Book Is Rallying Resistance to the Antivaccine Crusade

http://www.nytimes.com/2009/01/13/health/13auti.html

by scott_s • 18 years ago

20 20 18 years ago

mdasen2• 18 years ago

This is one of the reasons I love game theory. So, if no one gets vaccinated, lots of people die preventable deaths. If everyone is vaccinated except me (or my child in this case), no one will die because there are no carriers. So, in the face of the vast majority being vaccinated and wild claims about autism (I agree with the author), parents decide "well, my child has no chance of getting one of these diseases if all their classmates are vaccinated and I've been reading trumped up news reports that make me scared so i'll just not have my kid vaccinated!"

The problem becomes that there's a tipping point. If 5% aren't vaccinated, that's a lot of potential carriers. Then it becomes a fight of "i don't want my child vaccinated, but i want your child vaccinated to protect my child." It's not hard to imagine parents of immunized children then saying, "well, screw you trying to get us immunized while not taking the risk for your kid!"

Ah, the rights of the individual and the rights of the society! It's really fun to think about.

ConradHex• 18 years ago

>"...and I've been reading trumped up news reports that make me scared so i'll just not have my kid vaccinated!"

That's a fairly biased representation of those parents' viewpoint, isn't it?

mdasen2• 18 years ago

Totally! I mean, whether that's the reason why or because they have some secret knowledge, the game scenario is the same (and I'm way more interested in that). If you're in that camp, I meant no offense and I'm sorry if I offended you. Mostly, I like to make fictional people sound funny whether I agree with them or not because it makes the harsh reality that can be life more fun.

No one would claim that vaccination = autism. It's more like 0.001 * vaccination = autism if you're in that camp (1 in 1,000 times vaccination causes autism for those that might not understand my quasi-programmer speak).

For a lot of things in life, belief and reality are the same thing. Whether or not vaccinations cause autism, the belief that some have that it does cause autism alters behavior. Whether or not the economy is going to crash, if everyone believes it will and stops spending so they have money when it does crash will cause it to happen (since if everyone stops spending money, very soon businesses will have no money coming in). There is reality, but from a game theory perspective it often doesn't matter since people's behavior will be altered by perception of reality probably as much as by reality.

So, let's say it's real that vaccines cause autism in 1 out of 1,000 cases. If everyone looks at that and says, "no way my kid's getting vaccinated," we have a huge public health problem. On the other hand, if most submit to the social good, there will be large resentment of those who don't and are relying on the vaccination of others not to become infected.

We're not anywhere near the levels where it becomes a big issue in society, but if more parents go down this road there might be more heat to force them not to (for the public good). I'm not saying that's good or bad. Morality is better left to people better than me. I'm just saying it'd be interesting (I guess in the way a car wreck is interesting) to see how it played out socially.

showerst3• 18 years ago

Another econonmic (but non game theory) perpective on this is that non-vaccinators are incurring a cost to everyone else (paying for health care, the risk of getting sick via failed vaccinations, gov't costs for health campaigns, etc), thus imposing a 'negative externality'.

The general approach to preventing a negative externality is to tax it, so that before you can take an action that 'costs' everyone else, you pay that much into the system.

So raw economics suggests that we figure out the marginal 'cost' of adding one unvaccinated person, and offer to let them 'choose' not to vaccinate if they pay the cost to society up front.

Of course in reality that's all bollocks because the cost goes up once you hit a tipping point (as you said), and trying to identify a monetary damage per-non-immunized is sure to result in a WAG.

Fun problem to think about though.

Tichy3• 18 years ago

Isn't there a way to settle this discussion scientifically?

arockwell3• 18 years ago

Yes, it more or less has been settled. I have not heard of a reputable study showing that vaccines cause autism. The problem is that if you try hard enough you can stretch/fake/politicize scientific results to show just about anything. There is at least some causal link between giving the vaccines and autism (there has been a large rise in autism cases that coincide with the usage of certain vaccines).

