One unvaccinated child was patient zero of a measles outbreak | Hacker News Reader

One unvaccinated child was patient zero of a measles outbreak

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This will invariably lead to the argument whether government can or should mandate vaccinations.

Currently parents probably cannot be prosecuted for not vaccinating their kids. I think they should be (child endangerment comes to mind, kind of like putting the child in the car without a special car seat).

But in all likely-hood I can see easier laws being passed that might exclude un-vaccinated people from various venues. Travel (flying is not a right apparently), schools, hospitals, doctors' offices, concerts. "Show your vaccinations card and come and enjoy the music" kind of deal. Parents throwing birthday parties for their kids and checking vaccination cards at the door. Pretty strange, but maybe more viable that forcing vaccinations otherwise (forced medical treatment).

Or to look at it anther way, what is the legal precedent of parents refusing medical treatment over religious beliefs? You know let "Jesus un-break her arm instead of the doctor". Maybe this is in the same category.

Many states have had vaccine requirements for a child to enter public schools:

http://www.immunizationinfo.org/vaccines/state-requirements

Interestingly is that a check-mate for people who don't want to vaccinate? Since kids have to be in school But, I guess it forces them to home-school, move, or go to private school that don't have such a requirement?

In the majority of states these laws apply to both public and private schools, so home-schooling would be the only option.

many states also have exemptions for "religious"/"personal" reasons etc.

Bronze age gods know nothing about vaccinations. How can there be religious reasons to refuse vaccinations when vaccinations are a modern invention? Such exceptions in law are idiotic.

Some vaccinations use animals or animal byproducts which are deemed unclean by some religions. Some religions make vague statements about blood and cleanliness, etc. which might be construed one way or another.

Bronze and stone-age gods knew about the blood or meat of certain animals making you sick.

One of the interesting policy problems of forcing vaccines is that you have to ensure that people who can't get vaccines for medical conditions are able to get around in society, and that people with absurd anti-vaccine conspiracy beliefs don't get medical waivers.

My father, for example, can't get flu vaccines. The last time he got one was decades ago and he ended up hospitalized, completely paralyzed with minimal respiratory and heart functions, able only to move his eyes. He recovered, but it took weeks. They think he has Guillain-Barré syndrome and it kills many people who suffer from it (though they likely don't know until they suffer from it, the flu vaccine is one of the known triggers). The risk of immediate death is so high that he avoids most vaccines altogether.

> But in all likely-hood I can see easier laws being passed that might exclude un-vaccinated people from various venues

What about people who are not vaccinated for medical reasons, such as an allergy to the vaccine?

I am sure that is not the reason most people don't vaccinate their children. Maybe, some vaccines have alternative formulations. At least it shouldn't be hard to document and make exceptions for those few cases.

Is that a thing? I mean, how would you know? Many vaccines are administered once or twice in a lifetime...

The vaccines are once or twice in a lifetime, but the allergens are not. The MMR vaccine is manufactured using neomycin. The CDC says [1] for the MMR vaccine:

   Anyone who has ever had a life-threatening allergic
   reaction to the antibiotic neomycin, or any other
   component of MMR vaccine, should not get the vaccine.

Neomycin is used in many topical creams and ointments, so there are opportunities to find out that you have a problem with it other than through vaccination.

Also, as you noted, some vaccines are twice in a lifetime. MMR, for example, is given at ~1 year old, and at 4-6 years old. If someone has a life-threatening reaction the first time, the CDC says that they should not get the second dose.

Note that MMR vaccine allergies are very rare, so we aren't talking about a huge number of people who have to go around without MMR vaccination.

[1] http://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html

I believe people with severe egg allergies avoid some vaccines because of the presence of egg protein - eggs are used as bioreactors to grow the vaccine.

However, it looks like that's only the influenza vaccine, and that's not how the MMR vaccine is produced.

http://www.cdc.gov/vaccines/vpd-vac/should-not-vacc.htm

Yes, until I outgrew my egg allergy, I could not take certain vaccines. I was too young to remember which ones I could not take. I suppose that I relied on herd immunity for those specific diseases.

