I think vaccines should be mandatory for all children. If you don't vaccine your kid, CPS should take the kid away after multiple warnings, because you are an unfit parent and a danger to our community otherwise.

Vaccinations aren't without risk (though, clearly, autism is not one of those risks)- and, as long as all the other parents get their children vaccinated, your child can take a pass on some vaccines and come out ahead from a mortality perspective.

With that said, from a _societal_ perspective, it's imperative that parent's put their child's life at this (minor) risk so that the overall mortality rate goes down.

Don't be so quick to judge the parent as "unfit", though your comment about being a danger to the community does, in fact, hold.

And, perhaps we should be a little less quick to suggest the solution to other parents not doing what we want them to do is to have "CPS take the kids away after multiple warnings."

There is a cost to freedom, and sometimes it means that we have to let parents makes the call on these grey areas, even if it offends our own personal rational models of how the world should work. Vaccines are clearly not as cut and dry as something like a life-saving blood transfusion or surgery for appendicitis, in which I would suggest that there is an imperative to over-rule the parent should they decline treatment of their children.

Globally there is a huge unvaccinated population http://findarticles.com/p/articles/mi_m1272/is_2729_134/ai_n... all it takes is one passenger to bring something back and suddenly you end up with a large number of dead children. http://www.npr.org/templates/story/story.php?storyId=1291987...

PS: Because it's often local doctors that accept this Anti-Vaccination bullshit small locations often lose their herd immunity. It's one thing to randomly replace 1/100,000 vaccinations with an inert substance it's another for 10+% of the children in a small area to avoid vaccination.

I'm just hoping that while you see how we agree on that topic, that we perhaps should have a little bit more consideration or respect for the role of a parent, in determining what is done to their children, from the perspective of vaccination (and by extension, education, religion).

I'd rather we ensure that all parents vaccinate their children through enlightened understanding of why it's important, rather than because some third-party believes they aren't equipped to make informed decisions about vaccination and doesn't give them the choice. (Excepting, of course, unusual circumstances where you have a pandemic underway and there is immediate and significant threat to the populace from unvaccinated individuals - in that scenario, Civil Health overrides personal choice and you get vaccinated (adults and children) whether you like it or not) - but that's a rare scenario, usually the one at risk from a missing vaccination is the one missing the vaccination.

PS: A fire resistant couch save lives dispute the fact they can still burn in a hot enough fire, the benefit is focused on small ignition sources aka a spark or cigarette not a kiln.

EX: Just the M in MMR prevents ~1/2 million people from getting sick each and every year. The benefit of measles vaccination in preventing illness, disability, and death has been well-documented. The first 20 years of licensed measles vaccination in the U.S. prevented an estimated 52 million cases of the disease, 17,400 cases of mental retardation, and 5,200 deaths.[10] During 1999–2004, a strategy led by the World Health Organization and UNICEF led to improvements in measles vaccination coverage that averted an estimated 1.4 million measles deaths worldwide.[11]

http://en.wikipedia.org/wiki/File:Measles_US_1944-2007_inset...

Vaccinations prevent well over 50,000 deaths per year in the US alone along with a large number of vary serious side effects. On an individual basis the lifetime chance of infection is still higher than you might think and only increases as more people avoid vaccination. If we where talking about an adult taking the risks for themselves that's one things, but we are talking about making the choice for someone else as well increasing the overall risk to society.

If vaccination were only about your own health, then your conclusion is valid. But its also about those you will infect should you get the disease.

I understand a parent making selfish decisions about their child - in fact that's a defining characteristic of a parent. Just understand that its not always morally defensible. Or scientifically. Or logically.

I wonder what those risks are like compared to, say, driving your child around town on a somewhat regular basis.

This is true, of course, but who decides which kids should get the benefit of reduced risk? If it's not ok for everyone to skip out on vaccines, it should be ok for noone (unless we can figure out ahead of time which kids are vulnerable).

http://www.cdc.gov/mmwr/preview/mmwrhtml/00046738.htm

As you'll see, it discusses various studies and provides links to papers examining various cases in which people have had an adverse side-effect to a vaccine.

Please, everyone, no comments about how that may be true but what about this and that and the other; the poster asked for a link, here it is.

If everyone else is refusing to vaccinate, that's exactly when you should vaccinate, because your child is much more likely to catch chickenpox or the measles with a whole bunch of unvaccinated kids running around.

Someone posted a link below to a CDC summary of adverse effects from vaccinations. They describe other rare events which are orders of magnitude less likely than your child being killed in traffic on the way to school in the morning. If you want to argue that sending children to school endangers their lives, you can certainly find statistical evidence for children being killed on school buses...and by lightning strikes on the way to school, choking on hot dogs, etc.

In every instance I am aware of, the risks of a serious adverse event from a vaccine is orders of magnitude lower than these other dangers to which parents routinely (and unthinkingly) expose their children.

Please tell us exactly at what level this "good science" you've found somewhere <b>quantifies</b> this "endangering of" our children's lives, and the causal link(s) of this mortality to the vaccine.

At that point, we can compare them to lightning strikes etc, and most importantly, compare them against the well known and demonstrably associated common mortality and morbidity that has accompanied failure to vaccinate.

