Study showing vaccines cause autism is 'elaborate fraud'.

SallyNasty wrote:

Actually Larry, what I think I need a booster for is that there is an outbreak due to people not being properly vaccinated, the result of which is an advisory by my daughters' doctor that we should update vaccinations for a sickness that should no longer concern a first world country.

I understand that over time immunization degrades - fair enough and well noted- but whooping cough shouldn't be a concern in a first-world country.

"People" meaning "everyone," right? Not just children? If so, then that's a general public ignorance issue, not an anti-vaccine movement issue, since adults presumably can opt for their own vaccines whether or not their parents agree.

Whooping cough will cease to be a problem in ANY country (first world or otherwise) when every single vulnerable individual is vaccinated. That includes you getting your reupps regardless of the presence of outbreaks or not. YOU were not properly vaccinated. That's why you need the booster. Now you are. Presumably, most adults and teenagers in your vicinity are also not properly vaccinated against whooping cough, since it seems that your MDs only recommend it when there are outbreaks.

Would that be sassy?

Not particularly. It probably needed to be said. Of course, I don't need to be an American to recognize bad science.

FWIW, I always offer my own perspective, which is necessarily an outside and foreign perspective.

LarryC wrote:

Whooping cough will cease to be a problem in ANY country (first world or otherwise) when every single vulnerable individual is vaccinated. That includes you getting your reupps regardless of the presence of outbreaks or not. YOU were not properly vaccinated. That's why you need the booster. Now you are. Presumably, most adults and teenagers in your vicinity are also not properly vaccinated against whooping cough, since it seems that your MDs only recommend it when there are outbreaks.

I assume The Nasty One's lack of reupps is not due to a belief about the need for reupps, so I don't think you can compare the two situations. There's a difference between being unaware one is not properly vaccinated (if that is the case here--depends on that word "properly") and consciously rejecting a vaccination.

CheezePavilion wrote:
LarryC wrote:

Whooping cough will cease to be a problem in ANY country (first world or otherwise) when every single vulnerable individual is vaccinated. That includes you getting your reupps regardless of the presence of outbreaks or not. YOU were not properly vaccinated. That's why you need the booster. Now you are. Presumably, most adults and teenagers in your vicinity are also not properly vaccinated against whooping cough, since it seems that your MDs only recommend it when there are outbreaks.

I assume The Nasty One's lack of reupps is not due to a belief about the need for reupps, so I don't think you can compare the two situations. There's a difference between being unaware one is not properly vaccinated (if that is the case here--depends on that word "properly") and consciously rejecting a vaccination.

Thank you for stating it better than I would have:)

LarryC wrote:

Both reports you mention suggest that it's adult vulnerability to pertussis that's causing the problem, not parent refusal to have their children vaccinated (just as I suggested). If anything, that issue is a red herring that's confusing policy and introduces confirmation bias in assessing the data.

According to the first link you cite, less than 10% of adults were vaccinated, and this was due to ignorance of the general public, not the anti-vaccine movement. Indeed, it would not make sense for the anti-vaccine movement to influence adult vaccination, since no study ever made has even suggested that you can acquire autism as an adult from any source.

In here, SallyNasty thinks that it's because of the anti-vaccine people that he has to get boosters. That is not true. All pertussis immunization from vaccination wanes and must be re-upped on a regular basis, regardless of the pediatric immunization record. That's just good policy, not a necessity because of the reasons he thinks.

More on topic, I'm hoping states start prosecuting parents for refusing to vaccinate. Oregon has established a history of prosecuting parents who let their kids die because of their faith-healing beliefs. I don't see this as being any different.

Unnecessary and counterproductive. If it is decided that forced vaccinations are good public policy, then simply vaccinate the children perforce instead of resorting to criminalizing non-vaccination. The latter takes up additional judicial and law-enforcement time and energy for what is essentially the same thing.

1. Perhaps I was unclear, but enforcing vaccination for communicable diseases is not just for school children. Herd immunity covers the whole herd, not some arbitrary age range. I went and got my TDaP shot a couple of months ago since I was due. Immunization for dangerous, communicable disease as a voluntary action is an extremely foolish idea. I see zero downsides to requiring everyone to get their shots on a regular basis.

