn’t 100%. They don’t know how safe they really are. Perhaps they are responsible for the increasing auto immune diseases and maybe even some cancers.

    I believe our immune systems are supposed to protect us from diseases. I also believe in staying healthy to support my immune system.

    I guess it all comes down to the individuals belief and we each have to respect each others belief. You can’t expect person A to do something that they believe is harmful to themselves to protect Person B. We live on a planet that involves risks and they can’t all be eliminated. And vaccines can’t eliminate all viruses. Nature finds away.

    You guys seem to have so much faith in the system regardless of the cases I mentioned and others such as polio caused by vaccine. Thats too many mistakes and negatives for me to blindly follow the herd.

  146. Mark Hansen

    Diko, of course you have figures or references to back up your statement about unvaccinated kids being healthier, don’t you?

  147. Diko

    No, just anecdotal.

  148. @Diko

    Okay, so we show that the mercury angle is dead. We show how the 1976 flu bit does not apply. So then you pull stories out of the air with no substantiation about unvaccinated kids being healthier. You shift the goalpost to suggest that vaccines cause autoimmune diseases and possibly cancer (again, with nothing to support such a claim), and then trot out the polio canard.

    Here’s the thing about the polio vaccine. There are two types: oral polio vaccine (OPV – live virus) and the IPV (dead virus). Only the OPV can lead to vaccine-induced polio and spread polio. Where it is used, it is 100% effective in granting immunity, and it can spread immunity to those who are not directly immunized. This is an important feature of the OPV in areas where polio is endemic and represents a serious health risk. Overall, the benefits in those situations outweigh the risks from the vaccine. In the U.S., the OPV is no longer used, since polio has been eradicated and the risks of the vaccine now outweigh any benefits from that. For that reason, the IPV is the only one used (since there are still cases of people going abroad and bringing polio back from areas where it as not be eliminated, we still need to keep immunization with IPV up to prevent the diseases getting a hold again). Currently, in Asia, the WHO recognizes the issues of using OPV and has expressed concern that as the wild type is eliminated, mutated virus-strain polio could pose a potential issue. Unfortunately, the trivalent IPV doesn’t seem to be as effective among that population as vaccines tailored to single polio strains.

    To sum up, the polio eradication program was very successful in the Western hemisphere (the Americas, Europe and parts of Asia), and polio is no longer a public health threat in those areas. Since polio has no other animal reservoirs, if it is eliminated in humans, it’s gone for good. It’s because of the success of the polio vaccines that you no longer need to worry about the disease.

    Another question for you: would you take any other medicines if you got ill? If you had a serious accident, would you take any medications to help control the pain? If you developed cardiovascular issues, would you take any meds to help regulate your heart? Or would you only take herbal supplements and vitamins? I ask these questions to find out if it is only vaccines you distrust, or all of the medical industry. If only vaccines, why? They’re made by the same people that make all kinds of other medicines and medical devices. And if only traditional medicines, why not herbal supplement manufacturers? They are not required to show that their products are effective, nor do they need to show that they are even safe to use!

  149. Diko

    I’m not big on most medications. I realize they have their place. I’ve helped people reduce their need for medication with some basic nutrition and lifestyle modifications. And most doctors clearly have very little idea of what those modifications should be.

    Maurice Hilleman discusses contaminated vaccines in this interview http://www.youtube.com/watch?v=edikv0zbAlU

    The polio thing is hype. I realize it’s been eradicated from the western world, but look at the trend lines of polio cases and you’ll clearly see it was down trending well before the vaccine came along. Maybe it was on it’s way out regardless.

    It’s the same as the fluoride prevents tooth decay argument, yet the countries with fluoride had the same decline as the countries with no fluoride. Fluoride may have helped it along, but you can’t say its all fluoride. Same with polio.

    I’m not sure how the 1976 flu doesn’t apply. They rushed a vaccine due to public demand….who do you think creates the public demand? The media, just like they’re doing now with the H1N1. Who controls the media?…..etc,etc. Then you say the vaccine didnt kill anyone, just gave 500 of the GBS which in turn killed 25. Same result, 25 dead people thanks to the vaccine for a flu that killed 1.

  150. > The polio thing is hype. I realize it’s been eradicated from the
    > western world, but look at the trend lines of polio cases and
    > you’ll clearly see it was down trending well before the
    > vaccine came along. Maybe it was on it’s way out regardless.

    This is the sort of off-the-cuff claim that *really* annoys people on this blog, sir. You need to provide some sort of evidence that this is true. You need to cite specific studies that talk about these trend lines, so that we can examine your evidence.

    See, the problem is that often times we see instances of people accepting other people’s analysis of evidence without rigor. Bob tells Alice, “I read a study that said that trend lines were already down prior to the vaccine!” Of course, what Bob is forgetting to tell Alice is that in the study Bob is talking about, those trend lines are discussed, analyzed, and evaluated, and the conclusion *of the study that Bob is citing* is that the trend lines were in fact going down, but that the casual factors can be attributed to other health interventions, and in any rate the marked change in rate upon the institution of the vaccination program is significantly statistically significant, and thus shows that the vaccinations are certainly working.

    But, Bob didn’t tell Alice that. Alice posts that on a message board. Alice has already demonstrated on the message board that she’s a likable gal, so the people that read Alice’s posting accept what Alice is saying without analysis… and then eventually those claims wind up here. It’s like the child’s game “telephone”.

    If you want us to accept your claim, you’re going to have to show that you have actually read the evidence yourself, and understood the whole scientific study. That means that you need to provide a citation. We’ll go look at the paper, and perhaps we’ll find something very interesting. Then we change our opinions.

    Without the evidence to analyze, though, your claims are worse than baseless; they’re obfuscatory.

  151. Angelica @ 144:

    No I don’t really see where you are going with your slippery slope fallacy. See my blog entry linked in post 142 for why.

    Long and the short – you have to show the mechanism by which one leads to the other, you can’t just claim it will happen.

  152. Diko

    I’m not sure if there are peer reviewed studies on the trends of polio and vaccine introduction.

    Watch this: http://www.youtube.com/watch?v=ukdUwgnbwWg and this http://www.youtube.com/watch?v=HH8s5aVxf3U&feature=related

    and read some of this: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/polio-508.pdf

    Then it’s up to the viewer to decide. Until people realize that power and money is the driving force behind our ‘health’ care they will never doubt the medical system.

  153. Is power and money also the driving force behind the socialised medical systems of Europe?

    Just wondering.

  154. Mark Hansen

    Interesting the way she reads that graph, Diko. Notice that Polio was also decreasing in 1946 (2:33 in the first clip). Why then did it come back? Dipped again in 1950, then spiked in 1952. I’m no medical expert but it seems to me that you have to look at the whole graph, rather than just the parts that suit your point of view.
    It’s a pity she doesn’t cite her sources for her other figures so that they can be checked out. But we can trust her because she hasn’t got any financial interest in this, such as peddling videos, has she?

  155. Diko

    So you assume that it would have jumped back up had the vaccine not been introduced. I see your point, but we will never know. If the graph is accurate in showing when the vaccine was actually introduced you can see it was declining to a 20 year low. I’ve seen another graph where it was showing the vaccine was introduced at the top of that 1952 spike. I would need to research this some more to be certain.

    Tenpenny usually cites sources for all her ‘facts’. I’ve watched the whole 3hrs and alot comes from the Merck manual.

  156. Sorry Diko, perhaps you missed my question in #154:

    Is power and money also the driving force behind the socialised medical systems of Europe?

  157. Diko

    Jimmy,

    Is it all free over there in Europe is it? The drug companies don’t make billions? The government regulate and control it all and they are in bed with the drug companies. I think we could have a good socialist system, but at the top, it’s all about money and power.

    Are you of the belief that that Big Pharma is all about the health of the people and would happily go bankrupt if it it meant curing the world of disease?

  158. @Diko

    From that CDC link you provided, I noticed the following text:

    In the immediate prevaccine era, improved sanitation allowed less frequent exposure and increased the age of primary infection. Boosting of immunity from natural exposure became more infrequent and the number of susceptible persons accumulated, ultimately resulting in the occurrence of epidemics, with 13,000 to 20,000 paralytic cases reported annually.