There may be much longer-term benefits to vaccination. Children vaccinated against polio and hep B, for example, appear to have a lower incidence leukemia (ALL), as well as all cancers combined.

http://www.pediatricsupersite.com/view.aspx?rid=80272

They are in some places, and that is what happens unless you object on moral or religious grounds. I worked at a pediatric clinic, and on several occasions, we called CPS on parents that did not bring in their children for routine physicals and vaccinations.

Also, it's very difficult to get a child into the school system unless the child has been vaccinated.

/I moonlight as ER nurse, and I've done contract work at Chicago Children's, University of Chicago Children's, Fresno Children's and a satellite of Boston Children's.

Personally? I think it's not up for debate. The exact age and type of vaccine used might be if there are various options and risks to weigh, and as a parent I might want to choose those, but vaccinating our children against incurable diseases they are likely to be exposed to isn't up for debate in my mind. Why, as a society, would we not want to wipe out said disease?

Now, I think of my own vaccination history (hypothetically). When I was a kid, they didn't vaccinate us against Hep-B. They didn't. It wasn't part of the program. Then a few decades later when I had a Hep-B scare and read up on it, I said, WTF, how on earth are we not vaccinating our society against one of the most virulent diseases on the planet?

(The answer would be cost, and chances of someone from my country contracting it short of travel to other locations or IV drug use)

We stopped vaccinating against smallpox before I was born. IF smallpox shows up again, that will change.

Handling this a society requires trusting your health organisations - and that's where the problem comes in - people these days don't trust the established authorities.

A single unvaccinated child in a vaccinated society is not a risk to the entire society. A small number of unvaccinated children spread around a vaccinated society is not a risk to the entire society. At a certain number, i imagine, things suddenly go from "safe" to "deadly" with no middle ground.... so this is the type of problem that can probably be dealt with through education rather than force.

One of the key enablers of this is that people like you-- who soundly reject science-- believe they have "facts and science" on their side.

The idea that "things...are not up for debate" is the most profoundly anti-science (and anti-intellectual) thing that can be said. I have yet to meet a pro-vaccination person who was willing to talk about the actual science.

Please, also realize when you say "mandatory" you are saying that you endorse the use of violence on people who-- for whatever reasons-- choose to make a different choice about the healthcare of their children.

It is one thing to incarcerate, or kill if they resist, someone who has committed a crime like murder or rape. It is quite another for you to endorse the use of violence for the "Crime" of not being politically correct.

Your ideology posits that whatever you deem to be "good for society" gives you the justification of using violence to enforce. First I'd like to point out that there hasn't been a tyrant known to the face of the earth who didn't use such rationalizations. But secondly, it is worth noting that implicit in this claim is the presumption that everyone is your slave, and everyone's life is to be lived according to your (or your creed's) edicts.

That is the opposite of liberty, and contrary to the entire history of common law, and specifically the US constitution which recognizes people as having inalienable rights. One of these rights recognized in the declaration of independence is the pursuit of "life". Quite literally, that means the right and power to make their own health care choices, based on their best understanding of the state of knowledge at the time.

In my experience, those who are wary of vaccines are pretty well aware of the state of the science on the issue, while those are pro-vaccines are generally after an ideological agenda of mandatory vaccination, and only invoke the word "science" to put forth the idea that their opposition rejects it.

Well, I see thru your claim. You reject science, the scientific method and the entirety of intellectualism. You are being dogmatic.

Edit: Everyone who votes me down without responding to my issues, proves my claim. I made an argument here that substantially contributes to the discussion. You vote me down and you vote to make HN a popularity contest where posts are ranked by adherence to The Party Line, rather than contributing to discussion.

By doing so you just prove that the claim about being influenced by "facts and science" is false and the reality is political ideology over all.

> It is one thing to incarcerate, or kill if they resist, someone who has committed a crime like murder or rape. It is quite another for you to endorse the use of violence for the "Crime" of not being politically correct.

By not getting vaccinations, they are putting other people's health at risk (cf. herd immunity, and children too young to be vaccinated). This is not simply an issue of free choice or ideology. This is not an issue of just what the consequences are to themselves (if it were, I wouldn't have issue). The issue is that they are endangering the lives of others. Force, or the threat of force, is a reasonable response to the endangerment of human lives. I would go so far as to say that it's qualitatively similar to murder (though quantitatively smaller). We have several documented cases every year of infants too young to receive the vaccination dying of whooping cough that they contracted from unvaccinated adults.

"Things are not up for debate" only in the sense that no amount of rhetoric can disprove an empirically proven fact. The facts, which were arrived at through science, are that vaccines save lives, and that when individuals are not vaccinated they put not just themselves but other people at danger as well. In the hypothetical, were science to discover new facts disproving this, I would revise my opinion, but these facts have been established over such a long time by so many studies that I consider the odds not just remote but literally impossible.

My experience, and you may be an exception although I doubt it, is that people who are ideologically opposed to vaccines have read scientific studies, but aren't actually familiar with science as a process. That is to say, they read a study, and think that it's science and its conclusion must be true. Evaluating a study means also examining its process for sources of bias, examining alternative explanations, and reproducing results in repeated studies. The effectiveness of vaccines and the concept of herd immunity has gone through that process. Anti-vaccination literature that I have seen does not withstand that process.

Either you're lying or not looking.

Here's the scientific argument of interest:

1. Before vaccinations, there existed several diseases that killed millions and maimed millions more on a routine basis.

2. Vaccines have been developed for many of these diseases, and deployed out into the population.

3. These diseases no longer kill millions and maim millions more.

If you find the "pro-vaccination" side a bit uninterested in the question of whether one in a few hundred thousand vaccinations have bad side effects at times, that's because scientifically it is worth how to further mitigate those risks but it isn't even remotely a scientific answer that vaccinations shouldn't take place.

