Sorry to be a bit snarky here but what word of “as effective in combination as they are individually” is not being understood?
The link and the CDC site both discus that giving them together is no better and no worse than giving them separately. Again the question was asked and answered.
Giving them separately does not reduce side effects nor increase efficacy. All it does is delay when protection is achieved. Which is a real harm.
I suppose under the circumstance, I can’t call you out for missing the statement above, but I can and will for:
No, it is not; it is a risk. A risk doesn’t always result in a harm.
That is why we promote vaccinations; every vaccination has an inherent risk, but most do not result in a harm. The harms vaccinations can result in are usually* less severe than the harms the disease can result in.
It is good for the individual and better for the community to promote, even require vaccinations, but that does not mean we should mislead people.
People already do not trust their doctors, and not always because of misinformation found on the internet, but for very real historical misdeeds and blind arrogance leading to horrible medical practices. Dismissing their concerns does no favor to the practice of medicine.
True, but the idea that massive concurrent vaccinations aren’t dangerous is counter-intuitive, especially given most laypeople’s understanding of how vaccines work. “We’re going to hurt you a little so that you don’t get hurt a lot later,” might be a common explanation for a child. If that’s your only understanding of vaccines, it would seem like common sense that hurting someone a little bit times 1000 is going to kill them. This is just one of those cases where the common sense is wrong, and when people like Dr. Rand Paul publicly announce that they’ve spread out their kids’ vaccinations it only adds to the confusion.
Hell, I was given options as a new parent, and after doing the research I was very annoyed that the inconvenient “make a half a dozen trips to the doctor’s office” option was even suggested. Even though the doctor said there was no evidence that concurrent shots was bad, some part of our squishy ape brain is going to think that there must be some benefit to the inconvenient option, and that benefit must have something to do with concurrent shots being dangerous.
I think this is an excellent description of how most people think about vaccines; all you left out was “no smoke without fire”.
I would argue, though, that your doctor was right to present all your options, s/he just should have given you all the information necessary - like a basic idea of how vaccines work - to make an informed decision.
Well, probably getting 1,000 injections in one day might be as assault on your skin that could have unforeseen consequences, but that’s arguing ad absurdum (which anti-vaxxers do). Getting five or six injections, as opposed to two or three is pretty much the same thing, as far as getting injections goes. A diabetic gets two to five injections every day, plus finger sticks, and some survive decades upon decades of it. Premature neonates survive a lot of skin assaults, and if they can do it, a healthy three-month-old certainly can.
I’m not worried about the vaccine itself, but what about the preservative or whatever fluid is in the bottle? I’ll take all the inoculations you want to give me but maybe I don’t want a gallon of formaldehyde or thimerosal in my arm? Does the non-vaccine part of the shot limit how many a person could/should receive at any one time?
Thimerosal has been eliminated from nearly all vaccines approved for use by the FDA.
Actually, there’s one easily foreseeable consequence: blood loss. I usually lose a volume of blood sufficient to create a 3-4 millimeter spot on a Band-Aid after an immunization. Let’s say the mass of that much blood is 1 gram. 1,000 immunizations means 1 kilogram of blood, or slightly under 1 liter (brief Googling suggests that whole blood is about 6% denser than water.)
That’s approximately 20% of all my volume of blood (~5L). A Class II hemmorhage is 15-30% blood loss, and usually requires intravenous replenishment of fluids (though no transfusion.) Class III hemmorhage, or 30-40% blood loss, is generally fatal without a transfusion.
The American Red Cross apparently draws 1 pint from the typical blood donor, and anyone who has given blood knows that’s enough to make you feel weak and/or dizzy. In other words, 1,000 immunizations given immediately might not kill you but you’re probably going to feel pretty crappy for a while (leaving aside the 1,000 slightly painful spots all over your body.)
ETA: some vaccines are dispensed in non-injectable forms, but the only one I can think of is FluMist.
This doesn’t make sense. If you “had” to get them, then they were required, not recommended. “Recommended” means “This is what we think the best plan of action is, but in the end you have to make your own decision.”
I don’t see the problem - I got the impression that the school district REQUIRED what the medical community RECOMMENDED. Doctors can’t require anything.
a 3-4 mm spot = 1 gram??? :eek:
I think you’re off by a bit at least.
A drop is about 50 microliters (or 20 drops to the milliliter), a drop of blood results in a stain of over a cm on cotton gauze. And density is such that it’s about 1.05 grams to the milliliter of blood.
So you’ll need about 20 drops of blood to get a gram of blood, and let me tell you, 20 drops of blood make a much much bigger mess than a 3-4 mm spot.
You and I see harm differently. To me putting a population of kids at avoidable risk is a measurable harm. Will the harm of morbidity or mortality hit everyone of them? No, of course not. Only a small minority. But it will hit someone given a sizable n. It is the same rationale behind calling moderately chronically elevated blood sugars in diabetics a harm even though some will never have morbidity or mortality as a result. The significant elevation of risk *is *the harm. You are entitled to not see it that way but we will strongly disagree on that point.
