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every health system has flaws. You're talking about one of the most complex components of any economy - 10% of spending in Australia, up to 20c in every dollar

every health system has flaws. You're talking about one of the most complex components of any economy - 10% of spending in Australia, up to 20c in every dollar in the US. there are no simple fixes. > If it's so important to vaccinate, why not build a much better live data system that concerned individuals/parents can query in real time I'm not sure what you mean. The evidence behind vaccination has been out there since Jenner in the late 1800s. The idea that this is an argument that needs rehashing every year or so, for what is undoubtedly an invention that has saved more lives than anything humanity has ever invented (with the possible exception of sanitation and sewerage) is in the first instance a victory to those who wish to sow doubt in an area where there is none. Now, having said that, you can get a bit more nuianced - for example, generally speaking the NNT to prevent a case of the seasonal flu (dependign on the prevailing strains of the year) is around 20-30. Ie. 20-30 vaccinations for one prevented case. Whereas, when it comes to Hep B and Smallpox, your NNT is effectively 1 (depending on the titre response from the vaccine). As a result, we have eliminated Smallpox from the wild and massively reduced the disease burden of Hepatitis B. But we don't force every person to have the flu vax every year. As a healthcare worker, I consider it my responsibility to have mine, because I am constantly exposed to the elderly and young and others with compromised immune systems, where infection poses a very real risk to their lives. Other communicable diseases (ie the childhood vaccination ones) that are really what the anti-vaxxers are all about being 'pro choice' on, are significantly more deadly than the flu (which, depending on your stats and year of illness, probably rate somewhere around the 0.005% death rate and 0.01-0.02 severe infection/needing hospitalisation rate). Against the numbers of lives saved and morbidity avoided by vaccinating for these severe diseases, the risks of vaccination are basically the same as that of crossing the street and getting hit by a bus. Let's keep in context that The current wave of anti-vax hysteria was kicked off by (Former Doctor) Andrew Wakefield's false study that claimed that the MMR vaccine caused Autism. The death toll from his bullshit propaganda, just in Samoa in the last 6 months, is 83. Whilst there is a non-zero rate of harm from vaccination (ranging, at the worst end, apparently 1-2 deaths per million vaccinations for Smallpox back in the day, down to just rashes and fevers on the low end, but including Guillian-Barre Syndrome which may mean a patient needs ventilator support for a while), the discussion around risk-benefit is not an equivocal one - the evidence is literally littered in journals and around the web from publications stretching back over 150 years

breck 7y ago
Thank you for the detailed response. I plead ignorance on the specific anti-vax movement and don't know of Wakefield and the events behind it. I believe the ballpark estimates you provided on the low risks of vaccination. I get vaccines (and my family does as well). I do not have the unfortunate problem that you must have to deal with of convincing folks to make the good bet and getting vaccinated. I would like to eliminate that problem as well. But instead of the approach of attempting to censor "false" information, I think we need to revolutionize the way we put out good medical information. As you describe it, and I would completely concur with, "the evidence is literally littered in journals and around the web from publications stretching back over 150 years". The problem is exactly that: the evidence is "littered" and even if one works in the field (as I do), it is a huge burden to answer questions with sound data backing. Imagine if you had a parent express skepticism about getting their 1 year old vaccinated, and you could take out your tablet in front of them and say "show me health outcomes for all babies in the past ten years, grouped by vaccination status" and it would pull up live data on one hundred million patients, that's where I think we need to go.
- robbiep 7y ago
  This is interesting, but where do you draw the line? I mean, even showing the specific data from your example above, you may have long periods of time where the unvaccinated proportion of the population (take for example Australia's Northern Rivers region or areas of California recently) that, for a long time experience declining immunisation rates, with no increase in disease. Then eventually herd immunity falls low enough that they aren't protected and someone gets infected and it rips through a population. For 10 years, the data may have shown no adverse impacts one way or another - the only way to tell the difference between a vaccinated and unvaccinated child would have been to measure antibody titre. Then, all of a sudden, lots of people are sick and a few babies are dead. You can't convince people to read the 'good' information. I mean, to take another example, the information for healthy eating and lifestyle are all around us but it certainly hasn't lead to a change in average BMI heading anywhere but upwards in the last 30 years. Literally the first 10 google queries for Vaccines are form the CDC, Mayo Clinic and other excellent resources going through the evidence for vaccines. I'm not sure how a further portal is going to help people who have decided to make decisions contrary to the evidence. It's a quasi-religious belief that is being fought

breck 7y ago

Thank you for the detailed response. I plead ignorance on the specific anti-vax movement and don't know of Wakefield and the events behind it. I believe the ballpark estimates you provided on the low risks of vaccination. I get vaccines (and my family does as well). I do not have the unfortunate problem that you must have to deal with of convincing folks to make the good bet and getting vaccinated. I would like to eliminate that problem as well. But instead of the approach of attempting to censor "false" information, I think we need to revolutionize the way we put out good medical information. As you describe it, and I would completely concur with, "the evidence is literally littered in journals and around the web from publications stretching back over 150 years". The problem is exactly that: the evidence is "littered" and even if one works in the field (as I do), it is a huge burden to answer questions with sound data backing. Imagine if you had a parent express skepticism about getting their 1 year old vaccinated, and you could take out your tablet in front of them and say "show me health outcomes for all babies in the past ten years, grouped by vaccination status" and it would pull up live data on one hundred million patients, that's where I think we need to go.

robbiep 7y ago
This is interesting, but where do you draw the line? I mean, even showing the specific data from your example above, you may have long periods of time where the unvaccinated proportion of the population (take for example Australia's Northern Rivers region or areas of California recently) that, for a long time experience declining immunisation rates, with no increase in disease. Then eventually herd immunity falls low enough that they aren't protected and someone gets infected and it rips through a population. For 10 years, the data may have shown no adverse impacts one way or another - the only way to tell the difference between a vaccinated and unvaccinated child would have been to measure antibody titre. Then, all of a sudden, lots of people are sick and a few babies are dead. You can't convince people to read the 'good' information. I mean, to take another example, the information for healthy eating and lifestyle are all around us but it certainly hasn't lead to a change in average BMI heading anywhere but upwards in the last 30 years. Literally the first 10 google queries for Vaccines are form the CDC, Mayo Clinic and other excellent resources going through the evidence for vaccines. I'm not sure how a further portal is going to help people who have decided to make decisions contrary to the evidence. It's a quasi-religious belief that is being fought