# Is there any good reason not to mandate national vaccination? **URL:** \ **Category:** Great Debates\ **Created:** [March 24, 2014, 3:54pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447 "2014-03-24T15:54:44Z")\ **Posts on this page:** 20\ **Page:** 12
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [April 3, 2014, 10:11pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/221 "2014-04-03T22:11:52Z")
> [@Marley23](#): > > And how do you know that? Czarcasm’s post # 109 ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [April 3, 2014, 10:12pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/222 "2014-04-03T22:12:25Z")
> [@kanicbird](#): > > I do not know that, I assume they are a very vocal minority. Look it up instead of assuming. > [@](#): > > Must have missed that, please provide me where this has happened Go back and find it yourself. > [@](#): > > Do you wish to challenge Czarcasm’s cite? If not how can you say there are not hard numbers that can be determined? I am not challenging **Czarcasm** ’s cite. I am making the very simple and elementary point that these are ranges, and thus it’s hard to know exactly how many people need to be vaccinated. ---
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [April 3, 2014, 10:16pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/223 "2014-04-03T22:16:05Z")
> [@Marley23](#): > > Look it up instead of assuming. > > Go back and find it yourself. Well, I think we end it at this point, you are making a unsubstantiated claim and ask me to prove you right. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [April 3, 2014, 10:16pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/224 "2014-04-03T22:16:24Z")
No, I’m telling you to read things that were already posted. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [April 3, 2014, 10:19pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/225 "2014-04-03T22:19:29Z")
> [@Marley23](#): > > And how do you know that? He doesn’t. There are estimates for what levels of vaccination are needed to provide adequate herd immunity for different diseases, and 85% would fall around the minimum threshold for some of them (not that you want to be monkeying around at the bare minimum immunization rate). However, higher vaccination rates are thought necessary to contain pertussis and measles (over 90%), and even then the conventional models [may be overly optimistic](http://cid.oxfordjournals.org/content/48/5/685.full). If you get a susceptible person introducing disease and there are enough clustered individuals not protected by immunization (or whose shots have been rendered less effective by the passage of time or because their immunity is deficient for whatever reason), it may not matter if \>90% of the overall susceptible population is vaccinated. All the more reason to keep the vaccination rate as high as possible and not rely on the “minimum” number. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [April 3, 2014, 10:26pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/226 "2014-04-03T22:26:45Z")
Part of the problem is that, without a national health records database, we just don’t know for sure what percent of our population is being vaccinated. We have several different ways that we try to gather that information. Some groups interview individual doctors to gather data on how many of their patients have been vaccinated. Some groups examine school records to determine how many of those students have been vaccinated. Some groups telephone parents to ask them if their children have been vaccinated. Some groups track how many vaccine doses are purchased by hospitals, doctors, pharmacies and clinics to try to estimate how in demand those vaccines are. All of these methods have flaws. Doctor interviews don’t give us information about people who get immunized at vaccine fairs. School records tell us nothing about homeschooling families. Parent interviews don’t account for faulty recognition, misunderstanding of the vaccine schedule or outright lying to tell the interviewer what the parent thinks they want to hear. Vaccines dose orders don’t give us information about doses that were discarded due to error, expiration or because someone overestimated how many patients would want the vaccine this month and ordered too many. All of them suffer from selection bias, in that the group interviewed or tracked may not be representative of the population as a whole. And even if we could get an accurate measure of how many doses of a vaccine have been administered, we don’t have accurate census numbers of our population! We do a national census every 10 years. So we can’t account for births, deaths, emigration or immigration to truly know our population at any current time. The WHO collects estimates from each member country, [and the US numbers are available here](http://apps.who.int/immunization_monitoring/globalsummary/coverages?c=USA). Notice that even there, our most recent information is 2 years old. We have no idea how many people are \*currently \*vaccinated, because we’ve had a lot of new individuals added to our population in two years, and a lot of individuals leave our population in two