Widespread vaccine exemptions are messing with herd immunity | Hacker News Reader

Widespread vaccine exemptions are messing with herd immunity

arstechnica.com

23 pointsshawndumas51 comments

    "There is a cult of ignorance in the United States, and
    there always has been. The strain of anti-intellectualism
    has been a constant thread winding its way through our
    political and cultural life, nurtured by the false notion
    that democracy means that "my ignorance is just as good as
    your knowledge."

        -- Isaac Asimov

I sometimes wonder if this is the "true price of freedom"...

There was a person I knew in college who ardently believed in a lot of popular pseudo-science myths, like the ones about vaccination, and that global warming isn't real, that it's just a conspiracy of climate scientists.

In about a year, that person will be awarded a PhD in Aerospace Engineering. The cognitive dissonance is astonishing to me.

Almost no adults who promote universal vaccinations for children are up to date on their own vaccinations.

Doubt this? Survey the people at your office about their last boosters for each vaccine of interest.

Survey of whether adults have EVER had a Hep B vaccine:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5518a3.htm#tab

Total average: 34.6% of all US adults surveyed. That's much lower than the rate at these schools.

Have you had your adult booster for measles? Only one dose was given to children before 1996. This is now known to be inadequate. Those born before 1996 who have had no booster may consider themselves among of the inadequately vaccinated.

http://www.fraserhealth.ca/about_us/media_centre/news_releas...

So what? The document you linked to says the Advisory Committee on Immunization Practices recommends "universal vaccination of infants; catch-up vaccination of unvaccinated children and adolescents; and vaccination of unvaccinated adults at increased risk for infection. " It does not recommend universal vaccination of adults for Hep B.

The main recommended one for adults is a tetanus/diphtheria/pertussis booster every 10 years. My last tetanus shot was about 2 years ago. I got my last MMR shot as an adult - there was an outbreak in Florida and the colleges required MMR boosters for all students.

The other vaccines in the US are recommended only "if you have a specific risk factor" or for "certain medical or other indications."

Congratulations on being up to date on MMR, unlike 65% of other adult americans.

Here are the CDC's vaccine recommendations for you.

http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-...

So now that you found that your first link didn't show your point, you're digging up other links? Except the chart you pointed to is incomplete. You picked the "easy read" chart instead of, say, the more detailed one at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6104a9.htm .

Take for example chickenpox. The chart you linked to recommends 2 doses. However, http://www.cdc.gov/vaccines/vpd-vac/varicella/basic-immunity... says: "You do not need the chickenpox vaccine if you meet any of these criteria for evidence of immunity ... Birth in the United States before 1980." That's me!

Where did you get the 35% number for MMR? I can't find mention of it.

I found that "For the 2007--2008 season, influenza vaccination coverage among adults aged 50--64 years was 34%, and coverage among adults aged ≥65 years was 66%" and that "the goals for adult vaccination coverage with influenza and pneumococcal polysaccharide vaccines are 90% for each vaccine."

I hadn't realized that. 10 years ago it was only recommended for people in their 50s or older. I have never gotten influenza virus, as I followed the recommendation of a now outdated schedule.

Before people stopped vaccinating their children, there were like 0 cases of measles in the US. One dose was adequate.

Italy France and Spain don't vaccinate against it widely. Most of the few current cases came in via adults from Western Europe and are spread in part by the lack of vaccination of US adults. The western europe situation, and low rates of adult immunization have been issues for decades.

How to solve the problem? Mandate adult vaccinations? Require immunization certificates for everyone entering the country? These are much larger factors than a few childhood immunization exemptions and a rational approach would thus focus on them first.

Children should't pay for their parents ignorance. Vaccines should be mandatory with very few exception where the child can't be vaccinated because of some real problem.

What would you tell the parents of a child who died due to the vaccines you mandate? Yes, kids die, and have other complications.

And if a kid gets killed by a seatbelt, do we say that we shouldn't have seatbelt laws? The data is pretty clear that universal vaccination is less harmful than the alternatives.

Did you know that almost all vaccines contain aluminum as it makes the vax more effective through an as yet unknow means? Did you know that aluminum is a neurotoxin? Did you know the there are ZERO studies on acceptable levels of aluminum exposures to new borns and infants?

