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Should childhood vaccines be compulsory ?

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  • The White Coat Investor The White Coat Investor 
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    Obviously I’m going to vaccinate my kids but this concept of ” we know better than you” is pervasive.

    Vaccines saved millions of lives in the past. They save some now. But preventing obesity would have a numerous fold greater effect. Why don’t we regulate kids diets? Not allow them to be fat. That would do way more for health than vaccines for anthrax.

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    Sometimes we actually do know better. Not liking it doesnt make it any less true.

    Someone having an obese kid doesnt put my kids at risk. It sucks and shouldnt be so common, but its not a danger to everyone else either.

    So far, all these arguments are terrible.

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    It’s a danger to their wallets because their health insurance premiums go through the roof.

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    #197625 Reply
    The White Coat Investor The White Coat Investor 
    Keymaster
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    And if they’re going to be mandatory, they should be paid for with tax money. Those suckers aren’t cheap. Add it all up:

    https://www.walgreens.com/topic/healthcare-clinic/price-menu.jsp

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    #197627 Reply
    Liked by Ykcor
    portlandia portlandia 
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    Ticker, you don’t qualify for the HPV vaccine. But your kids do. You might be a saint. But do you trust the person or people your children will be intimate with? If I trusted that anti-vaxers would stay at home with their kids we wouldn’t be having this discussion. But they can’t be trusted to do so.

    I think I’m willing to revise my opinion to say that anti-vaxers have to pay, as an immediate penalty, for the full cost of an outbreak, discounted by the likelihood of that outbreak on a per person basis based on the prior year’s anti-vax numbers.

    “No, I don’t want to vaccinate.”
    “Ok, that will be $100,000.”

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    It doesn’t matter whether he trusts his kids or whether you trust people who might have stds to not have sex with your children. This is about public policy and the only way this argument makes any sense, and doesn’t devolve into pure government tyranny over the rights of the individual, is an argument for normally communicable diseases. Saying one persons’ kid might sleep with another and give them an STD so everyone needs this vaccine means giving government the authority over any possible individual choice that might affect another. I prefer my freedom, danger and all, to the security of a dystopian world of this sort.

     

     

    #197638 Reply
    Avatar Anne 
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    This isn’t really a question about individual rights.  It’s a question of children’s rights vs parent’s rights.  Should a parent be able to make a decision that overall presents a greater chance of harm than risk to a child, based on their personal lack of understanding of risk/benefit profiles?

    I vote yes, make them compulsory.  But given that a bunch of doctors can’t reach consensus on this I don’t see any chance of this happening.

    Jonas Salk is one of my personal heroes.  I think I heard him turn over in his grave a few times while reading through this.  Sorry Dr. Salk!

    #197641 Reply
    Zaphod Zaphod 
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    Vaccine for cancer=dystopian tyranny?

    We might be reaching here guys..

    #197645 Reply
    portlandia portlandia 
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    Vaccine for cancer=dystopian tyranny?

    We might be reaching here guys..

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    No, that is a strawman. I have nothing against a vaccine for cancer. The issue is whether government has the moral right to compel people to get vaccinated for an STD that cannot be communicated unless two people decide to have sex. This is dramatically different than arguing that one needs a pertussis vaccine because we all share the same air. We don’t have to all share the same bed. 🙂

    #197649 Reply
    Avatar Anne 
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    I sent two patients home myself with heart block after smallpox vaccination and treated multiple cases of cellulitis. 

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    yes those are fringe cases. that vaccine is not even available to the general public. not a great example.

    influenza has been linked to GBS. its still important.

    again, we are talking about <18yo, unable to consent, and the recommended CDC schedule.

    That vaccination was certainly not listed in my HPSP contract. 

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    maybe not. is this a reputable website for military information? because it says differently…

    https://www.health.mil/Military-Health-Topics/Health-Readiness/Immunization-Healthcare/Vaccine-Preventable-Diseases/Smallpox/Smallpox-FAQs

     

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    I’m not clear what you’re referring to. Are you saying my contract did say I would have to get the smallpox vaccine because you found a website 20 years after I signed the contract that says something about smallpox? Do I need to upload the contract to get you to believe me? I agree it’s a mandatory vaccine for many military members (and certainly was for me if I, along with every other doc I knew, had not come up with a strange case of eczema the week before that prevented us from receiving it. No way in heck were we going to get that vaccine after shipping a handful of 22 year olds with heart block home after getting it.) I might have risked the vaccine if there was any serious realistic case of me being exposed to smallpox.

    If vaccines are mandatory, what’s next? Gonna outlaw alcohol? How’d that work out for you? How about outlawing guns in schools and hospitals? That just makes gun-free zones into soft targets.

    No, I think a balanced approach is better. Mandatory for public school attendance without a medical excuse? That gives people the option to home school if they want. But I think we need to be careful what is mandatory. Tetanus shouldn’t be mandatory to attend school. It’s not contagious. Same with smallpox and anthrax. But MMR? Diptheria? Pertussis? HiB? Sure.

    I just think outlawing stupidity is a very slippery slope. There are lots of dangerous things I do that lots of reasonable people probably think should be outlawed too. And yes, me doing them could cause other people to be hurt coming to rescue me.

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    The HPSP contract says you need to take an appointment as a military officer.  To take that appointment you need to swear that you will obey whatever lawful orders you are given.  That would include any mandatory vaccines.  Yes, you can get around it by claiming eczema.  Not the best example as an officer if one doesn’t actually have eczema but I guess that’s their choice.

