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I do not understand the downvotes here,especially with no argumentation. It only illustrates my opinion: people have too extreme opinion on the subject. I maintain that being unconditionally pro or anti vaccines is a bad approach.


You have made an implication, without basis, that the immunization policies in the US are "unconditionally pro", or at least that the people here are "unconditionally pro."

This is not the case. Read any of the CDC, NIH, or WHO history of vaccinations and you'll see the reasons for the decisions. You'll see the numbers of how much it costs to vaccinate, how much it costs to treat, the likelihood of disease, the likelihood of death, and the effect of side-effects. You'll see research to reduce those side-effects, like improved treatment methods for those with egg allergies.

You'll see treatment policies change over time. The polio vaccine in the US use to be the more effective Sabin vaccine, which used attenuated vaccine strains that occasionally mutated to a more virulent form that gave 144 known cases of vaccine-associated paralytic polio (VAPP) between 1980 and 1999.

Since polio doesn't exist in the US, we switched to the deactivated form in 2000. This isn't as effective, which is why there's now one more shot in the vaccination series, but the old treatment, if continued, would have been deadlier.

There has always been a policy to allow people to opt out of vaccines, usually for religious reasons. (The last outbreak in the US was among Amish groups. The virus came from the Netherlands.) A reason why is because there will always be resistance to any mandate, and vaccines don't require 100% coverage to be effective in a population. It's better to let a few not be vaccinated than to use the indiscriminate and blunt threat of government intervention against them.

This means the CDC and others have to be very cautions and sensitive. For example, even though there's no evidence that mercury preservatives in vaccines cause side effects, you'll see that the vaccines were reformulated to remove thimerosal. The general policy is to minimize objections to the process, and not to force people to comply.

This is absolutely not an "unconditionally pro" policy, so you are downvoted because you're speaking out of ignorance and a blithe appeal, as jlgreco rightly points out, to an argument to moderation.


> You have made an implication, without basis, that the > immunization policies in the US are "unconditionally pro", > or at least that the people here are "unconditionally pro."

You have interpreted this. Read my comment without considering me as anti-vaccines and maybe you'll understand you over-reacted....

My reflection was about pushing administration of vaccines against for example stomach ulcers (vaccine in development) or rotaviruses in developed countries. Would you be for mandating, in high-income countries, the administration of a vaccine against rotaviruses knowing their efficiency is only 45%? Rotavirus is evaluated at 1% of children deaths in these countries [1] (from CDC, a source you mention yourself). Will you also push for a vaccine for the 99 other percent?

[1] http://wwwnc.cdc.gov/eid/article/9/5/02-0562_article.htm


Would you be for mandating, in high-income countries, the administration of a vaccine against rotaviruses knowing their efficiency is only 45%? Rotavirus is evaluated at 1% of children deaths in these countries [1] (from CDC, a source you mention yourself). Will you also push for a vaccine for the 99 other percent?

Where to start with this?

45% is a pretty low effectiveness rate. I'd prefer to see it higher, but nevertheless 45% success should improve herd immunity, right?

Rotavirus is evaluated at 1% of children deaths in these countries

If that is correct, then that is a HUGE death rate. Anything to reduce that seems sensible.

Will you also push for a vaccine for the 99 other percent?

Well.. can you predict in advance which are the 1% who are going to die? If you can then vaccinate them! If not then it would seem sensible to vaccinate everyone to develop her immunity. That will (a) directly decrease the death rate by making some who would have died immune, and (b) indirectly decrease the death rate by making it less likely to be transmitted.

Edit: Reading a bit, I believe your numbers are incorrect - or at least the way you have phrased it. 1% may be the rate in developing countries, but it isn't in developed countries.

The Wikipedia article on Rotavirus[1] makes the vaccine seem pretty compelling: In Mexico, which in 2006 was among the first countries in the world to introduce rotavirus vaccine, diarrhoeal disease death rates dropped during the 2009 rotavirus season by more than 65 percent among children age two and under.....In the United States, rotavirus vaccination since 2006 has led to drops in rotavirus-related hospitalizations by as much as 86 percent. The vaccines may also have prevented illness in non-vaccinated children by limiting the number of circulating infections.

So yes, in my opinion - based on 10 minutes of research only - it should be mandatory.

[1] http://en.wikipedia.org/wiki/Rotavirus#Prevention


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

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


"Read my comment without considering me as anti-vaccines"

I didn't regard you as such in the first place. I regarded you as making the incorrect appeal to argument by moderation.

Now you have switched the topic, from the implication that the US health policy and/or supporters in this forum are "unconditionally pro" vaccination, to a question about a specific vaccine and disease.

I do not wish to discuss this new topic.


I don't understand why you think I'm discussing US policy... It seems we don't understand each other and ending our discussion is indeed the best option.


I never said you were talking directly about US policy. I both times used the word "implication." You say there are two camps. I point out that the majority view, which includes the views of the CDC and WHO, and described in their publications, is in neither of those camps that you proposed.