Edit: f'd by autocorrect

There's "unknown" and there's "unknown." A 2009 paper ("HUMAN HEALTH RISK ASSESSMENT FOR ALUMINIUM, ALUMINIUM OXIDE, AND ALUMINIUM HYDROXIDE") states:

Aluminium hydroxide is one of the adjuvants most commonly used in routine human vaccines against hepatitis B virus (HBV), hepatitis A virus, and tetanus toxoid (TT) and in veterinary vaccines (see also Effects on Humans, Effects from Non-Occupational Exposure, Irritation, Irritation after Injection of Aluminium-Adsorbed Proteins (Vaccines and Hyposensitization Regimens)). Although it has been investigated since 1926, the mechanisms of action of aluminium adjuvants are not yet fully understood. It is likely that aluminium adjuvants induce immune activation which includes interleukin (IL) -1 production by monocytes, induction of eosinophilia, compliment activation and increased specific and non-specific immunoglobulin (Ig) G1 and IgE antibody responses (Gupta & Siber, 1995; HogenEsch, 2002; Jensen & Koch, 1988; Larsen et al., 2002; Norimatsu et al., 1995; Shi et al., 2001). Limitations of aluminium adjuvants for human vaccination include local reactions, augmentation of IgE antibody responses, ineffectiveness against some antigens and inability to augment cell-mediated immune responses, especially cytotoxic T-cell responses (Gupta, 1998).

Now, on to the question of "acceptable levels." Elsewhere in the same paper:

Further, the administration of aluminium-containing vaccines for extended time periods was found to be associated with the development of [macrophagic myofasciitis] at the injection site. In the past, individuals with impaired renal function receiving dialysis were reported to be at greater risk for aluminium intoxication associated with contaminated replacement fluids. However, this incidence has diminished markedly in recent years with the use of non-contaminated fluid and replacement of high-dose antacid therapy with alternatives. Although infants and children may be at higher risk for toxicity due to aluminium, a causal relationship was not confirmed. Hence, it should be noted that only at excessive concentrations of aluminium are toxic manifestations seen in human sensitive subpopulations.

I interpret this as saying that the reason there are "ZERO studies on acceptable levels of aluminum exposures" (and I have not researched this enough to be definitive that there are ZERO) is because there's no need to expose children to a high enough level of aluminum in order to find the limit. There's no major effect seen at current Al levels, other than reactions by a small population which has a reaction to the metal, and there are many cases where infants and young animals have been tested, without seeing obvious effects.

Indeed, there are plenty of papers which compare the effects of vaccines with and without aluminum adjuvants, in infants. One such is http://jid.oxfordjournals.org/content/184/9/1211.long . While http://www.biomedcentral.com/1471-2334/3/17/ doesn't compare the two but observes that "The 11-PncTD vaccine is safe, well-tolerated and immunogenic in infants."

So if the existing level of aluminum has an effect on infants then it's subtle. Now, do you really want people to put more aluminum into the bloodstream of infants in order to find out what the acceptable level might be? Or can we say that as best as we can tell, the current levels aren't a problem, and leave it at that?

The same thing you tell a parent of a child that dies of pertussis caught from an unvaccinated schoolmate. I am sympathetic to exceptions to vaccination, but only those that accept the science. When pseudoscientific twaddle preys on the natural fears of parents, it has transcended bafflegab and is flirting with actual evil.

For example:

http://www.nytimes.com/2011/12/28/opinion/for-the-herds-sake...

http://danamccaffery.com/openletter.html

It's a tragedy. It's horrible that what we have is the best we can do. We're putting lots of research and funding into making vaccines and treatments even safer. I really wish there were a better way to prevent the mass epidemics which will happen if we don't have vaccines. Nothing we do can replace your child. We can offer counseling if you want someone to talk to, and of course our heart-most sorrow.

Now, what would you tell the parents of the children in iron lungs that got polio because we decided that we couldn't mandate vaccinations?

What Benjamin Franklin said centuries ago, when vaccinations were far more dangerous:

> "In 1736 I lost one of my Sons, a fine Boy of 4 Years old, by the Smallpox taken in the common way. I long regretted bitterly and still regret that I had not given it to him by Inoculation. This I mention for the Sake of Parents who omit that Operation on the Supposition that they should never forgive themselves if a Child died under it; my Example showing that the Regret may be the same either way, and that therefore the safer should be chosen."

> Vaccines should be mandatory

I think everyone should vaccinate, but I don't agree they should be mandatory because they would set a horrible precedent.

Do you really want to allow the government to force people take medication? Even criminals with psychiatric problems are rarely forcibly medicated.

Here is a link to the American Journal of Public Health article underlying the Ars Technica article kindly submitted here.

http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.3...

Alison Buttenheim, Malia Jones, and Yelena Baras. Exposure of California Kindergartners to Students With Personal Belief Exemptions From Mandated School Entry Vaccinations. American Journal of Public Health: August 2012, Vol. 102, No. 8, pp. e59-e67.

doi: 10.2105/AJPH.2012.300821

The website Science-Based Medicine has especially good reporting and commentary on vaccine policy issues,

http://www.sciencebasedmedicine.org/index.php/category/vacci...

with two recent stories of note:

"Holding the Polio Vaccine Hostage,"

http://www.sciencebasedmedicine.org/index.php/holding-the-po...

describing what's holding back efforts to eliminate polio in the same way that smallpox was eliminated by mass vaccination,

and

"Steve Novella vs. Julian Whitaker on vaccines at FreedomFest,"

http://www.sciencebasedmedicine.org/index.php/battling-antiv...

describing a debate between an opponent of vaccination and a knowledgeable doctor.

