US measles outbreak as fewer parents vaccinate

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Re: US measles outbreak as fewer parents vaccinate

Postby Tirian » Wed Feb 04, 2015 12:15 pm UTC

[In response to my request for actual data]

qetzal wrote:
A resurgence of measles occurred during 1989–1991, again demonstrating the serious medical burden of the disease. More than 55,000 cases, 123 deaths, and 11,000 hospitalizations were reported [7]. Two major causes of this epidemic were vaccine failure among a small percentage of school-aged children who had received 1 dose of measles vaccine and low measles vaccine coverage among preschool-aged children.


That's one death for every 447 cases, and one hospitalization for every 5 cases! And note that this was relatively recently, so you can't plausibly argue that general improvements in medical care would have greatly reduced death & hospitalization rates since then.


In fact, I do suspect that medical care has significantly advanced in the past 25 years, both in terms of quality and public availability to children. To back up that suspicion, I would look back to the graph at the top of the thread. There have been approximately 1500 cases of measles in the United States since 2003. The 1:500 mortality ratio would expect three deaths in that time; there have actually been none. That's outside the 90% confidence interval, but not quite to 95%. So I think it is rational to not outright reject the hypothesis that mortality is unchanged but still be open to the possibility of rejecting it as the outbreak continues.

But thank you for that actual data that we can discuss; it is more valuable than trusting the scientific media to interpret the results on our behalf. It is frightening to contemplate that the current outbreak could grow to be 100 times the current number of cases before it is over and that measles is absolutely a disease that can and will continue to be fatal to some folks. Here is another interesting probabilistic discussion of why we shouldn't be surprised that six of the cases from the recent Disneyland outbreak had had the recommended two stage vaccination treatment, and also some anecdotal evidence that properly vaccinated children are better prepared to fight measles and slow the contagion even if they contract it.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Wed Feb 04, 2015 1:23 pm UTC

Zamfir wrote:Which I think most anti-vaxxers do. They don't vaccinate themselves either, they don't begrudge their parents for not vaccinating them as kid. They honestly try to make the best decision for their kids as they would for themselves, even if I think that decision complete craziness.

I don't have to like it, I might try to change their minds, but I'll accept parental authority. Or more exactly: I believe that parental authority should in such cases be treated on equal footing with adult authority over their own lives. Parents can be forced to vaccinate their kids, to the same extent that we force adults to vaccinate themselves. For their own good or for public health.
I think you're wrong here - much of the anti-vax movement is young enough that many of these parents who are opting to not vaccinate were themselves in fact vaccinated. They probably don't begrudge being vaccinated, because they 'didn't develop autism'. To them, I've read, they think their parents gambled, and won.

You shouldn't accept that parental authority. Parents *aren't* the best arbiters of what is best for their children, medical professionals are. Medical professions are there to inform parents of what is best for their children, and in the case of options (because not all medicine is black and white!), allow the parents to decide for the children, hopefully with the childs best interest in mind.

Hypothetically, I can absolutely understand a parent deciding that a fourth round of chemo with a low chance of success is simply not worth a childs suffering. That's a hard decision I wouldn't wish on anyone, but I can understand a parent who makes it.

I cannot understand, nor abide, this whole 'moms know best' movement, or the notion that a parent can *disregard* a medical professionals counsel. Parents who refuse life saving treatment for their children when it is as binary as vaccinations are being criminally negligent with the lives of their wards. In the same way that we would not bat an eye at mandating, say, that a driver wears corrective glasses if they wish to drive and have wretched vision, we should not allow parents to choose to not vaccinate kids because of the perpetuation of misinformation.
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Re: US measles outbreak as fewer parents vaccinate

Postby Zamfir » Wed Feb 04, 2015 1:52 pm UTC

I think you're wrong here - much of the anti-vax movement is young enough that many of these parents who are opting to not vaccinate were themselves in fact vaccinated.

