Bioethicist says parents who don't vaccinate should face liability for consequences - Page 5 - Mothering Forums
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#121 of 412 Old 07-29-2013, 04:54 AM
 
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Thanks for posting that. Interesting to read the argument from a legal perspective.

You seem to be implying that Dorit Reiss's perspective is the only legal perspective. Mary Holland is also an attorney.
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#122 of 412 Old 07-29-2013, 09:03 AM
 
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This thread has been on my mind.  Is it possible I could be sued for failure to vaccinate from a stranger if the stranger gets a VAD from me?  Sure, it is possible.  People are allowed to sue over pretty much anything.  Do I think it is likely or that they will win?  No, I don't.

 

1.  How can they prove I am unvaxxed?  I am not going to give them my blood, and I am not sure they can make me.  Anyone know?  Even then, what does it prove - I could be vaxxed but the vaccine did not take.  Vaccine are not 100% effective, and in the case of the more common disease (flu and pertussis come to mind) significantly less so.  I actually live in an area without vaccine registries - they would have a hard time proving I was or was not vaxxed and I would not help them. 

 

2.  I do not live in an area with a duty to act. I know this from first aide.  I am under no obligation to "help" by vaxxing, particularly as it involves risks to me. 

 

At this point in time, the math on me having a VAD, giving it to someone, and that person choosing to sue me seems really, really low.  I am not going to worry about it for one second. 

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#123 of 412 Old 07-30-2013, 07:18 AM
 
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That reference points out something very important. Coverage IS NOT higher than ever, it peaked around 2004-05 and now it's been slowly dropping for most vaccines in the table. Hence the general concern. In some European countries in the 90s they had some marked drops in vaccination and so outbreaks afterwards (the Wakefield debacle).
As discussed before, the researchers and authorities DO acknowledge that vaccinations may have lead to serious injury. But since they have a very low probability of happening they are deemed as 'safe'. Calling them something else, say, 'relatively safe' may be misinterpreted by the public.

[quote/]

Nationally, there was a 3% drop in uptake between 2004-2009. 1.5% from 2005. Do you have proof of causation, (not correlation) that this minor drop *caused* additional measles outbreaks?
Caplan certainly doesn't, but he's trying to base the brunt of his argument on that premise.

By higher than ever, I mean that for the first time in the history of U.S. epidemiology, we are seeing uptake rates at 90% and above. (Counterintuitively, we are also seeing more disease-mongering, hate-mongering, and hysteria than ever against parents who don't comply with recommendations and mandates).

I won't even go into your paternalistic proposal of withholding from consumers the fact that vaccines aren't completely safe. It's unrealistic, anyway. These kinds of lies are impossible to pull off in the Information Age.
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#124 of 412 Old 07-30-2013, 07:39 AM
 
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Nationally, there was a 3% drop in uptake between 2004-2009. 1.5% from 2005. Do you have proof of causation, (not correlation) that this minor drop *caused* additional measles outbreaks?
Caplan certainly doesn't, but he's trying to base the brunt of his argument on that premise.

By higher than ever, I mean that for the first time in the history of U.S. epidemiology, we are seeing uptake rates at 90% and above. (Counterintuitively, we are also seeing more disease-mongering, hate-mongering, and hysteria than ever against parents who don't comply with recommendations and mandates).

I won't even go into your paternalistic proposal of withholding from consumers the fact that vaccines aren't completely safe. It's unrealistic, anyway. These kinds of lies are impossible to pull off in the Information Age.

 

This is an interesting read, published in 1966 by The Public Health Services National Communicable Disease Center of Atlanta, GA, the forerunner of the CDC, claming they had to tools to eradicate measles in one year with just a 55% immunity rate. Obviously it didn't work.

 

David J. Sencer, M.D. H. Bruce Dull, M.D. Alexander D. Langmuir, M.D.

 

it is evident that when the level of immunity was higher than 55 percent, epidemics did not develop. This is an estimate of the threshold of herd immunity providing protection to the city against a measles epidemic.  

 

There is no reason, however, to question the validity of the basic assumption that the occurrence of measles  epidemics depends upon the balance of immunes and susceptibles, and that for all areas and special groups in this country the immune threshold is considerably less than 100 percent.

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#125 of 412 Old 07-30-2013, 08:00 AM
 
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Preventing measles epidemics is not the same thing as eradicating measles.


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#126 of 412 Old 07-30-2013, 08:08 AM
 
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Preventing measles epidemics is not the same thing as eradicating measles.

