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8 hours ago, Ausmumof3 said:

Thanks.  That makes more sense.  I thought you were saying there were large scale mandatory vaccination programs using untested vaccines.  Glad to know that’s not the case.

yes I see the compulsory thing historically with smallpox.  Maybe that’s why they actually managed to eliminate it. 

I have more sympathy toward extreme measures during and actual outbreak than in my country where there is very few cases per year and they are generally linked to overseas visitors.

The coordination between many countries to erradicate smallpox is why we have managed to eliminate it. This has also been the specific goal for other diseases; definitely has been the goal with polio and goals have been repeatedly set for measles, but not met. 

I do also have more sympathy for drastic measures when there are actual outbreaks, but where compliance is over 90%, there is less probability of outbreaks because of the firewall against transmission. No host = no outbreak. This is true even when measles comes in from overseas, which is usually how an outbreak gets going here. 

I often think if we (in the world) were only now trying to erradicate smallpox, we would not accomplish it. It was the foruitous timing of being able to beat the disease when there wasn't instantaneous world-wide communication that facilitated it. There were accidents, side-effects and deaths, not to mention the “gun” used to administer the vaccine would be decried by parents today. 

Measles might have been eliminated by the end of the last century if it hasn’t been for the anti-vaxxer success in scaring parents about autism. 

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Here's the thing though-- a lot of the most vocal and knowledgeable "anti-vaxxers" are actually "ex-vaxxers." People who trusted the CDC's schedule, vaccinated according to their guidelines, and ended

In veterinary medicine we had people that didn't want to vaccinate and saw no reason to. And honestly, they were right in that their indoor only cat had little chance of exposure to rabies. But we sti

You are okay with kids dying because it is more fulfilling to insult people and call them names than actually practice empathy and have a respectful dialogue? Really? Gee, and you wonder why they don'

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55 minutes ago, Quill said:

The coordination between many countries to erradicate smallpox is why we have managed to eliminate it. This has also been the specific goal for other diseases; definitely has been the goal with polio and goals have been repeatedly set for measles, but not met. 

I do also have more sympathy for drastic measures when there are actual outbreaks, but where compliance is over 90%, there is less probability of outbreaks because of the firewall against transmission. No host = no outbreak. This is true even when measles comes in from overseas, which is usually how an outbreak gets going here. 

I often think if we (in the world) were only now trying to erradicate smallpox, we would not accomplish it. It was the foruitous timing of being able to beat the disease when there wasn't instantaneous world-wide communication that facilitated it. There were accidents, side-effects and deaths, not to mention the “gun” used to administer the vaccine would be decried by parents today. 

Measles might have been eliminated by the end of the last century if it hasn’t been for the anti-vaxxer success in scaring parents about autism. 

I don’t know?  Maybe.  I think the fear factor with smallpox was probably a little more powerful.  The death rate in measles is something like 1 in 10,000 which feels less terrifying.

actually in the history timeline thing you posted there seemed to be some pretty significant anti vax protests for smallpox vax which led to the first allowances for conscientious objection to vaccination.  There’s always the risk when you rule out personal choice that for some people it increases antagonism.

i have spent way too much time down this rabbit hole the last few days and need to step away from the discussion for a bit soon bit one other thing I read was about the current nasty outbreak in Philippines occurred because a separate vax for dengue fever caused or was alleged to have caused several deaths resulting in lack of trust and decline in vaccination rates.  In Perth there was a bad flu vax and trust definitely waned.  

I just don’t know that legislation aimed at coercing compliance increases trust.  I’d like to think making manufactures liable when things go wrong may help, but I don’t know for sure.  From what I’ve been reading the biggest issue here is difficulty getting access (around 3-4pc) versus diehard vaccine refusals (1.5pc).  If you could reach everyone who was willing probably that would be enough.  And even more reliable discussion and education.  I must admit when I had my first kid I knew nothing, and ended up just going with the current recommendations but that can go either way.  I know of someone who walked in and saw the 1 in 100,000 or whatever it is risk of encephalitis and turned down mmr.  Had she been more aware and done a compare and contrast between mmr vaccine versus measles virus I think she would have gone ahead. 

So maybe adding some education on it to antenatal classes could be beneficial.  

Also last thing I find a lot of the information in the media is very much short sound bites and a little condescending.  It might be just me but I think more detailed information about studies, safety etc could be reassuring for some people.  Rather than just “well science says this so you should trust us and do it”.  fine but glysophate was fine for years and now maybe it causes cancer.

when you go looking there are lots of good studies/outcomes for the vaccines but maybe if they shared more detail with the public about how they figure it out/test it etc that might help with trust.

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when you go looking there are lots of good studies/outcomes for the vaccines but maybe if they shared more detail with the public about how they figure it out/test it etc that might help with trust.

If you don’t have time to reply, that’s okay; I just wanted to talk about this more in this thread. 

The problems as I see it in my little anecdotal experience is anti-vaxxers I am currently discussing with on-line are so suspicious of the govt, it does not matter what information authorities give out. Anybody can get tons of solid, accurate information about both diseases and vaccines themselves from Centers for Disease Control (CDC) website, or other authoritative sites like renowned hospitals and National Institutes of Health. But anti-vaxxers will, IME, not even *look* at those sites. They look at dubious sites filled with grammatical errors, slanted to confirm their already-held beliefs. 

Years ago, I read the book Louder Than Words, written by that paragon of medical knowledge, Jenny McCarthy. The book was interesting, but what was so baffling to me is, certain as McCarthy seems to be that the MMR vaccine caused her son’s autism, she describes with extensive detail about how there were signs all was not well with him before he ever got vaccinated. This is true for someone I know IRL as well - she believes her child was injured by vaccines but she also told me in detail he was diagnosed in utero as having something non-specific but not typical. So - I don’t really understand that, unless it’s just the impulse to find someone else who is responsible for your child’s damage. 

I also, anecdotally, knew two different people who refused to consider or accept their child had ASD; they did not vaccinate and continued to believe the problems with their children were due to food allergies and intolerances. One believed her child had Celiac’s disease and numerous other allergies, though never having received confirmation of those allergies. Literally whenever her kid had a bad episode of raging/acting abnormally, she would start looking for some other food to eliminate. The other woman did this, too. She would always say he was “so much better” on his strict diet but the moment he acted out, she would look for another food to elimate; i.e., “I think he might have a corn allergy, too, because he ate tortillas earlier today...” PS I am no longer in touch with either of these ladies so I don’t know what ultimately happened with their sons, who would now be young adults. 

