Free riding behavior and vaccination - Mothering Forums

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#1 of 53 Old 03-27-2014, 10:07 AM - Thread Starter
 
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Since this was brought up in the measles discussion and I think it's worthy of debate, I wanted to make a spin-off thread on this topic. I also think it ties into a discussion awhile back "Vaccines are a victim of their own success"

 

To be clear, I'm talking about "free riding" specifically as an accepted academic term, not an insult. Not "freeloading" or anything else. Non-vaxxers have been accused of being free riders when it comes to public health. In this case, they benefit from a positive externality (click the link below for definition).

 

Here's the generally accepted academic definition and it applies to many things other than vaccines:
 

Free rider

A person who chooses to receive the benefits of a "public good" or a "positive externality" without contributing to paying the costs of producing those benefits.

https://www.auburn.edu/~johnspm/gloss/free_rider

 

Here are some research/academic articles published on the topic:
 

"BACKGROUND:

Mathematical models have formalized how free-rider effects can threaten the stability of high vaccine coverage levels under established voluntary vaccination programs. However, little research has addressed the question of when free-riding begins to develop when a new vaccine is first introduced in a population." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939872/

Free-riding behavior in vaccination decisions: an experimental study.

http://www.ncbi.nlm.nih.gov/pubmed/24475246

 

And from wiki:

Rational individuals will attempt to minimize the risk of illness, and will seek vaccination for themselves or their children if they perceive a high threat of disease and a low risk to vaccination. However, if a vaccination program successfully reduces the disease threat, it may reduce the perceived risk of disease enough so that an individual's optimal strategy is to encourage everyone but their family to be vaccinated, or (more generally) to refuse vaccination at coverage levels below those optimal for the community.[3] [...] Governments often allow exemptions to mandatory vaccination for religious or philosophical reasons, but if too many of these exemptions are granted, the resulting free rider problem may cause loss of herd immunity, substantially increasing risks even to vaccinated individuals.[6]

http://en.wikipedia.org/wiki/Vaccination_policy#Individual_versus_group_goals

 

 

Although I understand where people are coming from when they make the statement that NVers are "free riders", I generally consider free riding a product of free market decisions, and less applicable to programs that have a large amount of government funding. 

Since vaccines are tied up with government-led public health programs, and private insurance often charges similar rates for children whether their parents vaccinate them or not, this seems to muddle the argument.

 

I'm curious what you all think about these questions:

 

If parents of unvaxed kids are paying the same standard rates as others, then are they really free riders?

 

Is the health risk taken on by those who vaccinate (the risk of adverse effects) significant enough to call those who avoid these risks and still benefit from herd immunity "free riders"?

 

Does the free riding effect threaten public health, and can it be reasonably mitigated in some way, without requiring mandatory vaccine compliance?

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#2 of 53 Old 03-27-2014, 10:18 AM
 
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I don't mind it because I would vaccinate regardless so I don't feel as if I am taking on extra risk, but I do mind when vaccine critics deny that they benefit from lowered rates of disease and transmission (yes, I know that pertussis may be an exception to this).

 

I don't think insurance benefits/finances are really relevant here.

 

Re: mandatory compliance -- there seems to be some disagreement on these forums about what exactly comprises "mandatory compliance".  Some feel that any pressure to vaccinate is the ethical equivalent of mandating compliance.  Some others feel as if "mandatory compliance" means armed officers forcing vaccinations and anything short of that cannot be considered "mandatory".  I think there are some intermediary steps that could raise vaccination rates without forcing compliance, such as making it at least as difficult to get an exemption as it is to get a vaccine (must visit the doctor's office to get the exemption, for instance).


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#3 of 53 Old 03-27-2014, 11:02 AM
 
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Hello!

 

I usually just lurk but need something to keep my mind off my strep throat..

 

I have a child injured by his vaccines.  I've had his titres checked and they come back a big fat zero.  If that does determine his level of immunity then he is not protecting anyone.  Sorry (although it isn't me who should be apologizing).  My other child (NT)'s titres tested on the low side IIRC.   We can know the percentage of the population that is vaccinated but unless there is testing done periodically through the years,  the true level of herd immunity is just an assumption.