Note title of paper:

 

EPIDEMIOLOGIC BASIS FOR ERADICATION OF MEASLES

 

 

 

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#127 of 412 Old 07-30-2013, 08:28 AM
 
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This is an interesting read, published in 1966 by The Public Health Services National Communicable Disease Center of Atlanta, GA, the forerunner of the CDC, claming they had to tools to eradicate measles in one year with just a 55% immunity rate. Obviously it didn't work.

 

They never made that claim.  They were speaking specifically about one area of the country during one time period and in the following sentences state:

 

"It must be recognized that the immune threshold of the 55 percent estimated for Baltimore for the period 1897 to 1927 may not have direct applicability to other communities in the United States in 1966. In fact, it is difficult to estimate whether the threshold of herd immunity for an average Ameriean city now would be higher or lower than Hedrich's estimate for Baltimore 30 to 70 years ago. Obviously, a considerable variability must be assumed for this threshold from urban area to urban area and within varying ethnic and socioeconomic groups in a single urban area."

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#128 of 412 Old 07-30-2013, 10:40 AM
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That reference points out something very important. Coverage IS NOT higher than ever, it peaked around 2004-05 and now it's been slowly dropping for most vaccines in the table. Hence the general concern. In some European countries in the 90s they had some marked drops in vaccination and so outbreaks afterwards (the Wakefield debacle).
As discussed before, the researchers and authorities DO acknowledge that vaccinations may have lead to serious injury. But since they have a very low probability of happening they are deemed as 'safe'. Calling them something else, say, 'relatively safe' may be misinterpreted by the public.

[quote/]

Nationally, there was a 3% drop in uptake between 2004-2009. 1.5% from 2005. Do you have proof of causation, (not correlation) that this minor drop *caused* additional measles outbreaks?
Caplan certainly doesn't, but he's trying to base the brunt of his argument on that premise.

By higher than ever, I mean that for the first time in the history of U.S. epidemiology, we are seeing uptake rates at 90% and above. (Counterintuitively, we are also seeing more disease-mongering, hate-mongering, and hysteria than ever against parents who don't comply with recommendations and mandates).

I won't even go into your paternalistic proposal of withholding from consumers the fact that vaccines aren't completely safe. It's unrealistic, anyway. These kinds of lies are impossible to pull off in the Information Age.


Perhaps you replied to my post to hastily?

1. Never said in my post that U.S. vaccination drop has caused outbreaks. I said that MARKED DROPS in vaccination rates in Europe has lead to outbreaks. You can find references to this everywhere online

2. Caplan's argument is that further drops will eventually lead to outbreaks, not that they will happen now. The vaccination rate threshold depends on the infectious disease and some other factors

3.  Your table shows rates over 90% in the 90s for several vaccines..... about 20 years ago. Saying "First time in history" does not seem adequate

4. NEVER said to withhold information from consumers. I said (in that and other posts) that the public must understand that the governments and experts definition of safe is that there's low probability of SERIOUS side effects.

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#129 of 412 Old 08-03-2013, 08:20 AM
 
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Actually, I'm not sure why you're dragging European data into the discussion.  This was an article by a U.S. academic about the U.S. experience making the unsubstantiated claim that U.S. measles outbreaks are to blame on U.S. parents declining the MMR vaccine.  All of that is in his first paragraph of Caplan's article, which I quoted in a previous post.  "For the first time in history" is a perfectly accurate phrase even with the high uptake trend lasting 20 years.  

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#130 of 412 Old 08-03-2013, 10:36 AM
 
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What's the country got to do with it. The human body works the same wherever you're from.

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#131 of 412 Old 08-03-2013, 10:39 AM
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Focusing on the fact that the statement relates to some European countries misses the point. The point is that when vaccination rates are below a certain level, outbreaks occur. This has occurred in countries in Europe and also in: Japan, Russia and Australia (with pertussis) http://www.fcs.uga.edu/cfd/cdl/docs/vaccines_exemptions.pdf. In fact, low vaccination rates caused a measles outbreak in the U.S in 1989 http://www.health.harvard.edu/flu-resource-center/vaccines-and-your-health.htm

 

Hence comes Caplan's argument. In general, rates in the U.S are going down (as shown in the table provided in http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/coverage.pdf). Once it hits a certain level (somewhere below 90%) outbreaks become more likely. As the table shows, in 2009 the U.S MMR vaccination rate was 90%.

 

Caplan implies that the more likely outbreaks occur, the more likely we may see a vaccination lawsuit.
 

