Winnie the Flu and Mandatory Vaccines.

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So there was this:

https://video.foxnews.com/v/embed.js?id=6158135199001&w=466&h=263

In this Adam Dershowitz warned that if a Coronavirus vaccine becomes available, it could be mandatory.

I admit to having very mixed feelings on this.  Readers of this blog should know my position of vaccination (Vaccinate your kids, people).  On the other hand, readers of this blog should also know my position on the use of the coercive power of government (I’m agin’ it; a few exceptions but outside that pretty much always).  Still, there is an argument to be made.

Public health is the very epitome of what economist call “External costs” or “neighborhood effects” (basically, where your choices affect not just you but everyone around you and it’s hard to tie the specific “cost” imposed on one person to the specific person imposing that cost). Not just costs but there’s also “external benefits”–where folk other than those directly involved in an economic transaction benefit from it. If something has significant external costs (the commonly used example is pollution, but spreading of illness also works), you’ll have more of it than if the costs were fully paid by those involved. Likewise, if something has external benefits, you’ll have less of it than if the benefits were fully realized by those involved.

Even quite libertarian folk like economists Thomas Sowell and the late Milton Friedman recognize that in such cases a government approach can improve on the free market. Friedman’s example was to use an “effluent fee” to be paid by businesses for waste discharge–“X dollars paid for every ton of Y pollutant”–thus internalizing the external costs.

Sowell, however, is quick to point out (perhaps Friedman did as well, but I don’t recall an example offhand) that just because government can improve on the market in such situations doesn’t mean that it will.  There are very few situations so bad that “well-intentioned” government intervention can’t make them worse.

Thus, I am…uncertain of the best course to chart here.  If there were some way to make folk who choose not to vaccinate responsible for any harm caused to others (see previous posts on why “if you trust vaccines…” is not a valid response to that), then I’d be all for letting people make their own choices.  Absent that, I don’t know.

Nowhere is it writ that I will always have a pat answer for any problem that comes up.

23 thoughts on “Winnie the Flu and Mandatory Vaccines.”

  1. Frankly, I’m a diehard vaxxer – which has caused friction within family for me (but I don’t give a damn.) I’m against /forcing/ vaccinations, but I’m all for /strongly/ /encouraging/ vaccinations (and I’m fully in support of separating out antivaxxers to a sort of Coventry – you can come back whenever you like, you just have to take a full series of vaccinations and undergo a 30-day quarantine on your way in. We’re trying to eradicate a few more diseases here – send measles, mumps, /et/ /al/ the way of smallpox and polio.) And I firmly believe that the anti-vaxxer movement is based wholly on flawed “science” (it’s so flawed I hesitate to even use the word science to describe it!) being that it was a hatchet job, and Wakefield had his license pulled due to the antivaxx report! No other doctor has been able to show a correlation between autism and vaccinations – I’m certain that my getting vaccinations didn’t cause my HF-ASD, nor did it cause it in my nephew (who had his vaccinations spread out, because my kid sister didn’t want to strain his immunities overmuch. He still got the full series – so did his sister – they just got spread out over a little bit of time, is all. I approve.)

    If they come up with a vaccine for SARS-CoV-2 and SARS-CoV-2a (there’s a new strain out, with a HIGHER R-naught value of around 5.7…) and it’s shown to be safe (how about Congress takes it first?) I’m willing to take the shot myself – although I’d honestly not be surprised if I had the antibody test right now and it showed that I’d had the virus and I’d gotten over it already. Something like 80% of people who get it remain asymptomatic, as I recall, and I usually fight off the grippe and colds rather handily (both caused by other virii in the coronavirus family. Only reason I get the flu shot? My wife is asthmatic, so I want insurance.)

    At the very least, can we make anti-vaxxers wear signs?

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      1. Well, we could go old school and have them cry “Unclean. Unclean.” as they walk among the rest of us.[/sarc]

        My hope is that simply arguing why vaccines are such a damn good idea that most people will do it voluntarily so that herd immunity makes it so the few out there who don’t. get. the. message. aren’t a great threat to those who are immunocompromised, too young to vaccinate, allergic to some particular vaccine ingredient, or just roll “snake eyes” and happen to be the person for whom the vaccine did not work (it does happen). Thus posts like the “vaccinate your kids people” linked in the blog post above.