 

And how about the adults?  In Canada, anyone 44 years or older is presumed to have had the natural measles.  Does vaccine induced immunity (if and when it exists) confer lifetime protection?  (And the cheeky answer would be- only if you get a lifetime of boosters).  So as someone who had the measles, mumps, chickenpox I would like to declare that the free riders are actually those who did not have the disease.  ;)


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#4 of 53 Old 03-27-2014, 11:11 AM
 
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Hello!

 

I usually just lurk but need something to keep my mind off my strep throat..

 

I have a child injured by his vaccines.  I've had his titres checked and they come back a big fat zero.  If that does determine his level of immunity then he is not protecting anyone.  Sorry (although it isn't me who should be apologizing).  My other child (NT)'s titres tested on the low side IIRC.   We can know the percentage of the population that is vaccinated but unless there is testing done periodically through the years,  the true level of herd immunity is just an assumption.

 

And how about the adults?  In Canada, anyone 44 years or older is presumed to have had the natural measles.  Does vaccine induced immunity (if and when it exists) confer lifetime protection?  (And the cheeky answer would be- only if you get a lifetime of boosters).  So as someone who had the measles, mumps, chickenpox I would like to declare that the free riders are actually those who did not have the disease.  ;)

 

I couldn't agree with the bolded more. I too have had measles, mumps, and rubella (not chicken pox - but have been exposed so many times I am going to assume I am immune), there is no way I am a free rider on the synthetic, vaccine immunity of the vast majority of the population.

 

Thanks for joining the conversation!


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#5 of 53 Old 03-27-2014, 11:26 AM
 
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Hello!

 

I usually just lurk but need something to keep my mind off my strep throat..

 

I have a child injured by his vaccines.  I've had his titres checked and they come back a big fat zero.  If that does determine his level of immunity then he is not protecting anyone.  Sorry (although it isn't me who should be apologizing).  My other child (NT)'s titres tested on the low side IIRC.   We can know the percentage of the population that is vaccinated but unless there is testing done periodically through the years,  the true level of herd immunity is just an assumption.

 

And how about the adults?  In Canada, anyone 44 years or older is presumed to have had the natural measles.  Does vaccine induced immunity (if and when it exists) confer lifetime protection?  (And the cheeky answer would be- only if you get a lifetime of boosters).  So as someone who had the measles, mumps, chickenpox I would like to declare that the free riders are actually those who did not have the disease.  ;)


Excellent points--I'm so glad you de-lurked!

 

It's all an assumption.  We were told that the MMR confers lifetime immunity for 95% with just one shot--but everyone must get 2 shots to get that 5%.  It's assumed that there is no risk in this, though clearly there would be less risk in doing titers. Yet, in every measles and mumps outbreak the majority of the people who come down with the disease are those who are not just partially vaccinated, but FULLY vaccinated.

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#6 of 53 Old 03-27-2014, 11:46 AM
 
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Excellent points--I'm so glad you de-lurked!

 

It's all an assumption.  We were told that the MMR confers lifetime immunity for 95% with just one shot--but everyone must get 2 shots to get that 5%.  It's assumed that there is no risk in this, though clearly there would be less risk in doing titers. Yet, in every measles and mumps outbreak the majority of the people who come down with the disease are those who are not just partially vaccinated, but FULLY vaccinated.

According to the Canadian government health website, adverse events are more likely to happen to those that didn't respond to the first dose. This makes a more compelling argument to 

check titres after the first dose, no?

http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/docs/measles_chapter.pdf


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#7 of 53 Old 03-27-2014, 12:20 PM - Thread Starter
 
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Originally Posted by samaxtics View Post
 

According to the Canadian government health website, adverse events are more likely to happen to those that didn't respond to the first dose. This makes a more compelling argument to 

check titres after the first dose, no?

http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/docs/measles_chapter.pdf

 

To look for what specifically?

If you didn't respond to the first dose, then your titers would be low. Assuming you want them high, you get revaccinated and have that higher-than-average risk of a reaction from the second dose because you didn't respond to the first.

 

If your titers are high, then you are skipping a second dose that was unlikely to cause any additional reactivity because you already have immunity, therefore reactivity is most likely going to be low or nonexistant for the second dose anyway.

