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But how do you quantify it? How much harm is caused to herd immunity by 1 more child not getting vaccinated? What is the expected value of that -- the probabi

by pzxc 12y ago

But how do you quantify it? How much harm is caused to herd immunity by 1 more child not getting vaccinated? What is the expected value of that -- the probability that the disease for which the vaccine is available actually occurs in such a way that the voluntarily-nonvaccinated person contracts it and then passes it on to someone who is involuntarily nonvaccinated? How does the expected value of that harm (probability assessment) compare to the expected value of harm from secondhand smoke? What about the harm from wood fireplaces? What about swimming pools and trampoline and the probability of injury or death from both? All I'm saying is, some of the commenters in this thread are (in my opinion) being just as irrational and hyperbolic as the anti-vaccine crowd. (Especially the people replying to me playing devil's advocate). For example the one comparing it to drunk driving. And it's a shame.

dinkumthinkum 12y ago
Fortunately we have these things called "science" and "math" and we have no trouble quantifying these things. Or are you suggesting that there is literally only ONE child in the entire world that is not vaccinated? I'm not sure this is making any sense, to be honest. We have a lot data about times when vaccines did not exist. We have a lot of data about what happened after there was widespread vaccinations. We also have data now about significant numbers of people following an actress' decision to not vaccinate and the resulting emergence of infections. I don't think anyone is being irrational or hyperbolic. I think it is irrational to compare antivaccinationism with anticircumcisionism. That is just outlandish.
- pzxc 12y ago
  Your tone is sarcastic, but I'll try to explain again. I'm not suggesting only one child in the world is unvaccinated, that would be absurd. I'm suggesting that if the unvaccinated child never contracts the disease, then there's no harm, right? And if the unvaccinated kid gets it, but doesn't pass it to anybody, no harm no foul again. (To others, that is, which is what we're really discussing as far as first amendment limits right? My fist-throwing rights ends just before your nose) So what I'm saying is, it's difficult to quantify the expected value of real-life situations because there are so many variables and direct and indirect effects, and because of that difficulty it's easy for many people to ignore relative probability altogether and go with their gut reaction, and that's a mistake, because the relative probability of harm coming from a person choosing not to vaccinate their child is a relatively rare event... and so in light of other very rare events, that we nevertheless do not have much of a problem with (like allowing families with children to have wood fireplaces or trampolines or swimming pools), then maybe, just MAYBE, parents who don't vaccinate are not really that harmful and it's not worth overriding individual choice, even though we all agree that the smart choice is to vaccinate. Any better? I'd love you see you quantify the relative probability of all those events with your "math" though, since you say it's so easy. :)
  - moultano 12y ago
    We can base it on the consequences. If someone dies from an outbreak, and an unvaccinated person is found to be a vector, they are guilty of involuntary manslaughter. Hopefully the prospect of that is enough of an incentive.
nl 12y ago
Playing devils advocate is all very well, but your questions have pretty easy answers. Unfortunately they involve math, and so people tend to tune out. But how do you quantify it? How much harm is caused to herd immunity by 1 more child not getting vaccinated? Herd immunity is a threshold. For measles (which is highly contagious) it is generally accepted to be between 82% and 94%[1]. What is the expected value of that -- the probability that the disease for which the vaccine is available actually occurs in such a way that the voluntarily-nonvaccinated person contracts it and then passes it on to someone who is involuntarily nonvaccinated? In a non-vaccinated population, a single case of measles can be expected to infect 12 to 18 people[2]. In the recent Disneyland incident, 3 people were vaccinated and caught it (because the vaccine is only 97% effective - less if you have only received the first dose). 2 children who were infected were too young to receive the vaccine[3][4]. 32 people were infected in total. [1] http://en.wikipedia.org/wiki/Herd_immunity http://en.wikipedia.org/wiki/Herd_immunity [2] http://en.wikipedia.org/wiki/Basic_reproduction_number http://en.wikipedia.org/wiki/Basic_reproduction_number [3] http://www.wired.com/2015/01/vaccinated-people-get-measles-disneyland-blame-unvaccinated/ http://www.wired.com/2015/01/vaccinated-people-get-measles-d... [4] http://www.iflscience.com/health-and-medicine/disneyland-measles-outbreak-hits-children-too-young-be-vaccinated http://www.iflscience.com/health-and-medicine/disneyland-mea...
- chrismcb 12y ago
  Maybe I'm doing the math wrong, but if herd immunity threshold is 82 to 94% then isn't it ok that 7% of the children aren't immunized?
  - soneil 12y ago
    It's borderline. If 7% have 'personal belief exemptions', then the 'herd' is at 93%. And we have at least one example (the child in the article) of further members who aren't vaccinated outside of this 7%. So the actual number is likely to be a little lower than 93%. Personally, I don't believe a model as simple as a % is likely to be workable in a school. If one of those 7% happens to sit beside him in every single class, the odds are going to defy the 'threshold' very quickly.
  - 12y ago
bequanna 12y ago
I understand what you're saying, and I get that you're playing devil's advocate here. I'm not saying 'screw vaccination deniers', I think we should have this conversation. My position is simply that your rights end where mine begin. This isn't like teaching alternatives to evolution in public school. If you don't want to believe in evolution, it irks me, but that doesn't really hurt me. People can die when others refuse vaccination for bogus reasons. Even if it isn't readily quantifiable, I think many would agree with that statement. If enough people start refusing vaccinations, it is reasonable to expect that a LOT of people could get very sick and many could die. >What about the harm from wood fireplaces? There are regulations in populated areas. The Bay Area has 'Spare the Air' laws >What about swimming pools and trampoline and the probability of injury or death from both? There are laws requiring fences around pools. And home insurance rates skyrocket when either of those is present.
- DougN7 12y ago
  > My position is simply that your rights end where mine begin What about where your rights might begin? I'm thinking of the dangers of alcohol, drugs, etc. where my use doesn't guarantee causing you trouble, but it definitely increases the likelyhood - much like not gettig vaccinated.
  - bequanna 12y ago
    Not sure I follow you here. If you 'cause me trouble' on drugs/alcohol, that is a decision you are making as an individual. If you drink and drive, if you punch me, you are actively choosing to cause harm. Being drunk or high isn't really a valid excuse for bad behavior or committing crimes.
    - DougN7 12y ago
      I guess I'm thinking not getting vaccinated doesn't actively cause you harm. It might. So someone getting drunk/stoned/high might cause you harm. I guess there is some lessened ability to make a decision, but causing an accident for example is something no sober person would do. But we allow people to drink and take the chance. Seems similar to allowing people to not get vaccinated to me.
DanBC 12y ago
> - the probability that the disease for which the vaccine is available actually occurs in such a way that the voluntarily-nonvaccinated person contracts it and then passes it on to someone who is involuntarily nonvaccinated? This part contains an error. Herd immunity is important because not all vaccinations are 100% effective. So, when there is an outbreak some of the people who are vaccinated will be at risk.

