5 ms·

I think we should be making a financial/societal incentive to do the right thing if the science is settled enough. The trouble with the view presented here is

I think we should be making a financial/societal incentive to do the right thing if the science is settled enough. The trouble with the view presented here is that sure the children get the vaccine due to this hypothetical rule. what happens when later the children get a severe cold (say) and the mom who remembers the previous visit thinks - bloody doctors I will just keep my kid home and pray for him to get better? Much better approach: "Ok Sacha since you declined the vaccination now I have to report it to all medical insurers. Your family insurance just doubled." At school: "Sacha your kids are not vaccinated and we do not admit any students not vaccinated." Apartment: "Ok Sacha your kids are not vaccinated (per this website where we can query); we will need to charge you a fee that is contributed to our residents' medical fund to cover the risk of housing you." If you really truly start to hurt in the pocketbook, I bet there will be much more incentive to really read up on the Science.

JumpCrisscross 12y ago
> At school: "Sacha your kids are not vaccinated and we do not admit any students not vaccinated." I thought this would perpetuate social stratification. But my hypothesis, that poor families are less likely to vaccinate their children than rich families, was incorrect. The National Network for Immunisation Information finds that "compared to fully immunized children, unvaccinated children were more likely to be non-Hispanic white and live in larger households. Educational levels, family income and other factors did not differ" [1]. Removing the philosophical exemption, at the federal level, seems a prudent first step. "States that allowed philosophical exemptions to immunization laws in schools had many more unvaccinated children than states that do not have philosophical exemptions." [1] http://www.immunizationinfo.org/science/demographics-unvaccinated-children http://www.immunizationinfo.org/science/demographics-unvacci...
- Terr_ 12y ago
  Alternate theory: "Poor families" are more likely to be aware (either directly or "institutionally") of the impact of the various preventable diseases or conditions. Reminds of of a Bujold quote. The character is referring to how over time people forget how hard things were: > "They like to play dress-up and pretend being [noble-class] ladies of old, rescued from menace by romantic [noble-class] youths. For some reason they never play 'dying in childbirth', or 'vomiting your guts out from the red dysentery', or 'weaving till you go blind and crippled from arthritis and dye poisoning', or 'infanticide'." > "Well, they do die romantically of disease sometimes, but somehow it's always an illness that makes you interestingly pale and everyone sorry and doesn't involve losing bowel control."
  - gretful 12y ago
    Alternate theory 2: "Rich families" are more likely to have seen that there is reason to distrust the government and medical establisments.
    - Terr_ 12y ago
      Poor families trust the government, you say?
  - Sanddancer 12y ago
    I think that may be fairly dead-on. My step-grandfather had polio as a child, and as a result, had his growth stunted, and severe nerve damage in his lower legs, requiring him to wear orthotics throughout his life. As a result, when the polio vaccine was announced, he made damn sure that my stepfather and his siblings all were properly vaccinated.
- tzs 12y ago
  > But my hypothesis, that poor families are less likely to vaccinate their children than rich families, was incorrect Indeed. The Waldorf School of the Peninsula, an expensive private school ($20k/year tuition for kindergarten and elementary school, $21k/year for middle school, and $28k/year for high school), full of the children of very well off people from top Silicon Valley companies, had a 23% immunization rate a few years ago (I haven't seen what the current rate is). Compare to 90% for the public schools in the same city, and 94% for the public schools in the county.
DanBC 12y ago
I would love it if schools and nurseries started to disallow children who were not vaccinated. Unfortunately there are enough parents to make "no vaccinated children allowed" (you are not allowed in if you've been vaccinated) schools viable. See "Measles parties" and the sending of items infected with chicken pox through the post for examples.
- JonnieCache 12y ago
  There are really measels parties? I've heard of chicken pox parties, which makes sense because there's no vaccine and the adult form is vastly worse than the infant form. But measels parties, that's just medieval. EDIT: apparently there is a chicken pox vaccine, but it isn't administered to the general population in the UK, only NHS workers. Interesting.
  - bane 12y ago
    That's interesting, the MMR vaccine is a normal vaccine here in the U.S. as part of the normal shots infants get. There's usually a booster shot as a young adult and again in middle-late age. edit apparently I forgot reading comprehension, I see now that you were talking about Chicken Pox vaccines. I didn't know either, I just know the MMR. AFAIK people just have Chicken Pox parties for their kids and make sure they get exposed. I remember when I was about 4 or 5 my mother was so thrilled when the lady who owned a store down the way had two kids who got Chicken Pox. The next day she took me out of school and I "met" their kids for about 30 minutes. Got the Pox sure enough right after that. My Uncle somehow missed it and ended up getting it in his 40s. I think he spent part of it in the hospital. The difference between adults and children's responses to it is quite remarkable.
    - cbhl 12y ago
      MMRV only became available in 2005. Source: http://www.webmd.com/children/vaccines/chickenpox-varicella-vaccine http://www.webmd.com/children/vaccines/chickenpox-varicella-...
    - Spooky23 12y ago
ISL 12y ago
Do you want people to read up on the science, or to accept what's "settled"? As a professional scientist, there are few things more anathema than the idea that a scientific theory is "settled". Experiments can only falsify theories; they can never be proven to be correct. The best a theory can hope for is to remain consistent with observation. Once upon a time, it was well-settled in large communities that the universe spun about the Earth.
- jbooth 12y ago
  Yeah, but we're talking about not vaccinating your kids, here. It might be that we're all living in a computer simulation and none of this matters but we should still act on what we observe.
  - ISL 12y ago
    I'm personally convinced that vaccination is worthwhile; I've been convinced of that by my education, my experience, and my understanding of the scientific literature. The benefit to the individual and to society of vaccines is, to me, well-established. I'm willing to compromise part of my herd's immunity for those who wish not to receive a vaccine, even if it increases my risk somewhat. I don't think that anti-vaccine activists are correct, but it's a hell of a thing to inject stuff into their children that they think could bring them harm. Though we do it every day as a society, I don't want to be a part of a herd that resorts to compulsion on ethical questions. Inextricable from this discussion is the fact that the children won't reach majority before the decision must be made. If we could wait until people turned eighteen before presenting them with the choice of vaccination, this debate would be different. As a final thought -- if everyone else is immunized, it may be to your advantage to skip vaccination to avoid a tiny risk of side-effects. There's an equilibrium here, and it's not at 100% vaccination rates, even if 100% vaccination could yield eradication.
    - rmrfrmrf 12y ago
      There's the rub: it's not about you or what you want. There are already enough people who cannot be vaccinated -- people with egg allergies, people with compromised immune systems, etc. Furthermore, vaccines don't always take, so there may be more unvaccinated people out there than we actually know of. Herd immunity works by everyone who can participate participating; the more, the better. What irritates me about anti-vax more than anything is the selfishness and privilege that goes along with it. "I don't need to put a vaccine in my child's body; if herd immunity really works, then my children won't be the problem!" Never mind the fact that every person this child comes in contact with now has a greater risk for infection, or even transmission of diseases. Lastly, your usage of "convinced" really rubs me the wrong way. Granted, you have a "right" to believe whatever you want, but if you trust that evidence-based science is correct, it's really not a "take it or leave it" kind of situation.
GhotiFish 12y ago
>I bet there will be much more incentive to really read up on the Science. You mean capitulate to a forced perspective? If she learned fundamental statistic, pored through paper after paper, found errors and miscalculations, would she get her money back? No, so ignorant or not is irrelevant. Your utopia is terrifying.

