Advice to new parents


Vaccinate your kids.

Tara Smith is an expert in infectious diseases, and she also has a new baby (congratulations!) fussing up her house, so she knows what she’s talking about…and she explains why she vaccinated her kids. Just do it. It’s the only smart choice.

Comments

  1. says

    Yes. Please. Your child is not a special snowflake such that you can keep them from the (incredibly temporary) pain of an injection. They’ll get over it. What they won’t get over is the bad, potentially life-threatening side effects of diseases that used to kill children all over the world.

    NYC has a measles outbreak, that’s going to be likely an epidemic shortly, thanks to people not vaccinating.

  2. says

    If vaccinations cause problems in some children, how many is it? One in a million? One in a thousand? How many kids will get sick without vaccination? One in ten? Those were guesses off the top of my head before I looked it up.

    http://rationalwiki.org/wiki/Anti-vaccination_movement#Known_side_effects

    Children who get measles have a 1 in 20 chance of developing a serious complication; however, serious complications from the vaccine number 1 or 2 per million, according to the Institute for Vaccine Safety at Johns Hopkins University.

    Even if the deluded and ignorant anti-vaxxers were right, the number of kids they claim are affected by vaccinations is still smaller than the number affected by not being vaccinated. Their arguments are defeated by their own numbers.

    The only people more dangerous are the ones who deny the link between HIV and AIDS.

  3. Trebuchet says

    That’s an excellent article. The anti-vaxxers haven’t hit the comments yet (at least when I looked 1/2 hour ago) but I expect they will.

  4. says

    And not just your children: get YOURSELF vaccinated as well.

    Even if you got the usual childhood shots against measles, mumps, rubella, pertussis, et al., immunity fades over time unless you are repeatedly exposed. Because of vaccination programs, most people are not repeatedly exposed and need a booster shot. Do yourself, your partner, your co-workers, your children and your children’s families a huge favor and make sure you aren’t a vector for their illnesses.

  5. barbaz says

    I was once talking with other parents from our baby-group, and at some point the discussion arrived at vaccinations and its pros and cons, and I was ask if we were going to vaccinate our child. My answer was a very matter-of-fact “yes, of course”.

    And then … the other parents all stared at me in disbelief.

    They all decided to vaccinate their children, too, but apparently not even considering not doing it makes you a bad parent because you are mindlessly delivering your children to the dangers that vaccinations are … or something.

  6. says

    Two cases of measles in Ottawa at the moment, one brought back from a trip abroad, then passed to a classmate. Both kids unvaccinated, of course.

  7. says

    I am firmly in favor of a legal requirement for vaccinations, barring an exemption for specified, valid medical reasons, issued by a qualified medical professional. This would, of course, also require that vaccinations be made available free of charge to the public, but as has been endlessly noted, we’d all be better off of all medical care was made available free of charge to the public.

  8. Trebuchet says

    And not just your children: get YOURSELF vaccinated as well.

    Worth repeating. A couple of years ago my doctor said “Looks like you’re due for a tetanus shot” and gave me one. I assumed it was TDAP. Later I checked and found out it wasn’t — just tetanus. We went and got the whole thing. Very important for adults to get pertussis to avoid passing it on to children too young to get vaccinated or have nutball parents.

  9. Trebuchet says

    I did, of course, mean it was important for adults to get pertussis SHOTS! Oh, for an edit function.

  10. Amphiox says

    I am firmly in favor of a legal requirement for vaccinations, barring an exemption for specified, valid medical reasons, issued by a qualified medical professional. This would, of course, also require that vaccinations be made available free of charge to the public, but as has been endlessly noted, we’d all be better off of all medical care was made available free of charge to the public.

    I would not. Beneficial or not, free or not, a vaccination is still a trespass on an individual’s bodily autonomy, and therefore should not be compelled without that individual’s consent.

    And even if one tried to make the case that the public health benefits are a good enough reason to abrogate the bodily autonomy of other human beings, I would not favor resorting to compulsion if a less coercive alternative were available and had the potential to be equally effective. At the very least I would not resort to coercion until such alternatives had already been tried. A properly effective public education campaign that can get enough people to agree to do it voluntarily to maintain herd immunity would suffice.