In terms of the costs/benefits analysis of vaccinations, you are up against the deaths of millions on the plus side. You should expect it to be a bit of a challenge to lay out enough cons to win your point! The deaths of millions are hard to miss, if they weren't a great stonking benefit you wouldn't have to be arguing, it would be plainly obvious.

So, for the sake of argument, I will stipulate every pre-existing scientific argument you can show me is true. (Thatm is, you don't get to take advantage of my preemptive agreement to make new ones.) Show me how the scientific costs outweigh the scientific benefits, and given the nature of the benefits bear in mind that I'm demanding to see millions upon millions of bodies a decade and absolutely nothing less. Go for it.

Science isn't about slinging around big words or running lab tests. It's about making hypotheses, testing them, looking for why your hypothesis is wrong, and iterating that process. A pro-vaccination advocate does not need to go into biochemistry or argue about sub-.01% cases to make their point. They simply point at the positive results of vaccination and rest their case. That IS science, in its purest form. Stringing together words and selectively reading studies and biasing the argument until if you squint you might have a point in some cases is the opposite of science. If you're not finding people "scientifically" engaging with you I submit it's because the pro-vaccinators do not have a need to engage in what you think is "science" to prove the point, because they've got real science (and millions upon millions upon millions of non-corpses) on their side.

I'll just leave this here:

http://www.vaclib.org/sites/debate/web1.html

I've seen similar graphs over the years, basically arguing that these diseases were in long-term decline before the introduction of their respective vaccines, and that the vaccines merely sealed the deal.

Were I more ambitious, I'd seek out the source data from official sources, and confirm or refute the analysis myself.

This paper appears to have asked the same questions:

http://www.ncbi.nlm.nih.gov/pubmed/9088445

It came to the following conclusion:

Historical data provide evidence of proof of efficacy of mass immunization for measles, polio, rubella, mumps, and pertussis, but not for diphtheria or tetanus.

This does not contradict the claim that the incidence of said diseases were already in significant decline prior to the introduction of immunizations, or that immunizations were not necessary for eradication.

It seems like a rather obvious analysis to do: compare the maximum historic incidence of said disease, the incidence at the time of vaccine introduction, and the rates of decline prior to and following said introduction. It should be fairly easy to argue from that whether a) the vaccine contributed to eradication, and b) the vaccine was necessary for eradication.

> http://www.vaclib.org/sites/debate/web1.html

Ooh, is that a rabid anti-vax site? Let's look at the home page...

GRAPHICAL EVIDENCE SHOWS VACCINES DIDN'T SAVE US

HISTORICAL FACTS EXPOSING THE DANGERS AND INEFFECTIVENESS OF VACCINES

DOCTORS AND SCIENTISTS CONDEMN VACCINATION

WHY VACCINES ARE INEFFECTIVE

WHY VACCINES ARE HARMFUL

WHY VACCINATION CONTINUES

THE BENEFICIAL NATURE OF CHILDHOOD INFECTION

Yep, looks like it.

similar graphs, less inflammatory sites:

http://ocw.jhsph.edu/imageLibrary/index.cfm/go/il.imagesByTo...

http://jama.ama-assn.org/content/281/1/61.full

http://phe.rockefeller.edu/death/

The CDC addresses the claim of historical decline here:

http://www.cdc.gov/vaccines/vac-gen/6mishome.htm

with this graph:

http://www.cdc.gov/vaccines/vac-gen/images/measles_incidence...

Well, sure, so the measles vaccine sealed the deal, yes. But then you look at the longer timeline, and the vaccination occurred on the tail end of a much longer decline.

Science-Based Medicine has a particularly indignant blog entry on the topic here:

http://www.sciencebasedmedicine.org/?p=4431

Note the same trimming of the timeline.

I suspect the truth here is that vaccines were indeed effective in the (near-) eradication of most infectious diseases, but these diseases were already in longterm historic decline due to other more instrumental factors, like increasing urbanization and improved sanitation.

Yes, yes I did. The next time you want to make a point, pick a site with a bit more credibility.

Better hygiene and medical care helps stop people dying of infectious disease. But your inference is that because of this, vaccines are ineffective. Oh look, here's a better image:

http://ocw.jhsph.edu/imageLibrary/index.cfm/go/il.viewImageD...

Right? There are hundreds of these sorts of graphs and epidemiological studies out there, and they all look pretty much exactly the same. Better hygiene only gets you so far - to completely wipe out an infectious disease, you need vaccination.

I'm not here to spoon feed you information in line with your heuristic baggage. You can "take me seriously" or not.

But your inference is that because of this, vaccines are ineffective.

My inference is that vaccines were not instrumental in the longterm decline of infectious diseases, contrary to the OP's claim. I thought I was pretty clear on that point.

to completely wipe out an infectious disease, you need vaccination.

This is a sound public policy message to encourage vaccination, but the data, as far as I can see, does not support such a strong and sweeping conclusion. Yes vaccines appear effective in the reduction of some infectious disease. It does not follow that vaccines are thus necessary to wipe out infectious disease. Surely this modest level of nuance is not too much to grasp?

1. Diseases such as measles were still established in developed western countries in the 50's and 60's, when hygiene and diet were comparable to today.

