Tag: Vaccination

Science Sunday: Why You Should Vaccinate, Part 457

One issue that I am fairly militant about is vaccination. Vaccines are arguably the greatest invention in human history. Vaccines made smallpox, a disease that slaughtered billions, extinct. Polio, which used to maim and kill millions, is on the brink of extinction. And earlier this week, Rubella became extinct in the Americas:

After 15 years of a widespread vaccination campaign with the MMR (measles-mumps-rubella) vaccine, the Pan American Health Organization and the World Health Organization announced yesterday that rubella no longer circulates in the Americas. The only way a person could catch it is if they are visiting another country or if it is imported into a North, Central or South American country.

Rubella, also known as German measles, was previously among a pregnant woman’s greatest fears. Although it’s generally a mild disease in children and young adults, the virus wreaks the most damage when a pregnant woman catches it because the virus can cross the placenta to the fetus, increasing the risk for congenital rubella syndrome.

Congenital rubella syndrome can cause miscarriage or stillbirth, but even the infants who survive are likely to have birth defects, heart problems, blindness, deafness, brain damage, bone and growth problems, intellectual disability or damage to the liver and spleen.

Rubella used to cause tens of thousands of miscarriages and birth defects every year. Now it too could be pushed to extinction.

Of course, many deadly diseases are now coming back thanks to people refusing to vaccinate their kids. There is an effort to blame this on “anti-government” sentiment. But while that plays role, the bigger role is by liberal parents who think vaccines cause autism (you’ll notice we’re getting outbreaks in California, not Alabama). As I’ve noted before, the original research that showed a link between vaccines and autism is now known to have been a fraud. This week, we got another even more proof:

On the heels of a measles outbreak in California fueled by vaccination fears that scientists call unfounded, another large study has shown no link between the measles-mumps-rubella vaccine and autism.

The study examined insurance claims for 96,000 U.S. children born between 2001 and 2007, and found that those who received MMR vaccine didn’t develop autism at a higher rate than unvaccinated children, according to results published Tuesday by the Journal of the American Medical Association, or JAMA. Even children who had older siblings with autism—a group considered at high risk for the disorder—didn’t have increased odds of developing autism after receiving the vaccine, compared with unvaccinated children with autistic older siblings.

96,000 kids — literally 8000 times the size of the sample Wakefield had. No study has ever reproduced Wakefield’s results. That’s because no study has been a complete fraud.

There’s something else, though. This issue became somewhat personal for me recently. My son, Hal 11000 Beta, came down with a bad cough, a high fever and vomiting. He was eventually admitted to the hospital for a couple of days with pneumonia, mainly to get rehydrated. He’s fine now and playing in the next room as I write this. But it was scary.

I mention this because one of the first questions the nurses and doctors asked us was, “Has he been vaccinated?”

My father, the surgeon, likes to say that medicine is as much art as science. You can know the textbooks by heart. But the early symptoms of serious diseases and not-so-serious one are often similar. An inflamed appendix can look like benign belly pain. Pneumonia can look like a cold. “Flu-like symptoms” can be the early phase of anything from a bad cold to ebola. But they mostly get it right because experience with sick people has honed their instincts. They might not be able to tell you why they know it’s not just a cold, but they can tell you (with Hal, the doctor’s instinct told him it wasn’t croup and he ordered a chest X-ray that spotted the pneumonia).

Most doctors today have never seen measles. Or mumps. Or rubella. Or polio. Or anything else we routinely vaccinate for. Thus, they haven’t built up the experience to recognize these conditions. Orac, the writer of the Respectful Insolence blog, told me of a sick child who had Hib. It was only recognized because an older doctor had seen it before.

When I told the doctors Hal had been vaccinated, their faces filled with relief. Because it meant that they didn’t have to think about a vast and unfamiliar terrain of diseases that are mostly eradicated. It wasn’t impossible that he would have a disease he was vaccinated against — vaccines aren’t 100%. But it was far less likely. They could narrow their focus on a much smaller array of possibilities.

Medicine is difficult. The human body doesn’t work like it does in a textbook. You don’t punch symptoms into a computer and come up with a diagnosis. Doctors and nurses are often struggling to figure out what’s wrong with a patient let alone how to treat it. Don’t cloud the waters even further by making them have to worry about diseases they’ve never seen before.

Vaccinate. Take part in the greatest triumph in human history. Not just to finally rid ourselves of these hideous diseases but to make life much easier when someone does get sick.

