US measles outbreak as fewer parents vaccinate

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sardia
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Re: US measles outbreak as fewer parents vaccinate

Postby sardia » Fri Feb 06, 2015 6:24 pm UTC

morriswalters wrote:
Izawwlgood wrote:This isn't a political issue, this is a public health issue.
You can't do this by fiat. The only way to achieve it is by the political process. Tobacco is still in use today in some form or another despite all the best efforts of science, with more than enough data to support its position. And it kills more people than measles. Thinking good thoughts isn't sufficient. However it isn't my task to make you see the world as I see it, I've given my opinion and supported it.

Bullshit. Measles has been killing people for centuries. Tobacco did not wipe out the Indians. Diseases did. The only reason it has a lower death rate today is because of mandatory vaccination efforts. The very effort you are saying is wrong to pursue. The only downside would be using public safety for immoral or erroneous goals like sterilization of prisoners. But this is not that scenario.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Fri Feb 06, 2015 6:36 pm UTC

morriswalters wrote:
Izawwlgood wrote:This isn't a political issue, this is a public health issue.
You can't do this by fiat. The only way to achieve it is by the political process. Tobacco is still in use today in some form or another despite all the best efforts of science, with more than enough data to support its position. And it kills more people than measles. Thinking good thoughts isn't sufficient. However it isn't my task to make you see the world as I see it, I've given my opinion and supported it.
But tobacco is a terrible analogy, because it is a risk assumed voluntarily. Sure, you can legislate against ad campaigns and the like, but the fact is, no one physically forced you to smoke. People can choose to do whatever they want to themselves when it doesn't endanger anyone else (well, feasibly, hopefully, etc). Second hand smoke isn't even a good analogy, because the effects are smaller, and acute.

Unvaccinated children playing in public parks are actually factually akin to some jackass going into a public park and releasing snakes. Or going around extinguishing cigarettes on future people. We're trying to point out that it is a public health issue, and the risk of allowing nonvaccinated people to interact with our ENTIRE society is a health risk that we need to take extremely seriously. Requiring vaccines for attendance of schools is a fine first step, in the same way that adding breaks to a car is a fine first step in creating an automobile.
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Re: US measles outbreak as fewer parents vaccinate

Postby ObsessoMom » Fri Feb 06, 2015 6:51 pm UTC

sardia wrote:
Izawwlgood wrote:What we are pointing out is that if a child is unvaccinated and homeschooled, they are still both at risk, and a risk to the other people in the community.

Aren't unvaccinated people a risk period? Unless you're accounting for a synergistic effect that makes it riskier.


Yes, they are at risk themselves, and a risk to others. Keeping unvaccinated kids out of school and daycare environments is a step in the right direction, and may provide a powerful incentive for some parents to get their kids' shots up to date...but it's not going to change the fact that unvaccinated people of all ages still go to the grocery store, the library, the pool, the zoo, church, parks, movie theaters, medical offices, restaurants, airplanes, etc.

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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Fri Feb 06, 2015 7:28 pm UTC

sardia wrote:Bullshit. Measles has been killing people for centuries. Tobacco did not wipe out the Indians. Diseases did. The only reason it has a lower death rate today is because of mandatory vaccination efforts. The very effort you are saying is wrong to pursue. The only downside would be using public safety for immoral or erroneous goals like sterilization of prisoners. But this is not that scenario.
Yes, I know. And I've had it. And I didn't say you shouldn't do anything, I said that an absolute mandate isn't going to fly. In point of fact I suggested strengthening the current extant mandate, by removing exception for Religion and philosophical grounds. The point on tobacco speaks to the ability of people to rationalize their behavior despite the prostrations of the public health authorities.

Just for laughs and giggles, can you tell me where the statistical data on vaccination is drawn from? In addition do you think that any government agency, or combination thereof, has all the birth records, or that those records are complete? And who is the keeper of all the vaccination records? For instance I just received a DPT shot from my private physician. Is he mandated to report that fact to any agency? Assuming your absolute mandate these would be the bare minimum records required to enforce it I believe.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Fri Feb 06, 2015 7:46 pm UTC

morriswalters wrote:Just for laughs and giggles, can you tell me where the statistical data on vaccination is drawn from? In addition do you think that any government agency, or combination thereof, has all the birth records, or that those records are complete? And who is the keeper of all the vaccination records? For instance I just received a DPT shot from my private physician. Is he mandated to report that fact to any agency? Assuming your absolute mandate these would be the bare minimum records required to enforce it I believe.
The CDC I wager. And yes, all these things are pretty accurate. Assuming each person has a social security number, which is largely a pretty safe assumption, I'd say, is not more outlandish than assuming each person has medical records that are available/reported to the CDC.

Your physician may not have reported that YOU specifically got that vaccine, but you better believe your physician reports how many patients they see, and how many vaccines they administered.

morriswalters wrote:In point of fact I suggested strengthening the current extant mandate, by removing exception for Religion and philosophical grounds. The point on tobacco speaks to the ability of people to rationalize their behavior despite the prostrations of the public health authorities.
Well, no, it's just another example of how people are bad at assessing assumed risk. No one is going to outlaw drinking, and alcohol kills more people than measles.