2. Similar diseases (eg. Polio) are on the brink of being wiped out in 3rd world countries with inadequate infrastructure and hygiene - largely by vaccination.

This is not "heuristic baggage". You're just wrong about vaccination.

For example, that paper I linked to, Incidence of infectious disease and the licensure of immunobiologics in the United States, probably includes a decent bibliography of relevant sources. Here's the conclusion again:

Historical data provide evidence of proof of efficacy of mass immunization for measles, polio, rubella, mumps, and pertussis, but not for diphtheria or tetanus.

That's fairly weak, actually. All they had to do there was establish a trend and then show some minimum degree of deviation. One suspects the data does not support a stronger conclusion. Why not? On first glance I'd guess it's because immunizations were introduced so late into the game, with the trend rapidly approaching zero, that you can't draw strong statistical conclusions.

But that's all conjecture on my part. How about other regions of the world? You take it on faith that "similar diseases...are on the brink of being wiped out in 3rd world countries with inadequate infrastructure and sanitation", but spend some time with the primary sources and you might come to a more nuanced position.

I really don't care what you're demanding to see because your sides position is to assert that "science agrees with our ideology" (without providing any backing and even though science and ideology are really fundamentally different) and then to demand arbitrary proof for the opposition to even be granted the chance to have an opinion.

While your at it, please feel free to prove-- scientifically of course- the claim that people concerned about the safety of vaccines want to "kill children".

You have made no scientific claims or scientific arguments. I think the unfortunate thing is that you do not even realize that you are rejecting science.

You don't get to pick and choose, and you don't get to reject results simply because they disagree with your ideology (which is what you're doing when you make up arbitrary bars to be met, which is positively absurd when you aren't meeting any bars yourself.)

One of the great dishonesties about this debate is that the pro-vaccination side won't even make a specific, defendable, scientific claim and then defend it.

Which makes sense because the entire point of this "debate" is for your partisans to label those who might opt out of vaccines as irrational...

It is nothing more than a witch hunt, and it is extremely offensive for you to wrap yourselves in the realm of science while absolutely refusing to even look at the literature on the subject.

No, you are. I said science and explicitly held myself to the topic of science. You said you never met anyone willing to talk about the science, and that is all I addressed.

"You have made no scientific claims or scientific arguments."

And you are 100% utterly, totally, completely wrong. I told you, science isn't about big words or biochemistry or any sort of why, it is about what. Before vaccines, disease. After vaccines, nearly no disease. Causality established via details I didn't go into but you are free to investigate, at this point they are plausibly common knowledge. THAT'S SCIENCE. That's it. Right there. On the topic of whether vaccines are a net good, that is the argument. Mechanisms are irrelevant. Whys are irrelevant.

And the reason science works that way is that it avoids exactly the error you're trying to induce me into, where we bring various bits of "whys" to bang against each other until we're arguing about how many angels can dance on the head of a pin and whether Pisces are more likely to marry Tauruses or Cancers, and all the other massive cognitive errors that way of thought creates, by valuing "explanations" over facts. The fact is that where vaccines go, deaths go down, and no amount of arguing to the contrary matters. This is exactly why science is so important, because it's one of the few ways known to prevent the error you're stuck in.

You're the one offering up psuedoscientific approaches and freely conflating ideology with the simple matter of how science determines the most likely outcomes for things. It is certainly a common delusion that science is about why, but the why comes later; once you establish that vaccines prevent disease, the next study hypothesizes a reason and tests that hypothesis, but no amount of fancy hypotheses will change the previous results.

You don't see science because you can't recognize it, not because it doesn't exist. You're asking for the ounce of proof and noticing the metric tons I'm handing you in the form of every living person who would be dead without them, in the millions. You may very well be one of them, even if you weren't vaccinated. Mercifully, we'll never have to find out.

(I actually freely admit the fact that vaccines are incredibly powerful and effective does not immediately prove compulsory vaccination is moral or correct, but I'm not addressing that, by choice. Science first, moral reactions to scientific results second. Neither step can be skipped but they should never be done out of order.)

MMR doesn't cause autism, as was fairly obvious at the time and the now-settled science shows. Do you accept that, in this case, it is not true to say "those who are wary of vaccines are pretty well aware of the state of the science on the issue," and in fact those people were flat out wrong?

> their own health care choices,

We are talking about childhood vaccinations. I agree these are difficult moral and political issues, but you can't just quote the founding fathers and act like you've proved your point. Children do not make their own healthcare choices, their parents do, and society is more than happy to restrict the choices of both parents and children.

> politically correct

This is ridiculous dog-whistle. Please taboo it and use a phrase that describes what you mean in each case. It like "health and safety", to which I say: Do you object to having people not die in factory accidents or is it that you want the privilege of drinking polluted water?

Only in the realm of politicians and ideologues is the term "settled science" used.

Since your opening position-- and that of the mandatory vaccination ideology-- is to reject science and claim that you don't have to be accountable under it because you claim your opponents reject science-- you have already lost.

Of course every tyrant used such "rationalizations"--every governing institution in the history of man explicitly initiates force and infringes upon individual freedom in favor of the common good, and we have things like taxes, freeways, and food inspections to show for it. The kind of libertarian objection you mention isn't just an objection to especially oppressive government--it's an objection against all government.

