Vaccination & epidemic

[lumberjim]

Originally Posted by Undertoad

But right here in the thread we have someone who has spent probably 16 years studying medicine and who does have kids. You dismiss her beliefs as conspiracy theory.

I am not sure what gave you that impression. I did ask if there were financial pressures on doctors to maintain vaccination quotas. She denied knowledge of it. I have no reason to disbelieve her on that point. It does not mean it's not happening, though.

Doctors offices are businesses. Big practices are organized like big businesses. They get paid by the job, just like a mechanic. If a young doctor in a big practice is not overseen and reviewed by seniors, I'd be very surprised. If that young doctor had a noticeably higher percentage of unvaccinated patients, there would be questions asked. That doctor I mentioned seemed quite upset that we were delaying the mmr vaccine. Not frantic, but frustrated to be sure. Maybe offended that we were questioning her recommendation. ... anyway, if she HAD seen 'so many kids die of measles' it would have HAD to have been in another country. But she didn't say that. So she was deceptive at best. She was trying to scare us into doing as she wanted.

I don't recall discounting orthos experience or acumen. Although, as far as I know, she is neither an immunologist, nor a pediatrician. What kind of Doctor is an ortho? Orthopedic? Is she qualified to offer advice or cast judgements?

I recall saying that I knew I was not going to change her mind. But, instead of affording me the same respect, she chose to lecture me on the benefits of vaccines, and she chose to state that I smeared all hard working physicians by questioning their motivation. She chose to talk down to me as though I were ignorant about this topic. I'm not. I may not have the same priorities as she does, but I'm not uninformed. I know that the sun causes the rooster to crow.

A Phd does not confer intelligence. It does not even mean you have a better source of information anymore. She mentioned journals. Who publishes those? It's not conspiracy. It's business. Pharma companies see doctors as front line salespeople. If any one has a biased source of information, Its doctors. Couple that with the inherent superiority complex they usually develop, and I'm sorry, but I'll think for myself. I accept the information she offers. I'll weigh it against the risk myself.

[Undertoad]

What kind of Doctor is an ortho? Orthopedic? Is she qualified to offer advice or cast judgements?

While we wait for Ortho's answer, Jinx's degree is in what? I honestly don't know.

[Happy Monkey]

And Jenny McCarthy's?

[lumberjim]

Ok, you're gonna act like that. Great. Have fun agreeing with each other in this thread. I'm out.

[Undertoad]

Act like what now?

[tw]

Originally Posted by xoxoxoBruce

We make thousands of decisions every day. Some are more meaningful and require more thought and varying degrees of research. Of course tw's standard response is you have to have the facts and numbers.

And when we do not have perspective (numbers are just one example), then we take extreme care. And make a guess only after accessing the risk. BTW, why is the Silicon Valley so innovative? They make mistakes. Then do not get angry. Instead they learn why they made a mistake. That was the point lost when some, instead, well, it will be explained.

[tw]

Originally Posted by DanaC

You misunderstand me. I wasn't saying Jim and Jinx approached the decision emotionally. It's this thread and this conversation which will always provoke emotion.

You may think so. But read what I posted. I never even implied that. And am rather confused how one would reach that conclusion without adding, well, its explained below.

If I was criticizing lumberjim's and jinx's parenting skills, then you would have read multiple reasons why I reached that conclusion. At this point you should know I routinely provide multiple reasons for a conclusion. This post will be a classic example.

A first post discussed conclusions about vaccines and surge protectors. What do both have in common with parenting skills? Nothing. That was a clue that you were reading what was not posted.

Many (probably most) only read what they expect to read. A conclusion based in motivated reasoning. How do surge protectors define bad parenting skills?

The point was bluntly about how people make conclusions. As discussed previously. This topic goes right back to how children think verses how adults think when using a pre-frontal cortex. No way around that reality. Children and adults who are thinking like children entertain a "motivated reasoning" process. Adults eventually discover that something must be read at least three times to understand it - especially when a concept is new. Otherwise motivated reasoning takes hold.

If you understood it with a first reading, then it said only what you already knew it would say. And probably overlooked the most important part (numbers).

