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[GavJ]

So the only way to verify it is to record over 85% of the US population getting the vaccine?

That's only if you want to verify a policy of pushing for a higher than 90% coverage rate.
To verify a policy of pushing for a higher than, say, 80% coverage rate will require far fewer participants.
To verify a policy of pushing for a higher than 70% coverage rate will require fewer still (and in fact I calculated earlier in the thread it'd be about 45,000 only, based on the Italian data)

ALSO:
1) It's just 300,000,000 people, for the length of a study. I never said they all had to live in America. You could draw from similarly industrialized countries. Europe + America + Canada, etc., now you're only looking at about 1/4 of the folks.
2) Only half the sample would be assigned to the unvaccinated group, i.e. 150,000,000, so that's 1/8 of the population.
3) The study of course does not require that these people stay unvaccinated for their entire lives. Only for like 6 months, maybe. Then they can go do whatever they want. Including getting vaccinated immediately afterward if they feel like it.

Besides that, actual statistics suggest that the benefit is good enough.

Except for the part where there aren't any statistics anywhere on that page.
(Also the part where it is a webpage about autism, which isn't even what I'm talking about)

[Putnam]

Except for the part where there aren't any statistics anywhere on that page.

http://www.jennymccarthybodycount.com/Anti-Vaccine_Body_Count/Preventable_Illnesses.html
http://www.jennymccarthybodycount.com/Anti-Vaccine_Body_Count/Preventable_Deaths.html

unless you have some odd definition of statistics that I'm not aware of

[GavJ]

Except for the part where there aren't any statistics anywhere on that page.

http://www.jennymccarthybodycount.com/Anti-Vaccine_Body_Count/Preventable_Illnesses.html

That's just counting. It does not in any way address any of the logic in this thread. I began with the same data they are presenting there in the OP...

[Putnam]

Wow, you actually managed to post between my post and immediately-rethink-post-and-edit.

[GavJ]

To be crystal clear just in case: That website counts up deaths from diseases. Which the CDC already did and the results of which i already took for granted from the first post of this thread.

This number is meaningless by itself, though, because it's only one half of a subtraction problem.
You need to compare that to deaths from vaccines, to know which one is bigger... (what the rest of this thread is about)
X - Y > 0? Or X - Y < 0?
All they've done is solve for X and completely ignored Y, which doesn't let them solve the problem. They aren't even pretending to TRY.

[Putnam]

Are there any deaths from vaccines? If so, is that number even remotely within the order of magnitude of the deaths that could have been prevented by them?

[GavJ]

Are there any deaths from vaccines? If so, is that number even remotely within the order of magnitude of the deaths that could have been prevented by them?

It's not a number that's sitting around. I'm not a moron, do you think I have been sitting on some exact number and just haven't thought to subtract the two yet? 

Again, NOBODY KNOWS how many people have died from vaccines.
1) There is a terrible reporting system.
2) Even if we have excellent systems with mandatory reporting (which we DON'T), people still can't report things they don't even notice, and there is no guarantee that whatever deaths vaccines might case that they would be easily noticeable, linkable, trackable, or that they would necessarily happen in reasonable timeframes of observation.
3) Clinical trials solve this problem, since they are designed to be able to find any effects that exist down to the threshold they have the power for, whether predicted or not, whether easily noticeable or not.
4) However, we do not have anywhere close to enough power to answer the question that is needed, due to the embarrassingly small number of people run in clinical MMR trials.

(although yes we do know it is absolutely higher than zero. Even with the terrible reporting, lack of followups, not enough causal experiments, and people bickering over what counts or doesn't at every opportunity in the absence of clinical data, there are still sometimes completely unambiguous cases, such as dying of anaphylaxis within minutes of a shot)

[scrdest]

Just as a note, in drug safety tests, you're not going for an alpha of 0.05, you're going for 0.01.

[i2amroy]

Bit of a long post here, sorry bout that.

I think I'll agree with others in the thread that for anything serious such as diphtheria or mumps, it's a definite vaccination need. This is also compounded greatly for any diseases that we actually have a chance of eradicating, like we did with smallpox. Even if those eradicable diseases only succeed in causing a very small handful of deaths each year, once you multiply that amount by the expected number of years remaining for the human race, your number is almost certainly going to be larger than whatever extra losses are caused during the (relatively) smaller number of years by the vaccine.

That said unless some megacorporation takes over the world sometime soon, I don't ever really see a scale of that size ever being carried out, let alone being carried out enough times to be scientifically verifiable. (An alternative study direction could be slowly compiling data over time, but then you are looking at a multi-generational type of study, which is equally likely to not be carried out for a variety of other reasons). As such it's kinda a moot point to attempt to discuss anything about such a study, since it's locked firmly in the realm of hypotheticals and opinions.

Personally? I know that I'm getting vaccinated because there is a very strong and studied correlation in your chances of not dying from a disease if you are vaccinated and what studies we have done so far have shown that generally your chance of suffering death or permanent damage from a vaccination are not statistically significant in anything short of enormous population groups, and so my chance of suffering that personally is small. You are always free to disagree, but as has been pointed out it's currently impossible to provide any sort of data on the exact risk values of various vaccines, and it's not very likely that those values will be obtained to the needed level of precision to discuss them any time in the coming decades, so there isn't exactly much that I can do to convince you on my opinion about the "exact" level of risk vs. reward.

I'd assume that that also has something to do with why vaccines are currently handled the way they are. If we could obtain exact data we could probably eventually balance out a risk vs. reward thing and obtain a better system (though implementing it would still be a problem) but until such point that we can obtain that data and enforce it somehow it's better politically and medically to simply choose one side of the argument and stick to it until proven different.