years. NOW, add in the fact that immunity for some, maybe all, vaccine effectiveness wanes over time, and add in that some people who do vaccinate never “seroconvert” - they don’t actually form the immunity to the thing they were vaccinated for. We don’t know those numbers, either. So we’ve got a lot of people who were indeed vaccinated, but who don’t count for establishing herd immunity. So the best we can come up with, with any of these methods, is an \*estimate \*of what percent of our population is probably vaccinated and probably immune. And we do have estimates. We have lots of estimates, derived from lots of ways of trying to count, and they don’t all agree! But yes, we can, compare estimated vaccination rates to the theoretical herd immunity rates. And the results aren’t good. For the visually inclined, [here are a couple of graphs which show which states met or did not meet theoretical herd immunity vaccination levels in 2011](http://media.wbur.org/wordpress/15/files/2013/08/too-many-children-go-unvaccinated_2.jpg). Red marks mean they were below herd immunity vaccination rates. Blue marks mean they met herd immunity marks. These graphs are for DPT and MMR. There’s way too much red on these graphs. So, no. Apparently we don’t have “room” for the personal choice exemptions if our goal is herd immunity vaccination rates, because with that system, we’re not meeting herd immunity vaccination rates. You may have just persuaded me that truly mandatory vaccination is actually a good idea. I’m going to have to go ponder that some more… ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [April 3, 2014, 10:31pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/227 "2014-04-03T22:31:25Z")
> [@kanicbird](#): > > Yes I took that specific post in mind throughout this debate, that shows that in certain cases up to 15% or more of the population can remain vaccinated while still maintaining herd immunity. > > So what is the issue here, that leaves 15% of the population able to remain un-vax (Large enough I assume to include both the health compromised and the anti-vax crowd). And yet you totally ignore my followup statement that among the remaining 15% there are those that cannot be vaccinated due to allergies, that that will not be vaccinated because they are accidentally skipped over, those that mistakenly think they have already been vaccinated, and those for whom the vaccination just didn’t take. How much leeway is there left for those that just don’t want to get vaccinated? Who the hell knows? ---
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [April 3, 2014, 10:33pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/228 "2014-04-03T22:33:53Z")
> [@WhyNot](#): > > So, no. Apparently we don’t have “room” for the personal choice exemptions if our goal is herd immunity vaccination rates, because with that system, we’re not meeting herd immunity vaccination rates. your link is broken > [@](#): > > You may have just persuaded me that truly mandatory vaccination is actually a good idea. I’m going to have to go ponder that some more… This GD is also persuading me that mandatory vaccinations is a good idea. ---
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [April 3, 2014, 10:36pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/229 "2014-04-03T22:36:37Z")
> [@Czarcasm](#): > > And yet you totally ignore my followup statement that among the remaining 15% there are those that cannot be vaccinated due to allergies, that that will not be vaccinated because they are accidentally skipped over, those that mistakenly think they have already been vaccinated, and those for whom the vaccination just didn’t take Already accounted for **Czar** so yes i did take that into consideration, very mucnh so and have from the start. My question is if there is additional room, which has not been addressed. > [@](#): > > How much leeway is there left for those that just don’t want to get vaccinated? Who the hell knows? that is what I stated multiply times it’s up to the mathematics. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [April 3, 2014, 10:40pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/230 "2014-04-03T22:40:08Z")
> [@kanicbird](#): > > Already accounted for **Czar** so yes i did take that into consideration, very mucnh so and have from the start. My question is if there is additional room, which has not been addressed. Then let me address it directly: Unless and until we know exactly how much of the 15% those categories I mentioned take up, we cannot assume that there is _any_ additional room. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [April 3, 2014, 10:52pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/231 "2014-04-03T22:52:29Z")
> [@kanicbird](#): > > CITE PLEASE!!! As I said, the CDC has all the information you need. I see no reason to replicate their research. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [April 3, 2014, 10:54pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/232 "2014-04-03T22:54:29Z")
