Maybe we are doing that, maybe we are not. Not my job to tell you. I am not the mule skinner.

I have the impression that people who have been taken in by anti-vax thinking, but only to some degree, who are not acolytes of that cult, get the stick when push comes to shove. They think about their health, their children, and they make the right choice. Certainly, it does not go the other way. Add this to the fact that a) the most refusing population out there is the US population, and in the US the refusal (as well as the acceptance, by the way) of the vaccine is almost entirely political, and we can guess that much of the “no, no” really means “ok, whatever.”

Yet another factor is the reporting. Whenever a poll has an undecided middle, or a weak “yes” or “no” element, it is possible to report the poll in a biased matter, even if the poll itself isn’t biased. This is clearly what happens when we see “X% say nope” without mentioning that a number equal to a third or fourth of that said “I don’t know, whatever.”

Here are some data for three polls that address this topic.

An April 2020 survey in seven European countries, with 7,662 respondents showed that 81.1% of the population were indifferent or willing to be vaccinated. (73.9 were explicitly willing.)

A Pew Research Center poll in mid September of Americans compared May and September. This September poll was taken at the height of cynicism about the Trump regime’s handling of Coronavirus, just before Trump himself got the virus. In this poll, 49% of all respondents said “no” (to some degree) to the vaccine (“I don’t know” was not a choice in this survey), with 56% of Republicans preferring to not be vaccinated, and 42% of Democrats preferring not.

The May survey showed those numbers at 27% for the whole survey, and 34% and 21% for Republicans vs. Democrats, respectively.

The September poll is probably the one most cited by those who prefer to be alarmed, but it actually underscores the likelihood that people will get the the shot at much higher numbers. A waft from 27% to 49% over four months indicates that the pollsters are not sampling what the questions indicate they are sampling. There is a huge amount of elasticity in what people say. Also, the fact that this survey had no room for “I don’t really have an opinion” forced people into a category. Given the high degree of politicization of the disease, which mainly consists of many Republicans preferring to appear to be reject science (in order to make lefty big city elite academics cringe) or Democrats rejecting a vaccine they see likely to be yet another Jared Kushner scam, the best numbers, among these, in my opinion are optimistic. In May, before the politicization occurred to a great degree, 72% of Americans said yes to the disease, but only 11% felt strongly about no. That conforms with the other surveys.

A survey reported in late October and published in Nature, across 19 countries, showed that 82% were indifferent or preferred the shot (61.4% were willing, the rest indifferent). Of those who seemed not to want the shot, only 9.8% felt strongly that way.

My friend, scientist Roderiko Kampen, recently suggesting, while agreeing that resistance to the vaccine will diminish over time, to “never underestimate human stupidity. Nothing is stable or ‘normal’ now, every single day some butterfly may flap the global hurricane. Humanity has thoroughly outlived its stay and is now beginning to meet that cool adversary – i.e. my great friend – called reality.” I agree. There will be pockets of resistance that will prove troublesome, and lives will be taken and illness spread because of resistance to science. But, ultimately, most people are going to get the shot, and at some point, schools are going require Covid-19 vaccination alongside the already required vaccinations in order to attend.

Look, people endlessly complain about TSA, and they complain more about TSA and the equivilant agencies around the world, the modern security systems at airports, even more than they complained about the totally fake ineffective security that was prevalent before 9/11, especially in the US. But they still get on the plane with a some sense of security. Covid-19 is worse than terrorism, by the numbers. We are having, in the US, a 9/11 level event every single day as I write this. The vaccine is the way out of this plague. People are going to get vaccinated. I would even go one step further. Anti-vax will always be with us. It is an industry, and anti-anti-vax is also an industry. But a movement (or, really, scam) designed to hamper the fight against this pandemic will get weaker, not stronger, over the next year.

Here is a letter from the American Academy of Pediatrics to the President of Delta Airlines:

Dear Mr. Anderson,

The American Academy of Pediatrics (AAP) objects to the paid advertisement/public service message from the National Vaccine Information Center (NVIC) being shown throughout the month of November on Delta’s in-flight programming. The ad urges viewers to become informed about influenza and how to stay well during the flu season without resorting to the influenza vaccine.