Specifically, you say "Sadly both camps (pro and anti vaccines) have too extreme positions to have a constructive debate."

The US health policy is decidedly pro vaccine. Therefore, I can use it an exemplar to determine if it has "extreme views" which are "too extreme positions to have a constructive debate."

I then showed that there is a lot of debate and cost/benefit analysis on the use of different vaccines, including a change in the vaccination policies over time as conditions change. Nothing about the debate looks "extreme".

Therefore either you don't understand the majority view or you are using an very different reference frame than the others on this forum, without explaining the context shift.

That's the likely source of the downvotes that you complained about.


Now I understand your reasoning. Stating there are two camps with no one in-between was maybe indeed too... extreme. I meant to say that there are a lot of people with strong opinions, and few with a balanced view acknowledging there are both risks and benefits.


I disagree. From what I can tell, there are a lot of people with strong opinions based on a balanced view acknowledging both the risks and benefits. And their opinion is in general favor of mass immunization.

You have only to go to the CDC, or the WHO, and read their reports. Every single Vaccine Information Statement from the CDC says "A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions." They also list the risks, and describe if there are groups of people who specifically should or should not be immunized.

Where then is this large camp of people with strong view for vaccination but who do not acknowledge that there are risks? Because to me it sounds like it's a hypothetical construct based on the assumption that there must be people who are equal but opposite to the anti-vaxxers, when as far as I can tell, such a pro-vaccination group is at best small and with little influence.

Can you point me to their web sites or other literature?


I know a pregnant woman trying to get information about which vaccines to administrate to her future baby. She either get as answer "do them all as there's absolutely no risk' or 'vaccines are bad'. So it's not an organised group publishing position papers as you asked. But she has a very hard time to get explanations of the implications of not administrating a vaccine against usually benign affections.

Also, I just found this article mentioning that the cdc used children as guinea pigs for a new vaccine. Of course i am not sure it is true but it makes me suspicious and distrustful. How could i believe them blindly as some commenters seem to do if they do such covert operations?


> She either get as answer 'do them all as there's absolutely no risk' or 'vaccines are bad'."

She's supposed to receive a handout from the CDC describing the known risks. That required by law, I believe. These handouts say, over and over, that there's always a risk, that there are common mild side-effects (redness or soreness where the shot was injected, for example), and that the severe side effects are extremely rare, as in larger than 1:1,000,000. It's hard even to know if some of the side effects are due to the vaccine or not.

The handout she gets is supposed to tell her where to report severe side effects, and tell her about the fund that's set up to pay money to those who have severe side effects.

But the side-effects are so rare that it falls into the background noise. It's hard to even think about odds this low, which is the reasoning behind the "micromort"; see http://en.wikipedia.org/wiki/Micromort . A risk of 1:1,000,000 is about the same as traveling 6 minutes by canoe, or 250 miles by car.

This is so low that most people say "no risk" rather than enumerate all the low-probability ways you could die.

> the cdc used children as guinea pigs for a new vaccine

I don't know how the paper defines "guinea pig." The answer is both 'yes' and 'no', depending on how you want to interpret it. If "guinea pig" means "children used as a subject for a medical test", then the answer is certainly "yes."

There's a point between "we think this is a possible vaccine" and "this vaccine is effective." At some point you need to inoculate children and see if the vaccine works. In this respect, those children are indeed guinea pigs.

But if by "guinea pig" you mean there's no knowledge of what the risks are, or even that the test is going on, then there's a long story.

Earlier in our history we would test physically and mentally disabled children in institutions (see Koprowski's work on the polio vaccine), or people in jails (see Southam's experiments with HeLa cells), or simply not tell them what was going on (see the Tuskegee syphilis experiment).

This is unethical, though it took a long time to establish and require those ethical standards. Human testing requires oversight by an institutional review board, and informed consent from the test subjects.

There's all sort of problems related to what "informed" means. Obviously, children cannot grant informed consent, so their parents are used as proxies to make the decision. Even then, it's hard to know if the parents have all the information they need to make a decision.

It gets even worse with overseas testing. There have been many attempts at coming up with a malaria vaccine. One such is RTS,S (or Mosquirix). You can read about the ethics behind the test http://www.nejm.org/doi/suppl/10.1056/NEJMoa1208394/suppl_fi... . There are several pages detailing what they did to maintain good ethics:

- follow international and local standards for testing

- get independent local doctors to provide oversight

- have community meetings, and meetings with local leaders

- discuss the goals and methods with the parents, including the use of an impartial witness for illiterate parents

and more. For example, we know that bed nets are effective at reducing malaria, so all of the children who volunteered for the trial - even if they weren't accepted - got insecticide treated bednets.

So yes, those 6537 infants are guinea pigs. We don't know of a better way to find out if a candidate vaccine works.


Vaccines save lives. Millions of lives. Pro-vaccine is not an extreme position, it is the sane position.