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30 minutes ago, Quill said:

If you don’t have time to reply, that’s okay; I just wanted to talk about this more in this thread. 

The problems as I see it in my little anecdotal experience is anti-vaxxers I am currently discussing with on-line are so suspicious of the govt, it does not matter what information authorities give out. Anybody can get tons of solid, accurate information about both diseases and vaccines themselves from Centers for Disease Control (CDC) website, or other authoritative sites like renowned hospitals and National Institutes of Health. But anti-vaxxers will, IME, not even *look* at those sites. They look at dubious sites filled with grammatical errors, slanted to confirm their already-held beliefs. 

Years ago, I read the book Louder Than Words, written by that paragon of medical knowledge, Jenny McCarthy. The book was interesting, but what was so baffling to me is, certain as McCarthy seems to be that the MMR vaccine caused her son’s autism, she describes with extensive detail about how there were signs all was not well with him before he ever got vaccinated. This is true for someone I know IRL as well - she believes her child was injured by vaccines but she also told me in detail he was diagnosed in utero as having something non-specific but not typical. So - I don’t really understand that, unless it’s just the impulse to find someone else who is responsible for your child’s damage. 

I also, anecdotally, knew two different people who refused to consider or accept their child had ASD; they did not vaccinate and continued to believe the problems with their children were due to food allergies and intolerances. One believed her child had Celiac’s disease and numerous other allergies, though never having received confirmation of those allergies. Literally whenever her kid had a bad episode of raging/acting abnormally, she would start looking for some other food to eliminate. The other woman did this, too. She would always say he was “so much better” on his strict diet but the moment he acted out, she would look for another food to elimate; i.e., “I think he might have a corn allergy, too, because he ate tortillas earlier today...” PS I am no longer in touch with either of these ladies so I don’t know what ultimately happened with their sons, who would now be young adults. 

You may be right.  Some anti vaxxers hear 1 in 100,000 chance of encephalitis with vax versus 1 in 10,000 without and seem to only hear the first statement.  I guess there’s something inherently more scary about a negative effect caused by something humans did than something that just happened for some people.

for the Jenny McCarthy thing I think there’s some thought that for some kids who have underlying health issues the mmr causes a different reaction that may exacerbate the issues/lead to more significant issues.  I haven’t read her book so don’t know if she’s talking about that.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2536523/

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Typically, doctors don't say to wait on vaccines just because there is something seems off with a child's health or behavior. They follow the recommended schedule.  Many docs aren't aware of studies showing increased risk of problems if certain vaccines are given at recommended times instead of delaying a few months. Most recommend Tylenol with each vax, even though it depletes the body's glutathione,  which is needed to deal with the toxic adjuvants in the vaccines.  For some individuals, that's a serious problem, but there's no testing done to determine who might be negatively affected, whether because of mitochondrial disorders or other metabolic disorders. They test babies  for PKU, and that's it.  I wish Jenny McCarthy and other moms weren't vilified for stating what they saw happen to their kids.  Even if they saw some problems before vaccination,  that doesn't mean the vax didn't further harm their kids.  

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16 hours ago, Ausmumof3 said:

Do you not have a register there?  Here we have a database with every kid and every vaccine they’ve received.  They just have to check it to know.  Lying would be pretty pointless.

Not where I live (middle US).  And frankly I wouldn't mind if they did have that kind of database, because I get tired of having to enter and re-enter the info every time I sign my kids up for a new summer camp or whatever.  When we change medical practices, the new place has no records from the past.  (And honestly, this is one way some abusive people stay under the radar.  Change doctors and you get a fresh start.)

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15 hours ago, Quill said:

Well, I do tend to want to say “all those which are on the schedule,” but since you’re asking in good faith, here’s my full belief about this:*

Measles, absolutely, because it is spread through snot droplets and is one of the most extremely contagious diseases. Therefore, maximum number of immunized population is desirable because it has a good chance of being eliminated here and that is A-OK with me. 

Rubella, absolutely, because it is dangerous to developing fetuses. Before rubella was widely used, thousands of babies were aborted because they were expected to have CRS. Others miscarried; others were born deaf, blind or with cognitive impairments. 

Mumps, because it is already combined with measles and rubella so there is no good reason to drop it. Fewer people with mumps is certainly worthwhile.

Varicella - I could debate this one but if it can be combined with MMR anyway, then I feel similarly to how I feel about Mumps. 

Polio, definitely until it is known to be erradicated everywhere in the world, because it is a horrid disease and I’m all for getting rid of it.

Pertusis, absolutely without question, because it is like Measles in terms of extremely contagious and spread through droplets. It is likely to be deadly to babies. It is highly dependant upon maximum vaccination in order to not break through. It is not acceptable to put babies at risk of coughing to death so someone else can feel they have autonomy to not vaccinate for “philosophical reasons.” 

Tetanus, not because it’s contagious but because people apparently have to be saved from their own stupidity on this front. It’s much easier to address Tetanus by prevention than after potential infection. And since it is combined with Pertussis, might as well keep it. 

Diphtheria because it is highly contagious, spread through droplets, and already is combined with Pertusis and Tetanus. 

Meningococcal B before college or group living situations.

I cannot speak knowledgably about Hib and pneumonicoccal. I cannot speak knowledgeably about Hep vaccines. I think people should get HPV vaccine before teen years, but I am on the fence about whether or not it should be required. 

*My list is for the US, because a) I can’t speak knowledgeably about other countries and; b) differents countries have different threats.

I mostly agree with which ones are important given our current reality in the USA.

I disagree on varicella.  They had a combination vax with MMRV, but that vax had many injuries associated with it.  If anyone is offered that combo, I would do some updated research before accepting it - or just say no.  Also I would really rather that vax be delayed until around age 9 or 10, while MMR should probably be done before entering school.

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1 hour ago, HeighHo said:

It would be interesting to see the genetic work up on these people..

Maybe an aside, but genetics is to the point where you can tell with genetic testing that certain people should not be given certain meds, or even certain vitamins.  I am sure this is an ongoing study.

I absolutely believe that there are some people who are predisposed to vax injury and that this can be discoverable, even though we may not be to that point yet.

I also believe that many doctors will continue push the CDC vax schedule on everyone without checking for known predispositions.  Based on my personal experience and what I know about the world.