2. You cannot simply "vaccinate the children" (or the adults) without criminalizing the refusal to do so. You can't make people take a shot without having consequences and actual enforcement. I don't understand how you think that we can vaccinate them when the people are willing to resist.

3. Since I doubt that mandatory vaccinations will happen anytime soon, I want the parents who refuse vaccinations for their minor children to be prosecuted when their children die of things like whooping cough. They refused to try and prevent the disease, just like the faith-healers refused to seek treatment that would have saved their sick children.

Kraint:

1. Perhaps I was unclear, but enforcing vaccination of communicable is not just for school children. Herd immunity covers the whole herd, not some arbitrary age range. I went and got my TDaP shot a couple of months ago since I was due. Immunization for dangerous, communicable disease as a voluntary action is an extremely foolish idea. I see zero downsides to requiring everyone to get their shots on a regular basis.

Cost. It may or may not be cost-effective to offer blanket immunization for the entire population, especially for uncommon diseases, but that's unclear, IMO. Certainly, just tetanus is not common enough to cover the cost of immunizing everyone regularly. Just antibodies and boosters for people at-risk is sufficient policy.

Similarly, blanket immunization for Hepatitis is also probably not a very good idea, but blanket coverage for health professionals is. I get boosters whenever my serology comes back low.

2. You cannot simply "vaccinate the children" (or the adults) without criminalizing the refusal to do so. You can't make people take a shot without having consequences and actual enforcement. I don't understand how you think that we can vaccinate them when the people are willing to resist.

There is no need to criminalize refusal. Simply decriminalize forced immunization. You CAN make people take a shot. Bind them and gag them if you need to. It's generally much easier than that, though.

3. Since I doubt that mandatory vaccinations will happen anytime soon, I want the parents who refuse vaccinations for their minor children to be prosecuted when their children die of things like whooping cough. They refused to try and prevent the disease, just like the faith-healers refused to seek treatment that would have saved their sick children.

I'll be more comfortable with you furthering that idea once you've actually had your child, which you love, die. After your child's death, I would like you to entertain the possibility of your being sued for it.

CheezePavilion:

I assume The Nasty One's lack of reupps is not due to a belief about the need for reupps, so I don't think you can compare the two situations. There's a difference between being unaware one is not properly vaccinated (if that is the case here--depends on that word "properly") and consciously rejecting a vaccination.

All I need to compare them is to see their respective influence on the herd immunity profile. It seems to me that the large fraction of unimmunized adults is due to ignorance - that is a greater, and more important, factor, so that should be tackled first. The germ doesn't care why the target isn't immunized, after all.

I'm not big on the "persecute them for their beliefs!" kind of thing.

LarryC wrote:

All I need to compare them is to see their respective influence on the herd immunity profile. It seems to me that the large fraction of unimmunized adults is due to ignorance - that is a greater, and more important, factor, so that should be tackled first. The germ doesn't care why the target isn't immunized, after all.

I'm not big on the "persecute them for their beliefs!" kind of thing.

I can totally go for better education, that needs to happen, screw the rest of it.

I'm not sure about criminal charges, either. I will admit there is a symmetry to some of it. (Around here it's mostly Tea Party types who are anti-vaccine, I can respect if it's different elsewhere, but that's the predominant opposition here.) Considering the party platform approaches enforced Christian beliefs. (And only loosely so. I need a term for would-be Christians' that Jesus would probably want to backhand.) I'd be amused if that turned around and bit them.

Not amused enough to want to see it happen because of precedent, but it would be funny.

LarryC wrote:

CheezePavilion:

I assume The Nasty One's lack of reupps is not due to a belief about the need for reupps, so I don't think you can compare the two situations. There's a difference between being unaware one is not properly vaccinated (if that is the case here--depends on that word "properly") and consciously rejecting a vaccination.

All I need to compare them is to see their respective influence on the herd immunity profile. It seems to me that the large fraction of unimmunized adults is due to ignorance - that is a greater, and more important, factor, so that should be tackled first.