But again, these are SELF-RISKS that the individual undertakes. Can you acknowledge that you understand this point, because it's important - an adult choosing to smoke is not analogous to an adult choosing to not vaccinate their child.
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Re: US measles outbreak as fewer parents vaccinate

Postby Tyndmyr » Fri Feb 06, 2015 8:13 pm UTC

sardia wrote:
Izawwlgood wrote:I'm not being combative. I'm trying to make sense of what you're saying, and your clarification helped.

I don't think anyone is claiming all homeschoolers are antivax. I also don't think anyone is claiming provaxxers are blindly provax.

What we are pointing out is that if a child is unvaccinated and homeschooled, they are still both at risk, and a risk to the other people in the community.

Aren't unvaccinated people a risk period? Unless you're accounting for a synergistic effect that makes it riskier.


It's a social clustering issue is all. Sure, unvaccinated folks are always a risk, but anti-vaxxers are particularly likely to be socially connected to other anti-vaxxers, which effectively negates herd immunity for that community. If you've got a nice cluster of unvaccinated folks, you've created a decent potential pool for one exposure to grow in, making the overall risk much larger.

Having them exist, but be sort-of excluded from mainstream society(and thus, more likely to have their own isolated sub-society) doesn't really address the risk. This is a weakness in tying compliance to school.

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Re: US measles outbreak as fewer parents vaccinate

Postby Yablo » Fri Feb 06, 2015 8:44 pm UTC

morriswalters wrote:Just for laughs and giggles, can you tell me where the statistical data on vaccination is drawn from? In addition do you think that any government agency, or combination thereof, has all the birth records, or that those records are complete? And who is the keeper of all the vaccination records? For instance I just received a DPT shot from my private physician. Is he mandated to report that fact to any agency? Assuming your absolute mandate these would be the bare minimum records required to enforce it I believe.

In the U.S. at least, your personal medical history isn't (nor should it be) reported, but you most definitely are included as "patient" in statistical data collection which is reported. In my state, that information is reported by hospitals and clinics to the state Department of Health and Social Services which would then be reported to either the U.S. Department of Health and Human Services, the Centers for Disease Control, or both.

I don't know for sure on this next point, but I would imagine that birth records are kept as specifics (child's name, parents' names, etc ...) at the county level, and in general at the state level. The federal level collects that general information every ten years in the Census.
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Re: US measles outbreak as fewer parents vaccinate

Postby BlackSails » Fri Feb 06, 2015 8:58 pm UTC

In NY, at least for children, personal histories are reported. There is a website doctors can log into to check immunization history.

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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Fri Feb 06, 2015 9:26 pm UTC

Izawwlgood wrote:The CDC I wager.
From the CDC.
For adults
NHIS collects information about the health and health care of the noninstitutionalized, civilian population in the United States using nationally representative samples. Interviews are conducted in respondents' homes. Questions about receipt of recommended adult vaccinations are asked of a randomly selected adult within the household. Definitions of high risk conditions* are based on ACIP recommendations for each vaccine (2). Additional analyses were conducted to estimate baseline coverage of persons with diabetes who recently were recommended for hepatitis B vaccination and for males recommended for quadrivalent HPV vaccination if aged ≤21 years or aged 22–26 years and at higher risk for HPV infection (4,5). Weighted data† were used to produce national estimates. Point estimates and estimates of corresponding variances were calculated using statistical software to account for the complex sample design. Statistical significance was defined as p<0.05.
For children.
The National Immunization Survey (NIS) has been conducted annually since 1994 by the National Immunization Program and the National Center for Health Statistics, Centers for Disease Control and Prevention. The NIS is used to obtain national, state, and selected urban area estimates of vaccination coverage rates for U.S. children between the ages of 19 and 35 months. The NIS is a random digit dialing telephone survey of households with age-eligible children followed by a mail survey of the children's vaccination providers to validate immunization information.
Izawwlgood wrote:Your physician may not have reported that YOU specifically got that vaccine, but you better believe your physician reports how many patients they see, and how many vaccines they administered.
I would assume so. However without connecting my name and/or social to that event, how would you know that I had been given it.
Izawwlgood wrote:But again, these are SELF-RISKS that the individual undertakes. Can you acknowledge that you understand this point, because it's important - an adult choosing to smoke is not analogous to an adult choosing to not vaccinate their child.
I understand the point you are making, however my point speaks to rationalization, not the source of the risk.
Yablo wrote:I don't know for sure on this next point, but I would imagine that birth records are kept as specifics (child's name, parents' names, etc ...) at the county level, and in general at the state level. The federal level collects that general information every ten years in the Census.
Yes and no. Then Census attempts to survey everyone, by mail, you are supposed to respond. I basically said fuck it the last time. Birth records assume that you are born in hospitals, which is a fair assumption, however that information is not shared by the states that I am aware of. The states are jealous of their prerogatives. Does the name Obama and the event "birth certificate" ring any bells?