> [@kanicbird](#): > > Yes I took that specific post in mind throughout this debate, that shows that in certain cases up to 15% or more of the population can remain vaccinated while still maintaining herd immunity. > > So what is the issue here, that leaves 15% of the population able to remain un-vax (Large enough I assume to include both the health compromised and the anti-vax crowd). Answered in post #210, I am not typing it all over again. Cite: Center for Disease Control in Atlanta, Georgia, USA. ---
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [April 3, 2014, 10:58pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/233 "2014-04-03T22:58:31Z")
> [@Broomstick](#): > > Answered in post #210, I am not typing it all over again. Cite: Center for Disease Control in Atlanta, Georgia, USA. Your cite #210 I also use to defend my potion, so yes I accept it yet it does not prove your point. ---
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [April 3, 2014, 11:00pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/234 "2014-04-03T23:00:28Z")
> [@Broomstick](#): > > Answered in post #210, I am not typing it all over again. Cite: Center for Disease Control in Atlanta, Georgia, USA. As for you cite, this is what I got from it: [https://www.google.com/maps/preview?oe=utf-8&client=firefox-a&channel=rcs&ie=UTF-8&q=Centers+for+Disease+Control+and+Prevention&fb=1&gl=us&hq=Center+for+Disease+Control&hnear=0x88f5045d6993098d:0x66fede2f990b630b,Atlanta,+GA&cid=1310566027616466354&ei=pOc9U-HCFJbLsQTw5YGYBA&ved=0CKQBEPwSKAAwCg](https://www.google.com/maps/preview?oe=utf-8&client=firefox-a&channel=rcs&ie=UTF-8&q=Centers+for+Disease+Control+and+Prevention&fb=1&gl=us&hq=Center+for+Disease+Control&hnear=0x88f5045d6993098d:0x66fede2f990b630b,Atlanta,+GA&cid=1310566027616466354&ei=pOc9U-HCFJbLsQTw5YGYBA&ved=0CKQBEPwSKAAwCg) I can’t see any relevant information in that to this subject although I can determine my drive time to it. It is apx 14 and 1/2 hours. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [April 3, 2014, 11:00pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/235 "2014-04-03T23:00:50Z")
Did you actually _go and look at some figures_ or are you still squeezing reality to conform with your fantasies? Only SOME diseases allow 15% unvaccinated, others require 95% _or more_ vaccinated. Please read the entire post rather than just cherry-picking. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [April 3, 2014, 11:03pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/236 "2014-04-03T23:03:31Z")
> [@kanicbird](#): > > As for you cite, this is what I got from it: > > I can’t see any relevant information in that to this subject although I can determine my drive time to it. It is apx 14 and 1/2 hours. #1 - you really need to be told to _go to their website?_ I know you’ve been on the internet longer than a week, please don’t pull stunts like that in GD. #2 - I’ve told you where I got my information, which is all that is required from a cite. If you can’t be arsed to actually look at the source I can’t help you. ---
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [April 3, 2014, 11:03pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/237 "2014-04-03T23:03:54Z")
> [@Broomstick](#): > > Did you actually _go and look at some figures_ or are you still squeezing reality to conform with your fantasies? > > Only SOME diseases allow 15% unvaccinated, others require 95% _or more_ vaccinated. Please read the entire post rather than just cherry-picking. And you are yet to prove that the people at risk (due to health reasons) and should not be vaccinated combined with the people who do not wish to be vaxed exceed even the 5% of the population in some cases. Is the anti vax crowd so numerous that they can actually make such a difference? ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [April 3, 2014, 11:15pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/238 "2014-04-03T23:15:19Z")
I don’t think we should allow them their way long enough to find out. If you don’t have a good reason for not being vaccinated you should be vaccinated. Ditto for your kids. It’s an issue of public health and safety. ---
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [April 3, 2014, 11:18pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/239 "2014-04-03T23:18:17Z")
> [@Broomstick](#): > > I don’t think we should allow them their way long enough to find out. It is a good point, however Czarcasm’s post #109 shows percentage of population to maintain herd immunity. So it is apparent that we have found out, where do we go from here? ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [April 3, 2014, 11:21pm UTC](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447/240 "2014-04-03T23:21:02Z")
> [@kanicbird](#): > > your link is broken Huh. It works for me. Try this one, and click on the graphic on the top for a bigger version. You might also want to read the article, as it’s directly relevant to the conversation, but way too much to quote here: [Opting-Out Of Vaccines; Dipping Below Herd Immunity](http://commonhealth.wbur.org/2013/08/low-state-vaccine-rates) [Previous page](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447.md?page=11) [Next page](https://boards.straightdope.com/t/is-there-any-good-reason-not-to-mandate-national-vaccination/684447.md?page=13)