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[GavJ]

That is why you average it.

No, why would you take meaningful, relevant marginal data and just throw it away for no reason by averaging it out? This does not make sense.

It MIGHT make sense if vaccines were a thing that you re-did every single year, thus having to reconsider everybody all over again. For flu, it is like that. For everything else, vaccinated people are already in the bank, so to speak. Averaging the concept of vaccinating them into your decision is ridiculous, because they're already set in stone, so you should most definitely not pretend like they aren't.

[Helgoland]

That is why you average it.

? Averages have nothing to do with it...
Okay, you could rephrase it to 'Each new vaccination decreases the average vaccination effectivity.' But that's just..  odd.

[Neonivek]

That is why you average it.

No, why would you take meaningful, relevant marginal data and just throw it away for no reason by averaging it out? This does not make sense.

Because... The first person is useless in your scenario.

The thing is that you constantly refer to "just one more person" but that isn't the system in place here. The order of people is not a definable variable.

"Just one apple" is worth a lot If you have none... but very little if you have plenty... Yet the same apple persists and the original value exists as well.

Since we are not just talking about "topping it off" but rather how much vaccines we will have in total.

So the worth is taken by the variable cost versus benefit? uhhh... I might have to delve into my notes.

[GavJ]

Um, yes it is because people get vaccinated one at a time...

I'm really not at all following what you're getting at. Please start over and explain in much more detail if you want to continue down that path of discussion.

edit:

"Just one apple" is worth a lot If you have none... but very little if you have plenty... Yet the same apple persists and the original value exists as well.

No actually that's not how it works even in economics with literal apples. People are willing to pay less each for 20 apples than for one, this is a fundamental fact of economics.
(Not that that has much to do with the reason for the vaccine situation, but your analogy is pretty poor since it actually lines up with what I'm saying...)

[Neonivek]

Ok sorry...

One apple is worth 100 dollars we will say... and for every apple you add to the plate the price goes down by 5 dollars. So one apple is worth 100, two apples are worth 95x2, three are worth 90x3.

At what point do you stop gaining worth by adding apples?

It isn't because "The last apple isn't worth a lot" it is because the worth of all the apples goes down.

Mind you I think I gave a bad example... but you get what I mean.

Basically the first apple's price drops as well.

[GavJ]

http://en.wikipedia.org/wiki/Demand_curve
re: apples. Notice how the willingness to pay / price goes down the more apples you're talking about. This is true even if you buy all the apples at once, at any quantity.

The same is true of vaccines. For slightly different reasons, but still, REGARDLESS of whether you consider each vaccination individually OR whether you decide how many youw ant total right at the start, the average value of many will still be lower than the average value of just a few.

So whatever, it's a bizarre way of talking about it I think, but if you want to average across all vaccines as if we were starting from 0% today, then go for it -- it doesn't actually change anything.

[Tiruin]

Um, yes it is because people get vaccinated one at a time...

I'm really not at all following what you're getting at. Please start over and explain in much more detail if you want to continue down that path of discussion.

It doesn't hold that much weight when you factor the organic aspect of it.

Disease is not immobile. It evolves and 'moves' as we do. Approaching from a purely mathematical viewpoint will not take in that factor, but instead would approach the matters as if they were static.

Looking back

The first people vaccinated add MUCH more protection each than the last people vaccinated.

Yes, true, but that doesn't mean this protection applies to the rest of the people--treated as numbers, sure. Treated as individual people...
Err. Many other factors also come in here, there.

[GavJ]

I think i see what he means. Any vaccinated person, whether they were first or last, resists new outbreaks equally well.
So in that sense, their value is equal / re-averaged as you go.

But since you can't un-vaccinate somebody, in terms of the actual decision you make to vaccinate or not, you don't need to consider it this way as an average, you can instead consider it as marginal value, and I think it's more natural to think of it that way. You CAN do it the other way too though, I think.

It is probably still the same exact math at the end of the day either way, just two rearranged versions of the same equations.  Fair enough?