by pzxc 12y ago

dinkumthinkum 12y ago

Fortunately we have these things called "science" and "math" and we have no trouble quantifying these things. Or are you suggesting that there is literally only ONE child in the entire world that is not vaccinated? I'm not sure this is making any sense, to be honest. We have a lot data about times when vaccines did not exist. We have a lot of data about what happened after there was widespread vaccinations. We also have data now about significant numbers of people following an actress' decision to not vaccinate and the resulting emergence of infections. I don't think anyone is being irrational or hyperbolic. I think it is irrational to compare antivaccinationism with anticircumcisionism. That is just outlandish.

pzxc 12y ago
Your tone is sarcastic, but I'll try to explain again. I'm not suggesting only one child in the world is unvaccinated, that would be absurd. I'm suggesting that if the unvaccinated child never contracts the disease, then there's no harm, right? And if the unvaccinated kid gets it, but doesn't pass it to anybody, no harm no foul again. (To others, that is, which is what we're really discussing as far as first amendment limits right? My fist-throwing rights ends just before your nose) So what I'm saying is, it's difficult to quantify the expected value of real-life situations because there are so many variables and direct and indirect effects, and because of that difficulty it's easy for many people to ignore relative probability altogether and go with their gut reaction, and that's a mistake, because the relative probability of harm coming from a person choosing not to vaccinate their child is a relatively rare event... and so in light of other very rare events, that we nevertheless do not have much of a problem with (like allowing families with children to have wood fireplaces or trampolines or swimming pools), then maybe, just MAYBE, parents who don't vaccinate are not really that harmful and it's not worth overriding individual choice, even though we all agree that the smart choice is to vaccinate. Any better? I'd love you see you quantify the relative probability of all those events with your "math" though, since you say it's so easy. :)
- moultano 12y ago
  We can base it on the consequences. If someone dies from an outbreak, and an unvaccinated person is found to be a vector, they are guilty of involuntary manslaughter. Hopefully the prospect of that is enough of an incentive.

