Damn right they should pay.
…with their children’s lives…[evil laugh]…
Let me just say that I must publicly advocate for a return to civility in the discussion regarding vaccines! 
My antipathy for Wakefield is well-known, and my “first, second, third up against the wall when the revolution comes” lineup is Wakefield, the Geiers, and Sears.
Why isn’t Jenny McCarthy in that list, you may ask? Because while I despise her, I truly think that she was frantic and frightened when her son developed problems, easily misled, and is simply just too fucking stupid to realize that she’s been led along by the nose by people who have an agenda.
Oh, and add Barbara Loe Fisher and Sherri Tenpenny to the list of people who need punched in the face.
That’s what it’s going to take. But those children will have to be white, and middle- to upper-class children for anybody to care.
I wouldn’t at all be surprised if middle to upper class white kids are the ones whose parents are the most likely to be anti-vaxxers. This kind of stupidity seems like a luxury, after all, and articles cite that higher income/more educated people (ironically) are the least willing to vaccinate.
I have no problems with charging more for insurance for unvaccinated people, or anyone on Chief Pedant’s list, really. Risky behavior leads to increased costs for everyone.
If we really want to get some vaccine doubters to vaccinate we should revoke the blanket immunity from prosecution and financial damages that drug companies and manufacturers of vaccines currently enjoy. I don’t think very many people really doubt or fear the concept of vaccination in general. The fear comes from the small but real chance of adverse reactions, contamination, inert ingredients that turn out to be toxic, mislabeling, and negligence or malfeasance on the part of anyone involved in the long chain from research to manufacture to distribution to storage and delivery to patients. Granting them all complete immunity encourages the creation of new vaccines that might never exist otherwise but it also harms public trust in the whole process.
Under the circumstances it isn’t that hard to understand why some parents think they are making a tough call (a dispassionate grasp of probability isn’t a legal requirement for parenting). And of course in those few cases where someones kid does die it would certainly be easy for them to argue that it would have been the best call, and that their kid shouldn’t have been forced to take one for the team. The same people would probably take their kid straight in for a tonsillectomy, eye exam, or basic dental work without hesitation. They trust in that process because the entire industry is regulated by the threat of severe financial and legal penalties for any negligence that leads to injury or death. Whether by the doctor, their equipment, medications, a nurse, receptionist or anything else - someone is going to get sued if a patient dies or is injured due to a simple mistake, negligence, or outright malicious intent. But no such reassurances exist for vaccinations. If they did, in a short time getting the kids vaccinated would be no more terrifying to a lot of the anti-vaccine parents than any other basic medical procedure is now.
I don’t know that would be such a good idea. Unless you’re going to keep them under quarantine, all this would achieve is putting a large number of prone-to-infection people in the same building as other likely-to-already-be-infected people, then letting them spread their plagues across the land come 3 o’clock.
A classic anti-vax argument, and a bad one at that.
I assume you’re referring to the “Vaccine Court,” and your information is wrong. First off, drug companies CAN be sued for vaccine problems, reactions, adverse events, etc…, they just have to be sued in the aforementioned vaccine court, which is a division of the US Court of Federal Claims, not in regular state or federal civil courts.
It was established because in the 1980’s, a LOT of people were suing makers of the DPT vaccine (for unfounded reasons, no less) and manufacturers were being forced to pay very large awards to the plaintiffs. Manufacturers were threatening to stop making the vaccine, which could lead to a resurgence in the diseases it vaccinated against, so a special court was created with funds from taxes on vaccines to compensate victims of legitimate adverse events from vaccinations.
Vaccines are loss-leaders for pharmaceutical companies. They make little if no money from them, and if there wasn’t a special federal court to mitigate costs associated with adverse events, many might stop making vaccines entirely because it wold be too costly for too little gain, especially with thousands of people now trying to sue them for autism related claims (though it seems several of them have found a loop-hole in that they are suing the manufacturers of thiomersal in regular court.)
Oh, and the vaccine court actually rules in favor of the plaintiff more often that regular malpractice cases, so it’s actually in the plaintiffs benefit to use that court and not a regular malpractice one as you advise.
Edit: I also forgot to add, I seriously doubt there are many (if any) parents that are unwilling to vaccinate simple because they are afraid they won’t be able to sue the drug company in regular civil court if something goes wrong. Most don’t vaccinated because they are un-educated on the issue, and prefer “real life” stories of other parents INSISTING that the vaccines gave their kid autism, rather than the cold, hard facts and percentages that say everyone that can get a vaccine is better off doing so.
