The math makes it clear why giving everyone absolute freedom to choose whether to immunize or not doesn't work very well.
If everyone else is immunized to the point where there is significant herd immunity, but immunization has a low but non-zero cost (e.g. feeling crappy for a few days), then the rational selfish action is to be a free rider and not immunize.
However, if everyone did that, then herd immunity can collapse down to a level where there is no herd immunity; people rationally choose to immunize only to protect themselves. However, given that immunizations aren't perfect shields, in that scenario, even immunized individuals will be at risk to infections spreading through the population.
Worth noting in the article (quoted out of order for emphasis):
"Determining the R0 of a particular microbe is a matter of more than academic interest. If you know how many secondary cases to expect from each infected person, you can figure out the level of herd immunity needed in the population to keep the microbe from spreading. This is calculated by taking the reciprocal of R0 and subtracting it from 1. For measles, with an R0 of 12 to 18, you need somewhere between 92 percent (1 – 1/12) and 95 percent (1 – 1/18) of the population to have effective immunity to keep the virus from spreading. For flu, it’s much lower — only around 50 percent. And yet we rarely attain even that level of immunity with vaccination.
...
The calculated R0 of the West African Ebola outbreak was found to be around 2 in a 2014 publication, similar to the R0 computed for the 1918 influenza pandemic based on historical data.
"
All of you ladies and gents who blow off your annual flu vaccine because "you just don't seem to ever catch it" - you're just lucky. It's only a matter of time with modern travel and climate change until another virulent strain hits.
> All of you ladies and gents who blow off your annual flu vaccine because "you just don't seem to ever catch it" - you're just lucky. It's only a matter of time with modern travel and climate change until another virulent strain hits.
Even if you do get the vaccine, there's no guarantee that it will actually include your new virulent strain. The flu vaccine is more involved (and uncertain) than others because influenza has a high mutation rate. It's a bit of a guessing game each year as to which strains should be included, and new ones crop up all the time.
The R0 of the original article is determined on the assumption that nobody is immunized at all.
Vaccine ineffectiveness is the odds that when you are potentially infected by a wild flu, the virus that you encounter was one that you were vaccinated against.
Vaccines are more effective when they correctly predict what varieties of flu will be circulating. But the more effective the immunization program, the more the ones that they predicted become and the less effective the vaccine becomes. However we all benefit because less flu is in the environment.
>All of you ladies and gents who blow off your annual flu vaccine because "you just don't seem to ever catch it" - you're just lucky
That's not true. There is a significant portion of the population who are resistant to the flu.
I'm 34 and I've never had the flu. None of my 3 siblings, nor my mom (who's 55) have either. This is despite never getting a flu shot, and spending several years riding public transit.
It's well documented that many people just don't become symptomatic or even contagious. A study in 2011 infected 17 people with live active flu virus, and only half developed any symptoms at all. Furthermore, it's likely that people with this immune response never develop the viral load necessary to easily spread the virus.
From about ages 12-21 or 22 I caught nothing. I consistently had a ~36hr period of very slight sniffles about once a year, and nothing else at all. Never bothered with flu shot, took no precautions, ate absolute garbage.
Then I started having 2-3 serious illnesses—very bad colds, the flu, sinus infections (I'd never had either of those last two)—every single year, and my nose is a little bit stuffy 100% of the time. 360 days a year, before, I couldn't blow my nose at all even if I wanted to—nothing would come out—but now I can a couple times a day, every day, when not actually sick.
I anecdotally concur. I never had allergies until my early to mid 20's, despite living in a very high allergen area. Now every other year or so I end up with bad allergies for a few weeks, and a persistent post-nasal drip that makes me cough and sound sick for extended periods of time.
You should try eating a spoonful of raw honey everyday— something which I'd just learned about myself! I'm usually not much one for holistic remedies, but I was surprised at how effective this was at alleviating my own allergies. Although I suppose this cure is a far cry from crystal healing; it's basically just sugary syrup and pollen, and you can imagine how this method works.
I've heard of that (but also with the suggestion to get local honey), but haven't remembered to try it when experiencing allergies, and it's just more sugar the rest of the time...
I wouldn't blame aging. I got sick normally (e.g. once per year) until my 25's or so when I started getting tonsillitis and related symptoms every 1-2 months.
After a year of that I had my tonsils out and suddenly I just didn't get sick anymore. I think in the 15 year period since I've maybe been sick twice (and not nearly as heavily).
> Now, if I have to go get it, or pay a $200 fine or something - yeah, I'll suck it up and go do it.
In an ideal world, all those who opt out should have to pay the medical expenses of those who get sick. Not vaccinating is the same sort of negative externality as environmental pollution.
Rather than making it a fine, a high opt-out fee could cover it without the stigma of "breaking the law".
Under your logic all those who eat fast food for lunch everyday and don't exercise should have to pay extra for medical insurance for not taking care of themselves.
If we had universal healthcare I'd believe that would be an appropriate response. Much like you can turn your home into a garbage dump and live in that if you have acres of empty land around you, but you can't in a dense city you are allowed to destroy your body but not at everyone else's expense
> Under your logic all those who eat fast food for lunch everyday and don't exercise should have to pay extra for medical insurance for not taking care of themselves.