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I have a question about the religious exemption to vaccinations. Are there really any religions that ban vaccines?  I mean in their scriptures or tenants. I know that the JWs ban blood transfusions because of an actual religious belief but are there actual religious beliefs behind why certain groups tend to not vaccinate?  Or is it “group think” and not really religious in nature at all?  (I am not trying to be disrespectful of religions. I am just trying to parse out the root cause of objection.). 

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6 hours ago, Carrie12345 said:

I don’t know if there’s a state to state issue. Ds got a dTap in the ER across state lines when he cut his leg. It didn’t show up on his vax record, and I’ve been having difficulty getting the hospital to send their record over to the ped, who is “sort of” taking my word for it for now, but I really need to check up on that before his next appointment!

dTap? Tdap? Whatever the heck it is now.

I've only attended school in two states (NJ and FL) and taught in two (FL and GA). When I attended vaccines weren't available except for smallpox and polio. So while we didn't have a record of vaccines we did have a record of which childhood diseases we had and when. That record was kept with your doctor but parents also had a copy, similar to how parents today have a record of their kids' vaccinations. IIRC, my mother had to show that record when we changed schools in NJ and when we moved to FL and she registered us for school, again, similar to showing proof of immunizations.

When I taught, the proof of vaccinations came from the doctor or health department and the parent had to show it when the child was being registered. I taught high school in Florida and if the student came from within the school system and therefore already showed proof of vaccinations they didn't have to show it again when entering middle school or high school. Students from outside the county, even if they came from another FL county, needed their vaccination records to register, even in high school.

Based on those experiences, I would say Florida and New Jersey didn't have a registry, at least not back then. I have no idea if they do now. Ds homeschooled all the way through high school so it's not something I would have needed to know. 

I can never remember if it's Tdap or dTap. I didn't even realize they changed it until my doctor recommended I get it. 

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6 minutes ago, Lady Florida. said:

I can never remember if it's Tdap or dTap. I didn't even realize they changed it until my doctor recommended I get it. 

They both exist, and are recommended at different boosters.  I don't remember the details though.

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8 minutes ago, HeighHo said:

 

You have some more research to do.  Tetanus is there for animal bites.  Its not a person's 'stupidity' to have lost out on the race to get to a safe position away from the law-breaking neighbor's loose animal.   Around here, the victim's health care provider visit for  tetanus and if need,  rabies treatment,  plus any collateral damage (broken hip if elderly for ex) will be paid for by the owner who disregarded the law, or he will be in court answering for his decisions.

I think you might be thinking about rabies here, which comes from animal bites. Tetanus comes from wounds, such as getting cut on a dirty rake or stepping on a rusty nail.  It lives in the soil. 

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On ‎3‎/‎28‎/‎2019 at 2:12 PM, SKL said:

The other thing is that it is pretty easy to lie about vaxes.  I've had to provide my kids' vax history various times, and they always accept whatever I say without any "proof."  When I was a kid, all that stuff was hand-written onto a card and could easily be faked.  I would not lie personally, but we all know that lots of humans do so without hesitation.

now - in my school district, the only record that counts is the record from the state health dept.   doesn't matter who does the vaccine - the information is sent to the state and entered into the child's vaccination record.

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4 hours ago, creekland said:

  A quick google search shows that approx 100,000+ folks died from measles in 2017 (worldwide).  A

 

 

I know that is a lot of people . However, by way of a comparison there were 1.3 million tuberculosis deaths.

 

 Have you read details on how smallpox was eradicated?  

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11 minutes ago, gardenmom5 said:

now - in my school district, the only record that counts is the record from the state health dept.   doesn't matter who does the vaccine - the information is sent to the state and entered into the child's vaccination record.

Which is good IMO, but of course still leaves out everyone who isn't school-aged and/or is just visiting your state.

I wonder what is done with kids who transfer in from another state or country which does not have this system.  At some point, I assume they would have to rely on parents' reports.

My kids got all their infant vaxes in a developing country.  All I have is the hand-written card.  When my kids were toddlers, their doctor entered those handwritten notes into the computer, so I have a printout that looks official.

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31 minutes ago, HeighHo said:

 

Please do some research.

Tetanus is caused by an infection with the bacterium Clostridium tetani,[1] which is commonly found in soil, saliva, dust, and manure.[2] The bacteria generally enter through a break in the skin such as a cut or puncture wound by a contaminated object.

https://en.m.wikipedia.org/wiki/Tetanus

Rabies is caused by lyssaviruses, including the rabies virus and Australian bat lyssavirus.[3] It is spread when an infected animal scratches or bites another animal or human.

https://en.m.wikipedia.org/wiki/Rabies

 

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1 hour ago, HeighHo said:

 

You have some more research to do.  Tetanus is there for animal bites.  Its not a person's 'stupidity' to have lost out on the race to get to a safe position away from the law-breaking neighbor's loose animal.   Around here, the victim's health care provider visit for  tetanus and if need,  rabies treatment,  plus any collateral damage (broken hip if elderly for ex) will be paid for by the owner who disregarded the law, or he will be in court answering for his decisions.

I'm not Quill but when I read that part of her post I figured she was talking about the kind of parents like the mother who refused to let her child get a tetanus shot in the ER and instead thought she should just learn to clean the wounds better. I scrolled back through the thread and couldn't find it but it's there. And that mother showed sheer stupidity. 

Tetanus can be caused by many things, including animal bites, rusty metal, and even just the soil. The stupidity is in thinking if your child is exposed to tetanus in one of the many possible ways, you can just deal with it and hope they don't die from it.

This was also stupidity. It happened last year just over an hour from where I live. My heart breaks for the parents but they didn't get their son the rabies treatment because he was afraid of shots. Instead, the mother googled how to clean it. She. Googled. 

 

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3 minutes ago, Lady Florida. said:

I'm not Quill but when I read that part of her post I figured she was talking about the kind of parents like the mother who refused to let her child get a tetanus shot in the ER and instead thought she should just learn to clean the wounds better. I scrolled back through the thread and couldn't find it but it's there. And that mother showed sheer stupidity. 

Tetanus can be caused by many things, including animal bites, rusty metal, and even just the soil. The stupidity is in thinking if your child is exposed to tetanus in one of the many possible ways, you can just deal with it and hope they don't die from it.

