to think it's not terribly helpful to keep referring to parents who haven't MMR'd as "whack jobs"...

[MsGillis]

..or morons, or unfit parents, or up there with people who drink and drive?

I appreciate that people have very strong feelings around the subject, but I think that we need to understand that there are a significant number of parents who didn't/haven't vaccinated, not because they are crystal waving nutjobs, but because they are actually scared shitless and paralysed into indecision?

Surely there are ways and means to communicate information, and arrogantly shouting about how one person is right and anyone who disagrees is all kinds of nobhead is not going to be conducive in opening up reasonable dialogue?

Measles hasn't been eradicated in Australia. There are still measles outbreaks.

Their claim to fame is that they meet WHO's "elimination criteria" of "80% of outbreaks having transmission of less than 10 cases".

Australia declared "endemic measles eradicated" in 2009 because 16 out of 19 measles outbreaks in the first quarter of 2009 had less than 10 cases.

Here is the source.

karlos don't worry I'm not about to argue for communism to be implemented in the uk (shudders at the very thought). Given the choice I'd rather have our health care system than the states - theirs is great, if you have money and insurance.

I'm not denying anything Lazyjane - stop being lazy and not reading what I am saying. I said that the only paper that looked at measles vaccination rate found that 94% of people in the UK had given a measles vaccination. Then I said if this was accurate (and it was a very pro vaccination paper) then this outbreak was occurring in a highly vaccinated population (which does happen).

I also said no-one actually knows what is going on as they don't have the figures.

I also saw a report (in a pro-vaccination report) saying that 25% of people going down with measles in this outbreak had been vaccinated - this seemed surprisingly high to me so I asked David Salisbury to comment and he didn't. So none the wiser.

IMO the 'best' case scenario is that 100% of people catching measles in the outbreak have been vaccinated as then it's easy to control. If 25% of them have had a measles vaccination then they need to rethink the current policy if they don't want a repeat in 10 years or so - but like I said, who knows, the only figures are MMR ones which doesn't actually tell you what you need to know.

I know what you were getting at, whenshe. I am saying that the two scenarios are completely different. And not only that, but the risks are completely different. And in addition, a bad reaction to antibiotics is far more likely to be accepted than a bad one to childhood vaccines.

And more to the point - I wasn't even talking about myself, my own attitude to risk or my habits when it comes to treating toothache . I was talking about the issue with parents giving informed consent when they are not actually informed, and neither are the people responsible for informing them. And the reason they are not informed is because the information isn't recorded.

sorry 100% of people catching have NOT been vaccinated - obviously

It's not 'I'm alright Jack'. Look, I'm usually all in favour of collective responsibility and do believe in society etc. But it's naive to not be able to see that the way immunisation policy is decided is quite political!

When you have to make a decision to vaccinate someone without their consent then of course they should be considered as an individual first, and their family background should be considered as well before thinking about whether that person needs a different vaccination schedule.

And none of this means that I don't care about people who are vulnerable to certain illnesses, more than most. Nor would I say something as vile as 'it's survival of the fittest'.

Oh and it 94% in the 2000-2002 birth cohort - a cohort you might expect to be low as they were born while MMR was very much in the news.

"I thought we had already established that a small number of individuals cannot be immunised"

Who are these women who can't be allowed to have such a mild and brief disease as rubella as children, cannot possibly have the rubella vaccination, presumably have a very weak immune system but can socialise with children and are perfectly capable of being pregnant and having babies? I'm genuinely curious.

And how many of them are there in the UK at any given time?

It's not an "I'm alright Jack" attitude. It is the fact that parents' primary responsibility is to their own babies, and that it is not ethical to expect all babies everywhere in the world to be injected, forced to take the vaccine risk no matter how small, and forego natural lifelong immunity which is in their best interests for the benefit of very few hypothetical women who cannot be allowed to have an extremely mild illness such as rubella nor be vaccinated for it.

LazyJane - re "You conveniently forgot the bit about this game outcome only working when the other 95% did get inoculated"

I didn't forget any such thing, because there was no such "bit" in the study I linked to In fact, I just read through it again and can't find the number "95" anywhere on it. Did you even bothered to look at that study?

The thing is the two scenarios aren't all that different we are still talking about severe reactions with a potential to kill. Chances of a reaction to both vaccine and antibiotics are around 1 in 100,000.

I'm not entirely convinced there is less likelyhood of a severe reaction not being reported for a vaccine (yes they probably won't report for a mild fever but most thrush doesn't get reported when its caused by antibiotics).

cote game theory explains why people make poor choices for the whole population and possibly even outcomes which are worse for themselves overall in aggregate.

For the rubbella example, one of the main reasons was that the group of immunised children had far fewer younger siblings with birth defects. Even with immunised mothers.

No immune system is foolproof. I'm very pro-mumps vaccination for a simple reason: I can't gain immunity to mumps. I've had a full course of MMR and still had the live disease twice (confirmed). Not being a man, this hasn't caused me any permanent issues, but it was very unpleasant. No other known immune problems, I'm just in the small percentage who can't be included in the immune people to contribute to herd immunity.

