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Frenzy
08-20-2008, 09:11 PM
As Diseases Make Comeback, Why Aren't All Kids Vaccinated? (http://www.popularmechanics.com/science/health_medicine/4273262.html)

By Glenn Harlan Reynolds
Illustration by Koren Shadmi
Published in the August 2008 issue of Popular Mechanics

Progress is easy to take for granted. When I was a child in the ’60s, polio was history, measles was on the way out, and diphtheria and whooping cough were maladies out of old movies. Now these contagious diseases are making a comeback. Take measles, for instance. The disease used to infect 3 to 4 million Americans per year, hospitalizing nearly 50,000 people and causing 400 to 500 deaths. In 2000 a panel of experts convened by the Centers for Disease Control and Prevention proclaimed that measles transmission had been eradicated in the United States, except for imported cases. But that caveat is important. An unvaccinated 7-year-old from San Diego became infected with measles while traveling with his family in Switzerland and ended up transmitting the disease back home to two siblings, five schoolmates and four other children at his doctor’s office—all of them unvaccinated. Whooping cough has also seen a resurgence: A school in the East Bay area near San Francisco was closed recently when some 16 students fell ill.

The reason for these incidents—and for recent outbreaks of polio—is that the percentage of parents vaccinating their children has fallen, perhaps because some parents see no point in warding off diseases they’ve never encountered. Religious or new-age beliefs may also factor into the decision: The San Diego outbreak spread in a school where nearly 10 percent of the students had been given personal-belief exemptions from the vaccination requirement. The East Bay outbreak started at a school that emphasizes nature-based therapy over mainstream medicine; fewer than half of the students were vaccinated.

Why would parents refuse to vaccinate their children against dangerous diseases? Many are skeptical of modern science and medicine in general. (And it is true that most vaccines carry exceedingly tiny—but real—risks of serious illness or even death.) But I think most are responding to the widespread belief that vaccines are linked to autism. Recent studies have soundly disspelled that notion. And a simple glance at health statistics shows that autism cases continued to rise even after thimerosal, the mercury-based preservative widely blamed for the supposed autism link, was largely phased out of U.S. vaccines by 2001.

Nevertheless, these unsubstantiated fears have led some people to say that getting vaccinated should be a matter of individual choice: If you want to be protected, just get yourself and your children vaccinated.

Only it’s not that easy. While the measles vaccine protects virtually everyone who is inoculated, not all vaccines have the same rate of success. But even if a vaccine is effective for only 70, 80 or 90 percent of those who take it, the other 30, 20 or 10 percent who don’t get the full benefit of the vaccine are usually still not at risk. That’s because most of the people around the partially protected are immune, so the disease can’t sustain transmission long enough to spread.

But when people decide to forgo vaccination, they threaten the entire system. They increase their own risk and the risk of those in the community, including babies too young to be vaccinated and people with immune systems impaired by disease or chemotherapy. They are also free-riding on the willingness of others to get vaccinated, which makes a decision to avoid vaccines out of fear or personal belief a lot safer.

Of course it is the very success of modern vaccines that makes this complacency possible. In previous generations, when epidemic disease swept through schools and neighborhoods, it was easy to persuade parents that the small risks associated with vaccination were worth it. When those epidemics stopped—because of widespread vaccinations—it became easy to forget that we still live in a dangerous world. It happens all the time: University of Tennessee law professor Gregory Stein examined the relation between building codes and accidents since the infamous 1911 Triangle Shirtwaist factory fire in New York and discovered a pattern: accident followed by a period of tightened regulations, followed by a gradual slackening of oversight until the next accident. It often takes a dramatic event to focus our minds.

The problem is that modern society requires constant, not episodic, attention to keep it running. In his book The Escape from Hunger and Premature Death 1700–2100 Nobel Prize–winning historian Robert Fogel notes the incredible improvement in the lives of ordinary people since 1700 as a result of modern sanitation, agriculture and public health. It takes steady work to keep water clean, prevent the spread of contagious disease and ensure an adequate food supply. As long as things go well, there’s a tendency to take these conditions for granted and treat them as a given. But they’re not: As Fogel notes, they represent a dramatic departure from the normal state of human existence over history, in which people typically lived nasty, sickly and short lives.