At this point the emotional, using motivational reasoning, will see these words but not read what is posted. Since I have already touched on a reality that angers, then many will not reread to understand the actual topic in that first post.

We know numbers prove benefits of infant vaccines far outweigh the risks. Facts and updated numbers from research repeatedly say so (including recent numbers that expose a decreasing effectiveness in one vaccine). Why do so many know otherwise? "Motivated reasoning" partially explains it.

Dr Kahan of Yale discusses, for example, how conservatives tend to value individualism, hierarchical organization, and a belief in ensuring their own prosperity. Therefore a "sacrifice of one for the many" (what should be a familiar quote) is contrary to many conservative beliefs. As a result, a CFL light bulb that is environmentally friendly creates a very negative response from this group. Their motivated reasoning explains why CFL bulbs sell least to most conservative thinkers. Even though its advantages over an incandescent bulb and numerous and significant.

Michael Shermer in an October issue of Scientific American further demonstrates the problem by using himself as an example. Citing his bias for unrestricted gun access. Opinions that were challenged by extensive research into guns, homicides, and accidental shootings eventually changed his motivated beliefs. He said

I find that, too often, my beliefs trump scientific facts. This is called motivated reasoning, in which our brains reason our way to supporting what we know to be true.

Shermer then discusses a trend he noted at the 2013 FreedomFest in Las Vegas.

but this year I was so discouraged by the rampant denial of science that I wanted to turn in my libertarian membership card. ... all of us are subject to the psychological forces at play when it comes to choosing between facts and beliefs when they do not mesh. In the long run, it is better to understand the way the world really is rather than how we would like it to be.

A commentary in Machine Design, notes (unfortunately) that scientific facts today must be 'tailored' to reader biases.

Strangely enough, that approach sounds a bit like something else that's exacerbated antiscience attitudes - namely, increasingly subjective media outlets designed to engage target audiences. That's where most people get the bulk of their science-related information right now.

Well, I did not do that, did I? I simply posted facts bluntly as facts without any concern for what was completely irrelevant here - the reader’s emotional biases. I expect you to know the minute you have assumed insult or cheapshot, then you know you have not grasped the point. And probably overlooked a perspective (the numbers). Again, most readers never see written numbers (the perspective) until after multiple rereads.

So, have you followed rather complex concepts posted here? If you did not read this at least three times, then you did not. A second benchmark point to add to one about rejecting claims that are only subjective; not quantitative. If your conclusions are not tempered by perspective (the numbers), then what was read may be a victim of motivated reasoning.

That first post says nothing critical about anyone. It is completely about how people see vaccines as dangerous when no quantitative research (even 30 years ago - 1982) said that. And about people who do same with surge protectors (ie assume it is high tech; therefore must do protection).

To suspect infant vaccines are more dangerous than beneficial is a perfect example of motivated reasoning. Defining one as easily manipulated (brainwashed) as the stripper and actress Jenny McCarthy. No quantitative conclusion even ten years ago could justify subjectively inspired fears. And yet that is what so many of us use for knowledge. Saddam's WMDs were another perfect example. The inability of TEPCO top management to make a decision to save three nuclear reactors from meltdown is another perfect example. Another is management that all but murdered seven Challenger astronauts. How many instead assumed these were accidents? At best, one could only conclude these were classic examples of brain freeze.

A conclusion based in emotions is not what the pre-frontal cortex does. But is a characteristic of how children think. When incapable of grasping something that contradicts beliefs, many have a brain freeze; simply resort to the brain mostly used by children. Many simply and foolishly decide based upon what makes them comfortable. People can die because of it.

Moving on. Did you ignore a statement about computer adjacent protectors even creating house fires? Why did that not get most of your attention? Were you reading for facts? Or reading only to be emotional or stay in your comfort zone? I intentionally included that ‘bait’ to see who would grasp for facts. How many instead remained in a 'feel good' mode; used motivated reasoning to even ignore how fires get created?

I never criticized anyone's parenting skills. I noted how people entertain their emotions rather than grasp facts and numbers. This fear of vaccines has long been a perfect example.