    In the early vaccine era, the incidence dramatically decreased after the introduction of inactivated polio vaccine (IPV) in 1955. The decline continued following oral polio vaccine (OPV) introduction in 1961. In 1960, a total of 2,525 paralytic cases were reported, compared with 61 in 1965.

    This would seem to show your argument about polio to be wrong.

    So you assume that it would have jumped back up had the vaccine not been introduced. I see your point, but we will never know.

    Yeah, we’ll never know for certain, but given the dramatic drop in cases following the vaccination program, it’s a pretty safe bet that the vaccine worked.

    I’m not sure how the 1976 flu doesn’t apply. They rushed a vaccine due to public demand…

    If you go back an read what I wrote, I said that it does not apply to vaccines in general. You cannot bring up the 1976 incident and then use that to say that all vaccines are bad. What happened was unique to that situation. If you noticed, I also mentioned how the media, whom you cite as a cause for media demand, also blew the adverse reactions out of proportion. They reported deaths due to the vaccine, but that later turned out to be false. They spread fear of the vaccine like wildfire. Again, I would urge you to read the article I linked to about the 1976 incident. It may clear up some misconceptions you have.

    Then you say the vaccine didnt kill anyone, just gave 500 of the GBS which in turn killed 25. Same result, 25 dead people thanks to the vaccine for a flu that killed 1.

    Like I said, the whole thing was poorly handled. I understand the fears that led to it. The people were scared. The government was scared. No one wanted a repeat of what happened in 1918. I understand the desire to rush ahead, though I am of the opinion that they should have waited for the lab results to come back before pushing ahead with the vaccination program. Same thing with the recent swine flu pandemic. This time, everyone was much more restrained and took the time to figure out if such measures would be needed. A few media outlets fueled some fears about the flu, but in general, things were kept a bit more calm (no thanks to Vice President Biden). It looks like this swine flu is not particularly virulent (most confirmed cases have been mild, IIRC), but I think getting a vaccine out for it in time for flu season is a wise course, as it seems likely that it will pop up again this fall and not be quite as nice.

  159. Diko, I speak as an Austrian here. From what I remember, child vaccinations are free here (or at least, practically free with only miniscule fees). Measles, Rubella, Polio and a host of other vaccines even with a vaccination rate of 90%+.
    Additionally, it is common here to vaccinate against tick-borne encephalitis (vaccination rates vary between 85-90% if I’m not mistaken) . We have to see ill effects yet in the four to five decades this program has existed so far.

    Adult vaccinations are a whole different story, and those cost, depending on the shot given.
    A simple TBE-shot costs 26 Euros, including adminstering it to the person; Other, rarer, shots can cost more (~52 Euro per dose for Hepatitis A/B, or ~150 for HPV).. but it’s totall worth it, in my eyes…

    Sometimes it’s hard to believe that people would gamble with lives like that. It seems that, much like wars, massive personal suffering is needed before people get it that it’s a good idea to remain peaceful/get vaccinated…

  160. Diko

    Mathias,

    Nothing is free, your taxes pay for your free vaccines. I say that just to stress the point that about big pharma is making billions regardless of weather we pay directly or not. And where there is big dollars there is always corruption. Thus, I have to be skeptical.

    You think it’s a gamble to not take the vaccines, but if you look at the statistics on hep b you will see the risk of cancer 10-30 years later is very, very low (somewhere around 1.25%). Most people don’t know they got it, many have some flu symptoms and get over it in a few days. And thats if you even contract it. Unless you’re a drug user, prostitute or homeless person you’re probably safe anyway. So the risk is nearly nothing.

    They you have the possibly risk of auto immunity due to the vaccine itself. See http://www.ncbi.nlm.nih.gov/pubmed/9115571

    It’s by no means proven, but needs to be considered. And thats just Hep B. HPV vaccine is early days still, but some claim it can cause seizures and even death…..(studies are needed).

    While I can’t be certain on the polio vaccine, I’m convinced that most vaccines (if not all) are unnecessary. The human immune system has been evolving for 4million years and only in the past few years have we been injecting virus’ into the blood stream. This is clearly not how nature designed our immune system. It seems that as we eliminate one risk another pops up. It’s like cholesterol, you can reduce it and heart disease reduces, but at the same time cancer increases – mortality stays the same.

    We are supposed to eat whole foods that arent contaminated with chemicals. We are supposed to sleep when it’s dark. We are supposed to do a moderate amount of exercise. We are supposed to have time out and relax. Instead we work 70 hours a week, eat the most processed sugar high diet of all time, watch TV to be given our opinions, exercise indoors on treadmills if anything at all and think that bacteria is our enemy.

    Personally I’d like to live a life free of medicine unless I need it. I’ll use some common sense to stay healthy and take my chances without vaccines until I can see that they are an improvement over our natural ability to fight disease.

  161. Diko

    Tom,

    I’m curious to know how Baxter or whoever will get a vaccine out for ‘yet to mutate’ H1N1? Meaning if they vaccinate for the current strain how will that help for the ‘not so nice’ version?

    And just how effective is the flu vaccine? I’ve read various numbers from 7% to 70% effective. It makes sense as my understanding is they pick the 3 most common viruses in Asia or Europe then bundle them together to make a rubbish vaccine that probably doesn’t work. So which strains does Europe and Asia choose?

    I don’t know how they get their 70% success rate. I have had the flu once in 32 years and I’ve never had a vaccine. If I get one this year, do they mark it as a success if I don’t get flu?

  162. @Diko

    The human immune system has been evolving for 4million years and only in the past few years have we been injecting virus’ into the blood stream.

    A few things about this statement. First, you seem to be forgetting to take into account that viruses also evolve and have been around longer than humans (and humans have been evolving for more than 4 million years, or less, depending on which species you’re looking at as “human”). We develop means of lasting through an infection, and the viruses and bacteria develop ways to get past those defenses to survive and multiply. Second, we do not inject viruses into the blood stream. Vaccines are administered either subcutaneously (under the skin) or intramuscularly (into the muscle). Then there are the few oral vaccines (like OPV, but that’s not used in the U.S. anymore).

    It seems that as we eliminate one risk another pops up.

    Well, that’s nature for you. With vaccines or without, it doesn’t matter. It is a constant arms race for survival.

    I’ll use some common sense to stay healthy and take my chances without vaccines until I can see that they are an improvement over our natural ability to fight disease.

    You seem to not understand how vaccines work, by this statement. Vaccines are an improvement because they grant immunity without the nasty effects of a full-blown infection. The immune response is the same; in other words, the virus/bacteria enters the body, the body produces a couple types of white blood cells (one to kill/destroy the invasive material, one to create “memories” of the shape of the antigen) and subsequent exposures are dealt with before the virus or bacteria can do any significant damage. The difference is that with wild-type infection, the body does not react quickly enough to stop the spread of the virus, because it’s busy trying to figure out how to fight it. Another bad aspect with WT infection is that some diseases cause the immune system to go a bit haywire and start attacking more than just the virus/bacteria. With vaccines, you don’t have that.

    There is a risk of adverse reaction to vaccines, but it is far lower than the risks of complications from the diseases being prevented. Take a look at some of the risk comparisons at the CDC web site: http://www.cdc.gov/vaccines/vac-gen/6mishome.htm#risk

    I’m curious to know how Baxter or whoever will get a vaccine out for ‘yet to mutate’ H1N1? Meaning if they vaccinate for the current strain how will that help for the ‘not so nice’ version?

    I’m assuming this was meant as a response to me, since there are no “Tom”s in the thread. What I meant was that there is a potential for the virus to mutate and become more virulent. That might happen, it might not. At any rate, a vaccine produced using this strain will likely prevent infection (since it’s the same strain, the body will still recognize it, even if it does mutate to a more potent form), and at worst, it will make a successful infection less aggressive (i.e., partial immunity). It’s similar to the varicella vaccine and its ability to lessen the effects of a shingles outbreak; it won’t give immunity, since the person already has the virus in their nerves, but it can lessen the severity when the virus reactivates.

    And just how effective is the flu vaccine? I’ve read various numbers from 7% to 70% effective. It makes sense as my understanding is they pick the 3 most common viruses in Asia or Europe then bundle them together to make a rubbish vaccine that probably doesn’t work. So which strains does Europe and Asia choose?

