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Comment by joezydeco | Hacker News Reader

We need to think of a better way to convince parents to vaccinate their children than hitting them with sarcasm. While these are fun to read from our smug pro-vax point of view, they provide no effect on everyone else.

We need to show parents what life was like before the polio vaccine. Before measles/mumps. Hell, before smallpox. Part of the problem is that younger parents don't believe that these diseases were all too real and way too common before the treatments. There aren't many polio survivors around anymore, and the only place you'll ever see measles is on Brady Bunch reruns.

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I used to be a mormon, and I served a mission. People that had been exposed to the absurdity of mormonism were difficult to convert, and people that had never heard of mormonism were relatively simple.

Satire and sarcasm might not convince an anti-vaxxer that vaccines are good, but they might convince an uninformed person of the ridiculousness that the anti-vaxxer position is. It can stop the conversion.

So you are saying that sarcasm is a vaccine against stupidity?

So you are saying sarcasm causes autism?

Bad sarcasm surely causes narcolepsy.

So you are saying that vacancies is a scram?

It's possible that's exactly what it is, in a cultural-transmission sense.

(Suggest discussing this one, rather than reflexively downmodding. The use of sarcasm and mockery as legitimate rhetorical tools has previously been brought up by people like Sam Harris. I thought it was a pretty interesting point when I first encountered it.)

I agree. The whole concept of memes that evolve and spread like genetic material is a useful tool (hell, that's where the 'viral' comes from). It's useful to talk about memetic immunity in individuals and groups. If sarcasm helps you defend against harmful memes, then that's exactly what it is - a vaccine.

And if you convince the large amount of uninformed people that anti-vaxxers are ridiculus, then it's easy to pass laws that mandate vaccination for schools, it's harder for anti-vaxxers to get a platform on TV.

So, satire is a vaccine?

If we consider memes, satire and parody could be ways to prevent certain ideas from being able to take hold in a person's mind. Once you realize the absurdity of a particular viewpoint (taken to its logical extreme), it's harder to be convinced of even more moderate takes on that idea/philosophy/whatever.

Consider people who grew up or lived under authoritarian regimes now living in countries like the US or UK. Seeing the current surveillance trends (well, not current it's been going on for a while), they may be less likely to consider what's happening as a positive. While those who grew up in the US or UK may have a harder time recognizing the negatives because they lack the relevant experience (and, hell, given how little of history my younger coworkers seem to know they won't even have the benefit of second-hand experience).

I agree and I think the anti-ACTA protests (biggest in post-soviet countries) shows exactly this.

Few people in UK protested ACTA.

In Poland it was the biggest protest in last decade.

Homeopathic party!

Drink as much homeopathic agent as you can.

Prosit!

There are situations where you should convince people, there are situations where you must mandate a decision. Whenever personal freedom produces large negative externalities, the law must mandate behaviours.

These mandated behaviours should be such that freedom is restricted by the minimum needed amount. As an unrelated example: smoking is not prohibited; Smoking in closed public spaces is.

For vaccination, I believe the sweet spot of mandated behaviour is to mandate vaccination of children participating in large public groups. Children that go to public schools must get vaccines. Children playing team sports must be vaccinated.

Parents then maintain the freedom of not vaccinating their kids, but must abide by the rules that prevent those kids from being a menace to the rest of the population.

Note that this is only needed because vaccines rely on "herd protection". If vaccination coverage drops, vaccine efficacy drops precipitously. The effect is very pronounced. 90% coverage is much less effective than 99% coverage. Not vaccinating a child poses a risk for the child, but also poses a risk to all other children he/she is in regular contact with.

P.S. A lot of other discussions may arise: Government prohibitions tend to be slippery slopes; Children should be somewhat protected from their own parents; Should groups be allowed to skip vaccination altogether?. These are secondary issues, irrelevant to the main decision that is: Mandate vaccination for children that are members of larger groups, so that the group maintains disease protection.

We should handle this the same way we handle other negative externalities. With taxes. You certainly have the right not to vaccinate, but you should bear the full cost of that decision and not simply be allowed to free ride on the herd immunity of other people who did accept the small (mostly perceived) risk of vaccination.

I'm betting once there is even a small tax on skipping out, most of this nonsense will vanish like smoke.

Taxing people who don't vaccinate their children has got to be the easiest way to pour gasoline on the libertarian fire.

I don't see why; if we can quantify the average economic cost to others of you not vaccinating your children, then by charging that to people who don't vaccinate, we are merely increasing the efficiency of the free market by removing an externality. That's about as Libertarian as you can get.

I think one problem would be how much can we legally restrict from society someone who isn't vaccinated? Can work places restrict this (especially ones like hospitals and the like)? What about government jobs? What about health insurance companies? Life insurance companies? Public transportation? Flying? What about the government-subsidized/provided health care? Can they mandate vaccines?

They're free to roam about our society as they please (within reason).

"Can work places restrict this"

Absolutely. Voluntary disease carriers are not a protected class under any law. If there is a scientifically and legally provable threat to others' health and safety, I'd say a business has a responsibility to reduce that threat. The main way these outbreaks start, quite likely including the one at Disneyland, is unvaccinated people coming back from places where measles are still endemic. Those people are walking bioweapons. If they're not going to be quarantined at the border, then it's up to businesses to contain the damage as best they can.

What about the ones that do it for religious reasons? I have to imagine that these are a non-trivial number of people.

Religion is protected, of course, but the majority of refusals to vaccinate are based on "personal belief" or "philosophical" rather than true religious grounds.

https://www.americanprogress.org/issues/healthcare/report/20...

Unfortunately, once you allow for religious exemptions it becomes hard to distinguish sincere people of faith from the more common agnostic (sometimes even actively atheistic) bioterrorists. Thus, it might be impractical for businesses and their proprietors to exercise their rights in this area.

There are people who claim religious exemptions, but aside from fringe sects of Christianity (some Amish, and a handful of <20k member denominations), no major religion or religious denomination practiced in the US forbids vaccinations.