  11. says

    Bodily autonomy does not include the right to endanger those around you. It is unfortunate that in this instance not being a threat to everyone around you requires a small infringement of that right, but everyone else’s right to not die or be damaged for life by measles, polio, smallpox, etc. trumps it. Sorry. Even in place which have got quite good public health programs, including education, we are seeing these anti-vaxxers cropping up and causing disease outbreaks, which spread to other parts of the population. When large numbers of people persistently choose a course that is actively harmful to others, the only remaining course is to remove the harmful option.

  12. Amphiox says

    Bodily autonomy does not include the right to endanger those around you. It is unfortunate that in this instance not being a threat to everyone around you requires a small infringement of that right, but everyone else’s right to not die or be damaged for life by measles, polio, smallpox, etc. trumps it.

    This would be justifiable only if the risk of getting and transmitting measles, polio, smallpox, etc solely from being unvaccinnated is sufficiently high. You cannot just say “harm to others”, you have to quantify the harm and show that it outweighs the competing interest of preserving a citizen’s right to bodily autonomy. Because virtually everything a human being can choose to do or not do can potentially cause harm to others. When I drive my car, I am emitting CO2 and other gases that cause harm to others. Should I be prohibited from owning a car? If I eat a hamburger, it will cause me to produce waste that goes into the public water system that may be more harmful than if I had eaten a salad. Should I be forced to eat salad and not hamburger?

    In cases where that risk IS high enough, we already have regulations and laws that mandate vaccination. So healthcare workers have to be vaccinated before they can see patients. People travelling to high risk areas in many jurisdictions have to be vaccinated for the endemic diseases before they are allowed to travel. If there is an actual measles epidemic breaking out, then mandatory vaccination of the populace in the regions suspected to be at highest risk is done, and justifiable.

    But in the general population? The onus is on you who would propose the coercive regulation to show the numbers and demonstrate that it is worth it.

    Even in place which have got quite good public health programs, including education, we are seeing these anti-vaxxers cropping up and causing disease outbreaks, which spread to other parts of the population.

    This would be a valid argument only if the *only* option to the current status quo is compulsory, mandated, coerced vaccination. The onus is therefore on you to demonstrate with evidence that other alternatives, like a different kind or more effective method of a public education campaign either cannot be done, does not exist, or will not work.

    This I think is the general overarching principle of liberal humanist ethics. If you want to use the coercive powers of the state to limit the freedom and autonomy of the individual, you must have a good reason, and you must have hard evidence to back up your reason, evidence that shows that the benefit outweighs the harm, or is sufficiently high that the limitation in individual liberty it entails is worth it.

    And we must apply the same standard to things we personally approve of, like vaccination, as we do to things we don’t approve of, like restriction of abortion access.

  13. says

    Amphiox #17

    This would be justifiable only if the risk of getting and transmitting measles, polio, smallpox, etc solely from being unvaccinnated is sufficiently high.

    Do you understand the concept of public health? Do you have any fucking conception of what the rates of the diseases named and the dozens I didn’t were like before widespread vaccination? It’s not about you being a precious fucking snowflake and having infinite fucking choices, it’s about the systemic causes of disease and the things that we as a society can do to eliminate them. It’s right up there with stopping people shitting into the drinking water supply.

    When I drive my car, I am emitting CO2 and other gases that cause harm to others. Should I be prohibited from owning a car?

    Prohinbited? No. There is a public utility to the existence of motor vehicles that there is not to people refusing vaccination. Pay considerably more to do so than you do now? Yes, absolutely. As with the publically funded healthcare system I mention above which is a precursor to the requirement for vaccination, though, many of the measures which would reduce the number of private internal combustion vehicles call for commensurate improvements in public transit and a restructuring of zoning and built environment to allow for increased non-motorized travel.
    Just as a for instance, there should be quite large carbon taxes on petroleum purchases, on top of an increase in the road taxes sufficient to actually pay for the fiendishly inefficient infrastructure required to have nearly everyone driving everywhere. The monies raised would go into paying for the items I outline above.

    If I eat a hamburger, it will cause me to produce waste that goes into the public water system that may be more harmful than if I had eaten a salad.

    That’s just about the silliest conception of the harms involved there that I think I’ve ever seen. Pretty much all the public harm that the burger causes happened already, before you ever saw the thing: CO2 from shipping it to hell and gone, antibiotic resistant bacteria and feces floods from the CAFOs where the cattle were raised, soil loss, aquifer depletion and groundwater/river/oceanic pollution from the huge monocrop fields of corn and soy that feed them, etc. The sewer can handle just about any kind of human waste without trouble, and if they were even a little better designed they could do it a sight cheaper too.

