Let me break down the overall scheme of vaccination, real quick.

  1. You get exposed to a dead/weakened/chunks of a pathogen (virus, bacterial toxin like tetanus, etc).
  2. Your body reacts to the vaccine ‘invader’ and triggers an adaptive immune response.
  3. Your adaptive immune system ‘remembers’ what it has seen, so when you are exposed to the real virus/bacteria/etc, it is already ready, and kills the pathogen before it can make you sick.

That is the ideal situation.

Sometimes your body just ignores the vaccine.  The vaccine is dead, so it degrades before your body even sees it, much less develops the appropriate adaptive immune response.

Sometimes your adaptive immune system ‘forgets’.  You get a vaccine, six months later you still have a great adaptive immune response to the pathogen.  Six years later your immune system is like ‘lol wut? Daves not here, man!’

And even under ‘ideal’ circumstances, the adaptive immune response you make to a pathogen isnt perfect.  It might make it so that if you are expose to the pathogen, you get a milder disease, because your immune system got a head start… but you still get sick.

And then there are the folks who just *cant* get vaccines for genuine medical reasons, like genetic or pharmaceutically induced immune suppression. ‘Weak’ virus in a vaccine for you? Meh.  ‘Weak’ virus in a vaccine for someone who just got a new lung? Eeeeeeeeeeeeeh.

But we can still have our bases covered with vaccines as long as everyone, who medically can be vaccinated, is vaccinated.  Most of us are properly protected, and we protect the folks who cant get vaccines and the random folks who didnt respond well to the vaccine and everyone is protected.

HURRAY!

Alas, there are bad parents and assholes among us who do not vaccinate their children, who grow up to be unvaccinated teenagers, unvaccinated adults, etc, and they travel all around the world to places where people do not have the luxury of turning down vaccines, where preventable diseases are endemic, and these assholes bring them home to the US.

So, of course the people who cannot be vaccinated are at risk.

And, the random people who didnt respond well are at risk (could be me! could be you!).

But most of us would be safe in an ‘outbreak’ scenareo, right?

Apparently, sometimes, no.

Mumps Outbreak in Orthodox Jewish Communities in the United States

A long time ago, in a galaxy far far away, parents actually loved their children, and made sure they got the MMR vaccine to protect them from measles, mumps and rubella.  These diseases became so rare physicians didnt even know what they looked like, at least in the US.  These diseases were fairy tale villains, conquered long ago.

And then some chode made up some data saying MMR was dangerous, and for whatever personal psychological reasons, parents refused to protect their children with vaccines, including MMR. Vaccination rates go down, herd immunity breaks down, people start getting sick from preventable diseases. Dead villains rising from the grave.

So in 2009-2010, there was an outbreak of mumps in New Jersey/New York, predominantly in Orthodox Jewish communities. Over 3500 people got mumps.

Over 3500.

“AH-HA!” Some of you might be saying. “I bet they refused vaccination for ‘religious’ reasons, and thats why they all got sick! STUPID!”

Minor problem.

The Orthodox Jewish communities impacted by this outbreak were not opposed to vaccines. They had totally normal vaccination rates.

… But… If everyone was vaccinated… how did do many people get sick?  What happened to herd immunity?

Genetics? Bad batch of vaccines?

I wish.

The index case patient in this outbreak was a twice-vaccinated 11-year-old boy who returned to the United States on June 17, 2009, from the United Kingdom, a country that was experiencing a large mumps outbreak at that time.

Patient Zero should have been protected, but he wasnt.

The majority of cases — 71% (2479 of the 3502 cases) — occurred among males.

…10% were unvaccinated, 14% had received one dose of MMR vaccine, and 76% had received two doses of MMR vaccine…

One dose should have been fine (ish), two is better, but 90% of the people who got mumps were vaccinated. And 71% were males, not including Patient Zero (also male and properly vaccinated).

What the hell is going on here?

The features of this outbreak are best explained by intense exposures, particularly among boys in schools, that overwhelmed the protection afforded by the vaccine. In general, Orthodox girls receive conventional schooling, whereas boys in yeshivas receive intense religious education starting at 12 years of age, with school days that are up to 15 hours long. Yeshiva study is typically interactive, involving a “chavrusa” (a study partner). Partners face each other across narrow tables or lecterns to study religious texts; the format is face-to-face, often with animated discussion. Frequently, several pairs of students study at a single table. A typical day involves several study sessions, with students changing partners for each session.

The protection we get from vaccines is not perfect, but it is enough to protect us from a random exposure to some jerk at the Superbowl or something.