No, the greater and more important factor would be that previous public health policies were not calibrated to accomplish herd immunity. Of course, that depends on you being right about the need for reupps.

LarryC wrote:
1. Perhaps I was unclear, but enforcing vaccination of communicable is not just for school children. Herd immunity covers the whole herd, not some arbitrary age range. I went and got my TDaP shot a couple of months ago since I was due. Immunization for dangerous, communicable disease as a voluntary action is an extremely foolish idea. I see zero downsides to requiring everyone to get their shots on a regular basis.

Cost. It may or may not be cost-effective to offer blanket immunization for the entire population, especially for uncommon diseases, but that's unclear, IMO. Certainly, just tetanus is not common enough to cover the cost of immunizing everyone regularly. Just antibodies and boosters for people at-risk is sufficient policy.

You've chosen a very poor example, since tetanus is non-communicable. The only one you are putting at risk is yourself. Polio and pertussis do spread, so one person's terrible choices can hurt/kill other people. And the cost is trivial compared to the risks. A combination tetanus, diphtheria and tetanus booster shot runs around $60US retail and protects for 10 years, and would scale far lower if we administered it to everyone. The US can afford $10/year/citizen to prevent thousands of cases of dangerous/deadly disease. Heck, at that rate, it would be one of the cheaper programs the federal government has.

LarryC wrote:

Similarly, blanket immunization for Hepatitis is also probably not a very good idea, but blanket coverage for health professionals is. I get boosters whenever my serology comes back low.

2. You cannot simply "vaccinate the children" (or the adults) without criminalizing the refusal to do so. You can't make people take a shot without having consequences and actual enforcement. I don't understand how you think that we can vaccinate them when the people are willing to resist.

There is no need to criminalize refusal. Simply decriminalize forced immunization. You CAN make people take a shot. Bind them and gag them if you need to. It's generally much easier than that, though.

This is like saying you are against making theft illegal, but are in favor of decriminalizing the involuntary imprisonment of thieves. Who are the thieves, and who is going to go out and drag them to prison? You would have to find some group that goes around hunting for the unvaccinated in order to get full coverage, rather than using all of the current law enforcement systems already in place.

LarryC wrote:
3. Since I doubt that mandatory vaccinations will happen anytime soon, I want the parents who refuse vaccinations for their minor children to be prosecuted when their children die of things like whooping cough. They refused to try and prevent the disease, just like the faith-healers refused to seek treatment that would have saved their sick children.

I'll be more comfortable with you furthering that idea once you've actually had your child, which you love, die. After your child's death, I would like you to entertain the possibility of your being sued for it.

Feeling remorse over a death you cause does not prevent you from facing the consequences. We have criminal laws against endangering the lives of others which leads to death, and this would surely fall into that category. As I said, we already send people to prison for this type of behavior. They failed to execute due diligence in protecting their child's life, and vaccines should fall into that category.

CheezePavilion:

No, the greater and more important factor would be that previous public health policies were not calibrated to accomplish herd immunity. Of course, that depends on you being right about the need for reupps.

No need to take my word for it, or to assume. I encourage everyone to scour the web for reputable sourcing on this subject. Here's the CDC pdf on DTaP, the for-children vaccine covering the three diseases in question:

http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-dtap.pdf

I'm a little out of date on immunization, since it's not in my line of work other than to elicit whether or not it's been given, but from what I recall, the primary intent for immunization is for individual immunity, not herd immunity. Herd immunity's just a backup for people who cannot be immunized, or as a public policy geared towards disease eradication (see: polio eradication).

It's more problematic to judge the cost effectiveness of herd immunity because it's hard to come up with an algorithm that will predict case incidences based on a particular immunity percentage reached by a program; thus the goal is not SMART (that's a management acronym) and cannot be judged as a policy.

Kannon:

I can totally go for better education, that needs to happen, screw the rest of it.

We are in agreement. At the very least, dispelling all unscientific myths about vaccination ought to be part of a government healthcare thrust. Once the knowledge is disseminated effectively, my experience is that people opt for free vaccination overwhelmingly.