This isn't a straw man attack, either. If you don't allow for some amount of initiative force for the common good, you don't allow for any system of government which has ever existed, including the US Constitution. Consistent libertarianism leads to anarchism. And that's why the force card isn't effective: it's the logical equivalent of saying "the government shouldn't mandate vaccination, because the government shouldn't exist".

The only two logical options are to be an anarchist, or to concede that some violence for the common good is justified--and then go on to discuss why this instance does or does not justify institutional state violence.

---

On the other hand, negligently infecting other people with communicable diseases is a form of physical force, and hence there is a legitimate interest in preventing this from happening.

---

Finally, what you're discussing is ideology. Now, it's important to point something out. There is an important distinction between science and "ideology", or whatever you want to call about it, in that science is only concerned with matters of fact. Matters of value and morality are explicitly outside of science. The closest science can possibly come to ideology is when the facts would dictate any sane person to choose one option over the other. For instance, if scientists tell us they are 99.99% certain that an asteroid will collide into the Earth 20 years from now, and that in the event of a collision, it is 99.99% likely the human race will immediately go extinct, any sane person would conclude "we have to do something to stop that astroid". But science, qua science, can't come to that conclusion by itself. If you were some type of madman who wanted to destroy all human life on Earth, the science would be just as interesting and convincing to you as it would be to a sane person, you would just be led to a different reaction due to your value system.

Or, back to this point--if your value system favors children not dying preventable deaths from 19th century diseases, you probably favor vaccination. But if your value system favors not being forced to do things against your will over children not dying preventable deaths from 19th century diseases, that's entirely up to you--just as long as you accept the facts of the situation.

And, historically, this is what a lot of anti-vax people fail to do. People aren't rational enough to just say "I value not being forced to vaccinate my kids over my kids' lives" (which is a disgusting value system, but you can't argue against value systems), they'd rather lie about facts and say "vaccines cause autism, therefore it's in the best interests of my child not to vaccinate them".

Heck, sixty years ago, the majority did not believe that tobacco was a carcinogen. What 'settled science' is going to be overturned in the next sixty years?

I encourage everyone to read his book - it's fascinating, enlightening, entertaining and rage-inducing all at the same time.

The media-at-large needs more people like him.

http://timelines.tv/index.php?t=3&e=10

3. As long as a vaccine kills less children than the disease it prevents, it is already preferable to the disease, there is no need to even prove that vaccines kill absolutely no one. A one percent likelihood of death is obviously preferable to a ten percent likelihood of death. (Numbers for illustrative purposes only.) All the evidence we have tells us that vaccines are perfectly safe — but even if they weren’t, they don’t automatically become useless.

I don’t think anyone has anything against being worried. Being oblivious to evidence and spreading lies kills children, not being worried.

Oh, and in the case of, for example, smallpox the situation was actually binary. As late as 1959 two million people were dying from smallpox every year and millions more contracted the disease every year. There have been no deaths from smallpox since 1978, it has been completely eradicated.

The smallpox vaccine saves millions of lives every year.

The 10 percent in my completely hypothetical example were obviously already factoring in the chance of getting the disease in the first place, otherwise the comparison wouldn’t even begin to make sense.

Today one problem is obviously that herd immunity protects individual defectors. The chances of getting measles even without being vaccinated are relatively low when everyone around you is vaccinated. I would have less of a problem with people who freely admit that they don’t want to vaccinate because they are selfish gits. That’s not the argument they are making, though (it also wouldn’t scale), they think that no one should vaccinate and if that were the case massively more people would die from measles and other preventable diseases. (We have already seen that herd immunity can be seriously compromised in places where many parents don’t vaccinate.)

No, the burden of proof modern medical science is built on is that the benefits of a procedure or treatment outweigh the risks of the treatment.

There is never a guarantee that _any_ medical treatment will not kill you. Acetaminophen (Tylenol) while great at reducing fever and treating pain is one of the most toxic drugs that can be taken in an overdose. Same thing can be said for aspirin. But, the benefits of taking acetaminophen or aspirin in the proper doses, outweigh the small potential risk that you may be allergic to the medicines.

That's a poor argument. I was once a proponent of further study based on Dr. Wakefield's "connection". Turns out his findings were absolutely bogus. And yet, it continues to impose unnecessary fear, and at times - death.

The burden of proof is far-stretching in this matter. For example, any one could supposedly find anything and then progress needs to stop to prove otherwise.

If an issue with a vaccine were to come to light, the solution is to make the vaccine better - not eliminate it.

It reminds me of Aspartame, probably the most studied food additive in the world, yet it still suffers propaganda from armchair MDs claiming carcinogenic, cancerous connections. Some of the connections being made aren't even scientific, just anecdotal hearsay. It's really disappointing to see people pushing fear instead of progress.

(Genuine query )Should he still be addressed as Dr.?

Of course, with Wakefield it's difficult to still muster such respect.

Probably for the same reason Saddam didn't get a real trial. In addition to having dozens of high-profile collaborators, including the heads of several medical schools, the kinds of practices he engaged in aren't even that unusual for medical studies. Even if Wakefield could be convicted of criminal wrongdoing, which may well be possible, there is no one in pharma or the medical world who benefits from a highly-publicized show trial.

What's actually more interesting that the Bill Gates thing is the fact that Salon.com just retracted their 2005 RFK, Jr. article because it was apparently finally debunked in Seth Mnookin's new book:

http://www.amazon.com/Panic-Virus-Story-Medicine-Science/dp/...