    All of the harms I list above can and should be corrected, mostly by eliminating the assorted subsidies that enable those practices; a side effect would be a rise in the price of meat, and thus probably a reduction in overall consumption, but the public benefit of having drinking water and topsoil and so forth is a pretty big one, I think we can take a minor hit to our meat consumption.

    But in the general population? The onus is on you who would propose the coercive regulation to show the numbers and demonstrate that it is worth it.

    Have fun.

    If you want to use the coercive powers of the state to limit the freedom and autonomy of the individual, you must have a good reason, and you must have hard evidence to back up your reason, evidence that shows that the benefit outweighs the harm, or is sufficiently high that the limitation in individual liberty it entails is worth it.

    a) See the link above
    b) I’m so fucking sorry that you feel a tiny injection is such a massive fucking imposition on your precious fucking liberty that you’re willing to let people die for your precious fucking principles. Seriously, this is the kind of bullshit I expect from libertarians.

    And we must apply the same standard to things we personally approve of, like vaccination, as we do to things we don’t approve of, like restriction of abortion access.

    I am. No person besides the one getting an abortion can even hypothetically be harmed by the process. It is a clear cut case of a decision where a specific individual’s bodily autonomy is the only consideration, as we have established at extraordinary length in no less than four threads in the past week, all of which you have participated extensively in. Seriously, what the hell? This kind of cheap shit is beneath you.

  14. says

    I know I should be focused on the HUGE IMPORTANCE OF VACCINATING YOUR KIDS, but damn, that little William is a cutie.

    Anyway.

    I am not fully vaccinated due to a really bad reaction to the pertussis vaccine, so it is especially important to me that 1) DarkToddler is up to date on her vaccines and 2) my family is up to date on their boosters. Except for my Dad (who’s shown himself to be an asshole, anyway), everyone’s been really good about getting their shots.

    (DarkToddler’s docs won’t see patients if their parents refuse to vaccinate. Of ourse, they also make it super easy to get shots– you don’t need to ever make an appointment to get your kids up-to-date.)

    Honestly, I’m angry enough about the anti-vax movement that I’m down with sending CPS after parents who refuse to vaccinate their kids without a valid medical reason (auto-immune disorder, reaction to previous vaccinations, etc).

  15. peptron says

    I have a compromise for Amphiox. Basically, I’d just follow the general rules that already exists in cases where you willfully become a public danger: you are responsible for the harm done. Essencially, you’d be free to not get vaccinated, but if you can be traced back as the cause for a child’s deformities from polio (to take a quite extreme, but entirely possible scenario), you’d be responsible for the treatment.

  16. kreativekaos says

    It’s interesting: the anti-vax sentiment isn’t that recent.

    I remember a married couple of a friend of mine from 35 years ago (a good group of very progressive/highly liberal people), who had a child that they refused to vaccinate, mainly out of mistrust of medicine and government, if memory serves. I remember feeling incredulous about their attitude on vaccination at the time, given the fact that the science and medicine underlying vaccines had so solid a foundation.

  17. Amphiox says

    Do you understand the concept of public health?

    I am a fucking neurosurgeon, Dalillama. Rest assured that I have given this concept a LOT of thought. I live it in my daily work every fucking day. The concepts of informed consent for medical interventions that trespass on people’s bodily autonomy is essentially my entire professional life. So knock it off with the condescension.

  18. Amphiox says

    We had established in the abortion threads that one cannot violate another human being’s bodily autonomy against his or her will EVEN TO SAVE A THIRD PARTY’S LIFE. Not just to mitigate against a risk of harm, but to FLAT OUT SAVE THEIR LIFE. Not even something as minor as a forced blood or bone marrow donation.

    A vaccine shot is still a foreign object inserted into your body against your will. A vaccine pill is a foreign substance you are forced to ingest against your will.

    Who the hell do you think you are, Dalillama, to determine for OTHER PEOPLE what they see has a significant or non-significant, a “big” or a “little” violation of their bodily autonomy? YOU may not think vaccination is a “large” violation of bodily integrity, I may not think so, but some people DO. Who do you think you are to impose on OTHER PEOPLE your own personal values with respect to what is and is not important with regards to what they do to their own bodies?

