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#102 Oct 22 2014 at 3:53 PM Rating: Excellent
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Herd immunity, dude. All those people on public transportation who don't feel that sick, or who just can't miss work no matter how crappy they feel, are potential vectors. The more people who are immunized, the less chance of a potentially deadly disease spreading.

You don't live in isolation. I know you think you do, but you really don't. If you can keep some infant or some elderly person from dying of flu, it is your duty to get vaccinated. It's good citizenship.
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#103 Oct 22 2014 at 4:12 PM Rating: Good
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gbaji wrote:
Professor Stupidmonkey wrote:
In fact, if you wanted to hole up in some remote area far from other people, and die of the flu, I say more power to you, you have my whole-hearted support.
if I were holed up in some remote area far from other people, I'd presumably not catch the flu in the first place.


I didn't say catch the flu in a remote area, I said DIE of the flu in a remote area.
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#104 Oct 22 2014 at 4:16 PM Rating: Excellent
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gbaji wrote:
Does anyone not get that "free flu shots" aren't actually free?

I'm pretty sure that everyone here understands that flu shots aren't magicked into being by vaccination faeries.
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#105 Oct 22 2014 at 4:17 PM Rating: Excellent
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Jophiel wrote:
gbaji wrote:
Does anyone not get that "free flu shots" aren't actually free?

I'm pretty sure that everyone here understands that flu shots aren't magicked into being by vaccination faeries.
Smiley: bah
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#106 Oct 22 2014 at 4:30 PM Rating: Excellent
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It's a dipshit argument anyway. Flu vaccination programs are local. They're funded by the local government or via state grants. There's no "Big Government/Big Pharma" collusion going on.

Actually, I just looked and I don't think my local government is even offering free shots this year (they did a year or two ago when all the news was Influenzamagaddon). They're having Walgreens host an event at the local library and charging $25 for a shot (or nothing if your insurance covers it). What? A business getting to stage an event at the library and charge people?! THERE'S your collusion!! Smiley: motz

Pre-emptive: Yes, Gbaji, we know that it's not "free" if the insurance covers it.
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#107 Oct 22 2014 at 4:43 PM Rating: Excellent
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No, but it's a hell of a lot cheaper than multiple doctor visits and antiviral meds, or worse.
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#108 Oct 23 2014 at 7:35 AM Rating: Excellent
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Samira wrote:
You don't live in isolation.
All things considered, let's not jump to conclusions on that particular bullet point.

Edited, Oct 23rd 2014 9:35am by lolgaxe
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#109 Oct 23 2014 at 8:56 AM Rating: Good
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The flu shot isn't free in Freehealthcareland.
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#110 Oct 23 2014 at 9:09 AM Rating: Good
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Jophiel wrote:
It's a dipshit argument anyway. Flu vaccination programs are local. They're funded by the local government or via state grants. There's no "Big Government/Big Pharma" collusion going on.

Actually, I just looked and I don't think my local government is even offering free shots this year (they did a year or two ago when all the news was Influenzamagaddon). They're having Walgreens host an event at the local library and charging $25 for a shot (or nothing if your insurance covers it). What? A business getting to stage an event at the library and charge people?! THERE'S your collusion!! Smiley: motz

Pre-emptive: Yes, Gbaji, we know that it's not "free" if the insurance covers it.
We capitalistically bargained with our health insurance provider to offer them up at no cost.
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#111 Oct 23 2014 at 9:28 AM Rating: Excellent
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Uglysasquatch wrote:
The flu shot isn't free in Freehealthcareland.

Have you tried importing vaccination faeries?
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#112 Oct 23 2014 at 9:38 AM Rating: Excellent
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Import them? They even let them get married!
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#113 Oct 23 2014 at 9:43 AM Rating: Excellent
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Hey, tomorrow is "Acupuncture & Oriental Medicine Day". Fight the flu with 25% off tiger dicks at your local pharmacy!
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#114 Oct 23 2014 at 9:46 AM Rating: Good
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Jophiel wrote:
Uglysasquatch wrote:
The flu shot isn't free in Freehealthcareland.
Have you tried importing vaccination faeries?
I'm picturing Dwayne Johnson. Anyone else?
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#115 Oct 23 2014 at 6:47 PM Rating: Good
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Flu vaccines are cheap; <$10 to manufacture for something that has a short salable life, has to be re-engineered yearly.

Vaccines are probably one of the best buys in medicine.

Even if we bought them and administered them for free to every american citizen (~$6bn), it's likely that they'd not move the US budget, as they'd decrease medicaid/medicare costs by the roughly .7% that would hit the break-even point.
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#116 Oct 23 2014 at 7:02 PM Rating: Decent
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Samira wrote:
Herd immunity, dude.


First off, the concept of herd immunity most directly applies to natural immunity, not the temporary and often less complete immunity a vaccination provides. However, for many illnesses, there is some herd immunity effect from vaccinations (typically based on how long the immunity from the vaccination lasts relative to the spread rate of the illness itself) so the concept can be applied.

Herd immunity has nearly zero large scale relevance to flu vaccinations though. As I said earlier, for those in certain professions which require them to be in close proximity to people with weak or compromised immune systems, it makes sense because you can achieve the needed immunity level in a narrow stripe of the population. But given the rate at which flu viruses mutate, and the number of strains that aren't protected against by any given vaccine, and the relatively short effective duration of the immunity granted by any flu vaccine, and the percentage of people who are just poor responders to flu vaccines anyway, the immunity effect of the herd isn't going to work at significantly affecting the spread of flu in the population as a whole.