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#8 of 53 Old 03-27-2014, 12:44 PM
 
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Quote:

 

To look for what specifically?

If you didn't respond to the first dose, then your titers would be low. Assuming you want them high, you get revaccinated and have that higher-than-average risk of a reaction from the second dose because you didn't respond to the first.

 

If your titers are high, then you are skipping a second dose that was unlikely to cause any additional reactivity because you already have immunity, therefore reactivity is most likely going to be low or nonexistant for the second dose anyway.

What, besides greed, would be the reason to re-vaccinate 95% of the population when they don't need to be?  Does it help the other 5%?  Nope.

And as a parent, if one knew that their child didn't respond to the first dose, and has a higher risk to have an adverse event to the second dose, shouldn't that be their decision whether they want to take the risk?  Isn't this true informed consent?


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#9 of 53 Old 03-27-2014, 12:49 PM
 
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If your titers are high, then you are skipping a second dose that was unlikely to cause any additional reactivity because you already have immunity, therefore reactivity is most likely going to be low or nonexistant for the second dose anyway.

 

Antibodies don't amount to a hill of beans with measles.

 

Measles antibodies doesn't mean you won't get measles (as we have already discussed in another thread). In fact very high measles (and rubella) antibody titers is not a good thing and has been associated with hepatitis b, mono and lupus. Also, you don't need antibodies against measles not to get the disease. A person (child) who is unable to make antibodies can cruse through measles infection without problems and will not get it again because, as you can read in medical text books, measles is 'fought' and overcome by front-line defenses not antibodies. Antibodies are simply a by-product of the process and have no roles in a first experience of a disease.

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#10 of 53 Old 03-27-2014, 01:01 PM
 
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Antibodies don't amount to a hill of beans with measles.

 

Measles antibodies doesn't mean you won't get measles (as we have already discussed in another thread). In fact very high measles (and rubella) antibody titers is not a good thing and has been associated with hepatitis b, mono and lupus. Also, you don't need antibodies against measles not to get the disease. A person (child) who is unable to make antibodies can cruse through measles infection without problems and will not get it again because, as you can read in medical text books, measles is 'fought' and overcome by front-line defenses not antibodies. Antibodies are simply a by-product of the process and have no roles in a first experience of a disease.

 

Why don't they get measles again?

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#11 of 53 Old 03-27-2014, 01:24 PM - Thread Starter
 
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What, besides greed, would be the reason to re-vaccinate 95% of the population when they don't need to be?  Does it help the other 5%?  Nope.

And as a parent, if one knew that their child didn't respond to the first dose, and has a higher risk to have an adverse event to the second dose, shouldn't that be their decision whether they want to take the risk?  Isn't this true informed consent?

 

Yes of course it should be their decision. This hypothetical parent made the decision to get the first one, so I assume they wanted to get immunity from the measles. Supposedly another 3% total can be covered with a second dose (3/5 or 60% of those who didn't respond to the first.) That's the WHY to your first question.

If they were going to skip the second dose regardless of whether titers are high or low, then why check titers at all? That's all I'm wondering. I don't care whether people get a dose and check titers and get another or not. I don't care if people skip all the doses.

 

I'm just curious about the logic behind it.

 

Plus, as Mirzam says, titers don't matter. I know that was directed at me, but since I'm not the one advocating titers in this hypothetical, I don't think there's anything for me to respond to. I'd be curious how you would respond to her statement, though, being someone who does seem to care about titers.

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#12 of 53 Old 03-27-2014, 01:27 PM
 
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Because the rest of the innate immune system is still working and deals with the infection reasonably well. This is not, however, the case of children being treated with chemotherapy and immunosuppressive drugs, because these wreak the immune system. Even if these children are vaccinated they can still get mealses.

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#13 of 53 Old 03-27-2014, 01:39 PM
 
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What, besides greed, would be the reason to re-vaccinate 95% of the population when they don't need to be?  Does it help the other 5%?  Nope.

And as a parent, if one knew that their child didn't respond to the first dose, and has a higher risk to have an adverse event to the second dose, shouldn't that be their decision whether they want to take the risk?  Isn't this true informed consent?

