Your close-minded disdain for anti-vaxxers isn't helping anyone | Hacker News Reader

Your close-minded disdain for anti-vaxxers isn't helping anyone

theweek.com

3 pointshonzzz12 comments

Strident anti-antivax here.

The main sticking point that I have experienced is that anitvaxxers refuse to accept that their actions impact other people (children) by way of herd immunity.

When they do see it, they are often too deep into the argument to back out.

The other issue is that the argument is often heavily laden with emotion - I had a discussion with ageing hippy grandparents who blame a last minute MMR vaccine on the still birth of their second grandchild.

It's not a fair argument when you are showing data and they are reacting to a still birth. Even harder when you deeply love the people you are having the damned argument with.

I think it's a little unfair to lump vaccination with diet/fitness/nutrition. The best of the university crop don't exactly rush into that field, so it's no wonder it's perceived (and rightly so) as pseudoscience or "junk" as the article points out.

Few studies on vaccinations are properly controlled for side effects or efficacy. And they mostly just compare their product to an older one and to vaccines for different diseases. Additionally, they are shielded from liability in the US.

Pharmaceutical companies have an atrocious record as far as product safety goes. I understand the theory of vaccines is sound but that hardly means anything when dealing with big pharma.

The studies I've worked on looking at side effects and efficacy of vaccines, and that several vaccines have been taken off the market because of product safety concerns will be surprised to hear this.

> several vaccines have been taken off the market

This is what I mean by atrocious record. Not with vaccines specifically, but looking across all medications.

Anyhow if you can point me to double-blind placebo controlled studies on all the major vaccines, please do.

Two rotavirus vaccines were suspected of causing a rare but serious side effect (that they actually caused it at higher rates is somewhat less clear). They were immediately pulled off the market, and replaced with a vaccine that doesn't cause said side effect - which has been vigilantly monitored with post-market studies ever since.

A smattering of double-blind RCTs for you:

https://clinicaltrials.gov/ct2/show/NCT00122681 (HPV) https://clinicaltrials.gov/ct2/show/NCT01266850 (Rotavirus) https://clinicaltrials.gov/ct2/show/NCT01171963 (also Rotavirus)

You'll find them relatively easily for novel vaccines. In another post I mention unethical studies. Asking for new RCTs for existing vaccines used to prevent childhood disease is absurdly unethical, and would never pass muster at any self-respecting institutional review board. The best you'll get is comparisons between new formulations and existing vaccines, ala https://clinicaltrials.gov/ct2/show/NCT00861744 because there's no reason to put a swath of children at risk of preventable childhood diseases when we have working vaccines with very little evidence of serious side effects.

I think doctors will need to get over these ethical issues before immunization could ever be compulsory. It's just as unethical to force a treatment that's not been properly tested on a population, as it is to not expose them to that treatment.

Vaccines are not like other medications. With many medications, there is a benefit only to one person. With vaccines, there are benefits to an entire society (especially those who are not healthy enough to take vaccines themselves).

We know that the highly recommended, widely used vaccines are safe. But even if they weren't, there should still be a higher tolerance of risk because the danger that they prevent is certain and extreme.

As an epidemiologist, what the author doesn't get is that we have been empathetic. We have been patient. We have explained, using everything from complex math to simple metaphor how vaccination works to protect populations. We have spent millions of dollars and person-hours of valuable research time chasing down the ghosts of anti-vaxx fantasy to make sure there's nothing to them. We have let VAERS become irrevocably contaminated with their crackpot reports, making it useless for its actual purpose.

We catered to their whims. Their shifting goalposts and their conspiracies. We refused their unethical study demands while listening to them malign those we could conduct.

We asked nicely. In the meantime, they propagate beliefs that endanger children.

That wears down empathy and patience after a few decades.

Wakefield was one of your own and VAERS takes reports from the medical community.

Vaccine rates are pretty high. If they're effective then they should be effective for the 90%+ people taking them.

Meanwhile Ebola with >50% mortality is raging and the medical community is up in arms over measles.

This comment proves that you don't understand what you're talking about. I'm not trying to be condescending -- I've learned a lot about this recently due to the outbreak, and I encourage you to do some reading as well.

Some vaccines are very effective at the individual level. Others are not, and so the safety of any individual is reliant on herd immunity. So when you say "they should be effective", I don't know if you mean to prevent an individual's illness or to prevent an outbreak. Either way, vaccines are not just intended to be effective for the individual -- they're intended to protect an entire society.

As far as Ebola: the medical community is certainly up in arms over that, as well. It's a huge crisis, and millions are being poured into its treatment and prevention.

The problem with Ebola is that there's a massive cultural barrier. Many of the most at-risk people are afraid of vaccines, and some of them totally misunderstand how Ebola is spread. Those two situations are getting better, but it's much harder of a situation to solve.

The reason you're reading so much about measles is that it's affecting a wealthy, educated country, and it's directly caused by misinformation from the "anti-vaxxer" movement. It's alarming because it's a backslide, and we know it's preventable because we did such a good job preventing it for so long.

VAERS takes reports from anyone, and isn't allowed to remove spurious reports. Someone once reported a vaccine turned them into the Incredible Hulk, and they cannot, by law remove it.

Vaccination rates are not pretty high when you're talking about highly contagious diseases. Measles has an R0 of roughly 16-18, which translates to a critical threshold of ~94% needing to be vaccinated in order to have herd immunity, assuming 100% efficacy. There are many communities below that threshold.

Wakefield isn't one of our own. We kicked him out for being a fraud.

Ebola is subject to a major public health response. I have friends in Sierra Leone. The 101st Airborne, the CDC, Doctors without Borders and many other groups are all in West Africa. Access to intensive care is driving down the mortality for Ebola. Believe me, there are still a huge amount of resources being spent on Ebola containment. We're capable of being worried about more than one disease at the same time.

Of course, we wouldn't have to be if people were vaccinated against measles.

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