Diphtheria, a once vanquished killer of children, is resurgent
nytimes.com
nytimes.com
> "Somalia is the first country to apply to Gavi for new funding to give children diphtheria boosters — shots delivered to children in their second year of life, then between 4 and 7 years old and 9 to 15 years old — in areas where the outbreak has seemed most severe."
RFK Jr. was personally responsible for ending US' involvement in Gavi, due to his insane view that the diphtheria vaccine is unsafe:
https://www.statnews.com/2025/07/02/rfk-jr-vaccines-former-c... ("RFK Jr.’s intellectually dishonest excuse for defunding Gavi, the Vaccine Alliance" / "The diphtheria, tetanus, and pertussis shot study he cites is fatally flawed")
Interestingly, our paediatrician in the US gave us a long lecture about why vaccines are important and this and that. He's an older gentleman and wouldn't brook any of my interruptions that I've been through this and to please proceed with the vaccination schedule and that I've had measles[0] when I was a young child and have no intention of subjecting my children to it. Presumably his insistence on the subject was because of hesitancy.
In the end, we got the usual ones but didn't give our daughter the COVID vaccine. I can't say it's a super principled position, except that I think I do want to minimize the number of vaccinations she gets to the ones that are the highest risk for her. That's the usual meningococcal, hepatitis for a neonate; the Tdap for an infant, and the subsequent measles et al. for older children. I think I'm content to leave the tail risk items in the tail.
0: I was eight months old, my parents were the only doctors in the rural Indian village, and consequently a local brought their very sick child to our home. The child was in the room for just a few moments before my mother rushed me to the other room. As it so happened it was too late for me. I became quite sick as well.
It's true this isn't the flood, but it's the sound of distant thunder and the sighting of a wall of black clouds on the horizon.
Better walk the dog and call the spouse and kids back from the playground.
You strike an interesting point.
From a scientific PoV, vaccine rejection in the West is pretty much unjustifiable according to mainstream medicine. But the not-worst-case, fairly bad outcome is kinda manageable. Your child gets measles, is probably OK, but if not, goes to an expensive hospital and will probably be fine. Even without vaccinations, it's probably not a life or death scenario. I'm not saying it's good, only that the price tag is likely low.
But of course it's completely different in poorer countries, many places in Africa among them. These are also places with poorer education on average, I'd imagine. And what do they think when the West is sending them (or they're buying out or scarce resources) stuff that we refuse because it's "dangerous"?
And if you get a measles outbreak in Somalia, you won't be worrying about childcare and copayment, it will literally be life and death.
People who peddle anti vaccine BS should think about this too.
I don't understand this take, if you are a parent. For example, RSV (respiratory syncytial virus), rarely causes death in developed countries. But 1) like SARS-CoV-2, almost every children will get infected at least once in their first two years of age and 2) a respectable number of non-deadly consequences come from this virus, some of them long term.
My point is death is not the only consequence you should weight. Just having your baby a couple of weeks in "expensive hospital" (i.e. ICU), with a chance short term consequences like respiratory problems and secondary infections, or long term non-deathly consequences like asthma and alergies, sounds like a danger serious enough to me. It seems like a very poor parent decision to not vaccinate your children against RSV, even if it's almost impossible for RSV to kill your baby.
But not so in poor countries.
The babies usually don't die, and usually get a full recovery. So it doesn't come up in the news. But you, as a parent, don't want to have your baby hospitalized or in ICU: it's very stressful, it has health consequences short and long term. My point is "don't reduce consequences to life-death", because there are a lot of in between consequences you don't want for your kid.
I like your "secondary safety net" image. It's secondary because you vaccine (the first safety net), but when people trust blindly the secondary safety net so they get rid of the first safety net, you only have one primary safety net. It's like getting rid of the safety belt now the cars have airbags.
This is a dilemma of the prisoner: you can "bet" your children won't get infected even without vaccine and even if he catches the infection he would get through it easily, so you don't have any risks from the vaccine. That works if non-vaccinated are only a few, but above some point the herd immunity is lost and the most vulnerable kids will have to suffer serious consequences.