This might be a cultural difference. I was mostly responding to Diadem (who if I am not mistaken lives fairly close to me), so I took our local situation as starting point. Most opposition here against vaccination is religious in nature, and as old as the vaccinations themselves. It does get mixed with quasi-medical arguments about the risks of vaccines, but that's a newer trend extending an old tradition.
I am somewhat surprised that you don't have this strain of Calvinist anti-vaccination sentiment in the US, or not as much. There are quite some churches in the US with a simiIar theological background as those opposing vaccination here.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Wed Feb 04, 2015 2:03 pm UTC

I just don't see a worthwhile distinction. edit for clarity: A Jehovah's Witness declining their child's need for a transfusion is to me, just as criminally negligent in caring for their child's well being.

My point was less to do with the reasons though, and more to do with the notion that we shouldn't respect parents decision making with their children's lives for all things, because parents are often extraordinarily wrong.
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Re: US measles outbreak as fewer parents vaccinate

Postby Zamfir » Wed Feb 04, 2015 3:45 pm UTC

People are often wrong, not just parents. It's one thing to push for a general vaccination duty, for adults and children alike. For public health, or straight up government paternalism. Wear a helmet and get your shots, because the experts are better judges of risk than us. I can see the point there.

It's another thing to push for a kids-only policy, on the ground that we cannot trust parents to take good care of their children. If the issue is not important enough to override the personal autonomy of adults, is it important enough to override parental authority? I am skeptical of such moves.

That's where the generation issue comes in: the local experience is that kids of anti-vaxxers tend to grow up to agree with their parent's choice. A vaccination program for those kids would basically exist to get the shots in before they are old enough to refuse. At which point people should just straight up argue for a overriding general duty, and not use kids as a backdoor.

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Re: US measles outbreak as fewer parents vaccinate

Postby CorruptUser » Wed Feb 04, 2015 4:00 pm UTC

Diadem wrote:
Tyndmyr wrote:If they were only putting themselves at risk, I wouldn't care one iota.

First of all, stupid people are still people, and still deserve our care.


Depends on the stupid. Everyone is stupid at something. But the problem are the stupid people who think they are smarter than the not stupid people. Like anti vaxxers who insist they know more than their doctor. Those people? No, they don't deserve our care.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Wed Feb 04, 2015 4:03 pm UTC

Zamfir wrote:It's another thing to push for a kids-only policy, on the ground that we cannot trust parents to take good care of their children. If the issue is not important enough to override the personal autonomy of adults, is it important enough to override parental authority? I am skeptical of such moves.
Yes. It is. There are plenty of professions where we require adults to get vaccinated for just this reason. If you have a non-medical objection to being vaccinated, you cannot (and should not!) be a health care provider.

I think this notion of personal autonomy as an argument against vaccinations holds little merit. Personal autonomy stops as soon as it endangers other people. I do not have the right to drive my car at 100mph through a crowded mall. I do not have the right to swing my machete wildly even if you are standing where I want to swing my machete. I should not have the right to infect other people with a preventable disease because I can't be buggered to get vaccinated. Criminal neglect is a thing.

Zamfir wrote:That's where the generation issue comes in: the local experience is that kids of anti-vaxxers tend to grow up to agree with their parent's choice. A vaccination program for those kids would basically exist to get the shots in before they are old enough to refuse. At which point people should just straight up argue for a overriding general duty, and not use kids as a backdoor.
This is an argument about how we should engage with anti-vaxxers, and I feel a somewhat different topic. If the name of the game is helping them, improving their health, and minimizing their contagion risk, then there's a lot of approaches to doing so. I don't think brow beating them with facts will do anything.
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Re: US measles outbreak as fewer parents vaccinate

Postby Tyndmyr » Wed Feb 04, 2015 4:37 pm UTC

Diadem wrote:
Tyndmyr wrote:If they were only putting themselves at risk, I wouldn't care one iota.

First of all, stupid people are still people, and still deserve our care.

Secondly, they are never putting themselves at risk, but their children. Are you saying a 9 year old unvaccinated child dying of measles has only herself to blame?


Note the "if". This does not apply to this situation.

And yes, a person declining treatment for themselves(assuming adulthood and all that) is something I'm entirely fine with. Even if I think it's stupid. But declining vaccination goes beyond that. It even goes beyond putting their children at risk. They are increasing risk for everyone around them as well. That makes it everyone else's business in a very clear fashion.

