a day ago
Related: US will overhaul childhood vaccine schedule to recommend fewer shots (33 points, 4 days ago, 11 comments) https://news.ycombinator.com/item?id=46504844
Unrelated: MHRA approves self replicating mRNA Covid-19 vaccine (10 points, 5 days ago, 6 comments) https://news.ycombinator.com/item?id=46500392
15 hours ago
This is directionally correct but methodologically flawed.
The US requires 5-10 more vaccines for children by 5 years old than Japan does. Japan also has a much more spaced out schedule over those 5 years.
Given that the American health machine is largely driven by pharmaceutical companies, it seems likely that there is some fat that can be trimmed. Did they trim it here? Who knows.
14 hours ago
Japan has a different medical system, different levels of adherence, different cultural hygiene standards, different exposure risk profiles for different pathogens.
Comparing the U.S. to Japan, or any other system for that matter, with a simple “well the vaccine schedule is different there” is simplistic and almost certainly not useful.
What is useful is to compare the U.S. with and without a certain vaccine or when delaying certain vaccines.
And we know how that plays out because all these vaccines have been added because of specific threats and actual diseases faced by Americans.
13 hours ago
Not sure "comparing A to B is 100% totally useless because A and B have some differences" is a good strategy?
21 hours ago
In many developing countries folks don't get vaccinated either and a lot of them die. TB, Typhoid, Hepatitis and others are still major problems.
So with this approach, the US will be going the way of those developing countries.
Apart from the deaths, there will almost certainly be economic damage.
20 hours ago
Like Japan or Denmark, which closely align to the new schedule?
20 hours ago
Without the postpartum and early childcare of those countries.
Denmark doesn't do mandatory vaccines to the same degree as they catch early development of disease and treat it when it appears, consistently across the whole population.
The US has a case for mandatory multi childhood vacination as the data shows otherwise preventable childhood diseases will spread untreated and unchecked.
If you like Japan and Denmark and want the same - get onto improving the US health system for everybody regardless of employment status.
an hour ago
A lot going on in your statement.
Postpartum, childcare is good but I doubt correlated much with vaccine need.
Denmark doesn’t do anything to “catch” disease early in regards to vaccines at least.
There’s data thing is too broad to even discuss really, there’s a whole ton of data and on the specific ones taken off recommendation the data I’ve seen looks not too controversial.
And US healthcare isn’t so bad as people want to make it out to be, we have easy access to vaccines, top tier hospitals, medicine, and low wait times. It’s expensive and overpriced, and unevenly distributed, but also better in many ways than anywhere else.
29 minutes ago
> we have easy access to vaccines, top tier hospitals, medicine, and low wait times. It’s expensive and overpriced, and unevenly distributed, but also better in many ways than anywhere else.
Aside from being expensive, overpriced, and unevenly distributed you mean?
I'm happy with Australia, it's affordable, available to all through a hybrid scheme, mothers with new babies get regular checkups with or without private insurance, etc.
It's not perfect but it's better than anywhere else.*
* as unsubstantiated as your comment, however in this case supported by a higher national life expectancy
20 hours ago
Really? This seems much stricter than you seem to be suggesting...
https://www.jpeds.or.jp/uploads/files/20240220_Immunization_...
2 hours ago
US moved from the most liberal when compared to all of Europe and Asia, to the more conservative end but not as conservative as Denmark, and close Japan. They’re similar.
20 hours ago
Japanese tend to be irrationally anti-vaccine
18 hours ago
Imagine all the lives saved from fewer immune stimulants.
18 hours ago
Imagining isn’t the way to do this. There is hard data on the harm vaccines cause and the benefit provided. That’s the point of the scientific organisations US taxes fund.
Abandoning a scientific approach and using whatever this administration is doing is what was voted for I guess.
21 hours ago
Looks like they want to reduce population
20 hours ago
Vaccines are unpopular with many. I don’t see why the motives have to be more complicated than that.
But, I would say that trying a different approach that acknowledges how patients feel could help rebuild public trust in healthcare institutions. Taking a broader viewpoint, this could save lives.
19 hours ago
Infants have rights too. It's against the law for a "seatbelt skeptic" not to put their kid in a safety seat.
13 hours ago
As you increasingly mandate things that the public thinks are optional, eventually mandates in general start to look unimportant, and eventually you get less safety seat compliance.
If there are some illnesses we can handle with without universal vaccination, then including those vaccines as mandates means you’ll eventually get less compliance for high-priority vaccines too. This is what we’ve seen play out when the public distrusts medical authorities. We live in a democratic society and (not) listening goes both ways.
5 hours ago
Every disease can be treated without a vaccine. But treatments aren't 100%, and treatments come with their own risk. Taking medicine isn't risk-free, and certainly not necessarily less risky than vaccinations. So, even if you believe it's fine to just treat the disease instead of trying to prevent it, that doesn't mean you skip out on risk. You could have more, just from the medicines alone, not even considering the effects of the disease itself.
5 hours ago
There are vast trade-offs that are worth considering beyond what you’ve outlined. I encourage you to think more about this.
8 hours ago
How many deaths are acceptable to say we can "handle" an illness?
Public health requires over 95% vaccination. There has never been a realistic path to that other than requiring students to be vaccinated to attend school. Without that requirement, even well meaning parents forget or may not make it a priority.