There are around 100K Christian Scientists in USA, they only must be vaccinated if required by law, and there are religious exemptions most places.

More people claim religious exemptions than are a part of religions that actually forbid vaccination, and Christian Science doesn't have a problem with vaccinations when they are required legally. If your religion doesn't have a problem with something if it is required legally, then it's not a religious problem: it's a policy problem.

A good lawyer could argue that non-vaccinated people are not taking sufficient precautions in preventing themselves from being an accidental bioweapon, and are through voluntary and explicit negligence committing a treasonous act.

Most hospitals(1) require all their employees to get yearly flu vaccinations with threat of termination if you refuse.

(1) I only have direct experience with two hospitals in the area, but based on other employees reactions, this is standard procedure.

Here, it helps that the problem is more acute in children groups. It is acceptable for schools to require proof of vaccination on admission. It is also acceptable for sports clubs to do so on admission. Mixed adult/children environments are not as problematic, because adults resist better to these diseases and so the infection rate gets a lot lower.

A lot of text to say that this is a Pareto rule scenario. Cover the 20% of places where kids spend 80% of their social time and you get most of the needed protection.

I think you're missing the point. The question is not whether it's effective for a business to exclude the unvaccinated. The question is whether it's legal, or perhaps whether it's morally acceptable. AFAIK yes it is, and it should stay that way for the exact same "get the government off everyone's back" reason that people use to resist a vaccination mandate. Businesses of all types should have that freedom, and IMO they should use it.

Pardon my ignorance, but I am curious. If one child in classroom full of children is not vaccinated, what risk is posed to the vaccinated children?

The issue is not just risk to vaccinated children, but risk to the legitimately unvaccinated - too young, immunocompromised, any other condition that's scientifically known to make vaccination unsafe. Those people can't rely on vaccination, so they must rely on herd immunity. When herd immunity weakens beyond a certain point, those people are completely vulnerable for reasons that have nothing to do with their own choices. When we talk about the freedom of some people to forego vaccination, we're talking about taking away these other people's freedom to participate normally in society without significant risk of contracting an often crippling or even fatal disease.

Other scenarios have already been given, but one risk to be considered is younger siblings of classmates who are not yet vaccinated.

Not far from where I live, a 3-month-old baby died of whooping cough. The DTaP vaccination against pertussis is given at age of 3 months, so the baby had no immunity yet; some scolded the baby's parents for being anti-vaxxers but that was cruel - they were simply following the standard vaccination schedule. The legitimately not-yet-immunized baby was killed by being exposed to someone who most likely had refused vaccination. This is difficult to prove, of course, and case details are not public.

Here is a concrete example. MMR is two dose regiment. The current anre recently updated CDC recommendation is that if a child experiences thrombocytopenia within six weeks after the first dose to not give the second dose. Thrombocytopenia is usually not serious - nose bleeds, easy bruising, bleeding of the gums - but since the risk is higher for those that experienced that side effect after the first dose, that is why it has become the recommendation.

One dose of MMR puts their effective immunity to measles at something like 85% during childhood. It varies with how strong the immune system is when the first dose is given, most children get it at six to nine months. At nine months one dose is 85% effective and at 12 months 95% for most infants. It is presumed that the effect is smaller in those vaccinated at six months and those that experience thrombocytopenia and the recommendation is relying on 95% immunization rate for herd immunity. Something like one in 25K children are in this category. There are other categories of people not immunized as well.

Not all children are able to be vaccinated for medical reasons (allergies, weak immune systems/cancer). They could also potentially carry the disease to children who aren't old enough to be vaccinated yet.

Vaccines increase individual resistance to infection, but they do not increase it to 100%. However, when a group is all vaccinated, the effect is that transmission rate drops below what is needed for a disease outbreak, and thus the group gets near 100% protection.

A cluster of unvaccinated children in a group create a living habitat for small outbreaks, lengthen exposure time of vaccinated kids, and thus create the conditions for the extra vaccine protection to get pierced.

Vaccines aren't 100% effective.

... on a single person, but in a close to 100 % vaccinated population, they are close to 100 % effective.

In the recent Disneyland/California measles outbreak, 5 of the infected were considered vaccinated against measles.

http://www.cdph.ca.gov/Pages/NR15-008.aspx

I'm less than 50 and I remember how life was (Italy here). When I was little some children had polio and couldn't walk properly, I didn't know why at the time. Luckily they were the last ones and luckily I was vaccinated. However I had both measles and mumps, not a big deal but maybe only because I was little or because of proper treatment. I think every child at school had them sooner or later and all of them came back to school. We were the last ones not to be vaccinated against those diseases.

As an adult I got vaccinated against hepatitis, cholera, yellow fever, typhus, tetanus etc (I travel around the world on vacations). No consequences. Vaccination for me is an obvious choice. I can think that measles is easily survivable but I won't expose a child of mine to polio. Get all the vaccinations they offer you, it's a good investment.

However, if you don't live a problem you don't really appreciate it. Example: talking with people born in the mid 80s, it was impossible to convince them that there was a real concern about nuclear war at the time they were born (remember Reagan, Brezhnev, Andropov, the Star Wars shield?) Obviously nobody was going to fire missiles, they say. Go read the newspapers, watch the movies, etc I say. No way.

Measles can become measles wncephalitis. It kills you in 12 hours.

Yes (+1), and to be clear: I would vaccinate my children against measles and everything else. My parents would have done it too. Maybe I should have written "I could think that measles is easily survivable..."

I (American) was born in 1980 and I clearly remember being told that the Soviets and their Evil Empire were going to kill us all some day. It was a time where calling someone a 'communist' was not just a rhetorical device, but an actual insult.

This was a common thread from school, to the news to my family. People were worried about the communists still and the rapidly degenerating situation in the USSR only increased the worry.