Zamfir wrote:
I think you're wrong here - much of the anti-vax movement is young enough that many of these parents who are opting to not vaccinate were themselves in fact vaccinated.

This might be a cultural difference. I was mostly responding to Diadem (who if I am not mistaken lives fairly close to me), so I took our local situation as starting point. Most opposition here against vaccination is religious in nature, and as old as the vaccinations themselves. It does get mixed with quasi-medical arguments about the risks of vaccines, but that's a newer trend extending an old tradition.
I am somewhat surprised that you don't have this strain of Calvinist anti-vaccination sentiment in the US, or not as much. There are quite some churches in the US with a simiIar theological background as those opposing vaccination here.


It does exist, it's just pretty obscure. There's a strain of anti-vaccination sentiment in the sort of folks that are extremely distrustful of authorities in general. Homeschooling folks, generally, often have other odd stances, like being against pasturization of milk. These folks are pretty marginalized and lack a lot of public voice for obvious reasons, but they still exist.

But...a lot of the opposition isn't religious, it's just frigging strange. A hippyish distrust of science, established medicine, etc. They glom onto the one study that supported their sentiment, and kind of willfully ignore everything to the contrary. Not that religious folks don't do that or anything...just that this particular madness doesn't seem religion-dependent in the US.

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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Wed Feb 04, 2015 5:53 pm UTC

Izawwlgood wrote:Criminal neglect is a thing.
So the parents are doing something criminal?

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Re: US measles outbreak as fewer parents vaccinate

Postby sardia » Wed Feb 04, 2015 6:15 pm UTC

morriswalters wrote:
Izawwlgood wrote:Criminal neglect is a thing.
So the parents are doing something criminal?

I could see that law passing muster. If we can mandate insurance, we can mandate vaccines.

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Re: US measles outbreak as fewer parents vaccinate

Postby Tyndmyr » Wed Feb 04, 2015 6:26 pm UTC

sardia wrote:
morriswalters wrote:
Izawwlgood wrote:Criminal neglect is a thing.
So the parents are doing something criminal?

I could see that law passing muster. If we can mandate insurance, we can mandate vaccines.


Maybe? I mean, vaccines are very important, and are a pretty direct form of care, where insurance is a little more indirect, but actually mandating specific actions that must be taken seems difficult/unpopular. Perhaps people would become worried about slippery slopes and what not.

If memory serves, the constitutionality of the insurance mandate was upheld as a tax. Perhaps a similar approach would suffice. Even if you can't outright criminalize lack of vaccination, imposing a penalty for those who choose not to do so seems like it's on safer grounds.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Wed Feb 04, 2015 6:30 pm UTC

morriswalters wrote:
Izawwlgood wrote:Criminal neglect is a thing.
So the parents are doing something criminal?

I think so. Choosing not to vaccinate your kids (again, for non-medical reasons) is, as I see it, akin to choosing to drive without your seatbelt, or your glasses, or choosing to fire your gun into a crowded space, or choosing to swing your arms wildly irrespective of who is standing near you, etc.

Just today this article made headlines. The dad claims to have been monitoring the kids via iPhone. It's stunning to me that we recognize this behavior as criminally negligent, but don't consider effectively withholding life saving preventative medicine that ALSO allows for herd immunity to be criminally negligent. Just like it's stunning to me that people make the argument of 'personal freedoms', or the 'right to defend yourself or your loved ones when attacked'.

Truthfully, I sort of expect someone to escalate a situation like this to violence, literally attacking the parents of an unvaccinatied child because they feel like their own child is being put at risk.
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Re: US measles outbreak as fewer parents vaccinate

Postby Tyndmyr » Wed Feb 04, 2015 6:35 pm UTC

Izawwlgood wrote:Truthfully, I sort of expect someone to escalate a situation like this to violence, literally attacking the parents of an unvaccinatied child because they feel like their own child is being put at risk.


A somewhat better way to escalate/reduce risk would be to simply ban unvaccinated children. Schools already do a form of this, to some extent.

Is it reasonable for a business owner to bar unvaccinated folks?