@Izawwlgood
As you can see from the responses that data are not as detailed as you believe. The capability exists, the data exists, somewhere. But no one repository exists that can be cherry picked to provide the capability that you desire. As BlackSails answer shows you, we might be one nation under God, but we are fifty states with a multitude of different ideas and prerogatives. The Social Security data base is as close as you can get to national database of who is extant in this country and I assure you, they don't know for certain. Either you are daft or you simply can't put your head around the idea that sometimes you have to settle with what you can do. I don't think you are daft. Schools and day cares are the first formal point of contact for children to social discourse. It is at this point, if you are lucky, that you get to kick the tires and check the data. I would love to see mandated rigid requirements to vaccinate. More power to you if your generation can pull it off.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Fri Feb 06, 2015 10:16 pm UTC

No, it's like I said, wherein health providers report how many immunizations they administer.

I'm also unsure why you think you've just disproven my point - I'll highlight the relevant part;
morriswalters wrote:The NIS is a random digit dialing telephone survey of households with age-eligible children followed by a mail survey of the children's vaccination providers to validate immunization information.


I.e., immunization providers keep records, and report those records.

morriswalters wrote:I would assume so. However without connecting my name and/or social to that event, how would you know that I had been given it.
We're talking about separate things - you asked how it was possible to know how many people had been vaccinated, and I told you. You're now shifting the goal posts and asking how it's possible prove you've been vaccinated, and that's easy - you provide records from the physician that administered your vaccinations.

morriswalters wrote:Does the name Obama and the event "birth certificate" ring any bells?
Well, many, but none that are pertinent to this discussion.

morriswalters wrote:@Izawwlgood
As you can see from the responses that data are not as detailed as you believe. The capability exists, the data exists, somewhere. But no one repository exists that can be cherry picked to provide the capability that you desire. As BlackSails answer shows you, we might be one nation under God, but we are fifty states with a multitude of different ideas and prerogatives. The Social Security data base is as close as you can get to national database of who is extant in this country and I assure you, they don't know for certain. Either you are daft or you simply can't put your head around the idea that sometimes you have to settle with what you can do. I don't think you are daft. Schools and day cares are the first formal point of contact for children to social discourse. It is at this point, if you are lucky, that you get to kick the tires and check the data. I would love to see mandated rigid requirements to vaccinate. More power to you if your generation can pull it off.
I'm not sure why you think that - the data is all right there, and you can look at it yourself.

I'm trying to tell you that 'just settle for what you can do' is a bad public policy, and I've outlined reasons why. You keep repeating various things that don't support any criticisms of the suggestion we're putting forth, but insisting that it stands as an argument. It doesn't. All you've done is list... I dunno, irritations or smallscale objections (freedom! less than 100% perfect record keeping!), while continuing to ignore the point that we're making about why 'ONLY insuring vaccinations in schools' is actually insufficient.

I don't think you're daft either, but I don't think you're approaching this debate in good faith. I think you're uncomfortable with the notion of federally mandated vaccinations, but are unable to articulate why, or support why. That's understandable, because government! big brother! not in my body!, but I don't think you should keep couching your objection in these poorly substantiated points while ignoring what's being said.
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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Fri Feb 06, 2015 11:35 pm UTC

Izawwlgood wrote:I don't think you're daft either, but I don't think you're approaching this debate in good faith. I think you're uncomfortable with the notion of federally mandated vaccinations, but are unable to articulate why, or support why. That's understandable, because government! big brother! not in my body!, but I don't think you should keep couching your objection in these poorly substantiated points while ignoring what's being said.
I've stuck everything in me that the government wants to stick in me, and I made my kids take the needles like little soldiers. You make me want to roll on the floor and laugh. This is somewhat sad since we vary only in how we would approach the result you desire. I was just reading an article on Vermont, here's a sample.
Gov. Peter Shumlin urged Vermonters this week to vaccinate their children. But when it comes to the philosophical exemption, Shumlin said Wednesday, "leave it alone."

"I think we did a pretty good job of walking a very difficult balance between common sense – vaccinating your kids – and parents who absolutely think it is the wrong thing to do," Shumlin said of the state's vaccination discussions. "I think Vermont has navigated those waters."

Health Commissioner Harry Chen also says he's "not convinced" that removing the philosophical exemption is the best strategy for increasing vaccination rates.

"Vaccination is the most important action you can take to protect your child's health," Chen said in a statement. "We are not convinced that removing the philosophical exemption will contribute to improved childhood immunization rates. We know some of the things that work — vaccination requirements for child care, school and college entry, recall reminders for parents, strong recommendation from providers, and the fact that we provide all the recommended vaccines at no cost to either the provider or the patient."
That's a response to a proposal to remove the philosophical exemption to the current mandate for vaccinations for schools and day cares extant in Vermont today. His words are a play to his base or cognitive dissonance gone wild. That is one state of 50 that you have to pass legislation in if you try to attack this on a state by state basis. Now sail your proposal through the House or the Senate on a Federal level in a Congress that has shown no willingness to increase the bureaucracy or regulation. They are currently thinking how to sink Obama's policies. Can you say non starter. That of course is my opinion. However be my guest. As for the rest I won't waste your time or mine.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Fri Feb 06, 2015 11:41 pm UTC

Is the entire premise of your argument that convincing the country to do this would be a Hard Thing, and thus shouldn't be attempted?

Mokele already addressed this contention. No one has claimed that it would be as easy as passing pork, but if all you've been arguing this whole time is that because people don't like being told what to do, we shouldn't tell them what to do, I'm not sure why you couldn't have been more clear about that to begin with, and why you feel that's actually an argument that holds any merit.

