The anti-vaccine crowd is a combination of woo guzzling liberals and conservatives. The biggest difference is that the liberals who are not vaccinating their kids don’t have significant elements of their favorably inclined political representation encouraging them while it looks like anti-vaccination will be yet another litmus test used to determine who today is a True Conservative ™ and who is a squish. Why? I think it might have something to do with how vaccines solve collective action problems and how the right does not like to recognize that these problems exist as a class.
Vaccines provide protection through two means. The first is direct protection. I get a shot for something and the probability of me getting that particular disease declines dramatically as my immune system now knows how to fight that type of invader. The second is indirect protection via herd immunity. If I get a shot, I go from being a possible vector and transmitter of a disease to another unvaccinated person to a very low probability of passing the disease along. Herd immunity only works when the vast majority of the population already is immune to a disease as the probabilities of a current carrier bumping into a receptive individual is fairly low if the general population is overwhelmingly vaccinated. If I am the only person in my county vaccinated for Itch Elbowitis (and no, I did not watch a lot of Nick Jr. last night with my kids), any current carrier of Itchy Elbowitis will be highly likely to bump into non-immune individuals by the time they get their first cup of coffee. A nasty bug won’t have the chance to get established in my community as it won’t bump into any receptive carriers during its infectious/spreading phase of its life cycle.
Should everyone get vaccinated?
Hell no.
Immune compromised individuals need to count on herd protection as they should not be placed at risk by even a weakened form of a disease. But this is a small proportion of the population. We as a society have also made a decision that Amish and a few other groups can opt out of most of the 20th century, but on a national scale, they are a tiny population with some local concentrations. But we basically count on high non-Amish vaccination levels to contain any Amish-centric outbreaks to just the Amish. We allow the Amish to free ride on the larger community’s high vaccination rate and thus they gain a low probability of transmitting infectious diseases into their community without particpating in the larger scheme.
Vaccination is a solution to a collective action problem of creating herd immunity. It may not be individually rational for any one individual to get a vaccine when 90% or more of the general population already have been vaccinated. In most cases in that scenario, a non-vaccinated individual will get the benefits of herd immunity by not running into carriers of a disease during its infectious stages without having to get a shot/pill/nose spray. They get to free ride on society. The problem is when there are a lot of free riders the positive externality of herd immunity breaks down.
We have seen that the conservatives in America have two reactions to the concept of collective action problems. The first is that responsibility is for suckers. There is an embracing of free riding and running down the collective commons as that is the individually rational thing to do, and St. Rand in her Commentaries preached that only individual interest matters. Fuck society.
The second is a bit more sophisticated argument that if we as a society value a positive externality, then there has to be some set of welfare raising side payments and agreements that can be made between people who want high vaccination rates and effective herd immunity and those who want to opt-out. It is coercive and therefore unjust to mandate vaccination without a really good reason (where hurt fee fees are not a good reason). Fuck Coase.
Baud
Kind of makes you wonder why we still waste our time with the selective service system.
Richard Mayhew
@Baud: There is a flag involved… that overwrites some of the fuck the community thinking
Violet
The Arizona doctor sums up the “me not we” thinking perfectly:
Since measles is now in Arizona and his kids are so healthy and “pure” I wonder if he’s going to take them over to play with the kids with measles. I’m sure they wouldn’t get it. Because they’re so healthy and pure, of course.
Belafon
OT:
1. I thought you all would enjoy this diary title from Meteor Blades at Daily Kos: Open thread for night owls. Andrew Sullivan ‘is to intellectuals what Vanilla Ice was to hip-hop’
2. Has anyone else seen the ad that says “Do you think students and faculty should be allowed [to pray] in public schools?” The reason I have the “to pray” in blocks is that, while they’ve got every other word lined up so you can see it, they’ve got those words off ot the right, where you can only see a little bit of the “t”. The background picture shows people praying. Of course, anyone foolish enough to click it will think it’s obvious that students should be allowed in school. I just find it funny that someone thinks that’s a large number of people will click on the ad.
Kylroy
I’m not sure I see the implications of the second conservative idea you present. Should we give people money to vaccinate their children, or charge them fines to not do it, indexed to the vaccination rate in their area?
I just Googled Coase, and the short version of the theorem does not begin to pass the smell test for me.