This was also stupidity. It happened last year just over an hour from where I live. My heart breaks for the parents but they didn't get their son the rabies treatment because he was afraid of shots. Instead, the mother googled how to clean it. She. Googled. 

 

I am flabbergasted that the parents in the rabies case didn't know that bats could carry rabies.  It just seems to be such a basic piece of knowledge to me.  But then, a lot of this health information about vaccines etc. seems to be basic knowledge to me but obviously isn't to a lot of people.  And that is why I don't mind that the government puts a lot of this health information in small sound bites.  Many people don't have the ability to read and digest information from studies and medical articles.  Except, as someone said a few posts ago, to many Government = bad so they aren't going to listen no matter how the information is packaged and disseminated.

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33 minutes ago, Cnew02 said:

Tetanus is caused by an infection with the bacterium Clostridium tetani,[1] which is commonly found in soil, saliva, dust, and manure.[2] The bacteria generally enter through a break in the skin such as a cut or puncture wound by a contaminated object.

https://en.m.wikipedia.org/wiki/Tetanus

Rabies is caused by lyssaviruses, including the rabies virus and Australian bat lyssavirus.[3] It is spread when an infected animal scratches or bites another animal or human.

https://en.m.wikipedia.org/wiki/Rabies

 

I think the poster was just pointing out that you can also get tetanus from animal bites, not just wounds related to objects. I've had to get a tetanus shot in the ER after an animal bite as has my mom. It's not unusual.

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12 minutes ago, Lady Florida. said:

I'm not Quill but when I read that part of her post I figured she was talking about the kind of parents like the mother who refused to let her child get a tetanus shot in the ER and instead thought she should just learn to clean the wounds better. I scrolled back through the thread and couldn't find it but it's there. And that mother showed sheer stupidity. 

Tetanus can be caused by many things, including animal bites, rusty metal, and even just the soil. The stupidity is in thinking if your child is exposed to tetanus in one of the many possible ways, you can just deal with it and hope they don't die from it.

This was also stupidity. It happened last year just over an hour from where I live. My heart breaks for the parents but they didn't get their son the rabies treatment because he was afraid of shots. Instead, the mother googled how to clean it. She. Googled. 

 

it also stated they thought he'd only been scratched, not bitten.  my understanding is the puncture wounds from bat bites are very small, and very easy to miss.

I can't imagine that dad brining home a bat.  my sil has had a bat in her house on two separate occasions (many years apart.).  we've heard the stories of the freak-outs while trying to catch it (while fully clothed and leather gloved)  and get it in a bucket to take it outside.

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37 minutes ago, Jean in Newcastle said:

I am flabbergasted that the parents in the rabies case didn't know that bats could carry rabies.  It just seems to be such a basic piece of knowledge to me.  But then, a lot of this health information about vaccines etc. seems to be basic knowledge to me but obviously isn't to a lot of people.  And that is why I don't mind that the government puts a lot of this health information in small sound bites.  Many people don't have the ability to read and digest information from studies and medical articles.  Except, as someone said a few posts ago, to many Government = bad so they aren't going to listen no matter how the information is packaged and disseminated.

 

People know what they know and don’t know what they don’t.  Rabies in bats was sensationalized for awhile, so some people know from that.  

Some people know groundhogs, raccoons, foxes  ...can also have rabies.  Some don’t.  

It depends where though.  In England, befriending a fox a la The Little Prince, might be safer than USA, for example.

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8 hours ago, creekland said:

 

 

Personally, I wish everyone without a serious reaction would also get the flu vaccine.  I know it's not as helpful as the others, but I've seen way too many stories of people who have lost loved ones, including kids, and including one that hit our church's prayer chain this year where a single mom lost her only child to the flu and her dh had died from an accident.  It's way too sad listening to all these folks afterward saying, "I wish..."  My heart breaks.  If your loved one dies anyway, at least you know you did all you could instead of wishing you had tried it.  Flu is also super contagious, but TBH, with my mom, it's one we try hard to have her avoid because there's such a low vaccination rate and the vaccine isn't as helpful as the others.

 

I agree. The flu is not just a bad cold. A high school friend lost her husband to flu related pneumonia when he was 42 years old. He was healthy. Another friend, a homeschool mom I know who was anti-vax lost a good friend to the flu. Yes, those are anecdotes but the thing is influenza kills. It kills young and healthy people as well as the elderly and immunocompromised. And it's highly contagious.

6 hours ago, Quill said:

 

Years ago, I read the book Louder Than Words, written by that paragon of medical knowledge, Jenny McCarthy.

If her influence didn't make me so angry that statement would be hilarious. She ranks right up there in my opinion with The Food Babe (pure oxygen!).

5 hours ago, klmama said:

I wish Jenny McCarthy and other moms weren't vilified for stating what they saw happen to their kids.  Even if they saw some problems before vaccination,  that doesn't mean the vax didn't further harm their kids.  

I wish Jenny McCarthy and people like her weren't seen as medical experts by other moms.

4 hours ago, Jean in Newcastle said:

I have a question about the religious exemption to vaccinations. Are there really any religions that ban vaccines?  I mean in their scriptures or tenants. I know that the JWs ban blood transfusions because of an actual religious belief but are there actual religious beliefs behind why certain groups tend to not vaccinate?  Or is it “group think” and not really religious in nature at all?  (I am not trying to be disrespectful of religions. I am just trying to parse out the root cause of objection.). 

I can only think of religions that are against medical intervention and I would guess that vaccinations count as intervention. I could be wrong though and I didn't take the time to look it up. That's just off the top of my head.

2 hours ago, Jean in Newcastle said:

I am flabbergasted that the parents in the rabies case didn't know that bats could carry rabies.  It just seems to be such a basic piece of knowledge to me.  But then, a lot of this health information about vaccines etc. seems to be basic knowledge to me but obviously isn't to a lot of people.  And that is why I don't mind that the government puts a lot of this health information in small sound bites.  Many people don't have the ability to read and digest information from studies and medical articles.  Except, as someone said a few posts ago, to many Government = bad so they aren't going to listen no matter how the information is packaged and disseminated.

I was also shocked that they didn't know. Almost every year there's a wild animal somewhere in Central Florida that tests positive for rabies. When the warnings are put out they also tell you what other wild animals carry rabies, and bats are always on the list. Like you though, I guess what I thought what was common knowledge might not be that common.