Yeah, my wife is 5 years younger than me, and that's the biggest cultural divide. I remember at one point she said, in all serious, "What's an ICBM?" when the topic came up. I found a copy of the Butter Battle Book, and the concept of feeling like you're living one step away from MAD was just foreign to her.

If they aren't convinced by science, and they can't be convinced by satire, what is left to convince them with?

This isn't limited to anti-vaxxers either. The number of people who believe we haven't visited the moon is growing year over year. There are also people who believe that the Holocaust did not happen, despite having survivors and well documented photographs.

As unfortunate as it is, there's little we can do for some folks, other than treat them as we do children who don't understand why sticking their fingers in outlets are bad, and say "Because I said so".

Empathy.

I agree with op; the anti-vax debate is not only the parents' failure to vaxinate their children, it is also ours for failing to convince them.

The confrontational tone of this debate achieves nothing but making people defensive. And that's not good for anyone.

Science and satire are woefully inadequate means of persuasion for many people. Empathy is typically well worth a try.

That's only true to a point. We knew for decades that cigarette smoke is terrible for you - and referred to them as "coffin nails" as early as 1888 - but people keep starting the habit. What more education could we possibly give that smoking is bad? People get it in their head to believe and do dumb things, regardless of how reasonably or empathetically they're told that those are dumb things.

You probably can't convince hard-core antivaxxers. They are likely lost causes. At this point, probably the best we can do is to so relentlessly ridicule the position that it becomes an embarrassing opinion to hold. For example, could you imagine your neighbors learning that you were a Flat Earther? No; you'd be the block laughingstock. That's what needs to happen to the antivax delusion.

> At this point, probably the best we can do is to so relentlessly ridicule the position that it becomes an embarrassing opinion to hold

I'm so sad that this is a solution for so many things these days. Science isn't the social justice movement, we have evidence. If people want to bully others for being racist or homophobic, whatever, but that's not how science works. All we have to do to "win" the argument is deescalate it emotionally and make it about calmly and rationally looking at the evidence. That's how science wins, not by marginalizing anybody who disagrees with us.

And when people ask how we know that science works, point at all the technology of the modern world. The phone in their pocket, the airplanes they fly in, the toilets that make their poop disappear, the International Space Station floating around the earth, the electricity in their wall sockets. We don't place blind faith in science, we believe in it because it works.

That tactic didn't work for evolution or climate change, why should it suddenly start working for vaccination?

The problem with being a good empiricist is that you start to find that your reasons for believing certain things differ very widely from those of other people.

You're right - for the long game. Stick with it for a century or two, and hopefully a majority will believe in geologic-time evolution. That hasn't actually happened yet in America because people keep coming along to loudly shout down science, but maybe some day.

Public health does not have the luxury of waiting centuries for naysayers to die out. Whooping cough won't do us the favor of not striking while we build consensus.

I strongly believe in the correctness of your approach. I just don't think that's an option here.

I agree in the sense that we shouldn't let unvaccinated kids go to school and risk the health of other kids.

But I also think it's important not to poison the long-term approach in the process. I know a lot of anti-science people and for many of them it stems from a few really bad experiences where somebody just beat them over the head with science. Then they latch on to any crackpot who claims they're about to revolutionize science and do away with "scientism."

>> "What more education could we possibly give that smoking is bad?"

I think most people who smoke now know this but choose to do so anyway because it's a trade off. They enjoying smoking enough to accept the risks. As long as that doesn't hurt me, fine. Anti-vaxxers are causing problems for the rest of society. In fact they aren't hurting themselves at all, they are hurting their children and other people's. With smoking we could minimise the negative externalities for non-smokers (ban on smoking in public places etc.). With anti-vaxxers that's difficult without excluding them from society completely.

No they don't. They're addicted and don't want to admit. Everything else is window dressing to that.

That explains smokers over the age of about 35-40, but what about everyone else? Why did they start?

How can you use empathy to break past the fact their entire ego is now wound up in their decision being the correct one?

Changing your point of view in spite of your ego requires some form rationality; no amount of empathy can make up for this lack.

No, I believe that the correct answer is a well funded marketing campaign. Every Jenny McCarthy needs to be countered with two Angelina Jolees. Every study published in a scientific magazine needs to be countered with one each in Time, Newsweek, and the WSJ. Every commercial needs to be bought out with prime time, big budget commercials.

Doing it this way ensures that the proper message gets to a person in the method they prefer, and in a way where they can use their standard values to pick the answer, as opposed to having to protect their ego against someone else.

The anti-vax thing is not a debate, just like the creationism thing is not a debate. It should not be treated as such. It's a question of how to deal with irresponsible acts of able-minded adults threatening childrens health.

Empathy and education may help, but in the end, no deviation from the scientifically proven right way can be allowed, lest children be threatened by diseases we've conquered decades ago.

So inform and educate to the extent possible. Then if that fails, sue them for parental neglect and passive biological warfare or whatever.

This is creationism/"intelligent design" all over, but with real consequences in the real world. I'm prepared to accept a lot of relatively harmless idiocy, but this is where I pull the line. And I think John Rawls (http://en.wikipedia.org/wiki/John_Rawls#The_Original_Positio... ) would agree with me.

I was deliberately using hyperbole above, stating: "Then if that fails, sue them for [...] passive biological warfare or whatever." Hyperbole, an exaggeration for dramatic effect.

Clearly, endangering people's lives like this in reality is more like drunk driving: a serious punishable offense, but not even remotely in the same range as "passive biological warfare".

"The number of people who believe we haven't visited the moon is growing year over year."

It took a lot of evidence to convince anyone that Vikings visited America before Columbus. There is at least a small amount of evidence to suggest that crossings and even a trickle of trade pre-dated the Vikings:

http://www.faculty.ucr.edu/~legneref/ethnic/mummy.htm

Other circumstantial evidence includes architecture and burial customs among South American native civilizations that could be interpreted as Egypt-influenced. Yet the majority of scientists greet these claims with extreme skepticism. How could the ancients have crossed the Atlantic? With what? Long boats?

