http://www.cbsnews.com/news/gardasil-researcher-speaks-out/I'm not presenting this article as proof/data for anything. But it bring up an important rhetorical point I didn't address much before:
Duration of immune protection is sometimes simply not well known for many vaccines, or if it's a brand new vaccine might purposefully not be measured for long enough to be certain about medium to long term outcomes, because they simply don't want to wait that long until release of the product. This may or may not be a reasonable decision, but it's a factor that has not been mentioned much yet, and adds extra uncertainty. For instance if 1/5th of vaccines turn out to wear off after like 5 years, then that means all vaccines in general have to be maybe 10% more effective than otherwise in your risk/benefit estimates, to offset the possibility of them being very short term "duds." or what have you.
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Also, regarding Gardicil: girls who get the vaccine are now in some places by policy NOT getting pap smears anymore. I don't think this is CDC endorsed or anything, but people have told me their gynecologists have specifically recommended this line of action. This is super dangerous, because pap smears can reveal all sorts of cancers that are not cause by HPV, and so now they are at risk from dying of those cancers too. This silly policy decision alone could potentially undo whatever good the vaccine does.
Now, of course you could simply market the vaccine and NOT add on that policy / tell patients the right thing, and avoid this risk. It's not like that policy is inherently packaged along with the vaccine.
But this still embodies a usually intangible factor of
culture -- people starting to put too much faith in vaccines and being sloppier in other ways as a result, such that it can undercut the benefits. Regardless of how much we continue to vaccinate more or less or the same, addressing some of the silly cultural trends surrounding it is an important thing to do in the meantime.
No, I did actually specify this in a concrete way. It's only better to be the first to get vaccinated if the "30% risk reduction" is greater in magnitude than the risk factor of the vaccine. But herd immunity can kick in to take the overall protection above the vaccine's risk level.
No, herd immunity is there from the VERY FIRST vaccine. That first dude not getting sick = one less dude that every other person he knows (hundreds of them) are now exposed to.
In fact, the strength of the herd immunity effect is
higher with that first dude than it is with any subsequent dude. Because the second guy who gets vaccinated in the same community? He provides that same lack of exposure risk to all his people he knows as well...
MINUS ONE - the first vaccinated person.
So his herd immunity contribution is actually slightly less than the first guy's. And so on.
(In actuality since not everybody knows everybody in the country, it is just flat at first in the graph, until at least a couple people are vaccinated in every community. Which as you can see, I actually took into account in the drawing, actually!)
As such, the only damage it produces in itself is autoimmune, and you cannot really factor in that kind of autoimmune response, because that's for the most part a shit happens kinda thing
...Except autoimmune "shit
doesn't happen", if there's no vaccine at all. So the autoimmune threat still needs to be factored in, however small.