This where veterinary science is always a few steps ahead of the humans because of the unfortunate shorter lifespan in animals making studies from generation to generation easier to conduct. Many more vets have moved on from yearly boosters to 1-3yr titers (depending on the levels found) and countless animals will be spared over-vaccination from this incredibly simple step.

 

And back to the OP and the question of free riding...Honestly, most times I feel like I'm paying into a system that I will rarely if ever use.  I had CP and I'm sure various other odd things for which I paid my dues.  I choose alternative medicine for our preferred method of care.  Some alternative avenues are now being covered by certain insurance carriers and policies, so for example via DH's employer we have pretty phenomenal coverage and so acupuncture, chiropractic, and naturopathic visits are included in our policy.  But...(there's always a but!)...as easy as it was to find a chiro that fit in our plan, I've had a hell of a time with naturopaths.  Currently the one we see doesn't accept insurance, and I have no problem with that because it's money well spent albeit out of pocket.  I just wish it was more equal.  I can run out and get any number and combination of prescription drugs no problem, insurance will take care of it.  But lord help me if I try and get reimbursed for a necessary supplement!  It forces people to remain dependent on certain providers to avoid the out of pocket expenses.

 

I mean I could save a lot of money just eating cheap processed foods, gets Rx's for every sniffle, and allowing my family to be vaxxed (and I'm not generalizing here).  But that's not the choice we've made and so we pay for that - literally.  Every penny is pinched to stick with a healthy (mildly restricted GF/CF) diet, to support our immune systems with essential oils, supplements to fill dietary gaps, homeopathic when needed.  But I won't change our struggle to save a buck here just to pay it to various groups for which I feel do not have my best interests in mind.  I pay with my money, I pay with my constant battling because I don't fit in the norm and must always explain my position.  That's payment enough.

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#14 of 53 Old 03-27-2014, 02:03 PM
 
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We also eat healthy organic (and more expensive than cheap processed food). That's nothing to do with choosing not to vaccinate.

Like it or not (and I have learned on here some do not like it and would prefer to have at least measles and cp circulating) the non vax are less likely to catch diseases on the vaccine schedule (excluding tetanus) because of all the people who do vaccinate, and who are taking the risk (however small) of side effects from those vaccines.

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#15 of 53 Old 03-27-2014, 02:21 PM
 
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And I would disagree with that statement but ok.  I don't choose not to vax because we eat a certain way - we eat a certain way in part because of vax injuries and in part because I believe it to be the best way to boost the natural immune system.  So for my family they do actually go hand in hand.

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#16 of 53 Old 03-27-2014, 02:29 PM - Thread Starter
 
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This where veterinary science is always a few steps ahead of the humans because of the unfortunate shorter lifespan in animals making studies from generation to generation easier to conduct. Many more vets have moved on from yearly boosters to 1-3yr titers (depending on the levels found) and countless animals will be spared over-vaccination from this incredibly simple step.

 

Funny that you mention it. I always think of vet practices as being a lot more strict. My current vet is a livestock vet and they seem more lax about things, but when I was taking my dogs to a companion animal vet she was very insistent about annual vaccinations, even for vaccines that are known to last 3-5 years or more. I've never been offered a titer for my animals. Actually, now I just go to the local Tractor Supply and can pick up any number of vaccines to administer myself on whatever schedule I want. I recently vaccinated a gang of feral cats that were suffering from respiratory viruses in my neighbors barn. I used the standard 3-way oral/nasal drops that vets give. Shockingly, none of the cats have been sick since they were vaccinated, and the kittens haven't gotten ill either. Herd immunity? I dunno. Just anecdotal.

 

It's interesting how different the two are, but I wouldn't say the veterinary group is more advanced about it. They have a bit less at stake.

My state also has an annual rabies vaccine requirement. Even if the vaccines are the 3-5 year doses. I know that's state and not veterinary policy, but obviously in the years since it has been in place, vets haven't risen up to fight it. They just comply.

 

On the other hand, we have all 3 exemptions for vaccines for people in my state. I didn't find it difficult to locate a doc who would let me avoid vaccinating. It was when I wanted to vaccinate that he got all flustered about how on earth we would catch up.

