Tagged: herd immunity

My Vaccine is Your Vaccine

Teaching children medieval superstitions in place of evolution is bad. Failing to grasp the facts and theories of climate change, and thus electing politicians who pander to and-or share such ignorance is worse. But scientific illiteracy among our fellow citizens can be lethal. Opting children out of vaccinations endangers those children directly, as well as many millions who have no choice but to depend on herd immunity for protection because they are unable to get vaccinated themselves.

There are plenty of decisions people make every day that endanger their own health. You can smoke, drink to excess, skip your meds, drive without a seatbelt, skydive or scubadive – it’s a free country, and you’re not hurting anyone but yourself. But your vaccine is my vaccine, and vice-versa. And the aggregate effect of many people failing to get vaccinated is many other people getting sick.

People with weakened immune systems cannot get vaccinated, and depend on the rest of us to act as a firewall, so when a case crops up, it doesnt spread beyond the afflicted individual. The four million children born each year in the US are among the most at risk, because they cannot be vaccinated until their 1st birthday. And no vaccine is 100% effective – even for healthy people, other peoples’ vaccines are an important part of one’s own individual health.

People didnt evolve in the urban environment most of us find ourselves living in today. When our species lived in bands of 20 to 50 individuals, there was no place for an infectious disease to hide. You werent gonna catch the measles from squirrels – if the people around you were healthy, you were pretty safe.

Things are different now. We live in massive networks of millions of people interacting directly and indirectly, amidst a world of billions tied together via modern transport. Unless a disease is globally eradicated (like smallpox), it can pop up tomorrow in a neighborhood near you. Putting aside the fact that life expectancy was about 30 in our evolutionary environment, relying on our own unaided immune systems just doesnt work.

So-called childhood diseases continued to sicken and kill many people in the West deep into the 20th century. The difference today is vaccinations. It is the only thing between us and measles killing a thousand or so children in the US alone each year. (Measles kills about 1 or 2 people per 1000 cases.)

Measles is among the most contagious diseases ever identified. But measles has one serious weakness: it cannot survive outside a human host, and needs a constant source of fresh carriers. Nasty though it may be, it can be nullified, if not eliminated, through mass vaccination.

There’s a catch. Because it’s so contagious, you have to vaccinate a huge fraction of a community to obtain “herd immunity” – the point beyond which a disease will vanish after an individual infection, instead of spreading. Measles require a vaccination rate of about 90%.

Because measles remains quite common in the developed world, it’s almost impossible to eliminate it completely in the West. (Vaccination efforts continue worldwide.) Over the past 15 years, the US saw only 60 or so cases in a typical year. In 2014 there were 600.

The reason behind the spike is simple. Many Americans are ignorant to the science behind vaccinations, and so they’re opting their children out of shots at an increasing rate. The problem isnt specific to measles, or to the US. (The UK and Japan have also had outbreaks.) But measles, which is given to outbreaks because of its extreme contagiousness, should be taken as a warning of what’s to come unless these trends are reversed.

The reason people continue making bad decisions is that they do not bear the full cost of the consequences. For that to change, from an economic standpoint, the cost of failing to get a child immunized should be monetized, and parents should be required to submit proof of vaccination when they file their taxes, or pay a penalty approximating the expected value of their decision. A pair of studies found the average cost of a measles case to be about $1,000 – including cases involving hospitalizations, whose average cost is $10,000. Those studies are 20 years old – the cost of healthcare has since more than doubled, and that’s on top of ordinary inflation. When you factor in that a single measles case in an unvaccinated population causes between 12 and 18 additional cases, you’re talking big money.

Using these crude figures, it seems that $5,000 to $25,000 would be a fair price to pay for failing to get a child vaccinated. Hey, it’s a free country, so the police arent gonna drag kids out of homes and stick needles in their arms. But it is reasonable to ask people to take personal responsibility for their decisions, and pay their own way. That’s what conservatism is all about – or so they tell us….

 

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