# Vaccinate Your Kids People (Combining my “Anti-Vaxers vs. Math” posts)

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:

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

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

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.

But wait, there’s more!

The other point that is claimed is that the vaccines themselves cause injury and are more dangerous than “acquiring immunity naturally” (which is weasel wording for “getting the disease”).  And one of the things they like to point to is the Vaccine Injury Court and all the awards it’s granted.  There, proof positive that vaccines are dangers and so you should avoid them.

Well, not so fast.  First off, there’s very little actual science in this Vaccine Injury Court.  As ZDogg (a practicing physician with popular YouTube and Facebook feeds) points out, you don’t need to prove beyond a reasonable doubt like in a criminal trial.  You don’t even need a preponderance of evidence like in a civil court.  All you need is to spin a story that’s reasonably plausible to people who only have a layman’s knowledge (i.e. none to speak of) of immunology and biochemistry.

But let’s take the strongest possible argument.  Let’s presume that every case where an award was granted really was because of vaccines.  In the thirty years between 1988 and 2018 20,728 petitions were filed with the vaccine injury court.  Of these, 6,579 were determined to be compensable, i.e. that presented a case that sounded good to folk essentially ignorant on the subject.

6,579 over 30 years, or an average of 219 per year.  In my previous post I noted that, before vaccination, the number of deaths from measles alone averaged about 450 per year.

Without vaccines, more than twice as many died from a single “harmless childhood disease” than all the compensable injuries (even at that very low standard of evidence) from vaccines–even if the compensable claims all, every single one, represented real injuries from vaccines instead of “just so stories”–combined.

And I’m still not done.

A couple of things that people claim about vaccines which continue to fail, or at least ignore, basic math:

## “Most of the cases of people who get X have been vaccinated.”

That’s simply because, at least for now, the vast majority of people are vaccinated.  Okay, let’s look at how that works.  Let’s take a population of 1000, all of whom are exposed to a disease.  Let’s say that the exposure is fifty percent likely to cause the person to get the disease.  Now, 99% of those people have been vaccinated with a vaccine that’s 90% effective in preventing infection.  So, let’s look at it.

First, the ten people who weren’t vaccinated.  Half of them get the disease (50% of those exposed).  That’s five unvaccinated people getting the disease.

What’s interesting, however, is what happens with the 990 who were vaccinated.  Half of them, or 495 would catch the disease except the vaccine prevents that in 90% of those cases (446–rounding up).  That leaves 49 who get the disease.

So, 49 vaccinated people got the disease but only 5 unvaccinated (total 54 sick people).  Per anti-vax logic this shows that vaccinating increases the risk.

Only without vaccinating, that number would have been 500–half of the entire population of 1000–not just 54.

This “most of the cases are people who have been vaccinated” simply means two things:  most people in the US are still vaccinated, and vaccines are not 100% perfect (which nobody claims except anti-vaxers in setting up straw men).

## “The Mortality Rate from X fell long before we started vaccinating.”

This one is a little sneakier.  It relies on the fact that what the “rate” is not based on the total population but only on the number who actually get the disease.

It goes like this.

One year, you get 10000 cases of the disease and 10% of them die.  That’s 1000 people dying.

Supportive care improves.  We get better at keeping people who have the disease alive.  So, at a later year only 1% die.  That’s 100 people.  900 people still alive who would have been dead before the improvement in supportive care.  That’s great.  That’s absolutely wonderful.  No joke.  No sarcasm.  It’s an unequivocal win for medicine.

But now, at a later date that 90% effective vaccine is introduced and the population is vaccinated with it.  Now, instead of 10000 cases of the disease we get 100.  With the same supportive care and 1% mortality that means only 1 person dies.

Looking at mortality rate over time we see the big drop in mortality rate happening before the vaccine is introduced and the mortality rate didn’t change much when the vaccine was introduced.  And that’s where the anti vaxers stop. “See, the _real_ improvement had nothing to do with vaccines.”

What they miss is that when you look beyond just the folk who have the disease and look to the total population, there are a lot fewer dead people because fewer people get the disease in the first place.  The improvement in mortality rate for those with the disease certainly may have improved the odds of those who get the disease, but many more people don’t have to rely on that because they don’t get the disease–because they’re vaccinated.