But if you are exposed to a ‘high dose’ of pathogen, from lots of transmission friendly interactions, its too much for even an educated immune system, and you will get sick.

People got really sick from this outbreak. Not ‘just mumps’, but pelvic inflammation, brain inflammation, pancreatitis– One person went deaf.  Permanently.  PERMANENTLY.

Those Mommy Warriors who dont protect their kids?

You could be their next victim.  Even if you are vaccinated.

Comments

  1. #1 Tom Fid
    November 5, 2012

    This is right on, but if you want to convince anyone who’s not already convinced, not calling them @$%&* would help.

  2. #2 ERV
    November 5, 2012

    No it doesnt.

  3. #3 Eric Lund
    November 5, 2012

    @Tom: There is a large hardcore anti-vax contingent out there, and no evidence that these people are persuadable by rational means.

    I’d be fine with people holding such views, were it not for the fact that by not vaccinating their kids who could be vaccinated, they are recklessly endangering the health of people who are dependent on herd immunity.

    We have several terms in English for people who act with reckless disregard for the health and safety of others. The politest such word, in our litigous society, is “defendant”.

  4. #4 Jacob Smith
    MA
    November 5, 2012

    So that’s a cool story about how vaccines have big limitations and this:

    “Most of us are properly protected, and we protect the folks who cant get vaccines and the random folks who didnt respond well to the vaccine and everyone is protected.”

    Is misleading. Seems to me that this story brings home how important factors *besides* vaccination rate are. Like community awareness about health, so that people could have noticed the outbreak earlier and stopped “chavrusa” temporarily.

    My problem with your vehement anti-anti-vaxxer position is that you trot out this argument that not vaccinating adds risk to the people around you as if it means anything. One’s existence, vaccinated or not, does in some ways put other people at risk. As a society, we have to decide how much risk it is acceptable for people to impose on each other.

    And that’s where your argument flies off the rails, because we’ve got thirty THOUSAND people dying annually from motor vehicle accidents in this country, and we have not decided that that is too many and that we need to mandate extensive training of individuals before they can get their license. How many people die annually as a result of anti-vaxxers? How many are crippled?

    So yeah, cool story about someone becoming DEAF PERMANENTLY OMGZORZ but we’ve got much, much lower hanging fruit to take care of if we’re trying to do this “communal risk reduction” thing. And if we decide to ban outright everything that causes as many deaths or more deaths as vaccination refusal, I think we’d be losing a lot as a society.

  5. #5 Grant
    http://sciblogs.co.nz/code-for-life
    November 5, 2012

    Jacob,

    “And that’s where your argument flies off the rails, because we’ve got thirty THOUSAND people dying annually from motor vehicle accidents in this country, and we have not decided that that is too many and that we need to mandate extensive training of individuals before they can get their license. How many people die annually as a result of anti-vaxxers? How many are crippled?”

    - This is the wrong comparison. It’s not vaccines v. other things. It should be vaccinating v. not vaccinating. You’re better off vaccinating.

  6. #6 L. Rosenblood
    http://opinionsquestions.blogspot.com
    November 5, 2012

    Unfortunately, there are many publications that purport to be scientific and present the “facts” about vaccination risks that convince many people that the rational, evidence-based approach to minimize risk is to avoid vaccinations.

    I speak from personal experience – a friend of mine decided not to vaccinate, and I tried to understand why. This led to a protrated, frustrating, and ultimately unproductive disucssion over the course of months.

    At one point, he sent me a book called Vaccine Safety Manual. For an analysis of the arguments used in this book, and the reaons why even a non-scientist should not trust their conclusions, see my review of the book. I think it will be of interest to people that care about the value of national immunization programs.

  7. #7 John C. Welch
    November 5, 2012

    The fact that many people die in car accidents is important, but has, literally, nothing to do with vaccinations.

    But it’s a nice distraction. How many people are murdered every year in this country? A lot, and it’s horrible, but, it has nothing to do with vaccinations.

    Unfortunately, your schtick works only too well with the masses.