2 hours ago, gardenmom5 said:

it also stated they thought he'd only been scratched, not bitten.  my understanding is the puncture wounds from bat bites are very small, and very easy to miss.

I can't imagine that dad brining home a bat.  my sil has had a bat in her house on two separate occasions (many years apart.).  we've heard the stories of the freak-outs while trying to catch it (while fully clothed and leather gloved)  and get it in a bucket to take it outside.

He was six. I can't imagine taking my six year old's word for something as serious as that, even if I thought he was a really smart kid. 

Edited by Lady Florida.
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2 hours ago, Pen said:

 

 

Some people know groundhogs, raccoons, foxes  ...can also have rabies.  Some don’t.  

 

True, but it seems people should know that is if it's a mammal it can carry rabies. At least, if they live in certain areas where it's more common they should know. I imagine many people don't think adorable otters can carry rabies, but they're mammals too. And they're wild animals. 

The story linked below is why it surprised me that the parents didn't know bats can have rabies.  As I said, it's not uncommon in Central Florida so it's really kind of hard to not know bats carry rabies. We hear about it often. After raccoons, bats are the most common carriers of rabies in Florida.

I live in one of the counties named in this story.

Number of Rabies Cases in Florida on the Rise

Edited by Lady Florida.
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4 hours ago, HeighHo said:

 

You have some more research to do.  Tetanus is there for animal bites.  Its not a person's 'stupidity' to have lost out on the race to get to a safe position away from the law-breaking neighbor's loose animal.   Around here, the victim's health care provider visit for  tetanus and if need,  rabies treatment,  plus any collateral damage (broken hip if elderly for ex) will be paid for by the owner who disregarded the law, or he will be in court answering for his decisions.

@Lady Florida. is correct in that I was particularly remarking on the fairly recent case of the 6yo boy who nearly died from Tetanus. Those parents are stupid in my not-at-all-humble opinion. 

Animal bites are one way a person might get Tetanus, but it lives in the soil and an unvaccinated person can get it from injuries that are not sterile. Where I live, that concern mostly comes down to farm equipment and barns my kids played in. 

Whether by animal bite or a garden rake, my point is still salient: it is much easier to prevent Tetanus than to treat it once developed. I think with kids in particular, it can be difficult because kids may not always tell about the injury in a timely manner. I remember concealing an infected splinter from my mom once, for example, because I was (rightly) afraid that removing it would hurt like hell. I also tried to conceal a dog bite because I (rightly) figured my mom would not keep a family dog that bit her child.  Kids don’t always reveal or properly explain injuries and I do believe it would suck pretty badly to only understand the gravity of the situation when my kid cannot open his mouth due to Tetanus, which could have been prevented. 

So - yes, keep tetanus in the schedule. 

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Just now, HeighHo said:

 

Perhaps you could relate the background so people will know that you are not making a general statement.

A vaccinated person can still get tetanus.  When you arrive at the provider office, they will determine your status and your need.

Yes; I know this. I think it is standard procedure to give you one if you arrive at the ER with any kind of wound likely to cause tetanus. But if you’ve never been vaccinated and you are exposed, your likelihood of contracting it is high. If you have dumb parents who think they’ll just clean it themselves, I suspect moreso. 

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5 hours ago, Cnew02 said:

I think you might be thinking about rabies here, which comes from animal bites. Tetanus comes from wounds, such as getting cut on a dirty rake or stepping on a rusty nail.  It lives in the soil. 

I have three girls that work with animals for a living. Any animal bite requires a tetanus shot.

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1 hour ago, Lady Florida. said:

 

He was six. I can't imagine taking my six year old's word for something as serious as that, even if I thought he was a really smart kid. 

1 hour ago, Lady Florida. said:

True, but it seems people should know that is if it's a mammal it can carry rabies. At least, if they live in certain areas where it's more common they should know. I imagine many people don't think adorable otters can carry rabies, but they're mammals too. And they're wild animals. 

The story linked below is why it surprised me that the parents didn't know bats can have rabies.  As I said, it's not uncommon in Central Florida so it's really kind of hard to not know bats carry rabies. We hear about it often. After raccoons, bats are the most common carriers of rabies in Florida.

I live in one of the counties named in this story.

Number of Rabies Cases in Florida on the Rise

me neither.

considering the incidence of rabies in bats is nearly 1 in 3,  - even if *i* thought it was only a scratch - i'd have gone in.  they had the bat!  it could have been examined and it would have been conclusive if he was exposed to rabies or not before he showed symptoms.  once symptoms start, it's fatal.

I can't imagine what the dad was thinking to take a bat home - and think he's going to nurse it to health!  he should have reported it to wildlife agency.

eta: speaking of racoons... the people who think they're cute and feed them.   I'm on a local wildlife FB page, and there will be people posting pictures of the racoons they regularly feed.  and the people who will attack those who post information from the rangers to DO NOT FEED RACOONS!... 

Edited by gardenmom5
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5 hours ago, Pen said:

 

 

I know that is a lot of people . However, by way of a comparison there were 1.3 million tuberculosis deaths.

 

 Have you read details on how smallpox was eradicated?  

Or road trauma at 1.35 million

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5 hours ago, Jean in Newcastle said:

I have a question about the religious exemption to vaccinations. Are there really any religions that ban vaccines?  I mean in their scriptures or tenants. I know that the JWs ban blood transfusions because of an actual religious belief but are there actual religious beliefs behind why certain groups tend to not vaccinate?  Or is it “group think” and not really religious in nature at all?  (I am not trying to be disrespectful of religions. I am just trying to parse out the root cause of objection.). 

I think some strongly anti abortion people oppose one of them - maybe mmr because it originally way way back used an aborted foetus cells to get the original culture or whatever it is they use in the vaccine.  It doesn’t seem like much of an argument.  I think maybe some Orthodox Jews have an issue?

and I’ve never heard of it but I guess if you were extremely vegan the vaccines with egg white or dairy products might bother you.

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9 hours ago, Pen said:

I know that is a lot of people . However, by way of a comparison there were 1.3 million tuberculosis deaths.  

 

And before the measles vaccine came about?  Should we go back to the days where it killed approx 2.6 million every year?  The measles vax is more reliable than the tb vax.  I believe a new tb one is in the works though.

"Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every 2–3 years and measles caused an estimated 2.6 million deaths each year.

Approximately  110 000 people died from measles in 2017 – mostly children under the age of 5 years, despite the availability of a safe and effective vaccine.