nl 12y ago

Playing devils advocate is all very well, but your questions have pretty easy answers. Unfortunately they involve math, and so people tend to tune out. But how do you quantify it? How much harm is caused to herd immunity by 1 more child not getting vaccinated? Herd immunity is a threshold. For measles (which is highly contagious) it is generally accepted to be between 82% and 94%[1]. What is the expected value of that -- the probability that the disease for which the vaccine is available actually occurs in such a way that the voluntarily-nonvaccinated person contracts it and then passes it on to someone who is involuntarily nonvaccinated? In a non-vaccinated population, a single case of measles can be expected to infect 12 to 18 people[2]. In the recent Disneyland incident, 3 people were vaccinated and caught it (because the vaccine is only 97% effective - less if you have only received the first dose). 2 children who were infected were too young to receive the vaccine[3][4]. 32 people were infected in total. [1] http://en.wikipedia.org/wiki/Herd_immunity http://en.wikipedia.org/wiki/Herd_immunity [2] http://en.wikipedia.org/wiki/Basic_reproduction_number http://en.wikipedia.org/wiki/Basic_reproduction_number [3] http://www.wired.com/2015/01/vaccinated-people-get-measles-disneyland-blame-unvaccinated/ http://www.wired.com/2015/01/vaccinated-people-get-measles-d... [4] http://www.iflscience.com/health-and-medicine/disneyland-measles-outbreak-hits-children-too-young-be-vaccinated http://www.iflscience.com/health-and-medicine/disneyland-mea...

chrismcb 12y ago
Maybe I'm doing the math wrong, but if herd immunity threshold is 82 to 94% then isn't it ok that 7% of the children aren't immunized?
- soneil 12y ago
  It's borderline. If 7% have 'personal belief exemptions', then the 'herd' is at 93%. And we have at least one example (the child in the article) of further members who aren't vaccinated outside of this 7%. So the actual number is likely to be a little lower than 93%. Personally, I don't believe a model as simple as a % is likely to be workable in a school. If one of those 7% happens to sit beside him in every single class, the odds are going to defy the 'threshold' very quickly.
- 12y ago

bequanna 12y ago

I understand what you're saying, and I get that you're playing devil's advocate here. I'm not saying 'screw vaccination deniers', I think we should have this conversation. My position is simply that your rights end where mine begin. This isn't like teaching alternatives to evolution in public school. If you don't want to believe in evolution, it irks me, but that doesn't really hurt me. People can die when others refuse vaccination for bogus reasons. Even if it isn't readily quantifiable, I think many would agree with that statement. If enough people start refusing vaccinations, it is reasonable to expect that a LOT of people could get very sick and many could die. >What about the harm from wood fireplaces? There are regulations in populated areas. The Bay Area has 'Spare the Air' laws >What about swimming pools and trampoline and the probability of injury or death from both? There are laws requiring fences around pools. And home insurance rates skyrocket when either of those is present.

DougN7 12y ago
> My position is simply that your rights end where mine begin What about where your rights might begin? I'm thinking of the dangers of alcohol, drugs, etc. where my use doesn't guarantee causing you trouble, but it definitely increases the likelyhood - much like not gettig vaccinated.
- bequanna 12y ago
  Not sure I follow you here. If you 'cause me trouble' on drugs/alcohol, that is a decision you are making as an individual. If you drink and drive, if you punch me, you are actively choosing to cause harm. Being drunk or high isn't really a valid excuse for bad behavior or committing crimes.
  - DougN7 12y ago
    I guess I'm thinking not getting vaccinated doesn't actively cause you harm. It might. So someone getting drunk/stoned/high might cause you harm. I guess there is some lessened ability to make a decision, but causing an accident for example is something no sober person would do. But we allow people to drink and take the chance. Seems similar to allowing people to not get vaccinated to me.

DanBC 12y ago

> - the probability that the disease for which the vaccine is available actually occurs in such a way that the voluntarily-nonvaccinated person contracts it and then passes it on to someone who is involuntarily nonvaccinated? This part contains an error. Herd immunity is important because not all vaccinations are 100% effective. So, when there is an outbreak some of the people who are vaccinated will be at risk.