  8. #8 B Griffin
    Florida
    November 6, 2012

    I doubt this comment will be well received, but it needs to be said:
    There are two problems with this commentary on vaccination participation; one significantly worse than the other.
    .
    Let’s start with the easier one:
    The specifics of the mumps outbreak in the Northeast, even viewed in the most favorable light, do nothing to support your assertions about increased risks brought about by those foolish people who could receive vaccines but choose not to.
    Considering 90% of the cases comprised of vaccinated individuals and Patient Zero was twice vaccinated; it is far from evident that the outbreak would have been significantly smaller if whatever portion of the 10% of un- vaccinated cases that were eligible for vaccination, actually had been vaccinated.
    Not knowing useful things like what portion of the un-vaccinated cases were eligible for vaccination….or the percentage of boys at that school were eligible yet not vaccinated, makes the example completely useless.
    .
    But it isn’t actually completely useless. It was used to great effect to describe the very real damage caused by a real disease in a real American town. The only thing that wasn’t real was a decent argument tying the scary real threat to the assertions made.
    .
    .
    OK, now to the larger problem:
    .
    What exactly is being proposed as an alternative to the current situation?
    .
    A solution has to be suggested, otherwise this is nothing more than whining about sand in your crotch.
    .
    Insisting on the depraved nature of those who choose to fore go vaccinations, makes it obvious that this piece was not written in an effort to shift pubic opinion and foster change through social pressure.
    .
    The only thing that makes sense from what is provided, is that the solution being advocated is legislation for mandatory vaccination of all medically eligible people.
    .
    If that is what you are advocating, you are a far greater risk of inducing tragedy than someone refusing vaccination.
    .
    I am a proponent of participation in current vaccination programs. I am vaccinated and would recommend a healthy person receive most available vaccines. I say most because there are a few that I would refuse in their current form…any of the recent experimental HIV vaccines and the current anthrax vaccine are two I would definitely refuse.
    .
    I insist on retaining my right to control what is administered into my own body, or those in my charge.
    .
    This is not some ancillary held over custom from hundreds of year ago, that should be revoked for the good of the masses. Control of what goes into one’s own body is what some wise gentlemen once described an inalienable right.
    .
    The never ending calls to action, rallying support to subjugate rights of the citizens, in the name of protecting the citizens, is almost never good for the citizens.
    .
    Please be conscientious in your words and deeds.

  9. #9 steve mitchell
    usa
    November 6, 2012

    well, although i do not place myself in the camo of the radical anti-vaccine folk.. except for the use of non-flumist influenza vaccines i’d like to go on record on this post’s assertions relative to the cause of the outbreak, etc… and the attack on those who sincerely believe their child has been damaged by the mmr – or any other vaccine –

    bullshit

  10. #10 Composer99
    http://composer99.blogspot.ca
    November 6, 2012

    B Griffin:

    I find your post is disingenuous, for one rather key reason:

    Unless you can point to the part where Abbie opines that vaccination ought to be compulsory (with fines/imprisonment for failure to comply), your whole second point is pointless.

    What she is doing is castigating people who choose not to vaccinate out of laziness or dogmatic objection to vaccines. If you think that is objectionable, feel free to say so.

    But please actually object to what is being claimed.

  11. #11 Dave
    November 6, 2012

    ERV’s logic seems pretty simple and unassailable — Even people who are vaccinated are at risk when the incidence of a vaccine-preventable disease explodes 100-fold due to “some chode made up some data saying MMR was dangerous.” Or did y’all miss the fact that patient zero caught the mumps, not in some third-world hell hole where low vaccination rates and high disease incidence might be understandable, but in the fucking UK?

  12. #12 B Griffin
    Florida
    November 6, 2012

    Composer99,
    Let’s start by making sure we are on the same page. The one problem you have with my post is you believe my second point culminates in finding fault with a trait which I unfairly attributed to ARV.
    Would it be fair then to say that you dispute nothing in my first point? I want to make sure that your actual objection is attributed to the correct claim.
    .
    Lets move on to your concerns about the second argument in my comment above.
    I believe you are missing the main thrust of that second point. In hindsight, it would have helped if I have created a heading providing a title for that portion of the argument. Something like:
    .
    ”…..2. What in the world is being advocated? What is the suggested plan? You do have a plan, right?….”
    .
    That is the bewildering part. ERV is clearly a highly skilled writer who ha no more problem making a precise description in exacting technical language, than eliciting emotion to enhance persuasion….and yet with all that ability to communicate, it remains unclear what is being suggested.
    .
    You claim that ERV’s intent and sole purpose is castigation. I considered and rejected this in my original comment.
    I give ERV more credit than that..there has to be more. Mere castigation, (when viewed in light of the incredibly small probability of one of those for whom the castigation is intended reads this blog an self identifying as one of those intended to be punished reprimanded, as well as the near certainty that this type of writing do nothing to change the minds of those it attacks) nothing more than cowardly divisive hate-conjuring when considered in light .
    That is to say, stroking the fires of hate upon a group (in this case antivaxers) without a meaningful plan to address the problem, and under the guise of dolling out severe reprimands when in fact those for whom the punishment is intended are highly unlikely to ever stumble upon the rant intended for the,m is so far removed from what might be valid approach of generated by a healthy mind, that it is relegated somewhere between completely ineffective at best, to possibly something far worse….budding signs of a sociopath or something.
    In any case, that doesn’t seem consistent what can be gleaned about ERV.
    .
    Which brings us back to the question….what alternative is being proposed?
    .
    Please take a moment to notice that my statement concerning the implications of pushing for mandatory vaccinations were prefaced with the conditional ‘IF”.