If I didn't want to vaccinate my kids, I would fight tooth and nail as a pro-vaccines, so the herd immunity covers them.
People who don't but live in "the West" are worse off in expectation but for most, not by much. They can mostly afford anti-vax BS because some good soul in a well equipped ICU looks after the kiddos.
But if this nonsense rubs off on people in poor places, if they start doubting the safety of vaccines because some influencer on Twitter says so, then that's a huge tragedy. To me at least.
I'm not in any way saying not vaccinating your children for no reason is ever a good idea.
An interesting angle, though I wouldn't say I agree. As one example, I believe all of us in India routinely receive the BCG vaccine against TB right after birth. It's not routinely done in the US (unless I'm wrong and don't remember it). The US choosing not to do it doesn't make Indian people want to not get it.
More likely, there's something else that's making people worried about the standard vaccines.
But then my understanding is that there's in particular higher levels of distrust against Western medicine in parts of Africa, following the AIDS epidemic.
Just wait for polio to make a comeback. It's life-altering, has no cure, and is easy to vaccinate against.
Which, I mean, was at least true for one of them. Cia, indirectly killing children since 1950 would be a great catchphrase.
What an incredibly selfish point of view. Both for ignoring the risks of measles in your own child, and more importantly, for completely leaving out of the equation the likelihood that they will spread it to someone who for medical reasons cannot be vaccinated or for whom the virus is even more dangerous.
> From a scientific PoV, vaccine rejection in the West is pretty much unjustifiable according to mainstream medicine.
The post is against anti-vax.
I do realize you mean to critique anti-vaxxers. That's good. But the way you paint measles as a minor inconvenience in the west is really bad.
But it's much worse if anyone from a poorer country takes notice and tries to copy.
https://www.cidrap.umn.edu/measles/measles-does-long-term-da...
After severe measles, children lost a median of 40% (range, 11% to 62%), and after mild measles they lost 33% (range, 12% to 73%), of their total preexisting pathogen-specific antibody repertoires. Paired, healthy controls retained approximately 90% of their repertoires over similar or longer durations.
You might want to rethink your above statement.
… and to hell with the unhealthy children? This is what I mean. Incredibly selfish thinking.
> Wikipedia quotes death rate of 0.2% in the US in the period 1985-1992.
Oh, so just thousands and thousands of dead children then. "Just an inconvenience". Your comment is disgusting!
> Presumably his insistence on the subject was because of hesitancy.
> In the end, we got the usual ones but didn't give our daughter the COVID vaccine
Perhaps the doctor deserves some slack.
I should have known better than to mention that. For obvious reasons this one virus is a bit of a politicized subject and activates the outrage machine.
I've got no problem with our paediatrician. Rather like him, if I'm being honest. Wouldn't be going back for every subsequent appointment if I did have a problem. The "long lecture" bit is more affectionate than complaining.
Covid is not a tail risk.
Additionally, by not getting a vaccine, you potentially put people at risk who cannot get a vaccine -- immunocompromised folks, etc. Vaccinating your child also protects everyone in their communities.
Choosing not to vaccinate because you want to limit the number for no expressed reason is vaccine hesitancy. You have expressed a position of vaccine hesitancy here.
COVID-19 vaccines are no longer indicated for most healthy children (or most healthy young adults) in most jurisdictions as the risk benefit analysis no longer supports it.
Almost literally everyone has and will continue to get COVID at this point. Not vaccinating your child, or all of the children in the US, won’t prevent that. I don’t know a single person that hasn’t had it, vaccinated or not. So, your child gets the vaccine. They’re then, what, maybe 50% less likely to get COVID for 6 months? Not exactly moving the needle as far as community transmission goes. This isn’t 2021 anymore.
If we had a better, longer lasting vaccine you might have an argument. Very, very few parents are going to do the COVID vaccine for their child every year. At the very least you’re risking them picking up something more serious just by going to a clinic or pharmacy to get it.