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#17 of 53 Old 03-27-2014, 02:55 PM
 
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In terms of taxes, I save my country money. Canada has universal health care.  Thus I save my country money for all vaccines and some doctor visits.  I am not sure what I save them, but I bet it is in the thousands per child.
 
Given the straight up fact that most VAD's do not circulate very much, there are no extra health care cost associated with my non-vaxxing.  Many VAD's are not associated with extra cost anyways, although if complication set in, they can be.  

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#18 of 53 Old 03-27-2014, 02:57 PM
 
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There is a huge resistance amongst many vets to stop vaccinating animals annually because it is lucrative business. It is largely thanks to Dr Ron Schultz that there are now more enlightened vets that have ceased annual vaccination and take titers instead, which at least it spares the animals from further harm.

 

"[I] used to look to the human medical profession...as essentially to their guidelines being modeled, not anymore.  The human medical profession is now worse than the veterinary profession with the combination products and the frequency and the age at which those products are being given. It's just obscene." - Dr Ronald Schultz


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#19 of 53 Old 03-27-2014, 03:33 PM - Thread Starter
 
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There is a huge resistance amongst many vets to stop vaccinating animals annually because it is lucrative business. It is largely thanks to Dr Ron Schultz that there are now more enlightened vets that have ceased annual vaccination and take titers instead, which at least it spares the animals from further harm.

 

"[I] used to look to the human medical profession...as essentially to their guidelines being modeled, not anymore.  The human medical profession is now worse than the veterinary profession with the combination products and the frequency and the age at which those products are being given. It's just obscene." - Dr Ronald Schultz

 

Sounds great.

I'm not opposed to evidence-based changes in vaccine policy.

 

"If [the kids] live through [pre-school shots] they are probably too dumb to learn anything else." - Dr. Ronald Schultz

Sounds like a very compassionate human being.

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#20 of 53 Old 03-27-2014, 03:38 PM
 
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Perhaps not the most compassionate of statements, but he is obviously aware vaccines can cause neurological damage, dog, cat or human.

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#21 of 53 Old 03-27-2014, 03:51 PM
 
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Yes of course it should be their decision. This hypothetical parent made the decision to get the first one, so I assume they wanted to get immunity from the measles. Supposedly another 3% total can be covered with a second dose (3/5 or 60% of those who didn't respond to the first.) That's the WHY to your first question.

If they were going to skip the second dose regardless of whether titers are high or low, then why check titers at all? That's all I'm wondering. I don't care whether people get a dose and check titers and get another or not. I don't care if people skip all the doses.

 

I'm just curious about the logic behind it.

 

Plus, as Mirzam says, titers don't matter. I know that was directed at me, but since I'm not the one advocating titers in this hypothetical, I don't think there's anything for me to respond to. I'd be curious how you would respond to her statement, though, being someone who does seem to care about titers.

 

I'm happy to agree that titres don't matter.  I only had my child's checked because of other parents in our situation that said their children's titres were quite high. What I was trying to get at in my OP when I stated "If that does determine his level of immunity then he is not protecting anyone" is that it is hard to know what the level of immunity is in the herd except for say, in the case of natural disease.  So who really are the free-riders?

I'm curious as to how they determine that 95% of people are immune after one dose.  Is there another test?

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#22 of 53 Old 03-27-2014, 04:05 PM
 
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I have attended two of Dr. Ronald Schultz's day lectures. They are worth taking in if one has the opportunity.
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#23 of 53 Old 03-27-2014, 04:39 PM - Thread Starter
 
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Originally Posted by Mirzam View Post
 

Perhaps not the most compassionate of statements, but he is obviously aware vaccines can cause neurological damage, dog, cat or human.

 

I'm interested in reading his research, assuming he has some published.

I just don't care much for his personal opinions on the subject. Not a bias against his views. I'd say the same about Paul Offit.

The lack of tact turns me off.

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#24 of 53 Old 03-27-2014, 04:49 PM
 
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Originally Posted by ss834 View Post
 
 

I'm interested in reading his research, assuming he has some published.

I just don't care much for his personal opinions on the subject. Not a bias against his views. I'd say the same about Paul Offit.

