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Why do we discontinue vaccines for "eradicated" diseases? Is it just to save money? Did the vaccine have side effects that stop being worth it? On the other han

by goda90 8y ago

Why do we discontinue vaccines for "eradicated" diseases? Is it just to save money? Did the vaccine have side effects that stop being worth it? On the other hand, besides protection from bioterrorism, can a vaccine provide some benefit in protecting against related diseases?

deleted 8y ago
[deleted]
mikeash 8y ago
Let’s say it cost $5 per person to vaccinate against smallpox. That’s well over $1 billion to vaccinate all Americans against a disease that no longer exists. Surely we could do something more useful with that money. Maybe vaccinate against a disease people can still catch.
- ComputerGuru 8y ago
  1 billion isn’t even worthy of a line item in the defense budget. Stick it there as part of national security in the event of biological warfare. QED.
  - nojvek 8y ago
    Yes but that 1 billion could go to the defense contractors, lobbyists and “donations” to politicians. Why would any rational politician do that?
throwaway76543 8y ago
All vaccines have side effects -- the side effects are quite rare but are sometimes severe. Several thousand people have life-threatening reactions to vaccination each year. The standard vaccination schedule is comprised of vaccinations with benefits which outweigh the medical risk and cost. If you travel to less developed areas you may receive a wider array of vaccinations. For an eradicated disease there is no benefit and therefore no reason to assume the risk, or cost.
jefftk 8y ago
> Based on past experience, it is estimated that between 1 and 2 people out of every 1 million people vaccinated may die as a result of life-threatening reactions to the vaccine. -- http://www.who.int/vaccine_safety/committee/topics/smallpox/questions/en/ http://www.who.int/vaccine_safety/committee/topics/smallpox/...
NeedMoreTea 8y ago
Let's be clear here. There are TWO eradicated diseases. Smallpox and a cattle disease that doesn't affect humans. Otherwise our track record isn't stellar. The efforts with other diseases that could be eradicated have struggled. Polio is closest with just a few remaining countries. Future eradication attempts may be much harder due to the rise of anti-vaxxers.
- joecool1029 8y ago
  > Polio is closest with just a few remaining countries. Actually Guinea worm disease is closest to eradication: closer than polio. https://en.wikipedia.org/wiki/Eradication_of_dracunculiasis https://en.wikipedia.org/wiki/Eradication_of_dracunculiasis
Spooky23 8y ago
Because they are not gone. Weaponized smallpox almost certainly exists. It escaped a Soviet lab in the 70s and other countries including the US worked on it. Smallpox is uniquely deadly... it wiped out something like 75% of the indigenous population of the americas.
- UncleEntity 8y ago
  > Weaponized smallpox almost certainly exists. Yep, when they shipped us off to the Middle East in '03 they gave us the smallpox vaccination even if you had it as a kid because, well, WMDs. Don't think I had it as a kid since I was born in '71 and that's around the time they were phasing it out -- or at least didn't have the vaccination scar before '03.
- opo 8y ago
  >...Smallpox is uniquely deadly... The indigenous people were exposed to many diseases, not just smallpox: >...Numerous diseases were brought to North America, including bubonic plague, chickenpox, cholera, the common cold, diphtheria, influenza, malaria, measles, scarlet fever, sexually transmitted diseases, typhoid, typhus, tuberculosis, and pertussis (whooping cough).[2][3][4] Each of these brought destruction through sweeping epidemics, involving disability, illness, and extensive deaths https://en.wikipedia.org/wiki/Native_American_disease_and_epidemics https://en.wikipedia.org/wiki/Native_American_disease_and_ep... >...it wiped out something like 75% of the indigenous population of the americas. It's hard to give a precise estimate of how many deaths occurred. Some say it was much higher than 75%. For example: >...Between 1492 and 1650 the Native American population may have declined by as much as 90% as the result of virgin-soil epidemics (outbreaks among populations that have not previously encountered the disease), compound epidemics, crop failures and food shortages. https://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/impact-european-diseases-native-americans https://www.encyclopedia.com/science/encyclopedias-almanacs-...
jogjayr 8y ago
According to Wikipedia, for smallpox the reason was: > Based on past experience, it is estimated that 1 or 2 people in 1 million (0.000198 percent) who receive the vaccine may die as a result, most often the result of postvaccinial encephalitis or severe necrosis in the area of vaccination (called progressive vaccinia). Given these risks, as smallpox became effectively eradicated and the number of naturally occurring cases fell below the number of vaccine-induced illnesses and deaths, routine childhood vaccination was discontinued in the United States in 1972, and was abandoned in most European countries in the early 1970s.
bzbarsky 8y ago
The smallpox vaccine used at the time of eradication had two main issues: 1) In some (fairly small) fraction of recipients it lead to severe side-effects, including death. 2) It was a live-virus vaccine, which meant a vaccine recipient could actually infect those around them (with the vaccine, effectively). This was a serious problem if anyone near the recipient was immune-compromised; the risk of deleterious side-effects in immune-compromised individuals, who would not be vaccinated normally) was much higher. There is a modern (a few years old!) smallpox vaccine that is a dead-virus vaccine and would have a very different cost-benefit tradeoff in medical terms. I don't know what the economic tradeoff looks like (i.e. how expensive it is).

by goda90 8y ago

deleted 8y ago

[deleted]

mikeash 8y ago

Let’s say it cost $5 per person to vaccinate against smallpox. That’s well over $1 billion to vaccinate all Americans against a disease that no longer exists. Surely we could do something more useful with that money. Maybe vaccinate against a disease people can still catch.