I mean, I want to walk around naked in the summer, but I don't, partially because of laws that tell me not to. The idiotically obvious slippery slope to what you're saying is that we should probably just stop legislating anything that people may disagree with, irrespective of its utility to society. Maybe we should start with taxes?
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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Sat Feb 07, 2015 3:48 am UTC

No, my argument is that it is impossible. Politically, practically. Period. You haven't shown the first bit of data or suggested any mechanism by which you could accomplish it. You haven't established that the Federal Government can , or under what authority they could act to override state law. You haven't shown that the Feds could handle the data or that Congress has any desire to do so. You haven't suggested a method of funding. In point of fact, in so far as I can tell your argument consists of I'm wrong, and we should vaccinate every child who can be vaccinated. You stated that it isn't a political matter, but a public health matter. Which is at best naive. It is purely political. If you have some type of idea of what it is that you wish to accomplish and how you might do so speak up. I'm listening.

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Re: US measles outbreak as fewer parents vaccinate

Postby Mokele » Sat Feb 07, 2015 4:32 am UTC

morriswalters wrote:You haven't established that the Federal Government can , or under what authority they could act to override state law.


"This Constitution, and the Laws of the United States which shall be made in pursuance thereof; and all treaties made, or which shall be made, under the authority of the United States, shall be the supreme law of the land; and the judges in every state shall be bound thereby, anything in the constitution or laws of any state to the contrary notwithstanding." - Article 6, clause 2, US Constitution, aka the Supremacy Clause.

You haven't shown that the Feds could handle the data or that Congress has any desire to do so.


So, they can wiretap every phone on the planet simultaneously, but not collect measles vaccination information?

You haven't suggested a method of funding.


They're called taxes.

It is purely political. If you have some type of idea of what it is that you wish to accomplish and how you might do so speak up. I'm listening.


If enough people put enough pressure on the Federal government to do something, they will, simple as that. If we can wage two pointless wars of choice while the NSA is simultaneously hoovering up every scrap of communication across the planet, I'm pretty sure we can accomplish this.

Now, whether there will truly be enough willpower to do it, that's a different question, but that's where activists come in. You can't say "there isn't enough popular will" while we're still trying to raise it - that's like firing a carpenter on her first day because the house wasn't build when she got there.

We just need to sell it to the US public. Perhaps if we could somehow involve killing foreigners and taking their stuff, preferably if they have a different skin color, that always gets votes in the US...
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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Sat Feb 07, 2015 5:33 am UTC

... The government outlawed alcohol, and you're claiming it's incapable of putting together a system to provide vaccines for everyone?

One can call the US government many things, but 'short on resources' I would not. We're a country absolutely obsessed with health care costs at the moment, and people are actually wisening up to preventative medicine. Throw around some numbers about how much money is saved on vaccines. Show pictures of sick kids in Africa. Pander to whatever denominator it takes to make people comfortable with the notion of saving fucking children - this is a no brainer.
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Re: US measles outbreak as fewer parents vaccinate

Postby sardia » Sat Feb 07, 2015 6:14 am UTC

morriswalters wrote:No, my argument is that it is impossible. Politically, practically. Period. You haven't shown the first bit of data or suggested any mechanism by which you could accomplish it. You haven't established that the Federal Government can , or under what authority they could act to override state law. You haven't shown that the Feds could handle the data or that Congress has any desire to do so. You haven't suggested a method of funding. In point of fact, in so far as I can tell your argument consists of I'm wrong, and we should vaccinate every child who can be vaccinated. You stated that it isn't a political matter, but a public health matter. Which is at best naive. It is purely political. If you have some type of idea of what it is that you wish to accomplish and how you might do so speak up. I'm listening.

You're saying that diseases like smallpox can never be eradicated from the earth? Or that we should give up on polio? Also, you are wrong about it politically. Being pro vaccination is about as popular as veterans and puppies combined.

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Re: US measles outbreak as fewer parents vaccinate

Postby Cleverbeans » Sat Feb 07, 2015 7:37 am UTC

sardia wrote:Being pro vaccination is about as popular as veterans and puppies combined.

Veteran puppies? Wouldn't they be adults by the time they became veterans? Are you saying that being pro-vaccination is as popular as a member of the empty set? :P
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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Sat Feb 07, 2015 2:30 pm UTC

sardia wrote:You're saying that diseases like smallpox can never be eradicated from the earth? Or that we should give up on polio? Also, you are wrong about it politically. Being pro vaccination is about as popular as veterans and puppies combined.
Yep. I like it myself. I even support it, as a mandate. Where I disagree is in the ability or utility of creating a new federal program to fix a problem that can be solved by tightening the standard by which the existing mandate in all fifty states works. I have presented an example of a program in a state, Mississippi, which has achieved 99 percent(actually 99.7 I believe) coverage. What have you presented?