  19. Amphiox says

    Essencially, you’d be free to not get vaccinated, but if you can be traced back as the cause for a child’s deformities from polio (to take a quite extreme, but entirely possible scenario), you’d be responsible for the treatment.

    Understand that for this to actually be possible, for this to actually happen, except in extremely unusual and very fortuitous circumstances, where the chain of evidence is preserved to a degree several orders of magnitude better than is the usual case, is virtually impossible in real life.

    In those rare cases where that IS possible, current law already allows for civil suits to that effect.

  20. anuran says

    fish gotta swim; birds gotta fly

    And surgeons don’t think they’re God because it would be a demotion.

  21. neuralobserver says

    Amphiox@22:

    Though I do accept the necessity of vaccination for the widest population possible, I have to admit, nice job presenting the other side of the issue; a professionally informed (if you truly are a neurosurgeon…. how do we know?) and thoughtful response to the compulsory vaccination crowd,i.e., the peanut gallery–thumbs up.

    And as for…

    fish gotta swim; birds gotta fly

    …..well I guess idiots have to be idiots.

  22. Doug Hudson says

    Remember folks, only Sith deal in absolutes! (said the Jedi, apparently unaware of the irony.)

  23. barbaz says

    Amphiox 23:

    There’s a difference between not saving someone’s live and being a danger to everyone around you. In the latter case it is widely accepted that a restriction of rights can be appropriate.

  24. says

    Amphiox
    How many dead of measles because some dumbfuck didn’t vaccinate themselves/their kids is acceptable to you? How many cases of paralytic polio? How many broken ribs from pertussis? My answer is none. What’s yours? What’s the threshold? How many have to die or be crippled or injured before it’s enough for you?

  25. Azkyroth Drinked the Grammar Too :) says

    I think there’s a rough validity to the idea that forcing people to get vaccinated is a violation of their bodily autonomy.

    There’s also a strong precedent for the moral acceptability, even moral duty, of separating people who refuse to stop behaving in ways that endanger others from the rest of society to prevent them from doing so, until such time as they give reasonable evidence that they are willing and able to stop.

    So, strapping a struggling anti-vax kook down and injecting them against their will? Yeah, I buy that as an ethical violation.

    Barring them from a broad range of, or even any and all, public spaces, and cultivating an ethic of “don’t let these dangerous freaks around your kids in private?” Not at all.

  26. Amphiox says

    How many dead of measles because some dumbfuck didn’t vaccinate themselves/their kids is acceptable to you? How many cases of paralytic polio? How many broken ribs from pertussis? My answer is none.

    That is the wrong question.

    The right question that must be asked is how many MORE people would not die if compulsory vaccination were instituted compared to 1) the current status quo using the existing programs of public health education to obtain strongly encouraged voluntary vaccination, plus mandatory vaccination for specific targeted subgroups based on a carefully calculation of need and risk, and 2) an alternative policy of an improved public health education (plus judicious application of less coercively invasive techniques as needed, such as quarantine and so forth)?

    You will not get “none” in respect to deaths even with a compulsory vaccination program. In fact I present to you the null hypothesis that you will get NO improvement because you will not be able to logistically enforce your compulsory vaccination program. The rabid antivaxxers will simply do anything they can to not comply with your law. And some if not most physicians will refuse to comply with your law as well, since forcing our patients to accept a medical intervention against their will is a direct violation of our professional oaths. What will you do? Send the police after these people? Forcibly strap them down to gurney’s and inject them? Enough of these people will slip through your nets such that the TOTAL increase in the immunized population of your compulsory vaccination program will produce will be a minuscule value so small that it will NOT actually improve the degree of herd immunity to any measurable extent compared to the current status quo of strongly encouraged voluntary vaccination. You could turn your nation into a vaccination police state and NOT ONE SINGLE additional “innocent” (in this case “innocent” would mean non-anti-vaxxer) life will be saved. (If an anti-vaxxer gets a vaccination preventable disease and dies himself, that is his right).

    That is the null hypothesis.

    You who propose compulsory vaccination have the onus of disproving the null hypothesis. YOU have to present the hard numbers and show us just how many additional lives you think your compulsory vaccination program will save.

    In this scenario, Nerd’s standard reply to creationists is actually apropos.