This departure didn’t happen on its own, and things don’t stay better on their own. Keeping a society functioning requires a lot of behind-the-scenes work by people who don’t usually get a lot of attention—sanitation engineers, utility linemen, public health nurses, farmers, agricultural chemists and so on. Because the efforts of these workers are often undramatic, they are underappreciated and frequently underfunded. Politicians like to cut ribbons on new bridges or schools, but there’s no fanfare for the everyday maintenance that keeps the bridges standing and the schools working. As a result, critical parts of society are quietly decaying, victims of complacency or of active neglect. (See PM’s special report on the nation’s infrastructure, “Rebuilding America”) It’s not just vaccinations or bridges, either. A few years ago, I attended an Environmental Protection Agency Science Advisory Board meeting, and the water-treatment discussion was enough to make me think about switching to beer.

What do we do about this? To some degree, we have to do what the reformers of the 19th and early 20th centuries did: Hector people about the importance of paying attention to our society’s upkeep. Alas, our main allies in persuasion will probably be the epidemics and other disasters that take place when too few pay attention. Sometimes, people have to trip and fall to be reminded that it’s important to watch their step.
~Waits for those of us in the medical community to pitch a fit~

Terez
08-20-2008, 09:22 PM
Callandor wrote several blogs on this, including these:

This is why vaccines should be mandatory (http://thestoneoftear.blogspot.com/2008/03/this-is-why-vaccines-should-be.html)

Jenny McCarthy pushes vaccine-autism "link" (http://thestoneoftear.blogspot.com/2008/04/jenny-mccarthy-pushes-vaccine-autism.html)

Cranks are forcing us to waste money, you know (http://thestoneoftear.blogspot.com/2008/04/cranks-are-forcing-us-to-waste-money.html)

An empirical fact all presidential candidates are wrong on (http://thestoneoftear.blogspot.com/2008/04/empirical-fact-all-presidential.html)

The last one in particular is a bit scary...

JSUCamel
08-20-2008, 09:53 PM
http://www.thelittleseed.com/blog/?p=28

An open letter from a doctor, supposedly.

Davian93
08-21-2008, 07:08 AM
Ahh...the brilliance of trailer trash ignorance...

"We're always getting the baby vaccines for diseases she doesn't even have!!!"

JSUCamel
08-21-2008, 08:07 AM
Ahh...the brilliance of trailer trash ignorance...

"We're always getting the baby vaccines for diseases she doesn't even have!!!"

That's kind of the point of vaccines, dufus. You don't wait til you have the flu and then get the vaccine -- by then it's too late, and you're doomed to a coughing, hacking, shivering, sneezing, going-to-work-anyway death by influenza.

Davian93
08-21-2008, 08:18 AM
That's kind of the point of vaccines, dufus. You don't wait til you have the flu and then get the vaccine -- by then it's too late, and you're doomed to a coughing, hacking, shivering, sneezing, going-to-work-anyway death by influenza.


Well yeah...I know that...some people fail to grasp the concept though.

Ivhon
08-21-2008, 09:09 AM
Im all for Democratization and everyone having a say. However, sometimes, "everyone" is too stupid to have a say that counts. Its a disturbing trend in the age of vote-on-everything that people think that their medical opinion counts as much as an MD's. Why the hell did the MD go through the ten billion years of hellish training if your GED medical opinion means just as much?

Standard Disclaimer: The above does not apply to me, of course.

Gilshalos Sedai
08-21-2008, 09:26 AM
Well.... when the current trend is to just throw a pill at the problem, like say... giving someone Prozac instead of testing her for thyroid issues... Yeah, I'm gonna have doubts about an MD.

Davian93
08-21-2008, 09:28 AM
Am I the only one that read MD as mountain dew in Ihvon's post?

Gilshalos Sedai
08-21-2008, 09:32 AM
JWB probably did, too.

John Snow
08-21-2008, 09:46 AM
is that nearly all of these diseases have some place to hang out other than humans. So while you don't hear about human cases of diphtheria often, we have to keep vaccination levels up because the bug a) is common and doesn't usually produce the toxin that produces the disease 2) doesn't need humans to survive. Tetanus is a common soil bacteria. Pertussis hangs out in adult humans, among other places, disguised as an annoying but minor cough. I have seen an outbreak of pertussis in children, in Appalachia - not pretty - coughing blood, broken ribs, vomiting. Almost the only exception is smallpox, and that's one of the biggest reasons we managed to stamp it out.

And, no offense to the MDs in the crowd, but it's not clinical medicine that has made these advances in preventive medicine and public health, it's public health practitioners and epidemiologists (some of them MDs, true, but none of them clinical docs).

Davian93
08-21-2008, 10:14 AM
Vaccinations should be mandatory even for diseases that are supposedly wiped out like polio...

tanaww
08-21-2008, 10:29 AM
Vaccinations should be mandatory even for diseases that are supposedly wiped out like polio...