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Wed Feb 04, 2015 6:39 pm UTC

Right, but if little Billy down the street is unvaccinated, can I ban him from playing on the playground that my little precious baby plays on? What about ban him from the grocery store when one of his parents takes him with them for the weekly shopping?

I don't understand (I really don't, I'm not just being incredulous here) why we're ok with mandating child protective measures AND school requirements, but we're not ok with mandating vaccinations. We take children away from their parents if they're being abused - allowing a child to remain at risk to wholly preventable disease and infect literally everyone around them is no different, as I see it, than sending your kid to school in the middle of winter in flipflops and a t-shirt, with no lunch, and covered in bruises from last nights 'lesson'. No, I am not being hyperbolic here.
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Re: US measles outbreak as fewer parents vaccinate

Postby Tyndmyr » Wed Feb 04, 2015 6:53 pm UTC

Izawwlgood wrote:Right, but if little Billy down the street is unvaccinated, can I ban him from playing on the playground that my little precious baby plays on? What about ban him from the grocery store when one of his parents takes him with them for the weekly shopping?


I really don't know where the bounds are for where acceptable bans begin and end. It should, it seems, somehow be connected to risk. Lack of vaccination introduces notable risk for a very poor potential reward(given actual reactions to vaccines). So, it seems like the sort of thing that *should* be considered very heavily for if a parent is negligent or not.

The best similar example I can think of is requiring kids to buckle up. This has been weakened by now, essentially requiring everyone to buckle up, but child restraint laws are sometimes still distinct from adult seatbelt laws, with harsher fines or additional requirements. So, that provides a somewhat similar analogy for requiring a positive action to protect a child from harm, and vaccinations have the additional reason of protecting others, which would seem to strengthen the case for them.

But as for how safe I'd be barring them from public spaces, or from a private business, legally speaking, I don't know. If they have a religious exemption, does a barring company risk being found guilty of discriminating via religion?

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Wed Feb 04, 2015 7:06 pm UTC

Tyndmyr wrote:But as for how safe I'd be barring them from public spaces, or from a private business, legally speaking, I don't know. If they have a religious exemption, does a barring company risk being found guilty of discriminating via religion?
Religious exemptions don't allow you to endanger the public! If my religion mandated that I set fires everywhere I went, I wouldn't be taken seriously!

Tyndmyr wrote:The best similar example I can think of is requiring kids to buckle up. This has been weakened by now, essentially requiring everyone to buckle up, but child restraint laws are sometimes still distinct from adult seatbelt laws, with harsher fines or additional requirements. So, that provides a somewhat similar analogy for requiring a positive action to protect a child from harm, and vaccinations have the additional reason of protecting others, which would seem to strengthen the case for them.
Yes, exactly. It is illegal for new parents to drive their infant home from the hospital without an approved car seat. ILLEGAL! As in, they will not release your NEWBORN CHILD INTO YOUR CUSTODY unless you have a Federally approved of car seat, in your automobile. In Judaism, it's traditional that you not purchase anything for a new baby until the baby is born, as kind of a 'don't jinx this', but you better believe Jews are still required to come to the hospital with a car seat.
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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Wed Feb 04, 2015 7:36 pm UTC

It is one thing to say that a child can't attend school because the child hasn't been vaccinated, quite another to say that a child must be vaccinated period. Neither Mississippi and one of the Virginia's, allow any philosophical or Religious exemptions for vaccinations prior to entering school. Those states however do not seem to speak to children who do not attend public school. And nothing that I am aware of guarantees absolute safety in public. We pick and choose when to apply certain rules. If seat belts are mandated in cars, are they mandated in school buses? And the same for child seats. Can babies ride in taxi's?

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Re: US measles outbreak as fewer parents vaccinate

Postby Angua » Wed Feb 04, 2015 7:38 pm UTC

In the UK, at least, babies are only allowed in taxis if they're in portable car seat things.
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Re: US measles outbreak as fewer parents vaccinate

Postby Chen » Wed Feb 04, 2015 7:53 pm UTC

morriswalters wrote:It is one thing to say that a child can't attend school because the child hasn't been vaccinated, quite another to say that a child must be vaccinated period. Neither Mississippi and one of the Virginia's, allow any philosophical or Religious exemptions for vaccinations prior to entering school. Those states however do not seem to speak to children who do not attend public school. And nothing that I am aware of guarantees absolute safety in public. We pick and choose when to apply certain rules. If seat belts are mandated in cars, are they mandated in school buses? And the same for child seats. Can babies ride in taxi's?