Smallpox - eradicated from the face of the earth (barring lab samples).

Polio - only 50 years ago, there were tens of thousands of cases in the U.S. Ten years later, after a serious vaccination push, it was down to a bit over a hundred cases. 1979 - last indigenous Polio transmission in the U.S. (globally, it just won't die, in large part thanks to the efforts of religious fruit-loops convincing people it's a plot by the U.S. to sterilise them; we pushed it more or less down to a single country, and now heart-breakingly it's spreading from there again).

Whooping cough - beaten down from tens of thousands of deaths to dozens in the U.S., and then cases started rising again when people stopped having their children vaccinated at the start of the 21st century.

The list of diseases that no longer present a real daily threat to people goes on and on. Let's have someone big from the relevant government agency on the news telling people that they're killing children by dodging vaccinations.

Given that, I don't think it is that bizarre that people might have developed a general mistrust of these agencies.

Of course you're conveniently leaving out all of the people who have died from FDA wrongdoing, and government wrongdoing in general.

The fact is that around 1 in 3 Americans die from drug use or drug-related causes. When you put it that way it doesn't sound like the FDA is such a trustworthy agency, does it?

Likewise, opiates kill a lot of people. But how many people would forgo life-saving surgery because of the pain they would have to live with after the surgery if effective painkillers were illegal? My guess is a lot more than the number of people who are killed by opiates directly.

The duty of the FDA is to make sure that drugs are safe and effective. If they're overpermissive, more people will die of drugs themselves. If they're too restrictive, people won't get the medicine they need to stay alive. It's a tricky balance to strike, and I think the FDA is doing a reasonably good job.

Also, I'm fairly confident that drugs being illegal causes fewer people to die from drug use directly.[1] Drug illegality makes drugs more expensive, which makes it more difficult for the average junkie to obtain a lethal dose.

Another big issue is medical errors. This isn't a government problem so much as it's a problem with our health care system. I'm not really sure whether government-run healthcare would improve this (by removing the profit motive to see as many patients as possible) or make it worse, by creating the wrong incentives.

It's really easy to blame the government for everyone's problems, but government regulation often saves lives, even if it ends up indirectly killing some people. For example, if the FDA kills people by prohibiting a potentially life-saving drug for safety reasons, they look really bad. But you don't see the people whose lives were saved because they didn't take a drug that turned out to be severe latent carcinogens.

[1] Of course, drugs being illegal makes more people die from drug-related violence. Violence is probably a worse problem, even if it's less deadly than overdosing, because it can affect nonusers.

Cite, and cross-reference to deaths avoided/delayed by use of same drugs.

And are you really claiming that smoking cigarrettes is saving hundreds of thousands of American lives each year?

Thought by whom? There are plenty of chemical carcinogens in cigarettes that are undoubtedly playing a role.

I hang out there for reasons having nothing to do with being anti-vax and I was very slow to agree with the idea that vaccines are a problem. I did eventually stop getting my annual flu vax. The reason: Every single person or good source of info that was actually helping me get healthier when doctors said it couldn't be done had very strong negative views of vaccines. My decision had nothing whatsoever to do with reading any anti-vax studies or with any personal opinions regarding the FDA or other government agencies. I was getting real world results in terms of solving "unsolvable" health issues and this gave me faith (so to speak) in the opinions of people helping me achieve that.

Just out of interest (and without making any statement on what these problems are), would you agree that on a societal level (i.e. I'm not talking about individual unlucky cases where someone has a bad reaction to a vaccination, but in terms of wider society) the problems of not having vaccines (i.e. the problems that would exist had vaccines never been invented) outweigh the problems of having vaccines?

Ideally, I would prefer to make effective alternatives more widely adopted. But I am not happy with the general stance on both sides of this argument that it needs to be an all or nothing approach. The anti-vax crowd wants them outlawed. The pro-vax crowd wants them mandated for everyone. I think both positions are insane.

I guess that's a form of saying "yes, I agree" but I'm not really comfortable with your framing of it.

I wasn't aware that there were any serious effective alternatives to vaccination (besides living in a sterile bubble) and I just did a quick search. Obviously it has been only the most superficial look, but I'm seeing things like homeopathy and acupuncture recommended (as well as changes in diet, which I think is very optimistic indeed when confronted with the horrors of Polio), and at risk of offending, I'm still not convinced there are any effective alternatives. Of course, it was only a brief search, so I'm by no means stating that there aren't any; just that they're not in the top of the google list :)

However, this is at risk of turning into an off-topic digression and, even worse, one of those vaccer vs. anti-vaccer flame wars.

Back on topic, go go Bill Gates. If he decides to spend his fortune killing a disease, I for one will consider the years of putting up with MS Windows an extremely good deal.

I bet I wasn't careful enough and I've sparked a war now. :(

No. HN has a long history of being pro-evidence. (As opposed to being pro-vaccine). If you give us strong, irrefutable evidence that vaccines cause harm, and you give us an alternative that is - again - proven to be comparable, there is a high probability that we would all turn on a dime.

That's completely the opposite of a vaccine. Antibiotics are heavy-handed cures that quickly make a problem go away while potentially causing more problems for you and everyone else down the line. Fighting infections without antibiotics is backed by sound science.

In my experience, lots of infections are very effectively treated with herbs, dietary changes, and so forth -- more effectively than with anti-biotics and similar.