Also, Belafon, I got the same ad but the text is centered and across four rows, so there’s no way the version I’m seeing could end up cropped like you describe. Guessing they’re running multiple styles of ad.
jibeaux
What I read recently about the Amish is that they are not anti-vaccine as a philosophy, but that that particular community reportedly had 2 kids who had reactions to a vaccine, so they decided not to vaccinate for that reason. Unlike most of the SoCal types, my understanding Is that their attitude is malleable and that hundreds of cases of measles will likely mean they’ll vaccinate again in the future.
Baud
In case you were curious (via Vox)
HRA
The Amish are not a strictly closed society as are believed by some. When I had a child in the hospital, there was an Amish man standing in front of me to pay a hospital bill.
Also a co-worker talked about going to the Amish community to have a bedroom set built by them.
Patricia Kayden
@Baud: Not really surprising that the party which doesn’t trust scientists in regards to climate change also doesn’t trust scientists in regards to the safety of vaccinations. Anti-intellectualism at its best.
Violet
@jibeaux: I thought there was a measles outbreak among the Amish in 2014. I guess even that didn’t motivate them to change their stance on vaccines.
Felonius Monk
Shorter Rand Paul (self-licensed Doctor of Eyes) on vaccines and immunization: “Quack!Quack!”
Violet
Wow. I hadn’t seen this part from the crazy Arizona doctor:
Our children have rights to get deadly diseases! How dare you take away their rights!
Callisto
@Violet:
This is the attitude behind a great deal of the left-wing side of anti-vax. “My child is the only child that matters.”
When I was very young, my mother would use the argument “what if everybody did that?” a lot. Seems many parents today didn’t have that experience, nor did they pay attention to any of the myriad stories out there describing life before vaccinations against polio, smallpox etc.
The Other Bob
Sanjay Gupta this morning stated that people are more likely to have an adverse reaction to Aspirin than a vaccine. I think this is excellent messaging for the simplest minds.
dedc79
This is a critical part of it. The same people who don’t trust all the scientific studies telling them their concerns are groundless think that the fact their own kids haven’t gotten measles is a result of them raising their children in a “healthy” environment and is therefore also proof that the vaccine is unnecessary. That is, they benefit from the herd protection you describe, but attribute that benefit to their own paranoid anti-vaccine crusade.
Mystical Chick
I’d like to represent the WOO contingent and say not all of us are idiots and simpletons. (some airy-fairy types who believe whatever shit is handed down, yes, but in the main, we are practical and down-to-earth)
Not all big pharma is right for your body but I’d encourage everyone to do research from reputable sources if they feel alternative therapies are needed. Tune in and see what feels right. And do your damn research. Don’t just listen to whatever person is on the tv box.
If I had a child, yes, I would have them vaccinated. And I’m as woo as they come, yo.
jibeaux
@Violet: there was. According to vox, many did immunize during and after the outbreak; and that the fact that many were not before was the result of people talking about these alleged adverse reactions, plus the fact that they are overall less engaged in the whole health care routine, not needing physicals to play sports, having home births, etc.
scav
@Violet: But we’re talking about the Amish, there are likely to be multiple stances on vacinations, just as there are black top Amish and white top Amish and long arguements about if cell phenes are exactly the same as landline phones, and I seem to remember roller blades. There certainly are groups that are fine with high tech medicine when needed.
eta, no, not if rollar blades were the same as telephones, but somehow a group were having some sort of debate about them. over something.
raven
Sean Duffy (R) Wisconsin just said that some really well read, smart people are anti-vaxx, not just dumb people.
Violet
@jibeaux: @scav: Yeah, I’m sure there are many differences and reasons for their decisions. I’m not very knowledgeable about the Amish. Don’t live near Amish country and have visited only once.
OzarkHillbilly
@raven: Proving that intelligence does not guarantee immunity to stupidity, one of the most highly infectious diseases known to man. I myself have been inflicted with this dread malady on multiple occasions.
beltane
@raven: Yep, they’re going all in on this one. To the Republicans, good parenting involves giving your toddlers full access to firearms and no access to vaccines. Maybe it’s part of the FSM’s plan to rid the world of future Republicans.
RSA
@dedc79:
Dunning-Kruger Nation.
OzarkHillbilly
@OzarkHillbilly: AFFLICTED AFFLICTED… Stupid brain.
jibeaux
@Mystical Chick: there’s no alternative therapy to a measles vaccine, and “tune in and do what feels right” is not really a substitute for “listen to the medical consensus.” It doesn’t feel right to listen to a crying baby who’s been stuck with a needle and shoots you that look of complete betrayal. But it is right.
Elizabelle
Do you think that stretching out the vaccine schedule, for parents who request it, might assuage some parents’ fears? Think I read that some kids get 6 vaccines in one doctor’s visit — is this true?