When a great, almost mythic feat is not repeated for a very long time, people will begin to doubt it. That's not new and it's not because "people are stupid." It's because people lie and exaggerate a lot, and thus people respond to that by being skeptical of grandiose claims. It also doesn't help that governments often lie as a matter of standard policy, a fact that very rationally leads people to be generally skeptical of what they say.

If our civilization fell and another rose in thousands of years, I'd expect that many would respond with tremendous incredulity to the idea that the ancients visited the Moon with primitive metal tubes full of fossil fuel and discrete component computers. How absurd. Instead, they would reason, this was obviously some sort of national myth and a part of the American cult of state -- the rocket is an obvious phallic symbol and it being full of oil represented petroleum as the basis of American power, etc.

The only way to disabuse people of the moon hoax theory is to go back to the Moon (or further).

I happen to think we went to the Moon. I also happen to think it's at least possible that ancients (Egyptians, Phoenicians, etc.) crossed the Atlantic. But I guess I'm a bit of an optimist about what humans can do when they really put their minds to it... with tubes full of fossil fuel, or long boats. :)

It reminds me of what my mother told me when she was studying archeology few years ago - that whenever archeologists don't have any clue about what was the purpose of a particular finding, they say "it was used/built for religious purposes".

Yeah, I can easily imagine future archaeologists postulating the use of left-over Saturn V hardware as part of a burial ritual for the Potus (our high priest) or some such thing.

I do often wonder if things like the pyramids had some actual function. I'm not talking about the far-out sci-fi speculations like landing pads for aliens, but some function other than to look awesome and store mummies.

A fascinating thought, thanks.

Except it was science which told them vaccinations were dangerous and caused autism in the first place. Now of course the scientific position has (rightly) changed, but we have to explain when it wasn't correct before, and is broken now.

When I talk to my relatives, they remember when vaccinations were dangerous, when we switched from "global warming" to "global cooling", and now to "climate change" which lets science claim any old change as forwarding their cause.

To be clear, I side with science on this, but for people who don't follow science all the time, I can see how it's easy to get tired of the "no, we have the right answer now, ignore that previous answer". See also basically everything to do with eating/fats/etc.

LATER EDIT: I was not clear in this post. By "science which told them" on the first line, I meant to say "The version of science as portrayed by much of the media". The media blew the autism/vaccine issue hugely, and kept the controversy going for a long time.

That's 100% false. The scientific consensus has always been that vaccines are safe and effective, and do not cause autism. One individual paper that said otherwise was an outlier, and was relatively quickly debunked.

It's important to differentiate between a single paper written by a scientist, and the scientific consensus, which is what the bulk of scientists agree is right. It's not that the consensus is never wrong, but it is wrong a lot less often than a individual paper is wrong.

The consensus on vaccines has never changed and to desribe it as such is misleading.

Sorry, I should probably have put science in quotes, or more particularly, many media outlets suggested that science believed that vaccines were dangerous, and caused autism. In general the media made the process of the debunking much more confusing than it had to be.

The doctor who published the paper positing a vaccine autism link was a fraud that has been stripped of his license to practice medicine.

http://en.wikipedia.org/wiki/Andrew_Wakefield

That's the publication process failing to catch the fraud, not science being wrong.

I guess there are probably other things that happened, but that one person is a source of an awful lot of the nonsense we see today.

> Except it was science which told them vaccinations were dangerous and caused autism in the first place.

It really wasn't. One doctor with an enormous conflict of interest told them, and all other evidence both then and now contradicted his claims.

The crook Andrew Wakefield had a paper published in a respected peer-reviewed journal. That paper was reported by a variety of journalists - sometimes real science journalists in respectable mainstream quality newspaper. Normal not-idiot doctors started offering single vaccines instead of MMR.

Please be aware of the hindsight fallacy.

Looking back now - now we know he had developed his own single measles vaccine and had been paid to find flaws with the MMR vaccine for a lawsuit and we know he took samples without permission and falsified data - now it's easy to say "oh but it's all nonsense!"

It really wasn't that easy at the time. That's why many of the people who declined MMR didn't reject all vaccination - they took seperate vaccinations for measles, mumps and rubella.

This is exactly the right answer. The lack of credibility of science has provided a foothold for anyone with a plausible idea and good marketing. The "science" that we see today in the common press is just not a reliable source of information. Between academic fraud, cherry picking results, governments failed oversights no one can tell truth from fiction so it's back to our biological dispositions.

Have you ever been persuaded to not use a particular OS by someone calling you a mindless fanboi?

If those tactics don't work for you and operating systems why do you think they'll work for anything else?

I like the answer empathy below. A bit of everything really is a good approach, depending on the audience. I also think fear will help it along. Pediatricians around Chicago are getting calls form more parents now.

http://www.chicagotribune.com/news/local/ct-measles-chicago-...

We have to understand the position that there were people that respected the opinions of a friend or loved one. When it came to their own child it was a difficult decision to make considering that herd immunity was making it a non-issue for so long. Satire can be an excellent approach to limit the numbers of those opinion makers.

For the parents that decided against immunization I think it is important to remember that we can disagree but still be respectful. At the other extreme calling those parents privileged or gullible will not go as far. It all depends on audience.

Any idea how big the Anti-vaxxer movement is? I'm not really finding any polls that suggest what percentage of people in any particular region are antivaxxers.

People are anti-vax, disbelieve the moon landing, because they don't trust, actively mistrust, American institutions.

And not only American institutions, although American institutions appear to be privileged enough to be not trusted by very many people outside the U.S. as well.

Anti-vax, anti-chemtrail, anti-this-and-that is popular, and it is "intellectual" to be against, a dissident.

I fully support peoples right to choose for themselves due to the fact that there is a small chance that death or other bad side effects can occur from taking certain vaccines.

Does it really have to be more complicated than that?

(edited for clarity)

> Does it really have to be more complicated than that?