I simply demonstrated how lumberjim, et al were easily manipulated by Jenny McCarthy, et al type myths. Does not matter when they did the research. It was still a conclusion from reasoning also demonstrated by Jenny McCarthy. Never a criticism of lumberjim or jinx. And yet lumberjim did exactly what so many do when motivated reasoning is exposed. A majority get angry rather than learn from their mistakes. A majority get angry rather than do what Michael Shermer does (professionally).

[orthodoc]

Originally Posted by lumberjim

I did ask if there were financial pressures on doctors to maintain vaccination quotas. She denied knowledge of it. I have no reason to disbelieve her on that point. It does not mean it's not happening, though.

What kind of Doctor is an ortho? Orthopedic? Is she qualified to offer advice or cast judgements?


She mentioned journals. Who publishes those?

I'm late to the conversation; I was driving all day. I'm sorry LJ has left.

For anyone else who wonders if doctors are under pressure to 'maintain vaccination quotas', the answer is no. Vaccines do not make money. They are break-even at best, sometimes a money-loser. Most pharm companies have gotten out of manufacturing vaccines because of the Jenny McCarthy craziness and the huge lawsuit settlements given by jurors who believed Jenny McCarthy rather than the facts. The few remaining vaccine manufacturers sometimes can't keep production up, and we experience shortages at times. This has the potential to bite us big-time, in the next pandemic.

Procedures are what make a profit, because that's what insurance companies have decided to pay most for. Vaccines make nothing.

What kind of doctor am I? I've been a family physician since 1986 and have seen MANY children because, in Ontario, pediatricians are strictly referral specialists. No one is allowed to take their children to a pediatrician for primary care. Family docs see all the kids for preventive and primary care. I'm currently finishing a residency in Preventive Medicine and Occupational/Environmental Medicine. I will finish my Master of Public Health next spring. I'll write board exams next fall that will require that I have a specialist's level of knowledge about vaccines and immunizations. My pre-medical degree was a double major in biochemistry and chemistry. But it doesn't matter how qualified I am. That's not going to change anyone's mind who thinks vaccines harm us and that all doctors are in league with Big Pharm to get rich by forcing immunizations on the public.

Who publishes scientific and medical journals? They are edited by peer-review committees of respected scientists who examine submitted papers for study design, quality, and contribution to existing knowledge. Anyone who publishes a paper or serves on an editorial board must disclose all potential conflicts of interest. Big Pharm does not publish the journals.

I think a question was asked about whether there is any evidence that measles, mumps, and rubella actually cause harm greater than the vaccines against them do. Rubella is a mild illness in the sufferer, but a scourge when unborn children encounter it. An unvaccinated person could have rubella and not even realize it, communicate it to an unvaccinated pregnant woman, and the result would be catastrophic damage to the baby. Mumps causes deafness and orchitis resulting in infertility. Measles is what causes encephalitis, not the vaccine. It also kills via pneumonia. There is no treatment for these diseases. They're virus-caused and we don't have good antivirals against them.

Public and preventive health are concerned with the social contract. They focus on the health of populations, and vaccination is a population issue. When the herd is immune, it's protected; when a significant proportion is not immune, disease outbreaks occur. We didn't see measles, mumps, and rubella for a few decades in the late 20th century because immunization rates were extremely high. Now we're seeing outbreaks as a result of immunization refusal. Not lecturing; it's just information.

[Clodfobble]

Originally Posted by orthodoc

Measles is what causes encephalitis, not the vaccine.

Encephalitis is a known potential side effect of the MMR vaccine. Of course the corollary assumption is that it's rare, but check your package insert. It's written right there.

[orthodoc]

The MMR vaccine is a live attenuated virus vaccine. In a severely immunocompromised person (including unborn children), it may cause disease. Disease then carries the potential complication of encephalitis. We don't give live vaccines to pregnant women or those who are severely immunocompromised. The conditions under which the vaccine could/might cause it are extremely rare (this is not an assumption - see http://www.cdc.gov/vaccines/vac-gen/...ffects.htm#mmr), but every possible risk of adverse reaction must be listed on the insert. Encephalitis is not a material risk of the MMR vaccine. We, and our children, face much higher risks from the disease.

One of my children developed varicella (chicken pox) encephalitis when he contracted it at 8 years old. There was no vaccine then. It was a horrible thing to watch him go through.