I agree. I'd also like to vaccinate against incompetence and ignorance. Thanks!

John Snow
08-21-2008, 10:34 AM
Vaccinations should be mandatory even for diseases that are supposedly wiped out like polio...

and polio isn't wiped out, especially in Africa, partly because it's a hardier bug than smallpox - it's transmitted in shitty water, and the vast majority of polio infections are and always have been very mild - a little case of the runs, maybe. There's also a problem in Africa with some superstitions about the vaccine (just like the US).

Davian93
08-21-2008, 10:39 AM
I meant wiped out in the States, Prof.

Cary Sedai
08-21-2008, 11:16 AM
My grandmother had polio, and I remember learning about polio and seeing the scar from the polio vaccine that all my older relatives had. I wanted to be vaccinated, too. So I could have the same scar. I was between 3-5 yo.

Now, though...

I have a different reason for wanting to be vaccinated. The reasons stated in the article pretty much sum it up. I'll be doing more research on this when I have a family, and I'll find the best way to go about it, if I can. But my kids will be vaccinated. Not being vaccinated, to me, is sheer stupidity.

I agree. I'd also like to vaccinate against incompetence and ignorance. Thanks!

If only it were that easy! :D

Davian93
08-21-2008, 11:35 AM
Don't some countries do that with forced sterilization?

tanaww
08-21-2008, 11:36 AM
If only it were that easy! :D

It is in Texas. You can conceal and carry the injection tool.

Cary Sedai
08-21-2008, 12:06 PM
It is in Texas. You can conceal and carry the injection tool.

You're mixing threads! :p

JSUCamel
08-21-2008, 03:46 PM
It is in Texas. You can conceal and carry the injection tool.

Last time I unconcealed my "injection tool" in public, I got arrested :(

Cary Sedai
08-21-2008, 03:48 PM
Last time I unconcealed my "injection tool" in public, I got arrested :(

Not that tool! ;)

tanaww
08-21-2008, 03:55 PM
Last time I unconcealed my "injection tool" in public, I got arrested :(

Keep your glock in its case, then.

Mort
08-21-2008, 04:36 PM
I love vaccine!

Did a few a couple of weeks ago because I'm going to Tunisia in September. Diphteria (spelled correctly?) Polio, Tetanus and Hep A + B. I feel invincible know! :D

Ishara
08-21-2008, 07:44 PM
Funny, I always feel kind of crappy after my innoculations, but okay, invincible is another option. :p

Yuri33
08-22-2008, 01:47 AM
And, no offense to the MDs in the crowd, but it's not clinical medicine that has made these advances in preventive medicine and public health, it's public health practitioners and epidemiologists (some of them MDs, true, but none of them clinical docs).

It's okay, we know they just couldn't get into med school to begin with... :)

Davian93
08-22-2008, 07:06 AM
It's okay, we know they just couldn't get into med school to begin with... :)


:p

tanaww
08-22-2008, 07:20 AM
:p

Come on Dav, I'll make room on the ESC for you. This is going to be an awesome battle of the science geeks!

(I looked for the BBT video where Sheldon is trying to kill Leonard with his eyes, but I couldn't find it - sorry)

Davian93
08-22-2008, 07:38 AM
~sits down~


This should be interesting.

tanaww
08-22-2008, 07:54 AM
~sits down~


This should be interesting.

Indeed. Coffee?

Davian93
08-22-2008, 08:02 AM
Indeed. Coffee?

Thanks!

Mort
08-22-2008, 08:11 AM
*Comes over with silver tray to ESC couch*

What will it be today? Uppers, downers, laughers, screamers?

*shows the range of supplies on tray*

Frenzy
08-22-2008, 09:10 AM
Not getting your kids vaccinated and trusting that everyone else will do it anyway to protect you. Isn't that like not getting a job and trusting that everyone else will work for you to support you? Or not taking out your garbage and trusting that everyone else around you will take theirs out so the vermin won't go thru their dead zone to get to you?

Are people really that trusting to place the lives of their children on the dilligence of their fellow people? Especially if those fellow people don't share their views?

either that's a lovely example of hypocrisy, or it's Darwin's feeding trough.

GonzoTheGreat
08-22-2008, 09:14 AM
Here in the Netherlands, there are some people who refuse vaccinations (for themselves and their children) too. They do it based upon religious considerations. In their view, it is a choice between trusting God or getting vaccinated. If they trust God and get sick, that's part of His plan and not something they should try to avoid. They have Biblical quotes to support this viewpoint. If they get sick, they do seek out a doctor, since the Bible does support that (the story of the Good Samaritan, for example).