    The flu vaccine is pretty effective, depending on whether the analysis of potential dominant strains is correct or not. Each year, scientists need to look at what strains of flu are most likely to occur (I don’t know the specifics, as I’m not an immunologist or expert in infectious diseases) and pass that analysis on to the manufacturers. They pick the top 3-4 candidates and go from there. Sometimes they get it right, sometimes nature throws them a curve-ball and a different strain turns out to be the dominant one. That’s happened only once in the last several years, IIRC. If you get immunized, you have a pretty high (>90%) chance that you will not get infected with any of the strains in the vaccine.

    Part of the problem with whether the program is successful or not depends, however, on how many people get immunized. Flu immunization rates are not anywhere near as good as childhood immunizations, at least in the U.S., leading to lack of good herd immunity. Some pockets will have better rates, some will have lower rates. I will admit that I have my own irrational thoughts on this and have not gotten the flu vaccine before, because I just haven’t viewed the flu as a serious disease, even though it kills lots of people every year, and even though certain strains are significantly more dangerous for people with strong, healthy immune systems. I am going to start getting the flu shot, though. If not for myself, then for those around me. I have a friend who is a transplant recipient and has to take immunosuppressant drugs. I’d rather not become a carrier for an infection that could kill him.

    If I get one this year, do they mark it as a success if I don’t get flu?

    Your individual case doesn’t amount to much when figuring out the success of the vaccine. What they will look at is a population-level analysis. Were there major outbreaks? How many total infections were there? What was the severity? How many deaths?

    Remember, when people are immunized, there is a very high chance that they will not become a carrier when they’re exposed to the infectious agent. Think about how many people you come into contact with on a daily basis. The people in your family, your coworkers, people on the bus or train, people in a restaurant, market or store. If you become infected, you may very well be contagious before you show any symptoms. Every single person you come close to is a potential new host to spread the virus or bacteria, and each of them comes into contact with still more people.

    In closing, a question for you. If human immune systems have evolved so well, then why do diseases like measles have such high rates of serious permanent injury and even death? Please provide citations to support your reasons.

  163. Diko:

    Is it all free over there in Europe is it?

    Essentially, yes. The tax burden is actually very small, particularly when compared to the cost of health insurance in the USA. So, vacinations are, to all intents and purposes, free. That’s the founding principle of the NHS in the UK for instance – free at the point of need.

    The drug companies don’t make billions?

    I’m sure they do. But then so does the alternative and complementary medicine community. Does the amount of money a company makes automatically make them corrupt? Why aren’t you ranting against the alternative and complementary medicine community then?

    The government regulate and control it all and they are in bed with the drug companies.

    No they don’t. You fail. Perhaps you should go away and actually try to understand the systems in Europe before making such claims.

    I think we could have a good socialist system, but at the top, it’s all about money and power.

    Interesting that the NHS in the UK is chronically underfunded then, wouldn’t you say? Interesting that doctors in the UK are reluctant to prescribe medication if there are alternatives. You don’t have even the remotest idea how the health care systems work in Europe do you?

    Are you of the belief that that Big Pharma is all about the health of the people and would happily go bankrupt if it it meant curing the world of disease?

    Yeabuhwha? So let me get this straight. Big Pharma is pushing vaccines that prevent disease and that we don’t need, but Big Pharma wants there to be disease? You don’t think this a contradiction at all?

    Pat Cahalan:

    Your figures are wrong or misleading (not to mention made up), including the 90% coverage you cite from the CDC, check out my reply to you on my blog.

  164. @ Jimmy

    Sorry, your blog doesn’t allow copy and paste in the comments, and it’s just too much work to retype everything, so here’s the responses:

    > You say you get your figures from the CDC. Where at the CDC
    > – give us a link or citation.

    Technically, this is the AAFP citing the CDC, but here’s the link:

    http://www.aafp.org/online/en/home/publications/news/news-now/clinical-care-research/20090114kids-teens-vacc-rates.html

    FTA: “The study indicated that 90 percent or more of the children surveyed had received all vaccines in the 4:3:1:3:3:1 series except for the fourth dose of diphtheria-tetanus toxoid-acellular pertussis, or DTaP; the coverage rate for the full-four dose DTaP series reached 84.5 percent.

    In addition, coverage with one or more doses of varicella reached 90 percent for the first time in this age group.

    Overall, more than 77 percent of children received the full 4:3:1:3:3:1 series recommended by the CDC. The federal government’s Healthy People 2010 program has set a target goal of 90 percent vaccination rates for all vaccines in the 4:3:1:3:3:1 series.”

    So, yes, you’re correct, I was oversimplifying. Mea culpa -> again, I was using estimations to show the *cost effect*, *not* to provide a rigorous analysis of vaccination rates.

    > You really don’t want me to quote the adult figures if you
    > think the CDC says 90% coverage.

    I don’t think we’ve ever discussed making adult vaccinations mandatory on this thread (you’ll note, I explicitly never included them, and assumed outright we were talking about children). If you want to, I’ll gladly include that in my analysis, but then your functional audit process gets completely haywire: how do you propose we audit adult vaccination rates?

    > Nice attempt at an argument from authority. Also
    > meaningless. Do you want me to add my own? Or
    > would that have no bearing on whether or not the
    > figures which you made up are worth arguing over?

    > I am sure you would like to go a few rounds over
    > your figures but I am not going to – I am not going
    > to argue with someone who uses figures he made
    > up to prove his argument when they apparently
    > can’t even get the actual figures from the source
    > they claim to be citing correct.

    Okay, now I’m starting to lose my temper. An argument from authority is only a fallacy if in fact the authority claimed is claimed improperly. I stated baldly, several times over, that I *was* making up numbers… to illustrate the problem of *cost*, which nobody else on the thread was talking about… so claiming that making up numbers somehow is evidence that I’m not a credible authority is sort of disingenuous. If you want to put forth some sort of claim to expertise, go right ahead. Odds are pretty good that I’ll grant you expertise you *do* have ;)

    > Furthmore, your fictional figures are meaningless
    > without a comparison to the cost of not vaccinating,
    > which you don’t give. What figure would you put on
    > the human cost for instance?

    Yes, I didn’t include them. There is a reason for that. I’ll explain. Before I do, though, you make an error here in an otherwise completely fair question…

    A full cost/benefit analysis does indeed require the benefit to be included as part of the full analysis. The benefit in this case is *NOT* “not vaccinating”, because we’re not comparing “mandatory vaccinations costs and benefits” to “not vaccinating”. We’re comparing “mandatory vaccinations costs and benefits” to “voluntary vaccinations costs and benefits”, in the context of “what else might we want to spend this money on, since the money needs to come from somewhere”.

    What I have been talking about on this thread is effectiveness, as a function of cost and benefit. I’m not talking about the effectiveness of the *vaccine*, which I gladly accept as a damn good thing. I’m talking about the effectiveness of the process Phil is proposing.

    With any process, you have a goal. Your object is to reach that goal as cheaply as you can, so that you can maximize your available funds in reaching other goals. I see this time and again in American politics; people argue (both on the left and the right) that some goal is worthy in and of itself, and as a result spending money to achieve that goal is a worthwhile function of government. “We must secure our borders” means we have to spend billions of dollars on fencing that won’t stop illegal immigration. “We must have safe air travel” means that we spend billions of dollars on the TSA when most of the “added security” since 9/11 has been laughable (if you’re not willing to accept my off-the-cuff evaluation of that, go read Bruce Schneier’s blog, Arstechnica, SearchSecurity, EFF, ACLU, etc., etc.)

    Of course, that’s not the case here. We *know* vaccines work. However, here’s where (again, on the left and the right), people stop thinking rationally. “I know vaccines work, and I know that people ought to get them, ergo any method that encourages that is worthwhile” is plainly silly. It goes back to my earlier analogy – you can dig a ditch with explosives, 12 guys with shovels, or a backhoe. Which one is the right tool depends on dozens of other factors; where the ditch is, if the ground can support the backhoe, whether or not you have a qualified explosives expert, etc. etc.

