Tuesday, September 20, 2011

Booster shot

Steve recently wrote a very helpful post on mandatory vaccination and public policy.

On a lesser note, here are some of my scattered thoughts:
  • The flipside of herd immunity is if there are significantly more non-vaccinated and non-immunized individuals in society than there are immunized ones, then it could potentially pose a threat to society. If say only a very small percentage of people in a society were vaccinated against polio, then it's possible polio could re-emerge. It's possible people who otherwise would not have had polio could have polio and suffer from its adverse effects such as paralysis, physical deformities, etc. For example, Christopher Hitchens (of all people) writes in his book God Is Not Great about how polio has re-emerged in a certain heavily Muslim populated part of Nigeria because local Muslims issued a fatwah against polio vaccinations since they thought the polio vaccination involved some sort of American or Western conspiracy against them.

  • Herd immunity applies to diseases which can be transmitted from human to human. But it doesn't apply to diseases which are derived from the environment such as tetanus. Tetanus can be very deadly without vaccination. I think something like 25% of all non-immunized people who are infected with tetanus end up dying, although the percentage is higher in infants and the elderly. So in the case of a disease like tetanus, I don't see how some people can use the herd immunity argument that as long as most or a significant enough number of individuals in society are protected against a disease then they can skip vaccination since herd immunity wouldn't apply to such diseases.

  • Some secular libertarians might argue it's a woman's right to choose what to do with her body including aborting her baby. But I doubt conservative Christian libertarians would argue this. In fact, I would think some of them would support policies which would undermine the legality of abortion. And I think some would support making abortion illegal. At the same time, some of these conservative Christian libertarians might argue it's wrong and should be illegal to mandate vaccination of underaged children because no one else should impose on the parents' right to choose what they allow or disallow for their kids. Gov't policy-wise, this seems inconsistent to me, but it's possible I'm missing something.

  • Of course, none of this means we can't oppose a particular vaccination being mandated for this or that individual, by what method or route a vaccine is administered, etc. For example, my take is it would be a very good idea to mandate vaccination against polio in most people given how lethal and devastating polio can be and how quickly it can spread in a non-immunized community, whereas I'd be fine if no one mandates vaccination against influenza each season (which, well, no one does as far as I know).

  • Or for diseases like the chickenpox I suppose someone could arguably debate whether vaccination is better or worse than actual exposure to chickenpox, at least as a young child. I'd personally be in favor of vaccination, but I know people from places like Asia who never were vaccinated but did get the chickenpox and became immune as a result. They seem perfectly fine and healthy. Then again, I think they may have a higher chance of developing a slightly more serious disease like shingles later on.

  • As an interesting historical aside, the first vaccine against the very serious and deadly smallpox was derived from cowpox. Cowpox is much, much milder. People recover from it quite well. But cowpox is very similar to smallpox such that if someone gets cowpox, then he or she will be immune to smallpox. That's the connection that an English doctor named Edward Jenner made in the late 1700s or so. So Jenner made the first vaccine against smallpox by using cowpox. I believe that's also where the word "vaccine" comes from (vacca = cow). Jenner is considered the modern father of immunology.

  • There are also different types of vaccinations with varying degrees of risk (e.g. inactivated, attenuated, and sub-unit each carry their different benefits and risks for different individuals). We'd have to look at each one on a case by case basis, based on the individual's health, circumstances, etc., I think, to best determine whether or not to vaccinate against this or that disease.

  • However some people simply can't be vaccinated. Or at least not during certain times in their lives. Like maybe they're immunocompromised, too young, too elderly, pregnant, on other therapies like chemotherapy which weaken or suppress their immune system, etc. Some people have to live as bubble boys their whole lives.

  • One potentially positive about HPV vaccination is that it might offer cross-protection against other HPV types not in the vaccine, according to this article.

  • Here are a couple of articles on the HPV vaccine. The first article supports the vaccine and has some possibly useful stats. The second article is more skeptical.

3 comments:

  1. Some secular libertarians might argue it's a woman's right to choose what to do with her body including aborting her baby. But I doubt conservative Christian libertarians would argue this. In fact, I would think some of them would support policies which would undermine the legality of abortion. And I think some would support making abortion illegal. At the same time, some of these conservative Christian libertarians might argue it's wrong and should be illegal to mandate vaccination of underaged children because no one else should impose on the parents' right to choose what they allow or disallow for their kids. Gov't policy-wise, this seems inconsistent to me, but it's possible I'm missing something.

    There is a huge moral difference between the outright murder of a child and preventing the administration of a vaccine that protects a child from a life-threatening disease that he may or may not be exposed to.

    Pro-life libertarians would argue that abortion is one of the rare cases in which government intervention is appropriate since child murder is directly antithetical to the libertarian credo of life, liberty, and property (in that order). I don't see how government-enforced vaccination is remotely analogous.

    Vaccinations are better understood in terms of risk management, weighing the relative risks of vaccination (possible adverse reaction) with the risks of non-vaccination (possible exposure to debilitating or deadly diseases later in life).

    Parents are best equipped to make these decisions for their children, not unaccountable bureaucrats or politicians who get their palms greased by pharmaceutical manufacturers.

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  2. Elected officials are not "unaccountable." They are answerable to the voters. They can be voted out of office, or even recalled.

    Conversely, there are conscientious parents and negligent parents.

    We can still debate the pros and cons of mandatory vaccination, but let's avoid sweeping overstatements.

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  3. UNCLE DICK SAID:

    "Vaccinations are better understood in terms of risk management, weighing the relative risks of vaccination (possible adverse reaction) with the risks of non-vaccination (possible exposure to debilitating or deadly diseases later in life). Parents are best equipped to make these decisions for their children, not unaccountable bureaucrats or politicians who get their palms greased by pharmaceutical manufacturers."

    Risk management operates at a corporate level as well as an individual level. Not just the risk to an individual child, but the risk of infection for other children who come into contact with one each. Your position is unresponsive to the issue of contagious disease and epidemics.

    The decision one set of parents makes for their children can impact the children of other parents. Their parental decision can co-opt someone else's parental decision.

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