    Show us the evidence. Show us the hard numbers. Or go home.

  27. anuran says

    @28 LykeX

    Courtesy of the SGU (episode #452): Antivaccination Parents Dig In Heels Even after Receiving Medical Info. Apparently informing about the safety of vaccines can sometimes be counter-productive. People are weird.

    Saw this a little while back. Facts don’t help. Scaring doesn’t help. A gentle approach doesn’t help. Really, the only thing you can do is make it mandatory with serious penalties for failure to comply.

  28. Amphiox says

    Saw this a little while back. Facts don’t help. Scaring doesn’t help. A gentle approach doesn’t help. Really, the only thing you can do is make it mandatory with serious penalties for failure to comply.

    As you said, scaring them doesn’t help. Now if the threat of measles encephalitis, or paralysis by polio is not enough to scare them into complying, do you think a threat of a fine or jail time would?

    I find that doubtful. Whether you have a compulsory law or not, the antivaxxers will not comply.

    Or would you propose making refusal to vaccinate a CAPITAL offense? Because I suspect EVEN THAT would not be enough to make some of the anti-vaxxers comply.

    The onus is on you to demonstrate with hard numbers that you have a way of enforcement or inducement that will increase compliance by an amount that would make a noticeable difference compared to the status quo.

  29. Amphiox says

    I will also point out again that forcing a treatment of any kind upon a patient who does not wish it is a direct violation of the professional oaths taken by all physicians, and indeed all healthcare workers. Many, many, many physicians, and other health care professionals, will refuse to participate in any program of mandatory vaccination for the general public.

    This may even result in a DROP in the total numbers of vaccinated people as people who want to be vaccinated start having trouble finding a healthcare professional willing to vaccinate anymore.

    You will need to create an entire new parallel infrastructure for the administration of your compulsory vaccines, composed of people who are not medical professionals.

  30. The Mellow Monkey: Non-Hypothetical says

    Azkyroth @ 33

    So, strapping a struggling anti-vax kook down and injecting them against their will? Yeah, I buy that as an ethical violation.

    That’s what immediately came to my mind. If someone refuses to have something done to their body, how can you enforce that without grossly violating them? How can you in turn expect medical professionals to violate their own code of ethics in order to force an unwanted treatment on people?

    Universal (except in cases where it’s not medically advisable) vaccination is a wonderful goal, but how could it realistically be reached through legislation and force?

  31. terminus says

    I agree with Amphiox…so long as his “neurosurgeon” germs don’t “trespass on [my family’s] bodily autonomy.”

    Sorry, but I feel there are some liberties worth giving up in a civilized – and scientifically informed – society. For this reason, I find your conflation of abortion and vaccination to be specious.

    As for the anti-vaxxers not yet appearing on Tara’s site…Steve Walters has already opened his mouth and taken shit.

  32. Jerry says

    While Amphiox’s earliest comments sounded like gLibertarian talking points, I tend to agree that later comments are well-reasoned. However, both Amphiox and Azkyroth are staking out the extreme far ends of their positions, that I think are leading to unnecessary vitriol. Let’s take a step back. We have laws on the books that strongly encourage vaccination (e.g. required for kids in schools) which allow for parents to choose not to vaccinate, but allow the state to not accept their kids into public schools. No bodily integrity violations, just choices. However, where state legislatures are failing, IMNSHO, is in allowing very loose exemptions for “personal” or “religious” reasons, not just stricter medical requirements. States should tighten up those laws back to strict medical needs (allergic to the shot, documented immune deficiency, etc.) or a small selection of very strict tiny religious sects (sorry, necessary to get the law passed today). If the states passed these laws, we would not need to violate physicians oaths, bodily integrity, or bring up other major ethical dilemmas, and it would bring vaccination rates back to safe levels. While they’re at it, they could actually allow science to be taught in science class, reducing the number of utterly stupidly pig-ignorant anti-vaxxers to a handful of kooks. I know, I’m dreaming.

  33. otrame says

    I’d like to stress again the importance of adults getting revaccinated, especially for pertussis. I had a friend who got whooping cough as an adult. She had been vaccinated as a child, but her immunity had faded. She was sick, out of work, for two weeks and continued to cough horribly for a couple of months afterwards. 2 years later another friend who worked with us had a little boy. He was in the hospital, starting at 2 months, for 3 months, nearly died several times, and ended up with permanent damage to his lungs. It is not a minor matter. Please get revaccinated if at all possible.