Measles is caused by a virus in the paramyxovirus family and it is normally passed through direct contact and through the air. The virus infects the respiratory tract, then spreads throughout the body. Measles is a human disease and is not known to occur in animals.

Accelerated immunization activities have had a major impact on reducing measles deaths. During 2000– 2017, measles vaccination prevented an estimated  21.1 million deaths. Global measles deaths have decreased by  80% from an estimated  545 000 in 2000* to  110 000 in 2017."

https://www.who.int/news-room/fact-sheets/detail/measles

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3 hours ago, Pen said:

 

Fatalities.

 injury and disability (mild to severe) from car crashes, is much higher than the fatality rate 

 

And like vaxs vs disease, some folks are more afraid of airplanes than cars!  Both sets of reasoning boggle the mind if one looks at statistics.

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33 minutes ago, creekland said:

 

And before the measles vaccine came about?  Should we go back to the days where it killed approx 2.6 million every year?  The measles vax is more reliable than the tb vax.  I believe a new tb one is in the works though.

"Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every 2–3 years and measles caused an estimated 2.6 million deaths each year.

Approximately  110 000 people died from measles in 2017 – mostly children under the age of 5 years, despite the availability of a safe and effective vaccine.

Measles is caused by a virus in the paramyxovirus family and it is normally passed through direct contact and through the air. The virus infects the respiratory tract, then spreads throughout the body. Measles is a human disease and is not known to occur in animals.

Accelerated immunization activities have had a major impact on reducing measles deaths. During 2000– 2017, measles vaccination prevented an estimated  21.1 million deaths. Global measles deaths have decreased by  80% from an estimated  545 000 in 2000* to  110 000 in 2017."

https://www.who.int/news-room/fact-sheets/detail/measles

 

 

Prior to measles vaccination —1945, 1950, 1955, 1960 ish — measles was killing around 0.2 - 0.3 people per 100,000 population in USA — and probably similar in other places with good sanitation, and medical care —  way down from rates early in century.   It (death rate) was already way down before the vaccinations.  over 100 deaths per year in USA—but lower than 500 most years.  (After vaccination it has come down to only 0 to 3 deaths per year in USA, and this is the case without making the vaccination for it mandatory and without rules that unvaccinated people aren’t allowed in public places .  ). [This is iirc, not re-looking up statistics. ]   The fatality rate from vehicle crashes is order(s) of magnitude higher than from measles even as the measles fatality rate was in the later years prior to vaccination availability .    

Tuberculosis is the contagious illness for which a vaccine exists that is the top killer worldwide.  There are higher rate causes of death, but not with available vaccinations

iirc.    

I think sticking with the 0-3 deaths from measles per year in USA with vaccinations available and recommended but not mandatory is acceptable.  If it were to quadruple to 0-12 deaths per year, that’s still very low

I think measles vaccination (and others too) should be made easily available and for free so that lack of funds isn’t a reason not to get them.   And So that lack of access — place and time —should not be a reason not to.  I think education and perhaps public service announcements should be used.

I think the same targeted approach as was used for small pox should be applied worldwide 

I don’t think measles vaccination should be mandatory at this time, no.  

Though I do think exclusion of the non-vaccinated from child care, preschool, etc is reasonable certainly during outbreaks.  

 

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4 hours ago, Ausmumof3 said:

I think some strongly anti abortion people oppose one of them - maybe mmr because it originally way way back used an aborted foetus cells to get the original culture or whatever it is they use in the vaccine.  It doesn’t seem like much of an argument.  I think maybe some Orthodox Jews have an issue?

and I’ve never heard of it but I guess if you were extremely vegan the vaccines with egg white or dairy products might bother you.

 

Anti-abortion people oppose the Hepatitis A, Rubella (part of MMR), Varicella, Zoster (shingles), Adenovirus, and Rabies vaccines because they were developed using cells from two aborted human fetuses.  

The Roman Catholic Church's position on vaccines is that Catholics should avoid vaccines developed using fetal tissue when alternative vaccines are available.  But when alternates are not available:

“One is morally free to use the vaccine regardless of its historical association with abortion. The reason is that the risk to public health, if one chooses not to vaccinate, outweighs the legitimate concern about the origins of the vaccine. This is especially important for parents, who have a moral obligation to protect the life and health of their children and those around them.”

Per JD Grabenstein, "What the World's Religions Teach, Applied to Vaccines and Immune Globulins,Vaccine (April 12, 2013), objections to vaccinations are personal rather than theology based.  Leaders of many faiths have issued statements in favor of vaccinations. ( A summary of Grabenstein's paper is available at Skeptical Raptor)

Researchers estimate that vaccines created using cells from one fetus aborted more than 50 years ago has helped prevent 11 million deaths.  (Source)

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3 minutes ago, Pen said:

 

 

Prior to measles vaccination —1945, 1950, 1955, 1960 ish — measles was killing around 0.2 - 0.3 people per 100,000 population in USA — and probably similar in other places with good sanitation, and medical care —  way down from rates early in century.   It (death rate) was already way down before the vaccinations.  over 100 deaths per year in USA—but lower than 500 most years.  (After vaccination it has come down to only 0 to 3 deaths per year in USA, and this is the case without making the vaccination for it mandatory and without rules that unvaccinated people aren’t allowed in public places .  ). [This is iirc, not re-looking up statistics. ]   The fatality rate from vehicle crashes is order(s) of magnitude higher than from measles even as the measles fatality rate was in the later years prior to vaccination availability .    

Tuberculosis is the contagious illness for which a vaccine exists that is the top killer worldwide.  There are higher rate causes of death, but not with available vaccinations

iirc.    

I think sticking with the 0-3 deaths from measles per year in USA with vaccinations available and recommended but not mandatory is acceptable.  If it were to quadruple to 0-12 deaths per year, that’s still very low

I think measles vaccination (and others too) should be made easily available and for free so that lack of funds isn’t a reason not to get them.   And So that lack of access — place and time —should not be a reason not to.  I think education and perhaps public service announcements should be used.

I think the same targeted approach as was used for small pox should be applied worldwide 

I don’t think measles vaccination should be mandatory at this time, no.  

Though I do think exclusion of the non-vaccinated from child care, preschool, etc is reasonable certainly during outbreaks.  

 

 

Doctors were treating measles patients with penicillin and other antibiotics that are less effective today than they were then.