We mandate many things for public safety and security. You know, obeying traffic signals, not randomly shooting fireams in the air, not lighting buildings on fire etc. We don't currently mandate people to get vaccinated, but I hardly see that as a reason why we SHOULDN'T. Sure we could do it in a roundabout way by disallowing them to go to school, and then maybe parks, and then maybe all public spaces unless vaccinated. But at that point we might as well just make it mandatory, barring actual medical reasons against it.

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Re: US measles outbreak as fewer parents vaccinate

Postby mathmannix » Wed Feb 04, 2015 8:28 pm UTC

morriswalters wrote:If seat belts are mandated in cars, are they mandated in school buses? And the same for child seats. Can babies ride in taxi's?

School buses:
According to this article,
If cars have seat belts, why aren't they generally required in school buses? Because modern school buses are already remarkably safe, and because seat belts don't work the same way in buses as they do cars, research shows.

Numerous federal and academic studies have concluded that school buses are the safest form of ground transportation of all, in fact. The National Safety Council says they're about 40 times safer than the family car.

About 440,000 public school buses carry 24 million children more than 4.3 billion miles a year, but only about six children die each year in bus accidents, according to annual statistics compiled the National Highway Traffic Safety Administration. About 800 children, by contrast, die every year walking, biking or being driven to school in cars or other passenger vehicles, said Ron Medford, the agency's deputy director.


Obviously, taxis are different - they're the same as cars (or sometimes as minivans or SUVs). But a little research shows that (1) many taxi companies across the US will let you call ahead for the driver to provide carseats, and (2) carseats are not that difficult to install in a taxi if you want to bring it yourself (which you would be doing anyway if, for example, your child was still in a stroller that the carseat snaps into.) I don't use a taxi myself, except maybe on business trips when I fly by myself to a city and would need it to get from the airport to the hotel to wherever. I have a car and don't live in a big city where I can walk everywhere to get what I need; I understand it would be different for people that live in New York or wherever and don't want the hassle of having to park a car. If I flew into a city with my family I would rent a car, which I would order to come with a carseat.
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Re: US measles outbreak as fewer parents vaccinate

Postby Krealr » Wed Feb 04, 2015 8:53 pm UTC

Tyndmyr wrote:Is it reasonable for a business owner to bar unvaccinated folks?


Some doctor's are refusing to see patients that won't get there vaccinations.

http://www.oregonlive.com/today/index.ssf/2015/01/some_doctors_wont_see_patients.html

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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Wed Feb 04, 2015 9:16 pm UTC

Yes. From your article.
'Costs far exceed benefits'
Taking all those factors into account, many transportation safety experts conclude that seat belts aren't worth it.

"Costs far exceed benefits, and school bus seat belts appear to be less cost-effective than
other types of safety treatments," the Alabama study declared. The NHTSA said its research, going back to 1987, suggests that the benefits are "insufficient to justify a federal requirement for mandatory installation of such belts" in larger buses.
mathmannix wrote:many taxi companies
You will notice that there is no mandate(as in many versus all). Assuming that herd immunity doesn't give measles a home in the US, the problem doesn't require an absolute mandate. A proscription in travel for the unvaccinated or a quarantine at the borders, would accomplish the same goal. Thereby achieving the desired goal with the maximum latitude for fools. Social pressure can do the rest.

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Re: US measles outbreak as fewer parents vaccinate

Postby EMTP » Wed Feb 04, 2015 10:05 pm UTC

Zamfir wrote:
Diadem wrote:Secondly, they are never putting themselves at risk, but their children.

Then again, we generally accept that parents make decisions on behalf of their children, including decisions about risk. For most purposes, we give parents a similar authority over their (young) children as over their own lives, almost if the kids are extensions of their parents. As long as they do not abuse that power, and act as careful for their kids as they act for themselves.


