Vaccines don't cause autism
kottke.org
kottke.org
In my opinion, anti-vaccine people should be tossed out of everyone's homes, circles of friends, and businesses. This is for people who them OR their children aren't properly vaccinated. Even IF autism or any of the plethora of things were caused by vaccines, the diseases themselves which are prevented by them are much worse, all causing death or maiming.
Vaccinations aren't 100% effective, usually more like 70-85% effective. This means EVERYONE needs to be vaccinated for the disease to not continue to find hosts to pass along to.
We should safeguard the people who are willing to get stuck by ostracizing those who are foolish enough to not vaccinate.
This is not correct. In an extreme case, if there is only 1 left unvaccinated, the disease won't spread. If there are two left unvaccinated, the chances of one having the disease and the other being initially uninfected and then subsequently infected by the one possible vector is astonishingly small.
In reality, for a vaccine to be effective, the portion of the population that needs to receive that vaccination is significantly less than 100%.
Moreover, vaccines based on attenuated vaccines (e.g., the polio vaccine) actually infect the recipient with an impotent version of the virus. This virus will be transmitted to others in the community through normal contact, thus conferring immunity to many that did not receive the vaccination directly.
(this isn't intended to be an endorsement of those who refuse to get vaccinated)
Irrelevant. In reality, for a vaccine to be effective, public policy must target 100% vaccination.
(this isn't intended to be an endorsement of those who refuse to get vaccinated)
You may not be endorsing it, but it's important to point out that this argument is ethically dubious.
My favorite ethical test is Kant's categorical imperative, which is briefly that an act is ethical if everyone else can act the same way. For example, if you're wondering whether it's ok to slip onto the subway just as the doors are closing, delaying the train by just a second, you can ask: what if everyone boarded the train that way? Of course, the train would never depart, being constantly delayed by each as-the-doors-close boarder.
If everyone thought that vaccines are ok for others but not themselves, then no one would be vaccinated. Thus this argument is unethical. Let's go beyond "not endorsing" it-- let us all actively condemn it.
There are a bunch of other actions that most people would consider perfectly ethical that fail this test too. Is going childless ethical? If everyone did that, we'd all die out. How about going to your favorite hamburger joint? If everyone did that, the line would be miles long, and nobody would get served.
The problems work in the other way too: there're some actions that people do consider unethical where there are no problems if everyone did it. Consider cheating (by a constant percentage) on your tax returns. If everyone did it, the government would just raise tax rates to compensate, everyone would end up paying the same taxes anyway, and nobody would be worse off (except perhaps having to throw an additional calculation in). Yet few people would say that cheating on your taxes is ethical.
Why is going childless considered okay, yet killing your infant considered abhorrent? They have the same effect on the world - in both case, there's no kid. They have the same effect on the world if everyone does them - in both cases, we all die out. And yet one is considered fine while the other is highly unethical.
The categorical imperative is a nice heuristic to determine whether some behavior will benefit the greater good, but it's also nothing more than that. There is nothing inherently 'ethically dubious' about deviating from a rule of thumb, firstly because the heuristic returns false positives and secondly because you may disagree whether something is a 'greater good'.
If you want to argue that this deviation from this rule of thumb is 'ethically dubious', you'll have to argue exactly that and not argue some blanket claim that everyone should disagree with.
The categorical imperative is not the only or best rule, but it is a good rule of thumb. It's a good test in this case because it clearly demonstrates the folly of going unvaccinated-- if everyone relies on "herd immunity" there will be no herd immunity.
It matters what we say. The mixed messages out there already are dangerous. Kottke put it best in TFA:
So get your kids (and yourselves) vaccinated and save them & their playmates from this whooping cough bullshit, which is actually killing actual kids and not, you know, magically infecting them with autism.
As long as only a small percentage rely on "herd immunity", we're fine. If only those who actually have severe reactions to vaccines rely on "herd immunity", we're fine. Even if a few nutjobs fear autism and a few others simply don't get around to it, we're fine.
The problem is that too many people are relying on it for foolish reasons (fear of autism) and not weighing the risks appropriately. Going unvaccinated without extremely good reason, in the present circumstance, is foolish, but don't overgeneralize.