I realize that parents might see a reaction — bad vaccine! — when it’s the usual ear infection or kid germs.** But maybe allowing parents more control over the timing and number of vaccines — within limits — would sugarcoat that they really have to do it, unless it’s medically inadvisable for the child. Which will be a small subset.
*** The fallacy of post hoc, ergo propter hoc: what follows was caused by event A.
Thanks NYTimes, for increasing my Latin with yesterday’s article on the debunked because fraudulent Wakefield study.
Scott S.
@Baud: And now we’ll see the wingnuts (and their pundit puppets) denouncing the Round World Heresy and Blue Sky Blasphemy.
Elizabelle
@beltane:
Please Dog.
Eric U.
the problem is that autism shows up right after a kid would have their first round of vaccines. My mother noted that my brother showed his first symptoms of autism shortly after he got his first vaccinations.
I think Cleek’s law needs to go more mainstream. Would it still be true if they knew we know?
Callisto
@jibeaux:
Likewise, how do you rationalize an “alternative therapy” when that raises the chance of measles spreading in your community?
BubbaDave
My apartment complex required proof that my cats were vaccinated before I moved in (although a letter from my vet explaining that she did not vaccinate my elderly and unwell cat due to her health was a substitute in that case). If I want to travel with my cats on an airplane, I need a certificate of health that includes information on inoculations.
I’d be happy to start with that sort of thing. You want to take your kids on a flight? Great– let’s see their health card. You want to move in to this complex? Sure– let’s see the proof that they’re up to date on their shots.
If the anti-vaxxers want to load the Family Truckster up and drive to Branson MO, go ahead– but at least you don’t get to share your mumps with everybody in an enclosed space with recirculated air….
dmsilev
Hillary Clinton:
Now we just need Jimmy Carter to weigh in and we’ll have a History’s Greatest Monsters Trifecta.
RSA
@Baud: I wonder how important context is in the Republican anti-vax movement? That is, would it even exist if we had a Republican President right now?
Callisto
@Elizabelle:
The vaccine schedule is there in part because of studies showing the best time to vaccinate (minimum amount of material producing maximal antigen production) as well as compliance (having a million doctor visits for individual shots increases the likelihood of kids missing at least a few).
The number of shots these days is much higher than in the old days which freaks a lot of parents out. What they tend not to understand is that the shots today contain far less material than the shots of old even with the higher number of shots. Better timing, better formulation.
Also, a child’s immune system has to code for more junk sitting in a park sandbox for 15 minutes than from a couple of shots. Changing the schedule a little bit, as long as the kid still gets all of his or her shots, doesn’t really hurt but there’s still no rational medical reason for it.
scav
@Eric U.: Given that the symptoms of Schizophrenia show up in early adulthood — I guess that’s why so many true believers opt out of maturing?
There’s indeed a certain vein to mined in the Our snowflakes shoot bullets first don’t get shots vein of American religious exceptionalism and faith-based democratic approach to science results, Freedum! Liberty! and Safety! it’s a bit too rich to be easily digested meal of absurdity this early in the morning.
Richard Mayhew
@jibeaux: That is why in the Mayhew household, the only debate on vaccines is what is the proper reward. My toddler son believes it is a lollipop and a cookie while my six year old daughter believes it is a sticker and an ice cream… Both are right
Redshift
@Elizabelle: “Too much at once” is another ploy of the anti-vaxxers, designed to appeal to “that sounds reasonable” when there’s no scientific basis for it. I think pandering to that kind of reasoning just gives it more credence. It would be better to explain that the reason it’s safe to give vaccines on a more compressed schedule is that vaccines are better than when we were kids, and they contain a lower dose. Appeal to scientific and technological progress, which everyone is familiar with in their daily lives, instead of reinforcing unfounded fears.
Felonius Monk
@beltane:
Also, this.
BubbaDave
@Elizabelle:
I’ve heard the argument for spreading out shots just because it’s easier to isolate the cause of an adverse reaction. Downside is that while “just make one doctor visit per week for 6 weeks” might be medically acceptable, it’s a whole lot less likely to actually happen. Life gets hectic, and suddenly little Dave has only 4/6 shots.
Elizabelle
@BubbaDave: and Callisto and Redshift:
Thank you. We are on the same page there, and I appreciate the explanation about MOAR vaccines because they are safer. That’s a great and gentle but firm rebuttal.