[Clodfobble]

Of course. And risk vs. reward is the debate everyone should be having, both on an individual and a collective level. But that involves acknowledging that there is some level of inherent risk. It's the "100% safe guaranteed no matter what" rhetoric that causes people to mistrust doctors.

Interestingly, all the doctors I know are notorious about hedging their answers when it comes to any medical knowledge. Every procedure carries risk; every assumption could always use more research. Except this one thing.

[orthodoc]

The link I provided above is to a page that specifically discusses vaccine risks. This is public information. More importantly, Vaccine Information Sheets (VISs), which provide information on the benefits and risks of the vaccine to be given, are required by law to be given to every patient/guardian prior to them receiving the vaccine. See http://www.cdc.gov/vaccines/hcp/vis/...facts-vis.html.

You're right, clod, every procedure carries risk. The material risks from vaccines are very, very small. Nevertheless, every medical office provides information on those risks with every vaccination.

Eta - That said, you and LJ have both expressed frustration with feeling that providers were too overbearing in encouraging immunization. It's probably the most successful, best-documented public health measure. Just as you are passionate on the topic, most physicians, after learning about the rates, complications, and mortality due to these diseases prior to the availability of vaccines and the drop in those measures after, tend to be passionate about it too.

[Lamplighter]

Using death to assess risks is an extremely stringent end point.
Even using the signs and symptoms of the disease is quite narrow,
and fails to describe the entire situation of many families.
Some families have stay-at-home mothers or fathers... but not all.

For example, a working mother may be faced with difficult issues of child care
if/when the child becomes ill with an otherwise preventable disease.

If that working mother is also a single working mother,
the situation probably even more difficult.

If that single working mother is also low income, a sick child can lead
to significant loss of income... and possibly even the loss of her job.

To think about a single, working, man taking time off from his job
to care for his sick child is yet another POV ... for me that's almost too weird !

[Griff]

http://www.cdc.gov/vaccines/vac-gen/...ffects.htm#mmr
Some numbers by the vaccine people. Note what counts as a moderate reaction.
A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions.

The risk of MMR vaccine causing serious harm, or death, is extremely small.

Getting MMR vaccine is much safer than getting measles, mumps or rubella.

Most people who get MMR vaccine do not have any serious problems with it.

Mild Problems

Fever (up to 1 person out of 6)
Mild rash (about 1 person out of 20)
Swelling of glands in the cheeks or neck (about 1 person out of 75)

If these problems occur, it is usually within 7-12 days after the shot. They occur less often after the second dose.

Moderate Problems

Seizure (jerking or staring) caused by fever (about 1 out of 3,000 doses)
Temporary pain and stiffness in the joints, mostly in teenage or adult women (up to 1 out of 4)
Temporary low platelet count, which can cause a bleeding disorder (about 1 out of 30,000 doses)

Severe Problems (Very Rare)

Serious allergic reaction (less than 1 out of a million doses)
Several other severe problems have been reported after a child gets MMR vaccine, including:
Deafness
Long-term seizures, coma, or lowered consciousness
Permanent brain damage

These are so rare that it is hard to tell whether they are caused by the vaccine.

It was a long time ago, but here is my 2 cents from my sometimes selective memory. My kids got all the recommended vaccines. With the older girl we were able to spread out the shots over a longer schedule and were able to get some vaccines commonly given in multiples as individual shots on individual days. She had no significant issues just mild swelling and fever. With the younger the politics of vaccination were in play and we were badgered into pretty much following their schedule. Little Griff had significant swelling and fever and gave us at least one long over-night of screaming baby with associated parental guilt. Beating up on vaccine skeptics is common place even among people who normally question the interplay of government and corporations. I get that it's important, many of my age-mates were exposed to German measles en utero and suffered serious birth defects. I just think that people are unable or unwilling to discuss this topic like adults because, maybe rightly, it could suppress vaccination numbers. This lack of discussion can itself harm children because 1 in 3000 is significant, at least to the 1 in 3000.

[Aliantha]

We are given an info sheet with every vaccination our kids get. I told them last time not to waste the paper, but they insisted i have it anyway. Apparently it is required.

None of my kids have ever shown the slightest reaction. Lucky for us i guess.