It is, because by choosing not to vaccinate, you compromise herd immunity and put others at risk. An unvaccinated child in a school would impact the right of a kid with leukemia to go to school, for example.

OK, but it's still didn't get more complicated.

Are we going to force people to make the same decision as you or not? If you don't want to to that, then you're actually agreeing with me.

> Are we going to force people to make the same decision as you or not?

When it comes to vaccinating children who are medically sound to be vaccinated? Yes. Without hesitation, yes.

Yes, it should be forced. It's the same as allowing people to choose if they want to participate in taxation. It doesn't work because of free-riders.

There is a small chance of death or severe illness from taking vaccines. So, no...I don't support you making that decision for me.

That's the difference between taking a vaccine and paying your taxes or buying car insurance.

There's a small chance your decision means death or severe illness to me or my family members. I don't support you making that decision for me.

You don't get to drive 100 mph on the highway because it entails risks to other people. Same situation here.

There is a small chance that the second IRS takes your money your house burns down and that you die in cold and hunger because you didn't have that last thousand dollars that was taken from you as a tax. I'd say it's more less as probable as dying from a vaccine. The example is good.

We force drivers to have auto insurance coverage.

I get your point, but this is a bad analogy because it's quite easy not to drive. A better analogy would be the recent change to force everyone to buy health insurance.

Yes it does, because your decision has consequences for those around you that may include killing them. We have a history going back hundreds and hundreds of years that effectively says we as a society will reduce your freedom to whatever the hell you want to do if the consequences of it kill other people.

That's why "life, liberty, and happiness" is in the order that it is. Life before liberty before happiness.

Understand that some people can not get the vaccine. They are protected if everyone who can get the vaccine gets it. Now that a bunch of healthy people are note getting the vaccines, the ones that can not get it are at serious risk of not only illness, but death.

The vast majority of society has decided that your freedom is not worth the risk to other people. There was a minor exception for religion, and few people used it so it didn't really impact public health until very recently. Now a lot of people are abusing that provision, it is having a public health impact, and that provision and your freedom of choice on the matter need to be eliminated.

Endless war, cars and cigarettes cause far more death than non-vaxxers. Are you sure that you've gotten your priorities straight here?

That's laughable. The flu of 1918 killed 3% to 5% of the world's population that year, and killed somewhere between 10% and 20% of the people who got it.

Your position is only defensible if you don't believe that there are diseases that can kill or cripple you. While I wish that were true, that's not the world we live in.

You're conflating "death from the flu" with "death from a low percentage of people who didn't take a flu virus".

Can you cite a number of deaths that took place from the latter?

You're deflecting, which is usually when I walk away from these things. However I think it's important to make this point.

I agree with you on the things you are trying to distract with. You want to smoke? Great, that only impacts you. I want you to be able to make that choice for weed and heroin too. I'm with you on the wars, but that's so far from what we're talking about here it's not worth getting into.

I was a registered capital-L libertarian for many years. I campaigned for Ron Paul before the words "Tea Party" were anything other than a chapter in a history book. I get it.

But the libertarian (small-L) philosophy is let someone have the freedom to do anything they want, as long as it doesn't impact other people's freedoms.

This is one of those things. Anti-vax people are impacting my life, are impacting my kids life, impinging on my safety and well being and my kids well being.

If society isn't going to enforce a law about that, then what's the point?

Your definition of the libertarian philosophy (small-L) is an oversimplification and idealistic. We live in a world with finite resources; every action we make impacts others. At some point the line needs to be drawn as to what constitutes an 'impact' on other people. My understanding of small-L libertarianism was that this line shouldn't be drawn.

So, you support a law that every eligible person be forced to take a vaccine that has a small chance of death or serious illness? How does that square with your desire to not have other people's decisions forced on your own kids?

A more reasonable approach would be to bar non-vaccinated kids from public school and let private schools and home schooled children decide for themselves. That's the only law that I support.

Cars provide definite economic utility. I'm happy we're moving toward self-driving cars, but in the meantime, even as a non-driver, I don't want them banned. We let you trade our safety for your economic benefit (partly because our current economy depends on it).

We've regulated cigarettes to the point where they're mostly a threat to those who choose to use them. We let you trade your own health/safety for your own liberty.

Choosing not to vaccinate doesn't benefit anyone and does cause harm to other people. We're letting you trade our health/safety for your own liberty.

If you want to harm yourself, that's okay. If you want to put people at risk for society's benefit, that's okay. If you want to put society at risk because you don't believe in science, that's not okay.

Granted, war sucks.

"If you want to put society at risk because you don't believe in science, that's not okay."

WHAT?!

Let me fix that for you so that it actually follows the scenario:

"If you want to put society at risk because you don't want to [potentially] harm yourself (it happens with vaccines), that's not okay."

And that is crap. Society (as government) has the right to force every individual to play Russian roulette?

In Russian roulette, the chance of injury if you play is 1/6 and 0/6 if you don't. With vaccination the risk of injury is several orders of magnitude lower if you get it v. if you don't.

And the risk from not getting it effects not just yourself.

So, yeah, were the odds in Russian Roulette were such that playing it dramartically increased your health and safety and the health and safety of those around you, yes, the government should require it. But since those aren't the odds of Russian Roulette, it seems like a pretty dishonest analogy to use.

You're right. In a perfect world we would have some legislation regarding wars, cars, and cigarettes as well.

That position works for the "what you do in your own bedroom" arguments, but vaccines actually really are a social problem rather than a personal choice. (Disease management usually is)

Vaccines are a great example of a personal choice that does hurt other people, despite seeming like something that impacts only you.

Why? In short, because herd immunity is far more powerful than individual immunity, and protects even people who cannot be vaccinated. By choosing not to vaccinate, you chip away at herd immunity.

Actually, a couple anti-vaxxers would be OK. Herd immunity, as I said, allows for some people to safely be unvaccinated, and that is why it is powerful. The problem is when anti-vax'ing became a movement with the goal of convincing as many people as possible not to vaccinate.