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#132 of 412 Old 08-03-2013, 10:56 AM
 
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Focusing on the fact that the statement relates to some European countries misses the point. The point is that when vaccination rates are below a certain level, outbreaks occur. This has occurred in countries in Europe and also in: Japan, Russia and Australia (with pertussis) http://www.fcs.uga.edu/cfd/cdl/docs/vaccines_exemptions.pdf. In fact, low vaccination rates caused a measles outbreak in the U.S in 1989 http://www.health.harvard.edu/flu-resource-center/vaccines-and-your-health.htm

 

Hence comes Caplan's argument. In general, rates in the U.S are going down (as shown in the table provided in http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/coverage.pdf). Once it hits a certain level (somewhere below 90%) outbreaks become more likely. As the table shows, in 2009 the U.S MMR vaccination rate was 90%.

 


 

Whether or not the bolded can be argued depends highly on the vaccine and the disease.  It also depends on how you define outbreak. 


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#133 of 412 Old 08-03-2013, 11:00 AM
 
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Hence comes Caplan's argument. In general, rates in the U.S are going down (as shown in the table provided in http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/coverage.pdf). Once it hits a certain level (somewhere below 90%) outbreaks become more likely. As the table shows, in 2009 the U.S MMR vaccination rate was 90%.

 


 

The chart does not show this.  To me it looks like vaccination rates are fairly stable.  Some rates look a tiny bit lower this year (and some are higher).  Over all the MMR rates have gone up and down by up to 2 points every year from 1999-2009.


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#134 of 412 Old 08-03-2013, 12:01 PM
 
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What Kathy said... Do you have charts from the last 4 years? The chart you gave doesn't show an uptake below 90% since 1995. 1996 was the first year it was above 90% and it has stayed that way. I think it is reasonable to assume that it is going to go up or down a little bit each year. I don't see any big drops. ETA: Looks like the largest drop was in 1970 and only 3% less than the previous years.

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#135 of 412 Old 08-03-2013, 12:13 PM
 
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Among K grade children enrolled in public or private schools last years uptake rates were consistent with an overall above 90% rate...

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Overall, among the 48 states and DC that reported 2012–13 school vaccination coverage, median 2-dose MMR vaccination coverage was 94.5% (range: 85.7% in Colorado to ≥99.9% in Mississippi); http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6230a3.htm?s_cid=mm6230a3_e
 
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#136 of 412 Old 08-03-2013, 12:58 PM
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Whether or not the bolded can be argued depends highly on the vaccine and the disease.  It also depends on how you define outbreak. 


Not really. What can be argued is when after the rate level an outbreak occurs and what is the value of the level for an outbreak to occur. These two things are certainly combined with many other factors.

The table unequivocally shows MOST vaccines in that table peaking (at different times and sometimes more than once) and then rates going down. This is not to say that they are already too low to lead to large outbreaks. That doesn't seem to be the case....... yet. The media has claimed some U.S. outbreaks in recent times and some watch dogs are concerned about rates going down

http://www.nytimes.com/2008/03/21/us/21vaccine.html?_r=2&

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#137 of 412 Old 08-03-2013, 01:51 PM
 
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Not really. What can be argued is when after the rate level an outbreak occurs and what is the value of the level for an outbreak to occur. These two things are certainly combined with many other factors.

The table unequivocally shows MOST vaccines in that table peaking (at different times and sometimes more than once) and then rates going down. This is not to say that they are already too low to lead to large outbreaks. That doesn't seem to be the case....... yet. The media has claimed some U.S. outbreaks in recent times and some watch dogs are concerned about rates going down

http://www.nytimes.com/2008/03/21/us/21vaccine.html?_r=2&

Tetanus is not contagious and therefore contagious "outbreaks" are not an issue.

 

Hep. B is blood borne.  I would not expect to see mass outbreaks in the public

 

I do not believe we would have outbreaks of diptheria even if we stopped vaccinating, as it is primarily a disease of poor sanitation and overcrowding.  I could be wrong on this one - but we have not had more than 10 death in diptheria per year since 1972, and DPT rates were (according to the chart you provided) under 75% for the 1970s' and 1980's.  Some years were under 70'% vaccination rate.

 

You earlier said the graph showed rates going down.  I think chart shows stability in the last decade (ending in 2009)- some are up, some are down.   Is there are very slight downward trend?  Meh - perhaps.  It is far too early to draw conclusions about. People can look and decide for themselves.  Yes, it shows that there was a peak year from 1950-2009, and it is not this year - but then, so what?  We can only have one peak year - it is hardly surprising this one isn't it.  All numbers are less than the peak year.   