Err, that's exactly what happens. Your premiums would definitely be higher if you live a riskier and less healthy lifestyle because you would require more costly health care at a younger age.
And as another poster pointed out, we're now also coming around to the idea of disincentivizing poor food choices for the same reasons, like taxes on sugary drinks.
So this is not "my logic", but in fact the prevailing logic of most people.
We are sexual reproducers, and as such, we require other people to further our biological goals. This means that the health of our herd has a direct effect on our own adaptiveness. Don't speculate about biological motives with the "rationality" defined by economics. They are different terms.
It's because a portion of humans are just dicks and ruin it for everyone else, so we need systems that clamp down on dickish behaviour so it doesn't wreck everything.
I mean, I agree that this rule applies to everything. But I'm more worried about the organizations that have a monopoly on force, not on social networks.
In this case would communism not actually be a positive? If the communist government decided everyone has to get vaccinated it seems the problem would be solved.
Not an advocate of communism as a whole but it is an interesting mention that it would if applied by an aggressive state actor go a long way towards eliminating certain diseases assuming it has the financial resources.
That link kind of a shallow criticism of Marx considering it doesn't take into account the evidence of actual physically existing communities that existed and still exist that do not have the capitalist notion of private property.
To be clear, it's a critique of what someone else wrote about what he wrote.
> What existing communist communities are you thinking of?
I'm thinking of, for example, cultures that are based on gift economics. The most well known example is the practice of Moka exchange in parts of Papua New Guinea [0]. Other examples abound in anthropology. A light read that specifically tries to outline systems of human existence outside of capitalism is Fragments of an Anarchist Anthropology [1].
But what Marx would have been very familiar with because it had only recently been abolished is the commons that was used by peasants for thousands of years before the early capitalist states completed the process of enclosure which violently converted those common lands into private holdings. Marx actually does a poor job of describing pre-capitalist economies but he didn't need to-- he only needed to analyze them to determine the origins of capital. The concept he came up with is primitive accumulation, which is the process by which the class structure of capitalism originated [2].
The main point I was making is that human systems outside of capitalism exist. Marx doesn't need to make that case. In particular, he doesn't need to explain how to run a communist society in order to demonstrate that such a development proceeds after capitalism. He does this by examining how capitalism reproduces itself, and then he uncovers the contradictions within that reproductive process to predict what will happen when those contradictions become untenable. The main thrust is that capitalism is founded on a system where surplus value is expropriated by the owning class from the working class, and Marx's work is an analysis of how this determines the dynamics of capitalism. In particular, Marx predicts communism is what succeeds capitalism because he expects the resolution of this class conflict to be the abolition of class as a whole and the democratic management of the means of production.
This is a bold thesis, and certainly one that can be attacked. I just had a conversation at lunch about the ways in which Marx's analysis was incomplete or flawed, though he was impressively prescient considering how much mind-boggling technological and societal transformation that has occurred since then.
One needs to also understand that Marx was trying to explain in a scientific way the social unrest of his time. The history books they use in schools, unsurprisingly, undersell just how tumultuous and violent the rise of capitalism was, and how often it was in crisis.
From your link:
> Just as, a dam having been removed, a river will eventually reach the sea somehow, so capitalism having been removed society will eventually reach a perfect state of freedom and cooperation.
This is the same kind of error that is made when people reason about evolution as if it were a volitional process. Marx is describing the long-term behavior of the entire socio-political system. He's not making a deontological argument. His arguments are that the very same mechanisms that reproduce capital day after day lead to its instability and, ultimately, its transformation into a new system that has resolved its inherent contradictions (but it also, that new system will have its own contradictions that are unforeseeable).
> I am starting to think I was previously a little too charitable toward Marx. My objections were of the sort “You didn’t really consider the idea of welfare capitalism with a social safety net” or “communist society is very difficult to implement in principle,” whereas they should have looked more like “You are basically just telling us to destroy all of the institutions that sustain human civilization and trust that what is baaaasically a giant planet-sized ghost will make sure everything works out.”
Well, ok. So, funny enough, the theoretical justifications for the welfare state were based on Marx's theory of historical materia...
In Marxist analysis, there is a distinction drawn between personal property and private property. The former is one's possessions. The latter is exclusionary ownership over economically active assets, i.e. the means of production. For example, land, factories, machinery. The way private ownership works under capitalism is tangibly different from ownership forms anterior to it, for example feudal titles to land. In many societies, including say England before the industrial revolution, the primary means of production was the land itself which wasn't owned by anyone: It was the commons that commoners are named after. It was enclosure, a generations-long political and violent process which converted the common land into private property. This had two implications:
1) There was now a class of people that owned most of the resources necessary for a human to survive by their own work.
2) There was now a massive class of landless people who could no longer sustain themselves through their own work of the commons that now needed jobs.
This is the sort of system of property that is strongly associated with capitalism that need not exist in other cultures.