    That ‘IF’ is sufficient to establish that I was not arbitrarily assigning this intent to ERV, merely cautioning if it were to be true.

    I should probably proof read but I have to run out the door at the moment….

  13. #13 dr2chase
    November 6, 2012

    @B Griffin, you’re being too cute by half, first by attempting to demand a concrete proposal, and then by insisting that the concrete proposals would be unacceptable.

    So, here are some concrete proposals. Keep a firm hand on your pearls. In all cases “no vaccine” includes an exemption for medical reasons, but not for religion (because lately, I have not felt terribly charitable towards organized and/or cult religion, so there):

    1) No vaccine for communicable diseases puts you on the no-fly list for airplanes. This also applies to parents of unvaccinated kids. A two-week medical quarantine before travel can be used as a substitute.

    2) Parents of unvaccinated kids cannot work with sick people, the elderly, or children (not as nurses or doctors, not as day care providers, etc).

    3) Parents of unvaccinated kids will not be allowed to re-enter the country. A two week medical quarantine will be allowed as a substitute.

    So there, nothing put in your body, just some anti-contagion restrictions on jobs and travel.

  14. #14 William Wallace
    November 6, 2012

    Mighty white of you folks to tell other parents what they must do to their children for the good of all.

    But yet you don’t talk about the polio outbreaks that result from children who travel abroad and get vaccinated using the attenuated version of the virus, taking it back to the U.S., and infecting other children.

    Risks/rewards and macro versus micro analysis.

    You approach the problem as a collectivist, and the conclusion you come to is reasonable.

    Others are not collectivists, and the conclusion they come to is also reasonable.

  15. #15 The Negotiator
    November 6, 2012

    With Obama winning tonight getting a disease will be the least of your worries. I wish there was a vaccine to protect against liberalism. Oh yeah that’s right, there is. The Bible is the best for to protect against evil. Then again, evil never dies.

  16. #16 The Negotiator
    November 6, 2012

    Oh, and just so ya know. I refuse to take one of your killer vaccines. What are you going to do, lock me up in a FEMA concentration camp?

  17. #17 The Negotiator
    November 6, 2012

    @ Eric Lund,

    who said “We have several terms in English for people who act with reckless disregard for the health and safety of others. The politest such word, in our litigous society, is “defendant”.

    Cute! “defendant” is also used to describe anti-vaxxers who defend themselves with a large tactical tomahawk or large combat knife when a vaccine slurpers tries to force them to vaccinate. Forced vaccination usually leads to someone getting hurt, usually the one doing the forcing while the poor “defendant” goes to jail for trying to ward off evil vaccine pushers and their population control plans.

  18. #18 Julian Frost
    NOYDB
    November 7, 2012

    @The Negotiator:

    “defendant” is also used to describe anti-vaxxers who defend themselves with a large tactical tomahawk or large combat knife when a vaccine slurpers tries to force them to vaccinate.

    Please give examples of “vaccine slurpers” trying to forcibly vaccinate anti-vaxxers, or be considered a liar.

  19. #19 The Negotiator
    November 7, 2012

    Oh, you ask for an example. How democratic of you.

    If your kid does not get vaccinated what happens? He/she gets kicked out of school. Then when that happens men with guns(cops or feds) show up at your door to force a settlement.

    There have been instances where workplaces require their employees to get a dangerous flu vaccine. Doesn’t bother me much though. I have a friend who is a doctor who will sign a form saying that I got the vaccine. Wether I actually recieved one or not, no one will ever know. Now, how many other people are doing the same thing?

  20. #20 Julian Frost
    NOYDB
    November 8, 2012

    If your kid does not get vaccinated what happens? He/she gets kicked out of school.

    That only happens when there’s an outbreak. One it’s over, the child may return. In addition, you have the option to homeschool or enrol your child in a Steiner School.

    There have been instances where workplaces require their employees to get a dangerous flu vaccine.

    I’ll think you’ll find that the flu is far more dangerous than the vaccine. Every year, hundreds of people die of the flu. Also, many workplaces work with vulnerable populations (the very old, the very young, immunocompromised people) so getting the vaccine protects them, not just you.

