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Sunday, February 1, 2009 - 9:52amSanction this postReply
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I have seen the term "herd immunity" in several forums outside Objectivism used as a justification for compulsory immunization.

The argument basically says that having an overwhelming proportion of a population immunized against a readily communicable disease:

1. prevents epidemics;
2. protects those who cannot accept vaccines for health reasons.

Wikipedia says that "complications arise when wide spread vaccination is not possible, and when vaccines fail."

I would assume that rational people would immunize themselves and their children in a timely fashion. This would forego the need for compulsion. Likewise, I cannot argue against a private school owner expecting patrons to show evidence of immunization to assure protection of his clients from unwanted contagions from others. While the government has no business owning schools or compelling attendance, I have a hard time arguing against schools requiring students to demonstrate immunization against casually communicable diseases to attend.

An interesting twist on this comes with the HPV vaccine, which protects against a disease transmitted via intimate contact rather than casual contact. Some states are moving to mandate this vaccine for young girls because that represents the optimum time frame of protection. As you can imagine, many protest against this measure.

Can anyone name a circumstance in which the government of a free society could justifiably compel free, innocent people to become immunized against a given communicable disease?

(Edited by Luke Setzer on 2/01, 10:09am)


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Post 1

Sunday, February 1, 2009 - 10:13amSanction this postReply
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Hi Luke,

For kids, maybe dodging vaccines could be viewed as child abuse or neglect. Not giving kids proper food and exercise is child neglect, right? It diminishes their health. Not giving kids a vaccine is sort of similar.

For adults, the unvaccinated are like ticking timebombs that might or might not go off. We don't let people walk around freely with nukes. That exceeds the reasonable bounds of their rights. Why let them walk around with risk of mumps or measles? Maybe don't force them to get vaccinated; just prevent them from walking among us.



Post 2

Sunday, February 1, 2009 - 10:24amSanction this postReply
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Luke,

You said, "I would assume that rational people would immunize themselves and their children in a timely fashion." I don't know what that has to do with anything since we know that some people choose not to be rational. And they might have 'rational' reasons for not getting the vaccination (i.e., "I believe that the immune system in a person should not be subjected to vaccinations because natural exposure will result in an immune system that more closely matches the actual environment." Not good science, but it isn't raving lunatic, and it isn't faith-based nonsense, or mental incompetence).

Children have a positive right to be given adequate health care from the parents - which would include vaccinations.

All schools have a duty to ensure that children who might carry a disease (do not have the vaccinations) do not come to the school.

With adults it is a different story. Any use of force could only be justified by self-defense. If someone has a serious, communicable disease people have the right to impose quarantine on that person out of self-defense.

One could attempt to argue like this: 1) There is a disease that is known to be out there, 2) That disease is probably going to infect any person without a vaccination, 3) Once infected they will be a carrier, 4) Others infected by the carrier are at risk of significant harm or of death. Obviously, the key points the argument would have to make deal with the degree of certainty that a person without the vaccination would contract the disease, infect another person, and that person die or suffer significant harm. There would have to be a showing of immediacy. If some new disease agent, or some new outbreak of an existing disease became so immediately threatening that it was a different context than we have today, it might fit the self-defense conditions. I don't think it does right now.

Torts can attempt to handle a redress for harm done by a person who chose not to get a vaccination (after harm has already been done). But that seems very ineffective. Society, at the time of a threat, could protect itself, to a degree, by employer's and businesses open to the public, wanting to see proof of vaccination before letting a person into a building, or aboard a plane, etc. (like a night club that makes a person show proof of age to come inside).

Bottom line is that there are NO perfect sets of rules that will ensure perfect outcomes when we don't have perfect people. But the good news is that the more perfect we become, the less need we have any set of rules.

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Post 3

Sunday, February 1, 2009 - 10:28amSanction this postReply
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Yes, I think that nuke analogy fits well with HPV. I don't want your cervix exploding and killing me as I walk past.

Post 4

Sunday, February 1, 2009 - 10:42amSanction this postReply
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If I get immunized, I'm not sure I care whether the guy next to me did or not. Yes, I know, no vaccine is 100% effective, but I value freedom, too. As for the people who cannot take an immunization for health reasons, I have trouble arguing that the rest of us should have our freedoms curtailed for his sake. But I am one of the more socially Darwinian members of RoR.

Thanks for the interesting responses so far. I have kept my shots current for practically every vaccinable contagion known due to work with science specimens and international travel possibilities. I do this for my own sake, not that of others. Some were not required (e.g. hepatitis) but my employer offered them at no charge so I took them.

Post 5

Sunday, February 1, 2009 - 10:48amSanction this postReply
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I can see a point in requiring mandatory vaccination for lethal casually communicable plagues such as smallpox or forcible quarantine of people like Typhoid Mary. Your walking down the street shedding a plague amounts to the initiation of force. HPV, Hepatitis and HIV is another thing entirely.