The lack of tact turns me off.

 

Dr Schultz has had 'some' research published. I am sure a google search would turn something up. If you go to the first link I posted above it takes you to his page at the School of Veterinary Medicine at the University of Wisconsin which lists some of his recent publications. He is most know for the Rabies Challenge.

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#25 of 53 Old 03-27-2014, 04:58 PM
 
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Working on reply,
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#26 of 53 Old 03-27-2014, 06:14 PM - Thread Starter
 
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Originally Posted by samaxtics View Post
 

 

I'm happy to agree that titres don't matter.  I only had my child's checked because of other parents in our situation that said their children's titres were quite high. What I was trying to get at in my OP when I stated "If that does determine his level of immunity then he is not protecting anyone" is that it is hard to know what the level of immunity is in the herd except for say, in the case of natural disease.  So who really are the free-riders?

 

I'm curious as to how they determine that 95% of people are immune after one dose.  Is there another test?

 

On the first point, I agree with you mostly. The herd immunity concept is definitely informed by titers, but epidemiological surveillance ends up being more valuable for demonstrating herd immunity, not individual titers. As for your question, I have the same one. I kind of see the free-rider argument, but I think its a lot more murky than just the issue of who has and hasn't been vaccinated.

 

I should say that I wasn't questioning your logic on titers because of the statement you made about your son, but because of the Canadian data you referred to. I don't think titers are useless on an individual basis. I just wonder what a parent would do with the info on titers after a first shot, if they have no plans to get a second shot, except to be comforted or disappointed in the titer results.

 

As for your last question, yes specific titer tests (ELISA is the best for measles) are the raw data that are used for FDA approval and this is where the oft-quoted 95% comes from. But these titers aren't just added up and the percentage determined. The other test that's used is a statistical test.

 

Larger sample sizes (larger than 1) that lead to the 95% value are more valid statistically than individual titer tests. That's because there is some overlap between high and low titers and disease occurrence. There are also breakthrough cases where an individual with high titers still get disease. So most often logistical regression is applied to the raw titer data, and the result accounts for the fact that titer data isn't 100% accurate about disease risk but rather associated with lowered disease risk. Usually there is a P-value given, and a confidence interval, that says that there is a 1% chance (for P<.01) that the given confidence interval is inaccurate, or a result of chance.

 

The confidence interval might be 93%-97% protection. But the certainty that it falls into this range is never 100%. With a P-value of .01, it would be 99% certain that the titer test indication of protective antibody status of the 93-97% demonstrates immunity to disease. Individually, any one of those individual titer levels could be an anomaly, one where the "protective" level observed isn't actually protective for that individual. For the entire sample, though, we can be 99% certain that the protective levels of 95% are correct because of the statistical tests applied. (FYI I guessed at those confidence intervals because they vary a bit from study to study and I don't see one given specifically for the FDA approval of MMR II).

 

I'm tired but I hope I explained that clearly. Do you see why this is more useful than the titer data of one individual?

Here's a fun presentation on titer tests and their accuracy if you like statistical methods: http://faculty.washington.edu/peterg/SISMID2013/Slides/2013_SISMID_8_session_3_Chan.pdf

 

Even better, we have field studies that come out during outbreaks that give us a more realistic view of how effective vaccines are. These help to inform not only the efficacy of vaccines, but the reliability of titer tests. They typically produce results with a wider range because certain factors can't be controlled as they can in a clinical trial.

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#27 of 53 Old 03-28-2014, 10:56 AM
 
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I don't think non-vaccinators are free-riding financially, which makes the situation rather different from, say, someone who doesn't install pollution abatement equipment because his neighbors did, and one person's pollution is negligible. Non-vaccinators are free-riding because they get benefits of herd immunity without running the risks of vaccination, which I believe they greatly overestimate, but that in fact works against them: as long as the most of benefits of widespread vaccination are available to all, the more risky it is to vaccinate, the more people who accept these risks should be compensated. There are arguments against this, which can be found somewhere in anti-vax (word considered carefully) material: that vaccination is more risky than pre-vaccine levels of epidemics, that there is "no such thing" as herd immunity whence no positive externality, that there are means, such as vitamins, other than vaccinations to reach the same level of protection that somehow were not discovered in the millennia before vaccines, that the mainstream scientific explanation for measles, polio, etc. is mistaken, and I am sure others.