Do you support a law forcing every eligible person to take vaccines or not?

I might not support that law. BUT, if you're opting out of society, you can't complain that you're not being treated the same as everyone else. If you voluntarily opt out of the normal schedule of vaccines, you can't go to public school or to my kids' pediatrician's office.

I wonder if this would even be an issue if we would flip the equation a bit: you don't have to get your kids vaccinated, but then they have to go to a school filled with other unvaccinated kids. This wouldn't solve the overall problem, but it would do some 'fear aikido', redirecting them to see that they are trading a nebulous risk for a very real one.

Thank you. I'm not an anti-vaxxer but if I didn't want my kid to be vaccinated I think it's reasonable to expect me to home-school them and find a pediatrician who supports my freedom to choose even if it meant moving out of the country.

Those laws existed, and most people found them legitimate. If you read the "Treasure of the Sierra Madre" closely, there's one scene where the protagonists see a group of riders, which the old guy, the leader of the gold miners, identifies as physicians that vaccinate all of Mexico against smallpox, by force, if needed: "Just show them your certificate of vaccination, and they will leave you in peace. But if you haven't got on, they'll catch you and vaccinate you."

You don't get the sense the author condemns the practice. It's a strong statement from an anarcho-syndicalist like Traven. At least he was aware of the fact that everyone lives downstream of someone. With today's libertarians you get the strong notion that they imagine each of them living in their own bubble in Low Earth Orbit.

> Do you support a law forcing every eligible person to take vaccines or not?

I think that's both a more effective and humane approach to the danger posed by non-vaccination than the also-defensible alternatives of allowing people to make that decision but then legal prohibiting them from most public intercourse, or just punishing anyone who is found to have, as a responsible adult, chosen not to vaccinate themselves or their child to a disease where they knew, or reasonably should have known, an effective vaccine was available, without a valid medical reason, and where the person so unvaccinated then transmitted the disease to a third party, for battery or, in the event that death results, murder of the depraved indifference type (as well as, of course, allow civil damages against those responsible adults for the resulting harms.)

The problem is that they do not choose for themselves, they choose for their children and they endanger the life of their children on the first place. If a child had pneumonia, would you agree that is their parents right to choose to treat it with garlic oil rather than antibiotics?

While these are fun to read from our smug pro-vax point of view, they provide no effect on everyone else.

I actually suspect the effect may be negative.

The piece seems persuasive if you already agree with its premise: that vaccines are essential for safety, and that their costs and risks are overwhelmed by their benefits. But someone who disagrees with that would find the analogy false, and hence the piece merely obnoxious and misleading.

In fact, consider the effect such an article from the other side would have on you. Set in the 1950's, the author writes, "Well, sure I smoke tobacco. They keep coming out with studies that say it's beneficial, and the government sure seems to want me to, and sure I trust those guys..."

I'm not sure what your reaction would be to that sort of thing, but mine (which I suspect is common) is, "Ah ha! The fact that they are forced to resort to bad analogies proves they don't have any good arguments!"

By way of contrast, study my rhetorical hero, Milton Friedman. Seriously -- agree or disagree with his stance on things -- go watch a clip from a debate with him on Youtube. He radiates a profound respect and agreeableness, constantly smiles, assumes the best of his opponents' characters (even when arguing they are making the world a much worse place for many people!), seems almost apologetic that he is forced to disagree with them, and focuses relentlessly upon the meat of the argument as the source of that unfortunate disagreement. He makes it very easy to change your mind. Very easy to agree with him. By assuming you are a good and smart person and focusing only on evidence, it is safe to say, "Oh, yes, I hadn't thought about that", and remove emotion from the equation.

That is the most effective strategy I am aware of for changing people's minds -- and he's good at it.

I get all this, but I really think the only way to sort this out will be to heavily stigmatize it. It needs to be shameful not to vaccinate your child.

I think satire plays into that.

Plain old shame should work. Think of the littering campaigns and "earth day" movements in the 80's/90's. This is the sort of thing that needs to be won over on facebook, The View, and supermarket headlines.

A post of mine from another thread on this general topic:

https://news.ycombinator.com/item?id=8985668

I don't think you can stigmatize such a large group.

Trying to do so will polarize the society, not stigmatize few members of it. Not exactly a result you want.

I would prefer to live in a world where, as much as possible, rationality guides decisions instead of emotivist social pressure.

Unfortunately you don't, and you never will. You'll have to get used to the fact that "emotivist social pressure" is usually a more effective way to change peoples minds than reason.

If people can't be convinced by reason that their dangerous and unreasonable behavior is in fact dangerous and unreasonable, then little is left besides social pressures.

Even if something is effective at promoting a good cause, it isn't necessarily an unqualified good, even if one takes a utilitarian view of things.

I don't disagree with the use of social pressure in general. Many people have mentioned the idea of refusing to allow children without vaccinations to attend public schools, which might be reasonable, and might be effective. That is social pressure, and I am not in principle opposed to it. However, I am opposed to the idea of stigmatizing anyone who disagrees with one's point of view, even if they are wrong, and even if it will promote a good cause. The problem with public shaming is that it works equally well for both good and bad arguments. A lot of sarcasm just implies that the object has already been established as absurd, the writer doesn't actually have to do anything to establish the fact. Since he doesn't have to make any argument that the object is absurd, it works just as well against any object at all. It can be very distorting, and emotionally twisting, and can be easily used to hide the truth in any discussion.

This is what I mean by 'emotivism', the idea that rationality is useless, and therefore the best way to establish one's moral beliefs is by use of assertion and emotional manipulation. Even if it is effective, and even if it can never be fully avoided, I don't feel comfortable using it, because as soon as it becomes an acceptable weapon in any sort of public debate, any hope of rationality is destroyed. And ultimately, that is more important even than the very serious issue of vaccinations.