Unfortunately, all modern implemenatations of communism are authoritarian. USSR, China and NK. I understand that in theory it should not be that way but it is.
> In this case would communism not actually be a positive?
Not in general because the decision often depends on the will of few people in those regimes and those people are not necessarily enlightened as the history prove it.
> If the communist government decided everyone has to get vaccinated it seems the problem would be solved.
Yeah possibly. Everyone would be immunized. But then they'd die of hunger waiting in a bread line or in a labor camp somewhere if they said the wrong thing to someone.
As others have pointed out, communism would work perfectly here - immunize your child whether you like it or not.
At least by school age here is what they did - they'd come to school, call each classroom by age to the nurse's office. They'd be a visiting nurse with a https://en.wikipedia.org/wiki/Jet_injector or vials of oral polio vaccines and you'd be immunized no questions asked. Not even sure if they sent a note to parents or how they even recorded it happened.
So they did that pretty well. Many other things like like economy, freedom of speech, not so much.
Oh right, fair enough! I meant in the more general sense, specifically the "someone else will do it, why should I" (which I think would also apply to any form of optional taxes). I'm not sure how prevalent that was in communist-era Russia though.
> "someone else will do it, why should I" (which I think would also apply to any form of optional taxes). I'm not sure how prevalent that was in communist-era Russia though.
Very prevalent. One could argue that it was the reason for the downfall. "Why should I work harder if the corrupt state will just take away my profits and ideas etc. I'll just lay low and let someone else do the work, and still get paid the same amount".
But you gotta give to the devil what belongs to the devil and they provided free government housing, pretty good schools, and basic medical care. Oh and a cool space program and pretty fast industrialization, up until the 60s or so, at least. All the other stuff was rotten and corrupt to the core. It is surprising it even lasted that long.
To be fair, that's not actually what libertarian means. Well, not traditionally. It is the opposite side of authoritarianism on the political compass. Taken to absurd levels, it is anarchy and would mean no taxes to a government or whatnot.
But, it's a spectrum. It's left it right and a varied distance from authority. You have some libertarian principles. Well, I presume you do.
We can apply Kant's categorical imperative to lots of stuff. Some people don't want to have children. If everyone chose to not have children the human race would face extinction.
This does not imply that we must (or more importantly, can from a moral perspective) force people who do not want children to have them anymore that it implies that forcing people who do not want flu shots is the right thing to do.
In one case we are talking about the wellbeing of other actual human beings, in the second, the abstract concept of the human race. Seems like a bait and switch to me.
> If everyone else is immunized to the point where there is significant herd immunity, but immunization has a low but non-zero cost (e.g. feeling crappy for a few days), then the rational selfish action is to be a free rider and not immunize.
Except that's not really how it is. There's still a very non-negligible risk to catch any of a number of vaccine-preventable diseases. People die from measles on a regular basis.
You can in theory imagine a situation where this is different, but realistically Vaccines totally make sense even from a very egoistic perspective.
In Canada flu shots are free. It's pretty great - I catch the flu easily and I've managed to avoid getting sick the last few seasons possibly thanks to getting the shot.
i don't know why you claim it's rational to be a free rider with one breath and in the next explain how it isn't rational. only considering immediate considerations and immediate consequences doesn't have to be what rationality is. only considering your own self and your own interests doesn't have to be what rationality is. rationality is a nebulous term and i see people far to often use the word to refer to stupid selfishness and short sightedness.
if people tend to do something because it's easier for them but that will come the long way round and bite them, and a lot of other people, in the end then that's a demonstration of a failure of human to be rational.
You're absolutely right that the word 'rational' is so overloaded that it can be nearly meaningless -- that's why I qualified it with 'selfish'.
We do need to draw distinctions between consequences that are immediately faced by the decisionmaker, vs. the long-term consequences to the group.
Note that even if you do care about the long-term consequences to the group, it may still be narrowly rational to decide not to immunize. After all, your own individual decision is only going to have a tiny impact on whether herd immunity persists in your community, but will have a much greater impact on yourself.
This is the same logic over why companies pollute, people litter, fishermen overfish -- there is a 'commons problem' where people collectively benefit from collaboration, but selfish individuals can benefit by defecting and free-riding.
If one can't see how selfish behavior may appear rational, then it becomes very difficult to figure out how to structure norms and incentives to encourage group cooperation.
"it doesn't work very well" for the purpose of ensuring the absolute optimal immunity, but it does work very well for ensuring the absolute optimal individual liberty. I vaccinate, always, and I am hopeful that other people will too, but I absolutely do not want to force people to do what everyone else thinks is best for them, because then, where does it stop?
How far might we go in the pursuit of perfect immunity? Some contagions have no vaccine, will we require masks at all times? Will we criminalize handshakes? At some point, the benefit of immunity is outweighed by what you have to pay for it.
I guess I sound like an antivaxxer here. I probably sound like a Nazi elsewhere. All I am though, is pro-liberty.
Except we live in a world with others, and some of our actions affect others. It's a nice sound bite to say you're "pro-liberty" or freedom or whatever nonsense, but I'm sure you're not "pro-liberty" when it comes to performing obscene acts in public where your children can see them.