Vaccines in the News Again

Thanks to low vaccination rates, we are currently experiencing a large measles outbreak in this country. I’ve discussed vaccines before. My position is that vaccines are one of the greatest inventions in history, that they should be mandatory for public school students (with medical exemptions) and strongly encouraged for everyone else. And I’m glad to see that after spending a number of years waffling, our political establishment, from Hillary Clinton to Congressional and Gubernatorial Republicans are coming down strongly in favor of them.

But … there’s no public health crisis that the Left can’t try to politicize. You may remember last year when they tried to blame the Ebola outbreak on mythical Republican budget cuts. Well, now they are jumping on comments by Rand Paul and Chris Christie that supposedly embrace anti-vax lunacy. This supposedly represents how “anti-science” the GOP is (numerous pro-vaccine statement from every other Republican on the planet not withstanding).

The thing is, neither of them said anything crazy. Rand Paul supports vaccines, although he did apparently garble a statement about vaccines and autism and does think parents should make the decisions. And Christie’s statement was perfectly in line with the conventional wisdom. He vaccinated his kids, he supports vaccines but thinks mandates should be based on the danger represented. Both of these are well within the mainstream debate of whether vaccines should be mandated or not.

So … not really much there. And given the number of Republicans who are issuing strong unequivocal statements supporting vaccination, support programs that help poor people get vaccinated and support vaccination mandates for immigrants, this isn’t really a club to bash Republicans with. For all the supposed “anti-science” positions of the Republicans, this isn’t one. The only place I’m seeing opposition to vaccines is the fringe of both parties.

And I find this attention to Christie and Paul especially odd given that one of the biggest anti-vax nuts out there is Robert F. Kennedy, Jr., who has often gotten slavering attention from the media as some kind of environmental crusader. But you wouldn’t know that from the mainstream media.

Stop trying to make this a partisan issue, guys. It really isn’t.

Chasing Libertarianism Into A Corner

One of the problems I have with my libertarianism — indeed, a big reason I often describe myself as a conservative-libertarian — is the tendency of some libertarians to chase the philosophy into intellectual cul-de-sacs. All political philosophies have a tendency to favor ever “purer” strains. But because libertarians define our philosophy as one of personal liberty, we have a tendency to think that the only acceptable policies are those with maximum personal liberty. Any practical objections tend to be swept under the rug with a few unconnected words about “free markets”.

I’m not explaining this well. Let me illustrate with an unrelated example.

When I was in college, I took a philosophy class with a feminist professor. When we got to the portion on feminism, we were discussing third wavers who thought that women in an oppressive society fundamentally could not consent to sex, that all sex was therefore rape and therefore women should not have sex. My response was that any philosophy that countenanced, at least in theory, the potential extinction of the human race was fundamentally immoral. I said that these were the deranged ramblings of someone who had drunk too deeply of the feminist well. They had taken good ideas (women shouldn’t be second class citizens) and purified them to a bizarre extreme.

A more germane example: a number of libertarians oppose environmental regulation on the grounds that if my neighbor is polluting my land, he is violating my property rights and this should settled in the courts. That sounds good if you only consider the ideology. But as a practical matter, it is a recipe for disaster. First, it’s not always clear that pollution has happened. The residents of Love Canal had no idea why they were getting so many birth defects and miscarriages. By the time they did figure it out, there had been immense suffering already. Second, it’s not always clear who is responsible for ills caused by pollution. In the Woburn Massachusetts case, it wasn’t clear who poured chemicals into the river that sickened the children. The jury was asked to decide the lawsuit based on a series of bewildering technical questions. Third, even in cases where the culprit is clear, you are frequently talking about powerful businesses with armies of lawyers who can drag a case on for decades. The Exxon Valdez lawsuits dragged on for twenty years. You can imagine how bad it is when the polluter is the government itself or when you’re dealing with the decade-old pollution of a business that no longer exists. Fourth, the ability of such a system to prevent pollution is dubious since it’s not always clear that Substance X will produce Harm Y for a long time. Finally, it seems absolutely appalling to countenance reparations for birth defects, miscarriages, severe illnesses and deaths rather than just preventing them in the first place in the name of free markets.

Does this mean the government isn’t over-zealous in fighting pollution? It frequently is and often chases its own ideology into banning minimally dangerous substances. Does this mean government always makes the right decisions? Of course not; the aforementioned Love Canal community was built on land the local government was warned was dangerous. Does it sometimes carve out exemptions for big polluters while hurting little guys? Absolutely; see what happened after the lead toy debacle. But at some point, we have to accept these limitations rather than get seduced by the seductive appeal of bottomless liberty.

(Another good example, on the Civil Rights Act, is illustrated here by James Joyner.)