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  2. I share your views on vaccines almost exactly.

    However, my opinion on mandatory COVID-19 vaccination is most likely a lot more on the extreme “hell no” end of the spectrum.

    The reasons are threefold:
    1) I have worked in manufacturing ny whole life. I REFUSE to place a product that was rushed to market in my body, especially for a disease with a fatality rate as low as COVID19. If we were in the midst of a pandemic of something akin to a new strain of easily communicable ebola with a horrific 50% fatality rate, my risk/benefit consideration would probably be “stick me with the needle. NOW” but for COVID, not so much. Rushed products WILL (not maybe, WILL) have issues. I will not beta test with my health.
    2) A complete lack of trust in our government. They have proven incompetent at best, and outright malicious at worst during this entire debacle. Not across the board, but enough. They are ostensibly our servants, not the other way around. It’s well past time they were reninded if that.
    3) Utter contempt for a large portion of my so called fellow citizens. I will not be forced into anything by the brigade of Karens who attempt to shame and other anyone not gushing about how awesome a jackboot feels on their neck. If one thing has made me want to vomit more than anything else during this it’s friends and family I used to respect uncritically bowing to whatever bullshit the powers that be spout, and joining in ostracizing those who question ans resist it. It’s a human crab bucket.

    Alan Dershowitz has lost his goddamn mind. I will not comply. With violence if necessary. I am almost 50 years old with bad knees. I have no illisions regarding how that is going to work out for me, so I vehemently hope it does not come to that, but there’s a line and this is mine.

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    1. Personally, I don’t think that a COVID19 vaccine is in the offing. Like cold and flu, Coronavirus mutates quickly, and with “animal reservoirs” that allow it to percolate along and mutate until something that’s not stopped by whatever vaccine we had comes out.

      Best thing we can do for this kind of virus is:
      1) isolate those most vulnerable (the aged, the immunocompromised, those with significant breathing or circulatory problems)
      2) Have those who aren’t “the most vulnerable” go about their lives so that it spreads quickly through that portion of the population for which it is basically the flu.
      3) Once it spreads quickly through that population and new hosts for that strain become unavailable, the strain will die out.
      4) protecting the “most vulnerable” via herd immunity.

      Repeat as new strains arise.

      We pretty much did everything wrong with this.

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    2. “A complete lack of trust in our government”
      How can you have a complete lack of trust in government, but still trust the CDC with respect to vaccines?

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    3. 2) A complete lack of trust in our government.
      ^^THIS^^
      My “anti-vaxxer” position is entirely based on 3 things: distrust of gov’t, distrust of people demanding I comply (not necessarily the same), and I actually know just how “bad” measles and chickenpox were (I had them at the same friggin’ time). And I know how ineffective some of the vaccines are. OK, it’s based on four things….

      I don’t think they cause autism, or anything like that. I don’t think they’re secret experiments on the populace (though I was in the military and we did get some experimental vaccines). I just have a HUGE aversion to people screaming “SCIENCE!” and “Don’t you care about the children/ grandma/ puppies?!?!” at me in an effort to coerce me into something. Especially when I know science.

      Given what we actually know about Winnie The Flu, anyone demanding mandatory vaccinations is gonna get at least a two-finger salute.

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      1. BTW, those screaming “SCIENCE!” are practicing an appeal to authority. My problem is I know too many people who claim that mantle who don’t know what the hell they’re talking about. And then there’s the media twisting scientific studies and such – half 90% of the time they’re horribly misreporting what the study says. So I assume any appeal to authority is flawed to begin with.

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  3. There’s a service my Dr here in DFW offers: a blood panel that measures your immune response to various vaccine available diseases and tells you which ones you need a booster for. I get it every 5 years…. just to be safe.