Issues in life are not simple binary choices. We have to think about balancing individual goals, societal goals, national goals, and global goals. I'm of the opinion that we should err on the side of individual liberty, but when the evidence is so overwhelmingly positive to be pro vaccine, then obvoiously we might have to re-arrange our priorities.
So now, what am I supposed to think of all those claims that the flu vaccine is essentially a step or two behind nature.
Then, for me, I worry about the adjuncts and other stuff added to the standard vaccines as I have autoimmune problems. There are alternative vaccines that are available but I don't remember their efficacy.
So I refuse taking vaccines unless absolutely necessary until I see viable alternatives without aluminum, any kind of mercury, and so on.
These fears are based on bad science. The alleged "toxins" in vaccines are either present in microscopic quantities - micrograms or less - or were simply never there in the first place. It's like worrying about "sugar being bad for you" - which it is, in large enough amounts - because a single grain of table sugar got into your cereal. Details: https://sciencebasedmedicine.org/toxic-myths-about-vaccines/
I can't imagine how difficult it would be to be that sensitive to aluminum. I handle so many aluminum objects every day, it seems impossible i wouldn't consume some tiny amount daily, accidentally. Not to mention baking powder and cheese.
Anyone interested in these topics should look into the books "The Hot Zone" (about the first filovirus outbreaks, including Ebola) and "The Demon in the Freezer" (about several biological agents, most notably Smallpox, and their potential for use in warfare).
"The Demon in the Freezer" goes into the story of the eradication of Smallpox in the natural world, and talks a lot about containment of viral breakouts as well as the role of vaccination.
I've always wondered why the flu shot wasn't 100% free even without insurance. It wouldn't surprise me if one insurance company (or a collective of companies) could lower their net payout by increasing the number of total vaccinated people. A one day clinic recently that I went to only charged $30 for uninsured people.
It would not surprise me if the math actually worked out that it would be best to pay people $5 or something to get the shot.
It's be especially good if the payout was perhaps $2 to get it but $5 if more than 50% of the pop in an area got the shot. Maybe manageable with an Etherium contract?
Why would it benifit an insurance company? In effect, they would simply be subsidizing people who are not their customers (either because they are uninsured, or insured by a different company). Therefore, the insurance company would not see any reduction in payout.
Further, in effect insurane companies do pay their customers to get the flue shot, because they pay full price for the shot, but some distributors (like CVS) offer a discount on unrelated purchases for getting the shot.
I think the solution here is government provided shots. Even without going to full government healthcare, vaccinations seems to fall well withing the CDC's perview. And, due to the herd immunity factor, there is a general societal interest in people getting vacinated (beyond the costs on society of a person getting sick).
1) Insurance company has customers that don't get vaccinated
2) Insurance company pays for vaccinations of uninsured people
3) Uninsured people don't get sick
4) Uninsured people don't infect their unvaccinated customers
5) Insurance company has lower payouts because their customers don't get sick as much
From a financial point of view, this probably only makes sense if the cost of the vaccine is significantly lower than the cost of care of someone who catches the flu.
An insurance company can be more profitable if their customer base is more healthy (less payouts) then their competitors.
Society wide health improvement schemes like this generally hurt insurance company's profits since their profit and administrative overhead costs are capped to a percentage of the cost of their insurance plans[0]. One of the problems with healthcare in the US is that not many of the players are incentivized to improve costs. Industry wide inefficiency just means the insurance industry's 3% (or whatever) profit margin is larger in absolute terms.
If a statistical fluke or some sort of weird event caused far fewer people to file claims, but the insurance company is already collecting the money from employers and planholders, what would happen?
If its a fluke, they make short term profits. If you adopt a new policy that makes health insurance cheaper to provide in the long run, your competitors will force your prices down to that new price, lowering your profits.
Article doesn't mention that flu shots are always against previous year virus, not current. Developing a vaccine is a time consuming process (even one year is already a huge achievement).
So I'm still not convinced about flu shots. Other vaccines, like measles, are clear win, of course.
Huge point. I agree. The flu virus has mutated over loads of generations before it arrives again (it circles the globe with the seasons). The vaccine is a total crap shoot.
As another comment pointed out the effectiveness hovers around 50% - which is better than ~0% from doing nothing. And there's no cost if you live in glorious socialist Canada. America's crazy healthcare system alters this calculus of course.
That's not true, and it's not true in a totally fascinating way. The flu shot is aimed towards a projected virus, based in part on last year's viruses, but also on a host of other things. The nitty-gritty on it can be highly technical (and highly interesting, if you're into that sort of thing!), but here's a nice overview that should give the lay-person a broad idea of how it's done:
Great article. They did themselves a bit of a disservice referencing the Flu shot though. It is the most ineffective vaccine used in America. This would be more convincing to those against vaccination if they had just left it out of the discussion.