    Leaving all the acrimony upthread aside, I think the question of forced vaccination is one of those that people of good will can disagree about. My hatred of people who don’t vaccinate (unless there is a medical reason, of course) is intense, but I admit to being very uncomfortable with forced vaccination. Still, over all, I think that it should be required.

  34. says

    Dutchbaby is about to get her 4 month round. One of my favorite local baby stores unfortunately hosts “alternative to vaccination” lectures along side their very good post-partum meet and greets, baby music class, and baby food cooking class. I don’t know what they actually propose but it pisses me off, especially since where I live attracts lots of travelers from all over the world.

  35. mildlymagnificent says

    This type of coercion cannot be used for the general public.

    But there are other things you can do with the general public. My personal preference is that people who visit maternity and children’s hospitals in particular should have to wear masks – from the moment they step through the door – if they and/or their children are not vaccinated. If they don’t wear the masks, they don’t come in. That includes grandparents.

    And kids who aren’t vaccinated for non-medical reasons can live quite happily in their families. But they don’t get access to childcare or schools or anywhere they are a potential risk to others. Hospitals and doctor’s surgeries should have segregated waiting areas in my view. The other people in those areas are already known to be sick/injured/vulnerable. Going to a healthcare facility should not be a risk in itself.

    I have a couple of anti-vaxxer friends that I’m quite willing to spend time with, the fact that their grandkids are either not up to date or not vaccinated at all isn’t a concern for me at the moment. But that. will. stop. once I have grandchildren to consider. We’ll be getting booster shots shortly and once the babbies start arriving, I’ll not be risking them for the sake of friends. We’ll see them, but only away from home and only when we know we’ll not be seeing babies soon after.

  36. doubtthat says

    As an attorney, it is my unsolicited legal advice to not get in e-mail arguments with convicts. They have way more free time than you.

  37. JohnnieCanuck says

    Dutchgirl, I assume you are living in the Netherlands and you probably know how close you are to the 29 bible belt municipalities where MMR coverage is below 90%. Map here.

    We have just started a measles outbreak from a family traveling between Orthodox Reformed communities here and in the Netherlands. Last year it was pertussis, but that time it came indirectly via their community in Alberta. Don’t know if we’ve imported any poliomyelitis but I see there were outbreaks in the bible belt in the late ’90s.

    This, religion has done for us lately.

  38. Amphiox says

    But there are other things you can do with the general public. My personal preference is that people who visit maternity and children’s hospitals in particular should have to wear masks – from the moment they step through the door – if they and/or their children are not vaccinated. If they don’t wear the masks, they don’t come in. That includes grandparents.

    This would be far more acceptable and far easier logistically to enforce than any compulsory vaccination program, since it does not entail a violation of bodily autonomy, and would be a limitation of personal liberty on a similar order with compulsory seatbelt laws and the like.

  39. Amphiox says

    I agree with Amphiox…so long as his “neurosurgeon” germs don’t “trespass on [my family’s] bodily autonomy.”

    You actually have this right. It is part of my professional obligation to you if you were my patient and I was operating on you to ensure maintenance of the sterile field during the operation, and if I failed in this obligation to you and you contracted an infection from me, you could justifiably sue me for it.

    While Amphiox’s earliest comments sounded like gLibertarian talking points

    I’m sorry, but this is frankly offensive. My original position delineated in my first two posts was 1) mandatory vaccination is not appropriate for the general public without first providing solid evidence/real numbers that demonstrate the magnitude of the benefit, and 2) mandatory vaccination is in fact acceptable for specific circumstances and/or subgroups of high risk, and that such was already being practiced in most jurisdictions.

    Have you participated in those libertarian threads? What libertarian qualifies their position 1 as I did, and what libertarian even admits to the possibility of position 2?

  40. Amphiox says

    And kids who aren’t vaccinated for non-medical reasons can live quite happily in their families. But they don’t get access to childcare or schools or anywhere they are a potential risk to others. Hospitals and doctor’s surgeries should have segregated waiting areas in my view. The other people in those areas are already known to be sick/injured/vulnerable. Going to a healthcare facility should not be a risk in itself.

