Ethics of Vaccinations

[earljail]

So, there's a new mumps outbreak which started in my town.

Link (http://www.cbc.ca/canada/british-columbia/story/2008/08/26/bc-mumps-outbreak-spread.html), another link (http://www.canada.com/victoriatimescolonist/news/story.html?id=e2ce21f3-78a4-4aa2-961a-685d3597f44a).

Well over a hundred cases were found in an unidentified religious community after a member travelled to Alberta.

Two people from Alberta carried the mumps to a religious community near Agassiz that has a low rate of vaccinations, said Dr. Elizabeth Brodkin of the Fraser Health Authority.

"My understanding is their interpretation of scripture is that to immunize would be to show a lack of faith in God's ability to protect them, and therefore they choose not to do that," said Brodkin.

(I'm trying to think of what religious community it could be, but can't figure it out)

Obviously, most of us laugh at the idea of not vaccinating for religious reasons.

My question is this: Should vaccination be forced, since a parent's decision to not allow their kids to get vaccinated affects other kids?

The problem with a large quanity of unvaccinated population is that an outbreak is much more easily spread. (Remember, no vaccine is 100% effective) Also, some people are unable to be vaccinated due to medical issues. They rely on something called Herd_immunity.

[sparklecat]

Oh, now that's just not necessary.





We can just segregate the ones unvaccinated for non-medical reasons. Then they get to stand by their beliefs without endangering others. Separate classes, doctor's waiting areas, playgroups, etc. for this group of children.

[His Noodly Appendage]

Gah.

The number of people that choose not to vaccinate in this country is fucking terrifying - and they have the gall to call it 'discrimination' when people don't want them in their preschool/etc.

No, you morons. Discrimination is a problem when it's about what you are. Discriminating about things people do, especially when it puts others at risk, is called "sanity".

Fuck, they make me angry.

ETA:

Check it out (http://www.bubhub.com.au/community/forums/forumdisplay.php?f=180).

[Ray Moscow]

When I was young (standard old person's intro), we HAD to get vaccinated to attend school, for the good of the community.

What's wrong with that?

Parents in those days remembered polio and other bad stuff from their youth and were glad to get their kids vaccinated, anyway. The fear mongers have confused a lot of people nowadays, though. Bastards.

[ninewands]

My opinion on this subject is not so humble. The ONLY valid reason for rejecting vaccination is a medical reason involving a potentially life-threatening condition (e.g., a severe allegry to egg albumen). There is NO scientific evidence whatsoever of a link between vaccines and autism, and autism is not a life-threatening condition, anyway. Measles, mumps, diphtheria, smallpox, polio, etc., ARE life-threatening conditions. Religious objections to vaccination are just flat, fucking stupid.

Those who voluntarily choose to rely on herd immunity are self-centered "free riders" who deserve no place in civilized society. They are evil.

[earljail]

Those who voluntarily choose to rely on herd immunity are self-centered "free riders" who deserve no place in civilized society. They are evil.

Well, I think it's worse when you are voluntarily choosing children to rely on herd immunity than if you are volunteering yourself.

My parents didn't let me get a vaccination in Grade 6. I think it was either a Hepatitis B or C vaccination. Their rationale was that I could alway get it later if I chose to go into the health care field. (They are spread by blood contact)

Despite being religious, they didn't use that as an excuse. Looking back, I think it was a wrong decision. Sure, they hoped I wouldn't engage in unsafe conduct, but if it was free to receive, why not get it? Nobody can predict future actions. What if I tried saved the life of somebody dying on the street, or even a co-worker for that matter? I get canker sores, which would increase the liklihood of transmission if I had to give CPR.

I wonder if they would have been against the HPV vaccine. HPV is a primarily sexually transmitted disease. Yet even avoiding sexual contact doesn't always protect: that ignores the possibility of rape.

[Ray Moscow]

I wonder if they would have been against the HPV vaccine. HPV is a primarily sexually transmitted disease. Yet even avoiding sexual contact doesn't always protect: that ignores the possibility of rape.

And dating

[dug_down_deep]

A dart gun should be used to vaccinate 'em at a distance.

[Matty]

heh. thats a good idea. If we combine the segregation into a specific no herd immunity towns, fenced and that idea you could sell hunting/drive by holidays to rednecks and save a couple rare species at the same time.

I'd pay to go on a nicely alliterative Humane Hippy Hunting Holiday, who wouldnt? Uou could lay out bait of tofu or carrots, and leave trails of patchouli Shit you could even set up camp in th towen library which will surely be uninghabited.


Honesty i think the kids should not be allowed at school, daycare, camp, any other group place where the decision of their fucking moronic parents can rebound on anyone other than their unfortunate spawn. I'd maybe let them go to church but thats not for exactly humane reasons, more the same reasons i'm all for these kooky churches that pass around rattlesnakes as a sign of faith.