This all makes sense except perhaps for the flu. Only about 30% of people that come down with "flu like symptoms" actually have the flu. On the other hand the effective of flu vaccines can vary widely from year to year. This is because it takes months to make all the doses that are needed so the vaccine make up, which changes every year, has to be estimated in the advance. The actual prevalent flu though can change significantly by the time flu season starts.
The upshot is that the public doesn't necessarily perceive the benefit of the shot because a) they might get what they think is the flu (but isn't) and b) they might get a variant of flu that was not adequately covered by the vaccine. Obviously a more universal flu vaccine would help out a lot.
This was all over the news when it was discovered, but for those who missed it: measles vaccination protects against other illnesses too, because the measles causes your immune system to "forget" previously learned immune responses to other pathogens[0].
I wonder if this applies more broadly: if you're already immune to one disease, it would be reasonable to expect that your body has more energy left to fight any unknown diseases it comes across.
I have a counterpoint for discussion against taking the flu vaccine based on the facts we know, and a two independent assumptions I make.
We know that influenza is different from other viruses because
1) There are many strains of influenza, it has a high mutation rate
2) Flu vaccines are based on a forecast of likely strains and typically cover only at most 50% of the strains in a given year [1]
Now let us make the following assumption - Actual flu infection boosts immunity after recovery from the infection compared to vaccination (perhaps an analogy would be how muscle recovery happens after microtears after a strength training workout with heavier weights).
In which case, one might conclude - Since a stronger immune response is great against a fast mutating virus and around 50% of strains are not covered by vaccines anyways, that the benefit of boosting immune response against future infections (beyond the current year) outweighs cost of getting infected and is a better choice than getting immunized against 50% of the strains with increased chances of getting flu due to the other 50% anyways
Assumption 2 - Getting exposed, but not infected by flu, increases the number of strains one's body is immune to. Something sort of like vaccination, but without taking the vaccines themselves.
For the purpose of modelling, let us also make the assumptions that all strains arise and propagate independently. That is the strains not covered by vaccination expose the same number of people unaffected by herd immunity, while the strains covered by the vaccination face herd immunity.
Now consider the strains covered by the vaccine, whose spread is reduced due to herd immunity. It is great for everyone vaccinated against the strains, but for people not vaccinated against it, it prevents exposure from and hence immunity. This might be a case where the utility of vaccination decreases for non-vaccinated individuals instead of increasing (herd immunity) as a function of the fraction of vaccinated population. In other words, the more people vaccinated for flu, the less likely an non-vaccinated person is to get exposed, the less likely is he/she to develop immunity towards those strains naturally. Thus this would prevent population level immunity from arising, where it would have arisen naturally.
Note that in this scenario, one might question that in the natural course of events, a certain percentage of population will develop immunity anyways and hence become equivalent to the scenario where some part of the population is vaccinated. However there are three major differences. First is that there is a certain delay between getting infected, spreading to others and gaining immunity. Thus for the same percentage of immune population, there might be larger population exposed in the natural course of events. Second is that many individuals might get infected, transmit and immunized to a strain without getting infected, thus such an individual gets all the benefits of vaccination, but might help others get exposed and immunized to a strain. And third that vaccination is more aligned with socio-economic factors while infection less so.
To conclude, if any of the two assumptions I state are true, then we should perhaps not blindly apply the same logic that applies to other viruses for which we have vaccinations.
The 1918 flu pandemic killed what, 5% of the world population? The next predicted pandemic is to be much worse IIRC. Chief Justice Roberts called the simple efficiency gap math "gobbledygook"; is he, or is he not, willing to say the same about this math? what if push comes to shove and has to force America the free individual to be inoculated, saving the herd? This simple thought experiment highlights we are all connected, there is only the illusion of individual liberty because the herd would never intentionally let you kill it off.
> They’re about achieving a collective resistance to disease that goes beyond individual well-being
We don't get the flue vaccine for herd immunity and never have. I've never heard this argument from health departments or doctors.
This article seems to be confusing issues.
If the flue vaccine does help others they need to start publicizing that if it's true. If they are trying for heard immunity they also need to publicize that.
I don't watch ads but if people can link to any that claim this I'd be interested. If it was true then the vaccine sellers would be shouting it from the roof tops I would think.
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[ 2.6 ms ] story [ 79.2 ms ] threadIf everyone else is immunized to the point where there is significant herd immunity, but immunization has a low but non-zero cost (e.g. feeling crappy for a few days), then the rational selfish action is to be a free rider and not immunize.
However, if everyone did that, then herd immunity can collapse down to a level where there is no herd immunity; people rationally choose to immunize only to protect themselves. However, given that immunizations aren't perfect shields, in that scenario, even immunized individuals will be at risk to infections spreading through the population.
"Determining the R0 of a particular microbe is a matter of more than academic interest. If you know how many secondary cases to expect from each infected person, you can figure out the level of herd immunity needed in the population to keep the microbe from spreading. This is calculated by taking the reciprocal of R0 and subtracting it from 1. For measles, with an R0 of 12 to 18, you need somewhere between 92 percent (1 – 1/12) and 95 percent (1 – 1/18) of the population to have effective immunity to keep the virus from spreading. For flu, it’s much lower — only around 50 percent. And yet we rarely attain even that level of immunity with vaccination. ... The calculated R0 of the West African Ebola outbreak was found to be around 2 in a 2014 publication, similar to the R0 computed for the 1918 influenza pandemic based on historical data. "
All of you ladies and gents who blow off your annual flu vaccine because "you just don't seem to ever catch it" - you're just lucky. It's only a matter of time with modern travel and climate change until another virulent strain hits.
