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https://observablehq.com/@mbostock/the-impact-of-vaccines https://observablehq.com/@mbostock/the-impact-of-vaccines That figure is real hard to refute, or squa

https://observablehq.com/@mbostock/the-impact-of-vaccines https://observablehq.com/@mbostock/the-impact-of-vaccines That figure is real hard to refute, or square with any other cause of reduction of measles infections except vaccination.

DanAndersen 7y ago
That's true -- though the figure you're linking focuses specifically on measles cases rather than overall mortality, which is what the OP article is focusing on. (as an aside, it's really weird that the (first few) comments here on HN seem a little adversarial; I wonder if maybe some people looked at the headline only and assumed it was attempting some sort of anti-vax argument, which the article isn't doing at all.)
- manicdee 7y ago
  The problem is that anti-vaxxers will use the headline as their entire justification for their opinion which is not supported by the content under the headline.
- jasoncrawford 7y ago
  So there is something odd going on with measles. I haven't dug into the data, but from a couple of data points I've seen, it seems that measles mortality was declining for a long time even while measles cases were not. That is, there was a decline in the case-fatality rate, without a decline in cases. The disease was still around but getting less deadly. Then the vaccine actually reduced the number of cases. So what was reducing the case-fatality rate? I don't know, but it might have been nutrition. There's evidence at least that Vitamin A makes measles less severe/deadly.
  - oldgradstudent 7y ago
    > So what was reducing the case-fatality rate? Sanitation, antibiotics, oral rehydration therapy, machine ventilation, nutrition, and so on. It's not the measles itself that was the cause of most fatalities, it was the pneumonia, diahrrea, and other opportunistic infections that come with it.
dahfizz 7y ago
You are talking a different time scale. Take a look at this figure from the article: https://rootsofprogress.org/img/mckeown-1975-fig-6.png https://rootsofprogress.org/img/mckeown-1975-fig-6.png Modern medicine and vaccines have undeniably reduced the occurrence and severity of diseases, but the occurrences of these diseases were already down over 90% by the time we came up with vaccines. It's not wrong to recognize that tremendous achievement.
- wavepruner 7y ago
  Furthermore, it indicates that we do not need to paint vaccine hesitant people as harbingers of societal collapse. That belief has been used to justify hateful rhetoric that is divisive, unproductive, and cruel to those who believe they were injured by vaccines.
  - AstralStorm 7y ago
    On the other hand, we will have many more cases otherwise. Meaning more fatalities, though not at the "doom" level. Public policy should still be to force vaccination, injuries notwithstanding, as the cost benefit is on the side of benefit. Allowing choice here is bad policy, as people will be hesitant even if outcome is always statistically better. (We do have a bias to focus on rare events, fear mongers exploit it.) There is no actual reason to be hesitant, the few exceptions being rather clear cut. The only thing that would be fine here is identifying allergies, vulnerable subgroups better and quantifying adverse effects more reliably.

DanAndersen 7y ago

That's true -- though the figure you're linking focuses specifically on measles cases rather than overall mortality, which is what the OP article is focusing on. (as an aside, it's really weird that the (first few) comments here on HN seem a little adversarial; I wonder if maybe some people looked at the headline only and assumed it was attempting some sort of anti-vax argument, which the article isn't doing at all.)

manicdee 7y ago
The problem is that anti-vaxxers will use the headline as their entire justification for their opinion which is not supported by the content under the headline.
jasoncrawford 7y ago
So there is something odd going on with measles. I haven't dug into the data, but from a couple of data points I've seen, it seems that measles mortality was declining for a long time even while measles cases were not. That is, there was a decline in the case-fatality rate, without a decline in cases. The disease was still around but getting less deadly. Then the vaccine actually reduced the number of cases. So what was reducing the case-fatality rate? I don't know, but it might have been nutrition. There's evidence at least that Vitamin A makes measles less severe/deadly.
- oldgradstudent 7y ago
  > So what was reducing the case-fatality rate? Sanitation, antibiotics, oral rehydration therapy, machine ventilation, nutrition, and so on. It's not the measles itself that was the cause of most fatalities, it was the pneumonia, diahrrea, and other opportunistic infections that come with it.

dahfizz 7y ago

You are talking a different time scale. Take a look at this figure from the article: https://rootsofprogress.org/img/mckeown-1975-fig-6.png https://rootsofprogress.org/img/mckeown-1975-fig-6.png Modern medicine and vaccines have undeniably reduced the occurrence and severity of diseases, but the occurrences of these diseases were already down over 90% by the time we came up with vaccines. It's not wrong to recognize that tremendous achievement.

wavepruner 7y ago
Furthermore, it indicates that we do not need to paint vaccine hesitant people as harbingers of societal collapse. That belief has been used to justify hateful rhetoric that is divisive, unproductive, and cruel to those who believe they were injured by vaccines.
- AstralStorm 7y ago
  On the other hand, we will have many more cases otherwise. Meaning more fatalities, though not at the "doom" level. Public policy should still be to force vaccination, injuries notwithstanding, as the cost benefit is on the side of benefit. Allowing choice here is bad policy, as people will be hesitant even if outcome is always statistically better. (We do have a bias to focus on rare events, fear mongers exploit it.) There is no actual reason to be hesitant, the few exceptions being rather clear cut. The only thing that would be fine here is identifying allergies, vulnerable subgroups better and quantifying adverse effects more reliably.