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  4. The reason the annual flu doesnt infect the entire population is that are enough people with natural immunity and enough poeple that take a flu shot, resulting in 30% -60% of the population having effective immunity. So when the flu hits every year, the chain reaction of infecting everyone keeps petering out as virus keeps hitting those with immunity and those immune individuals dont infect others.

    Credible Estimates range from a low 40% to a high of 80% immunity in the population to have very effective control / containment of Covid.

    As noted in the cruise ship Princess, and the santa clara study, USS roosevelt, lots of people become infected and show no symptoms. We can save a lot of time by reopening and developing immunity in the population,

    And NO! – I am not recommending killing “grandma ” by reopening the America.

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    1. What “grandma” needs is to be isolated and proper care taken so that grandma gets infected. Letting it spread quickly through the low-risk population will get us sooner to the herd immunity will add provide protection for those more vulnerable.

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      1. I advocated “flu parties” from nearly the beginning, including the use of something like HCQ-zinc-Z-pack as people from that group demonstrated symptoms. Heck, I still advocate it.

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  5. From the numbers I’m seeing (MN, ND, SD, MA, IL) regarding COVID-19 related deaths:
    – 99% had underlying conditions (heart disease, diabetes, obesity, etc.)
    – 84% over 70 years of age

    Mandatory vaccines are the wrong approach (just like this shutdown fiasco).

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    1. CV19 is, despite Ferguson’s nonsense predictions (which apparently were pulled out of his nether regions) it does not appear to be that infectious. It’s highly risky for some folk but for most it’s, basically, the flu.

      That the people most at risk are older or have other problems does not, however, absolve folk from spreading preventable diseases (which CV19 isn’t). If I negligently inflict a minor cut on someone and, because they are hemophiliac they die that’s still manslaughter even if the cut would have been “no big deal” for most people. (While I’m not saying you are, some people do take an awfully callous approach to older folk or who have other underlying health conditions. I just don’t think the current approach is the best, or even a particularly good, way to protect them.) Exposing people without their individual consent to preventable diseases is just another form of assault. (Individual in that you can’t consent for me and I can’t consent for you and no group of people can consent for another group of people.)

      If it were possible to hold individuals responsible for the harm they cause to others, some way to tell who infected grandma and hold them accountable for the consequences, that would be the best way to deal with it. Don’t want to be vaccinated? Fine. So long as you’re willing to risk charges of negligent homicide if someone’s grandma dies as a result. Unfortuntely, we can’t.

      Perhaps something like Friedman’s “effluent fees” (his proposal for dealing with polluting entities to internalize the external costs). Vaccinate or pay a modest fee as an indemnity to cover the risk of infecting others. If based on actual risk (which, I’ll admit, government would truly suck at and part of why I say there are no easy answers) it would seem to be the course that least infringes on people’s rights (there is no “nobody’s rights are infringed” answer; at least so long as you recognize people’s rights not to be unwillingly exposed to preventable diseases).

      As I said, there are no easy answers. There are only tradeoffs. And part of the problem is that nobody is taking a good hard look at all the consequenses–good, bad, or indifferent–to not just the obvious but to second and third order effects in order to chart a best course that minimizes negative consequences and preserving to the greatest extent possible individual liberty. Instead we’re being deliberately stampeded.

      The thing about people stampeding others–it’s never for the benefit of the ones being stampeded.

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  6. Once again, logic is the first victim. Person A chooses to be vaccinated. Person B chooses to not be vaccinated. If the vaccination is effective, Person A has nothing to fear from Person B. So long as Person B does not require payment of medical expenses, incurred in the event of infection, by Person A, Person B’s decision has no effect on Person A. If Person A fears for the health and safety of his family, he can suggest that they, too, be vaccinated. So long as Person B does not force his opinions or decisions on others, his decision should be honored by society.

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    1. “Once again, logic is the first victim.”

      And you killed it. We can start with the fallacy of insufficient options. You don’t just have Person A choosing to be vaccinated and Person B choosing not. You have Person C whose mother had a nearly deadly allergic reaction to vaccine D, likely passed on to child E which makes the particular vaccine contraindicated for said child. Then there’s infant F, who’s simply too young to have the full course of vaccines but for whom some of those diseases can be deadly. Oh, and there’s person G who’s immunocompromised and who’s only real defense is having everyone around G sufficiently immunized that the disease never reaches G.