    What I was attempting to do, in my off-the-back-of-the-envelope calculation (which again, *I never made any attempt to claim was accurate*), was show the sorts of costs that are attendant in this process you’re proposing, most of which people (in general, perhaps not in your particular case) don’t realize are included in what they’re proposing. Generally speaking (again, this not specifically addressed to you), people don’t understand big numbers. Their ability to address costs breaks down when you start talking about processes with lots of attended direct costs and lots of indirect costs when applied to large populations.

    What behavior are we trying to enforce?
    * (A full vaccination schedule? Partial?)

    Who decides what’s on the list?
    * (the CDC? How often to they revisit the list?)

    Who are we covering?
    * (Just schoolage children? Infants? Adults?)

    How many of them are already doing what we want anyway?
    * (In which coverage windows?)

    How do you propose that they prove their compliance?
    * (Required to… enter public school? What about private schools? Daycare? Drive a car? Register to vote? What are your avenues for authorization?)

    How do you propose that we trust the authorization mechanism?
    * (Who can sign off? Doctors? EMTs? Nickle clinic workers? How do the people who *check* the authorization actually check it? Do they check a doctor’s signature against an authoritative database? Is there a physician ID number? Who has access to this information? How do you secure it? How do you ensure that FERPA, HIPAA, and other privacy regulations (in the case of the U.S.) are followed and enforced?)

    How do you have a reasonable audit?
    * (You must assume that in the above there are going to be people who attempt to circumvent the process. Your audit design must therefore incorporate every weak part in the chain to a suitable degree, and in the above there are thousands of venues. How do you make sure that doctor’s are legitimately signing the forms? How do you make sure that school clerks who don’t believe in vaccination aren’t just rubber-stamping forms out of a sense of political freedom? How do you prevent fraud? How do you prevent forgery?)

    How do you enforce the audit?
    * (What is your penalty system when people circumvent the process? Do doctors lose their license? Do you expel children, so they’re now uneducated and unvaccinated? Do you revoke driver’s licenses, so drivers now can’t get insurance? Revoke licenses for professionals?)

    NONE of that includes all of the indirect costs. Running the campaign to get the measure on the ballot. Advertising to get the law passed. Surviving court challenges by religious objectors. Lost time to parents to get paperwork. Lost time in classes when kids forget their paperwork (they will, just ask your local 3rd grade teacher). I could go on.

    When you look at what I describe above, and you think about the implications in the context of the illustrative post I gave earlier, you get an idea of the complexity involved. The fact that I made up the numbers in the estimate above isn’t the point (which is why I took pains to point out that I was making them up); I wasn’t attempting to actually work up a budget for this sort of thing, I was trying to illustrate to those people who assume that “it won’t cost all that much” that they’re probably acting off of *way* too many assumptions.

    BUT… to return to your fair point, let us examine the cost of *not requiring mandatory vaccinations*, which is what we’re actually comparing in our cost/benefit analysis.

    Let us assume that the process you’re advocating (mandatory vaccinations, required by law, for every person regardless of age without a medically approved reason for not vaccinating) is $1 per person. If you don’t like that assumed number (I assume that it is ridiculously, absurdly low, but if you’d like to use a different number hit me with it). Let us assume that we’re talking about the United States, in 2009, with a population of 306 million. That means that you’re talking about spending $306 million dollars to enforce mandatory vaccinations.

    Okay, now we have how many deaths directly attributable to those preventable diseases this year? I’m not going to bother to look them up, but I’ll say 1,000. Hell, let’s say it’s 100,000, for that matter. Let’s assume that your process is 100% effective, and the increase in vaccinations completely eliminates these deaths (and also the disfigurements, lost time wages, business closures due to pandemic fears, whathaveyou).

    So we’re spending $306 million dollars on that. That doesn’t seem like a lot to save 100,000 lives. Sure, anybody would be on board with that, right?

    The National Cancer Institute awarded $660 million dollars in grants to study cancer in 2007 (http://report.nih.gov/success_rates/index.aspx). Cancer is the number two cause of death after cardiovascular disease, and it kills about a half-million people a year (http://www.reuters.com/article/newsOne/idUSN1926392720080220). That $660 million dollars had a 21% success rate (according to the NIH’s success criteria, with which I’m not familiar). While you don’t have pandemic fears with cancer, I will state that I think it’s reasonable (given the actual, real frequency of cancer deaths to communicable disease deaths in the U.S.) to guess that the attendant indirect costs (lost wages, business closures, etc.) are comparable.

    Even if they’re not… why do you not think it would be a better idea to take this $306 million dollars and give it to the NCI? Or the American Heart Institute? Or even give the $306 million dollars to drug companies to develop newer vaccines for diseases we don’t currently have covered? Any one of those things seems more worthwhile, to me.

    Again, from a security standpoint, spending money on audit is effectively wasted money. You’re spending money to make sure that something happens. You’re never going to be able to counter a new threat with money that you spent on audit. You’re never going to be able to make something new with money that you spend on audit. Whenever you’re auditing something that people are likely to do anyway, you’re probably doing something extremely wasteful.

    Now you may say, “Why don’t we do both?” Okay, I’ll grant you that is a question in and of itself, but given the fact that every governmental body that I know of is currently *cutting* expenditures (with the exception of bailout monies), I’m going to say that I don’t think it’s credible to assume that we can do that without cutting something else. If you want to cut something else, you’ll have to explain to me what you want to cut, how you think it is feasible to propose that you’ll be able to cut that thing politically, and so forth.

  165. Mark Hansen

    Diko, please take a look at Boiron’s (a homeopathic company) website. Dig around a little and see what they estimate France’s spending on homeopathic products to be. It might make you rethink your “Big Pharma™ is only in it for the money” statement. It appears that Big Homeo™ likes the big bucks (or Euro’s in this case) too.

  166. @ Jimmy

    > Sorry, your blog doesn’t allow copy and paste in the
    > comments, and it’s just too much work to retype
    > everything, so here’s the responses:

    Sorry; the workaround is to use IE8 and not Firefox with NoScript enabled. Comment left over at your blog.

    Not sure why FF/NS doesn’t allow copy and paste on your blog when it does with other blogger blogs, it might be your theme. I could probably troubleshoot it, but I confess I’m already spending way too much time on this thread than I ought.

  167. Diko

    Jimmy,

    You take this personally I see. Like I’m attacking you personally. Interesting.

    I haven’t had enough time to learn every aspect of the medical system in every country, but I’m making decisions for myself based on my correct understanding. If you think government, pharmacuticals and every other multinational corporation have the best interests of the people in mind then I wish you all the best in your TV fantasy world. Even if they were out to eradicate all disease the current model doesn’t allow for it. It just wont happen with all the money involved. Look a little deeper if you can’t yet see the corruption.

    It’s much like the war on drugs, doesn’t work, never will. Only makes things worse.

    I’m not challenging the alternative medicine field because this was originally about compulsory vaccination.

    Todd,

    Not Tom, sorry about that. I don’t have time to fully respond. It’s nice you would put you’re own health at risk to protect your friend, but if its’ a shot in the dark flu vaccine then your efforts are worthless. And mercury isn’t good for you.:)

    I realize what vaccines are supposed to do in theory and they do work in many ways. But if autoimmunity or cancer or some other epidemic is a result then i’m not ready to get on board.

    Show me the study that vaccinated kids are healthier than vaccinated kids. As far as I know there isn’t one. Thats group one vaccinated, group two unvaccinated.

  168. @ Diko

    > Show me the study that vaccinated kids are healthier
    > than vaccinated kids.

    Please define what you mean by “healthier”. If someone’s going to go looking for a medical reference, we want to make sure they find evidence that you’ll accept. Otherwise we’ll go find some study and you’ll say, “I disagree with what they mean by ‘healthier’.”

    > If you think government, pharmacuticals and every other
    > multinational corporation have the best interests of the
    > people in mind then I wish you all the best in your TV
    > fantasy world.

    The converse of this is likewise fantasy. If you think government, pharmaceuticals, and every other multinational corporation are fully and completely driven by a massive conspiracy to milk everyone of every ounce of profit without regard to their health and well-being, you’re likely in need of professional therapy.

  169. G Williams

    @ Diko

    > Show me the study that vaccinated kids are healthier
    > than vaccinated kids.