[Reudh]

I am actually finding some of GavJ's points quite interesting, even if I do not agree with them. Mathematically, there is a point where vaccine risks outweigh benefits, this is true - BUT, and I may stress this:

Societally, the benefit continues to outweigh the risks. A single brick in the wall protects more than that gap did, even if it is a tiny amount.
Also, a small number of Guillain-Barre syndrome contractions is a small price to pay for near total societal immunity to a highly infectious disease. What's more, Guillain-Barre syndrome at least is fully treatable by plasmapheresis, and a grand majority of those who come down with Guillain-Barre will recover completely.

As to flu shots, I'm not sure what the point of them is. Influenza is relatively easy to survive, unless you're prone to cytokine storms / are elderly / are very young. I don't think we have them in Australia, but we don't really have much influenza outbreaks reported that I know of either.

[Neonivek]

In otherwords Reudh is saying that the marginal cost never reaches the marginal benefits.

and that while the marginal benefits are fixed the marginal costs can be decreased through efficiency over time.

[GavJ]

Societally, the benefit continues to outweigh the risks. A single brick in the wall protects more than that gap did, even if it is a tiny amount.

Well yes, for bricks, that's true. Bricks aren't very risky -- the analogy was not meant to convey that part of the story.

For vaccines, they may also not be risky, but we don't know. They might actually be quite risky, relatively speaking. So that "tiny amount" you speak of is outweighed perhaps by the danger of the vaccine, making it not good for society anymore.

Also, a small number of Guillain-Barre syndrome contractions is a small price to pay for near total societal immunity to a highly infectious disease.

Again, just saying stuff like this doesn't make it true or known.  Guillain-Barre is A price to pay. Whether it is "small" or not depends on the relative benefit of the extra bit of disease immunity from however many vaccinations there are per bad outcome like that.

Also, Guillain-Barre is only one of dozens of potential issues, including ones we might not know about at all yet. But also including ones we do know about, such as several other issues with different names than Guillain-Barre that basically amount to the same thing, or allergic anaphylaxis. The disease reduction benefit must be weighed against the sum total of all risks, including also any we haven't picked up on yet.

Plus, even the ones we know might occur, we don't know exactly how common they are, for lack of enough studies + almost no proper enforced reporting system.

The only way to scientifically know that you've covered every possible outcome, including ones you might not have noticed or thought about yet, is to simply run a sufficient number of experimental and control participants and see the overall outcome rates of death and/or quality of life from both. Which we haven't done.

In otherwords Reudh is saying that the marginal cost never reaches the marginal benefits.

Yes, he is saying that.
He is not proving that.

[Leafsnail]

The information we are missing is how often vaccines hurt or kill people. We basically have no idea whether it's anything in between 0% of the time all the way up to 1/10,000 or so. Could be almost anywhere in between there.

And depending on exactly where, it dramatically changes the right choice about vaccines.

We are not "missing" this information.  We know that, for instance, the measles vaccine causes a severe allergic reaction in 1/1,000,000 cases.  What we don't know is their fatality rate, but that's because no fatalities have ever been observed.  That suggests the chance is vanishingly rare, and certainly far lower than 1/1,000,000.

Really though this seems to be the entire crux of your case, and it fucking sucks.  You keep asserting that we can never know basic things like what percentage of people need to be vaccinated to prevent diseases from becoming endemic - that's basic epidemiology, and it's the same value as the one to prevent outbreaks only over your entire population rather than just a given area (I have no idea why you decided to baselessly assert otherwise even though you clearly have no understanding of the science involved).  It's an argument entirely based on your willful ignorance, and an assumption that the people who study these areas are just as ignorant as you are.

As to flu shots, I'm not sure what the point of them is. Influenza is relatively easy to survive, unless you're prone to cytokine storms / are elderly / are very young. I don't think we have them in Australia, but we don't really have much influenza outbreaks reported that I know of either.

They're for protecting the elderly.

I bolded it in the OP! What more should I do?

Vaccinate if you want.
Don't vaccinate if you want.

Since my position is that nobody really knows what's best in our situation, neither of these is more right or wrong than the other, obviously, so just live and let live.  That is my call to action.