California should start a special charter school for the unvaccinated children.

No, parents who want their kids to remain unvaccinated should do so. California should not enable anti-science stupidity; not with my tax dollars, at least.

I think the idea was to put the unvaccinated children into their own ghetto so those with selfish parents don't infect the rest of us.

tl:dr: ignorant people are hurting themselves

Correction: they hurt us all.

Indirectly I suppose. How does my sick neighbor directly hurt me?

By decreasing herd immunity, they're raising the chance that a given disease will become endemic, and that others, particularly the young or immunosuppressed, will catch said disease.

Vaccines aren't 100% reliable, so your sick neighbor has a (small) chance of infecting you.

Two obvious and immediate ways.

1) From the article: "That means far more students are coming in contact with peers who are unvaccinated—a serious risk, since vaccines are not 100 percent effective."

2) Increasing taxes to deal with the huge extra onslaught of people getting sick.

Scare tactics. Vaccinations are nearly 100% effective.

Vaccines also decay in efficacy. When was your last pertussis booster?

"Nearly." So lets say they're 99% effective.

100 people = 1 person. 1000 people = 10 people. 8.2 million people (the population of NYC) = 82,000 people.

That's a non trivial number, and that's just for one city.

TFA: "Herd immunity occurs when a few unvaccinated children are protected by the fact that almost everyone around is vaccinated and therefore cannot infect them. It's important for those for whom vaccines have not worked, those who have immune problems, or those who cannot be vaccinated due to specific health risks"

Additionally, vaccines are not 100% effective- think of them as conferring greatly improved resistance, rather than total immunity. Herd immunity helps add that last few %.

Pretty simple. You take your newborn baby to a doctor's office. Another older child is there as well who has not been vaccinated and is sick. He gets your newborn baby sick.

Some worries are justified, why doesn't a startup want to come with a solution to the actual vaccine that has lots of side effects because of all the adjuvants like mercury?

Is sad that facebook and instagram are the examples that most want to follow instead of making startups that have goals that can really help society.

Because virology is not a zero-capital business? Too, it can't be learned to any usefully significant degree by reading Microbiology for Dummies and watching Khan Academy videos?

I think you managed to sum up the ignorance of startup culture nicely there.

I believe it's also somewhat regulated by the government- we don't allow just anybody to play around with polio in their lab.

Because the real side effects are almost negligible compared to the diseases they prevent.

... for high enough values of 'almost negligible'

How much do you know about the various diseases that are vaccinated against?

Rabies, for example? Before treatments were developed, rabies had an essentially 100% mortality rate. (Though I believe the rabies vaccine is usually administered to animals, rather than humans)

How about smallpox? Historically, ~30% mortality.

I don't know about you, but I've never heard of vaccines causing 30% mortality.

The vaccine is the treatment for human exposure to rabies. Animal vaccination is used to reduce the prevalence of the virus.

The virus moves slowly, so the vaccination is able to prompt an immune response before the infection becomes severe.

Because those adjuvant don't have the side effects you think they do?

Because mercury is mostly removed from US vaccines, excepting a couple of types, and has been for a decade?

According to the study I found, 1 in ~300 Amish have autism. 1 in 90 of the regular population have autism.

The fear of autism shows people are in fact paying attention; whether vaccines "cause it" of course is really the question...

Try plotting the incidence of autism and number of reality television shows on the same graph.

Apparently, the quality of men's sperm declines as they get older resulting in various genetic abnormalities.

The Amish seem to have families quite young whilst the rest of us are slaving away trying to get a house in the suburbs before we have children.

I'd consider that to be a better correlation than vaccines.

Not to mention, the Amish are a fairly isolated genetic pool. The Amish could simply have a lower prevalence of autism the same way those of Northern European ancestry have a higher prevalence of red hair.

That's a very good point. Genetic diversity brings good and bad.

No, it's not the question. Vaccines don't cause autism. This has been established beyond doubt. Further speculation about a link between the two is nothing other than dangerous.

http://arstechnica.com/science/2010/02/the-lancet-retracts-p...

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjourna...

http://www.newscientist.com/article/dn7076

http://onlinelibrary.wiley.com/doi/10.1002/ajmg.a.31846/full

http://www.health.ny.gov/prevention/immunization/vaccine_saf...

Don't understand the downvotes - thought that the quotes around "cause it" would make it clear that I am not subscribing to any theory. That autism has increased is not questioned, what causes the increase is still unknown...

Assuming the study is correct, then you should really say: "1 in ~300 Amish are diagnosed with autism."

Amish are far less likely to take their kids to the Dr. and the Amish family life is quite different from the rest of America. So behaviors that cause problems in public schools are not a concern there.

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