It's not fair for kids and others vulnerable in society to die because certain parents are ignorant.
5 hours ago
Are you prepared to jail people who don’t get covid vaccines? If not, then you understand that there are trade-offs and limitations to what public policies will actually be effective in the real world that actually exists.
Edit: added the following.
> Public health requires over 95% vaccination.
This statement, made without qualifiers, shows that you have more room to think about this. For example, we haven’t had anything like 95% immunizations for smallpox or tuberculosis for a long time, yet public health is no worse off for these reasons.
5 hours ago
Huh? As I mentioned, it has always been a requirement for students to get vaccinated to attend school. My point still holds that if not for this requirement then we'd be below the critical threshold, whether it's 95% or slightly less.
5 hours ago
So, let’s start from the idea that a certain vaccination compliance threshold is needed for each illness that we need to and have the ability to prevent.
And then let’s consider the reality that many parents—enough of them to matter—think there are too many vaccines, so compliance has been eroding.
This is the actual challenge: the medical recommendation might be solid, but a public policy doesn’t work unless people follow it.
Because eroded compliance threatens to undermine those critical thresholds, the public policy’s effectiveness is collapsing.
We can stay the course and watch things collapse, determined that the experts are correct and that the general public cannot be helped, or we can update the policy to be more focused so that we achieve those critical thresholds for the most essential immunizations.
4 hours ago
So you're suggesting that in response to misinformation about provably beneficial safety standards, we should erode the standards.
That encourages even more misinformation, and further erosion of public safety.
3 hours ago
Ah yes, we’re back to the idea that the public cannot be helped. The answer is that the problem is a different, unsolvable one: presumably due to misinformation, members of the public have opinions that are too strongly held for them to follow policies.
19 hours ago
I think the idea that changing stated recommendations based on the public opinion is a questionable strategy that can just backfire into more distrust and behavior that follows the "true" best practices even less as they look for the 'sensible position between extremes'[1].
There are a lot of examples from the response to COVID: frequent early mixed messages around the effectiveness of masks for preventing infection and transmission not based on the actual understanding of said effectiveness but in order to manage supply shortages, arguable overstatement about the one-time long-term effectiveness of the initial vaccines against infection and transmission and not just severity of disease, overemphasis on ineffective measures like hand hygiene or six-foot-distancing over effective measures like air cleaning and masking based on the perceived willingness of the public to follow them, reduction of the stated duration of contagiousness without evidence of such.
It's one thing if it's genuinely not known what the best practices are, but knowing and misleading can confuse people who are willing to follow them and can further alienate skeptics who may seek out charlatans promising them the "real, unfiltered truth".
13 hours ago
Expert opinions are pluralistic, not a monolith, so there’s a judgement call when a policy is written. There is a spectrum of importance when you consider medical interventions. A pluralistic society, including pluralistic opinions among experts, is the norm outside of 1984. It’s just reality.
Policymakers could prioritize more or fewer vaccines, and the reasons to prioritize any particular vaccine would be expected to change over the decades.
Why the CDC isn’t prioritizing more vaccines might be seen as reckless to some. I think it’s a huge mistake that there isn’t a strep vaccine and a universal mandate for that, but it’s clearly not been historically prioritized. Strep has been known for decades to cause mental health conditions in children.
On the other hand, some infections might be better handled by vaccinating around where cases show up, a capability that is possible only now that we have electronic medical records, better tests, the information era, etc. Just-in-time logistics is a huge success story of the modern world.
Opinions of experts are important: expertise requires that opinions should change as the realities do.
An expertise that’s required of a policymaker is to maintain the effectiveness of their institutions by translating expertise into policies that are actually listened to. We have serious warning signs that public trust in healthcare is disintegrating, and that the vaccination campaigns are failing. Policies that are more focused could play out better.
20 hours ago
Vaccines eradicated some of the worst diseases humans had. If thousands of kids were paralyzed by polio vaccines would become very popular again.
19 hours ago
The federal vaccine recommendation on polio vaccines is not changing.
12 hours ago
Why polio and not others?
12 hours ago
Please see: https://news.ycombinator.com/item?id=46566754
17 hours ago
Common Kennedy is THE person that worked very actively and hard to turn people against vaccines.
He wanted to make them unpopular, partially succeeded and now is trying to remove them.
17 hours ago
Maybe we should bring back leeches if we're just going to ignore medical science and instead just go with the feelings of a misinformed public.
13 hours ago
Do you want public advice that is followed (useful) or public advice that is ignored (not useful)?
The ability to have the public accept advice is a capability that has unquestionably eroded. However smart an expert may be, they aren’t helping anyone if people won’t listen when they speak.
12 hours ago
Public advice should be as complete and accurate as possible. If there's a recommendation that is unlikely to be followed, then that can be indicated along with the alternate next best suggestion. e.g. "COVID prevention is best with a complete Hazmat suit, but just a mask may provide some benefit"
The job of experts is mainly to provide information and the job of the public is to pay attention to relevant information. If the public decides to ignore advice (e.g. "no level of alcohol consumption is safe"), then that doesn't change what the advice should be.
11 hours ago
I appreciate the nuance you’re bringing to this topic.
The child vaccinations schedule is a step further than public advice due to its role in clinical practice and social expectation setting. Policymakers have a job that stands apart from that of both the medical experts and the general public, and the child vaccinations schedule is a policy document, not simply a medical one.