We also accept that the state shares with parents the right and responsibility to protect and advocate for children. If you as a parent don't want your child to get an education, too bad. If you want your child to be your drinking buddy, too bad. If you want your child to die as the result of refusing a blood transfusion, too bad.

The question with vaccinations is twofold; whether the damage to the broaden society justifies stern legal requirements to vaccinate, and whether harm to the children themselves does. I would say yes on bother counts.

Rand Paul is wrong. Parents don't own their children (1). Kids aren't extensions of their parents, and the law doesn't regard them that way.

As to the discussion about the mortality of measles, we fortunately do not have enough cases yet to develop hard numbers based on the last ten years in the US, but we have more extensive experience over the last 20-30 years, and no, treatment has not changed dramatically in that time. Care remains supportive. ICU care may be slightly better.

The key thing to realize is that for measles as for almost any serious disease, the primary harm is not death; it's serious complications, what we call "morbidity." There is a lot of morbidity from measles, due to the powerful systemic inflammatory response triggered by the virus:

Image

Pneumonia, for example, is about twenty times as prevalent as death:

Image

. . . and pneumonia is no joke. Hospitalization is no joke. Serious medical complications like these, especially at the extremes of age, can make you less functional for life and more vulnerable to the next health threat. These costs aren't easily tallied but they are very real.

And measles is a tiny piece of the death and disability prevented by vaccinations, which continue to improve. We now have a vaccine that can prevent most cases of cervical cancer, a disease that kills 5,000 American women per year. We have vaccines against the worst of the pathogens causing bacterial meningitis, including a nasty bug by the name of Haemophilus influenzae. We got a vaccine for that not forty or fifty years ago, but just 25 years ago. This is what happened:

Image

---------

And the Economist reminds us that even if parents did own their children, that's still not an argument against mandatory vaccination:
When Mr Paul says "the state doesn't own your children", he seems to be saying that the state has no standing to override or undermine the authority of parents by telling them what to do with their kids. The language of ownership is unfortunate. We don't own our children. Even if we did, however, it wouldn't follow that ownership implies that the state can't justifiably tell us what to do with our property. I literally own my dog. He is chattel. (Sorry, Winston!) I can have him euthanised pretty well whenever I like. (Don't worry, Winston!) Nevertheless, I am required by law to have him vaccinated for rabies, and rightly so. This does not imply that the state owns my dog. Property in the real world always comes attached with all sort of liabilities that smooth the tensions between private control and public welfare.
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Re: US measles outbreak as fewer parents vaccinate

Postby Isaac Hill » Thu Feb 05, 2015 3:26 am UTC

I wonder what happens to parents who don't vaccinate their kid, but the kid develops autism anyway. Do they change their views on vaccines, or try to rationalize it away so they don't have to admit they endangered their child for false reasons?

Maybe people will be scared into vaccinating their kids by the threat of terrorism. If we leave ourselves vulnerable to these diseases, a terrorist could infect himself and walk around to spread the disease innocent civilians. I don't know how likely that is, but it sounds plausible enough to be scary.

Or, we just quarantine everyone who chooses not to vaccinate. Wyoming's pretty useless. If you don't want to vaccinate your kids, and you have no medical reason not to, fine, but you have to move to Wyoming. Current Wyoming residents who are vaccinated can leave.
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Re: US measles outbreak as fewer parents vaccinate

Postby DaBigCheez » Thu Feb 05, 2015 4:34 am UTC

Isaac Hill wrote:I wonder what happens to parents who don't vaccinate their kid, but the kid develops autism anyway. Do they change their views on vaccines, or try to rationalize it away so they don't have to admit they endangered their child for false reasons?

While I could be wrong, I don't believe that anti-vaxxers in general believe vaccines are a *necessary* condition for autism. Just that it substantially raises the chances.
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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Thu Feb 05, 2015 1:19 pm UTC

Isaac Hill wrote:I wonder what happens to parents who don't vaccinate their kid, but the kid develops autism anyway. Do they change their views on vaccines, or try to rationalize it away so they don't have to admit they endangered their child for false reasons?