Prevention through cultural practices. Older societies frequently have practices like taking your shoes off at the front door and bowing instead of shaking hands. These are generally societies that have had to deal with relatively dense city populations for much longer than most cultures where an epidemic was a serious threat.

In my experience, diet and lifestyle go a long way towards providing protection from disease. As I understand it, study after study after study (for heart disease, cancer, etc) agrees with this conclusion.

This all being the case, we have with scientific methods in order to overcome these annoying biases. None of which are perfect, of course, but they are vastly preferable to, "trust me! it seemed to work for me!"

All of which is to say: show me the evidence. "I got better!" is not convincing.

Cultural practices: Which cultures? When? Was there any evidence that certain diseases were present but did not spread as quickly as in other societies?

Also: let's not move the goalposts. You're absolutely correct that diet and lifestyle have an effect on heart disease risk, and to a lesser extent on cancer (besides the obvious, like smoking), but those are not infectious diseases. And I'm sure there's a protective effect to diet and lifestyle on the capacity of the immune system, but is it anywhere near as effective as vaccination?

Dude, I love to hear other people's subjective experiences. It's data of unknown dimensionality, the most challenging sort, and good input for the synthetic mill. I assign assertions a rough weighting along various axes, and then build out multiple overlapping, often contradictory models of reality. There are branches, revisions, mergers, etc. It's awesome.

Anecdotal data is among the most interesting data to deal with, because the weighting is quite challenging, and because despite all the noise and static, it is here that I most frequently discover something new and revelatory.

Cultural practices:

In Africa, for I believe ebola (see the book "The Hot Zone"), tribal elders barricaded the roads into and out of the area, told their people "do not go to the white man's hospital (because you would go with a broken leg and die of infection) and quarantined sick people to their huts. They would leave food outside the door. If the food stayed there too many days, they burned the hut to the ground without going in to check if anyone was still alive. This finally contained the problem when modern/western/conventional medicine was failing to do so.

Historically in the US, it was common practice to contain the spread of venereal disease by getting the names of all your prior sexual contacts and contacting them to make sure they got treatment if necessary. This went out of fashion with the advent of AIDS, probably because it was in America primarily a disease of gays and IV drug users who had good reason to not want to give up those names. My understanding is this is part of what fueled the search for a vaccine for AIDS.

During the plague in Europe, flea markets were born of a desire to keep traveling sales people and their fleas out of the city to try to prevent the spread of the plague. Farmers would leave their goods by the side of the road and leave a dish filled with vinegar. Buyers would take food and leave coins in the vinegar, to try to kill the infection so the farmers wouldn't catch it.

Cooking is so widespread it is not really viewed as specifically intended to prevent the spread of disease. But undercooked or raw meat is well known to spread infection. Similarly, monogamy is a very widespread cultural value, in part because it helps reduce the spread of disease.

The name "malaria" basically means "bad air". They did not know what caused it but did understand that you got it from visiting the swamps. One practice was to live in the mountains to try to not be exposed to "bad air". Since mosquitoes don't typically go up to higher altitudes, this was somewhat effective in protecting people.

A "gin and tonic" was developed as a means to protect against malaria. Europeans who were living in Africa would drink a gin and tonic nightly in hopes of killing the infection before it was too developed to effectively treat. Similarly, in Europe during the middle ages, it was standard practice to drink alcohol with dinner instead of water because the well water was usually not safe to drink. It was too filled with bacteria.

There are many ways in which cultures prevent the spread of disease using cultural or lifestyle practices in place of drugs and vaccines. Diseases like AIDS have proven so far to be much harder to treat than to avoid getting by just not engaging in certain practices.

As for goalposts, sorry, but my mental model is different from yours. For example, I believe cancer is most likely viral and is thus infectious, though it doesn't spread rapidly like a cold. Human papilloma virus is known to cause cervical cancer and this is why women get annual pap smears -- to test for it. Women who have had more than X number of partners (IIRC, 20 partners) are at increased risk of getting cervical cancer because it is caused by a virus which is hard to catch but is apparently sexually transmissible. Warts and cold sores are also caused by virii and cause "growths" on the body, similar to the way cancer causes tumors. Mulloskum (sp?) is a viral infection which causes growths on the skin similar to skin tags. These growths are described in the literature as "benign tumors".

Diet, certain herbs and supplements, and an eye towards body chemistry can prevent viral infection and/or effectively treat it, something modern medicine generally does a poor job of. So, yes, I believe these things can be not only as effective but more effective than vaccines, antibiotics and other modern drugs.

Ebola outbreaks are very containable by Western medicine - the patients go into a quarantine ward, everyone observes fluid precautions religiously. It's never really made it out of Africa. In addition, traditional funeral rites in many areas exacerbated outbreaks, as they involved touching the dead.

Notification of partners is great for sexually transmitted diseases that are curable, but AIDS wasn't (and still technically isn't, even if sufferers can live long lives with current medical technology).

The plague killed somewhere between one and two thirds of Europe's population, so bringing it up as an example of successful cultural practices is rather baffling. Bubonic plague is entirely treatable by modern medicine, too.

Modern medicine fully endorses cooking food.

Malaria has been eradicated in the developed world by modern medicine, and modern technology has additionally made water safe to drink without needing to add ethanol to it.

> Diet, certain herbs and supplements, and an eye towards body chemistry can prevent viral infection and/or effectively treat it, something modern medicine generally does a poor job of.