I bring up this subject because there is a debate going on at Reason between Ronald Bailey and Jeffrey Singer over mandated vaccinations. Singer’s op-ed, which you can find here, crosses as me the rambling of someone drunk on libertarian ideals. It’s a series of libertarian statement strung together in the hope that it makes an argument. And it winds up saying bizarre things like this:

The phenomenon of herd immunity allows many unvaccinated people to avoid disease because they free ride off the significant portion of the population that is immunized and doesn’t, therefore, spread a given disease. Economists point out that free riding is an unavoidable fact of life: people free ride when they purchase a new, improved, and cheaper product that was “pre-tested” on more affluent people who wanted to be the first to own it; people free ride when they use word-of-mouth reviews to buy goods or services, or to see a film; those who choose not to carry concealed weapons free ride a degree of personal safety off the small percentage of the public that carries concealed weapons. So long as a person being free-ridden is getting a desired value for an acceptable price, and is not being harmed by the free riding, it really shouldn’t matter to that person. Achieving a society without free riders is not only unnecessary, it is impossible.

Well, duh. But we should try our best to limit the free riders to people who can not be vaccinated — people who are immunocompromised, for example. And while we can’t force 100% compliance, we can do as much as we can to get the immunization numbers into the 90-95+% numbers necessary to establish the herd immunity that protects the millions who have no choice but to free ride. Or people for whom the vaccine didn’t take.

On this subject, I find myself agreeing with Bailey: your freedom to swing your fists ends where someone else’s nose begins. I find it very difficult to countenance any version of a “free society” that includes the freedom to run around potentially spreading dangerous and deadly diseases. Most people are smarter than their government. But you don’t need a large percentage to be dumber to have, as we now do, huge outbreaks of entirely preventable diseases that are leaving dead and hurt children in their wake. Are those children to be human sacrifices to our idealized notion of freedom?

If we were talking about sexual transmitted diseases, I would agree with Singer. But these are diseases that can be spread by casual contact. They can be spread by people who are already vaccinated. They can be spread by people who never catch the disease themselves. This isn’t the moral equivalent of seat-belt law; this is the moral equivalent of laws against drunk driving.

Vaccinations are one of the greatest achievements in human history. They have destroyed smallpox and put hepatitis A and B, rotavirus, diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, varicella and some forms of meningitis on the run. These diseases used to kill and maim millions. Their eradication is far too great an achievement to trust to the ideology-addled hope that people will act in their own enlightened self-interest.

Because too many people don’t.


I occasionally like to take a break from my regularly scheduled programming to give a laurel and hardy middle finger to the anti-vaccine movement. Here is yet another reason to say, “Fuck you.”

Last year was the worst year for measles in the U.S. in 15 years, health officials said Thursday.

There were 222 cases of measles, a large jump from the 60 or so seen in a typical year. Most of the cases last year were imported — either by foreign visitors or by U.S. residents who picked up the virus overseas.

U.S. children have been getting vaccinated against the measles for about 50 years. But low vaccination rates in Europe and other places resulted in large outbreaks overseas last year.

Generally, the Americans who got measles last year were not vaccinated. At least two-thirds of the U.S. cases fell into that category, including 50 children whose parents got philosophical, religious or medical exemptions to skip the school vaccinations required by most states, CDC officials said.

One child was almost killed. This is on top of recent outbreaks of whooping cough, which almost took the life a six-week old baby in Boulder.

All of this is connected with plunging rates of vaccination, particularly in granola-oriented areas where a huge percentage of parents have bought into various vaccine myths. And while some vaccines are not administered because of philosophical objections or medicals reason, a huge number are still because of the scientific fraud that indicated vaccines caused autism.

Our political class has not been nearly as noisy as this subject as they are on, say, Mitt Romney riding a horse. Diseases never go away. Vaccination saves lives. There are some small movements in the right direction, but we need a larger push to call the vaccine-autism link out as pseudo-scientific bullshit.

The HPV Question

The big fireworks in Monday’s debate were about Rick Perry mandating the HPV vaccine for girls in Texas. Bachmann basically accused him of taking a bribe, Perry admitted the policy was mistaken, lots of applause lines were had.

Did Perry make a mistake? There’s a lot to untangle on the HPV question, so I’ll break it down.

On a personal level, I’m very much in favor of the HPV vaccine. I intend to have Sal 11000 Beta inoculated when she gets to the right age as well as any other Betas that come along. This includes any boys, since I don’t want them catching or spreading the illness. The things mows down 4,000 women a year and that’s just the tip of the iceberg. There is growing evidence that HPV can be spread through saliva and cause throat cancer.

