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[GavJ]

So GavJ it is an allergic reaction.

More people die a year from eating Peanuts...

Research isn't going to help in this case, this is just one of those situations where people roll death on their d20s.

You can easily prevent an immune reaction to a vaccine by not giving the vaccine...

That's why the research I'm suggesting is not to prevent the allergic reaction (or other immune response) in the first place. Although that would also be nice (and if completely successful would make it a moot point). It is about finding the optimal rate where the risk of giving it exactly balances the benefit of giving it.

[Neonivek]

But, would that have saved the person GavJ? or would they have had a reaction somewhere down the road?

You could save everyone allergic to nuts just by... not having nuts.

It is about finding the optimal rate where the risk of giving it exactly balances the benefit of giving it.

And how much control do you have over this rate? You can mathematically prove that 90% creates deadly gaps.

[GavJ]

You could save everyone allergic to nuts just by... not having nuts.

There is an easily available and accurate test for nut allergies to identify those people. And then they DON'T have nuts.

If you can point me to a safe, reliable, routine test available at my local pediatrician for pre-screening for immune response to vaccine antigents/adjuvants/combos, then great! Problem solved. Problem is that doesn't exist, unlike with nuts.

If you know of people who are about to develop something like that, then great, let's spend some government funding on their work! Somebody posted some companies earlier that might be working on something like that. I haven't had a chance to read up on them yet, but plan to.

[Neonivek]

There is an easily available and accurate test for nut allergies to identify those people

Not really. Especially if you understand how allergies work.

[Neonivek]

To the tough part is that you are not born with all your allergies

It isn't unusual to eat a peanut butter sandwich and have no reaction. only to die later from a little

[Leafsnail]

But most people don't have active smallpox immunity in the U.S. So you'd be vaccinating at a higher rate than only newborns, by a lot.

This is absurdly pedantic.  Nobody is suggesting vaccinating people against smallpox because the disease was eliminated by vaccines, it has no relevance at all to the conversation (except as a way to demonstrate the benefits of disease elimination).

But sure, okay, most conservative way of doing it = 300/78 = 3.85 deaths a year.  Still VERY high above measles disease death risk at 90% coverage. That's much closer to Italy's death rate at ~70-75% coverage.

You should actually check how many children there are rather than doing such a lazy calculation, but that would be a lower death rate than say measles in the UK.

The thing is, though, it's a completely irrelevant figure.  Even if we assume that the 1960s vaccine for a much more deadly disease is the same as the present-day measles (or MMR?  You aren't really being clear) vaccine all you've shown is that dropping your vaccine rate to 0% would prevent about 3.5 vaccine related deaths in the US per year.  However, we know that doing so would also cause hundreds of measles deaths.  What you actually have to look at is the number of deaths that would be prevented by lowering the vaccination rate by, say, 10%, vs the number of additional deaths that would be caused by allowing a measles endemic to return.  In the UK the result is pretty emphatic: increasing our rate by 10% would mean vaccinating about 80,000 more children per year. So that would cause about 0.08 additional deaths per year, (this is using the figure for a far more antiquated and dangerous vaccine, mind you).  If this eliminated our endemic and prevented the death per year we have due to measles then we're still ahead, not to mention the fact that eliminating it here help the global eradication project by preventing our citizens from re-infecting other countries.

I honestly do not understand why you think that "the treatment is causing more deaths than the disease!" means that the treatment should be reduced, and it's quite easy to demonstrate the absurdity of this idea.

Let's imagine there's a disease that's 100% fatal and which hangs around in the atmosphere, so that anyone who is not vaccinated will soon catch it.  There's a universally administered vaccine that's 100% effective, but which kills 1/1,000,000 people who take it.

Every year this vaccine kills 3.84 people in the US.  That's more than the disease, which (due to the vaccine) doesn't kill anyone.  By your logic this vaccine is being overused.

[Leafsnail]

In fact I think this smallpox data kindof finishes off your argument - in order for it to hold you'd have to demonstrate that modern vaccines are somehow well over ten times more deadly than far less sophisticated vaccines that contained relatively dangerous live pathogens.

[Neonivek]

Well Leafsnail I'd hate to bring this in...

But one of the major reasons why the Smallpox vaccine was so dangerous (along with early Polio) was because of poor handling of its production. MOSTLY because they were trying to get the vaccine out as soon as humanly possible, or rather even faster than that.

They eventually corrected each vaccine. (Actually I think Smallpox finished its run before it was perfected... Polio has gone through many versions. The modern day polio vaccine is actually an astounding piece of modern medicine.)

Today though it is likely we wouldn't use the old Smallpox vaccine it is truly antiquated and was extremely prone to just flat out not working (there is literally a LIST of ways it can just not work)

[Leafsnail]

Well smallpox was killing literally millions of people per year at that point so even a fairly dangerous vaccine would have been worth using.

It's true that there's a more advanced smallpox vaccine, it's just not used outside of people who work in smallpox labs because... you know, eradicated.

[EnigmaticHat]

It always makes me vaguely nervous that they keep those things on hold.

Edit: That reads like I'm implying they intend to release them, but what I mean is that as long as its there someone could steal it.  Also that's a good point future greatorder

[GavJ]

This is absurdly pedantic.  Nobody is suggesting vaccinating people against smallpox because the disease was eliminated by vaccines, it has no relevance at all to the conversation (except as a way to demonstrate the benefits of disease elimination).