As an entire country, you are correct (for many diseases, especially ones who have vaccines in the 85% effectiveness ranges). The range of the outbreaks will largely be limited to those 15% who didn't get immunity once vaccinated, and the remainder of those who aren't vaccinated due to their ignorance.
However for small groups, they GREATLY increase the chance of the disease hitting your population. By small groups, I mean circles of friends, co-workers, schoolmates, nurserymates, etc. You should IMMEDIATELY kick people from those groups, as they increase your and your children's chances of getting infected quite a bit. (Remember, you and your children have a 15-30% of the vaccine you DID take to not work).
Remember, you're not looking at just 15-30% from one disease. They have 0% immunity to EVERY disease.
Something people overlook is that the slippery slope fallacy is only a fallacy in a logical context. People aren't uniformly logical entities, and slippery-slope arguments are not always fallacious when applied to human actions.
At some point in any analysis of human behavior and ethics, philosophy is no longer the right tool for the job. You have to turn to psychology.
The US Constitution doesn't provide any mechanism for a public policy of vaccination (the existence of NIH, CDC, etc notwithstanding). While such a policy might be desirable, overstepping the extent of federal power granted by the Constitution would, in your Kant explanation, lead to a collapse of all Constitutional control [1]. That would be bad, so we can't allow the single transgression.
I'm in favor of getting vaccinated. I even ensure that I'm up-to-date on everything whenever I leave the country. However, our society is founded on individualist ideals. We are not communitarians or collectivists, and the fact that my action might not be optimal for the community as a whole does not constitute a rationale for controlling my behavior. This is why we tolerate free speech even from evil people; it's why we're willing to let some criminals go free in order to prevent punishing the innocent, etc.
[1] Not that this hasn't happened already.
If you want to do otherwise you will always have the freedom to do so. But according to the latest science, there is no publicly acceptable argument for going unvaccinated or for advocating against vaccinations.
I have a friend whose son is mentally handicapped, apparently [1] because, as an infant, his vaccination was both (a) done incorrectly and (b) massively overdosed.
I say this not to advocate against vaccination, but to remind that no medical procedure is without risk. Accidents happen, and there are also individual circumstances that would make some treatments unadvisable.
A statement as categorical and sweeping as yours is taking things too far.
[1] Nobody will ever be able to prove it, but the evidence is convincing to me.
UPDATE: forgot to mention about the (very small) inherent danger in using attenuated virus vaccines, such as the OPV (Sabin, not Salk) polio virus. It seems that in this case, it mutates and reverts to the virulent, paralyzing form in 1 / 750,000 cases [2]. This is tiny, but you can't categorically call it safe.
[2] http://en.wikipedia.org/wiki/Polio_vaccine#Iatrogenic_.28vac...
Any time you stick a needle into someone, you risk giving them a brain embolism. Life is risk. However vaccines are CLEARLY in the make you much safer part of risk, like seatbelts and washing your hands.
Even if your near-baseless statement of risk is accurate, it is clear that a non-vaccinated world is much riskier for children than a vaccinated one.
In one case, yes, but the danger of malpractice is certainly well known.
In my other case (iatrogenic polio), it's a very well documented effect. Virtually all polio in the USA since the 'late 60s (give or take) has been the result of this.
But in both cases, the risk is vanishingly small.
My point was that a statement like "stop whining: it's perfectly safe" is not correct. In the end, such hyperbole only gives the tinfoil hat crowd a toehold.
And again, using the polio example, an understanding of the tiny risk of iatrogenic polio can help those at particular risk due to immune problems to avoid what is a non-trivial danger for them.
And you're right, the risk of an ill effect is non-zero. That doesn't mean it's not safe, though. If our definition of safe means absolutely zero risk, then almost nothing is safe. Relative to most medical procedures, vaccines are incredibly safe.
I'm going to continue telling everyone I know that they should vaccinate their children because that position is supported by the best available science, and because the alternative is definitely not safe.