Anyway I haven't tested since the pandemic so I wouldn't have known if I'd had it afterwards.
I've been exposed three times (twice by my SO) and only tested positive once, but I had symptoms both other times as well.
All my tests for those were done at home and I wouldn't take "I did it wrong" out of my equation.
Could be something like our viral load wasn't high enough to register on the test, maybe our immune systems just dealt well with covid.
Judging by how badly I got COVID (twice) and how I tend to get every single cold my daughters bring back home, I'm pretty sure that gene is running in reverse for me.
Except I like to claim it's because of an intentional approach
https://wiki.roshangeorge.dev/w/Low_Dose,_Frequent_Exposure
Not very likely, but amusing nonetheless.
Also tested whenever I felt unwell during the pandemic.
I've discounted the other effects as they were generally associated with comorbidities (lung scaring was a % of hospitalized people).
I've also discounted long-covid because of comorbidities, self-reporting bias, nocebo effective, and depression/anxiety overlap. Yes I know its still real, but the true rates are difficult to know.
Edit: I should have factored clotting as well
he can't really use stairs, or walk a long time, etc. he sleeps a lot, and basically can't be active for a long time anymore. his reaction time also worsened apparently (used to be ridiculously fast).
hospital folks (in 2 different countries) directly linked it to the vaccine.
so yeah it's rare but it can get really bad...
No. You probably thinking some other vaccine and infection, not covid. For covid once infected, vaccinated people express similar number of virus in their saliva as unvaccinated (see for example [1]). Additionally, infected vaccinated people have lower intensity symptoms or now symptoms at all, and thus more likely to go about their business as usual (and thus spread the virus) than to stay home like unvaccinated. As a result the vaccinated people do possibly spread more infection than unvaccinated. The obviously propagandistic and using government force push "do it for the good of the community" (very USSR style) for covid vaccinations against the science - as those results were already known at the end of 2021 - drove a lot of new people into vaccine-sceptic crowd.
[1] https://www.ucdavis.edu/health/covid-19/news/viral-loads-sim...
"new study from the University of California, Davis, Genome Center, UC San Francisco and the Chan Zuckerberg Biohub shows no significant difference in viral load between vaccinated and unvaccinated people who tested positive for the delta variant of SARS-CoV-2. It also found no significant difference between infected people with or without symptoms.
...
Although vaccinated people with a breakthrough infection are much less likely to become severely ill than unvaccinated, the new study shows that they can be carrying similar amounts of virus and could potentially spread the virus to other people."
> As a result the vaccinated people do possibly spread more infection than unvaccinated.
You are using a subset of the groups to argue around the entire groups.
If the entire (much larger) group of vaccinated got infected at a rate of unvaccinated, your argument would hold, but they don't and it doesn't.
they do. Covid vaccine doesn't significantly decrease infection rate [1] (that, if you think a bit about how immune system works and how covid infects, in particular is why viral load is the same in vaccinated and unvaccinated). The vaccine only softens, a lot, the symptoms.
Thus widely vaccinating healthy people, we do increase threat to immunosuppressed and the likes.
[1] https://www.theguardian.com/world/2021/oct/28/covid-vaccinat...
"The results suggest even those who are fully vaccinated have a sizeable risk of becoming infected, with analysis revealing a fully vaccinated contact has a 25% chance of catching the virus from an infected household member while an unvaccinated contact has a 38% chance of becoming infected."
[2] https://news.northeastern.edu/2023/11/02/covid-flu-vaccine-e...
"Why do some vaccines (polio, measles) prevent diseases, while others (COVID-19, flu) only reduce their severity?"
No they don't.
> "The results suggest even those who are fully vaccinated have a sizeable risk of becoming infected, with analysis revealing a fully vaccinated contact has a 25% chance of catching the virus from an infected household member while an unvaccinated contact has a 38% chance of becoming infected."
A couple of points here:
1) 25% vs 38% is an enormous difference in compounding risk of transmission across populations.