I presume that is also possible for rubella. If that's only a very small percentage, it doesn't matter for stopping the spread of disease, but as a pregnant individual whose child has rubella it would be very serious, especially as its easy to not know you aren't immune.

lottie the I'm alright Jack wasn't aimed at you. I fully accept that some people can't be immunised. But that is why I think it is so important that everyone who can be should be.

Was about to answer cote but mrshoarder got there first

I had a severe reaction to an antibiotic. I was hospitalised for a few days and suffered for about a week. It wasn't fun but there was treatment for it. I was fine afterwards.

Some children have a slightly more scary reaction to vaccines - regression, lifelong disability, for which there is no cure. It is nowhere near the same thing as having a reaction to an antibiotic.

By the way, you are confusing probability ("1/100,000") with risk where:

Risk = Probability x Expected Outcome

I presume that is also possible for rubella. If that's only a very small percentage, it doesn't matter for stopping the spread of disease, but as a pregnant individual whose child has rubella it would be very serious, especially as its easy to not know you aren't immune.

You would have to eliminate it on a world-wide basis for this policy to be effective. It's normally such a mild disease that it can go unnoticed, so could easily go un-notified.

I would very much rather see a public health policy aimed at women of childbearing age to tell them to check their rubella status at intervals. I say this with an adult daughter who travels to out of the way places where health care is poor or downright bad. She has had the rubella vaccition. Did she know the immunity could wear off? No.

Oh and it 94% in the 2000-2002 birth cohort - a cohort you might expect to be low as they were born while MMR was very much in the news.

No it wasnt it was 75% for two doses of mmr and 84% for a measles containing vaccine

vaccine coverage tables

HPA tables the same

think you are reading the wrong column, the slide down started in 1998 surprise surprise

Bruffin - I said it was a paper in the BMJ. You are reading the wrong thing.

here - BMJ paper

Not sure how they can have single vaccines recorded from 2000 -2002 and they did not officially collect the data as anyone who had them done had them done privately.

Risk can be defined in six different ways

1. a probability of injury, loss, liability .....

I'm really not interested in getting into a debate with a statistician because I would lose, badly

I was just point out the chance of an adverse event occurring.

Do you have any evidence vaccines cause regression?

There are many people who cannot be vaccinated, have suppressed immune systems yet are fit enough to be pregnant. Being immunosuppressed doesn't mean you are unable to live a full life.

Anyway summary of that paper is data on singles is not routinely collected & lots of people who don't have MMR have singles. Of the ones who have a single vaccine nearly all have measles. Of course their participants may not be representative but it's the best estimate I've found.

MrsHoarder - re "game theory explains why people make poor choices for the whole population and possibly even outcomes which are worse for themselves overall in aggregate"

That is not the purpose of Game Theory.

I studied Game Theory. It explains why individuals make choices that make sense for them, although they might easily differ from the choices that another party might decide is best for them.

"For the rubbella example, one of the main reasons was that the group of immunised children had far fewer younger siblings with birth defects. Even with immunised mothers."

I have no idea what you just wanted to say here, sorry.

"I can't gain immunity to mumps. I've had a full course of MMR and still had the live disease twice (confirmed). Not being a man, this hasn't caused me any permanent issues, but it was very unpleasant."

That is very unfortunate for you. Maybe have a test if you have the immunity now. I had measles twice and I am immune now. Sometimes it takes the immune system more than one go to form immunity.

I had mumps, too. Yes, it was unpleasant. If I had it again, I wouldn't be happy. But no, I wouldn't expect the entire baby population of the world to be vaccinated so that little old me doesn't get sick with mumps again.

Cote, you said that game theory "concludes that it is perfectly normal for parents to decide not to vaccinate where perceived risk of a vaccine is higher than its expected benefit". By "normal" you seem to mean acceptable or reasonable. That's why I said that game theory does not validate the non-vaxx decision.

The quote you gave supports me not you: its says "it is impossible to eradicate a disease through voluntary vaccination when individuals act according to their own interests". So, we can't eradicate when sufficient numbers of people are selfish...agreed, but that's NOT validation, it's confirmation of the harm from selfishness and scaremongering against vaccines!

WhenSheWas - I had a point when pointing out that Risk = Probability x Expected Outcome, and it wasn't to rub your nose in my superior knowledge in this field

My point is that two "bad" outcomes with the same probability of occurring don't make up the same risk, if one possible outcome is an annoyance and the other is a catastrophe.

So, imagine that how bad or good an outcome were to be graded on a scale of -1,000 (Terrible Catastrophe) to 1,000 (Wonderful Blessing), I might assign the values of -300 (nasty but not terrible since it can be treated) to an adverse reaction to antibiotics and -900 (regression, permanent disability for which there is no cure nor treatment).

So the calculations would be:

Risk of antibiotic = 1/100,000 x -300 = -0.3%
Risk of vaccine = 1/100,000 x -900 = -0.9%

... meaning the risk of one would be three times the other's, even assuming that their probabilities are the same.

"Do you have any evidence vaccines cause regression?"

Not personally. I just trust the authorities who have accepted that vaccines have triggered regression and permanent disability in some children, and have paid out compensations to their families.

I also can't bring myself to judge as liars and idiots all these articulate and intelligent parents on MN like Jimjams and Beachcomber who talk about the damage that their children have suffered from vaccines. That is a personal preference, you might not agree with.