    This kind of restriction must be justified by the SIZE of the potential risk. One cannot arbitrarily declare by fiat this sort of segregation (it is a limitation of freedom of association and assembly) just for any unquantified nebulous risk.

    The risk an unvaccinated child poses to other children correlates with the incidence of the disease in question which in turn varies from time to time and place to place. If the incidence is in fact zero, then the risk is zero. If the incidence is low then the risk is also low. Thus if the incidence is sufficiently high, it would be reasonable and justifiable to segregate/quarantine the unvaccinated. In fact this is the policy of at least some jurisdictions, only that the bar they set for “incidence high enough” is very high, like epidemic outbreak level, and they’ve got quarantine of the unvaccinated as part of the epidemic response plan. (Compulsory vaccinations are also part of many epidemic response plans, btw, but only for the area affected, not the general public as a whole.)

    One can argue that the bar is set too high, and we should have a lower bar. The local incidences of many diseases can be monitored and even predicted to a certain degree if one makes the effort to do so. It is what we already do when we create the annual flu vaccinations – we predict the expected incidences of the common flu strains to know which strains to put in the vaccine.

    But to simply declare by fiat that ALL unvaccinated children without condition, even in times and places where the incidence of the disease in question is so vanishingly low that the likelihood that an unvaccinated child will catch it and transmit it to another is almost zero, must be segregated at all times is simply using onerous regulation to punish people you have a value-disagreement with, and also a means of subtle coercion to try and force them to “voluntarily” comply with what you want them to do (ie get vaccinated) by making it increasingly inconvenient not to comply. It is no different conceptually than the odious GOP plans involving burdening abortion clinics with unreasonable demands for clinic space, or OR privileges at local hospitals for their doctors, or even Romney’s sickening “self-deportation” idea, which is predicated on making regulations so onerous that people will “voluntarily” leave the country.

    In other words, all proposed limitations of personal liberty, bodily or otherwise, must be justified by QUANTIFIED benefits. The smaller the limitation the smaller the benefit is needed. Mandating seatbelts and bike helmets, for example, is a tiny limitation, and therefore only a smallish benefit is required to justify it. Violating another person’s bodily autonomy is a large limitation, and requires a LARGE quantified benefit to justify it.

    You must show the numbers. Always.

    And this is NOT a libertarian position. This is, in fact, the very core of the LIBERAL position.

  41. says

    JohnnieCanuck: it so hapens I no longer live in NL, but have made Hawaii my home. Here we get lots of immigrants and tourists from everywhere. I personally think its irresponsible to not vaccinate in this environment.

    anuran: yummy, but no, this Dutchbaby is not for eating (although her little apple cheeks are delicious according to her doting father, who has to pretend eat them at least once a day)

    As for the above arguments: I cannot support ‘forced’ vaccinations, whatever that might look like, but I think the answer is in better education in science and statistics and how to read and understand research, and teaching trust in science and that world-wide-scientific-conspiracy would be very very difficult to pull off. I think its lack of good understanding built on a structure of mistrust that gives rise to anti-vax attitides.

  42. says

    I’m in favour of mandatory vaccination of children, because I think that children have the right not to suffer from horrible diseaes because their parents are assholes.
    Parents are stewards, not owners. The right to make medical decisions for their children is granted to them under certain conditions and can be removed (here Jehova’s Witnesses regularily lose medical custody). I see no reason why the part “vaccination” is taken out of the general privilege. I also don’t have the right not to take my children to their check-ups. They are mandated by law. So, why not vaccinations, too?

    +++

    And not just your children: get YOURSELF vaccinated as well.

    That’s easier said than done in some places. I recently got the tetanus/diphteria booster and now I can’t get a pertusis shot because that’s only avaible in combination head->desk.
    Germany is notoriously BAD in vaccinating people. While there have been some publucity campaigns in recent years, you still have to make an appointment, yadda, yadda, yadda, it’s not clear which shots are recommended for whom (I’ve been discussing measles shots with my GP for quite a while. I should be safe because I had measles, horrible stuff, but better safe than sorry, same with pertusis) and so on.
    During my study abroad in Ireland they did a mass vaccination against meningitis. They put up posters, set times when which groups were scheduled and then you could come into the main gym where the vaccination booths had been set up. People, including myself stood in line for some three hours, but we got vaccinated. You could say that making an appointment is less time consuming that standing there for hours, but it was a low threshold activity. Making a phone call is often more trouble for people.