This is an absurd policy proposal even if we accept that we currently do not know anything about what percentage we need (and as I've repeatedly demonstrated this is actually a basically settled matter of science - Gav has provided no evidence to suggest that there's any controversy or significant uncertainty in this area at all).  Unless you're prepared to just allow deadly diseases to become contagious again if the public mood swings away from vaccination you should at the very least be trying to encourage vaccination up to a certain level (and if the optimal level is unknown then we should surely be pushing for it to be as high as possible to be on the safe side, since measles has been known to cause hundreds of deaths per year and measles vaccinations have not been known to even cause 1 per year).

[GavJ]

We know that, for instance, the measles vaccine causes a severe allergic reaction in 1/1,000,000 cases.

Anaphylactic shock in particular is something that, if it's going to happen, it's going to probably happen within minutes of the vaccine being delivered.*

So yes, we have the ability to measure this one potentially accurately (although the fact that doctors are not required to report such events to any central agency means that you don't actually know whether the incidence is higher than that or by how much).

This is not true, however, of other potential complications, like long term immunological influences, or kidney interference 6 months down the line, or who knows what all. People could be dying routinely and not being statistically recorded simply because a time delay makes the cause/effect unclear, and it's still rare enough that individual doctors don't notice ongoing patterns and thus don't file reports which then can't be found by larger studies easily (even just 1/10,000 would be quite rare enough to fly under the radar with a moderate time delay and no routine investigations or required reporting system). You cannot simply assume that all possible complications work on the same timescale as allergic reactions.

*Although also, even allergies can be delayed reaction. Often, your allergic reaction system has a tendency to lie dormant until you have built up half a dozen different allergens and then it starts failing. So you could have a situation where somebody has 4 allergen sources, and is somewhat allergic to shellfish, but adding that one wouldn't have done anything to them.  but then they get a vaccine. The vaccine isn't enough to tip the scales either, but adds to the allergen load.  Then a week later, they eat some shellfish and now we are up to 6 and the system is overwhelmed and they go into shock.

Nobody would report that as a vaccine reaction, but in that example, it essentially is just the same as one for practical purposes.

and if the optimal level is unknown then we should surely be pushing for it to be as high as possible to be on the safe side

But you. don't. know. it's. the. safe. side. As high as possible might just as easily be the dangerous side. Which is why this is not a useful default policy.

"The enemy is either on the left or the right. Civilians are on the other. We have no idea which is which. But just to be on the safe side, we should shoot left as often as possible" <-- this is equally logical as what you're suggesting the policy be.

[Neonivek]

Yes, he is saying that.
He is not proving that.

So, shall he do it though a damage analysis and compare it to the worth of a single life?

Given we are working with an uncontrolled system.

Since we are talking about, for example, not vaccinating children for a generation.... unless there is another mechanic.

Though I guess what we should do is compare the cost of the medical expenses for people taking it versus the expenses for insurance and medical bills... Per capita.

[GavJ]

So, shall he do it though a damage analysis and compare it to the worth of a single life?

Given we are working with an uncontrolled system.

Yes, that's what we WOULD do, if we knew how many people were dying from vaccines or not.

(also in this case, you don't really ever have to quantify a human life in dollars or anything, because you can simply compare lives vs. lives, since both the risk and benefits sides are about health outcomes. Which is easier and less controversial)

Though I guess what we should do is compare the cost of the medical expenses for people taking it versus the expenses for insurance and medical bills... Per capita.

This type of database is not available in the United States. Or indeed anywhere, as far as I know, with the possible exception of Denmark and a couple similar places which have a PORTION of this sort of data that you want, but not all of it. And they only started a couple decades ago, and data populations are not high enough to inform us at 1/60,000,000 levels of confidence, or anywhere near.

With database studies, you also have to worry about things like whether people self-select for vaccines for reasons that might also influence their health for non-vaccine reasons, conflating the data, etc. But we don't need to get into discussing all of that until/if the data populations get high enough in the first place for it to be relevant.