Secondly, according to your interpretation of Kant's categorical imperative it's perfectly ethical for no one to get vaccinated because everyone can act in that way. You may not like the outcome, but your gedankenexperiment satisfies the categorical imperative because everyone holds the belief and thus it is ethical.
Kant's categorical imperative is merely a way for a large percentage of the population to force their ethics on others. Largely because the primary way it is used is to justify policies rather than have policies stem from it. Since not everyone can agree that everyone should be vaccinated policies to vaccinate everyone are unethical according to Kant.
Government doesn't (or shouldn't) have the power to force me to do this. But there's nothing wrong with each individual in the community attempting to persuade those who don't want it.
By analogy: the government doesn't have the authority to endorse any religion, but I'm certainly free to tell you about mine (if I had one).
Vaccines don't necessarily grant immunity. They give you a 70%-85% chance to gain immunity. So even if 0 are left unvaccinated, 30% of the population has no immunity.
It is unlikely to infect a large portion of the population, but especially for vaccines which are only 70% effective, it's highly likely 1 or 2 others will get infected who were vaccinated but it didn't take. In addition to the 30% of people who do not have immunity, immunocompromised people often time can lose immunity to certain viruses based on their condition. They are the 1 or 2 people our society has chosen to be effectively infectable in spite of vaccination. That's why its very important everyone else gets vaccinated.
The likelihood of a huge outbreak is still relatively small, but you're wrong on the statistics of the small infection, as you'd see from a friend coming by or out to dinner with you or going to day care. Roughly 15% to 30% will get many of the diseases when "intensely exposed". The chance of a small outbreak is moderately large with 70% vaccines and even moderate lack of vaccinations.
Your argument, in addition to be attempted technical nitpicking which is wrong, is very dangerous as other posters have made. The effect of one additional unvac on a given population is extremely noticeable on small populations, such as groups of friends and daycares and businesses, aka the very places I suggested ostracizing people from.
I'm curious to know if there have been results that show what sort of percentages of vaccination are needed to be safe from specific diseases. I presume this will vary between diseases as well as demographics.
It wouldn't be right to ostracize people simply because their parents can't tell the difference between a stripper and a doctor and took medical advice from Jenny McCarthy.
http://www.ottawa.ca/residents/health/conditions/id_preventi...
Any parent decline for religious reasons.
And missing one vaccine because their parents are idiots isn't the point. Its the walking infection vectors who are the people who have absolutely no vaccines in them in are the issues.
As a father, some other part of me kicked in that wasn't very logical. This is much harder decision than it seems.
My mother in law shared with me her first-hand experience of 'watching-the-lights-go-out' in a healthy 3-year old minutes after she was vaccinated. It's not autism, and it's anecdotal evidence, but it made me dig deeper, and doubt any certainty on either sides.
Studies are NOT conclusive. Dozens of studies where done defending the use of mercury in amalgam fillings for example, and just now the dentist community is coming around to admitting that it does negatively impact patients' health. Years after many people were saying that, and were called naysayers.
I didn't vaccinate my son. It wasn't an easy decision. And I'm not certain of it. He will receive a shorter list of vaccines, on a longer less-stressful schedule than the one recommended by the govt.
Anybody who assumes certainty for either side of this argument hasn't given this enough thought imho
Vaccinations are important. End of story.
Furthermore vaccinating the most of the world is not going to happen until they are made strictly for all people and not for profit. Patenting medicine and vaccines and distributing it to only those who are "deserving" sound a bit off no?
In the U.S., though, we do actually have quite a lot of free vaccination clinics, and many people have health insurance that covers vaccinations. It's possible there aren't enough free clinics, and if studies show that a large % of people not being vaccinated are skipping it due to the expense, then that's something we should work on. But I don't believe that's currently the case--- a large proportion of the people skipping vaccinations could have had them completely paid for, either by their health-insurance plan, or via free vaccination clinics, but deliberately chose not to get them.
edit: Actually, are there good studies on the primary causes of non-vaccination? It'd be interesting to see estimates of the numbers of people who fall into categories like: 1) fear of autism/etc.; 2) fear of allergic reactions; 3) religious objections; 4) too expensive; 5) too inconvenient / never got around to it.