Even if you do get the vaccine, there's no guarantee that it will actually include your new virulent strain. The flu vaccine is more involved (and uncertain) than others because influenza has a high mutation rate. It's a bit of a guessing game each year as to which strains should be included, and new ones crop up all the time.
True, for reference look at this table from the CDC: https://www.cdc.gov/flu/professionals/vaccination/effectiven...
But I still get my flu shot every year, better to be 40-50% protected than 0%.Vaccine ineffectiveness is the odds that when you are potentially infected by a wild flu, the virus that you encounter was one that you were vaccinated against.
Vaccines are more effective when they correctly predict what varieties of flu will be circulating. But the more effective the immunization program, the more the ones that they predicted become and the less effective the vaccine becomes. However we all benefit because less flu is in the environment.
That's not true. There is a significant portion of the population who are resistant to the flu.
I'm 34 and I've never had the flu. None of my 3 siblings, nor my mom (who's 55) have either. This is despite never getting a flu shot, and spending several years riding public transit.
It's well documented that many people just don't become symptomatic or even contagious. A study in 2011 infected 17 people with live active flu virus, and only half developed any symptoms at all. Furthermore, it's likely that people with this immune response never develop the viral load necessary to easily spread the virus.
That's fascinating. Do you have a link to the study?
Then I started having 2-3 serious illnesses—very bad colds, the flu, sinus infections (I'd never had either of those last two)—every single year, and my nose is a little bit stuffy 100% of the time. 360 days a year, before, I couldn't blow my nose at all even if I wanted to—nothing would come out—but now I can a couple times a day, every day, when not actually sick.
Aging sucks and/or HGH is a hell of a drug.
That's definitely not just a result of being over the ripe old age of 22.
After a year of that I had my tonsils out and suddenly I just didn't get sick anymore. I think in the 15 year period since I've maybe been sick twice (and not nearly as heavily).
Sure, call me selfish, but it's just not worth it for me.
Now, if I have to go get it, or pay a $200 fine or something - yeah, I'll suck it up and go do it.
In an ideal world, all those who opt out should have to pay the medical expenses of those who get sick. Not vaccinating is the same sort of negative externality as environmental pollution.
Rather than making it a fine, a high opt-out fee could cover it without the stigma of "breaking the law".
Under your logic all those who eat fast food for lunch everyday and don't exercise should have to pay extra for medical insurance for not taking care of themselves.
1: https://en.m.wikipedia.org/wiki/Fat_tax
Err, that's exactly what happens. Your premiums would definitely be higher if you live a riskier and less healthy lifestyle because you would require more costly health care at a younger age.
And as another poster pointed out, we're now also coming around to the idea of disincentivizing poor food choices for the same reasons, like taxes on sugary drinks.
So this is not "my logic", but in fact the prevailing logic of most people.
Edit: I mean everyone thinking "well someone else will do it, I dont have to", specifically regarding to paying taxes or contributing to society.
Not an advocate of communism as a whole but it is an interesting mention that it would if applied by an aggressive state actor go a long way towards eliminating certain diseases assuming it has the financial resources.
What existing communist communities are you thinking of?
To be clear, it's a critique of what someone else wrote about what he wrote.
> What existing communist communities are you thinking of?
I'm thinking of, for example, cultures that are based on gift economics. The most well known example is the practice of Moka exchange in parts of Papua New Guinea [0]. Other examples abound in anthropology. A light read that specifically tries to outline systems of human existence outside of capitalism is Fragments of an Anarchist Anthropology [1].
But what Marx would have been very familiar with because it had only recently been abolished is the commons that was used by peasants for thousands of years before the early capitalist states completed the process of enclosure which violently converted those common lands into private holdings. Marx actually does a poor job of describing pre-capitalist economies but he didn't need to-- he only needed to analyze them to determine the origins of capital. The concept he came up with is primitive accumulation, which is the process by which the class structure of capitalism originated [2].
The main point I was making is that human systems outside of capitalism exist. Marx doesn't need to make that case. In particular, he doesn't need to explain how to run a communist society in order to demonstrate that such a development proceeds after capitalism. He does this by examining how capitalism reproduces itself, and then he uncovers the contradictions within that reproductive process to predict what will happen when those contradictions become untenable. The main thrust is that capitalism is founded on a system where surplus value is expropriated by the owning class from the working class, and Marx's work is an analysis of how this determines the dynamics of capitalism. In particular, Marx predicts communism is what succeeds capitalism because he expects the resolution of this class conflict to be the abolition of class as a whole and the democratic management of the means of production.