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#138 of 412 Old 08-03-2013, 04:33 PM
 
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WA, OR & CA have just passed laws that they promise reduce exemption rates & make the process more burdensome, so I would expect rates to go *up* next year, @ least 4 the Western States. One issue is that in some states you can file exemptions for individual vaxes & those children are counted as exempt even if they are 90% UTD. So true exemption numbers (which also include parents who were Vaxing & then quit) seem higher than they actually are.
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#139 of 412 Old 08-03-2013, 06:43 PM
 
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I didn't read the thread, but when I read this thread title on the main page, my initial thought was... "Only if parents of kids who get sick from vaccines because they didn't bother to research anything do."

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#140 of 412 Old 08-03-2013, 06:46 PM
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Tetanus is not contagious and therefore contagious "outbreaks" are not an issue.

 

Hep. B is blood borne.  I would not expect to see mass outbreaks in the public

 

I do not believe we would have outbreaks of diptheria even if we stopped vaccinating, as it is primarily a disease of poor sanitation and overcrowding.  I could be wrong on this one - but we have not had more than 10 death in diptheria per year since 1972, and DPT rates were (according to the chart you provided) under 75% for the 1970s' and 1980's.  Some years were under 70'% vaccination rate.

 

You earlier said the graph showed rates going down.  I think chart shows stability in the last decade (ending in 2009)- some are up, some are down.   Is there are very slight downward trend?  Meh - perhaps.  It is far too early to draw conclusions about. People can look and decide for themselves.  Yes, it shows that there was a peak year from 1950-2009, and it is not this year - but then, so what?  We can only have one peak year - it is hardly surprising this one isn't it.  All numbers are less than the peak year.   


For a while now in this thread the context of the discussion has been on MMR and DTaP vaccines. Caplan's statement does not really apply with many other vaccines.

 

The vaccines rates have gone down, especially for MMR and DTaP (DTP). As stated before, not dramatically so yet, but there is concern that this could be the case in a few years. For MMR 90% is already close to what's believed to be the limit for herd immunity. For MMR it's gone down more than 3% from its peak. Another way of seeing the issue is that for MMR, the rate has not been this low since 1995 (when it was a bit lower). For the DTPs rates 2009 was the lowest since 1994 and 2002 respectively. I'd like to be clear in that I'm not saying that the decline has been dramatic or that they will definitely lead to an issue, but nonetheless it is there and it could eventually lead to outbreaks of say, measles or pertussis

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#141 of 412 Old 08-03-2013, 08:22 PM
 
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Just to throw even more into the discussion, I think Caplan's argument is altered by the specific legislative avenues and compensation availability in each particular country.

 

In Australia, there is, as yet, no form of no-fault compensation for vaccine injuries. The Royal Australasian College of Physicians has asked the government to put one into place, but nothing yet. Sure, there is the brand new Disability Insurance Scheme, but that has to do with disability support in general and is not vaccine injury specific.

 

Or you could try and sue the manufacturers as Saba Button's parents are doing, but in that particular case, the vaccine manufacturer (CSL) states that, despite their product not having been trialled in children before roll out and despite the number of severe reactions reported and its eventual ban for children under the age of five years, their company is not liable for Saba's permanent injuries. They say liability lies with the government who did not notify the manufacturers in a timely manner of any issues with the product.

 

http://au.news.yahoo.com/thewest/a/-/wa/17845400/company-denies-fault-over-ill-baby/

 

http://www.theaustralian.com.au/news/features/virus-in-the-system/story-e6frg8h6-1226063484330

 

I think Caplan's assertion that parents need to be held accountable and risk lawsuit for infecting others appears ironic from over here. How can a bioethicist demand that parents "do the right thing," when some countries, like Australia, don't have any programs in place for parents whose children were injured when they did what Caplan advocates?

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#142 of 412 Old 08-04-2013, 05:50 PM
 
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NO!  *YOU* just said the vaccine is not 100% effective!  So, if the vaccine is not 100% effective and that is how your child got sick, how do you prove that my child would not have gotten it even with the vaccine--or developed it FROM the vaccine, since MMR is a live vaccine, that can happen....and given it to your family ANYWAY?


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#143 of 412 Old 08-04-2013, 06:13 PM
 
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For a while now in this thread the context of the discussion has been on MMR and DTaP vaccines. Caplan's statement does not really apply with many other vaccines.

 

The vaccines rates have gone down, especially for MMR and DTaP (DTP). As stated before, not dramatically so yet, but there is concern that this could be the case in a few years. For MMR 90% is already close to what's believed to be the limit for herd immunity. For MMR it's gone down more than 3% from its peak. Another way of seeing the issue is that for MMR, the rate has not been this low since 1995 (when it was a bit lower). For the DTPs rates 2009 was the lowest since 1994 and 2002 respectively. I'd like to be clear in that I'm not saying that the decline has been dramatic or that they will definitely lead to an issue, but nonetheless it is there and it could eventually lead to outbreaks of say, measles or pertussis

 

You statement is supposition and has not proven to be the case, at lease, where I live. My county has a fully vaccinated rate of 60%, that means 40% of children are either unvaccinated or under-vaccinated. The has been no major outbreak of measles in recent years. The last confirmed case was in 2006 in a 9 month old child, who traveled to Thailand and India. In 2012 there was suspected case in a 24 year old, but proved to be negative when tested. My city is affluent, educated and extremely health conscious, with alternative practitioners out numbering conventional ones.