For what it's worth, I don't think the blog post in question falls squarely into this description. He was making an argument by analogy rather than using sarcasm to imply that an argument already exists. This was just by way of response to the sentiment that social shaming is a tool that ought to be used.

I would like the former too, but I'll accept the latter if the former isn't feasible.

Keep waiting.

That sounds dreadful.

It takes a lot of effort to convince people of things. For many things, it is worth spending the time to understand why people believe what they believe, and crafting arguments to try and sway them.

For the anti-vax crowd, it's simply not. We don't spend a bunch of time trying to figure out how to convince people it's not a good idea to fire off an AK-47 in their backyard when they have neighbors. A large majority of us decided rationally that such behavior causes way too much risk to the rest of us, and made it illegal.

The anti-vaccination crowd are on equally shaky ground. I'm not saying we should mandate the flu shot or a brand new vaccine, but for something as contagious as measles with a 60+ year track record of safety and efficacy, I don't have time or patience to reason with the last 3% of people that don't want to vaccinate their kids.

I've had some serious health problems in my life that were just luck of the draw in genetics. I'm now short one organ, and I'm incredibly thankful that I live in 2015 and I can live a healthy and happy life due to modern medicine. Still, I'm at risk for a lot of diseases because I'm weaker than I would otherwise be. It pisses me off that healthy people don't realize that their actions can kill other people. If my kid was the one with leukemia and his healthy classmates were not getting their vaccines because their parents are idiots, I would be spending all of my time fighting to keep those kids out of schools, doctors offices, public places, etc.

I slightly disagree.

> We need to show parents what life was like before the polio vaccine. Before measles/mumps.

The problem is if they already decided to not vaccinate unless you take them back in time, whatever you show them will just be "yeah this is propaganda you are working for 'them'" this is all computer generated.

In a way this seemingly calm and rational way to handling this is already a loosing ground. For example see how you (perhaps unconsciously) phrased this:

> our smug pro-vax point of view

Note the "pro-vax" label. That is the problem. Once you start calling everyone "pro-vax" it validates the crazies as if their point as equally valid. It should instead be "crazies" vs "non-crazies".

Nobody discusses whether we should be "pro-rape" or "anti-rape". There is nothing to debate there. Granted, it should be the same way about torture. We lost that ground. We are just discussing how effective or ineffective torture can be in intelligence gathering as opposed assuming anyone who does it is a sick criminal. I think vaccinations should be in the same domain of discourse.

So quickly pushing for legislature to restrict opting out based on "personal beliefs" is the right choice.

What are you going to do? Tie people down and force-inject them? In America? What's that going to look like? You'll make these people martyrs.

You can stop kids from entering public schools without them, sure! But how far do you want to take this?

> You can stop kids from entering public schools without them, sure

Public schools, universities is a good first step.

Well the 0th step if you wish is to not accept their argument during discourse on equal footing. As in "it is a free country and your crazy opinion is just as valid as well established science, now let's discuss".

So treating them like crazies is important, they are to be made fun of and marginalized. Which is kind of like what this blog did.

Well, let me know when making fun of them starts working.

I think the best we can hope for is that this is a fad, like macrobiotic diets or biodynamic grape farming.

Most individuals and groups want to be accepted, respected and taken seriously. That is why making fun works, because it attacks that. Nobody want to be a part of a group that is mocked and ridiculed by a majority.

This happened a bit with cults after Jonestown massacre in late 70s. A lot of cult-ish group tried very hard not to be seen as cult-ish. Because it brought bad associations.

This link has been going around the news recently, you can spread it around some more.

Roald Dahl (author of Charlie and the Chocolate Factory) had a daughter who died of complications from the Measles. He wrote a letter about it:

https://roalddahl.com/roald-dahl/timeline/1960s/november-196...

A local school district kicked a bunch of kids out of school for 20 days recently when someone came down with pertussis. Those kids didn't have their vaccine. Guess what happened. The majority went out and got he vaccine and were back in a day or two. Can you imagine being a kid in that position? They probably unleashed the fury on their parents and demanded the vaccine.

This is pretty much the way to handle it. Kids can say some amazing things to change a parents mind. Satire doesn't work worth beans, it just pushes people farther into positions they wouldn't normally hold. People are remarkably stubborn. I sometimes think the direct (less subtle or funny) satire the internet has exposed us to had contributed to the extremes.

Some sensitivity to children that cannot for proper, documented medical reasons receive the vaccine needs to be in order. I am not sure how you handle that without subjecting them to the same shame. I would guess isolate them until the outbreak ends making sure the kid knows the doctors and parents are doing what they can given the kid's condition.

I agree with you but I think some of the following needs to happen as well. There is a huge miss trust of government and pharma. Vioxx, AZT, Fen Phen, and Thalidomide to name a few 'miss steps'.

- Big pharma should have some responsibility and making sure vaccines are safe. [1]

- There should be a clear line between what vaccines are absolutely necessary and which ones aren't. Right now it seems like you need all (maximum profit)

- Big pharma should not be permitted to lobby for new vaccines to be mandatory (HPV?). That decision should be made by someone not under a motive to make profit.

[1] http://www.fiercevaccines.com/story/supreme-court-drugmakers...

First off I'm pro-vaccination. However this example doesn't really add up for me. I'm not a doctor, but if the rest of us vaccinate our kids, won't they NOT GET SICK? Hence calling it an immunization.

So if the rest of us are immunized the only people getting sick are the anti-vaxxers. For this allegory of the Car Brakes and Social Responsibility to truly be a 1-to-1 comparison of social risk with regards to pro/anti immunization he'd have to basically present the premise that everyone else who has car brakes is protected from the less informed anti-brakers.

Unfortunately, it's not that simple. Maybe 95% of the people who get vaccinated are subsequently immune, the rest (and people who have depressed immune systems) are dependent on herd immunity. So the small number who choose not to vaccinate can make life much more dangerous for the few who can't or for whom the vaccination was ineffective.