Eg.
http://www.scielosp.org/scielo.php?pid=S0042-968620080006000...
I honestly feel as a matter of public health it should be free. If it was someone I saw every day who alleged this reason, I'd take them to the doctor right then for the shots, paying for it.
Staggering vaccinations is unlikely to be helpful or harmful, but in general would reduce adherence, so should be discouraged on a population scale without evidence supporting it.
Never been thrilled with the insistence of infant immunization of Hep B either. Main vectors: sewage an sexual contact. I think we an safely rule those out for a few years at least.
Don't dismiss sewage. A surprising fraction of people don't wash their hands, and if you don't wash your hands before preparing food you can pass on diseases.
This is a surprisingly common disease vector.
Correct.
Here's a review of Dr. Bob's schedule from the journal Pediatrics:
The autism concerns are almost certainly overblown, and the benefits of vaccines are enormous, as has been pointed out.
But I think its also a mistake to unreflectively get every vaccination possible. Side effects can and do happen. As with every medical procedure, responsible parents should know what they're getting into, and what the pros and cons are. Even though the answer SHOULD be to get vaccinated in 95% of cases.
P is no longer used, and now it's aP (acellular pertussis, DTaP), which doesn't cause those reactions.
If you're going to be ignorant, then you should go ahead, trust your doctor, and get the vaccination. But I don't think it's wrong to do the research on something before it goes into your child's body, just as long as you are properly scientific about it and rely on good research.
You will probably find that anything you discover in your research is already being done.
All the things that are marginal and maybe won't be "good research", although of course you may considers the "possible" results enough reason to act, but you need to be very knowledgeable on the subject, and few people are.
I don't mean to pick on you, but this is exactly the kind of thing so many here have a problem: that some people still equivocate and hedge because they think "hey, who knows?" in spite of all the evidence being on one side. How many studies will it take to convince you that there is no link at all between autism and vaccines?
I'd like to see schools required to disclose any children who have not been vaccinated without a valid medical reason. (I'm in California -- you can get into school without vaccination if you state a personal belief.)
His next vaccine is only at 12 so we could just do nothing but we want to know if tetanus shots could be the culprit because they are often administered following an accident.
We need some sort of legal construct that would hold those who do not vaccinate responsible if there is an outbreak in the area. For example, you don't vaccinate your daughter for whooping cough and my daughter(too young to vaccinate) catches it. My daughter has to suffer months of terrible pain and discomfort in addition to potential long-term consequences. I should be able to seek compensation from you.
Of course there are other social alternatives, such as lychings.
As a side note, you probably don't know shit about vaccines. What makes you think spacing them out will improve her reactions to them?
I don't think you should find the allergic culpable in your scheme, because if the reaction is bad enough, you're asking them to either endure suffering or die so that there is no possibility that they can harm you.
For instance, if someone with whooping cough coughed hard, then left the room, and 10 minutes later your daughter walked through the room on the way to meeting the other person's daughter, how exactly could you tell that?
I think that there ought to be a law against people who think "there ought to be a law against X" ...
Set the standard of evidence to whatever the current technology can provide. Right now I'm fine with unvaccinated people having responsibility for all outbreaks in their area.
> I think that there ought to be a law against people who think "there ought to be a law against X"
I think there ought to be a law against people who don't know the difference between civil and criminal law.
For the same reason that I let my toddler eat dirt if she wants to. The longer her immune system has to build up a defense, the better it will defend against something in a vaccine that causes her medical or allergic distress.
If your kid was allergic to peanuts, would you be allowing your neighbors to force her to eat peanuts?
You should just admit that you are making medical decisions about complex phenomenon based on vague feelings. Why do we even bother studying immunology? Let's just ask how camworld is feeling today!
The thinking probably goes something like, "If A and B each individually cause severe symptoms, A and B combined will probably be worse." This accurately describes most things.
An eye-opening documentary.
Vaccinating a child is not a matter of choice, but compulsory, because unless the parents of an un-vaccinated child can guarantee that their kid will not spread a terrible illness such as polio/whooping cough/ whatever, they should be quarantined. If you watch the documentary, you will understand what I am saying.