Kraint:

You've chosen a very poor example, since tetanus is non-communicable. The only one you are putting at risk is yourself. Polio and pertussis do spread, so one person's terrible choices can hurt/kill other people. And the cost is trivial compared to the risks. A combination tetanus, diphtheria and tetanus booster shot runs around $60US retail and protects for 10 years, and would scale far lower if we administered it to everyone. The US can afford $10/year/citizen to prevent thousands of cases of dangerous/deadly disease. Heck, at that rate, it would be one of the cheaper programs the federal government has.

I actually cited two examples, one being tetanus, because it's part of the DPT vaccination program; and hepatitis because it's deadly and communicable. From a public policy standpoint, the communicability of a disease only matters in terms of incidence and methods of prevention. Herd immunity being applicable to pertussis is certainly in its favor, but its generally more common incidence is a far greater, umbrella factor. Tetanus by itself is not cost-effective not because it's noncommunicable, but because it's very uncommon.

You are arguing from a moral standpoint. We do not have common ground there. I do not support moralistic leanings in the formation of public policy. It doesn't matter whose fault it is. What matters is data and goals.

This is like saying you are against making theft illegal, but are in favor of decriminalizing the involuntary imprisonment of thieves. Who are the thieves, and who is going to go out and drag them to prison? You would have to find some group that goes around hunting for the unvaccinated in order to get full coverage, rather than using all of the current law enforcement systems already in place.

Nonsense. All children invariably come in for checkups and/or go to school. At the very least, they live in a house, or seek shelter somewhere during a blizzard. You can enforce vaccination in those locations with very high efficacy.

No need to look for these groups. You can simply rule that all children seeking routine well-baby checkups be also vaccinated without seeking parental consent. Additionally, you can ask school healthcare services to check for vaccination records for all their students, and ensure vaccination on a per-school basis (effective for creating a bubble of immunity in high child traffic areas). Finally, you can task neighborhood watches to report on the presence or absence of home-schooled children and schedule home visits by MDs to enforce and check on vaccination, if homeschooling is prevalent enough in an area.

If you're really paranoid, you can even task the ERs to get in on it. MDs routinely ask vaccination history anyway as part of the History and PE, so it's not like they don't know.

No need for courts. No need for prisons. No need for litigation. No arrests. Just send the vaccination squads to stick a needle in every person they can get their hands on. It's much easier and cheaper to do this rather than do all this and sue people who oppose the movement, and then feed and clothe them for free while they live behind bars unproductive for however long you think is appropriate to satisfy your righteous wrath.

It's not about punishment. This isn't about morality. It's about vaccination, first and foremost. Cut the middleman and just do it.

Feeling remorse over a death you cause does not prevent you from facing the consequences. We have criminal laws against endangering the lives of others which leads to death, and this would surely fall into that category. As I said, we already send people to prison for this type of behavior. They failed to execute due diligence in protecting their child's life, and vaccines should fall into that category.

To be honest, that piece of news scares me quite a bit. This erodes patient and parental rights significantly, if people can be sued for not undergoing procedures and interventions that the government deems rightful. It looks good when you approve of the procedures, but what if you don't? It sets a dangerous precedent, IMO.

New subtopic: How can we address the information gap?

I may be introducing an alien and inoperable concept here, but in my experience, people don't reject science out of hand, presented as science; they reject ideology, even when masked with science.

My view is that a fair amount of the pro-vaccine information is being tainted with ideological content that is not related to vaccination whatsoever. Further, the entire discussion is mired in pseudoscience and a mythological understanding of scientific facts and theories by most concerned, and certainly by laymen.

While I, myself, am wary of studies funded and propagated by moneyed interests, the data on the autism angle is clearly compromised by faulty methodology, low study power, and its suggestive (rather than conclusive) nature. It is by no means a conclusive or authoritative work.

In contrast, it is easy to endorse vaccination procedures in general simply by citing the virtual eradication of polio worldwide. The facts, cited accurately and wholly, cannot fail to convince. Moreover, an accurate understanding of what a vaccine is belies the autism angle. It is simply an attenuated (weaker) form of the disease, and unless a widespread number of diseases all cause autism, it is silly to suggest that milder forms of them will, just because of their mildness!