For a good look at the maths, see this blog post: http://www.goodmath.org/blog/2015/02/05/quick-vaccine-math/

As many people have pointed out here, the issue is http://en.wikipedia.org/wiki/Herd_immunity. Vaccines are not 100% effective, and some people can't get vaccinated (due to allergies, immunodeficiency, chemotherapy, etc).

Infections spread exponentially, with each infected person infecting X other people (I'm oversimplifying here of course). The key is to make infection of a random person sufficiently unlikely that X < 1, so the infection dies out rapidly instead of becoming epidemic.

> I'm not a doctor, but if the rest of us vaccinate our kids, won't they NOT GET SICK?

No. Many vaccines are very effective, but not 100% effective. In addition, while vaccines are generally safe, there are people people that are not "anti-vaxxers" (or their children) who are not vaccinated, including those two young to receive a particular vaccine or those who do to particular health condition cannot safely receive a particular vaccine. General vaccination not only reduces the probability (but not to zero) of those vaccinated getting sick if exposed to the disease, by doing so it reduces the probability of them exposing others to the disease.

If vaccination is not general to all those who can safely receive it, its effectiveness in preventing disease both in those who are vaccinated and in those who are not vaccinated is reduced, because both the vaccinated and the non-vaccinated are more likely to be exposed to the disease than they would be if vaccination was general.

    >So if the rest of us are immunized the only people getting sick are the anti-vaxxers.

You are leaving out the infants that are not yet old enough to immunized as well as those with immunodeficiency that cannot be vaccinated.

The recommended age to vaccinate is 12 months (I've read as early as six months). Until those babies are able to be vaccinated, they're at risk.

There aren't many polio survivors around anymore

I've come to the conclusion that this is really the key change that allowed the anti-vax movement to flourish.

Not sure what to do about it though.

"they provide no effect on everyone else"

I'm not so sure. In between convincing the anti-vaccine folks that they're wrong (not gonna happen) and mere trolling is a third option: moving the Overton Window.

http://www.mackinac.org/OvertonWindow

Many people believe that we shouldn't try to be "fair and balanced" when it comes to vaccination. The science is just too solid, and the stakes are just too high. If one is pushing for a mandate, then one tool is to marginalize and trivialize the anti-vaccinationists' POV to such a point that nobody even listens to them. Then there's no resistance. To that end, derision does serve a purpose.

Note that I'm not actually condoning these tactics, even though I believe that in this case the goal is a worthy one. I'm just explaining part of what I believe lies beneath these otherwise-just-obnoxious kinds of comments and posts.

The problem here is that not all diseases are the same in terms of risk to health/life or even the ability to infect others. Comparing Smallpox to Polio to the Measles in equal terms is a stretch at best and probably closer to being dishonest. Many people recognize that either wittingly or unwittingly and so getting vaccinated against Measles and Chicken Pox just isn't a high priority. Now to talk about the MMR vaccine: It has had a rough go the last few decades. It was reformulated a couple decades or so ago and the efficacy was massively reduced to around 30% or less if I remember correctly. They went back to the old formulation later but not after a full decade or more of using the new formula that didn't really work. In several of the measles outbreaks of the last decade or so - most, if not all, of those that got the measles had been vaccinated. Of course then everybody blames the anti-vaxers for the outbreaks :(

I guess you could stand in front of abortion clinics with pictures of children in iron lungs, wheelchairs or braces with a sign that days "Choose life, choose vaccination" but there's an overlap with people who are both anti abortion and anti vaccination, oddly. I'm not sure you can convince someone using faith-based arguments without potentially challenging their faith.

Well, anti-vaxxers are about to see how bad it gets with all these measles and whooping cough outbreaks they've caused.

Personally, I'm past convincing parents to vaccinate. Let's move straight ahead to involving Child Protective Services and throwing anti-vax parents in prison for criminal negligence.

Normally, I would be the first to mention that sarcasm is the lowest form of wit. But in that case I'll say: I will hit with whatever works. Be it sarcasm, legislation, or graphic photos of people with vaccine-preventable diseases.

What about asking the kids that were recently exposed to do a public service campaign and visit the homes and families of other anti-vaxxers so that they can see the effects of MMR "in the flesh"?

Studies show presenting hard evidence to irrational believers strengthens their beliefs. I'm not sure how you can convince these people. The best thing I've found is to lead by example.

> We need to think of a better way to convince parents to vaccinate their children than hitting them with sarcasm.

False dichotomy -- we need to think of all the ways...

Was talking to a pediatrician friend the other day about this and he said he's completely befuddled by the anti-vaccine crowd. He started telling me things about the measles outbreak I had no idea about.

The one fact he said was how contagious measles are. He said someone with the virus can sneeze in a room and the virus will still be active 8-12 hours later.

I agree, I think it still comes down to education and getting the facts out parents and what the risks they're taking.

Measles can only last two hours air borne. Source CDC.

That's easy: Put the parents in prison for child endangerment.

Yes, let's have a government jail people and take responsibility for their children because some government beuracrat decided a certains vaccine was required. The Tuskegee expirement is one example of why the government shouldn't be trusted to do what is in the best interests of its citizens.

If you have to reach back to Tuskegee to discredit government health standards like vaccination, hand washing, seat belts, etc., you're probably stretching a bit.

The study went until 1972[1], that's not that long ago. Have humans changed that much since then?

[1] http://www.cdc.gov/tuskegee/timeline.htm

Tuskegee caused a dramatic change in how studies are run, with laws on informed consent and ethical requirements. Humans may not have inherently changed, but our procedures to prevent abuses by humans have.

Do you have to reach back at all to see that the government usually doesn't have it's citizens' best interests at heart?

OK, so sue them into oblivion instead. The downside is that we'd have to wait for innocent to get injured or killed before the law will grant standing, but if enough people do this then maybe the anti-vaxxers will decide that their oh-so-fashionable "principles" aren't worth the risk of losing all they own.

"We"... as in "we, the good ones"...

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