      Then there’s the “all or nothing fallacy.” Person A is vaccinated, sure, but except in fallacious arguments like this one no one claims that vaccination is a 100% impervious shield where one is absolutely, positively guaranteed not to get the disease. Measles vaccine, for instance, fails something like 4-5% of the time. So even a vaccinated person might be the unlucky one who gets sick.

      People choosing not to be vaccinated increase the risk on those other people. That’s imposing a cost on them (cost is not just money, reduced quality of life is a cost) without recompense. I was, in fact one of those 4-5% (possibly larger then since I was vaccinated before the protocol changed to vaccine plus later booster) where the measles vaccine failed.

      But if enough people are vaccinated, then far, far fewer people get sick to start with. They are far less likely to spread the disease to others, who themselves are far less likely to catch it (being vaccinated) and the spread quickly stops. It’s called “herd immunity”.

      So, yes, person “A” who is vaccinated does have just cause to be worried about person “B” (at least when there are a lot of them) who is(are) not vaccinated, if not on A’s own behalf then on the behalf of C, D, E, F, and G.

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  7. I see a common view here in some comments. “We can isolate all of the at risk people while the rest go back to work.”
    Let’s toss out some numbers (and sources).

    Heart Disease
    From: https://www.cdc.gov/nchs/fastats/heart-disease.htm
    Number of adults with diagnosed heart disease: 30.3 million
    Percent of adults with diagnosed heart disease: 12.1%

    From: https://www.heart.org/en/news/2019/01/31/cardiovascular-diseases-affect-nearly-half-of-american-adults-statistics-show
    This year’s report said 121.5 million adults in the U.S. – 48 percent based on 2016 figures – have cardiovascular disease

    So between 30 million with direct heart disease, 120 million adults total with some form of cardiovascular disease.

    Diabetes:
    From: https://www.diabetes.org/resources/statistics/statistics-about-diabetes
    Prevalence: In 2018, 34.2 million Americans, or 10.5% of the population, had diabetes.
    Nearly 1.6 million Americans have type 1 diabetes, including about 187,000 children & adolescents
    Undiagnosed: Of the 34.2 million adults with diabetes, 26.8 million were diagnosed, and 7.3 million were undiagnosed.

    From: https://www.cdc.gov/diabetes/library/features/diabetes-stat-report.html
    • 34.2 million Americans—just over 1 in 10—have diabetes.
    • 88 million American adults—approximately 1 in 3—have prediabetes.

    So 34 million adults with diabetes, another 88 million are in danger of it.

    Autoimmue diseases
    From: https://www.niehs.nih.gov/health/topics/conditions/autoimmune/index.cfm
    Collectively, these diseases affect more than 24 million people in the United States.
    An additional eight million people have auto-antibodies, blood molecules that indicate a person’s chance of developing autoimmune disease.

    So 24 million with an autoimmune disease.

    Cancer
    From: https://www.cancer.gov/about-cancer/understanding/statistics
    – In 2018, an estimated 1,735,350 new cases of cancer will be diagnosed in the United States and 609,640 people will die from the disease.
    – In 2016, there were an estimated 15.5 million cancer survivors in the United States. The number of cancer survivors is expected to increase to 20.3 million by 2026.

    So ~1.8 current cancer patients, ~18 million cancer survivors

    Obesity
    From: https://www.cdc.gov/obesity/data/adult.html
    The age-adjusted prevalence of obesity among U.S. adults was 42.4% in 2017–2018. The prevalence was 40.0% among younger adults aged 20–39, 44.8% among middle-aged adults aged 40–59, and 42.8% among older adults aged 60 and over.
    severe obesity among U.S. adults was 9.2% in 2017–2018.

    There are roughly 200 million adults in Americans, so 85 million obese adults, roughly 18 million severely obese.