Edited to add:
For some reason, they're the ones that are customarily hardest hit every time polio shows up again. Almost as though God is trying to tell something.

Frenzy
08-22-2008, 09:34 AM
i wonder if they wear seat belts...

John Snow
08-22-2008, 09:41 AM
It's okay, we know they just couldn't get into med school to begin with... :)

I didn't want to go to med school. I ended up teaching at med schools, but epidemiology (for me, your mileage may differ) is really fun.

Yuri33
08-22-2008, 10:46 AM
I keed, I keed. Medicine wasn't enough for me, that's why I went ahead and entered an MD/PhD program.

But I think we can both agree that it takes both doctors and non-clinical specialists (epidemiologists, bench researchers, etc.) to make large advances in healthcare.

No need for an ESC couch, guys...

Davian93
08-22-2008, 11:12 AM
There's always a need for the ESC couch...though this one was a bit disappointing.

CRIPPLE FIGHT!!!

tanaww
08-22-2008, 12:56 PM
I didn't want to go to med school. I ended up teaching at med schools, but epidemiology (for me, your mileage may differ) is really fun.

So is that like teaching Special Ed, Professor?

I can envision you saying "So if you were a REAL epidemiologist this is what you'd do, but since you're not, just call one so you don't hurt yourself."


Shh... Dav, let's see if he takes the bait... It's almost beer time on the couch!

Birgitte
08-22-2008, 01:18 PM
It's after 8:30 in the morning. That means it's definitely beer time. Remember the lessons of your grandmother, Mutti.

tanaww
08-22-2008, 01:24 PM
It's after 8:30 in the morning. That means it's definitely beer time. Remember the lessons of your grandmother, Mutti.

SINISTRUM! WHAT HAVE YOU DONE?

Birgitte
08-22-2008, 01:40 PM
You can't blame Sinistrum for your grandmother drinking beer at 8:30 in the morning. lol

tanaww
08-22-2008, 01:43 PM
You can't blame Sinistrum for your grandmother drinking beer at 8:30 in the morning. lol

But I can blame Sinistrum and Bryan for the fact that YOU find it acceptable. My grandmother was a 70 year old Norwegian. That's just what they do!

Ishara
08-22-2008, 01:51 PM
I just have to chime in with the fact that when we had dinner in Canada not to long ago, she had only Sprite. Even with me and my BIG ol' glass of red. Could have been Seeker's influence there though...drugs are bad....:D

tanaww
08-22-2008, 02:03 PM
I just have to chime in with the fact that when we had dinner in Canada not to long ago, she had only Sprite. Even with me and my BIG ol' glass of red. Could have been Seeker's influence there though...drugs are bad....:D

So you concur that the drinking problem apparently arose after she got to Houston.

Birgitte
08-22-2008, 02:12 PM
Nah... I just don't drink illegally in public places.

tanaww
08-22-2008, 02:20 PM
Nah... I just don't drink illegally in public places.

Were you illegal in Canadia? I thought the age was 18?

Ishara
08-22-2008, 02:33 PM
Nope, 19. But she never would have gotten carded.

John Snow
08-22-2008, 03:10 PM
So is that like teaching Special Ed, Professor?

I can envision you saying "So if you were a REAL epidemiologist this is what you'd do, but since you're not, just call one so you don't hurt yourself."


Shh... Dav, let's see if he takes the bait... It's almost beer time on the couch!

Is it that Yuri and I didn't kick up enough fuss to keep you entertained? I did teach grad students as well - which was usually rewarding except for the MS nursing students............

on edit: provided I survive whatever Brita does to me, I'm amused to think that I do from time to time say something pretty much like the above, both to med students and the people I teach nowadays, who are mostly residents and fellows.

tanaww
08-22-2008, 03:13 PM
Is it that Yuri and I didn't kick up enough fuss to keep you entertained?

I can neither confirm nor deny that I am stirring the pot. :D

Gilshalos Sedai
08-22-2008, 11:35 PM
Hey, now, my Norwegian grandmother drank beer at 8AM, too, with salt and green apples as a chaser. Sinistrum's a rank amature.

Frenzy
08-23-2008, 12:53 AM
Hey, now, my Norwegian grandmother drank beer at 8AM, too, with salt and green apples as a chaser. Sinistrum's a rank amature.
emphasis on rank http://www.mysmiley.net/imgs/smile/sick/sick0012.gif

Gilshalos Sedai
08-25-2008, 07:41 AM
I thought that went without saying.