Rex Tremendae
@Baud: Right now, some right wing sties are beating up Clinton for flip-flopping on the issue, pointing to a 2008 questionnaire in which she expressed a bit too much sympathy for anti-vaxx parents.
Violet
@BubbaDave: I don’t have any problem with parents having more control over when their kids get the shots, but only if its followed up by consequences if they don’t get all of them. Little Dave only gets 4 of 6 shots because Mommy got busy and forgot? Little Dave doesn’t get to go to kindergarten, Disneyland, fly on a plane. Mom and Dad’s lives get shut down because Little Dave can’t go places until he’s current on his vaccines.
BobS
My impression of the Amish is that they take a cafeteria approach to what elements of modern times they accept or reject. This includes them taking a horse & buggy to eat at Burger King, attempting to barter a quilt for their emergency room care, and collective ownership of vans (driven by non-Amish) for their building enterprises where they very adeptly use power tools. I haven’t been able to discern any logic in what is or isn’t acceptable. One of their practices that is a very dangerous pain-in-the-ass is them traveling by horse & buggy on relatively busy two-lane highways (both before and after dark) — I’ve experienced 55-65mph traffic in two directions suddenly slow or stop due to their one horsepower mode of travel.
Elizabelle
@Rex Tremendae: Gives Hillary a chance to clarify or support the new science that has emerged since. And remind people she’s a grandmother too.
Elizabelle
@Violet: Good solution.
CONGRATULATIONS!
Really, at this point Obama needs to get on the ol’ TV box and endorse breathing.
I never in my lifetime thought I’d see an actual, serious debate by politicians over the merits of vaccination. Cannot believe Americans are legitimately this stupid.
Gotta give credit to Dr. Carson. It’s probably the only thing I’d agree with him on, but he really didn’t pull any punches with his defense of vaccination. And to his credit, he did not use the phrase “you fucking retards”, which I would have, so he’s got impulse control going for him too.
cmorenc
@Richard Mayhew:
The context where this line of conservative thinking is most explicitly and purely exposes is where environmental regulation affects land use by owners. While most conservative ideologues acknowledge that there are a bare-minimalist handful of “really good reasons” to impose some restrictions without requiring everyone else to pay them “welfare-raising side payments”, their concept of what is a “taking” of landowner rights requiring such compensation for any degree of imposition is extraordinarily broad, and in most cases they regard the imposition so unnecessary and unjust that it shouldn’t be done at all. This same sort of thinking extends to vaccinations – except it’s their individual liberty interests of self-determination that is at stake rather than their land-owning liberties (though in conservative theory the latter is merely a fundamentally important extension of the former).
scav
@BobS: There’s often a logic, it’s just working with different goals, givens and constraints. Example I remember involved those telephones. Seemed to critically involve what it meant to be connected to the outside world, to be overly integrated and dependent. Wires, overly connected, so wired electricity a no-go (for their houses) but on-site generated electric ok. So, land-line telephones, wires, could not be connected to the house. Did seem to be ok for use if attached to a pole outside and communally owned. So, how do wireless cell phones get integrated? But, those examples are for one group working out their logic, and they can fission of differences in opinion.
Redshift
@Rex Tremendae: I’ll wait and see if that turns out to be completely bogus like the Obama one from yesterday. There’s no sense in trusting the research skills of wingnuts.
Lee
I was just reading an article this morning about the Ohio Amish. They stopped vaccines a while back when 2 kids had minor reactions.
When a missionary came back from Africa and it spread, they started getting vaccines again.
Here is the link
http://www.vox.com/2015/1/29/7929791/measles-outbreak-2014
Pee Cee
@Violet:
I looked up “integrative Cardiology”:
So, a fusion of medicine and bullshit. Not surprised that this sort would be pushing anti-vaccination nonsense.
JR in WV
@Violet:
There’s a doctor whose door I will never darken!
The state medical board (whatever they call it in AZ) should revoke this nutjob’s license to practice medicine.
WereBear
@Mystical Chick: As I pointed out yesterday, in the past we were all “pure.” We ate organic food, had no electrical devices, went to bed at sundown… and were still mowed down in epidemics.
WereBear
There isn’t any. It was one thing to shun The World when it was a case of one light bulb vs a lantern. Now, it’s like being a primitive hunter/gatherer vs a metrosexual.
The slide into modern life has begun.