    Don’t shift the burden of proof, you first brought up unvaccinated kids being healthier than vaccinated kids, it’s up to you to either prove your statement, modify it or retract it.

  170. Diko

    Pat,

    Not all, and not everyone within. Be we have more than one Monsanto out there. If you believe it’s all fine and everyone is good you are in need of some therapy yourself. And we only need to look at history to see what our governments are capable of. But thats right, we live in a democracy and we are in good hands with our elected government who has never once told a lie.

    G Williams

    I just stated what I’ve been told by parents of clients and friends (there aren’t too many of them) and it would be good to se a study.

    If you are trying to force vaccinations on the herd then show me that they are producing healthier kids. Otherwise, why bother.
    Lets assume polio and small pox has been controlled by vaccines. It’s quite possible that those vaccines have been legitimate. I guess what concerns me the most is the huge amount of vaccines for all the other childhood diseases. I’m of the belief that it puts a massive strain on their developing immunesystems thus causing more ear infections, etc.

    So maybe ‘healthier’ is less need for medical intervention. Maybe less days absent due to sickness. Do you have any clue what a healthy child is? They sure as hell don’t need the amount of antibiotics as most kids these days.

    Too me, this discussion is making me recheck my data and I’m learning more as I go. I dont claim to have all the answers, but I wont ever stop questioning these things.

    It’s been educational, thanks.

  171. @ Diko

    > If you believe it’s all fine and everyone is good you are in need
    > of some therapy yourself.

    I don’t believe that I said that, anywhere. That said, I know a *lot* of scientists and I have yet to meet one that wouldn’t sneer at a bureaucrat and tell him to go to hell if said bureaucrat showed up at the CDC or the NIH saying, “Senator Foo sent me and he’s getting a lot of money from Big Pharma so you need to adjust your science”. Sure, there are some… google the Bush Administration’s attack on science and you’ll hear plenty of horror stories, many of which are fairly well substantiated. On the other hand, try and find cases supporting your proposition that the CDC and the NIH are in the pocket of Big Pharma and you’re not going to find much. That in itself is pretty telling.

    See, it’s sort of hard to keep a conspiracy going when you have to involve lots of scientists. The ability to argue against the facts in your own field is something you have to *learn* after a decade of hard training in the opposite behavior. Sure it happens, but pretty irregularly.

    > And we only need to look at history to see what our governments
    > are capable of. But thats right, we live in a democracy and we
    > are in good hands with our elected government who has never
    > once told a lie.

    Sarcasm: your use is not compelling.

    I’m hardly so naive as to take political claims on face value (scoot over to my blog and search for the screeds I’ve written on warrantless wiretapping for evidence on that score).

    There is, however, a big difference between some members of the government covering up a toxic waste spill because a corporation lined a particular politico’s pocket and a completely separate science based organization that is loosely coupled to the political process rolling over and playing ball with someone’s political agenda in direct opposition to their training and calling.

  172. G Williams

    @ Diko

    >If you are trying to force vaccinations on the herd then show me that they are producing >healthier kids. Otherwise, why bother.

    That’s not how the burden of proof works, you’re the one challenging the staus quo and saying that practically the entire medical community is lying through their teeth about vaccinations, you’re the one who has to find the studies that prove your point.

    We could sit here all day tossing studies showing that vaccines are good for you and should be administered to children whenever possible, but if you’re just going to shoot them down as being produced by Big Pharma without producing any real evidence to back that claim up, then what’s the point?

  173. If a kid eats at McDonalds daily, gets sick early, and Health Care is the State’s business, then the State must take care of the sick person and pay lots of money. That money comes from you and I and the money is forcibly taken from us. So, if the State controls health, we shouldn’t allow kids to eat at McDonalds. And trust me, many liberals DO understand and like this !

    Oh yeah, I am against mandatory vaccines and I hate McDonalds. But my personal preferences should not be forced on others.

  174. @Diko

    It’s nice you would put you’re own health at risk to protect your friend, but if its’ a shot in the dark flu vaccine then your efforts are worthless. And mercury isn’t good for you.

    It’s not a shot in the dark. More like a shot in the late afternoon. Oh, and regarding mercury, assuming that your general statement applies to the amounts of ethylmercury found in the thimerosal in vaccines (provide some facts to support your claim), then it’s good that they have thimerosal-free versions available, though at a somewhat higher cost.

    Show me the study that vaccinated kids are healthier than vaccinated kids. As far as I know there isn’t one. Thats group one vaccinated, group two unvaccinated.

    Nope. You were the one to make the claim that vaccination = less healthy kids. The burden is on you to provide studies such as you request.

    Not all, and not everyone within. Be we have more than one Monsanto out there.

    While the overall governance of any given corporation can be prone to corruption, the actual nuts and bolts workers generally aren’t. Keep this in mind: the people that are running the clinical trials, looking for the endpoints to be measured, analyzing the data, and so on, they’re all regular people. They might need the drug they’re working on some day. Their family (husbands, wives, children, parents, grandparents, grandkids) might need those drugs. Their friends might need those drugs. They have a vested interest in ensuring that the data is accurate and clean, that the drug is safe (as compared to the risks of the drug and the risks of not using the drug) and that it has a meaningful effect. There may be some people involved in the process who get corrupted or let something slide when they shouldn’t, but when the hits the fan, their career is history. So, even if they don’t have the health of others in mind, it is still in their best interests to ensure that the product is a good one.

    That idea can be expanded to companies, too. It is in the company’s best interest to produce a product that works and that is safe (again, as compared to the risks). Companies can be ruined by just one bad product. Take a look at Vioxx. That fiasco very nearly caused Merck to go kaput. And if a product is bad, it will come out as independent investigators take a look at it once it’s on the market.

    I guess what concerns me the most is the huge amount of vaccines for all the other childhood diseases. I’m of the belief that it puts a massive strain on their developing immunesystems thus causing more ear infections, etc.

    Do you have any science to back up your belief that vaccines place a “massive strain” on their immune systems? Bear in mind that children are exposed to thousands, if not millions, of antigens and assaults on their immune systems every day. The amount of antigen in a vaccine is orders of magnitude less. The CDC addresses this concern in their vaccine misconceptions page (http://www.cdc.gov/vaccines/vac-gen/6mishome.htm#Givingachildmultiple)

    They sure as hell don’t need the amount of antibiotics as most kids these days.

    Just how much do kids today need? And how many is “most”? The only time antibiotics are needed is when a kid has a bacterial infection. If they have a cold, they do not need it, since colds are cause by viruses, which are not affected by antibiotics. Certainly parents (as well as some doctors) are partially to blame for the rampant use of antibiotics, demanding them for just about anything. At any rate, rather than make vague comments like this, please try to be specific and support what you are saying with valid evidence.

  175. Diko

    The problem is, no one is going to study healthy vs unhealthy kids as in isn’t in the best interest of the ones making the money. Someone has to fund it correct? So I have to go with anecdotal for now.

    Todd,

    The vioxx fiasco was intersting. I read a study 5 years before vioxx was pulled off the market showing it causes heart problems, or something of that nature. So to Merck, that was worth the risk. Bayer released HIV contaminated blood for thier clients and baxter released avian flu contaminated vaccines(why mix it with human flu in the first place). And thats just the recent cases, I’m sure I could dig up a bunch more.

    But it’s ok, because is the pharmaceutical industry.

  176. Diko:

    You take this personally I see. Like I’m attacking you personally. Interesting.

    Where, exactly, do I seem to be taking this personally? Where, exactly, do I seem to demonstrate or state that I think you are making a personal attack on me? You wouldn’t be trying to muddy the waters by suggesting you shouldn’t have to consider my arguments properly because they are simply unwarranted emotional reactions, would you?

    but I’m making decisions for myself based on my correct understanding.

    Your correct understanding of what? The problem is you don’t have a correct understanding of medical systems elsewhere – the Big Pharma conspiracy largely falls on its arse once you consider medical systems outside of the USA.

    If you think government, pharmacuticals and every other multinational corporation have the best interests of the people in mind then I wish you all the best in your TV fantasy world.

    Where did I say that was the case? You like attributing words to people don’t you, in particular if it means you can then attack that stance and not their actual stance. There is a name for that you know.