    You can prohibit guns in hospitals with the exception of the police/security who work there.  Seems like a balanced approach to me.  I certainly appreciate working in a hospital where this is the case.

    Adults get to make the decision to do dangerous things (as long as those things are legal), because they’re adults.  Deciding for children that they are going to do dangerous things is a bit different.

    #197652 Reply
    Liked by MaxPower, Zaphod
    Zaphod Zaphod 
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    Sure, reminder that I dont think it needs to be anything stronger than not letting people weasel out of them for basically zero reason, not mandatory governmental jab squads.

    They say nearly 100% of people have HPV at some point. Granted it’s not as serious an issue as those other things as far as for when youre a youngster.

    #197653 Reply
    MPMD MPMD 
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    Followed this thread w/ interest. I can see both sides and don’t have super strong feelings off the bat although I’m pro-vax obviously.

    I think the anti-vax movement has triggered a weird kind of reverse self-righteous moral panic. There is this subset of people in my life who are strongly pro-vax (e.g. constantly on social media about it) who are, how to say this delicately, not nearly as committed to logic and high quality information in all areas of their life.

    #197655 Reply
    Liked by portlandia
    ACPC ACPC 
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    And if they’re going to be mandatory, they should be paid for with tax money. Those suckers aren’t cheap. Add it all up:

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    Well, they add up to a lot less than one night in the hospital (or an ED workup at most hospitals), which we all pay for indirectly when someone un- or under-insured lands there…

    Preventative care is almost always the preferred care, and vaccines are a pretty easy sell from a societal perspective, both ethically and fiscally.

    Saying one persons’ kid might sleep with another and give them an STD so everyone needs this vaccine means giving government the authority over any possible individual choice that might affect another. I prefer my freedom, danger and all, to the security a dystopian world of this sort.

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    There must be a little more nuance to it than that. Whether in the sexual domain or elsewhere, some of our children’s choices will inevitably be different than what we would wish. I mean, one should at least consider the possibility that kids make different choices than their parents (or are unfortunate victims of sexual violence), and may need that protection one day. We love our children and want them to be protected and healthy even if we don’t agree with their choices. The math is pretty straightforward here.

    Again, preventative care is almost always the preferred care, and vaccines for HPV are a pretty easy sell from a societal perspective, both ethically and fiscally. The government should mandate child protection, and it’s pretty clear that’s what this is. With all due respect, it’s not your freedom that’s at stake here, it’s your grown child’s freedom to make their own choices with their own agency, and not be without immune protection against the consequences of those choices.

    #197656 Reply
    Liked by MaxPower
    Avatar RandomDoc 
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    First of all yes. They should absolutely be mandatory.
    I didn’t read all the posts. This thing blew up quickly. I would like to see insurance companies make this mandatory in order to continue be insured against vaccine preventable diseases. For instance, the kid in the Pacific Northwest who recently got tetanus and ran up a >$800,000 hospital bill, which doesn’t even include his rehab stay. His parents had not vaccinated him. Talk about quality of health care dollars spent, that’s crazy. I think it would be fair for an insurance company to say you could have at least tried to prevent this. We won’t pay for this preventable disease.

    #197657 Reply
    Avatar Anne 
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    Vaccine for cancer=dystopian tyranny?

    We might be reaching here guys..

    Click to expand…

    No, that is a strawman. I have nothing against a vaccine for cancer. The issue is whether government has the moral right to compel people to get vaccinated for an STD that cannot be communicated unless two people decide to have sex. This is dramatically different than arguing that one needs a pertussis vaccine because we all share the same air. We don’t have to all share the same bed.

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    But do parents have a moral right not to get their children vaccinated because it’s a vaccine for an STD, after all, and their children wouldn’t do *that*?

    I grew up near a very religious community.  The teenage pregnancy rate among my friends from that community was way higher than than the national average, because their parents didn’t think their kids would have sex and didn’t take sufficient precautions.  People now there get all up in arms about gardasil.  Even if cervical cancer has good prognosis with early detection, colpos and LEEPs are not exactly fun.  Should a parent be allowed to make that decision for their child?

    #197658 Reply
    Liked by MaxPower, Zaphod, ACPC
    ACPC ACPC 
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    Even if cervical cancer has good prognosis with early detection, colpos and LEEPs are not exactly fun.

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    Well put Anne.

    Also, lets not forget oropharyngeal and anorectal cancer from HPV.

    #197661 Reply
    Avatar Ykcor 
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    Unvaccinated children, drivers who drive while intoxicated, pit bull owners etc.  put others at serious risk. (I’ll leave off unregulated firearm ownership since it is a political hot topic). Obesity and outdoors smoking does not put others at risk. These can be regulated by higher health insurance costs.

     

    #197663 Reply
    Zaphod Zaphod 
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    Followed this thread w/ interest. I can see both sides and don’t have super strong feelings off the bat although I’m pro-vax obviously.

    I think the anti-vax movement has triggered a weird kind of reverse self-righteous moral panic. There is this subset of people in my life who are strongly pro-vax (e.g. constantly on social media about it) who are, how to say this delicately, not nearly as committed to logic and high quality information in all areas of their life.

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    Thats just human nature and we all do it to one extent or another.

    #197669 Reply

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