  43. barbaz says

    Amphiox,

    I’ll give you a real number: One.

    There will be at least one person in the next couple of years who causes someone’s death and could have prevented that by getting vaccinated today.

    Of course, to “quantify the benefits” we should evaluate the alternatives. So, the benefit from letting people choose whether to get vaccinated is … Zero. Maybe you save a few dollars in syringes.

    So it’s a life (and worst case, a life of someone who did not choose this for themselves) against a few dollars.

    Personally, I don’t care whether people get vaccinated against their will or are locked away until they are willing to, either way would be perfectly fine.

  44. A. R says

    My view on vaccination has always been that the best approach is a strong public health education program, combined with targeted mandatory vaccination, and generally making refusing vaccination very, very difficult to do and a general pain in the arse. Combined with aggressive programs to ensure that only vaccinated children and children who cannot be vaccinated for legitimate reasons can attend both public and private school (no religious or philosophical waivers), and imposing sanctions on physicians who spread anti-vax nonsense, such a system could, in theory, keep vaccination uptake high enough for herd immunity to largely protect unvaccinated individuals. In case you were wondering about my qualifications, I’m a working research virologist and health care worker (can’t specify what level).

  45. Anri says

    Amphiox @ 49:

    You actually have this right. It is part of my professional obligation to you if you were my patient and I was operating on you to ensure maintenance of the sterile field during the operation, and if I failed in this obligation to you and you contracted an infection from me, you could justifiably sue me for it.

    …but so long as it’s just your unvaccinated self exposing the kids at a booth in a restaurant, we can’t prove anything, so that’s totes ok.
    I mean, the kids will still die, but hey, them’s the breaks, yaknow? Not like there’s any way we could have prevented… um, never mind.

    How about we make a deal: I don’t get to force you to get a vaccination, and you don’t get to force your presence on any unvaccinated people not yet old enough to make that choice for themselves.
    Sound good?

  46. dianne says

    Also, that vitamin K shot? Get it! Pediatricians are seeing newborn hemorrhage again now that parents are refusing vit K for no particular reason. Seeing a baby die from bleeding in the brain is traumatic to everyone and can be avoided extremely simply.

  47. geekgirlsrule says

    As someone who got Pertussis as an adult and spent weeks sick, and who five years later still has coughing issues, get your fucking kids vaccinated.

    I work in a medical center, and outside of actual care providers, they didn’t (and actually still don’t) require clerical staff to have their vaccinations up to date. However, with the several outbreaks of measles, mumps, and pertussis in the region over the last several years, they have been holding free immunization clinics for the staff, in addition to bribing us with Starbuck’s gift cards to get the flu shot (I’d get the flu shot anyway, but hey, free coffee!).

    When I got pertussis I had never been warned by a medical professional that you needed to be reimmunized as an adult. Since I’d never traveled out of the country, except to Canada, they didn’t even think about it.

    Then I caught Whooping Cough, I wrote it up for Skepchick a couple years ago, complete with pictures of my eyes with every blood vessel in them burst from coughing. I coughed until I threw up or passed out on several occasions.

    I have one friend who has a child who had the 1 in 20 million or whatever bad reaction to the immunizations, medically documented. And what it’s done with her younger son, is make her stagger the immunizations a bit more out of a sense of caution, but it’s also made her more determined to get HIM immunized so he isn’t a threat to his sister.

    I think the reason that we’re seeing so many parents NOT immunizing, is that we have a parental population that has never seen the effects of these illnesses first hand. They were pretty much all immunized, none of their classmates died or had their health majorly altered by measles, mumps or pertussis. So they don’t GET how fucking dangerous these diseases are. My mom lived in a rural area where not everyone was vaccinated, and she remembers seeing people die from this shit.

    http://io9.com/5928722/this-graph-of-whooping-cough-cases-in-washington-state-should-scare-the-crap-out-of-you

  48. Azkyroth Drinked the Grammar Too :) says

    Building on my comment, it occurs to me that we already have a model to work from:

    “Hi, welcome to the neighborhood. I’m Firstname Lastname. In accordance with Name-Of-Prominent-Infant-Pertussis-Fatality’s Law, I am required to inform you that I am a Registered Fucking-Idiot-Who-Won’t-Vaccinate-For-No-Medical-Reason Offender.”