    Let’s add them up.
    30 million with direct heart disease, 120 million adults total with some form of cardiovascular disease.
    34 million adults with diabetes, another 88 million are in danger of it.
    24 million with an autoimmune disease.
    ~1.8 current cancer patients, ~18 million cancer survivors
    85 million obese adults, roughly 18 million severely obese.

    That’s 126 million at a minimum, possibly up to 271 million. But since a lot of these diseases travel together let’s arbitrarily cut that by three.

    You want to take 42 million, possibly 91 million adults out of the general population and isolate them? one-fifth to one-half of the adult population? Mind that a lot of these are working adults despite their conditions, and they could continue to work, except if _they_ contract Covid-19, they’re likely to spend multiple weeks in a hospital, if they survive.

    The idea, “Let’s isolate the vulnerable” sounds like a great plan, until you try to figure out how to do it. (Note: You do not want to calculate the mortality figures through this population…)

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    1. Ooo, the “let’s throw out the scary numbers bit.” First off, you can’t just “add them up” like that. How many of the 30 million with heart disease (for example) also have diabetes, autoimmune, etc. How many of them are “obese”? Then there’s the definitional issue: I am “diabetic.” My last few A1C’s have been between 5.5 and 5.7. The diabetes didn’t go away, it’s just very well controlled. I’m still part of that 34 million adults. How much risk does that give me. I suffer from occasional tackycardia and take medication for it, so I’m part of the “heart disease” numbers as well. I have occasional periods of shortness of breath (“reactive airway disease” is the best they’ve come up with). So lung disease.

      My BMI has been hovering around 30–obese by that definition–for the last several months (down from where it was a year and a half ago). My body fat percentage, however is about 17% (Note: I am not a bodybuilder or anything like that, just the way my body is structured) which is at the upper end of “fit”. Doctors generally use BMI, however, despite it really only being anywhere close to valid for a single body type and is a poor fit for most. So I’m also on the “obese” list.

      Oh, and “pushing 60” so we can add age to the mix as well.

      By all rights, according to simply adding up numbers I should have keeled over dead when the first Chinese person ate the first damn bat,.

      But it doesn’t work that way. Magnitude counts. It’s not just “diabetes” but “how bad is it and how well or poorly is it controlled”? It’s not just “cardiovascular disease” but what specifically, how serious it is, and again, how well controlled it is, or isn’t. And, yeah, I think we’ve disposed of “obese” there (but even so, how obese; these things matter).

      It’s easy to throw out scary sounding numbers without giving much thought to the reality behind them and the endless details that matter.

      But here’s the thing, your numbers can all be countered with one number: 330 million. Because the alternative to isolating and protecting the most vulnerable appears to be to isolate everyone. If “let’s isolate the vulnerable” is bad, then how in Hel’s Misty Halls is “isolate everyone, and incidentally tank the economy so that even more people die, probably more from that than from the disease itself” any better?

      But, hey, as long as folk wring their hands and shout “you just want Grandma to die” then it’s all good, right?

      “People will die!”

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  8. I’m with William Hada. I’m not interested in being a beta tester for a vaccine. But once it’s been through some good clinical trials (which unfortunately need to have a lot of subjects), then yes, sign me up! But you tell me to take it or the guys with guns show up and I’m probably reaching for mine.

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  9. Some people seem to be assuming (here and also places where I’ve shared this) that because I point out that there are some valid points to be made on the “mandate” side, this means that I support a government mandate. Nothing could be further from the truth. It’s entirely possible to acknowledge that one “side” of a debate has some valid points while still reaching a different conclusion from consideration of other factors in addition to those. Thus:

    1) Yes, folk arguing for mandating vaccines or other government pressures (not just for COVID, but from a public health perspective in general) have some valid points behind their position.
    2) However valid those points are, there are equally valid points against government sticking it’s damn oar in and trying to “drive the boat.”
    3) That on balance, the “no” overwhelmingly outweighs the “yes” when it comes to “should the government compel people to vaccinate” issue.

    More detail on that will be the subject of tomorrow’s blog post.

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