    Doesn’t bother me much though. I have a friend who is a doctor who will sign a form saying that I got the vaccine. Wether I actually recieved one or not, no one will ever know.

    Until you get laid low by the flu. Then they’ll start asking questions. Then they’ll charge you and your doctor friend with fraud.

  21. #21 The Negotiator
    November 9, 2012

    ” Then they’ll start asking questions. Then they’ll charge you and your doctor friend with fraud.”

    Really how will they know. Do they monitor me at all times? Even people who take the flu shot STILL get the flu sometimes. There will be no proof. Besides, they could be charged with fraud as well for telling people the flu shot prevents the flu when it does not.

    They have no authority to monitor me. I am a sovereign independant individual with rights given unto me by God and not government. They have ZERO authority over me. They may think they have, but they do not. Maybe I should seek my little gray buddies on them?

  22. #22 B Griffin
    Florida
    November 9, 2012

    Dr2Chase:
    .
    I find your concrete proposals to be…
    ….exceptionally good ideas.
    .
    These ideas that could possibly be developed into politically viable legislation.
    .
    I especially like that the suggestions work to encourage the preferred behavior by limits on certain privileges (not rights) for which participation of the non-compliant represents a significant risk to the public as a whole.
    .
    Based on the quality of your suggestions alone, I would wager that you have some decent life experience in areas requiring systems analysis, problem identification, developing and implementing a solution, for which success (or failure) is not trivial. Certainly beyond academia; in the world of real consequences.
    That experience separates you from most politicians, who have minimal experience problem solving but are granted status as experts and trusted with decisions of the highest level.
    Your short comment is the most important idea on this page, and yet I suspect very few people (who show some interest in the problem by visiting this page) will give it much consideration.
    Anyway, thanks for making the suggestions. I hope you are a prolific creator of suggestions of this quality. (If you only produce such gems when sufficiently annoyed by comments like mine, just let me know what blogs you regularly read and I’ll be happy to act as your muse, planting snarky quibbling comments to impregnate your mind with much needed solutions).

  23. #23 Jacob Smith
    November 10, 2012

    “- This is the wrong comparison. It’s not vaccines v. other things. It should be vaccinating v. not vaccinating. You’re better off vaccinating.”

    “The fact that many people die in car accidents is important, but has, literally, nothing to do with vaccinations.”

    You both have missed the point: I am responding to the notion that people should be strongly coerced or forced to be vaccinated. I’m not sure if the blog author herself has directly said this at any time, but it seems to be quite a prevalent attitude on her comment threads, and she seems to have quite the militant attitude.

    If we’re gonna start strongly coercing or forcing people to do stuff for the public good, there are much much *much* lower hanging fruit than anti-vaxxers. That was what I demonstrated with the statistic.

  24. #24 Julian Frost
    NOYDB
    November 10, 2012

    @The Negotiator:

    Besides, they could be charged with fraud as well for telling people the flu shot prevents the flu when it does not.

    Actually, it does prevent the flu. And in the rare cases where an inoculated person gets the flu, the symptoms are much reduced.

  25. #25 elburto
    November 11, 2012

    I am a sovereign independant individual with rights given unto me by God and not government

    Romans 13


    1 Let every soul be subject to the governing authorities. For there is no authority except from God, and the authorities that exist are appointed by God. 2 Therefore whoever resists the authority resists the ordinance of God, and those who resist will bring judgment on themselves.

    Spoiler warning:

    scroll down…

    There is no god, so it doesn’t matter anyway!

  26. #26 Call me Ishmael
    November 13, 2012

    Mr. Negotiator, the fact that you refer to “killer vaccines” and “FEMA concentration camps” just shows how wacky you really are. Shouldn’t you be out stocking up on canned goods and ammo, with the rapture and all that just around the corner?

  27. #27 Spectator
    November 15, 2012

    Just run it by Age of Autism, Natural News, etc.

    They’ll tell you it’s the kid’s defective natural immunity due to genetic inferiority and not eating kelp powder (or whatever) which got them mumps.

    *Their* special snowflake got over it just fine. Gotta thin the herd, ya know!

    // For any anti-vax nuts that don’t get it: you aren’t fit to clip erv’s toenails. Go self-deport an spread your infections where they’re welcome. I hear there’s a province in Pakistan where no vaccines are allowed.

  28. #28 Thomas
    May 5, 2013

    ” I have a friend who is a doctor who will sign a form saying that I got the vaccine.”

    Cool. Doesn’t everyone want a doctor who lies? Hope he cleans his equipment between uses (I know he says he does…)

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