2) Accepting the premise that viral load at peak is the same, multiple studies still show that vaccinations reduce duration of shedding and transmissibility. [1]
> Thus widely vaccinating healthy people, we do increase threat to immunosuppressed and the likes.
This is simply wrong based on above in both first and second order effects. On top of that, having fewer/less severe reactions in otherwise healthy people leaves more healthcare resources for immunosuppressed.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC9499220/
https://www.medrxiv.org/content/10.1101/2022.01.10.22269010v...
https://www.gov.uk/guidance/monitoring-reports-of-the-effect...
there is no compounding in a wide spread infection like Covid where you're guaranteed to meet a carrier several times a day, and thus there is no practical difference between 25% and 38%. You'll get it either way - say you meet 10 carriers, each time probability 25% or 38% (or even if were just 5% and 10%) - the end result is indistinguishably similar. And you meet carriers every day. So if not today, then tomorrow.
>2) Accepting the premise that viral load at peak is the same, multiple studies still show that vaccinations reduce duration of shedding and transmissibility. [1]
yep. Unvaccinated is sitting at home, feeling ill, shedding, yet not transmitting. While vaccinated is out and about, no symptoms, shedding and happily transmitting to everybody around during that "reduced duration".
>On top of that, having fewer/less severe reactions in otherwise healthy people leaves more healthcare resources for immunosuppressed.
That is another propagandistic BS. I've been to ER in the summer 2020 for a non-covid related issue - it was empty.
Is your argument: "I can come up with a scenario where the real-world-measured statistics are not relevant?"
> yep. Unvaccinated is sitting at home, feeling ill, shedding, yet not transmitting. While vaccinated is out and about, no symptoms, shedding and transmitting during that "reduced duration".
You're making up scenarios not reflected in real-world data.
> That is another propagandistic BS. I've been to ER in the summer 2020 for a non-covid related issue - it was empty.
https://www.medrxiv.org/content/10.1101/2020.12.16.20248366v...
He did all the mandatory vaccines, the rest is a tail risk. Unless you vaccinate yourself against the flu and your children for both flu and COVID, I don't think you have any leg to stand on.
Alarmism, militant shaming, and omission of details like the ones I mentioned above are three strategies that steer vaccine hesitant people away from taking vaccine advocates seriously. Personally, I would raise concerns about anything but COVID and ease up on the Newspeak.
Children have increased likelihood of anxiety, communication disorders, and other developmental mental health issues: https://pmc.ncbi.nlm.nih.gov/articles/PMC12290120/
In studies of children and adolescents, it has caused increased likelihood of fatigue, anxiety, and various other symptoms: https://pmc.ncbi.nlm.nih.gov/articles/PMC11339705/
Children are at significant risk of ongoing complications: https://academic.oup.com/cid/article-abstract/80/6/1247/8002...
Cardiovascular risk is demonstrably elevated post infection: https://pmc.ncbi.nlm.nih.gov/articles/PMC11992182/
Increased risk of kidney malfunction: https://pmc.ncbi.nlm.nih.gov/articles/PMC11992607/
- Ho much does this apply to the weaker strains that are still circulating today?
- To what extent does vaccination prevent any of these issues?
Most European countries don't offer vaccines for under 18's unless there's a very specific reason. Some don't offer the vaccine for general public except for vulnerable groups. Why? All medical interventions carry a risk and there is always a threshold where that risk outweighs any potential benefit. This is what sensible public health policy looks like.
Neither Germany nor France nor the UK advise against vaccinating children against COVID. The Germans explicitly say that the absence of a recommendation to vaccinate is only because children have relatively mild cases and safety or risk concerns are no factor.
Go look up long term effects from COVID in children. Everything I find says children are at risk for long COVID just like adults, and the effects and risks are not understood yet. Then tell me you won't vaccinate your child. (Or yourself, for that matter.)
Imagine saying this about anything else that's good for children. I want to minimize the amount of food she eats. I want to minimize the number of friends she has. Insane mindset, tbh.