Since no one can explain why the incidents of autism are increasing so rapidly there's a ton of crackpot theories which desperate parent's latch on to.

Tichy3• 18 years ago

What is a sensible person to do, get hold of some of the actual studies by oneself? Without prior knowledge of the problem, I feel inclined to believe the "no causation" camp. But I can also imagine that it is easy to select the proper studies to prove just about anything. For the book in question, how can I be sure that the author didn't chose to only quote the "no causation" studies, and not other ones that might come to other conclusions?

As I said, I would tend to believe the "no causation" camp, but I also don't have 100% faith in doctors...

Recently I was in a heated discussion with a friend about "The China Study", which claims that animal protein causes most of the worst "civilization diseases" like cancer and heart disease. At face value it sounds absurd, because it seems as if people have always been eating lots of meat (not sure if they really have, 150 years ago). So my friend completely rejected the possibility. The book sounded convincing to me, though - but at the end of the day, it is just one guy... At least I tried to Google for articles debunking the book and found none, but there is still a nagging feeling that one might fall for yet another diet scam (although as I said, the book really made a very solid impression on me). Just saying it is a similar problem, who is one to believe?

kyofiyfi• 18 years ago

That's the whole problem: it has.

But like so many things, the facts don't matter to some people.

The next time someone tells you that, like, science and knowledge is, lik, just your opinion, man, keep in mind that sort of willful ignorance is far from harmless and can be quite damaging.

tokenadult• 18 years ago

Yes, there is.

http://www.cdc.gov/ncbddd/autism/vaccines.htm

But as the page that leads into that link notes, "The weight of the evidence indicates that vaccines are not associated with autism. But CDC knows that some parents and others may still have concerns about this issue." If people don't look up the evidence for themselves, they may act contrary to the evidence when deciding what to do for their children.

Tichy3• 18 years ago

From that site I found references to about 5 studies that caused the autism scare, but according to the site, don't really provide evidence. If that is really all that is to the scare, I guess I will really take it upon myself to look up those studies should I ever have kids.

scott_s• 18 years ago

That's the point of the book that this article is about. The author tries to explain why scientists and doctors don't think there is a link between vaccinations and autism.

Scriptor• 18 years ago

This got me thinking. I am otherwise normally in favor of health care for everybody, but that would also mean health care for those who chose not to get vaccinated because of their own or their parents' beliefs. That would mean that when they get sick it's the public that has the further burden of supporting them.

arockwell3• 18 years ago

Are you in favor of health care for smokers and drinkers? People who eat trans fats?

Virtually any choice you make in life has some type of health care risk. I think that's almost impossible to draw a line and say these behaviors are ones we will deny care.

blurry2• 18 years ago

There is an interesting proposal out there related to organ donation which could be adopted for this type of situation.

The proposal is to separate people into two groups: those who agree to donate their organs, and those who decline. Later on, when people happen to need organ transplants, they receive them according to their group priority, i.e. if you decline to donate, you turn comes up only after everyone in the first group received their organs.

I think that is a fair system, and could be applied in this case also. If you choose to vaccinate, you are covered, and if you do not, you pay out of pocket.

showerst3• 18 years ago

Part of the problem with respect to applying this to vaccinations is that vaccines have a low but non-zero chance of failure.

If everyone gets vaccinated, and 1% fail (that's just an arbitrary number), it's no big deal because there isn't enough of a population to carry an outbreak.

But if 1% of vaccinated patients are vulnerable, and 5% of people choose not to get vaccinated, then now there's a potential for outbreak, and even some people who vaccinated get sick.

In economic terms, by not vaccinating you're introducing a negative externality into society that you're not paying for, so the true cost to non-vaccinators is artificially low.

anamax• 18 years ago

> I think that is a fair system, and could be applied in this case also. If you choose to vaccinate, you are covered, and if you do not, you pay out of pocket.

Hold it. If you're going to deny them govt-paid healthcare, how do you justify taxing them to pay for govt-paid healthcare?

Book Is Rallying Resistance to the Antivaccine Crusade

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