My entry into this foolishness started by expressing my fear of a polio resurgence if antivaxxers weren't stopped.
morriswalters wrote:It may well be zero. So? It was almost wiped out. I hadn't seen a case since I was a child. The same with whooping cough. I guess they won't be satisfied until polio makes a return to the US as well.
Smallpox has been eradicated, they no longer give the vaccine, and haven't since 1972. For the record I have had it.
Izawwlgood wrote:... The government outlawed alcohol, and you're claiming it's incapable of putting together a system to provide vaccines for everyone?
We all know how well that worked. I'm claiming that there is no political will. If a bill were introduced tomorrow it would be challenged in court, despite your prostrations, the outcome would be uncertain. Mokele believes the supremacy clause will cover it. Maybe. But it would still have to pass muster at SCOTUS. And no one has shown any interest at this point doing so on a federal level.

This conversation has moved into the realm of fantasy. We differ in one point only. The reaction is not unlike what might happen if I had said that I am in favor of drowning puppies. Pitch forks and torches. I believe and support a mandate, what I don't believe in is reinventing the wheel to fix a problem that can be fixed in a simpler way.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Sat Feb 07, 2015 2:50 pm UTC

morriswalters wrote:This conversation has moved into the realm of fantasy. We differ in one point only. The reaction is not unlike what might happen if I had said that I am in favor of drowning puppies. Pitch forks and torches. I believe and support a mandate, what I don't believe in is reinventing the wheel to fix a problem that can be fixed in a simpler way.
Nono, we understand that you are provax, and we understand that you want to see people vaccinated, what is strange and counter productive is your insistence that despite historical federal mandates for vaccination (as with polio), as well as the fact that all states presently mandate vaccinations for all children entering all schools, that the will to require all children be vaccinated is somehow an impossibility.
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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Sat Feb 07, 2015 4:31 pm UTC

What I see is a frivolous waste of time. There is already a program in place. If there was the political will to do more it would be done. But there isn't. And reaching 100 percent coverage probably isn't possible. They eliminated smallpox by eliminating it everywhere. In the end, IMO, you will eliminate measles in exactly the same way. And until you do that, we will have outbreaks.

In my reading the same type of things are repeated over and over. Politicians who don't want to disturb the staus quo and public health officials who fear a backlash if they push much harder. The recommendations you hear the most are to continue what we are doing and get and keep the public informed. It is faintly amusing that this isn't a problem caused by the poor, or by illegal immigrants. This is a problem of helicopter parents and a generation raised of on the web who are too stupid to be skeptical of dubious claims. And then, when the inevitable happens, panic sets in and everybody starts looking for a magic bullet.

I have been wrong before and will be again, but that is how I currently see it.

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Re: US measles outbreak as fewer parents vaccinate

Postby Izawwlgood » Sat Feb 07, 2015 4:40 pm UTC

Again though, your stance boils down to 'things are acceptable, so there's no sense or possibility in improving them'. Do we need to remind you that Disney Land happened?
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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Sat Feb 07, 2015 5:44 pm UTC

Izawwlgood wrote:Again though, your stance boils down to 'things are acceptable, so there's no sense or possibility in improving them'. Do we need to remind you that Disney Land happened?
No. And it will happen again. If not there somewhere else. And long before your proposed legislative efforts might pan out. At least some legislators in California are attempting to change the current law now. This is about as good as anywhere else to see if the political will exists to do anything. Even there, assuming that the removal of the exemptions pass, there will be court challenges even though this has already been litigated in the past. We'll see.

Here is something for you to read, I will quote the sections most relevant to our discussion. This from the Congressional Research Service, entitled "Mandatory Vaccinations:Precedent and Current Laws". This is a PDF so pardon the poor formatting.
Historically, the preservation of the public health has been the primary responsibility of state and
local governments, and the authority to enact laws relevant to the protection of the public health
derives from the state’s general police powers. With regard to communicable disease outbreaks,
these powers may include the enactment of mandatory vaccination laws. This report provides an
overview of the legal precedent for mandatory vaccination laws, and of state laws that require
certain individuals or populations, including school-aged children and health care workers, to be
vaccinated against various communicable diseases. Also discussed are state laws providing for
mandatory vaccinations during a public health emergency or outbreak of a communicable
disease.
Federal jurisdiction over public health matters derives from the Commerce Clause of the United
States Constitution, which states that Congress shall have the power “[t]o regulate Commerce
with foreign Nations, and among the several States....” Congress has enacted requirements
regarding vaccination of immigrants seeking entry into the United States, and military regulations
require American troops to be immunized against a number of diseases. The Secretary of Health
and Human Services has authority under the Public Health Service Act to issue regulations
necessary to prevent the introduction, transmission, or spread of communicable diseases from
foreign countries into the states or from state to state. Current federal regulations do not include
any mandatory vaccination programs; rather, when compulsory measures are needed, measures
such as quarantine and isolation are generally utilized to halt the spread of communicable
diseases.

As noted above, state and local governments have primary responsibility for protecting the public
health, and this has been reflected in the enactment of various state laws requiring that school
children be vaccinated against certain diseases before enrolling in school and that health care
workers be vaccinated as a condition of employment, as well as laws providing for mandatory
vaccination procedures during a public health emergency. Any federal mandatory vaccination
program applicable to the general public would likely be limited to areas of existing federal
jurisdiction, i.e., interstate and foreign commerce, similar to the federal quarantine authority.
88
This limitation on federal jurisdiction acknowledges that states have the primary responsibility for
protecting the public health, but that under certain circumstances, federal intervention may be
necessary.
Now if you have nothing of substance to add for your part, I've said everything I feel the need to say.

