I'm pretty sure you must be doing this deliberately. You slice up my posts into tiny pieces and pick up on all kinds of (usually misunderstood) details, but you cut out the key points and ignore them. For that reason I will once again just state the massive misunderstanding in your position so you can't weasel your way out of acknowledging them. The only responses you should make to this post are 1) an explanation of why you think this misunderstandings is actually justified or 2) an acknowledgement that you are mistaken. I will not respond to anything else.
You seem to think that the point at which a treatment and the disease it seeks to prevent kill the same number of people is the "ideal coverage" for that particular treatment.I won't let you pretend you aren't making this assumption. You make it here:
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.
Here you compare the total number of people that would be killed per year by a vaccine (if we are to accept the safety figures for an old vaccine that is clearly a lot more dangerous) to the number of people killed per year by the disease, and suggesting that if these are equal you'd be at a "break even" point, beyond which you should not vaccinate.
This is completely incorrect. What we are looking for is the
point at which there are fewest deaths in total, not the point at which the damage the vaccine is doing and the damage the disease is doing are equal.
My example shows how absurd this notion is: under your "break even point" theory we should leave 3-4 people unvaccinated, so that the disease is allowed to do as much damage as the vaccine. You deliberately cut out the reason I created this example and attacked it on an irrelevant basis.
The thing is though, I can even demonstrate that your "break even point" idea is nonsense by referring to real-world data. Let's make our assumptions even more generous: vaccines are actually killing 0.9 people per year, the same number as the disease. We're already at this point, beyond which we (according to you) should stop vaccinating.
Ok, so the total number of people dying from the vaccine and the disease at 92% coverage is 1.8, that is 0.9 from the vaccine and 0.9 from the disease.
Let's say we increased our vaccination coverage to 100% (this is impossible in practice, but let's say we can). I think it's fair to say this would eliminate all deaths from measles - it would eradicate the endemic cases and prevent all but the tiniest of outbreaks. It would also cause more vaccination deaths - we're now vaccinating about 9% more people per year than we were before. So that would increase the number of people that vaccines are killing per year to 9.8 people. So if we round up we now have 1 person dying per year due to the vaccine and disease put together (1 + 0 = 1).
This is fewer deaths than under status quo.
This demonstrates that 100% vaccination coverage would be better than what we have now even if we assume we've already reached the "break even point" - in other words, your ideal level is higher than the 92% coverage we got through pushing for universal coverage. I realize that there is going to be an "optimum level" where the disease is so totally obliterated that we don't need any more vaccinations, but it's likely to be so high that between people with compromised immune systems, babies and anti-vax nuts that we'll never reach it.
Can you see the problem with your assumption now? 100% vaccination coverage would be better than our current level in terms of overall deaths. What you're failing to realize is that you need to look at the
change in risk between different vaccination levels, not just the total risk (unless you're trying to argue that the optimum rate is zero, which I think we've established quite firmly by now is not the case).