REally though. I AM all for the kids to be vaccinated anyway, the same as i am all for JW kids' lives being saved and fuck their parents opinions. I'd take it a bit further, their parents should be charged with willful negligence or some sort of abuse. If you denied the kid food you would, how about denying them an immune system, isnt that as bad?

[His Noodly Appendage]

Oh, it gets better.

I've heard people boasting that they weren't compromising their child's immune system by subjecting it to these unnatural stresses. It's the reason so many people get sick, y'see...

Gragh. Must... kill...

[earljail]

REally though. I AM all for the kids to be vaccinated anyway, the same as i am all for JW kids' lives being saved and fuck their parents opinions.

Yeah. I think the forced vaccination thing is debatable, but preventing a proper medical procedure for a life threatening issue is not.

[dancer_rnb]

Those who voluntarily choose to rely on herd immunity are self-centered "free riders" who deserve no place in civilized society. They are evil.

Well, I think it's worse when you are voluntarily choosing children to rely on herd immunity than if you are volunteering yourself.

My parents didn't let me get a vaccination in Grade 6. I think it was either a Hepatitis B or C vaccination. Their rationale was that I could alway get it later if I chose to go into the health care field. (They are spread by blood contact)

Despite being religious, they didn't use that as an excuse. Looking back, I think it was a wrong decision. Sure, they hoped I wouldn't engage in unsafe conduct, but if it was free to receive, why not get it? Nobody can predict future actions. What if I tried saved the life of somebody dying on the street, or even a co-worker for that matter? I get canker sores, which would increase the liklihood of transmission if I had to give CPR.

I wonder if they would have been against the HPV vaccine. HPV is a primarily sexually transmitted disease. Yet even avoiding sexual contact doesn't always protect: that ignores the possibility of rape.

Hepatitis isn't limited to sexual transmission. I know one woman who passed Hepatitis on to her son, and he almost died of it.

[Laton]

Oh, it gets better.

I've heard people boasting that they weren't compromising their child's immune system by subjecting it to these unnatural stresses. It's the reason so many people get sick, y'see...

Gragh. Must... kill...


Pisses me of no-end this kind of thing.

This idea that parents have that "I know whats best for my child" is getting out of hand. If that's so why do they even bother going to a doctor when the kid gets sick?

[Obd]

"My understanding is their interpretation of scripture is that to immunize would be to show a lack of faith in God's ability to protect them, and therefore they choose not to do that," said Brodkin.

I fail to see how disease are any different from all kinds of other statistical health risks. Do they cross a highway because they have faith that God will protect them? Do they build houses in places known for risk of being struck by natural disaster, because they have faith that God will protect them?

[Monad]

"My understanding is their interpretation of scripture is that to immunize would be to show a lack of faith in God's ability to protect them, and therefore they choose not to do that," said Brodkin.

I fail to see how disease are any different from all kinds of other statistical health risks. Do they cross a highway because they have faith that God will protect them? Do they build houses in places known for risk of being struck by natural disaster, because they have faith that God will protect them?

imho they are showing a lack of faith in god by eating

[Codec]

I just wanted to chuck a little theory in this thread - as I think its interesting, I'm doing a course on infectious diseases, and it helps my revision to see if I can explain it!

Each infectious disease has a particular metric associated with it, called R0 (http://en.wikipedia.org/wiki/Basic_reproduction_number), which says on average how many other people you are likely to infect. In the case of mumps, it has been worked out to be between 4 to 7. So that means that someone with mumps is likely to infect from 4 to 7 other people during the course of the disease (assuming everyone is susceptible). Other diseases, measles for instance, are much better at spreading and so have much higher R0. Any disease with an R0 that is more than 1 will spread through the community, if its less than 1 - it will die out.

However the interesting bit is that the more people who have had the disease, or are otherwise immune (vaccinated) will obviously decrease the effective R0 value. Now if enough people are immune to the disease this will eventually bring the value of R0 to less than 1, and at that point the disease will die out.

You can calculate this value, it is 1 - {1 \over R_0} and this value is called the critical immunisation threshold. If you can get to or exceed this value, then the disease will start to die out.

So for mumps it is between 75 and 86% - so if you get the population - termed the herd immunity level, to 86%, then mumps will die out.

Of course to really kill it off, you need to make sure that you don't get infection from other communities with herd immunity less than the critical level, or that it doesn't have a reservoir of infection (such as in other animals).

So this is why vaccination affects everyone. It has two effects, making you safe, and attempting to kill off the disease.

One other nasty thing - which is particularly bad with mumps is that if you are approaching the critical immunity level, what this does is bring down the value of R0, but still above 1 obviously. However the side effect of this is as there is less chance of catching the disease, this distorts the average age you get it. If a disease is very common (like chicken pox) you will be very likely to get it, and get it at an early age. As it becomes less common, you are less likely to get it - but if you do get it, on average it will be at an older age.