JumpCrisscross 12y ago

> At school: "Sacha your kids are not vaccinated and we do not admit any students not vaccinated." I thought this would perpetuate social stratification. But my hypothesis, that poor families are less likely to vaccinate their children than rich families, was incorrect. The National Network for Immunisation Information finds that "compared to fully immunized children, unvaccinated children were more likely to be non-Hispanic white and live in larger households. Educational levels, family income and other factors did not differ" [1]. Removing the philosophical exemption, at the federal level, seems a prudent first step. "States that allowed philosophical exemptions to immunization laws in schools had many more unvaccinated children than states that do not have philosophical exemptions." [1] http://www.immunizationinfo.org/science/demographics-unvaccinated-children http://www.immunizationinfo.org/science/demographics-unvacci...

Terr_ 12y ago
Alternate theory: "Poor families" are more likely to be aware (either directly or "institutionally") of the impact of the various preventable diseases or conditions. Reminds of of a Bujold quote. The character is referring to how over time people forget how hard things were: > "They like to play dress-up and pretend being [noble-class] ladies of old, rescued from menace by romantic [noble-class] youths. For some reason they never play 'dying in childbirth', or 'vomiting your guts out from the red dysentery', or 'weaving till you go blind and crippled from arthritis and dye poisoning', or 'infanticide'." > "Well, they do die romantically of disease sometimes, but somehow it's always an illness that makes you interestingly pale and everyone sorry and doesn't involve losing bowel control."
- gretful 12y ago
  Alternate theory 2: "Rich families" are more likely to have seen that there is reason to distrust the government and medical establisments.
  - Terr_ 12y ago
    Poor families trust the government, you say?
- Sanddancer 12y ago
  I think that may be fairly dead-on. My step-grandfather had polio as a child, and as a result, had his growth stunted, and severe nerve damage in his lower legs, requiring him to wear orthotics throughout his life. As a result, when the polio vaccine was announced, he made damn sure that my stepfather and his siblings all were properly vaccinated.
tzs 12y ago
> But my hypothesis, that poor families are less likely to vaccinate their children than rich families, was incorrect Indeed. The Waldorf School of the Peninsula, an expensive private school ($20k/year tuition for kindergarten and elementary school, $21k/year for middle school, and $28k/year for high school), full of the children of very well off people from top Silicon Valley companies, had a 23% immunization rate a few years ago (I haven't seen what the current rate is). Compare to 90% for the public schools in the same city, and 94% for the public schools in the county.