Post 6

Sunday, February 1, 2009 - 11:02amSanction this postReply
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Yes, even Leonard Peikoff yields in his video on Objectivism that a person radiating an unchosen disease has no right to spread it to innocent others.

So I cannot argue against the quarantine of such a person.

As for the rest of the adults, I prefer no compulsion in favor of social Darwinism, meaning that people too dumb to get vaccinated get what they deserve.

I have no children and will refrain from further comment on them as I have no horse in that race.

SW wrote:

You said, "I would assume that rational people would immunize themselves and their children in a timely fashion." I don't know what that has to do with anything since we know that some people choose not to be rational. And they might have 'rational' reasons for not getting the vaccination (i.e., "I believe that the immune system in a person should not be subjected to vaccinations because natural exposure will result in an immune system that more closely matches the actual environment." Not good science, but it isn't raving lunatic, and it isn't faith-based nonsense, or mental incompetence).

It has everything to do with freedom -- let them die or suffer quarantine.

(Edited by Luke Setzer on 2/01, 11:15am)


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Sunday, February 1, 2009 - 2:11pmSanction this postReply
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My husband noted that individuals who decline to get vaccinated, who contract the disease (some deathly disease) and communicate it to another should be liable under law, assuming this is a widely known issue and the vaccine is made available.

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Post 8

Sunday, February 1, 2009 - 4:35pmSanction this postReply
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MN wrote:

... communicate it to another ...

I have to wonder why the "other" did not take the vaccine.

If that person could not take it for health reasons, how does that become the "Respond-Sybil-Itty" of the healthy person who did not take it and spread the disease?

Does a healthy person who knew to take the vaccine, failed to take it, and contracted the disease have any grounds to complain?

Does an unhealthy person who cannot take the vaccine have the right to impose his "need" onto all others around him?

Does a pregnant woman have the right to make that demand to protect her fetus?

This begs many questions.

(Edited by Luke Setzer on 2/01, 4:38pm)


Post 9

Sunday, February 1, 2009 - 5:39pmSanction this postReply
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The problem, Luke, is that while grizzly bears are visible, viruses are not. No one would question the wisdom of a law requiring that one not feed man-eating creatures or that one not leave his pantry open to passing bears. It would be a menace to the general population.

The same follows for deadly plagues, transmissible invisibly, for which a simple prevention is possible. It is quite reasonable to expect people to get vaccinated for such things as smallpox. Don't tell me that you have the right to get smallpox, and that I should hope my vaccination will protect me from you. Vaccination is not one hundred percent. And even if I am wearing a bullet proof vest (am vaccinated) you don't have the right to go shooting of bullets (be a carrier). We require everyone to get vaccinated as the cheapest and safest way to safeguard everyone. I am not talking about HPV or GWB, which is spread intimately. Only lethal casually communicable threats.

Of course there may be scientific reasons for allowing certain people exemptions. But the fact that some unshaven paranoid anarchist pacifist thinks it's his right to leave his virii on all the doorknobs he opens is not one of them.

Post 10

Sunday, February 1, 2009 - 7:28pmSanction this postReply
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    "I am not talking about HPV or GWB, which is spread intimately."
GWB? Hell, I didn't vote for him and I still got caught by that disease! Inoculate early and often.

Regards,
--
Jeff

Post 11

Sunday, February 1, 2009 - 7:34pmSanction this postReply
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There is a growing sentiment among some groups that vaccines are not completely safe. Specifically, that they increase the risk of autism. I'm not up on the science involved, so i'm not going to comment on the viability of the theory. How would that alter your thinking if it were proved.
There is also an angle that i'm not seeing addressed. In a society where imdividual rights are respected to the level we're discussing, private property rights would be rigidly protected. If a person has the right to deny vaccination, YOU have the right to forbid access to your property or business on that basis. I think this would lead irresponsible individuals being virtually removed from society, with the exception of their property and enclaves of like minded people. At least until plagues hit them.

Post 12

Sunday, February 1, 2009 - 7:54pmSanction this postReply
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Ryan:

You bring up a good point about the concern about risks associated with vaccines. There was a show on TV recently where this issue was raised. A mother had an autistic child that started demonstrating symptoms of autism shortly after the child was inoculated for measles. Despite doctor's assurances that there was no known medically verifiable connection, and that the risks from contracting measles far outweighed the risks for autism, she was refusing to now vaccinate her younger child for fear that he too might become autistic. The doctor, knowing best, then forceably inoculated the child anyway.

We have had other discussions over the years about people, who for various reasons, often religious, refuse medical treatment of one sort or another for their children, placing them a risk. There has been a split between those that think the parents should have the final say over the care for their children in these circumstances, while other argue that it is appropriate for the state to intervene and impose the scientifically accepted course of treatment despite the parent's wishes.

What do you think is the right course of action?

Regards,
--
Jeff


Post 13

Sunday, February 1, 2009 - 8:23pmSanction this postReply
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Let's see, 30% infant mortality due to infectious disease, or 1 in 1000 with autism?