In my view, it is probable that anti-vaccine advocates will appreciate their error when approached purely from a scientific point of view, without the baggage of ideology.

LarryC wrote:

In my view, it is probable that anti-vaccine advocates will appreciate their error when approached purely from a scientific point of view, without the baggage of ideology.

And I think that's where you're losing everyone else. As much as we all deeply wish that everyone could be swayed by facts and science, we have a substantial segment of our population that does not trust "mainstream science" for whatever reason. (The reasoning of why is immaterial, but it covers everyone from faith healers to Jenny McCarthy, to "Oh noes, big pharma").

So, public policy here in the US needs to be aimed at dealing with that, which, since serious communicable disease is just a boogeyman here, not like you mentioned it was there.

I really think this is just one of those cases where culture differences are a massive factor.

LarryC wrote:

CheezePavilion:

No, the greater and more important factor would be that previous public health policies were not calibrated to accomplish herd immunity. Of course, that depends on you being right about the need for reupps.

No need to take my word for it, or to assume. I encourage everyone to scour the web for reputable sourcing on this subject. Here's the CDC pdf on DTaP, the for-children vaccine covering the three diseases in question:

http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-dtap.pdf

I'm a little out of date on immunization, since it's not in my line of work other than to elicit whether or not it's been given, but from what I recall, the primary intent for immunization is for individual immunity, not herd immunity. Herd immunity's just a backup for people who cannot be immunized, or as a public policy geared towards disease eradication (see: polio eradication).

It's more problematic to judge the cost effectiveness of herd immunity because it's hard to come up with an algorithm that will predict case incidences based on a particular immunity percentage reached by a program; thus the goal is not SMART (that's a management acronym) and cannot be judged as a policy.

The issue is that it's all part of public health: rather than focus on getting every individual to have non-degraded immunizations for life, the idea may have been to immunize everyone possible in childhood and have the widespread nature of the degraded immunization do the work in adulthood. Introduce a lot of non-immunized children into the mix when that's the strategy, and you'll get outbreaks.

CheezePavilion:

I know what the idea is, Cheeze. I am an MD, after all. The prevailing idea behind the policy surrounding mainly DPT immunization in young children is because those disease entities are much more deadly and disastrous in children than they are in adults. It is thought that the disease being relatively survivable in adulthood does not warrant the risks of immunization. Clearly, this policy mindset is based on individual immunization, not herd immunity.

I have not heard of any policy, study, or practice saying that compromised serology profiles can work in any fashion to prevent disease, individual or otherwise.

The same idea lies behind the thrust for widespread flu immunization for the elderly.

LarryC wrote:

CheezePavilion:

I know what the idea is, Cheeze. I am an MD, after all. The prevailing idea behind the policy surrounding mainly DPT immunization in young children is because those disease entities are much more deadly and disastrous in children than they are in adults. It is thought that the disease being relatively survivable in adulthood does not warrant the risks of immunization. Clearly, this policy mindset is based on individual immunization, not herd immunity.

I have not heard of any policy, study, or practice saying that compromised serology profiles can work in any fashion to prevent disease, individual or otherwise.

The same idea lies behind the thrust for widespread flu immunization for the elderly.

I'm sure the risk estimate for whether immunization was warranted or not for adults did not factor in people rejecting vaccination. Maybe public health campaigns need to change in response to this recent unexpected outbreak of chronic dumbassery, but I can't imagine it was foreseen.

CheezePavilion:

No need to imagine. It was not.

The risk-assessment for continued DPT vaccination in adults has been, as far as I can tell, mainly studied and considered on an individual level, i.e. individual risks vs. individual benefits. Since the balance is against vaccination, it doesn't matter that anyone opposes universal vaccination, and herd immunity as a positive benefit hasn't been factored in significantly. The article linked above is the first suggestion I've run into that assays widespread adult DPT immunization for the purpose of herd immunity, and it's a tentative suggestion, without experimental validation.