I strongly suspect that once the antivax parents realize that they won’t be able to benefit from a relatively high percentage of immunized children in their school and that their kids are facing a heightened risk of infection, they’ll discover the benefits of vaccines.
It’s uncertain how low the vaccination rate will have to get before these people wake up. In some California schools 40% or more of kids are unvaccinated.
As others have noted, it probably will take a major epidemic (of measles or diphtheria, for example) to get through to parents who refuse to protect their children. Not that I am nostalgic for the days when even worse ailments were around, but there was a major awakening in the 1940s in New York City when smallpox reappeared there after a long absence. There were “only” about a half-dozen deaths during that outbreak; however it was remarkable how fast residents lined up to get vaccinated (going from very spotty to near 100% coverage in a matter of days).
Yes, I have read the Wikipedia article on vaccine courts too. it is their existence that prompted my post, they are designed to shield the manufacturers and those involved in the distribution and application of vaccines from liability and criminal prosecution. The so called vaccine court is a joke, it is purely an instrument we used to bypass our own civil and criminal justice system specifically for the protection of vaccine makers because we feared mass shortages of vaccines if the drug companies started bowing out due to legal and financial liabilities they faced. Incidentally I am not an ‘anti-vax’ person. I understand probability and I am vaccinated. If I were a parent my children would be too, despite the audacity of the premise of ‘vaccine courts’.
What I meant to say (but admittedly never actually got around to saying in my late night post), was that the current system offers no legal or financial penalties to vaccine manufacturers even in cases of outright negligence. They don’t pay any awards that come from the vaccine courts, we do. As a part of the 1986 National Childhood Vaccine Injury Act that created this court, a surcharge on vaccinations was also created to contribute to a fund for paying out vaccine court claims.
This system practically encourages negligence and corner cutting on their part. Its like having a $2.00 “pizza court” charge added to every pizza sold in the country to fill up a fund for paying out liability claims in case a pizza restaurant accidentally sends you a pie covered with glass shavings and rat poison on it. The executives of all pizza restaurant chains would be given completely criminal immunity from any injuries related to their pizzas and consumers who are injured as a result of eating their pizza have only one redress, a ‘pizza court’ that is strictly liability court paying settlements out of the “pizza fund” If a mistake like that weren’t going to cost the company millions and possible criminal prosecution for those involved, and if any financial settlement would just come out of a fund that pizza customers paid for in the first place I would be very afraid to see what happens in pizza kitchens across the country. If that new pizza court made a lot of news headlines, and at the same time there was a vocal lunatic fringe out there claiming pizzas caused autism, contained mercury, etc. we would see a steep drop in the number of consumers who did business with pizza restaurants.
I am not an anti-vax person. I understand probability and calculated risks. I am vaccinated. If I had children, they would be too. But I disagree that shielding vaccine companies from any criminal liability and all financial liability does not prevent people from vaccinating their kids. It does. I have heard the argument numerous times from people who are ‘anti-vax’. Seriously doubt whatever you like - it is an easily verified point, read a few lines on any anti-vax forum or website and you will quickly find this argument rises to the top trumping most claims of autism, mercury, etc. It is way up there on the list, and it doesn’t make any sense to me even being a supporter of vaccination.
Minnesota has it right, I think:
Unfortunately, the idiots have an out and its name is Christ . Because it’s so irritating, I’m posting the whole thing.
Fking nutty sh. This pisses me off to no end.
I would strongly suggest that you read the new Paul Offit book. Dr. Offit is the head of the infectious disease unit of the Children’s Hospital of Philadelphia. In Deadly Choices: How the Anti-Vaccine Movement Threatens Us All Offit goes into great detail about the court in question.
He lays out the case that the isn’t that courts are shielding vaccine manufacturers. On the contrary, he argues that the courts have been bending over backwards to pat the anti-vaxxers on the back and give them money to support bad claims.
Vaccines aren’t like pizza. You can go through life without it. Granted I think you’ll miss one of life’s great delights. But non-vaccination is not like that. Either we vaccinate our babies or they get sick. Either we give measles vaccines or we will get measles. The problem is that when give vaccines out we will get a very small percentage of the population that will suffer serious side effects as a result.