So in the case of mumps, if the level starts to dip below the critical level, it will mean that people tend to get it at an older level. Mumps is not too bad a disease at an early age, but has serious issues in males after puberty. So if it dips below the critical level, it will tend to target those people that it will have a large impact on generally. This is one of the unwitting side effects of immunisation - nearly getting to the critical level can be worse than missing it by a mile.

[His Noodly Appendage]

Over here, it's not the fundies that are the main non-vaccinators, it tends to be the 'natchral' crowd (not even hippies) that have seen too much Oprah/etc.

[Gagundathar Inexplicable]

When did vaccinations become optional dammit?
(I mean in the USA).
This is one of those VERY few occasions when I think federal intervention is required.
All it would take is for one of the classic childhood ailments (mumps for example) to become epidemic for attitudes to change, but by then we would have lots of suddenly sterile guys and a bunch of deaf folks (with mumps at least).

What is wrong with people? Have they no memories?

[Matty]

Over here, it's not the fundies that are the main non-vaccinators, it tends to be the 'natchral' crowd (not even hippies) that have seen too much Oprah/etc.

same in the UK. And as far as i know here in Canada too. More of the "doctors and scientists are evil and just want to sell drugs that dont work for a profit when if only they used natural herbs the world would be full of rainbows and puppies......." type of new age hippy type. .

Y'know, like magdlyn. :D

[jess]

<slaps Matty>

[Matty]

JOKE FFS. JOKE. :)

[trendkill]

I don't like the idea of forced anything, really, but I'm having a hard time coming up with a good reason to justify letting people refuse to get vaccinated unless there's a specific, legitimate medical reason why they can't.

[Teshi]

I don't think vaccinations should be enforced, but I don't think you should be able to enroll your kid in school, or daycare, or any sort of group program unless they're vaccinated for all the usuals.

[nygreenguy]

I don't think vaccinations should be enforced, but I don't think you should be able to enroll your kid in school, or daycare, or any sort of group program unless they're vaccinated for all the usuals.

Ok, but what about when they generally go out in public? They could be a walking epidemic.

[Teshi]

Ok, but what about when they generally go out in public? They could be a walking epidemic.

I think that most people, when given the choice between having to homeschool and otherwise isolate their child and sucking it up and risking the vaccination, will probably choose to vaccinate, despite their misgivings. The handful of nutballs who won't would probably do their best to ignore and evade mandatory vaccination laws anyway.

[trendkill]

Yeah, good point. Probably just making it mandatory for school, etc. is fine.

[sparklecat]

And yet there are cases of unvaccinated children being brought into doctor's offices and infecting other children, to the point that they are seriously ill/dying.

[dancer_rnb]

And yet there are cases of unvaccinated children being brought into doctor's offices and infecting other children, to the point that they are seriously ill/dying.

Do you have a link to proof of this?
It would be a pretty strong response to anti-vaccine advocates.

[sparklecat]

And yet there are cases of unvaccinated children being brought into doctor's offices and infecting other children, to the point that they are seriously ill/dying.

Do you have a link to proof of this?
It would be a pretty strong response to anti-vaccine advocates.

There is this (http://www.kinderaerzte-im-netz.de/bvkj/aktuelles1/show.php3?id=2836&nodeid=26) and this (http://www.kinderaerzte-im-netz.de/bvkj/aktuelles1/show.php3?id=1517&nodeid=26&nodeid=26&query=sspe) case; unfortunately, they're in german. We also have this (http://findarticles.com/p/articles/mi_m0689/is_4_57/ai_n25336792), also here (http://www.latimes.com/news/local/la-me-vaccine2-2008may02,0,6944471.story); however, all those infected in that case were unvaccinated. I'm working on finding other links to the two cases above, but not doing too well thus far.

[Teshi]

And yet there are cases of unvaccinated children being brought into doctor's offices and infecting other children, to the point that they are seriously ill/dying.

I don't want to sound heartless, but it strikes me as being so rare as not to warrant legislation.

[sparklecat]

And yet there are cases of unvaccinated children being brought into doctor's offices and infecting other children, to the point that they are seriously ill/dying.

I don't want to sound heartless, but it strikes me as being so rare as not to warrant legislation.
"The United States is on track to report its highest incidence of measles cases since 2001, exacerbated by a rise in outbreaks worldwide and by clusters of people who are opting out of the vaccine because of religious beliefs or fears of a purported link between the shot and autism, health officials said Thursday."


From the last of my links above. It also says that one in five cases of measles warrants hospitalization. It may currently be relatively rare, but if the tendency to not vaccinate were to increase...