My point I was making doesn't require them to actually be planning vaccination of anybody (although incidentally the CDC does have a stockpile of vaccinia pox vaccine on hand for terrorists or something: http://www.bt.cdc.gov/agent/smallpox/vaccination/faq.asp). I was pointing out that at the numbers they cite, if they were to vaccinate as many people as they want to vaccinate for measles (i.e. everybody), they are already admitting that they would predict hundreds of deaths. And 4 deaths a year ongoing.

This is relevant not because I think it would happen, but because it gives us a number for how much safer the measles vaccine would have to be than the smallpox: about 80x safer, for the death rate to equal the likelihood of saving your life from measles. This lends mathematical perspective that has nothing to do with actually administering smallpox vaccines.

You should actually check how many children there are rather than doing such a lazy calculation

Okay.
Number of actual live births 2012: 3,952,841 http://www.cdc.gov/nchs/fastats/births.htm
300 million rough / 78 = 3,846,154 (3.85 deaths at 1 per million)
Whatever.

but that would be a lower death rate than say measles in the UK.

https://www.gov.uk/government/publications/measles-deaths-by-age-group-from-1980-to-2013-ons-data/measles-deaths-by-age-group-from-1980-to-2013-ons-data
Average deaths from measles in the UK 10 year average = 0.9 per year.
At 64 million people, it'd be around 0.8 deaths per year from a smallpox-complications-level vaccine.
Pretty close to break even point.
UK has a 92% coverage rate.

But also remember a 50% higher basic reproduction ratio infection rate than the United States (requiring higher coverage for the same effect). Which likely explains the United States at roughly the same vaccine coverage experiencing a ~90x lower death rate. Their threshold for safety at the same level of vaccination is thus lower than ours is. I.e. their optimal rate would be higher (than our AVERAGE number. Maybe not that our dense urban area number, etc.)

vaccine all you've shown is that dropping your vaccine rate to 0% would prevent about 3.5 vaccine related deaths in the US per year.  However, we know that doing so would also cause hundreds of measles deaths.  What you actually have to look at is the number of deaths that would be prevented by lowering the vaccination rate by, say, 10%

Thank you for rewriting the opening post for me again. This is exactly the logic laid out from the very beginning. Comparing a LINEAR per person vaccine risk to a NON-LINEAR per person disease risk as vaccination rates lower. Which is exactly what I've been talking about all along.

[example of weird atmosphere disease]

No. If you apply this situation to the logic I laid out in the opening post, the blue curve in the graph would be astonomically higher than the red line of vaccine risk, all the way to the very right of the graph. As I explained in the opening post, in a situation like this where the red line is completely below the blue curve, the optimal rate of vaccination is 100%.

In no way does this incredibly extreme example invalidate the possibility that in far more normal situations, the red line would sometimes be in the middle of the blue curve, which would mean an optimal rate less than 100%.

I never said that it's ALWAYS going to be less than 100% for every disease. I didn't even say it would be necessarily for ANY disease. You need additional research to know. Notice how in your example, the population knows precisely the rate of death from vaccination -- i.e. they've already done what i'm suggesting. They've done enough research to know the risk and thus they can calculate the exact optimal rate, which in that case, just so happens to be 100%. Your story PRESUPPOSES exactly what I'm suggesting, which I think says quite a lot.

In fact I think this smallpox data kindof finishes off your argument - in order for it to hold you'd have to demonstrate that modern vaccines are somehow well over ten times more deadly than far less sophisticated vaccines that contained relatively dangerous live pathogens.

other way around, dude. They have to be < 1/80th asdeadly in the case of measles in the US. Not > 10x as deadly.

[Gentlefish]

I still fail to see how forever being 80% vaccination and -not- wiping out the disease is a better option than 100% vaccination, removing the disease, and never having to worry about it again once it's eliminated, preventing the indefinite timeframe for disease deaths that non-total vaccination implies.

[Putnam]

...Ha, wow. Yeah, the possibility of eradicating the disease (as would have happened with Measles etc. if it weren't for people who are against vaccination), preventing (very well-studied) deaths from the disease and (hypothetical) deaths from the vaccine forever after is way better from a utilitarian perspective. Yeah, before I figured the amount that vaccination should go through was between 99 and 100% due to GavJ getting through somewhat, but I had completely forgot about the possibility of eradication.

[Gentlefish]

Come on guys, we got rid of smallpox, a disease you're all talking about when it comes to vaccines. And it's not like it wasn't super contagious. And now it's extinct in the wild.

[GavJ]

I still fail to see how forever being 80% vaccination and -not- wiping out the disease is a better option than 100% vaccination, removing the disease, and never having to worry about it again once it's eliminated, preventing the indefinite timeframe for disease deaths that non-total vaccination implies.

but I had completely forgot about the possibility of eradication.

This has been addressed half a dozen times now in the thread, every couple of pages.

If and when the entire world is poised to reach eradication levels, then yes. At that point, and no sooner, will actual eradication be possible, and a push for 100% to wipe out all vestiges of the disease is worth the few extra deaths in order to be able to stop worrying about it entirely for the long term.

Up until that point, though, the United States is incapable of eradicating the disease on its own, so there is no such thing as eradication yet. All that a 100% rate means for now is a specific number of individual deaths versus deaths equations like any other day or any other coverage rate. There's nothing special about it yet, until all other countries have the means to get high enough.

And the world won't be ready to push for final eradication for at least another decade or two, given the sorry state that Africa and India are in, regarding measles in particular. Might as well ride the optimal point instead until they are capable of getting high enough.