In any case, it is not sound to suppose that it's the non-immunized children that form the bulk of vulnerable individuals in a population, since the number of vulnerable adults and teens is far greater than the number of unimmunized children below 7. If a pertussis outbreak happens, it's more reasonable to suppose that immunizing the adults would have a greater herd immunity effect, because there are more of them that are vulnerable.

I am not aware the anti-vaccine movement has expanded to include adults in its umbrella prohibition. Has it?

Kannon:

I confess that that is something that is frankly amazing to me. If I were ever insane enough to visit the US, I'd probably want to visit the MidWest so I can see me some true-blue Crazy Bible Belt Theists in the wild. Maybe I can pose with them, too. (wouldn't that be scary!)

Local anecdote about Jehovah's Witnesses:
(spoilered for peripheral relevance)

Spoiler:

I work in the OR and have significant experience with handling large blood and fluid losses. Some of those are from horrific trauma cases.

As such, I am often confronted with asking people to sign off on waivers that protect us from liability if we should withhold certain treatments per patient request. To date, I have not encountered a single incident where, given an immediate choice between life or belief, a Jehovah's Witness patient or relative chose belief. They have always chosen to sin against their Church rather than die.

LarryC wrote:

I am not aware the anti-vaccine movement has expanded to include adults in its umbrella prohibition. Has it?

Well, generally speaking, if someone believes vaccines are harmful, why would they get theirs updated? I know, it hurts my head, too, but logic really doesn't apply here.

Visiting Kansas would be... enlightening in the sense that you'd probably want to go hide in a cave afterwards, anyway. Sadly, they look like anyone else, if you could ID them by visual, it'd make life in general a lot easier. Now, batsh*t-crazy church signs, you could definitely pose in front of those.

Washington has a whooping cough epidemic.

The pertussis vaccine is commonly given in childhood, and many states require it for children of school age. But Washington State, according to a federal study last year of kindergarten-age children, had the highest percentage of parents in the nation who voluntarily exempted their children from one or more vaccines, out of fear of side effects or for philosophical reasons.

Economic factors also play into this.

https://www.nytimes.com/2012/05/13/h...

Interesting report. It seems that the reformulation of the vaccine as well as improved treatment methods (only 1% chance of death in the most vulnerable population group) decrease the effective duration of immunity, and reduce the relative risk of death from non-immunization, weakening the pressure to vaccinate.

That said, the cost of treatment on a state level could be weighed against the cost of vaccination. If treatment is more expensive there may be another way to promote vaccination - by levying health insurance premiums against individuals and/or their dependents who get diagnosed with the disease if they are also unimmunized.

Most of the Washington cases are reportedly between 8-12. This is a most interesting development. The pattern is not what could be expected if the main contributory factor is the anti-vaccine movement. The age range is about the ages where initial vaccination immunity would wane if boosters were not given, and the most likely to show and report symptomatology - many adults may also be infected but have mild cases and go unreported (these contribute to infection incidence as well!).

LarryC wrote:

Kannon:

I confess that that is something that is frankly amazing to me. If I were ever insane enough to visit the US, I'd probably want to visit the MidWest so I can see me some true-blue Crazy Bible Belt Theists in the wild. Maybe I can pose with them, too. (wouldn't that be scary!)

Local anecdote about Jehovah's Witnesses:
(spoilered for peripheral relevance)

Spoiler:

I work in the OR and have significant experience with handling large blood and fluid losses. Some of those are from horrific trauma cases.

As such, I am often confronted with asking people to sign off on waivers that protect us from liability if we should withhold certain treatments per patient request. To date, I have not encountered a single incident where, given an immediate choice between life or belief, a Jehovah's Witness patient or relative chose belief. They have always chosen to sin against their Church rather than die.

Actually you might fit in quite well, they have a similar stance to you, just differ in what they deem as the right thing to do is.

Today in autism crackpot news: (note, link is to a piece debunking the crackpottery)

On Saturday, the New York Times online ran a piece from its Sunday Review Opinion pages entitled, “An immune disorder at the root of autism.” The piece is packed with overstatements and overinterpretations and lacks much-needed modulation and qualification. More than that, it promises a "preventative" for autism that is, pardon me, off the hook(worm).