[GavJ]

As such it's kinda a moot point to attempt to discuss anything about such a study, since it's locked firmly in the realm of hypotheticals and opinions.

Me not having time to count my calories or exercise doesn't mean i can just pretend I won't get fat because "it isn't practical" and then expect it to be so. Lack of funding or knowledge is not an excuse to just go pretend things are going to work out or that you know things anyway.

I absolutely agree that that study isn't realistically going to get run. That does not change the fact that it would need to be run if you want to justify the current US policy. Without it, the government can and should only have a policy of ensuring either [minimum level of vaccination their data do support, which is probably around "60% or higher"] OR [level of vaccination that is known to break endemic disease levels, which for measles is at most around 75-80%], whichever is higher. And to remove penalties for people not vaccinating above that (retain them when the rate is below)

Both are currently less than 90% and even more less than 100%. And either one would be easy to advertise and justify in 1-2 sentences.

Other than that, once you achieve those levels, people should just be left free to follow their own intuition, since it is no better or worse than the science above those levels. Like your own personal intuition to get vaccinated, which is just fine.

it's better politically and medically to simply choose one side of the argument and stick to it until proven different.

Why? This is not how science works. Without positive results, you keep an open mind, not "pick something randomly and promote it..." Go ahead, go attempt to submit an article to any peer reviewed journal and tell them "Well I don't really have data for this, but it would be SO HARD to get any, so I just chose this theory by coin flip. Please publish. Kthxbai" and see how that works out.

I admit that as a scientist I'm also not a politician or a medical doctor, though. Can you further explain a reason why it is better for them to ignore the scientific choice here and "just pick one side" instead?


(Edit: Note that the above, lack-of-data coverage rate is NOT the same thing as an actual known optimal rate, and should be published by the CDC and related to any laws, etc. accordingly as just "we don't know how much higher than this is good or not." not "This is definitely the best.")

[Leafsnail]

I absolutely agree that that study isn't realistically going to get run. That does not change the fact that it would need to be run if you want to justify the current US policy. Without it, the government can and should only have a policy of ensuring either [minimum level of vaccination their data do support, which is probably around "60% or higher"] OR [level of vaccination that is known to break endemic disease levels, which for measles is at most around 75-80%], whichever is higher. And to remove penalties for people not vaccinating above that (retain them when the rate is below)

I've glad you've finally conceded this, considering your whole "IT COULD BE ZERO PERCENT" thing earlier in the thread.  Once again your numbers are wrong though, the actual scientifically derived figure to prevent eg measles spreading is around 95%, and I've seen nothing from you to challenge that mathematical analysis.  This varies greatly by disease though - where we don't have as effective a vaccine (with something like mumps, for instance) you need a much higher rate since a significant portion of your "vaccinated" population won't be protected and you'll need to rely on herd immunity to protect them.  And of course there's always the issue that if you try to "optimize" the rate based purely on national statistics you risk creating pockets of low coverage that can allow the disease to become endemic in certain parts of your country (and then spread in outbreaks to the rest of your population).

[GavJ]

"IT COULD BE ZERO PERCENT" thing earlier in the thread

That was before I looked up the Italian datapoint, which allowed me to infer some sort of a rough trendline. Before that, it might have been zero!

the actual scientifically derived figure to prevent eg measles spreading is around 95%

Citation?

I assumed you were using the "herd immunity threshold" cited in various places, except:
1) That's not it for measles. That's on the high end of a 10% range of about 85-95%.
2) The "herd immunity threshold" is pretty technical threshold that does not really factor in here much. It is defined as "the coverage level where disease would sputter out from a single index case even in a completely otherwise uninfected population. That is not the same thing as "the level below which measles would be endemic" not by a long shot. Why? Because of the "otherwise uninfected population" part. In reality, as a few of the susceptible people around you get infected, the reproduction ratio goes down, and a lower level of coverage can still reliably stop and limit the size of the outbreak without intervention (also various other unaccounted for factors for endemic status, most significantly natural immunity and whether the disease is one that lurks in your body or not, like malaria or chicken pox). It also, importantly, has absolutely nothing to do with vaccine risks whatsoever, doesn't even consider them. ALSO it is often (not always) calculated from computer models, not even actual observations of the infection rate. I don't know if the measles one is observed or simulated.

In other words, the herd immunity threshold is based entirely around (doing an acceptable though not stellar job of) achieving a goal of not having a single outbreak. Period. End of story, that's all it cares about. It doesn't consider the costs of achieving that, or whether they might be worse than the benefits of wiping out some extremely small outbreaks. And it isn't based on the necessary levels for disease extinction. It's actually quite simplistic, and is in line with a "let's just be blind to the entire other half of the the entire equation and pretend vaccines are magical infallible unicorn dust" philosophy.

But due to #1, maybe you're not intending to use that number. If you're using something else, please explain/cite what you're using instead.

[Neonivek]

I think what he means is, is that at 95% vaccination rate you are very unlikely to have outbreaks.

[GavJ]

Yes, I think that is what he meant.

But so what? Eliminating outbreaks should not be your main goal. Minimizing deaths should be your main goal, and they are NOT the same thing.

The possibility that at least one extra vaccine death would occur in 20 years (current projected measles death rate at 90%) from vaccinating an extra 15,000,000 people is actually extremely plausible.

Even just one vaccine death (detected/reported or not!) in those 20 years makes it neutral. 2 would make it twice as bad as the outbreaks. And at the same time, we also suffer the possible injustice of people getting punished (denied access to schooling, etc.) when in reality, their lack of vaccinating from 90->95% might be irrelevant or even better for the country.

[Neonivek]

But so what? Eliminating outbreaks should not be your main goal. Minimizing deaths should be your main goal, and they are NOT the same thing.

But they are directly proportional