Vaccination has done a great job of eradicating polio, smallpox, measles, and others. I eagerly await a list of diseases eradicated from the world via diet, herbs, and body chemistry.

And why deliberately make your kids sick, when you could just get them vaccinated, with far lower risk of death and injury? http://www.immunizationinfo.org/science/decline-chickenpox-d...

I stopped getting annual flu vaccines as an adult. Frequent vaccines are very common for people with cystic fibrosis (which is what I have). People with CF get sicker and sicker until they die. It is a slow, torturous gruesome thing. For me, it became apparent that drugs and vaccines were causing me harm and contributing to my decline. I worked hard to get off the drugs and I stopped getting vaccines. I am drug free. The hole in my lung has closed. I am getting my life back. Doctors told me "People like you don't get well. Symptom management is the name of the game."

For me, there came a point where I had a clear choice between the certain path of doom and the risky path of maybe getting better. I was so miserable, death would have been a welcome alternative to the future ahead of me. I felt it was win/win: Either do something really stupid and die quickly or gradually get better. Both options held more appeal for me than what doctors and all the world were promising me.

I can't recall the last time I had a cold. And I routinely nip infection in the bud when exposed to a sick person at work, without having to rely on antibiotics and other conventional drugs. So while I understand your skepticism and don't really expect to win you over, I'm not going to be won over by your view either.

Hardly. Many vaccines are made up of dead virus particles. A dead virus cannot cause disease. It causes an immune response, but immune responses are not diseases.

Tree pollen triggers an immune response in me, but that doesn't mean I'm getting a disease every spring.

Because even though you aren't symptomatic from the flu due to a strong immune system, you are still likely a carrier.

Peace.

Peace and best wishes.

That sounds like your case, but bear in mind that you'll be relying on herd immunity, so you should be encouraging people to get vaccinated. If your health is that bad, I doubt you'll be very happy if you do catch something like chickenpox or whooping cough.

Sorry, maybe I'm missing something here, but what's the precise difference between that and vaccination?

http://www.cdc.gov/vaccinesafety/Concerns/thimerosal/thimero...

> No, measles, mumps, and rubella (MMR) vaccines do not and never did contain thimerosal. Varicella (chickenpox), inactivated polio (IPV), and pneumococcal conjugate vaccines have also never contained thimerosal.

Additionally, you get more mercury from breathing in pollution from coal burning power plants than you ever will from vaccinations.

Up here in the northern EU, where there's really no discernible anti-vaccination movement, chicken pox isn't usually vaccinated against, since it's a very harmless disease when undergone at the correct age (2-13 or so?). The vaccination obviously exists, and I think it's sometimes recommended for people – particularly women – who have not had the pox in their childhood. I recall having intentionally been sent to play at a friend's house when he had it, and then ensuring my brother also contracted it. The idea isn't particularly revolutionary.

I'm not sure whether your cultural examples really derive from disease avoidance (for example, I don't wear shoes indoors because it's simply not necessary for foot protection), but I suppose they could be – at least in that societies with such customs could have been more likely to make it through epidemics.

I'd also worry about the youngish trend of ultrahygiene. Trying to disinfect everything and using antibiotics willy-nilly is counterproductive, especially for children who can't exercise their immunity by eating dirt every now and then. The best protection against disease is a good immune system.

I realize it's not. It's quite old fashioned. Just trying my best to answer the question someone asked me.

I'm about to get offline as I need my rest.

Later.

"And so the people who go and engage in those anti-vaccine efforts -- you know, they, they kill children." BillG certainly has. It's refreshing to see someone big just say it so clearly.

1) Proving yourself in a technical field gives me a better feeling about your perspicacity of another technical field (counter-example: Richard Feynman) than someone who hasn't. Mr. Gates has this background, Ms. McCarthy doesn't. Not a guarantee, but a first-order filter.

2) Your statement when you could just do your own review of the data negates your premise, unless you think parent is an MD.

3) Do you have any idea what Mr. Gates has been doing with his time and money since leaving Microsoft?

Doesn't that hold for every one of us as well?

Of course it holds, what point are you making?

If kids are less likely to die, then in theory, parents don't need to have as large a family in order to ensure that some survive.

I'm pretty sure that nowadays, counter to what might seem logical, there is a direct correlation between poverty and family size (ie: the poorer the culture, the more children they tend to have). I know I've read articles about India where this seems to be true, at least.

Eventually, with growth, people find that it's not as much of a necessity to have as many children, so they produce less. http://www.doceo.co.uk/background/riesman.htm The key here is to get to the top of the 'S'-shaped curve, and the only way to do that is to first improve public health.

Perhaps the threat of the government somehow secretly administering mind control drugs or whatever into everyone's vaccines is a little less likely than dying of polio if we stopped taking vaccines.

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

I wouldn't argue the point that unethical practices have caused legitimacy problems, but one might think that could be offset by the list of horrible diseases that are today unknown, such as polio.

You can read that to mean that he wants to kill people off using vaccines, health care, and reproductive health services, I suppose. I would read it as meaning that he believes that if quality of life increases, making it less likely for an individual to die due to preventable disease or injury, people will have fewer children.

Wow - that was an incredibly dumb thing for him to say, given some of the third world's beliefs about vaccination.

Infant mortality and subsistence farming in the developing world is one of the big causes for it. Raise the quality of living, prevent babies from dying, and people suddenly don't need to have 20 kids to subsistence farm a plot of desert.

It's only counterintuitive if you don't examine it closely.