ComputerGuru 8y ago
1 billion isn’t even worthy of a line item in the defense budget. Stick it there as part of national security in the event of biological warfare. QED.
- nojvek 8y ago
  Yes but that 1 billion could go to the defense contractors, lobbyists and “donations” to politicians. Why would any rational politician do that?

throwaway76543 8y ago

All vaccines have side effects -- the side effects are quite rare but are sometimes severe. Several thousand people have life-threatening reactions to vaccination each year. The standard vaccination schedule is comprised of vaccinations with benefits which outweigh the medical risk and cost. If you travel to less developed areas you may receive a wider array of vaccinations. For an eradicated disease there is no benefit and therefore no reason to assume the risk, or cost.

jefftk 8y ago

> Based on past experience, it is estimated that between 1 and 2 people out of every 1 million people vaccinated may die as a result of life-threatening reactions to the vaccine. -- http://www.who.int/vaccine_safety/committee/topics/smallpox/questions/en/ http://www.who.int/vaccine_safety/committee/topics/smallpox/...

NeedMoreTea 8y ago

Let's be clear here. There are TWO eradicated diseases. Smallpox and a cattle disease that doesn't affect humans. Otherwise our track record isn't stellar. The efforts with other diseases that could be eradicated have struggled. Polio is closest with just a few remaining countries. Future eradication attempts may be much harder due to the rise of anti-vaxxers.

joecool1029 8y ago
> Polio is closest with just a few remaining countries. Actually Guinea worm disease is closest to eradication: closer than polio. https://en.wikipedia.org/wiki/Eradication_of_dracunculiasis https://en.wikipedia.org/wiki/Eradication_of_dracunculiasis

Spooky23 8y ago

Because they are not gone. Weaponized smallpox almost certainly exists. It escaped a Soviet lab in the 70s and other countries including the US worked on it. Smallpox is uniquely deadly... it wiped out something like 75% of the indigenous population of the americas.

UncleEntity 8y ago
> Weaponized smallpox almost certainly exists. Yep, when they shipped us off to the Middle East in '03 they gave us the smallpox vaccination even if you had it as a kid because, well, WMDs. Don't think I had it as a kid since I was born in '71 and that's around the time they were phasing it out -- or at least didn't have the vaccination scar before '03.
opo 8y ago
>...Smallpox is uniquely deadly... The indigenous people were exposed to many diseases, not just smallpox: >...Numerous diseases were brought to North America, including bubonic plague, chickenpox, cholera, the common cold, diphtheria, influenza, malaria, measles, scarlet fever, sexually transmitted diseases, typhoid, typhus, tuberculosis, and pertussis (whooping cough).[2][3][4] Each of these brought destruction through sweeping epidemics, involving disability, illness, and extensive deaths https://en.wikipedia.org/wiki/Native_American_disease_and_epidemics https://en.wikipedia.org/wiki/Native_American_disease_and_ep... >...it wiped out something like 75% of the indigenous population of the americas. It's hard to give a precise estimate of how many deaths occurred. Some say it was much higher than 75%. For example: >...Between 1492 and 1650 the Native American population may have declined by as much as 90% as the result of virgin-soil epidemics (outbreaks among populations that have not previously encountered the disease), compound epidemics, crop failures and food shortages. https://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/impact-european-diseases-native-americans https://www.encyclopedia.com/science/encyclopedias-almanacs-...

jogjayr 8y ago

According to Wikipedia, for smallpox the reason was: > Based on past experience, it is estimated that 1 or 2 people in 1 million (0.000198 percent) who receive the vaccine may die as a result, most often the result of postvaccinial encephalitis or severe necrosis in the area of vaccination (called progressive vaccinia). Given these risks, as smallpox became effectively eradicated and the number of naturally occurring cases fell below the number of vaccine-induced illnesses and deaths, routine childhood vaccination was discontinued in the United States in 1972, and was abandoned in most European countries in the early 1970s.

bzbarsky 8y ago

The smallpox vaccine used at the time of eradication had two main issues: 1) In some (fairly small) fraction of recipients it lead to severe side-effects, including death. 2) It was a live-virus vaccine, which meant a vaccine recipient could actually infect those around them (with the vaccine, effectively). This was a serious problem if anyone near the recipient was immune-compromised; the risk of deleterious side-effects in immune-compromised individuals, who would not be vaccinated normally) was much higher. There is a modern (a few years old!) smallpox vaccine that is a dead-virus vaccine and would have a very different cost-benefit tradeoff in medical terms. I don't know what the economic tradeoff looks like (i.e. how expensive it is).