 

 

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1 hour ago, creekland said:

 

And before the measles vaccine came about?  Should we go back to the days where it killed approx 2.6 million every year?  The measles vax is more reliable than the tb vax.  I believe a new tb one is in the works though.

 

Fwiw, I’m not anti vaccination.  My child had full Mmr or mmrv series .  But I would be extremely upset if that had been by force or coercion.  

At this time, so long as the vaccination is available, affordable, and accessible, I think your idea of returning to the days of it killing 2.6 million per year is hyperbole.  

 

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6 minutes ago, Pen said:

 

At this time, so long as the vaccination is available, affordable, and accessible, I think your idea of returning to the days of it killing 2.6 million per year is hyperbole.  

 

 

But if the anti-vax folks convince the masses that vaccines are evil, it's not such a hyperbole.  Yes, we have better medical care now - the same medical care that saved the lad with tetanus, but do we really want to count on that when there's a safe, better alternative?  Airplanes and cars.  The car is more familiar and one feels "safe" (at least until there's an accident), but the airplane is far and wide the safer alternative even with two recent crashes in the world.

And may the newer tb vax in the works be truly better than the current one.  Any killer disease eradicated is a good thing.

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Education is also incredibly important.  We killed three suspected rabid (wild) critters near our farm in 2018.  None had suspected human or tame critter contact, so we just buried them and warned all the neighbors.  However, before we shot the last one (groundhog) I took a video of him stumbling around so I could show our new neighbors with 4 young children.  With rabies in our area it's incredibly important that kids know not to help the "poor wounded animal," esp if it happens to a feral cat or something they think is tame and in need of help.  I'm not sure if the parents had ever seen anything like it either.

I've since shown the video at school too.  Education is important.  Rabies is deadly.  Keeping pets vaxed is important.  Knowing to seek help is too.  Folks don't know what they haven't been exposed to.  Share when we can.

I'm still 100% in favor of vaxes for those who are able to have them, esp for folks who choose public schools and similar and even more especially when there are epidemics about.  Eradicate the diseases (or help our bodies fend off tetanus/flu).

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1 hour ago, creekland said:

 

But if the anti-vax folks convince the masses that vaccines are evil, it's not such a hyperbole.  Yes, we have better medical care now - the same medical care that saved the lad with tetanus, but do we really want to count on that when there's a safe, better alternative?  Airplanes and cars.  The car is more familiar and one feels "safe" (at least until there's an accident), but the airplane is far and wide the safer alternative even with two recent crashes in the world.

And may the newer tb vax in the works be truly better than the current one.  Any killer disease eradicated is a good thing.

 

There are people in USA,  particularly in rural and inner city areas who don’t have good access to vaccinations,  even though they aren’t against them— cost, distance, problems with missing work etc.  Making vaccinations easier for those, adults as well as children, who would like to get them or who perhaps just aren’t thinking about it one way or the other, would be helpful.  IMO 

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1 hour ago, creekland said:

Education is also incredibly important.  We killed three suspected rabid (wild) critters near our farm in 2018.  None had suspected human or tame critter contact, so we just buried them and warned all the neighbors.  However, before we shot the last one (groundhog) I took a video of him stumbling around so I could show our new neighbors with 4 young children.  With rabies in our area it's incredibly important that kids know not to help the "poor wounded animal," esp if it happens to a feral cat or something they think is tame and in need of help.  I'm not sure if the parents had ever seen anything like it either.

I've since shown the video at school too.  Education is important.  Rabies is deadly.  Keeping pets vaxed is important.  Knowing to seek help is too.  Folks don't know what they haven't been exposed to.  Share when we can

 

I agree.  I shared the video of the rabid cat here or on some thread because I thought seeing what it looks like is important.  I definitely think I or my dc could easily see an animal like that and want to help it with out knowing that presentation like that can be rabies.  

1 hour ago, creekland said:

I'm still 100% in favor of vaxes for those who are able to have them, esp for folks who choose public schools and similar and even more especially when there are epidemics about.  Eradicate the diseases (or help our bodies fend off tetanus/flu).

 

I’m 100% in favor of reaching out to more people who don’t have good access to vaccinations to help them to be able to get them rather than resorting to forcing people who are against it, in most situations.  An epidemic outbreak has always presented a legal exception .

There seems to be a presumption in this thread that the only people who don’t vaccinate are “anti vax “ or unable due to health (or religious?)

Wuite a few people have access trouble,

Here’s one discussion of one example

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2648888/

 

 

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5 hours ago, Pen said:

 

I’m 100% in favor of reaching out to more people who don’t have good access to vaccinations to help them to be able to get them rather than resorting to forcing people who are against it, in most situations.  An epidemic outbreak has always presented a legal exception .

There seems to be a presumption in this thread that the only people who don’t vaccinate are “anti vax “ or unable due to health (or religious?)

Wuite a few people have access trouble,

Here’s one discussion of one example

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2648888/

 

 

I can absolutely agree with that. When my oldest was about a year old, I had a big gap in health insurance and no access to any sort of “clinic”. He fell behind until I simultaneously moved and got reinsured. That was not anti-vax!

While important, those are not the people I’m seeing online, freaking out about their rights.  What I am seeing is people I know and genuinely like spewing outright conspiracy theories. (They’re using the word conspiracy, not me!)

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34 minutes ago, Carrie12345 said:

I can absolutely agree with that. When my oldest was about a year old, I had a big gap in health insurance and no access to any sort of “clinic”. He fell behind until I simultaneously moved and got reinsured. That was not anti-vax!

While important, those are not the people I’m seeing online, freaking out about their rights.  What I am seeing is people I know and genuinely like spewing outright conspiracy theories. (They’re using the word conspiracy, not me!)

But the reality is these are about 1-2pc if the population.  We can still maintain herd immunity if everyone else vaccinated. We probably come across more of them because of homeschooling I guess.

also I think there’s an element of the more you try to force people the more they dig in the heels. Really the best way to get them all to vaccinate would be to threaten to make it illegal!

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9 minutes ago, Ausmumof3 said:

But the reality is these are about 1-2pc if the population.  We can still maintain herd immunity if everyone else vaccinated. We probably come across more of them because of homeschooling I guess.

also I think there’s an element of the more you try to force people the more they dig in the heels. Really the best way to get them all to vaccinate would be to threaten to make it illegal!