JR in WV
Mrs J’s last surviving aunt died last week, and so we’re going to travel over there to be with her cousins – so you won’t see me blogging any more the next few days! Not that anyone will miss that…
Here’s hoping the snow holds off, and that the refinery strike doesn’t drive the price of gas up to $5/gallon. Or just make it unobtainium where we’ll be driving!!
steve
I recall Coase arguing that when property rights are very well-defined externalities can be internalized via contract/agreement between relevant parties with no need for government intervention (other than the courts). However, 1. when that is not the case the government needs to be involved and 2. the government may want to be involved even if property rights meet the Coase standard because of concerns over fairness/equity in who pays the cost of internalization.
I believe Coase was, himself, quite skeptical that the conditions he listed would obtain in most cases. But it has been a while since I read it.
F
@raven: We call that the Dunning Kruger Effect.
Mystical Chick
@jibeaux: I didn’t say there was an alternative therapy for measles. I was speaking in general. And, as I pointed out, while I do not have children, if I did, they’d be vaccinated. Woo does not equal stupid or easily led.
jl
@steve: Always nice to see Coase Theorem mentioned in a family blog like Balloon-Juice.
“I believe Coase was, himself, quite skeptical that the conditions he listed would obtain in most cases. But it has been a while since I read it.”
I believe you are correct, though I don’t have a link at hand right now. The Coase Theorem as piece of math fails when certain kinds of uncertainty are present, there is too much asymmetric information about each party’s costs and benefits of taking different actions, and transaction costs of negotiation are too high. IIRC correctly, also too in addition, the Coase Theorem is a piece of co-operative game theory, which assumes that if a group of people who are negotiating something are not at an efficient solution, they will see that and work out a deal that will ge them to efficiency. There is no detailed analysis of how individual incentives will actually work dynamically in the bargaining process to get the deal to the efficient frontier. (Edit: ignoring this issue can produce absurd reasoning, and is related to Krugman’s criticism of some macro people who ignore how individual incentives cause people to behave dynamically, and instead focus solely on equilibrium conditions and accounting identities)
I have read that Coase himself was intuitively aware of these problems, though he did not work out in detail all the situations where the Coase Theorem would fail. I think Kenneth Arrow wrote some of the most famous papers working through the details of how it would fail with, for example, some kinds of uncertainty.
But I believe Coase saw the idea named after him (and as he presented it, it is more of an idea rather than a precise statement of economic theory) as a guideline for identifying the conditions necessary for bargaining to produce an efficient solution. He did not see it, as some libertarians do, as a magic wand that would Eliminate All Problems of economic organization produced by the presence of externalities.
Finally, there are papers showing how rapidly the incentives to free ride increase as the population approaches herd immunity, and in accordance with intuition, it zooms up very rapidly as herd immunity is approached. Just as the value of an additional immunization becomes very large because it is protecting all who are not vaccinated, the incentive for an individual to get a vaccination goes to zero. So, free riding is a serious problem with immunizations for diseases where herd immunity is imporrtant.
Snarki, child of Loki
Pardon me, does anyone know where I can find some Measles viruses that can be spread on banknotes for spending at a gun show?
Asking for a friend.
Monala
@Elizabelle: My kid’s nine, so she has had her shots relatively recently. I pretty much follow doctor’s orders on vaccines, and I don’t ever remember her getting six shots at a time. The most I remember in any one visit was two.
ETA: I’m rather woo myself, and when I was pregnant, I remember reading the research for and against vaccines. The thing that was most convincing to me (besides the fact that the autism/vaccine link had been thoroughly studied and discredited), was the fact that kids are exposed to literally thousands and thousands of new germs every day, and their bodies for the most parts handle it. Being exposed to weakened forms of germs in the form of vaccines isn’t creating some major havoc on their system.
Penus
@Monala: But it’s not the germs, it’s the CHEMICALS that are the problem! Witness John McCain in 2008: “It’s indisputable that (autism) is on the rise among children, the question is what’s causing it. And we go back and forth and there’s strong evidence that indicates it’s got to do with a preservative in vaccines.”
Of course, there’s not one shred of evidence anywhere that “a preservative in vaccines” causes autism. The preservative in question is thimerosal, a mercury compound which has mostly been removed from vaccines because of these morons. Never mind that there’s more mercury in your average tuna sandwich than there is in any vaccine.
chopper
@Penus:
plus it’s a different type of mercury in thimerosal, one that is not shown to bioaccumulate. compared to the stuff in fish which does.
but oh, now it’s the aluminum in the adjuvants!
wait, my kid gets more aluminum by ingesting a handful of dirt on the playground?
but oh, uh…(shuffles papers)
Raven Onthehill
The right side seems unable to wrap its mind about the idea that to viruses and bacteria, humans aren’t individuals—they just taste good.