It is. But then you have ultra-processed food, junk food, food you might be allergic to...
Some medicines are good, some medicines are the lesser bad, some medicines will kill you if you take them when not needed, some medicines you might be allergic too, and some medicines are just a patch to have you feel well and keep you going.
Medicine is not an unqualified good. Here's a simple test. Go take some chemo meds. Assuming you don't have cancer, would that be good? Or go swallow a bottle of Tylenol. Would that be good?
Medicine is only good in certain specific circumstances when administered in the right way. Its not "more doses of anything labeled vaccine equals more good". Otherwise we would give children the rabies vaccine.
If you are a perfectly healthy person, one surefire way to become a not healthy person is to put a bunch of drugs that you don't need into your body.
I think the consensus across Western nations around the COVID vaccine to allow for shared clinical decision making rather than a universal recommendation is well-informed.
My daughter, like almost every child in the West, didn't get the BCG vaccine at birth either (I did). If this (and forgoing the COVID-19 vaccine) are mistakes, then that's life. Those of us who make those choices must live with the consequent regrets.
But she's got two surgeons as grandparents. And they're aligned with the CDC and STIKO schedules. I'm comfortable with the decision-making process.
0: errors like allergen management are unusual, and fairly quickly resolved; even the errors in COVID response were adaptively handled
The cool thing about medicine is that we get pretty good numbers pretty fast for everything. So in the end that choice would just be about knowing the numbers and picking your poison.
But that isn't how people make these choices. They will say "it is unnatural to stick a needle into a child" and then have their child infect half of their school plus the parents with measels.
The cost/benefit analysis of that hypothetical case is a damn no-brainer for the vaccination, yet that isn't how people act. Meaning if we talk about regular vaccinations (flu, corona, measels, tetanus) just getting all of them is the better choice for the society and yourself.
Unless those are crazy expensive for some reason in your place. Where I live all of those are free and take at max 20 minutes for me to get including the walk to the doctor's office. Not having the flu in the winter season is cool, because lying in bed for a week sucks more than a little sting of the needle with no noticable side effects.
I think it is a reasonable point of view to not want to be the testbed for vaccines that were also rushed to the market to reap the profits, let me remind you.
Oh and, I've gotten the vaccine. I'm just not tribal about it.
Given the biological mechanism of these vaccines, the risks are well-known at this point. The mRNA does not integrate into DNA and degrades within hours to days. We were extremely lucky we had years of science on the mechanisms when the pandemic broke out (+won the scientist who did it a Nobel price). The major serious (but rare) side effects are (1) myocarditis in young men with mRNA vaccines and (2) thrombosis with adenovirus-based vaccines. Both were either known already or identified quickly because of the mentioned huge number of doses given and the careful monitoring then. These risks are measurable, have clear incidence rates, and are lower than the same complications from infection (otherwise millions would have had them).
There is no plausible mechanism for any delayed catastrophic effects years down the line without any signal in the first billions of doses, neither for this vaccine nor for others. At this stage the vaccines are not exactly what I would call "experimental" anymore. They one of the most heavily observed medical interventions in history.
So if you believe there ought to be something wrong with the numbers (incompetence/grand conspiracy) or some weird thing is gonna happens with a delay of multiple years (black swan mechanism), the burden of proof IMO on your side.
I am not from the US, so I might not be up to speed with the tribal pandemic conflicts emerging in your culture. So you may call me tribal, but I prefer to mitigate real risks for my family and me, rather than hypothetical ones proposed by people who don't go into detail beyond a "who knows".
Note that 13.84 billion is a huge number, if every dose was a powerball lottery ticket we should see around 64 jackbot winners. That means nearly every weird thing that can happen by chance, will happen. And since people were on the edge every weird thing will be reported. But even these reports are all like "yeah that person eas already on the verge of dying or had some other weird medical condition and we can't really establish a clear chain of causality".