We have to find the some way of compensating these people for taking that risk. The vaccine court is flawed but it is the best solution to an otherwise extremely difficult problem. If we give people the unlimited right to sue vaccine manufacturers, we give them the right to put the vaccine makers out of business. That benefits no one include children who react poorly to vaccines as they will react to contagious disease as well.
This is a public issue not a private one. FYI, vaccines are seriously vetted before being brought to market. They continue to be monitored afterwards as well. If issues are found, the vaccine is removed for further testing.
You raise one legitimate point, and a bunch of irrelevant ones.
Being fat may or may not be a conscious health-related choice. Sleepers-around, sure, but it’s virtually impossible to determine who is and isn’t promiscuous, just as it is to determine who consumes excessive quantities of alcohol.
Smokers, on the other hand, are different.
Thus, I have no problem with higher rates for smokers. They already pay higher life insurance premiums, and in many cases they do pay higher health insurance premiums (or do not benefit from non-smoking discounts, which amounts to the same). It’s easy to tell them apart from non-smokers.
Similarly, it’s easy to draw a bright line between vaccinated children and non-vaccinated children.
A mandate with an exemption for “my imaginary friend says so” is no mandate at all.
Sure, I could easily support the idea in only those cases of the rare but inevitable adverse reaction not due to any errors or negligence. And I’m not saying that people can’t collect even in negligence claims as it is now, but that money doesn’t come out of the company’s pockets it comes out of ours, everyone who does get vaccinations. It’s not a question of the likelihood of negligence, and it is a given the vaccines are meticulously tested and vetted despite the company facing no real risk if an error is made. Its all about perception. The trust or mistrust of the on-the-fence-about-it person who is otherwise reasonable. These are private, for-profit companies and they should be setting aside money for paying claims in any cases that they just screw up. Knowing that any screw up, no matter how grossly negligent or dangerous to consumers, won’t cost them a dime or expose them to any form of criminal prosecution can not be expected to bolster consumer confidence. Combine that with wild claims of autism, conspiracies, religion, etc. and you have the ‘anti-vax movement’. Take it away, and the rest of them would pretty much go by the wayside. There will always be a lunatic fringe but among all of the anti-vax arguments, complete immunity from criminal and financial penalties for negligence granted to these for-profit, private companies is the only one that seems to also resonate with otherwise reasonable, mainstream society.
The point raised in the book you recommend is undoubtedly true, as the vaccine court pays claims fast and easy (because hey its free money, its not costing the drug company or the court a penny to do so) it probably encourages others to believe there is a greater risk of adverse reaction than there really is.
It’s my understanding that the 1980s legislation that set up the Vaccine Court (as it’s popularly known) did not totally exempt manufacturers from being sued elsewhere. The law refers to protection against suit due to “unavoidable” risks of vaccines. It would be difficult to argue that something like gross negligence in the manufacturing process is an “unavoidable” situation.
What’s now up for ruling by the Supreme Court is whether a vaccine maker can be sued outside the vaccine court for not using an allegedly safer vaccine design than the one that went to market.
Additional facts about the vaccine court: before the legislation was approved a number of DPT vaccine makers had stopped production and there was a real threat of not meeting supply needs. Even with the protection that exists against lawsuits, we had a situation a few years ago where there was a major shortage of flu vaccine due to a U.S. maker’s production problems, and we were dependent on imported British vaccine. If companies are blithely racking up profits in vaccine manufacture free from litigation worries, how is it that there are so few manufacturing vaccines as compared to years ago?
If we return to the litigation-happy situation of years past, look for remaining companies to drop out of the market entirely. Then the government will have to step in, and costs to taxpayers will go through the roof.
It is a little understood (and even less advertised) fact about vaccine immunity that it rests upon periodic boosting via exposure in much the same way as natural immunity does.
The difference is that the fully vaccinated and “immune” acquire and circulate subclincal infections and remain largely asymptomatic, whereas the unvaccinated or those with failed vaccine immunity tend to display clinical infections and symptoms.
One effect of this is that the fully vaccinated can and do transmit infections to others. Another is that they can do so without ever displaying any symptoms of infection themselves, making it impossible to identify or isolate them.
I know this flies in the face of the meme of the unvaccinated individual being the sole vector of illness, placing everyone else at risk, but it is the case.