Also, the hope is that vaccination will become unnecessary in the future, for example, smallpox vaccines are not being administered anymore, because it has been eradicated completely. That is not the case with many other preventable diseases (there are many areas in the world where they still occur, and so it is necessary to exercise caution).
There might be some legit concern as far as simultaneous vaccination for several diseases goes, though, but that is not sufficient reason to endanger the larger population until the (possible) causal relationship between vaccines and brain damage is firmly established.
...the government’s Division of Vaccine Injury Compensation concluded that five shots Hannah received in July 2000, when she was 19 months old, “significantly aggravated an underlying mitochondrial disorder” and resulted in a brain disorder “with features of autism spectrum disorder.”
http://www.ajc.com/health/content/health/stories/2008/03/06/...
Records were sealed at the time. Don't know if they have since been released.
EDIT: Summary of latest news, 2010-09-11:
US Vaccine Injury Compensation Program (VICP) will pay over $1.5 million to the family of a child whose parents allege acquired autism after routine vaccinations in 2000....However, the payment does not acknowledge a vaccine-autism link.
http://blogs.nature.com/news/thegreatbeyond/2010/09/us_vacci...
The 27 August 2010 Decision Regarding Damages: http://www.uscfc.uscourts.gov/sites/default/files/CAMPBELLSM...
EDIT 2: You can't make this stuff up:
Then-director of the Centers for Disease Control Julie Gerberding (who is now President of Merck Vaccines) stated: "The government has made absolutely no statement indicating that vaccines are a cause of autism. This does not represent anything other than a very specific situation and a very sad situation as far as the family of the affected child."
http://www.cbsnews.com/8301-31727_162-20015982-10391695.html
This sounds like a dodge, frankly. I am not encouraged.
EDIT: I am further discouraged by the voting here. I see an instance of potentially non-conformed data. What do you do with non-conformed data?
As best I can tell, nothing can be done with this data right now, since details of the court's decision have not been released. The most you can do is reserve a measure of judgement till further information is available.
Instead, I see a strong desire to dismiss the data. This is poor epistemological form. This is not encouraging.
Two questions, for now:
* What symptoms of classical autism were not present?
* More to the point, why would classical autism be the standard, rather than autism spectrum disorders?
Apparently, the court's justification for giving the award is that the fever from the vaccine might have been one of the many fevers she suffered that led to the particular expression of this condition. Sadly, her parents had already given her the "autism" label, which only confuses the issue.
Here's the other side of the story: http://www.nejm.org/doi/full/10.1056/NEJMp0802904
I'm not closed to the idea that vaccines could conceivably have some subtle detrimental effect, in fact I have some other non-mainstream beliefs about health issues, but the evidence just isn't there. When you're reduced to citing the fact that people are trying to discourage you from believing X as one of the primary reasons you believe X you are firmly in conspiracy nut territory.
http://www.cnn.com/2010/HEALTH/09/17/california.whooping.cou...
(holding breath)
No. This won't change a damn thing.
When you're that committed to a cause, every scientific result that comes out against your cause is easy to dismiss as either wrong, a deliberate lie, incomplete, not 100% proof, etc.
This is especially troublesome in areas where the True Believers invert the burden of proof: rather than asking for proof that vaccines cause autism, they'd only be satisfied with proof that they don't, which is a much more difficult task (and don't get me wrong - I have no doubt whatsoever that even if rock solid proof was offered, they'd still reject it outright).
(I don't know whether Jenny McCarthy has ever talked on Oprah, but she must be talking somewhere.)
Very, very quietly.
I wonder if truth-denial is genetic.
There are risks to being vaccinated, and risks to not being vaccinated.
That (from the article) : --- "The last result is a bit of an anomaly in that it implies that exposure to TCVs from birth to 1 month and birth to 7 months actually protects against ASD. The authors quite rightly comment on this result thusly:
"In the covariate adjusted models, we found that an increase in ethylmercury exposure in 2 of the 4 exposure time periods evaluated was associated with decreased risk of each of the 3 ASD outcomes. We are not aware of a biological mechanism that would lead to this result." ---
Should tell you that this cannot be said to be a completely conclusive study.