While hand washing and covering sneezes are parts of a larger strategy to prevent the spread of influenza, influenza vaccine continues to be the best way to protect against the disease. It is especially important in enclosed settings where disease droplets can easily spread to passengers sitting in close quarters, especially infants and children and those with special health care needs.

The AAP and many other child health organizations have worked hard to protect children and their families from unfounded and unscientific misinformation regarding vaccine safety. The influenza vaccine is safe and effective.

By providing advertising space to an organization like the NVIC, which opposes the nation’s recommended childhood immunization schedule and promotes the unscientific practice of delaying or skipping vaccines altogether, you are putting the lives of children at risk, leaving them unprotected from vaccine-preventable diseases. Diseases like influenza can have serious consequences. From September 2010 to August 2011, 115 children died from influenza disease, most of whom were unvaccinated.

The AAP’s 60,000 member pediatricians urge you to remove these harmful messages, which fail to inform the public about the safety and efficacy of influenza vaccine. Please do your part to help reassure parents that vaccinating their children is the best way to protect them from influenza disease, particularly during this busy travel season.

Please sign this petition.

I’m pretty sure the anti-Vax movement does not overlap much with the Tea Party, so this is a major boost for Minnestoa’s Own Michele Bachmann!

(Click to see video)

Michele, I truly hope this keeps you in the race and advances you in the polls. Seriously. I want that very very much.

From the abstract:

On 12 February 2008, an infected Swiss traveler visited hospital A in Tucson, Arizona, and initiated a predominantly health care-associated measles outbreak involving 14 cases. … Of 14 patients with confirmed cases, 7 (50%) were aged ?18 years, 4 (29%) were hospitalized, 7 (50%) acquired measles in health care settings, and all (100%) were unvaccinated or had unknown vaccination status. Of the 11 patients (79%) who had accessed health care services while infectious, 1 (9%) was masked and isolated promptly after rash onset. HCP (Health care personnel) measles immunity data from 2 hospitals confirmed that 1776 (25%) of 7195 HCP lacked evidence of measles immunity. Among these HCPs, 139 (9%) of 1583 tested seronegative for measles immunoglobulin G, including 1 person who acquired measles. The 2 hospitals spent $799,136 responding to and containing 7 cases in these facilities.

Suspecting measles as a diagnosis, instituting immediate airborne isolation, and ensuring rapidly retrievable measles immunity records for HCPs are paramount in preventing health care-associated spread and in minimizing hospital outbreak-response costs.

Measles infected between 3 and 4 million Americans a year before vaccines stemmed the disease in the early 1960s. Between 2000 and 2008, between 37 and 140 cases were reported annually in the US. The typical pattern is for an imported case of measles to cause a local outbreak among unvaccinated people. Those unvaccinated people are almost always of two kinds: Those who are not vaccinated because of the Anti-vax movement, or those who were too young to be vaccinated (or who are unvaccinated for some other equally valid reason) and are thus victims of the anti-vaxers.

The study points out that because measles is such a nasty disease, those infected often end up in a health care facility. For this reason, health care professionals have a higher risk of acquiring the disease. The other group at higher risk for getting measles is, of course, patients in the health care facility. Take Patient 4 from the Tucson outbreak:

Patient 4 was an unvaccinated 11-month-old boy who had spent 45 min in an ED room across the hall from patient 2 at hospital A on 24 February. Fever (temperature, 38.9°C) developed on 4 March, and a maculopapular rash developed on 10 March.

And some of those at risk are at risk because their parents chose to put their children at risk:

Patients 5 and 6 were siblings aged 3 and 5 years, respectively, who had not been vaccinated because of parental opposition to vaccination. Both children were exposed to patient 2 while visiting their mother at hospital A on 24 and 25 February. Their fever onsets occurred on 5 March (temperature, 39.5°C) and 6 March (38.9°C), respectively.

And, these accidental accomplices can then put others at risk in a kind of vicious cycle. Consider, for example, Patient 8:

Patient 8 was an unvaccinated 1-year-old girl who was exposed to patient 4 in the pediatrician’s office on 10 March while waiting to receive MMR vaccine. Fever (temperature, 38.5°C) developed on 19 March, a generalized maculopapular rash developed on 20 March, and earache developed on 20 March.