I downvoted you because I think you are presenting a false compromise. An "argument to moderation": http://en.wikipedia.org/wiki/Argument_to_moderation


A lack of moderated opinions is hurting a lot these days. Read my answer to dalke, because I would like ask you the same question: Would you be for mandating vaccines against rota-viruses in high-income countries?


I don't have the expertise to make that call, and neither I suspect do you. I am comfortable with the CDC making that call.

Moderated positions should not be your priority. Rather factually correct and defensible positions should be.


Looking at the facts lead me to a moderate position.

I let you feel confortable following the cdc, i prefer to keep a critical mind, though i agree it is hard for non experts like us to get good and objective information.


>Looking at the facts lead me to a moderate position.

Mention them, rather than "moderation", and people may not downvote you.


I listed an example about the rotavirus in my subsequent comments, but here's another one mentioned by Patrick_devine in the comments: http://www.cbc.ca/news/canada/british-columbia/story/2012/09...

This illustrates that the precautionary principle[1] might sometimes be forgotten or be put on the background.

[1] http://en.wikipedia.org/wiki/Precautionary_principle


That's a random fact, but not evidence in support of your thesis, which is that the currently accepted set of vaccines should be evaluated for their costs and benefits by individuals.

The evidence that individuals are better equipped and are less biased than the current scientific establishment to evaluate the costs and benefits of a particular vaccine is the evidence I'm looking for. The evidence that vaccine X was crappy is not. Evidence of people trying to get a new vaccine into the market or required for children is definitely not.


You ask for facts, I give an example of what I mean but then you reject it as random and needing evidence of a thesis I never formulated....

As for your second paragraph, the scientific establishment can be very wrong. Example: 20 years ago the scientific establishment rejected the idea of exoplanets. Today, there are hundreds catalogued. Although I had no facts to support my view, the consensus felt just wrong to me. I just think there might other be cases where the scientific consensus just feels wrong, a good reason to keep a critical mind!


"20 years ago the scientific establishment rejected the idea of exoplanets"

What?! No, they didn't. The Drake equation even had a term, f_p, for the fraction of those stars that have planets.

Drake's 1961 shot-in-the-dark estimate for f_p was 0.2-0.5 (one fifth to one half of all stars formed will have planets).

Sagan and Drake were believers in the principle of mediocrity, which says that "the Earth is a typical rocky planet in a typical planetary system, located in a non-exceptional region of a common barred-spiral galaxy." (Quote from Wikipedia.)

Others were believers in the Rare Earth hypothesis, yes, but there definitely wasn't the consensus rejection of the idea of exoplanets. The consensus was more that we don't have the information to stay one way or the other.

There are plenty of examples of when the scientific establishment was very wrong. Geologists didn't accept Wegener's theory of continental drift for many decades, and it wasn't until the 1980s that Warren and Marshall showed that most stomach ulcers and gastritis were caused by H. pylori infection, instead of the then-consensus view that they were caused by stress or spicy food.


"...you feel confortable following the cdc, i prefer to keep a critical mind..."

* Do you have information that is not available to the CDC?

* Do you have evidence that the CDC is biased in a fashion that prevents it from being suitably "critical"?


* Did I have information showing that the NSA was accessing private data stored at big providers like Google, MS, Apple, etc? No.

* Was I right to have kept a critical mind regarding storing data in the cloud? Yes

So in response to your comment, I'm not saying the CDC is not to be trusted or biased. I'm just saying keeping a critical mind is a must.


The factors are not the same in the two comparisons.

It's people who develop these vaccines. These people have friends and family, with children. These children will be vaccinated. Why would they want to place these children at too high of a risk?

If your thesis is true, then you would expect that the children or grandchildren of pharmaceutical researchers are less likely to be inoculated. Do you think that's the case? Do you have any evidence for that?

(Personal anecdote: I once met a woman who worked at Glaxo-Wellcome, back before they became GSK. Once the chicken pox vaccine was available, she immediately got her daughter inoculated.)

There are many public health organizations besides the CDC. There's the WHO, and the public health organizations of different countries. The EU, for example, also has a very extensive set of requirements and oversight. So you can also look towards the UK, or Australia, to see what they think. (I picked English speaking countries to make it easier on you.)

There are significant differences between the CDC and NSA: 1) the NSA is institutionally secretive, while public health research is not, 2) the NSA staff are less likely to have an adverse effect by the NSA accessing their private data than the public at large, and 3) other espionage organizations, who are in the position of finding out what the NSA does, are also secretive and not likely to publish that information to the public.

I assume you considered these differences as part of your critical analysis. Why did you think they aren't significant?


Writing, as you did in the grandparent post,

but sometimes i have the feeling we may not get sick anymore

may not need any more response than a downvote. Perhaps if you were more explicit about what you mean, your comment would be better received.


This formulation was not very good, I agree. Thanks for the constructive comment. What I meant is that some push for overly-broad vaccination when the benefits/risks ratio is too small. Just like rotavirus vaccination in high-income countries like I mentioned in two other comments clarifying my initial post.




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