Anti-Vaxers vs. Math

Sigh.

Over on the book of faces, the subject of vaccines has come up and the usual suspects are screaming about how they’re a scam designed only to get money for “big pharma.”

So let’s look at that.  Let’s use “measles” which is often dismissed as a “harmless childhood disease” and so would be one of the more routine (and therefore cheaper) things to treat. (Please note:  I am just dealing with the ” vaccines are a scam to make money” argument here.  Other anti-vax arguments can wait for another day.)

Before the vaccine came out, the US averaged about 400 cases of measles per 100,000 citizens per year:

measles cases2

That’s per 100,000.  Looked at in total numbers:

measles-cases-1950-2013

Now, this “harmless, childhood disease” was perhaps less harmless than people may have thought.  Looking at deaths per year we get the following:

measles-deaths-1950-2013

Before the vaccine an average of about 450 per year died from measles.  I will note that a number of sites out there have charts that show the “mortality rate” for measles going down, way down, long before the vaccine was introduced.  However, what the naive reader might miss is that they are looking at the mortality rate of measles cases.  I.e. what chance someone who got measles had of dying.  The chart says nothing about the likelihood of getting measles in the first place.

Comparing the death numbers with the total number of cases and we get a death rate of about one in a thousand or 0.1%. (Other sources give a rate of 3 per 1000 or 0.3%–for purposes of this post I’ll use the lower number.)

In addition to the death rate, measles can require hospitalization.  In the years 1985-2002 an average of 757 patients per year were hospitalized for measles (total 13621).  The low was 19.  The High was 5856 in 1990.  For comparison, over that period 147 patients died (above chart).  So for every death there are 93 hospitalizations.

So with modern medicine and standards of care, if we had the same number of measles cases as before the vaccine was introduced the number killed (correcting for current US population, 1.8 times what it was in 1960) would be 810 per year (about 30 per 100,000).  And the number hospitalized would be over of 75,000 or just under 4300 per 100,000.

A typical hospital stay is 5 days at a cost of $10,000 and that’s just for the bed and the most basic of care.  It doesn’t include actual treatment.  It certainly doesn’t include any time in the ICU.  That means the cost per 100,000 for treating measles, what “big pharma” could get from letting people get measles and treating those who require hospitalization is $43 million per year per 100,000 people at an absolute minimum.

So how does that compare to how much they make from vaccines?  Well, the MMR vaccine costs about $100 per dose.  That is for three diseases, but let’s leave that aside and only consider measles.  The standard is a dose and a booster in one person’s lifetime.  Considering an average lifespan of 75 years that works out to about a bit under 2700 shots given per 100,000 people per year assuming everyone gets the vaccine.  Or, $270 thousand per year per 100,000 people.

$43 million to treat.  $270 thousand to vaccinate.  Letting people get the disease and treating it grosses 160 times as much as vaccinating.

If they were really about selling out your health for money, they’d let you get sick.

 

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16 thoughts on “Anti-Vaxers vs. Math”

    1. Convincing “True Believers” is not the purpose. Internet argument is a spectator sport. It’s the people out there who haven’t been convinced by the anti-vax folk, who, seeing only one side of the argument, might find their claims convincing. There are people who can be swayed. I’d like to provide ammunition to help sway them in a way actually supported by evidence and not the breathless claims of conspiracy theorists.

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    1. 1) Doesn’t need to be more than a small percentage. Anything more than 0.63% would put the “more profitable” advantage on the side on that of treatment rather than prevention.
      2) The investors behind “big pharma”, generally speaking, don’t care “pharma” “hospitals” or even anything related to medicine at all. They care “return on investment.” So if it were simply a matter of being able to charge more, treating would be a more profitable investment than prevention via vaccines. Except…
      2a) Thanks to competition, once a lower cost alternative is in place, it takes business away from the higher cost businesses (unless those higher cost businesses provide something to compensate for that higher cost–there are reasons that Bentlys cost more than Fords).

      After all, look at the big fortunes made in history. John D. Rockefeller made his fortune (5 times that of the second richest man in the world back in 1918) by making kerosene cheaper, a lot cheaper, than his competitors. Andrew Carnegie made steel cheaper. Henry Ford made cars cheaper. Want to get swimming in cash rich? Find something that has potential broad appeal, that people are already paying lots of money for, then find a way to bring it to the public at a lot lower cost.

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  1. ‘Anti-mathers* vs. vaxers’ also works for me.

    * strictly speaking they’re anti-arithmetickers because the only operations needed to reason this out are addition, subtraction, multiplication, and division

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  2. I had an aunt who didn’t die of measles. She got brain damage instead. She was institutioonalized after her mother died from 1940 until her death in the 70s. It isn’t just about mortality.