Maybe I am a bit allergic to a generic anti-modern-medicine stance, since my neighbour (my best friends mom), died of a preventable disease because she didn't want to get the known-safe medical remedy and spent a fortune on shamans and other greedy healers instead. She wanted a natural thing and died (as was natural before the advent of modern medicine).
For anyone that isn't afraid of needles and a little arm pain, it's worth it for the peace of mind alone.
This is just wrong. Go figure out which vaccines you haven't had, and then figure out why they haven't been prescribed to you. (Hint: It's not because your doctors are anti-vax)
It's hard to exhaustively list all qualifiers to statements in short form communication.
I don't think it's being particularly pedantic to say "there is no downside to any vaccine" is just wrong, and not really something that should be repeated. It's more of a religious statement than anything else, and it's the exact kind of thinking that comes out of the insane pressure put on people during covid.
I'll address one as an example, and you tell me if/how I'm wrong: LAVs, like the MMR vaccine, specifically the Rubella portion is contraindicated in pregnancy for the risk of CRS (in the fetus) and recommended instead after pregnancy. But that is because the risk of contracting it is low enough to not warrant immediate protection. But it is recommended both for the adults and children. It's a temporal recommendation, not against.
You are not weighing it against getting Rubella itself, so it falls under the conditional "illness you are likely to come in contact with".
Same difference. "There is no downside to any vaccine" means at any time, if you see a label that says "vaccine", it's never a bad idea for you to take it.
I'm not claiming any expertise here, but some examples:
The jannsen covid shot: you're likely to come in contact with covid, this one is only recommended for folks who can't do mRNA for whatever reason. (The same concept applies to any vaccine that isn't considered the best of its kind)
HPV: not just blanket recommended to everyone, yet you are very likely to come into contact with HPV.
Chatgpt comes up with plenty more examples, but the concept is simple. Just because something is called a vaccine (or medicine in general) does not make it some kinda special power up that everyone should be maximizing their exposure to.
No it isn't. Getting rubella while pregnant would be much much worse for the fetus, while likely mild for the woman.
> The jannsen covid shot: you're likely to come in contact with covid, this one is only recommended for folks who can't do mRNA for whatever reason. (The same concept applies to any vaccine that isn't considered the best of its kind)
Ergo: The Jannsen vaccine is better than getting covid without it.
> HPV: not just blanket recommended to everyone, yet you are very likely to come into contact with HPV.
It is blanketly recommended before coming in contact with HPV.
> Chatgpt comes up with plenty more examples
Ok, if you're open to explore, keep them coming.
> , but the concept is simple. Just because something is called a vaccine (or medicine in general) does not make it some kinda special power up that everyone should be maximizing their exposure to.
Vaccines are better than the illness they're protecting from. That's the arguement:
> "There is no downside (not grossly outweighed by the upside) to taking any vaccine (against an illness you are likely to come in contact with)".
Does the doctor give the pregnant woman that vaccine? (I meant same difference about "temporal recommendation" vs "recommending against")
> Ergo: The Jannsen vaccine is better than getting covid without it.
If you had already recovered from covid and were younger, the upside was negligible, so I don't think it would meet "grossly outweigh".
> It is blanketly recommended before coming in contact with HPV.
It seems to be recommended for ages 9 to 26, so presumably there is a downside for those younger than 9.
(https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...)
If you just compare the downsides of a successful vaccine (which is not all vaccines) to the downsides of the disease it targets, it should obviously always come out that the vaccine was a net win. But you can see how that gets pretty far from "there is no downside to any vaccine" right?
Chat gpt mentions oral polio. You're probably better off having had the oral polio vaccine if you are 100% going to be exposed to polio. But you wouldn't be doing a random first world resident a favor advising them to get the oral polio vaccine (which isn't suggested by "there is no downside to any vaccine")
So granted, you have an infinitely better argument than the original. And maybe that's the argument they meant to make.
If that was not what you were positing, I think the original poster thought you did. But we're veering far into speculation at this point. I'm happy to have explored the topic with someone equally curious at least.
Oh, you're one of those.
Decisions that take you in opposite directions.