    Even if they were out to eradicate all disease the current model doesn’t allow for it. It just wont happen with all the money involved. Look a little deeper if you can’t yet see the corruption.

    Your claim, prove it.

    I’m not challenging the alternative medicine field because this was originally about compulsory vaccination.

    Talk about a half-arsed dodge. I’ll just take it as read that you aren’t actually going to address the substance of my points and ignore you from now on.

    Pat Cahalan:

    I’ve responded to the points you made on my blog over there – but will respond to the points you made here on here!

    With regards to figures – it appears that actually we have both been a little off the ball. Check out this link :

    Vaccination coverage amongst children in kindergarten

    In 75% of states coverage is at or above 95% for young children. The reason? Mandatory vaccination for children entering kindergarten. We’ve actually been arguing about the usefulness of something and whether it should happen when that something is already happening and working in at least one instance. Where we have a problem, and this is actually what the figures show, is that vaccination rates are often far too low for pre-kindergarten age children and teens. This is apparently where the work needs to be put in.

    As I point out over at my place, if you then remove non-medical exemptions (figures for which you can find here) then you will get pretty darn close to 100% coverage at kindergarten age in some states. You still have a significant problem before and after that though.

    how do you propose we audit adult vaccination rates?

    Actually I am undecided on whether or not we should ensure adult vaccination rates once childhood-teen vaccination is mandatory (and I am not entirely sure how I would propose auditing that) – I included that merely to highlight that you were oversimplifiying the vaccination coverage rates.

    An argument from authority is only a fallacy if in fact the authority claimed is claimed improperly.

    It was in response to a completely unwarranted and unnecessary reference to your career and degree, not to mention the pompous way it was phrased – why else did you throw that in if not to establish a degree of authority on the matter? I say “If we accept your inaccurate figures” and you respond with – “I’ve been a programmer for 15 years and have a degree in IS.” How does your career and degree make your argument about the cost/benefit of compulsory vaccination any more solid?

    If you want to put forth some sort of claim to expertise, go right ahead. Odds are pretty good that I’ll grant you expertise you *do* have

    Actually, my experience in this area is limited so I wouldn’t claim it, nor would I drop my irrelevant experience in just randomly in response to a non-related statement.

    The benefit in this case is *NOT* “not vaccinating”, because we’re not comparing “mandatory vaccinations costs and benefits” to “not vaccinating”. We’re comparing “mandatory vaccinations costs and benefits” to “voluntary vaccinations costs and benefits”,

    My point is that you do not include the cost of not vaccinating in the costs of “voluntary vaccinations costs and benefits” – so your costs analysis is woefully incomplete. The cost of not vaccinating has to be included since part of voluntary vaccinations is volunteering not to have them – and you do not include that cost. I am not comparing “mandatory vaccination” to “not vaccinating”. I am saying you are not fairly comparing “mandatory vaccination” to “voluntary vaccination”.

    I’m talking about the effectiveness of the process Phil is proposing.

    A process that is already largely in place and can be adapted – and yes I understand it would cost, and no I don’t have a proposal for an audit mechanism. Yes I do understand it may be both costly and difficult – that is not an excuse.

    I am also not advocating that we blindly rush into it – my point is that if we see the benefit at kindergarten age then we should not simply ignore that because extending the program will be difficult and expensive.

    You raise plenty of significant issues in regards to auditing the system and I don’t have answers for you because this is not my area of expertise – but the fact that there is a system in place that works also suggests that a process has been found and that there are answers to your questions. What they are, I don’t know. How much it would cost to expand it to cover pre and post kindergarten age I do not know.

    To answer a few that I can:

    It would be enforcing the full vaccination schedule; the CDC would revisit the schedule at least once every two years (unless new and more effective vaccines are released in the interim); we’re covering newborn infants to 19 year olds (high school graduates) – I am undecided on adults; pre and post kindergarten ages have poor vaccination coverage compared to the desired level >95% and so do some vaccines in adults; vaccination should be required to enter daycare, public and private school and university/college (home schoolers I confess to not having an immediate answer for) and actually requiring vaccination to register to vote is a good one if you ask me; I would require doctors or nurse practitioners for the sign off; doctors/nurse practitioners would lose their license/position if knowingly signing off on vaccinations that had not happened; children would either have to be taught seperately or graduation could be witheld until they can prove vaccination levels; depending on the professional it may be necessary to revoke their license; no non-medical exemptions.

    As to the questions I missed out – I don’t want that to be taken as an admission that they are an insurmountable obstacle, just that I don’t think I have the expertise or knowledge to propose a satisfactory answer.

    I could go on.

    I don’t doubt it – but then I never said that it would be easy or cheap.

    Okay, now we have how many deaths directly attributable to those preventable diseases this year?

    Bear in mind that this may be the case now (whatever figures you choose), but that the number of people choosing philosophical exemptions is growing, 2008 saw double the number of cases of measles than the average level for 2000-2007 (131 compared to 63). The potential is there for the number of unvaccinated to grow and for the number of deaths to therefore increase. Part of my reasoning for making vaccines mandatory is that people are starting to choose not to because of their ignorance, and that number is increasing (see this report).

    While you don’t have pandemic fears with cancer, I will state that I think it’s reasonable (given the actual, real frequency of cancer deaths to communicable disease deaths in the U.S.) to guess that the attendant indirect costs (lost wages, business closures, etc.) are comparable.

    Actually I don’t grant this as being reasonable at all – cancer is not an infectious disease – people are afraid of cancer but not because they think they can catch it by being in a public place. Cancer is a terrible analogy to use here. People do not stay at home because of fear of catching cancer. Stock Markets do not close because people are afraid of catching cancer. International travel is not suspended because people are afraid of catching cancer. Health care facilities are not overwhelmed by people who think they have cancer because they suddenly have one or two symptoms that could be associated with cancer. Businesses are not closed because people are afraid of catching cancer. Cities are not shut down because people are afraid of catching cancer. Cancer does not spread amongst unvaccinated populations. Cancer cannot be prevented by herd immunity. With respect, cancer does not even come close to resembling the costs of an infectious disease pandemic – very poor choice of comparison.

    Even if they’re not… why do you not think it would be a better idea to take this $306 million dollars and give it to the NCI? Or the American Heart Institute? Or even give the $306 million dollars to drug companies to develop newer vaccines for diseases we don’t currently have covered? Any one of those things seems more worthwhile, to me.

    Healthcare is not a case of fighting one battle at a time, you have to invest in all avenues. And to reverse the question – Why do you think giving money to organisations that already recieve funding is better than giving money to an effort to prevent potentially lethal pandemics? Incidentally, vaccinating against measles, as one example, costs less than $1 according to the Measles Initiative.

    Whenever you’re auditing something that people are likely to do anyway, you’re probably doing something extremely wasteful.

    But people are becoming less likely to vaccinate – exemptions are growing and this is only likely to get worse as the anti-vaccine movement becomes more vocal and celebrity filled. On top of this – people are only likely to do it because it is already mandatory for kindergarten entrants. As the CDC report suggests – where philosophical exemption is allowed the number of unvaccinated children is increasing. Look at figures from Europe to see how quickly disease returns and can become endemic from small drops in vaccination rates. Even herd immunity is not a concrete guarantee of protection for the unvaccinated.

    People are only likely to vaccinate now because it is mandatory – when it isn’t (pre-kindergarten, post kindergarten) vaccination rates clearly drop to well below herd immunity levels (remember, we are talking down to 50% in some cases), and what of home schooling and private schooling where vaccination may not be mandatory?

    Look at what figures are presented by the CDC – vaccination is 95% or less where it is mandatory for kindergarten entrance. Whilst 44 states included private schools in their figures, only 6 included home schooled children for the 2006-2007 figures. Are the home schooled likely to be vaccinated if it is not mandatory? Again, the figures for pre and post kindergarten suggest no. Note that this report also says:

    State laws requiring proof of vaccination at early school entry are key to the U.S. vaccination program and help ensure that no child is unvaccinated. The effectiveness of these laws depends on school nurses, teachers, health department staff members, and others identifying children whose vaccinations are not up to date.

    I’m going to say that I don’t think it’s credible to assume that we can do that without cutting something else.