Without taking the time to look up stats, I can tell you that it’s most definitely not 1-2% in MY population - the people my kids are around on a regular basis. Perhaps it is where they go to work or take college classes, but not where they spend a lot of time with other homeschoolers.  Almost 50% is a reasonable estimate in our homeschool community. I’d say 30% of members I’m FB friends with are posting anti-vax stuff, while I’m confident there are more like me who have at least one kid who isn’t fully UTD, but don’t post about it.

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10 minutes ago, Carrie12345 said:

Without taking the time to look up stats, I can tell you that it’s most definitely not 1-2% in MY population - the people my kids are around on a regular basis. Perhaps it is where they go to work or take college classes, but not where they spend a lot of time with other homeschoolers.  Almost 50% is a reasonable estimate in our homeschool community. I’d say 30% of members I’m FB friends with are posting anti-vax stuff, while I’m confident there are more like me who have at least one kid who isn’t fully UTD, but don’t post about it.

Article I posted has the stats.  This is for Australia though, US could be quite different.  You do tend to have more conspiracy theorists and prepper types I think.

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25 minutes ago, Ausmumof3 said:

But the reality is these are about 1-2pc if the population.  We can still maintain herd immunity if everyone else vaccinated. We probably come across more of them because of homeschooling I guess.

also I think there’s an element of the more you try to force people the more they dig in the heels. Really the best way to get them all to vaccinate would be to threaten to make it illegal!

Maybe in Aus but not in certain states in the US that permit “philosophical exemption.” The number of people in Texas a year or two ago claiming philosophical exemption was 57,000. (This was in an article I think linked to this thread but I doubt I can find it now.) 57,000 kids, probably many of them homeschooled, is not a tiny amount and Measles and Pertussis require high vax rates to hold. When a person is coming down with measles, they don’t know it’s measles for 3-4 days. 

So to me, it isn’t “fair” (sorry for the jeuvenille terminology) for the philosophical objectors to threaten the population that did vaccinate, or would but kids are too little, or can’t due to medical reasons. IMO, we cannot wait for an outbreak in some area before we try to close the barn doors. 

Also, I’m not sure exactly what we’re talking about when we say forced. Is it forced if you can’t register your kid to school or camp? Is it forced if you can’t get social services like welfare or supplemental nutrition, until your kids have been vaxxed? Is it forced if there’s a decree from local govt that “due to an outbreak of measles cases, we are requiring unvaccinated people from going out in public.” How is that even enforced? 

Your last line does make me chuckle. 

The book I’m reading right now (called Nudge) speaks of the need for “libertarian paternalism” in govt and authority bodies. What the authors say about this, I find true: pure libertarianism does not really work, because people do not necessarily choose well simply because they are free to do so. I find this true! So, an ideal program with any goal is to have a degree of freedom (because you are right - people resist being coerced), but with features in place that make it easier for people to choose well. So, at a public park, dogs are not banned because they leave piles of poo, but the park might have little baggie dispensers and signs properly marketed to induce people to pick up their dog’s piles. Also, if the social tide turns to pro-clean parks, positive peer pressure will also induce more people to pickup after Fido. (In my region, this is true with public smoking. Public smoking is banned in a lot of places, but the social vibe is probably even more Relevant.) 

IMO, the ideal vaccination policy is like this too. The default is to get your kids vaccinated according to the govt schedule. If you want or need to participate in any social (govt sponsored) programs, inlcuding school, camps, social services), you must show proof of vaccination. If you cannot vaccinate, you have to secure a doctor-issued waiver or a waiver by a religious leader like a Rabbi. No “philosophical objections.” 

I am very much in favor of free or reduced cost vaccination available everywhere, but this does not increase compliance to the degree one expects. People often do not value things they can get for free. There is also a propensity to put off something you can get at any time for free. All fall and winter, there are flu shots available where I live for free, but lots of people still won’t get them. People tend towards inertia. 

 

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1 hour ago, Ausmumof3 said:

Article I posted has the stats.  This is for Australia though, US could be quite different.  You do tend to have more conspiracy theorists and prepper types I think.

I wasn’t aiming to dispute your specific stats, just inform you of mine. 
For whatever it’s worth, preppers and anti-vaxxers don’t necessarily go hand in hand.

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5 hours ago, Carrie12345 said:

I wasn’t aiming to dispute your specific stats, just inform you of mine. 
For whatever it’s worth, preppers and anti-vaxxers don’t necessarily go hand in hand.

Exactly. When one is fleeing the zombie apocalyse, having your entire group come down with measles or whatever preventable disease we're discussing is a Really Bad Thing.*

 

*No disrespect intended to either preppers or parents who have dealt with their kids' bad reaction to vaccines.

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14 hours ago, Pen said:

 

There are people in USA,  particularly in rural and inner city areas who don’t have good access to vaccinations,  even though they aren’t against them— cost, distance, problems with missing work etc.  Making vaccinations easier for those, adults as well as children, who would like to get them or who perhaps just aren’t thinking about it one way or the other, would be helpful.  IMO 

 

I agree.  I don't think there should be just one approach and expect it to work for everyone.  My preference in life is to offer incentives of various sorts and only end up with punishment if there's no other recourse.  That approach works super well for me in school.  There my view is to educate on how to review ideas/theories so more folks don't end up believing nonsense simply because they read it on the internet.

14 hours ago, Pen said:

There seems to be a presumption in this thread that the only people who don’t vaccinate are “anti vax “ or unable due to health (or religious?)

 

I don't see that presumption.  I think the anti-vax folks are just the ones who turn people off due to their faulty reasoning, and esp in times of epidemics, how much at risk they put everyone else.  I think everyone understands those who have real health issues.  I think everyone would want to help those who have other obstacles (like cost or access).  Some states are better at that than others.  Plenty of places offer free flu shots.  My state offers free recommended vaccines at our county health office if one doesn't have insurance to cover them.  There's still the issue of getting there.  I know my school tries to help people when they see families in need.

Otherwise, I know plenty who get annoyed when someone with the flu shows up to work.  They are only spreading their germs and no one I know wants to catch it.  It's that same annoyance with those who chose not to get vaxes when something like measles is around.  The underlying (often spoken out loud) comment is STAY HOME if you end up sick or think you might have been exposed.  With measles... really, it's not that tough to get a vaccine if one wants it.  As Quill pointed out, the problem with many is inertia.

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