Vaccination, when it “takes”, protects against clinical illness in the vaccinated individual. It does NOT necessarily prevent infection or transmission. Indeed, if it DID, vaccine immunity would wane very rapidly, even more so than it often does…there must be a certain level of transmission going on in the population to periodically boost the immunity of the vaccinated.
Given the percentages involved, it is usually more likely that an outbreak originated in a fully vaccinated person and spread to an unvaccinated or vaccinated but non-immune individual or individuals. But of course, since the unvaccinated or otherwise non-immune (vaccine failure/waning) victims are the only ones who display any clinical symptoms, they are the only ones who get diagnosed (and blamed).
Just something to bear in mind in the on-going railings against the disease-spreading, evil, ignorant unvaccinated. 
A few (of the many) examples of this in action:
Damien B, Huiss S, Schneider F, Muller CP. Estimated susceptibility to asymptomatic secondary immune response against measles in late convalescent and vaccinated persons. J Med Virol 1998 Sep;56(1):85-90
“Serological evidence indicates that measles virus (MV) could circulate in seropositive, fully protected populations. Among individuals fully protected against disease, those prone to asymptomatic secondary immune response are the most likely to support subclinical MV transmission. The serological characteristics of protected subjects who developed secondary immune response after reexposure to measles have been described recently [Huiss et al. (1997): Clinical and Experimental Immunology 109:416-420]. On the basis of these data, a threshold of susceptibility was defined to estimate frequencies of secondary immune response competence in different populations. Among measles, late convalescent adults (n = 277) and vaccinated high school children (n = 368), 3.2-3.9% and 22.2-33.2%, respectively, were considered susceptible to secondary immune response. A second vaccination did not seem to lower this incidence. Even when estimates of symptomatic secondary immune response (e.g., secondary vaccine failure) were taken into account, susceptibility to subclinical secondary immune response was still 5-8 times higher after vaccination than after natural infection. Although viral transmission between protected individuals has never been directly demonstrated, the data describe a population in which protected but infectious persons could potentially be of epidemiological importance.”
(Please note that the older adults (those who were NATURALLY immune to measles due to having had it as children) were FAR less likely to be vulnerable to subclinical infection and transmission than their younger, vaccine-immune, counterparts. )
http://www.cdc.gov/ncidod/eid/vol6no5/srugo.htm
“Pertussis Infection in Fully Vaccinated Children in Day-Care Centers, Israel
We tested 46 fully vaccinated children in two day-care centers in Israel who were exposed to a fatal case of pertussis infection. Only two of five children who tested positive for Bordetella pertussis met the World Health Organization’s case definition for pertussis. Vaccinated children may be asymptomatic reservoirs for infection…
The whole-cell vaccine for pertussis is protective only against clinical disease, not against infection (15-17). Therefore, even young, recently vaccinated children may serve as reservoirs and potential transmitters of infection.”
(This applies to the modern-day, non-whole-cell pertussis vaccine as well, jftr)
"Lancet. 1999 Jan 9;353(9147):98-102.
Effect of subclinical infection on maintaining immunity against measles in vaccinated children in West Africa.
Clinical measles occurred in 20 (56%) of 36 unvaccinated children and in one (1%) of 87 vaccinated children. Subclinical measles occurred in 39 (45%) of 86 vaccinated children who were exposed to measles and in four (25%) of 16 unvaccinated children. The frequency was inversely related to pre-exposure antibody concentration (p<0.001 for trend) and directly related to intensity of exposure (p=0.002 for trend). Antibody concentrations in subclinical cases increased on average by 45-fold and remained raised for at least 6 months.
…Increased antibody titre after subclinical measles may be common in vaccinated children in West Africa where the intensity of exposure is high. As measles vaccination coverage increases, the circulation of wild measles will decrease, and vaccine-induced antibody is less likely to be boosted. Thus, new epidemics, albeit milder in form, may occur in vaccinated areas which should be recognised in campaigns to eradicate measles."
Sigh. Another misleading and misinterpreted Gish Gallop from our resident antivaxer, InterestedObserver.
This latest post attempts to shift blame for disease outbreaks onto the vaccinated. But it doesn’t wash.
No one claims that vaccines are 100% effective in preventing illness. In some instances an immunized person can develop infection, whether in less severe form or not.