It turns out that in Minnesota, the current outbreak is facilitated in part by misinformation being spread among certain fairly recent immigrants. After arrival in the US, they were indoctrinated into the anti-vax ideology by someone. I’m not sure how this happened exactly, but apparently members of the Somali community are concerned that anti-vax misinformation has been circulated and is causing many individuals to avoid vaccinations. This is being addressed.

In the mean time, get your vaccination and get your children vaccinated.

Chen, S., Anderson, S., Kutty, P., Lugo, F., McDonald, M., Rota, P., Ortega-Sanchez, I., Komatsu, K., Armstrong, G., Sunenshine, R., & Seward, J. (2011). Health Care-Associated Measles Outbreak in the United States After an Importation: Challenges and Economic Impact Journal of Infectious Diseases DOI: 10.1093/infdis/jir115

When Julia (now a teenager) was an infant, her pediatrician told me that one of the reasons she liked being in that particular sub field of medicine is that, as it turns out, she did not have to see a lot of people who were suffering with terrible illnesses, and her patients, basically, never died. Children who become severely ill are seen by specialists, and such cases are more often than not some form of cancer or other non-infectious disease. But clearly that was not the case in the past in the US and other Westernized countries. Those working with ill children in some parts of the world need to become quite accustom to their deaths. I’ve had the opportunity to work with those who are ill in non-Westernized places. I’ve probably seen more babies die than Julia’s pediatrician has. A very large percentage of the babies and toddlers who contract malaria in the Congo do not survive. Well, they may survive a bout or two, but eventually, a very large percentage die before their immune system is able to handle the parasite. However, in the past, in the US, babies, toddlers and young children often died of a wide range of diseases that are now routinely treated (like infections) or routinely avoided entirely … by vaccination.

What a parent has to do when watching their baby getting poked with the needles, or when looking at the very long list of childhood vaccinations that we expect to be carried out on all infants and toddlers these days, is to relate the vaccination to what it is good for. If there is a vaccination that you can honesty, comfortably claim prevents a disease that you would not mind having your child come down with, then ask that needle-bearing vaccinations nurse if it is possible to avoid that particular one. But do make sure you are honest with yourself, and for that, you may well have to reach beyond your own immediate discomfort and look at history.

Paul Offit’s new book, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, does this. He begins by going into recent history to look at several cases of unvaccinated individuals picking up a disease and spreading it among other unvaccinated individuals, to cause mini epidemics that give a flavor for what would happen if vaccination was widely rejected. He looks at the history of medicine focusing on anti-vax or vaccine-fearing rhetoric and related events. Again and again, he pits fear of vaccines against the consequences of non-vaccination, and the vaccines, and the practice of vaccination, pretty much win out.

The key message of Offit’s book is that the Anti-Vaccine movement harms all of us by producing an increased number of vectors for very nasty diseases that have seemingly disappeared but really haven’t, and by decreasing herd immunity.

Offit is well known among anti-Vaxers for his earlier book (Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure). He is a highly qualified expert in the field (I know, to conspiracy loving paranoid people this makes him evil) as an actual vaccinologist and infectious disease expert. In this book, he effectively addresses claims that vaccines cause autism, cancer, and other disorders or diseases. In particular, he analyzes how parents of sick kids have been fed misinformation and developed as anti-vax crusaders by the operatives in the anti-vax movement, as well as how the entire anti-vax message is used as media fodder, and serves as a potential source of income for ambulance chasing lawyers. What makes Offit’s book especially interesting is the way in which he brings this discussion well into the past. It turns out that there has been an anti-vax sentiment of one kind or another since there have been vaccines. For instance, when the smallpox virus was first developed, the anti-vaxers of the day made the claim that, since it was derived from a cow-pox source, it would turn people into cows. (As it turns out, that didn’t happen!)

Accomodationist medical journalists and celebrities who seem to drive the anti-vax movement are roundly criticized in Offit’s book. Even Bill Maher is scathed.

In the end it is not possible for a reasonably intelligent fence sitter to read this book and honestly walk away with anything left of their anti-vax feelings.

During my kid’s pre-natal months and first several months after he was born, the whole vaccination thing came up several times. Other parents in some of the same “classes” we were in, relatives, etc. expressed either concern about vaccines or routine ignorance about things like flu immunity. If Deadly Choices: How the Anti-Vaccine Movement Threatens Us All was available then, I would have been handing out copies. Seriously.