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  3. Before the vaccine, measles for the vast majority was a one-time infection that most everyone got in childhood.

    https://www.cdc.gov/measles/about/history.html

    “In the decade before 1963 when a vaccine became available, nearly all children got measles by the time they were 15 years of age. It is estimated 3 to 4 million people in the United States were infected each year.”

    So the risk of death then would have been approximately 400 divided by 3-4 million (and it generally involved other factors creating compromised immunity, so honestly measles could be argued to be a secondary in cause of death).

    Now where are we? Infants are not protected by natural maternal immunity because the vaccine immunity wanes and is less robust, while infants are more vulnerable to harm from measles (and the risks of the vaccine, see CDC whistleblower William Thompson’s revelations the CDC suppressed links to MMR and autism) and technically every vaccinated child is deliberately given a case of measles anyway, just one that rarely produces a rash (rashless measles is associated with increased risk of some adverse outcomes, so that may not be a plus). Since the vaccine wanes CDC believes (using imperfect titer measurements) nearly half vaccinated adults are no longer immune. Boosters perform more poorly (by titer measurements) with each repeating dose, so eventually measles could be a disease adults and elderly have to fight naturally (when they are less able to do so). Also, much of the immune system priming leading to an observed lowering of cancer risk from the natural infection appears to be lost by vaccinating.

    Perhaps pertinent, the first measles vaccine was an unattenuated live virus vaccine (they injected the whole virus into children without fear of doing that–they just decided to vaccinate because they figured they could). That turned out to be not such a good idea because introducing the virus that way by bypassed parts of the immune system, provoking antibody immunity which typically comes toward the end of infection (if at all) and signals things are wrapping up, allowing the virus to proliferate before other aspects of the immune system were mobilized (but that is just beginning to be understood now).

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    1. So the risk of death then would have been approximately 400 divided by 3-4 million

      Which is all well and good provided your child is not one of those 3-4 million. That’s 400 that don’t need to die today. You can argue all you want but the fact remains that the incidence of measles has fallen dramatically since the introduction of vaccination. Fare fewer people need to be hospitalized. Far fewer people die. As for the “could be a disease adults and elderly have to fight naturally” considering how long the vaccine has been in common use, if that were going to be the case we’d be seeing it already–well, we might start seeing it now thanks to the anti-vaxers providing more vectors for people to get the disease in the first place.

      And that “observed lowering of cancer risk” comes from one “study”, which was basically a questionnaire given to cancer patients by “anthroposophic general practitioners” (i.e. anti-vaxers) in Sweden.

      But all that aside, note that this wasn’t a complete treatise on vaccines, but strictly limited to one common claim made by the anti-vax community: that vaccines are only to “make money” for “big Pharma.” That claim is patently ridiculous. Treating even with “common, harmless childhood diseases” like Measles–as you point out, the risk of a particular individual dying is slight, as is the risk of needing hospitalization–the cost of hospitalization is so much higher than the cost of the vaccine that if making money outweighed patient welfare that’s where you’d go.

      This is so easily verified–none of the information I used in the post is hard to come by–that there’s no excuse for anyone to make that claim. Thus, anyone making it is either lying to you or naively (as in, never bothered to check) repeating someone else’s lies. Which means that their word is worthless on the subject.

      And once you realize that, the whole anti-vax house of cards comes tumbling down.

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      1. All the benefits of the current status – fewer cases of measles, fewer deaths from measles, etc – will disappear as more and more people think like you do and don’t vaccinate their children. The reason we had gotten to a point where measles, mumps, rubella, and whooping cough had virtually disappeared is because most people were vaccinated. When more and more people stopped vaccinating their kids, these diseases came back. Not just measles and mumps, but whooping cough and polio. Polio! So far outbreaks have been fairly local, a school, a city, a county, but as more people stop vaccinating their kids, those downward trend in the graphs are going to reverse and start climbing upward and we are going to have an epidemic. Babies who are too young to be vaccinated are going to die. Elderly, ill individuals, and those who are immumo-compromised who can’t be vaccinated are going to die. We will totally lose those benefits of vaccination that you cite as good things.

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    2. So maybe some bad things were done, mistakes happened at the beginning of vaccination. We used to not have seatbelts in cars even at a point where manufacturers, the government, researchers, everyone knew deaths and major injuries were the result. Then they required lap belts, but it turns out that people in accidents suffered major internal injury because of the lap belts. Yet manufacturers and the government continued with lap belt only requirements. People had to have their bowels removed, or died. Now we have much better seatbelts. You’re not going to refuse to wear a seatbelt today because at the beginning those who “administered” the seatbelts did bad things early on. What happened at the beginning is irrelevant to today.

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