 

So with such a low vaccination rate where are all those measles cases?

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#144 of 412 Old 08-04-2013, 08:00 PM
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You statement is supposition and has not proven to be the case, at lease, where I live. My county has a fully vaccinated rate of 60%, that means 40% of children are either unvaccinated or under-vaccinated. The has been no major outbreak of measles in recent years. The last confirmed case was in 2006 in a 9 month old child, who traveled to Thailand and India. In 2012 there was suspected case in a 24 year old, but proved to be negative when tested. My city is affluent, educated and extremely health conscious, with alternative practitioners out numbering conventional ones.

 

So with such a low vaccination rate where are all those measles cases?


Actually no, my statement is not supposition and is based on the research. See some of the previous posts for some examples of the studies. But your argument comes from a common misconception of statistics. When the experts say that unvaccinated clusters are more likely to suffer an outbreak, this does not mean that a cluster will definitely suffer an outbreak in a short period of time. Furthermore, if you the cluster doesn't suffer an outbreak in a given period of time this doesn't mean that their more likely to suffer an outbreak on the next period of time (events on each separate period of time may be probabilistically independent). On the long run however, the probability that an unvaccinated cluster suffers at least one outbreak is likely to be high. Personally, I'm not sure what would be considered a period of time to be classified as long run in these cases, but that might depend on the disease in question, the vaccination rate, and some other factors (size of county, interactions with outsiders etc).
 I can't go into examples with the 60% vaccination rate. I'd be assuming this number is true. Do you have a reference? I'd be happy to crunch some numbers given a proper reference :)

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#145 of 412 Old 08-04-2013, 08:28 PM
 
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Originally Posted by bakunin View Post


When the experts say that unvaccinated clusters are more likely to suffer an outbreak, this does not mean that a cluster will definitely suffer an outbreak in a short period of time. Furthermore, if you the cluster doesn't suffer an outbreak in a given period of time this doesn't mean that their more likely to suffer an outbreak on the next period of time (events on each separate period of time may be probabilistically independent). On the long run however, the probability that an unvaccinated cluster suffers at least one outbreak is likely to be high. 

This sounds a little fear based and too theoretical for me.  

"Well, you have seen no outbreaks, there is no guarantee you will get one *next time* but it is coming, I swear." 

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There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

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#146 of 412 Old 08-04-2013, 08:34 PM
 
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What's the country got to do with it. The human body works the same wherever you're from.

Really?  So the 1 in 23 rate of autism amongst the Somali population in Minnesota is a sign that the human body will work the same for everyone,no matter what you inject into it, and no matter what the individual genetic predisposition are like?

 

Yeah, that's REALLY scientific, there.

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#147 of 412 Old 08-04-2013, 08:52 PM
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Originally Posted by kathymuggle View Post

This sounds a little fear based and too theoretical for me.  

"Well, you have seen no outbreaks, there is no guarantee you will get one *next time* but it is coming, I swear." 


I'm afraid statistics is the best we've got in these situations with so many unknowns. As strange as the results sound statistics is useful. They are not fear based whatsoever. Decisions based on fear would not rely on the evidence. Like being concerned about adverse events that hardly ever occur (or sometimes are not scientifically linked to vaccines) :)

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#148 of 412 Old 08-04-2013, 09:26 PM
 
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Again with the 'hardly ever'. That is not a scientific statement @ all. At best it is a vague opinion statement that is inherently undefinable.
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#149 of 412 Old 08-04-2013, 10:04 PM
 
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CREATOR: gd-jpeg v1.0 (using IJG JPEG v62), quality = 80

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               "Those who are able to see beyond the shadows and lies of their culture will never be understood, let alone believed, by the masses."

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#150 of 412 Old 08-05-2013, 05:23 AM
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Originally Posted by dinahx View Post

Again with the 'hardly ever'. That is not a scientific statement @ all. At best it is a vague opinion statement that is inherently undefinable.


1 in a million really is hardly ever. After all, since the beginning of this thread we've been focusing on serious side effects. And the data shows that the serious side effects have that low of a chance.

 

Tell me dinahx, do you play the lottery?

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