Maybe people will be scared into vaccinating their kids by the threat of terrorism. If we leave ourselves vulnerable to these diseases, a terrorist could infect himself and walk around to spread the disease innocent civilians. I don't know how likely that is, but it sounds plausible enough to be scary.

Or, we just quarantine everyone who chooses not to vaccinate. Wyoming's pretty useless. If you don't want to vaccinate your kids, and you have no medical reason not to, fine, but you have to move to Wyoming. Current Wyoming residents who are vaccinated can leave.

People can rationalize anything.

Of course it would work, what exactly do you think is happening now? The government scared you into giving up a significant amount of freedom by making you afraid of Muslims.

People in Wyoming might resent having a concentration camp put in their state. Of course the CDC doesn't have any vaccination data on Wyoming. So maybe that is a good place.

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Re: US measles outbreak as fewer parents vaccinate

Postby leady » Thu Feb 05, 2015 2:00 pm UTC

it comes as no surprise to me that parents watching their child suffer, particularly as toddlers, without obvious cause or cure, will latch onto any crazy thing as an answer. Years ago it would have been god, demons, magic. Now its vaccines, plastics bleeding into bottled milk, GMOs...

Personally I'm happy that parents get the choice to be slightly crazy, but there is a need for education, social shaming and a need to get the externalities paid (no school, no benefits? )

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Thu Feb 05, 2015 2:04 pm UTC

leady wrote:Personally I'm happy that parents get the choice to be slightly crazy, but there is a need for education, social shaming and a need to get the externalities paid (no school, no benefits? )
Oh, I would never begrudge parents the right to worry. I draw the line at their intuition not only endangering their child, but endangering other children.

It was briefly mentioned, but there is a dialog to be had for how to best convince parents to vaccinate. Bombarding them with data has been shown to further polarize their views, as has shaming them.

What remains to be seen is if the impetus to participate in public utilities like school will incentivize parents sufficiently. The name of the game is not 'make life more difficult for denialist parents or worse yet, their children', but at some point you need to cut your losses and perform the difficult mental calculus of what is more valuable, a population with largely intact herd immunity, or a small population of children disadvantaged because they were born to shitty parents who isolated them in one way or another.
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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Thu Feb 05, 2015 2:18 pm UTC

Being a good parent is a whole range of behaviors, not any one thing.

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Re: US measles outbreak as fewer parents vaccinate

Postby leady » Thu Feb 05, 2015 2:40 pm UTC

but to put it in perspective, speeding and other bad driving behaviours nets you a £70 fine and is within an order of magnitude the death and incapacity rate that measles has / would have unconstrained (I won't stand over this if someone wants to do a real check - but it looks like nearly 1 in a 1000 kids get brown breaded every year, and I suspect a good lump of those are car related).

so yes its irresponsible and yes a lot of people doing it is bad, but the social price on these things is pretty low

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Thu Feb 05, 2015 2:47 pm UTC

@morris: But it is generally accepted that 'things that are objectively wholly avoidable, with zero benefits and a host of detriments' fall into the 'bad parenting habit'.

This isn't like 'letting your kid stay up late and eat candy'. This is more akin to not babyproofing your kitchen or putting knives in little Billy's playpen. It's willful negligence.

leady wrote:so yes its irresponsible and yes a lot of people doing it is bad, but the social price on [driving] is pretty low
Yes, but that's because driving has positive utility to the productivity of society. Not vaccinating does not.
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Re: US measles outbreak as fewer parents vaccinate

Postby Mokele » Thu Feb 05, 2015 3:25 pm UTC

leady wrote:so yes its irresponsible and yes a lot of people doing it is bad, but the social price on these things is pretty low


As I pointed out earlier, the death rate and morbidity from measles is roughly comparable to venomous snakebite.

Driving too fast may get a small fine, but letting your kid play unsupervised with copperheads will get them taken away by CPS. And copperhead bites aren't transmissible between children.
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Re: US measles outbreak as fewer parents vaccinate

Postby Tyndmyr » Thu Feb 05, 2015 3:44 pm UTC

Krealr wrote:
Tyndmyr wrote:Is it reasonable for a business owner to bar unvaccinated folks?