The supposed connection is post hoc propter hoc nonsense. Autism is diagnosed at the same time children receive innoculations. People take this as cause. It is perception based thinking. It takes conceptual thinking to recognize the fact that thousands don't die due to innoculation.

Oh, and yes, the risks of innoculation are real and long noted. It is possible for that to be addressed, but to accept a 30% risk of death because of a .1% chance of autism (if that were real would be absurd.

The thinking of the anti-innoculator is the same as the pacifist - he expects everyone else to keep him safe, while he refuses to pay the cost of defending himself.

Post 14

Sunday, February 1, 2009 - 9:33pmSanction this postReply
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Ryan,

The vaccines-autism connection is pretty much bunk.

MMR Vaccine Safety Research

Many carefully performed scientific studies have found no link between MMR vaccine and autism. These studies include:
  • A September 2008 case-control study published in Public Library of Science (PLoS) was conducted in 2004-2008 to determine whether results from an earlier study that claimed to find measles virus RNA in the intestinal tissue of a specific group of autistic children could be confirmed. The results could not be confirmed, and no link between MMR and autism was found.

  • An April 2006 study conducted by the National Institute of Child Health and Human Development (NICHD) of NIH and the CDC assessed data from 351 children with autism spectrum disorders and 31 typically-developing children. The study did not fhttp://www.youtube.com/watch?v=4CG-DmaAaqEind a link between MMR vaccination and autism. The results were pubished in the Journal of Autism and Developmental Disorders.

  • A February 2004 case-control study examined the possible relationship between exposure to the MMR vaccine and autism in Atlanta, Georgia. The results were published in Pediatrics.

  • A November 2002 study by CDC and the Danish Medical Research Council that followed more than 500,000 children over 7 years and found no association between MMR vaccination and autism. The results were published in the New England Journal of Medicine.
 -Center for Disease Control.

That said, sure there is a remote risk of something going wrong with a vaccination. Regarding kids, the food analogy stands. We feed kids food despite the risk of food poisoning. Food is to innoculation as poison is to blah blah blah. Regarding adults, the nuke analogy also stands. The dude holding the nuke risks getting harmed when we take it away and disarm it. But we still need to disarm it. Letting the dude walk around with it still exceeds the reasonable bounds of his rights. The dude must abide.

Jordan


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Sunday, February 1, 2009 - 9:36pmSanction this postReply
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About three years ago it was hard to find a flu shot and even harder to find a toddler dose. We found one and my whole family was waiting in a line that extended outdoors. The line was barely moving. I entered the facility to observe what was happening with the line inside. Paperwork! Tables of paperwork. Forms, claims, redemptions, etc… There were as many forms helpers as nurses! Beyond the tables were about nine nurse stations, only two or three busy. All the nurses had shots ready to go, the bottleneck was the forms tables.

“Forms for what?” I asked the people waiting to fill out the forms.

“For insurance,” I was answered.

“Insurance for a $20 flu shot?” I asked.

“Of course.” I was answered.

I thought about how silly they looked.

“Do you fill out auto insurance forms when you need windshield wipers?” I asked.



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Sunday, February 1, 2009 - 9:37pmSanction this postReply
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Wow, even just today another report came out debunking the main hypothesese alleging an autism-vaccine link. It's times like this I feel like I'm in the Truman Show.

Jordan


Post 17

Sunday, February 1, 2009 - 9:48pmSanction this postReply
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At present, the only statistical anomaly seen of autism is that those born very premature have a higher percentage of being autistic than otherwise - and that is raising more questions, since not by any means those autistic are all preemies...

Post 18

Monday, February 2, 2009 - 5:44amSanction this postReply
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I would agree that the evidence isn't there for the autism angle, although I am not completely informed on this issue as I stated. Any thoughts on the second part of my post regarding how the the freedom to make poor health choices might be reconciled with everyone else's freedom in a individualist society?

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Monday, February 2, 2009 - 7:15amSanction this postReply
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Ted, what is GWB?

An acronym check listed everything but what I thought it meant (Genital Warts and Bumps).

Regarding your position, I would be very curious to know how this would be enforced.

For instance, for those who homeschool their kids (in a free society) and never let them set foot in any other school, what authority checks to verify they have had their shots?

If a plague does strike, how would the bureaucracy verify that people have their shots?

I'm turning this in my mind and getting disturbing images of adults getting dragged kicking and screaming to jail, "no knock" warrants, random searches, etc. along with falsified immunization records.

I'm very skeptical of any mandates beyond those already in place that schools and workplaces implement combined with effective marketing strategies, reductions in paperwork (per Jon's post), good hygiene via trespassing laws, and other methods that appeal to reason in a free realm.

As an aside, flu shots are only 80% effective for local travel and 60% effective for national travel due to the many different strains.

I think the bottom line is that a plague would amount to an equivalent of a state of war in which traditional rights get curtailed in the interest of saving the lives of citizens. I dislike this conclusion but have trouble drawing any other one. What about the rest of you?

(Edited by Luke Setzer on 2/02, 7:41am)


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