No. He was foolish to do so.
My job as a doctor is not to offer options that put both the child and others who the child come into contact with at increased risk and to then let the parent decide between them.
The decision that is at hand for most of us is not presenting that choice but whether or not we are willing to be part of the care if parents decide against our advise to put their and other children at increased risk. I have up to now been of the mind that we should continue to offer care for two reasons: one, the kid still deserves otherwise good care and if no decent docs will care for them then they will end up in the hands of complete quacks; and two, because more often than not over time and with parents developing a relationship with us, we get them to trust us more than the Playboy bunny. But we also make it easier for people to put their and other kids at risk (a harm in my mind) and to some degree validate that course of action as somehow being a reasonable one, even as we tell people the risks they are subjecting their kids and other kids to and have them sign forms stating that they understand such.
No. He was foolish to do so.
My job as a doctor is not to offer options that put both the child and others who the child come into contact with at increased risk and to then let the parent decide between them.
The decision that is at hand for most of us is not presenting that choice but whether or not we are willing to be part of the care if parents decide against our advise to put their and other children at increased risk. I have up to now been of the mind that we should continue to offer care for two reasons: one, the kid still deserves otherwise good care and if no decent docs will care for them then they will end up in the hands of complete quacks; and two, because more often than not over time and with parents developing a relationship with us, we get them to trust us more than the Playboy bunny. But we also make it easier for people to put their and other kids at risk (a harm in my mind) and to some degree validate that course of action as somehow being a reasonable one, even as we tell people the risks they are subjecting their kids and other kids to and have them sign forms stating that they understand such.
Most kids vaccines anyway are now preservative free.
No, you’re playing Humpty-dumpty there; a risk is not a harm, it is the potential for a harm.
People decide to not vaccinate their children when they cannot distinguish between the risk and the harm. By conflating risks and harms, you are undermining efforts to create an informed populace who will not endanger children because of wide-spread lies.
People are not stupid; even if they have not been educated in the fundamentals of risk analysis, they do know that a vaccine eliminates a risk - prevents contracting a disease - rather than ameliorates a harm - such as curing a diseases.
Your job as a medical professional is to provide your patients or their care-givers with the information necessary to make informed decisions. You cannot make their decisions for them. You should not provide them with only the information you think will encourage them to make the decision you approve of.
When patients doubt the wisdom of medical advice, dismissing their concerns as unwarranted without clear explanations is only effective with a small population, usually those with post-secondary education in non-scientific disciplines.
Really? So every single fear or perception that anyone has ever had **must **have some basis in reality?
It couldn’t possibly be that folk axioms are of no value in assessing medical matters?
You’ve missed the fact that there was a legitimate medical concern that concurrent injection of live-attenuated-virus vaccines might not be as effective as spaced-administration.
This is the reason that those studies were done.
Millions of people were warned not to have their injections too close togethor: many people don’t remember that, bit it had an effect on the cultural understanding of vaccinations.
That does not follow, at all.
steronz provided a description of “most laypeople’s understanding of how vaccines work.” I think it was accurate. I added my suspicion that most laypeople have a “no smoke without fire” attitude to criticism of vaccines.
Nowhere did I (or steronz) suggest that what you impute to me.
But I will push right back; trivializing and mocking a person’s concerns is not an effective way to get them to trust you or accept your advice.
We are not discussing folk axioms here; we are discussing one of the most important elements of biochemical based medicine. I would argue that the only thing more important to public health than vaccinations is clean drinking water.
This is an incredibly important issue, not a matter for attempts at rhetorical point-scoring, in this thread or IRL. We should not dismiss people’s concerns out of hand, especially when those fears are based in a large part on mistrust of medical professionals.
These people have not read Brian Deer. They have not signed up for daily email alerts from the CDC. They have no idea how the immune system works. They don’t understand how peer-reviewed scientific journals work. Hell, most probably don’t grasp the distinction between a thesis and a theory.
But they want to make the best choices for their children, and there is not a whole hell of a lot a historical justification for believing that blindly following the recommendations of a medical establishment will do that, and arrogantly sneering at those who question the recommendations will not persuade them to do so.
Ignorance fought. I’m not very good as estimating the weight of things.
I totally agree with you, FWIW. Suppose you have a parent who is overly concerned about side effects of a medicine, even if it’s something like a cough medicine, that may be more for comfort, and not as necessary as say, an antibiotic (yes, I know there may be some situations where a cough medicine can be life-saving-- my son has had croup). It is not your place to say, “Well, there are homeopathic ‘remedies,’ which are just water, but if you really sell them them as working well, and maybe put a little flavoring in them so they taste like real medicine, they might have a placebo effect.” That would technically be presenting ALL options, but it would also be stupid. You’d get deservedly laughed at by other doctors, and by at least some of your patients.