Some doctor's are refusing to see patients that won't get there vaccinations.

http://www.oregonlive.com/today/index.ssf/2015/01/some_doctors_wont_see_patients.html


I have really mixed feelings about this.

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Re: US measles outbreak as fewer parents vaccinate

Postby Mokele » Thu Feb 05, 2015 4:06 pm UTC

Tyndmyr wrote:
Krealr wrote:
Tyndmyr wrote:Is it reasonable for a business owner to bar unvaccinated folks?


Some doctor's are refusing to see patients that won't get there vaccinations.

http://www.oregonlive.com/today/index.ssf/2015/01/some_doctors_wont_see_patients.html


I have really mixed feelings about this.


Why? A doctor's office will have a higher-than-average proportion of kids that are immunocompromised or too young to get the required vaccine, thus is one of the places that an unvaccinated kid can cause the most damage. While the kids have a right to medical care, they don't have a right to endanger other people's kids while doing it.

Besides, it's a bit hypocritical of the parents to refuse to listen to reason about vaccines, then turn around and expect antibiotics.
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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Thu Feb 05, 2015 4:07 pm UTC

Tyndmyr wrote:
Krealr wrote:
Tyndmyr wrote:Is it reasonable for a business owner to bar unvaccinated folks?


Some doctor's are refusing to see patients that won't get there vaccinations.

http://www.oregonlive.com/today/index.ssf/2015/01/some_doctors_wont_see_patients.html


I have really mixed feelings about this.

Think of it this way - bringing those non-vaccinated kids into a waiting room unneccesarily exposes every single patient that doctor sees. A wholly valid comparison would be 'Doctor refuses to allow medical waste to be stored in, around, throughout office'.

It is also important to recognize that you see a doctor to get medical advice and develop plans of action for diseases/ailments/etc. Why would you bother wasting a doctors time if you don't accept what they suggest? Another analogy would be me going to a mechanic when my timer belt is broken, being told I need a new timer belt, and saying "No, you're wrong, I'm going to replace my windshield wipers". If I then call the mechanic the following day and want them to look over my car, at what point are they able to say 'You know what, you won't listen to me, you deal with it'?
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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Thu Feb 05, 2015 5:03 pm UTC

Izawwlgood wrote:@morris: But it is generally accepted that 'things that are objectively wholly avoidable, with zero benefits and a host of detriments' fall into the 'bad parenting habit'.
Maybe. Are you a saint? I tend to look at outcomes before I classify some ones skill sets as shitty. I think anti vaxxers are foolish. But within the limitations put on them by evident lack of intellectual capacity, they mean well and may otherwise be spotless parents. And describing them as such, just makes them dig in and go "fuck you". Which isn't the desired outcome.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Thu Feb 05, 2015 5:13 pm UTC

Yes, I've brought up a few times now that there are approaches of dealing with them that vary in efficacy. I am not claiming to be a saint, I'm equating not vaccinating to being quite wretched behavior and parenting.

As Mokele pointed out, would you condone parents leaving their newborns around a bunch of snakes?
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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Thu Feb 05, 2015 6:06 pm UTC

No. But then again I would let my child play in an area where snakes live. It isn't that I believe you shouldn't vaccinate your children, I do and did. I just got a DPT shot. I might even choose to ostracize you for not doing so. Certainly if you enroll your children in public schools I can see letting there be no exemptions other than medically required ones. But I am not prepared to mandate shots outside of that venue. I believe in the maximum freedom and latitude that we can give parents. And I have a built in reflexive response to the phrase "shitty". My pardon for that. Kinda.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Thu Feb 05, 2015 6:14 pm UTC

Would you be on with someone bringing and leaving snakes into a playground, say, 3 to 5 times a week?
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Re: US measles outbreak as fewer parents vaccinate

Postby Mokele » Thu Feb 05, 2015 6:38 pm UTC

Izawwlgood wrote:Would you be on with someone bringing and leaving snakes into a playground, say, 3 to 5 times a week?


Absolutely!

Oh, wait, sorry, I thought the question was "Would you happily endanger local children to get unlimited free snakes?"
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