This is a bold thesis, and certainly one that can be attacked. I just had a conversation at lunch about the ways in which Marx's analysis was incomplete or flawed, though he was impressively prescient considering how much mind-boggling technological and societal transformation that has occurred since then.
One needs to also understand that Marx was trying to explain in a scientific way the social unrest of his time. The history books they use in schools, unsurprisingly, undersell just how tumultuous and violent the rise of capitalism was, and how often it was in crisis.
From your link:
> Just as, a dam having been removed, a river will eventually reach the sea somehow, so capitalism having been removed society will eventually reach a perfect state of freedom and cooperation.
This is the same kind of error that is made when people reason about evolution as if it were a volitional process. Marx is describing the long-term behavior of the entire socio-political system. He's not making a deontological argument. His arguments are that the very same mechanisms that reproduce capital day after day lead to its instability and, ultimately, its transformation into a new system that has resolved its inherent contradictions (but it also, that new system will have its own contradictions that are unforeseeable).
> I am starting to think I was previously a little too charitable toward Marx. My objections were of the sort “You didn’t really consider the idea of welfare capitalism with a social safety net” or “communist society is very difficult to implement in principle,” whereas they should have looked more like “You are basically just telling us to destroy all of the institutions that sustain human civilization and trust that what is baaaasically a giant planet-sized ghost will make sure everything works out.”
Well, ok. So, funny enough, the theoretical justifications for the welfare state were based on Marx's theory of historical materia...
In a culture that didn't have the notion of private property, what would a "gift" mean?
1) There was now a class of people that owned most of the resources necessary for a human to survive by their own work.
2) There was now a massive class of landless people who could no longer sustain themselves through their own work of the commons that now needed jobs.
This is the sort of system of property that is strongly associated with capitalism that need not exist in other cultures.
Not in general because the decision often depends on the will of few people in those regimes and those people are not necessarily enlightened as the history prove it.
Yeah possibly. Everyone would be immunized. But then they'd die of hunger waiting in a bread line or in a labor camp somewhere if they said the wrong thing to someone.
At least by school age here is what they did - they'd come to school, call each classroom by age to the nurse's office. They'd be a visiting nurse with a https://en.wikipedia.org/wiki/Jet_injector or vials of oral polio vaccines and you'd be immunized no questions asked. Not even sure if they sent a note to parents or how they even recorded it happened.
So they did that pretty well. Many other things like like economy, freedom of speech, not so much.
Very prevalent. One could argue that it was the reason for the downfall. "Why should I work harder if the corrupt state will just take away my profits and ideas etc. I'll just lay low and let someone else do the work, and still get paid the same amount".
But you gotta give to the devil what belongs to the devil and they provided free government housing, pretty good schools, and basic medical care. Oh and a cool space program and pretty fast industrialization, up until the 60s or so, at least. All the other stuff was rotten and corrupt to the core. It is surprising it even lasted that long.
But, it's a spectrum. It's left it right and a varied distance from authority. You have some libertarian principles. Well, I presume you do.
This does not imply that we must (or more importantly, can from a moral perspective) force people who do not want children to have them anymore that it implies that forcing people who do not want flu shots is the right thing to do.
Except that's not really how it is. There's still a very non-negligible risk to catch any of a number of vaccine-preventable diseases. People die from measles on a regular basis.
You can in theory imagine a situation where this is different, but realistically Vaccines totally make sense even from a very egoistic perspective.
Healthcare is a provincial responsibility in Canada
if people tend to do something because it's easier for them but that will come the long way round and bite them, and a lot of other people, in the end then that's a demonstration of a failure of human to be rational.
We do need to draw distinctions between consequences that are immediately faced by the decisionmaker, vs. the long-term consequences to the group.
Note that even if you do care about the long-term consequences to the group, it may still be narrowly rational to decide not to immunize. After all, your own individual decision is only going to have a tiny impact on whether herd immunity persists in your community, but will have a much greater impact on yourself.
This is the same logic over why companies pollute, people litter, fishermen overfish -- there is a 'commons problem' where people collectively benefit from collaboration, but selfish individuals can benefit by defecting and free-riding.
If one can't see how selfish behavior may appear rational, then it becomes very difficult to figure out how to structure norms and incentives to encourage group cooperation.
How far might we go in the pursuit of perfect immunity? Some contagions have no vaccine, will we require masks at all times? Will we criminalize handshakes? At some point, the benefit of immunity is outweighed by what you have to pay for it.
I guess I sound like an antivaxxer here. I probably sound like a Nazi elsewhere. All I am though, is pro-liberty.
Issues in life are not simple binary choices. We have to think about balancing individual goals, societal goals, national goals, and global goals. I'm of the opinion that we should err on the side of individual liberty, but when the evidence is so overwhelmingly positive to be pro vaccine, then obvoiously we might have to re-arrange our priorities.
Then, for me, I worry about the adjuncts and other stuff added to the standard vaccines as I have autoimmune problems. There are alternative vaccines that are available but I don't remember their efficacy.
So I refuse taking vaccines unless absolutely necessary until I see viable alternatives without aluminum, any kind of mercury, and so on.