It’s critical to remember that: abstinence and being right with Jesus does not insulate you from HPV. It can be spread by skin-to-skin contact and possibly by saliva. Half of Americans have it. Both partners could be virgins on their wedding night and still be exposed. This is not a disease that is confined to slutty women (as if that would matter anyway).

The vaccine itself is very effective and very safe, despite Bachmann’s claim that it left a girl “retarded”. With millions of doses given, it is showing few, if any, side effects. I’m unwilling to declare the vaccine perfectly safe until the first generation of girls start having children and show no ill effects. But … so far, so good.

Nothing I’ve said above is particularly controversial. One of the refreshing things about this issues is how quickly the entire Right Wing blogosphere sided against Bachmann, at least on the retardation issue. For the party that is supposed to hate science, I have seen very few entertaining the idea that this vaccine is unnecessary, unsafe or ineffective. A surprising fraction are familiar with Andrew Wakefield and his fraudulent research on the vaccine-autism link. It actually made me smile.

(One of the points debated — not in the actual debate, but on the blogs — is whether the HPV vaccine will make girls sleep around more. Count me in the “maybe a little, but not much” category. Try this thought experiment: what if all venereal diseases were eliminated? Would women suddenly sleep with everyone? I don’t think so. But I do think the lack of VD threat would make people in general less cautious. I’ll take that tradeoff — assuming it is a tradeoff.)

Where the debate really breaks down in on the mandate. And here — and I can’t believe I’m going to say this — I’m with Bachmann and … Richard … John … Santorum. No, really. Here’s what Santorum said in the debate.

Why — ladies and gentlemen, why do we inoculate people with vaccines in public schools? Because we’re afraid of those diseases being communicable between people at school. And therefore, to protect the rest of the people at school, we have vaccinations to protect those children.

Exactly. Measles, mumps, rubella, polio — these can be spread by casual contact. HPV requires more intimate contact. Not necessarily sex, but skin-to-skin contact or kissing. To me, that’s enough to take a pass on the mandate. I might be willing to mandate it for sports that involve skin-to-skin contact — wrestling or football, for example. And I would be fine with the state strongly recommending it, giving information to parents and paying for poor people to get it if they are on Medicaid. The possibility of dramatically cutting the incidence of HPV and saving thousands of women’s lives is simply too beautiful to ignore.

But on the mandate, I’m with … those guys.

Now, did Rick Perry mandate this because of a $5,000 donation to his campaign and the job it later gave to his Chief of Staff? While I thought as much at the time, I’m beginning to side more with Perry. That’s way too low a price for this kind of bribe. Merck has much better reasons to support Perry, such as the tort reform that limited Vioxx judgements and made Texas one of the least dangerous tort states.

So, in the end, I find myself agreeing with both sides. The vaccine should be used by everyone, should not be mandated, but Perry wasn’t bribed. That’s kind of rare for me to not be bashing someone over the head.

Measles in Mass


Measles continues to spread in Massachusetts, with two new cases confirmed this week, including one involving a 23-month-old boy from Boston who had received his first measles vaccination last year, according to the Boston Public Health Commission. The other was a teenage boy from outside the city who was treated at a Boston health care facility.

That brings the state total to 17 this year — and counting. In each of the previous four years, Massachusetts has had one to three cases. The surge has been occurring nationwide as well, with federal health officials announcing Tuesday that measles cases have been on their fastest pace since 1996. So far this year, 118 infections have been reported in 23 states, compared with 50 in a typical year.

And we’re lucky that most parents have not bought into the whole anti-vax nonsense:

France reported 10,000 cases — and six deaths — during the first four months of the year, most likely due to low vaccination rates. The US Centers for Disease Control and Prevention attributes the rise in measles cases in this country to the surge in cases globally, most notably in France, India, and the Philippines.

Vaccinations are one of the greatest scientific breakthroughs in human history. Measles alone used to strike about half a million Americans per year. At that rate today, we’d be seeing a few billion dollars and a couple of thousand lives gobbled by the virus every year. And that’s just measles. I won’t say anything about whooping cough, the resurgence of which has killed children too young to be vaccinated. Even if vaccines caused autism — which they don’t — they would still be worth the risk.

The efficacy of any vaccine is dependent on having herd immunity: having enough people vaccinated to deny the virus the reservoirs it needs to break out. For that, you need to vaccinate almost everyone who isn’t immuno-compromised. You can maybe make some religious exemptions. But you simply don’t have room for people who refuse to vaccinate because they believe the tissue of lies that was Andrew Wakefield’s discredited study.

For people to turn their backs on this miracle is maddening. It’s like they’re going back to living in caves. Only they’ll take a few innocent people with them.