 

There doesn't seem to be any disagreement that the incidence of pertussis, measles and polio (and haemophilus influenza and the others) has decreased by more than the percentage of the population that is vaccinated, even without accounting for unsuccessful vaccinations. It's hard not to see this as evidence that widespread vaccination creates a positive externality. So, on to the "refutations".

 

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  So as someone who had the measles, mumps, chickenpox I would like to declare that the free riders are actually those who did not have the disease.  ;)

 

I understand this as a joke, but I'm not sure it was offered as one. In the pre-vaccine era, such people were lucky, but there wasn't any intermediate-cost step they could take (assuming, arguendo, that vaccination has an intermediate risk higher than being lucky and lower than getting sick).

 

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 Yet, in every measles and mumps outbreak the majority of the people who come down with the disease are those who are not just partially vaccinated, but FULLY vaccinated.

Taximom5, I am not sure you realize how frustrating it is to encounter this fallacy over and over again. Do you read any explanations of why it is not an argument against vaccination? Let me try an extreme example. On your argument, the fact that the (overwhelming) majority of the people who died yesterday are Russian-Roulette-abstainers "implies" (it doesn't) that Russian-Roulette is safer than ordinary life. Statistically, non-vaccinators are disproportionately likely to get sick, just as Russian-Roulette participants are disproportionately likely to die. One-third of the entire USA measles cases for 2013 came from one non-vaccinating religious sect, plus some of the other two-thirds were also non-vaccinators. If non-vaccinators are 5% of the population and 40% of the measles cases, that is a very good argument in favor of vaccination.

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#28 of 53 Old 03-28-2014, 11:06 AM
 
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Taximom5, I am not sure you realize how frustrating it is to encounter this fallacy over and over again. Do you read any explanations of why it is not an argument against vaccination? Let me try an extreme example. On your argument, the fact that the (overwhelming) majority of the people who died yesterday are Russian-Roulette-abstainers "implies" (it doesn't) that Russian-Roulette is safer than ordinary life. Statistically, non-vaccinators are disproportionately likely to get sick, just as Russian-Roulette participants are disproportionately likely to die. One-third of the entire USA measles cases for 2013 came from one non-vaccinating religious sect, plus some of the other two-thirds were also non-vaccinators. If non-vaccinators are 5% of the population and 40% of the measles cases, that is a very good argument in favor of vaccination.

 

Or it's like saying that since the vast majority of people who got diagnosed with cancer yesterday were right handed that must mean right handed people are more likely to get cancer than left handed people. 

 

No.  It just means there are a lot more right handed people. 

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#29 of 53 Old 03-28-2014, 11:07 AM
 
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Epidemic of Mumps among Vaccinated Persons, the Netherlands, 2009–2012

 

Abstract

To analyze the epidemiology of a nationwide mumps epidemic in the Netherlands, we reviewed 1,557 notified mumps cases in persons who had disease onset during September 1, 2009–August 31, 2012. Seasonality peaked in spring and autumn. Most case-patients were males (59%), 18–25 years of age (67.9%), and vaccinated twice with measles-mumps-rubella vaccine (67.7%). Nearly half (46.6%) of cases occurred in university students or in persons with student contacts. Receipt of 2 doses of vaccine reduced the risk for orchitis, the most frequently reported complication (vaccine effectiveness [VE] 74%, 95% CI 57%–85%); complications overall (VE 76%, 95% CI 61%–86%); and hospitalization (VE 82%, 95% CI 53%–93%). Over time, the age distribution of case-patients changed, and proportionally more cases were reported from nonuniversity cities (p<0.001). Changes in age and geographic distribution over time may reflect increased immunity among students resulting from intense exposure to circulating mumps virus.

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#30 of 53 Old 03-28-2014, 11:16 AM
 
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No one is saying vaccinated people don't ever get sick (albeit that's implied in simplified messages). But it it demonstrably true they're much (much) less likely to get sick if they're exposed to a VPD they've had the vaccine for.
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