This study is, to date, the most complete and conclusive study available. It shows that vaccines, and particularly those that used ethylmercury as a perservative, do not cause autism or autism-spectrum disorders, just like EVERY OTHER FUCKING STUDY OUT THERE!
Person 1: Vaccines cause autism!
Person 2: No they don't! Here's proof!
Person 1: Well...it's still not 100% safe, so *there*! I win!
I have acquaintances who refuse to vaccinate their kids and you really can't argue much with them (though thankfully, they are not the type to be preachy about it). If someone wants to look it up, there is apparently some book about the problems with vaccines, but (from my experience) the logic goes something like:
* Vaccines aren't 100% effective. There are people that receive vaccines that still get the illness.
* Vaccines can give you the illness you are trying to prevent.
* There are various other side-effects associated with vaccines.
* [I added this one, though I've never heard anyone use it, and I still vaccinate my daughter] The companies that make the vaccines are immune to prosecution, so they don't have an incentive to produce a quality product.
* [the really crazies like this one too] The 'man' is putting things in vaccines to make poison us and/or make the 'lower classes' sterile as part of some sort of population-control method (See chem-trails and various other 'theories').
I have many older relatives in their 70s and 80s, some are taking e.g. flu vaccines and some do not; and as children, some received the standard vaccinations and some had chickenpox, measles, mumps, etc.
At this point, being familiar with their medical histories, (though not a doctor), I am not sure that I see a pattern of better health between the 2 groups.
Frankly choice of diet and amount of regular exercise seem to be a far better predictor of who is in the best shape.
Example: my mother and her closest sister are 11 months in age apart, 81 and 80. One exercises with walking and swimming 3x a week, watches food portions and needs only a mild sleeping pill for medication - still drives and has an active social life; the other has had 2 heart attacks, is overweight by 50+ lbs (and yoyo dieted while younger) and has been on 2-3 heart meds for over 15 years.
For example, (as an unvaccinated person) your chances of catching the flu while living in a city where 90% of the population is vaccinated is much lower than if only 40% of the population were vaccinated.
Also you have to consider the risks to others. Even with the vaccine there is still a chance of getting the disease, though one would need to come in contact with the disease to get it. So someone that chose to be unvaccinated is at a higher risk of catching the disease, and therefore transmitting it to someone that was vaccinated (though I'll admit that the actually numbers in this scenario are probably pretty low).
Vaccination is a risk you take with yourself or your children and everyone you and they come in contact with.
This is why you should be shunned. You're playing with the lives of those who should be shunning you.
We're not talking about the flu vaccine. We're talking about measles, mumps, rubella, Diphtheria, Tetanus, Hepatitis, Varicella, Meningitis, Rotavirus and various other VERY FATAL ILLNESSES. If there are enough flu vaccines for everyone in a year, you should get them, but we're talking about the main, childhood vaccines which protect against the horrible diseases of earth's past.
You not only should be shunned, you should have to walk around with a sign alerting people to your presence as a willing infection vector to make you well labeled enough the rational among us can avoid you.
Actually, it works sort of like this: the companies that make vaccines are immune from prosecution in normal courts, all jurisdiction for these cases goes to a special court (the Office of Special Masters of the U.S. Court of Federal Claims) that weighs scientific evidence, the facts of the case, and the relevant law to determine the outcome. The general idea is that there is a higher bar to cross regarding evidence and there is no jury for an ambulance chaser to sway. The court deals with specific instances of harm from vaccines and not general classes of claimants (e.g. no "class actions" in this court.)
I have seen it rated as high as 4 and as low as -1 (as of this moment it gets a 0, which is a downvote from 1 person).
Would seem to indicate that there is a lot of disagreement over the POV I posted.
Had you instead stated "there are risks to being vaccinated as well as to being unvaccinated. We should not punish or shun those who have decided the first set of risks outweigh the second" I'd have upvoted you instead. The ideas are the same, but the expression invites discussion.
EDIT: compare to your response to http://news.ycombinator.com/item?id=1702199 . Downvotes are the price you pay for "expressing a strong opinion on another person's POV in that fashion."