You can be allergic to certain common components, e.g. egg albumin.

http://en.wikipedia.org/wiki/Egg_allergy#Vaccine_hazard

> But in all likely-hood I can see easier laws being passed that might exclude un-vaccinated people from various venues

Duty of care, maybe? The school has a duty to protect kids from potential carriers. They know if you admit unvaccinated kids, then herd immunity is lost.

Also, maybe anti-discrimination laws would protect kids with genuine medical reasons from being excluded.

My niece got here measles vaccine two weeks ago. Ten days afterward she came down with, you guessed it, the measles. My first reaction was utter fear that she was going to die. But the doctor wasn't at all concerned. She'll be sick, it will suck for a little while and she'll get better.

So what the hell? First of all, the vaccine gave her the fracking measles! So who is actually spreading these diseases around?! Secondly if there's no concern of it being deadly than why the endless hyperbole over the few hundred people, out of 300 million, who get it per year?

The measles vaccine is live attenuated, so in the rare case it does cause disease, it's less severe than wild type.

Measles is one of the most infectious diseases known to man. In a fully susceptible population, one infected person can expect to infect 14 other people. The reason only "the few hundred people" get infected annually now is because of widespread vaccination campaigns.

Measles used to be all but inevitable, infecting literally millions, and killing hundreds each year in the US. The only reason we have come to fear vaccines is because we as a society no longer remember fearing these diseases.

http://www.cdc.gov/measles/vaccination.html

Correct or not, the doctor is confident that the attenuated virus in the vaccine is sufficiently attenuated that your niece isn't going to get the bad consequences of the wild type virus.

According to Wikipedia on the MMR vaccine, "10% of children develop fever, malaise and a rash 5–21 days after the first vaccination" With numbers that high, it sounds like statistically this isn't a serious problem.

Your niece is of course not a statistic, but at least based on what I know about medicine and biology, and what I've just looked up, the odds are strongly in her favor.

Skim comments to this Daily Kos diary for testimony from people older than me about just how bad things were before we had these vaccines, including of course the family and friends who didn't make it. My parents were born in the middle 1930s; they too attest to it.

there is a concern -- that unchecked the virus could affect children not yet vaccinated, or the elderly in an outbreak.

it's common to be symptomatic of a disease when you receive a vaccine -- this is not mean you received the full force of the disease.

Question. How are vaccines different than "over-use of antibiotics" that we always hear about?

Are the constant use vaccines creating superbugs?

Vaccines are very different to antibiotics. Antibiotics are agents which kill bacteria, whereas vaccines train the body to respond to infection using its own antibodies. Vaccines do nothing once you've been infected: they're about increasing your body's immune response to an infection down the line.

Additionally, most of the diseases we vaccinate against are caused by viruses. Whilst it's possible for viruses to mutate, this isn't a huge problem because we can simply modify the vaccine to use the new strain (hence why the flu vaccine is given annually). This doesn't apply for antibiotics: we need to find a new agent, which may not exist.

They're entirely different. Simply put, all a vaccine does is stimulate antibody production to improve immunity against a given disease. What you're effectively asking is if the human immune system itself is creating superbugs.

So the simple answer is "no."

What is the net functional difference between an "antibiotic" and "stimulating antibody production"?

"Stimulating antibody production" means you're protected from the antigen for some period of time, be it a virus, or at the other end of things in the case of tetanus, against the neurotoxin that's produced by the bacteria responsible for it. If there are enough antibodies in your system, they'll latch onto their specific antigen, which triggers other parts of the immune system to deal with it.

Antibiotics only work while their level in the body is high, and they pretty much are limited to zapping bacteria, by going after things that are different in them from the class of more evolved organisms that includes everything from yeast to humans (many have cell walls like plants, their protein producing machines are slightly different, etc.).

They are largely derived from compounds molds evolved to produce, to allow them to better ecologically compete (there are also some bacteria produced antibiotics, although I don't know if any are used as drugs).

Is HN also going to have a weekly anti-anti-vax post too? We're converting to Reddit format right?

..a place where we can all pretend we understand this stuff, suddenly manifesting degrees in medicine and/or a full understanding of the research.

Who would ever have guessed?

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