"The Demon in the Freezer" goes into the story of the eradication of Smallpox in the natural world, and talks a lot about containment of viral breakouts as well as the role of vaccination.
It's be especially good if the payout was perhaps $2 to get it but $5 if more than 50% of the pop in an area got the shot. Maybe manageable with an Etherium contract?
Further, in effect insurane companies do pay their customers to get the flue shot, because they pay full price for the shot, but some distributors (like CVS) offer a discount on unrelated purchases for getting the shot.
I think the solution here is government provided shots. Even without going to full government healthcare, vaccinations seems to fall well withing the CDC's perview. And, due to the herd immunity factor, there is a general societal interest in people getting vacinated (beyond the costs on society of a person getting sick).
1) Insurance company has customers that don't get vaccinated
2) Insurance company pays for vaccinations of uninsured people
3) Uninsured people don't get sick
4) Uninsured people don't infect their unvaccinated customers
5) Insurance company has lower payouts because their customers don't get sick as much
From a financial point of view, this probably only makes sense if the cost of the vaccine is significantly lower than the cost of care of someone who catches the flu.
Society wide health improvement schemes like this generally hurt insurance company's profits since their profit and administrative overhead costs are capped to a percentage of the cost of their insurance plans[0]. One of the problems with healthcare in the US is that not many of the players are incentivized to improve costs. Industry wide inefficiency just means the insurance industry's 3% (or whatever) profit margin is larger in absolute terms.
[0]: https://www.healthcare.gov/health-care-law-protections/rate-...
If a statistical fluke or some sort of weird event caused far fewer people to file claims, but the insurance company is already collecting the money from employers and planholders, what would happen?
So I'm still not convinced about flu shots. Other vaccines, like measles, are clear win, of course.
https://www.cdc.gov/flu/professionals/laboratory/genetic-cha...
The upshot is that the public doesn't necessarily perceive the benefit of the shot because a) they might get what they think is the flu (but isn't) and b) they might get a variant of flu that was not adequately covered by the vaccine. Obviously a more universal flu vaccine would help out a lot.
I wonder if this applies more broadly: if you're already immune to one disease, it would be reasonable to expect that your body has more energy left to fight any unknown diseases it comes across.
[0] https://www.newscientist.com/article/dn27481-measles-leaves-...
We know that influenza is different from other viruses because 1) There are many strains of influenza, it has a high mutation rate 2) Flu vaccines are based on a forecast of likely strains and typically cover only at most 50% of the strains in a given year [1]
Now let us make the following assumption - Actual flu infection boosts immunity after recovery from the infection compared to vaccination (perhaps an analogy would be how muscle recovery happens after microtears after a strength training workout with heavier weights).
In which case, one might conclude - Since a stronger immune response is great against a fast mutating virus and around 50% of strains are not covered by vaccines anyways, that the benefit of boosting immune response against future infections (beyond the current year) outweighs cost of getting infected and is a better choice than getting immunized against 50% of the strains with increased chances of getting flu due to the other 50% anyways
Assumption 2 - Getting exposed, but not infected by flu, increases the number of strains one's body is immune to. Something sort of like vaccination, but without taking the vaccines themselves.
For the purpose of modelling, let us also make the assumptions that all strains arise and propagate independently. That is the strains not covered by vaccination expose the same number of people unaffected by herd immunity, while the strains covered by the vaccination face herd immunity.
Now consider the strains covered by the vaccine, whose spread is reduced due to herd immunity. It is great for everyone vaccinated against the strains, but for people not vaccinated against it, it prevents exposure from and hence immunity. This might be a case where the utility of vaccination decreases for non-vaccinated individuals instead of increasing (herd immunity) as a function of the fraction of vaccinated population. In other words, the more people vaccinated for flu, the less likely an non-vaccinated person is to get exposed, the less likely is he/she to develop immunity towards those strains naturally. Thus this would prevent population level immunity from arising, where it would have arisen naturally.
Note that in this scenario, one might question that in the natural course of events, a certain percentage of population will develop immunity anyways and hence become equivalent to the scenario where some part of the population is vaccinated. However there are three major differences. First is that there is a certain delay between getting infected, spreading to others and gaining immunity. Thus for the same percentage of immune population, there might be larger population exposed in the natural course of events. Second is that many individuals might get infected, transmit and immunized to a strain without getting infected, thus such an individual gets all the benefits of vaccination, but might help others get exposed and immunized to a strain. And third that vaccination is more aligned with socio-economic factors while infection less so.
To conclude, if any of the two assumptions I state are true, then we should perhaps not blindly apply the same logic that applies to other viruses for which we have vaccinations.
[1] https://news.ycombinator.com/item?id=15562258
We don't get the flue vaccine for herd immunity and never have. I've never heard this argument from health departments or doctors.
This article seems to be confusing issues.
If the flue vaccine does help others they need to start publicizing that if it's true. If they are trying for heard immunity they also need to publicize that.
I don't watch ads but if people can link to any that claim this I'd be interested. If it was true then the vaccine sellers would be shouting it from the roof tops I would think.