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Re: US measles outbreak as fewer parents vaccinate

Postby sardia » Sat Feb 07, 2015 6:57 pm UTC

http://www.npr.org/blogs/health/2015/02 ... -just-tell
Apparently just telling parent they aref getting immunized instead of asking boosts vaccine rates from 20% to 70% , unless I did the math wrong. Maybe the people on the fence aren't vocal enough to object unless y the doctor is wishy washy about it.

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Re: US measles outbreak as fewer parents vaccinate

Postby Tyndmyr » Mon Feb 09, 2015 8:32 pm UTC

morriswalters wrote:No, my argument is that it is impossible. Politically, practically. Period. You haven't shown the first bit of data or suggested any mechanism by which you could accomplish it. You haven't established that the Federal Government can , or under what authority they could act to override state law. You haven't shown that the Feds could handle the data or that Congress has any desire to do so. You haven't suggested a method of funding. In point of fact, in so far as I can tell your argument consists of I'm wrong, and we should vaccinate every child who can be vaccinated. You stated that it isn't a political matter, but a public health matter. Which is at best naive. It is purely political. If you have some type of idea of what it is that you wish to accomplish and how you might do so speak up. I'm listening.


Well, mandatory vaccination basically exists now. It's just been a little derailed by this silly anti-vaxxer business.

It seems very obvious that such a regime can exist. If it should be federal or not is frankly, unimportant. I'd be quite satisfied with state enforced vaccinations as well. And if every state can do it, then yes, the fed can do it, because the difference between those things is fairly minimal in practice.

Nobody is really arguing for some sort of massive, sweeping changes. Just tightening up exemptions that are being abused, maybe improving education a little on the topic, stuff like that. We're already mostly there on vaccinations. We just need to keep this potential antivaxxer problem under control. That's it.

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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Mon Feb 09, 2015 8:49 pm UTC

Which oddly enough is what I've been saying. :D

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Re: US measles outbreak as fewer parents vaccinate

Postby Andries » Tue Feb 10, 2015 6:02 am UTC

http://www.eyeofthetiber.com/2015/02/06 ... -hostages/
Spoiler:
In a shocking new display of barbarism, the masked executioner known as Jihadi John announced in a newly released video that ISIS is planning to vaccinate two American bloggers against measles.

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Re: US measles outbreak as fewer parents vaccinate

Postby EMTP » Tue Feb 10, 2015 3:46 pm UTC

Updates on the current outbreak:

Measles outbreak grows to 166 cases across 18 states, DC.
The measles outbreak continues to generate significant media coverage and was covered by all three network newscasts Monday night. Scott Pelley reported on the CBS Evening News (2/9, story 11, 0:10, Pelley) that the measles outbreak has now spread to 166 reported cases in 18 states and the District of Columbia. Reuters (2/10, Whitcomb) specifies that 107 of those cases are in California alone, with 39 stemming from the Disneyland outbreak.

The Washington Post (2/9, Bernstein, Dennis), meanwhile, reports that the CDC announced yesterday that 19 additional people contracted measles last week as the disease spread to Nevada, Delaware, New Jersey, and Washington D.C. The agency said 121 people in 18 jurisdictions are now affected, with most cases stemming from the Disneyland outbreak in late December. According to the Post, “The total is on pace to easily surpass the 644 cases in the United States in 2014, the greatest number since measles was declared eliminated in the United States in 2000.”

The Wall Street Journal (2/10, McKay, Subscription Publication) notes that the CDC’s number may be smaller than numbers reported by individual states due to the time required to confirm and report suspected cases.

According to the AP (2/10, Stobbe), “All but 18 of the cases are tied to an outbreak that started at the Disneyland amusement park in California.”

Dr. Richard Besser noted on ABC World News (2/9, story 10, 0:45, Muir) that while “most people think about measles as a childhood disease,” in California, “59 percent of all the cases are in people 20 or older.”

Lester Holt reported on NBC Nightly News (2/9, story 5, 0:15, Holt) that some lawmakers are “calling on Congress to require all children in the Head Start program be vaccinated.”


The source for the above text is "AMA Morning Rounds."

I don't think either side in the morris-vs-everyone debate is wrong, except in the level of certainty they are expressing. Morris is suggesting strengthening the existing system by removing most religious and philosophical objections to school requirements. That would be a big help. Others would like to go farther, and legally require the recommended vaccinations for everybody, and that would work too. Certainly the federal government has many ways to accomplish that. The discussion of which method is better would be better if we focused on the advantages and disadvantages of each, rather than condemning the less-favored alternative as impossible.

But we all agree we need more comprehensive vaccinations. That's a lot of agreement for a fora thread!
"Reasonable – that is, human – men will always be capable of compromise, but men who have dehumanized themselves by becoming the blind worshipers of an idea or an ideal are fanatics whose devotion to abstractions makes them the enemies of life."
-- Alan Watts, "The Way of Zen"

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Re: US measles outbreak as fewer parents vaccinate

Postby sardia » Tue Feb 10, 2015 5:45 pm UTC

If we,re gonna focus on limited resources, then we should push for near complete coverage of kids u less it kills them. That way, even if they become anti VAX, its too late as they were already vaccinated.