I certainly intend, when I have children, to ask my pediatrician whether any of the families that come to them opt out of vaccinating and go somewhere else if they do.

[Teshi]

"The United States is on track to report its highest incidence of measles cases since 2001, exacerbated by a rise in outbreaks worldwide and by clusters of people who are opting out of the vaccine because of religious beliefs or fears of a purported link between the shot and autism, health officials said Thursday."

Sorry for the lack of clarity - I meant that it's extremely rare for someone who isn't one of the opt-outs to get sick as a result of the opt-outs. I may be wrong but I think the record high numbers are due to the opt-outs themselves falling ill.

And while that sucks for the children of the opt-outs, I can't think of a good way to enforce mandatory vaccinations that doesn't verge on a police state sort of situation.

[dancer_rnb]

"The United States is on track to report its highest incidence of measles cases since 2001, exacerbated by a rise in outbreaks worldwide and by clusters of people who are opting out of the vaccine because of religious beliefs or fears of a purported link between the shot and autism, health officials said Thursday."

Sorry for the lack of clarity - I meant that it's extremely rare for someone who isn't one of the opt-outs to get sick as a result of the opt-outs. I may be wrong but I think the record high numbers are due to the opt-outs themselves falling ill.

And while that sucks for the children of the opt-outs, I can't think of a good way to enforce mandatory vaccinations that doesn't verge on a police state sort of situation.

Little kids too young to be vaccinated would be vulnerable. They rely on not being exposed

[sparklecat]

Sorry for the lack of clarity - I meant that it's extremely rare for someone who isn't one of the opt-outs to get sick as a result of the opt-outs. I may be wrong but I think the record high numbers are due to the opt-outs themselves falling ill.

And while that sucks for the children of the opt-outs, I can't think of a good way to enforce mandatory vaccinations that doesn't verge on a police state sort of situation.

Little kids too young to be vaccinated would be vulnerable. They rely on not being exposed

As well as ones that can't be vaccinated for medical reasons. Apart from that, even the children that have been vaccinated aren't immune; vaccinations are better than nothing, certainly, but they're not perfect.

[Teshi]

Little kids too young to be vaccinated would be vulnerable. They rely on not being exposed

Again, though, how often does it really happen that kids under the age of vaccination, or people who can't be vaccinated, are infected? Even when they are, in a modern first-world population, the rate of death or serious lasting illness from most childhood diseases is quite low. I think in the case of measles it's less than one in a thousand. The reason we vaccinate against them is that they're so infectious that the sheer number of infections causes problems and increases the incidence of acute cases, and that for several of the diseases, they're a lot more dangerous to adults than to children.

I'm not saying that it's not a problem that needs addressing, but I suspect that any sort of active enforcement (as opposed to passive enforcement, like requiring vaccinations for school) would cause more problems than it solves.

[Daisy]

People who have compromised immune systems must opt out of vaccinations. These kids are at extra risk if they are exposed to diseases from infected kids whose parents are jerks.

[Loki]

Do you suppose part of the cause of this is that people have forgotten what a lot of these diseases are like/can do?

The cold-hearted bitch in me thinks natural selection should be allowed to take its course if these non-vaccination kids contract those diseases they should've been vaccinated against, much in the same way creationists shouldn't be treated for drug-resistant bacterial infections.

Question: those who opt out of vaccines: do they opt out of tetanus shots, too?

[Teshi]

Do you suppose part of the cause of this is that people have forgotten what a lot of these diseases are like/can do?

The cold-hearted bitch in me thinks natural selection should be allowed to take its course if these non-vaccination kids contract those diseases they should've been vaccinated against, much in the same way creationists shouldn't be treated for drug-resistant bacterial infections.

Heh. I kinda thought something along those lines but didn't say it.

Question: those who opt out of vaccines: do they opt out of tetanus shots, too?

I believe it depends on why they're opting out. The ones who are opting out for allergic reasons probably don't have to, and I don't think tetanus shots are one of the things the woo-woo crowd believe causes autism, so those guys probably wouldn't.

[ninewands]

And while that sucks for the children of the opt-outs, I can't think of a good way to enforce mandatory vaccinations that doesn't verge on a police state sort of situation.
Simple, do like they did when I was in the first and second grade ... those whose school records DON'T show that they have already been vaccinated get lined up and given the shot at school on the school district's nickel. The only ones excused had to have a doctor's certification that they were allergic to some component of the vaccine in their school record.

Back then (late 1950's) the cost to the school district of a major outbreak during the school year was much higher than the cost of the few vaccinations they gave each year.

[ninewands]

People who have compromised immune systems must opt out of vaccinations. These kids are at extra risk if they are exposed to diseases from infected kids whose parents are jerks.
They only have to opt-out of live vaccines. Killed vaccines are not going to cause disease.