    I didn’t say we had to do it right now or that reforms wouldn’t be needed first. In fact, I had assumed that would be the case and didn’t need stating. My mistake. This could not be an overnight solution, it would take time and money. Conditions are not perfect for it now.

    I still do not see a compelling reason for not doing it.

  177. @ Jimmy

    Most of what you posit here we’re talking about multiple elsewheres, and I get the feeling the longer this discussion goes on the closer we’re getting to agreement so the delta is becoming less significant compared to the magnitude of verbiage :)

    Aside from what I’ve left elsewhere, just two points on your last:

    > Actually I don’t grant this as being reasonable at all – cancer
    > is not an infectious disease

    All of your following points in that paragraph are true. However, what I’m saying is that the half-million deaths due to cancer yearly in the United States, with their business closures (the owner dies), lost time, care costs, etc. is comparable to the costs you mention *given the actual number of vaccine-preventable deaths/illnesses per year* (I can’t find a precise figure, but http://www.drugs.com/news/vaccine-preventable-deaths-reach-new-low-u-s-10011.html seems to indicate that the number is really small; the best note I’ve found is that about 600 people die from the flu every year, and that’s more than the rest combined. Maybe a couple of thousand, overall. All of those pandemic fears you’re talking about (business closure costs, other economic activities halted, etc.) are truly risks, but given the vast infrequency of them (at least the ones attributable to vaccine-preventable diseases!) I think the associated costs from cancer on a yearly average, compared for the last thirty years, is likely to skew well in the favor of cancer having a much higher cost aspect than communicable diseases.

    > But people are becoming less likely to vaccinate –
    > exemptions are growing and this is only likely to get
    > worse as the anti-vaccine movement becomes
    > more vocal and celebrity filled.

    I don’t think there’s sufficient evidence to support this hypothesis (yet), but you have a point, this is a serious danger. Yes, the rate of voluntary opting-out has increased, but until… what, six months ago… the anti-anti-vax movement was largely nascent.

    That is to say, hysterical anti-vaxxers gained ground among those that are swayed by their arguments, but it is not until recently that there has been a real attempt by people (like Phil, Orac, Amanda Peet, etc.) to counter the woo. Before we go around inflaming the woo folk by trying to impose “evil guvmnit forcing us to take vax!” (which might actually work out the opposite that either of us want), I propose we try information warfare :)

  178. Diko

    Jimmy,

    I felt you were in this on a personal level based on your comments. Perhaps I was wrong. I’m not trying to avoid or muddy or play another games. Sometimes I jump on here with 5minutes before work and say what I can.

    As far as Big Alternative companies making billions and telling lies, etc I dont know. They just dont get as much attention as the Big Pharma co’s. I’m no more a fan of going to the naturapath for herbs, potions, etc to fix me, than I am of going to the doctor for a pill fix. Alot of the supplemsnts are a waste of money as far as I can tell. Ther are a few good ones, but I’m more about food and lifestyle than anythjing else. There are also a few must have drugs out there also, but it’s the going to the doctor for the quick fix that is destroying our health.

    There is no way I could prove that Pharma’s would not go out of business for the sake of health. We would have to eliminate all disease first…which will never happen if they keep on treating the symptoms. Being truly ethical is almost impossible in business.

    I think if our health was all that mattered Eli Lilly wouldnt have re badged Prosac and called it Sarafem to treat a disease that probably doesn’t even exist. That is Premenstrual Dysphoric Disorder.

    But back to the vaccines:
    The FDA approved the anthrax vaccine that may have been the cause of Gulf War Syndrome. http://www.curehunter.com/public/pubmed10640454.do

    This is probably just another rare mistake.

  179. Mark Hansen

    @Diko
    “…As far as Big Alternative companies making billions and telling lies, etc I dont know…”
    I did suggest looking at Boiron’s website. http://www.boiron.com. On the left hand side of the page, click on “Economic reality of homeopathy”. It’s their own figures so they can’t accuse anyone of lying about what they earn (unless they’re lying about what they earn).

  180. @Diko

    The vioxx fiasco was intersting. I read a study 5 years before vioxx was pulled off the market showing it causes heart problems, or something of that nature. So to Merck, that was worth the risk.

    Vioxx was an interesting case, because before marketing, Merck truly was not aware of the risk of arrhythmias. From what I understand, an investigator at one site failed to report it. How Merck handled it afterward was an abysmal failure of marketing and management strategy, almost as if they were in denial because pre-market studies didn’t show it. They ended up having to go back and open up all of the studies that were done, reexamine the data extraordinarily carefully to look for hints that may have suggested the problem and then respond accordingly. I will say that Vioxx has its uses, and that the labeling should have been changed, rather than pulling it from market altogether. Let me explain before anyone goes off. Vioxx was very effective at relieving pain. Used short-term, it did not elevate the risk of cardiovascular problems. Those only arose with chronic, daily use over an extended period. So, for situations where people suffered from flares of intense, acute pain, it was a good drug.

    Bayer released HIV contaminated blood for thier clients

    Yes, at a time before accurate screening measures even existed and before much was really known about HIV. Stop regurgitating what you read on anti-vax sites. At best, they leave out pertinent information or distort the truth. At worst, they make stuff up and lie. I will grant, however, that Bayer did act irresponsibly, by buying blood plasma from high-risk groups and failing to follow regulations to test for viral hepatitis. Had they done that, the likely level of contamination would have been lower, but the risk of HIV-contaminated blood products still would have been present. Bayer was justifiably sued for damages. (http://en.wikipedia.org/wiki/Contaminated_haemophilia_blood_products)

    baxter released avian flu contaminated vaccines(why mix it with human flu in the first place).

    From what I’ve read thus far, investigation has revealed that a) it was not a vaccine that was contaminated, b) that the material was intended for lab use, not human use, c) that it was a Baxter-contracted lab, not a resaler or distributor that discovered the issue and d) that it was an accident, which has prompted looking at their quality control protocols. (http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aTo3LbhcA75I)

    But it’s ok, because is the pharmaceutical industry.

    No. When pharmaceutical companies do something wrong, they should be held accountable for it. However, to take one thing that they do wrong and use that to condemn everything the company does, let alone the entire industry, is poor thinking. It would be like saying that because Pontiac made a car that had issues with engine fires (Fiero) in the 1984 models with 2.5L engines, therefore every car Pontiac makes is bad, and not only that, but all auto manufacturers are corrupt and don’t care at all about the safety of their consumers; they’re just in it for the money. It’s an absurd premise.

    It would be different if the companies in question consistently made the same mistakes and regularly flaunted the law. Then that company should be shut down, and that does happen. If a company regularly fails to meet regulation, FDA will order them to close shop. The points that you brought up, though serious, are isolated incidents that were resolved with corrective action and subsequent scrutiny. Bear in mind, that when a company messes up, even a a reputable, FDA takes notice and takes a closer look at them.

    The problem is, no one is going to study healthy vs unhealthy kids as in isn’t in the best interest of the ones making the money. Someone has to fund it correct?

    Funding does not come solely from companies. In fact, except for clinical trials, very little money comes from industry, compared to other sources of funding. Lots of research is funded by the National Institutes of Health. There are also private foundations that provide money for research. In fact, the NIH grants would be the perfect source to fund trials like you want, comparing “health” between vaccinated and unvaccinated kids, since NIH-funded research must contribute to the public at large. Your protestations that “no one is going to study healthy vs. unhealthy kids, as in isn’t in the best interest of the ones making the money” is a hollow argument with no basis in fact. All you are left with, then, is your faith (belief without [or even despite] evidence) that “vaccines are just bad”.

  181. @Diko (180)

    which will never happen if they keep on treating the symptoms.

    There are many disease for which we know the causes and are working at treating the cause, not the symptoms. Cancer is a big one, there.

    The FDA approved the anthrax vaccine that may have been the cause of Gulf War Syndrome.