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Re: US measles outbreak as fewer parents vaccinate

Postby Tirian » Tue Feb 10, 2015 7:34 pm UTC

Mokele wrote:
morriswalters wrote:You haven't established that the Federal Government can , or under what authority they could act to override state law.


"This Constitution, and the Laws of the United States which shall be made in pursuance thereof; and all treaties made, or which shall be made, under the authority of the United States, shall be the supreme law of the land; and the judges in every state shall be bound thereby, anything in the constitution or laws of any state to the contrary notwithstanding." - Article 6, clause 2, US Constitution, aka the Supremacy Clause.


The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.
- Tenth Amendment to the U.S. Constitution

That is not to say that the federal government is powerless. As an above news source suggests, they could theoretically say that states can only accept federal Head Start funds if they require that all incoming students be vaccinated with an opt-out policy that is more expensive and time-consuming than getting the damned shots.

Perhaps it needs to be pointed out to morris' critics that the aforementioned plan still has an absolutely 0% chance of becoming law, and the people who are now suggesting the plan are fully aware of it. They are only doing it to paint the mainstream GOP as anti-vax and pro-outbreak, and hypocrites for suggesting last year that the (non-existent) Ebola outbreak in the US was the fault of the Obama administration but that they have no authority to fight the (fully existent and rapidly growing) measles outbreak in the US.

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Re: US measles outbreak as fewer parents vaccinate

Postby EMTP » Wed Feb 11, 2015 12:43 am UTC

The Congress shall have Power ... To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof.


We can do this all day. There's plenty of libertarian boards out there to complain about the scope and power of the federal government, but in point of fact, mandatory vaccination iswell within its purview:

Federal jurisdiction over public health matters derives from the Commerce Clause of the United States Constitution, which states that Congress shall have the power “[t]o regulate Commerce with foreign Nations, and among the several States....” Congress has enacted requirements regarding vaccination of immigrants seeking entry into the United States, and military regulations require American troops to be immunized against a number of diseases. The Secretary of Health and Human Services has authority under the Public Health Service Act to issue regulations necessary to prevent the introduction, transmission, or spread of communicable diseases from foreign countries into the states or from state to state.


Unless you can make the case that communicable diseases won't cross state lines, and the even more difficult case that they won't affect commerce, I'm afraid you don't have a leg to stand on here.

It would be better to argue for the best policy, or the most politically feasible effective policy, rather than pretend the expansion of federal authority over the last century never happened.
"Reasonable – that is, human – men will always be capable of compromise, but men who have dehumanized themselves by becoming the blind worshipers of an idea or an ideal are fanatics whose devotion to abstractions makes them the enemies of life."
-- Alan Watts, "The Way of Zen"

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Re: US measles outbreak as fewer parents vaccinate

Postby Tirian » Wed Feb 11, 2015 1:21 am UTC

EMTP wrote:Unless you can make the case that communicable diseases won't cross state lines, and the even more difficult case that they won't affect commerce, I'm afraid you don't have a leg to stand on here.


I can't even make the case that high school graduates don't cross state lines, and yet all public education decisions (including things like curriculum and standards for teacher certification) remain securely and inefficiently in the hands of the individual states. Gun trafficking seems like an obvious Commerce Clause issue and yet the Supreme Court in 1993 struck down the part of the Brady Act that mandated how states conduct background checks on Tenth Amendment grounds.

Given that the examples you cite in your text show only that the federal government can make medical decisions regarding immigrants and the military, two facets of civil life that the Constitution clearly cedes to the federal government, I wouldn't take a bet on the federal government's ability to make a universal vaccination policy that is stronger than at least 49 states have seen fit to impose on themselves. On the other hand, I would happily take the bet that Congress in our current political climate lacks the will to force states to do something that at least 49 of them currently don't want to do.

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Re: US measles outbreak as fewer parents vaccinate

Postby EMTP » Wed Feb 11, 2015 5:55 am UTC

Tirian wrote:
EMTP wrote:Unless you can make the case that communicable diseases won't cross state lines, and the even more difficult case that they won't affect commerce, I'm afraid you don't have a leg to stand on here.


I can't even make the case that high school graduates don't cross state lines, and yet all public education decisions (including things like curriculum and standards for teacher certification) remain securely and inefficiently in the hands of the individual states. Gun trafficking seems like an obvious Commerce Clause issue and yet the Supreme Court in 1993 struck down the part of the Brady Act that mandated how states conduct background checks on Tenth Amendment grounds.

Given that the examples you cite in your text show only that the federal government can make medical decisions regarding immigrants and the military, two facets of civil life that the Constitution clearly cedes to the federal government, I wouldn't take a bet on the federal government's ability to make a universal vaccination policy that is stronger than at least 49 states have seen fit to impose on themselves. On the other hand, I would happily take the bet that Congress in our current political climate lacks the will to force states to do something that at least 49 of them currently don't want to do.


So my example about the federal government mandating vaccinations is off point . . . but here's a 25-year-old ruling about guns. Uh huh.