It is ludicrous however to suggest that immunization against measles is a risk factor for measles outbreaks. Before measles vaccine was introduced in 1963, almost everybody got measles by age 20. The vaccine decreased incidence by more than 99%. By 2008 there were only 140 cases of measles reported in the U.S., mostly due to infection imported from abroad and mostly occurring in unvaccinated persons.
InterestedObserver apparently didn’t read the whooping cough article very well, since he/she missed the following conclusion:
“Whether a child who is serologically or PCR positive for pertussis and is clinically asymptomatic is a potential transmitter of infection has not been established.”
A high rate of immunization for pertussis (whooping cough) is not absolute protection against outbreaks, partly because vaccine protection wanes with age if boosters are not given (as the article notes). But a major factor is the rate at which the most susceptible (i.e. young children) get vaccinated. Potential spread of disease from older people with imperfect immunity becomes far less important if vulnerable kids are fully immunized.
I don’t think we want to return to the situation of decades ago in the U.S., where adults could have their immunity to infectious diseases “boosted” by coming in contact with large numbers of infected children. We have a lot more immunosuppressed people now (including those with HIV, post-organ transplantation and with immune suppression due to cancer therapy). Those people are at risk from preventable infectious diseases too.
That bullshit vaccine “exemption” is riddled with “Sovreign Citizen” garbage. Ugh.
InterestedObserver, even if the vaccinated were always carriers of the disease, being asymptomatic will still make them far less likely to transmit the disease to others. It is the symptoms of a disease that makes some of them so contagious - the common cold wouldn’t be anywhere as common if it didn’t make people cough and sneeze.
Besides, we have absolute proof that vaccination can reduce the rate of transmission below the level required for the long-term survival of the disease, because that’s how we drove smallpox to extinction. If not for these pro-disease lunatics, we would be far closer to doing the same to measles.
Allow me to add my two cents to Jackmanni’s comments.
No. Vaccine immunity does not rest upon periodic boosting via exposure. That is a bullshit comment.
Some vaccines do require boosting. Adults should be vaccinated for pertussis for example every ten years for that reason and primarily to protect those at greatest risk of becoming more seriously ill - those babies who have not yet had a chance to get their first three doses in - a number larger given all these stupid alternate delayed schedules out there.
Some people do still get disease after vaccination due to waning or incomplete immunity. Some also get subclinical infection. Those who still get disease are significantly less contagious than those who have disease without being vaccinated and those who get subclinical infection are very likely not contagious at all (at least there is no evidence that they are). In a highly vaccinated community (like in the developed world, rather than West Africa) this is a fairly small number because relatively few are exposed. That’s the whole point of herd immunity.
The cited articles demonstrate something very different that you seem to think they do:
Given ongoing exposure, such as in West Africa, those previously vaccinated may get subclinical infection 45% of the time, which has not been shown to be contagious at all. Actual disease among those vaccinated in face of such ongoing exposure? Only 1%. Those unvaccinated get disease 56 times more often than those vaccinated and less than one in four of those unvaccinated in that environment escapes any infection at all.
Even those with disease after vaccination are significantly less contagious than those who were vaccinated (see for example this study that demonstrated that clinical break through disease after chickenpox vaccination is half as contagious as disease in unvaccinated individuals).
Let’s take this one step further and look at two vaccine preventable diseases: pertussis and chickenpox. I choose them because they are somewhat opposites - pertussis is most dangerous for the young who are not yet fully protected and chickenpox most dangerous for the unvaccinated adult. Now choose surrounding those two individuals with people who are vaccinated or people who are not and introduce an infected individual into the town. Even assuming some significant degree of subclinical infection and assuming (even no evidence exists that such is the case) that there is some small degree of infectivity among those with subclinical infections, those at high risk of serious illness if they get disease have little chance of being exposed if surrounded by those immunized. However the more completely unprotected individuals around, the more they may serve as stepping stones to reach the highest risk person. Even if they are adults who don’t get bad disease from pertussis or kids who are fairly unlikely to get seriously ill from chickenpox.
Thank you very much for your highly informative post. I really appreciate it when posters with a medical background jump into these discussions. I’ve been following this issue for years from the point of view as a reasonably well educated parent with no science background. You and Jackmanii always do an excellent job helping us non-medical people increase our understanding of this vitally important subject.
Can you please explain to a complete layperson like myself what a subclinical infection is?