    The theory is that the anthrax vaccines contained squalene, which appears to have been an experimental adjuvant, and that the squalene caused GWS. The study that raised the question is from 2002 (http://www.ncbi.nlm.nih.gov/pubmed/12127050). Subsequent studies would seem to rule out squalene as a cause of GWS:

    * http://www.ncbi.nlm.nih.gov/pubmed/16762524 (“Enhancement of an analytical method for the determination of squalene in anthrax vaccine adsorbed formulations.”)
    * http://www.ncbi.nlm.nih.gov/pubmed/19379786 (“Antibodies to squalene in US Navy Persian Gulf War veterans with chronic multisymptom illness.”)
    * http://www.ncbi.nlm.nih.gov/pubmed/15087221 (“Detection of antibodies to squalene: III. Naturally occurring antibodies to squalene in humans and mice.”)

    It would appear that the anthrax vaccine, therefore, is not the culprit.

    I have personal reservations about how military personnel are treated, when it comes to medical products, but that is a whole ethical debate for another time.

  182. Pat:

    Most of what you posit here we’re talking about multiple elsewheres, and I get the feeling the longer this discussion goes on the closer we’re getting to agreement so the delta is becoming less significant compared to the magnitude of verbiag

    Agreed – I at the very least have a far better understanding of the expense and difficulty of what I would like to happen than before speaking to you.

    I think the associated costs from cancer on a yearly average, compared for the last thirty years, is likely to skew well in the favor of cancer having a much higher cost aspect than communicable diseases.

    I would tend to agree, my point was that since cancer research is already being funded though perhaps there is more gain to funding other health programs. I’d also ask (and I honestly don’t know the answer) – how does the amount of money going into research contribute to progress, does research progress increase directly in line with the money coming in, or does progress need increasingly more money the further along it gets (in the same way that it takes more energy to get from 450mph to 500mph than from 50mph to 100mph) – so you’re spending a lot more to only get a little further.

    Which upon reflection, is your argument for compulsory vaccinations. Good point.

    I don’t think there’s sufficient evidence to support this hypothesis (yet), but you have a point, this is a serious danger.

    Here I disagree with there not being enough evidence – check MMR uptake rates in the UK since Wakefield’s “research” was published. Vaccination rates have dropped (in somce cases not even significantly) in the UK and measles is now considered endemic, as one example. Some of the research from the CDC that I linked above also shows that measles is returning in the US, and primarily in the states which allow philosophical objections to vaccination. Add that to the figures which show that in age groups where vaccination is not mandatory vaccination levels can drop as low as almost 50%, and I think the evidence is convincing that the anti-vax movement coupled with laziness, ignorance and cost are driving down vaccinations levels where there is no level of compulsion.

    I propose we try information warfare

    Absolutely agreed – and if we could see evidence of this actually working then I would probably have to concede the point that mandatory vaccination at all ages would be too expensive to implement for its level of success. Unfortunately, you seem far more optimistic than I about the effect this could have!

  183. @Diko:

    “Nothing is free, your taxes pay for your free vaccines. I say that just to stress the point that about big pharma is making billions regardless of weather we pay directly or not. And where there is big dollars there is always corruption. Thus, I have to be skeptical.”

    Of course companies are out to make a profit. But to declare them to be the ultimate evil and enemy of mankind just because they intend to earn money isn’t the way to go either.
    Yes the money comes out of the taxpayers pocket, but what’s the big deal? It’s a service to the general populace, much like the health care system in place here which offers standard and neccessary treatments free of charge – at most there’s a co-pay which is usually not terribly high.
    A healthy population is in the best interest of the State – a healthy population works, a healthy population pays taxes which keeps the state going. Plus, I think I’ve read studies (they’re in German though, so probably not terribly useful to you) where the cost of preventative measures (vaccinations, regular examinations of healthy people) was compared to the costs incurred by sick people onto the health system – and if I’m not mistaken the study which compared vaccination costs vs. an epidemic that could have been prevented, the vaccinations were at least an order of a magnitude cheaper than riding out the epidemic..

    “You think it’s a gamble to not take the vaccines, but if you look at the statistics on hep b you will see the risk of cancer 10-30 years later is very, very low (somewhere around 1.25%). Most people don’t know they got it, many have some flu symptoms and get over it in a few days. And thats if you even contract it. Unless you’re a drug user, prostitute or homeless person you’re probably safe anyway. So the risk is nearly nothing.”

    Technically you’re right, that the contraction rate is not all that high – if you’re staying in your general area. I’m assuming, you’re from the continental United States here – and there, much like here in Central Europe, it’s not terribly common, though not unheard of. But then there are more areas on this planet than just the ConUS or Central Europe. A Hepatitis vaccination may be prudent though, if one -like me – visits India, South East Asia or Africa, where our ‘western’ hygiene standards are not as common. And all the while you might luck out and contract it with no ill effects, you still act as a carrier when you return, and can infect others who might not be so lucky. So I’m getting this (or rather: got this by now) to protect others, if not myself.

  184. @Mathias R.

    Plus, I think I’ve read studies (they’re in German though, so probably not terribly useful to you) where the cost of preventative measures (vaccinations, regular examinations of healthy people) was compared to the costs incurred by sick people onto the health system – and if I’m not mistaken the study which compared vaccination costs vs. an epidemic that could have been prevented, the vaccinations were at least an order of a magnitude cheaper than riding out the epidemic.

    Perhaps you are thinking of the WHO study that looked at the health costs of a measles outbreak in Duisburg, Germany in 2006: http://www.who.int/bulletin/volumes/87/2/07-050187/en/index.html

  185. Todd W., I’m not sure. I think it was issued by the Austrian department of health. It’s been a while since I had my hands on the specific study though, might’ve been this one after all.
    Cheers for the link, Todd W. :)

  186. Diko

    Todd,

    I’m not sure what you mean about merck not knowing about Vioxx before marketing, but this site reported the dangers in 1999 http://articles.mercola.com/sites/articles/archive/2008/01/02/painkiller.aspx
    It’s been reposted last year, but if you look around the site you will find other references around year 2000 and 2002.

    Mathias,

    My understanding of Hep B, was if I contract it, my body makes antibodies and I have immunity. This is in most cases. Am I then able to infect others? I guess my girlfriend is the only one at risk, so whats the real risk to both of us? So I weigh that up with the possibility of getting an auto immune disease as a result of the vaccine. It’s not proven, so do I wait for them to prove it(or otherwise) causes autoimmunity or go with my gut?

    I traveled in SE Asia for 4 months a few years ago and I plan on going to India very soon. All free of vaccines. I guess I’ll have to avoid the hookers and needles.

    Now I’ll have a look into the other vaccines recommended for travel to India and weigh it up.

  187. Diko, your body will generate antibodies if you’re infected, yes. But that takes time. Vaccinating gives the body a shooting range which provides you immunity withouth you being a carrier.

    In case of Hepatitis B, IIRC, you’re usually virulent for 1-6 months. So it’s (technically) not only your girlfriend who’s at risk, but pretty much every other human that you encounter in that timespan as well.

    Regarding your concern for autoimmune diseases.. where does that come from? Just curious, because in Austria I have yet to notice a significant rise in the number of autoimmune diseases.. and considering the vaccination programs started in the 50’s and 60’s, a lot of people born in that area are now of an age where breakout of such would be likely. Plus, you’d think I’d have come down with one as well, considering the number of shots I have received so far (especially considering that I got a TBE-shot every 4-5 years). The only thing ‘wrong’ with me is a case of Aspergers syndrome.. which runs on the paternal line of my family since a couple of generations, which is highly indicative of a genetic cause rather than a vaccinated one. ;) And I for one like the unique perspective this gives me upon this world. :D

  188. Diko

    Mathias

    http://rheumatology.oxfordjournals.org/cgi/content/abstract/38/10/978

    There are other studies out there, and there are studies showing that the vaccine is safe.

  189. @Diko

    The article your cite stated that the results were inconclusive and that more study would be necessary. Quite apart from that, it used a very small sample size (not enough power for statistical significance) and had no controls to compare against.

    In short, it does nothing to support a criticism of vaccines.

    As to transmitting Hep B, it’s not just transmitted through sexual contact. It can also be transmitted via blood (open cuts, transfusion, sharing needles, etc.) as well as other bodily fluids. Infants can also be infected by their mothers through breast milk. Hep B is not as easily transmitted as something like measles, but it can still affect people other than your girlfriend if you become infected.

  190. Sally

    Roald Dahl link is broken. Fix plz?

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