Betting on a Republican Congress to be on the wrong side of Americans' welfare is pretty easy money, one might say. Well, they are doing interesting things with executive orders these days. And Congress, for all their science-denying ways, doesn't like to be on the wrong side of public opinion, which is, you may have heard, pretty firmly anti-epidemic. As to whether the Supreme Court would then ignore the Commerce Clause and engage in right-libertarian judicial activism, only time will tell.

But the bottom line is that you are trying to evade a discussion about the right policy with an off-topic "Jefferson Davis Lives!" states-rights argument. Which is beside the point, as well as wrong.
"Reasonable – that is, human – men will always be capable of compromise, but men who have dehumanized themselves by becoming the blind worshipers of an idea or an ideal are fanatics whose devotion to abstractions makes them the enemies of life."
-- Alan Watts, "The Way of Zen"

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Re: US measles outbreak as fewer parents vaccinate

Postby Tyndmyr » Wed Feb 11, 2015 4:16 pm UTC

Immigration requirements are pretty settled as a federal thing, so health requirements for immigration being federal is expected, but does not mean that the same requirements will necessarily apply to citizens on the federal level.

The educational argument seems particularly on point, given the frequent tying of vaccination enforcement to school admission. We all understand that people cross state lines, so surely school policy in one state will affect anothers...but that doesn't seem to be a big factor in federalizing schools, and even the most general, inoffensive standards face significant opposition. See also, Common Core.

I do not think that federal enforcement of vaccination is necessarily impossible, but I care a great deal more about getting people vaccinated rather than the governmental level enforcement happens at. So, if one way is more efficient, I'm absolutely okay with pursing that method.

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Re: US measles outbreak as fewer parents vaccinate

Postby EMTP » Wed Feb 11, 2015 4:42 pm UTC

Tyndmyr wrote:I do not think that federal enforcement of vaccination is necessarily impossible, but I care a great deal more about getting people vaccinated rather than the governmental level enforcement happens at. So, if one way is more efficient, I'm absolutely okay with pursing that method.


I agree. The most efficient & effective method is the priority here, rather the nature of the enforcement.
"Reasonable – that is, human – men will always be capable of compromise, but men who have dehumanized themselves by becoming the blind worshipers of an idea or an ideal are fanatics whose devotion to abstractions makes them the enemies of life."
-- Alan Watts, "The Way of Zen"

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Re: US measles outbreak as fewer parents vaccinate

Postby gmalivuk » Sun Feb 22, 2015 3:43 pm UTC

Tyndmyr wrote:Immigration requirements are pretty settled as a federal thing, so health requirements for immigration being federal is expected, but does not mean that the same requirements will necessarily apply to citizens on the federal level.
It is pretty ironic, though, given that US citizens are far more likely to pose an outbreak risk than most immigrants.

Untitled-1.jpg

(from here)

The one in the northwest of Mexico came from Disneyland, and the other two dots represent three measles cases in 2011.
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Re: US measles outbreak as fewer parents vaccinate

Postby BattleMoose » Mon Feb 23, 2015 6:54 am UTC

A bit late to the party here but just wanted to weigh in.

Mandated vaccinations are an extremely good idea, in terms of consequences.

But it sets a precedent I am extremely uncomfortable with, that government, can decide on medical interventions that you have to take (or at least coerced if you want to go to school). It really wasn't so long ago that homosexuality was considered a "disease" and in instances was, "treated". That a precedent could exist to argue for some action like that, regardless of how unrealistic it might feel today, is still deeply unsettling. I have the right of "security of person", its mine and the government may not impinge on it.

I would rather that Anti-Vaxers be prosecuted based on the harm they are causing. And if we need new laws for that, then lets legislate them. (Well not in the USA because of near absolute freedom of speech there and such) Or perhaps education or educational campaigns.

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Re: US measles outbreak as fewer parents vaccinate

Postby CorruptUser » Mon Feb 23, 2015 7:09 am UTC

Just hold them accountable in the courts for reckless endangerment, mandate that they be forced to read a bunch of literature, etc, basically make it more trouble that it's worth. If the government can say, as a male, I have to register for the draft OR face a huge financial penalty and possible legal issues, then they can do the same thing to someone refusing to vax.

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Re: US measles outbreak as fewer parents vaccinate

Postby morriswalters » Mon Feb 23, 2015 10:28 am UTC

BattleMoose wrote:But it sets a precedent I am extremely uncomfortable with, that government, can decide on medical interventions that you have to take (or at least coerced if you want to go to school).
In the US this is settled law. The question is how hard to push to get the 8 percent of those who won't vaccinate.

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Re: US measles outbreak as fewer parents vaccinate

Postby Derek » Mon Feb 23, 2015 11:51 am UTC

mandate that they be forced to read a bunch of literature

FYI, this won't actually help. I'm not going to dig up the link right now, but the tl;dr is that ones people have formed a strong opinion, making them read opposing literature only further ingrains them. The anti-vaxers have seen plenty of pro-vax literature, and as much as you and I would like to scream at them that they're wrong and shove the evidence in their face, it doesn't help.

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Re: US measles outbreak as fewer parents vaccinate

Postby CorruptUser » Mon Feb 23, 2015 1:27 pm UTC

Then why do states force women to read a bunch of stuff before getting an abortion?


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