• Please get vaccinated

    Here’s another good end of year reminder: vaccinate your kids. Steven Weintraub, who has chronic lymphocytic leukemia, reminds us why:

    Unfortunately, vaccination rates for many diseases in Europe and in areas of the United States are falling. This is partly due to Andrew Wakefield, a British doctor who published a paper, now discredited, in 1998 in The Lancet tying childhood vaccines to autism. Celebrities like Jim Carrey have also taken a strong antivaccine view. As a result of these unwarranted fears, childhood diseases are returning. The rate of whooping cough cases has spiked over the past 20 years. In 1990, the incidence was 2 per 100,000 people; in 2000 it was 3; by last year, it had risen to nearly 10.

    Measles cases are also increasing. For each year between 2001 and 2008, the median number of cases in the United States was 56. In the first six months of this year alone, there were more than 150 reported cases — the most since 1996. A vast majority of those who were sickened had not been vaccinated or had uncertain vaccination histories. Before the vaccine was introduced in 1963, 400 to 500 Americans died of measles every year.

    I’ve written about Wakefield before.  But Weintraub reinforces a point I like to make about societal vaccinations. We don’t just vaccinate to protect ourselves; we also vaccinate to protect the least among us:

    Young babies, the immuno-compromised and people who get chemotherapy are not able to process most vaccinations. Live vaccines in particular, like those for measles and chickenpox, can make us sick. But if 75 percent to 95 percent of the population around us is vaccinated for a particular disease, the rest are protected through what is called herd immunity. In other words, your measles vaccine protects me against the measles.

    Flu season is here. Please vaccinate.


    • Actually, I’d be grateful if someone could dive into the cost-effectiveness of the flu vaccine.

      Per my understanding (and I’m not a clinician and I don’t specialize in infectious diseases), the flu vaccine is synthesized annually from likely strains of flu. It’s quite protective against those strains, but it may not protect against a mutated strain that wasn’t in the cocktail.

      For example, the folks at the link below contend that the flu vaccine is quite cost effective for kids age 6-23 months(~$12k per QALY saved for the little ones), but not cost effective for kids age 12-17 who aren’t high risk (~$119k per QALY for those annoying teens). So, in this particular case, one could justify not routinely vaccinating all children, just those at highest risk (have pre-existing conditions).


      I do remember that it’s a slam dunk to vaccinate seniors. But I’m not seeing any clear studies among young, healthy, childless adults. I assume it’s pretty clear that you vaccinate people who deal with kids. But, while I’m not questioning the case for any other vaccine, I do want to know, when you say, “Flu season is here. Please vaccinate,” is the evidence sufficient to justify everybody getting vaccinated? Is it reasonably cost effective?

      My wife and I, who don’t have kids yet, did get vaccinated, but we had to pay $30 out of pocket. Thanks for nothing, BCBS. I have a number of young childless co-workers who did not get their flu shots, though.

      • I don’t have time right now to go look for those studies, but they do exist.

        But, again, it’s important to remember that you don’t just get vaccinated to protect yourself. You vaccinate yourself to protect those you will likely come into contact with as well (this included seniors and small children). Some of those who need the vaccines the most can’t get them. Vaccines aren’t also 100% effective, so we need the herd immunity to make the virus less commonly available.

        I agree that it seems somewhat odd to ask individuals to volunteer to pay for a societal benefit. I think there’s a good argument to be made for socializing the payment for vaccines. But