DanBC 12y ago

I would love it if schools and nurseries started to disallow children who were not vaccinated. Unfortunately there are enough parents to make "no vaccinated children allowed" (you are not allowed in if you've been vaccinated) schools viable. See "Measles parties" and the sending of items infected with chicken pox through the post for examples.

JonnieCache 12y ago
There are really measels parties? I've heard of chicken pox parties, which makes sense because there's no vaccine and the adult form is vastly worse than the infant form. But measels parties, that's just medieval. EDIT: apparently there is a chicken pox vaccine, but it isn't administered to the general population in the UK, only NHS workers. Interesting.
- bane 12y ago
  That's interesting, the MMR vaccine is a normal vaccine here in the U.S. as part of the normal shots infants get. There's usually a booster shot as a young adult and again in middle-late age. edit apparently I forgot reading comprehension, I see now that you were talking about Chicken Pox vaccines. I didn't know either, I just know the MMR. AFAIK people just have Chicken Pox parties for their kids and make sure they get exposed. I remember when I was about 4 or 5 my mother was so thrilled when the lady who owned a store down the way had two kids who got Chicken Pox. The next day she took me out of school and I "met" their kids for about 30 minutes. Got the Pox sure enough right after that. My Uncle somehow missed it and ended up getting it in his 40s. I think he spent part of it in the hospital. The difference between adults and children's responses to it is quite remarkable.
  - cbhl 12y ago
    MMRV only became available in 2005. Source: http://www.webmd.com/children/vaccines/chickenpox-varicella-vaccine http://www.webmd.com/children/vaccines/chickenpox-varicella-...
  - Spooky23 12y ago

ISL 12y ago

Do you want people to read up on the science, or to accept what's "settled"? As a professional scientist, there are few things more anathema than the idea that a scientific theory is "settled". Experiments can only falsify theories; they can never be proven to be correct. The best a theory can hope for is to remain consistent with observation. Once upon a time, it was well-settled in large communities that the universe spun about the Earth.

jbooth 12y ago
Yeah, but we're talking about not vaccinating your kids, here. It might be that we're all living in a computer simulation and none of this matters but we should still act on what we observe.
- ISL 12y ago
  I'm personally convinced that vaccination is worthwhile; I've been convinced of that by my education, my experience, and my understanding of the scientific literature. The benefit to the individual and to society of vaccines is, to me, well-established. I'm willing to compromise part of my herd's immunity for those who wish not to receive a vaccine, even if it increases my risk somewhat. I don't think that anti-vaccine activists are correct, but it's a hell of a thing to inject stuff into their children that they think could bring them harm. Though we do it every day as a society, I don't want to be a part of a herd that resorts to compulsion on ethical questions. Inextricable from this discussion is the fact that the children won't reach majority before the decision must be made. If we could wait until people turned eighteen before presenting them with the choice of vaccination, this debate would be different. As a final thought -- if everyone else is immunized, it may be to your advantage to skip vaccination to avoid a tiny risk of side-effects. There's an equilibrium here, and it's not at 100% vaccination rates, even if 100% vaccination could yield eradication.
  - rmrfrmrf 12y ago
    There's the rub: it's not about you or what you want. There are already enough people who cannot be vaccinated -- people with egg allergies, people with compromised immune systems, etc. Furthermore, vaccines don't always take, so there may be more unvaccinated people out there than we actually know of. Herd immunity works by everyone who can participate participating; the more, the better. What irritates me about anti-vax more than anything is the selfishness and privilege that goes along with it. "I don't need to put a vaccine in my child's body; if herd immunity really works, then my children won't be the problem!" Never mind the fact that every person this child comes in contact with now has a greater risk for infection, or even transmission of diseases. Lastly, your usage of "convinced" really rubs me the wrong way. Granted, you have a "right" to believe whatever you want, but if you trust that evidence-based science is correct, it's really not a "take it or leave it" kind of situation.

GhotiFish 12y ago

>I bet there will be much more incentive to really read up on the Science. You mean capitulate to a forced perspective? If she learned fundamental statistic, pored through paper after paper, found errors and miscalculations, would she get her money back? No, so ignorant or not is irrelevant. Your utopia is terrifying.