Even if every single person got a flu shot every year, there would always be a sufficient number of potential carriers in the population to maintain and spread the virus. This is just a poor argument for this particular illness.
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#117 Oct 23 2014 at 7:04 PM Rating: Excellent
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gbaji wrote:
First off, the concept of herd immunity most directly applies to natural immunity, not the temporary and often less complete immunity a vaccination provides.

Smiley: laughSmiley: facepalm

No
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#118 Oct 23 2014 at 7:20 PM Rating: Excellent
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Aside from the fact that you don't know what you're talking about re: herd immunity:

1. Yes, the virus does mutate. However, we get a sneak peek a year or more in advance of any particular virus spreading throughout a given population, and that's the lead time we need to develop a vaccine for two or three of the more threatening viruses;

2. The flu vaccine is effective for about six months, easily covering the worst of the flu season;

3. "Poor responders" include the chronically ill, the very young, and the very old, which is exactly why the rest of us need to be immunized to help protect them. That is how herd immunity works in the real world;

4. If every person were immunized every year, flu would not be a major heath concern. See? I can cite my opinion as fact, too!

5. Even where the flu vaccine does not provide full immunity, there is substantial evidence that it does help lessen the duration and severity of the flu.
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#119 Oct 23 2014 at 7:58 PM Rating: Decent
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Jophiel wrote:
gbaji wrote:
First off, the concept of herd immunity most directly applies to natural immunity, not the temporary and often less complete immunity a vaccination provides.

Smiley: laughSmiley: facepalm

No


Yeah. Whoever wrote that article doesn't actually understand that immunity and vaccination are not one and the same thing. The opening paragraph is completely wrong. Herd immunity does not innately have anything at all to do with vaccination. How the herd becomes immune isn't the point. It's the concept that if a sufficient percentage of the herd is immune (more specifically, not infectious if exposed to a disease), then the spread of the disease will be sufficiently reduced to protect the whole.

The problem is that in many cases (especially something like the flu), the immunity percentage is so high that you're not really protecting the herd. Remember the entire point is that by granting immunity to just X% of the herd, you protect the whole herd because the disease wont spread. But if you have to vaccinate say 100% of the population to achieve this, then herd immunity didn't actually take effect. And the data on flu vaccines is really bad with regard to herd immunity. Again, let's remember that the whole point is that we assume some percentage of the herd can't take a vaccine themselves and/or wont gain any benefit from it, thus we must protect them by immunizing everyone around them. The problem with the flu is that it spreads so easily, that even a tiny percentage of the population with the ability to spread it will ensure that the spread will follow patterns more or less unrelated to vaccination patterns (ie: It'll follow the same transmission pattern regardless of what percentage of folks along the way are vaccinated).

The percentage of the population for whom a flu vaccine wont be effective, or can't take them, or will transmit the virus even though protected from the most severe symptoms themselves is sufficiently high to prevent any herd immunity effect on the population as a whole.


In small groups, you can achieve this. So, for example, if you only allow people who are good responders to flu vaccines, and who take them every 3 months to work at your health care center specializing in the elderly and people with compromised immune systems, then you can protect those people from infection. You can even put a small dent in transmission in classrooms (maybe, the data is still sketchy on this) by vaccinating teachers. But the general population is too open, with too many angles of transmission, and too many people who will always be capable of transmitting in any given location for herd immunity to work.
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#120 Oct 23 2014 at 8:17 PM Rating: Decent
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Samira wrote:
1. Yes, the virus does mutate. However, we get a sneak peek a year or more in advance of any particular virus spreading throughout a given population, and that's the lead time we need to develop a vaccine for two or three of the more threatening viruses;


Sure. But it's a guessing game. If you get the right vaccine during the time period it's effective, your chance of not getting sick to that particular flu strain is significantly lower. No one's arguing this. But there's no indication that the odds of *you* getting the flu (ie: any random flu strain) this year is in any way affected by the percentage of people in the population as a whole who receive a vaccine.

Quote:
2. The flu vaccine is effective for about six months, easily covering the worst of the flu season;


I've heard three months. It's why people who work with people with compromised immune systems get them every 3 months.

Quote:
3. "Poor responders" include the chronically ill, the very young, and the very old, which is exactly why the rest of us need to be immunized to help protect them. That is how herd immunity works in the real world;


No. Poor responders are those who respond poorly to the vaccine. Specifically, those for whom the vaccine either will provide no immunity, reduced immunity, or shortened immunity. And while this can (and certainly does) intersect with the set you are speaking of, I used this term separately from that set because I was specifically referring to otherwise healthy people who simply wont gain immunity if they take a vaccine (or will still be able to transmit the virus despite taking the vaccine, which is the more relevant issue).

I'm not talking about the folks we're trying to protect with herd immunity, but the people who at any given time will be able to get and pass on the flu virus regardless of their vaccination status. And at any given time, there will always be a percentage of the population in this category for any of a number of reasons.

Quote:
4. If every person were immunized every year, flu would not be a major heath concern. See? I can cite my opinion as fact, too!


Yay!

We've seen outbreaks among populations where immunization was 98% or higher. And no, the point isn't about the percentage of those who got sick being mostly those who didn't get a vaccination. The point is that they were not actually protected by being surrounded by a herd of people who did. Ergo, herd immunity didn't work. There's just too many vectors of infection in the population for it to work, and even a small percentage of the whole being capable of passing on the virus will allow it to do so.


I'll say again: We're not using herd immunity if the only people protected are those who take the vaccination.

Quote:
5. Even where the flu vaccine does not provide full immunity, there is substantial evidence that it does help lessen the duration and severity of the flu.


Yes. But herd immunity only takes effect if they can't pass on the flu, not just by having reduced symptoms. Hence, the problem. A percentage of people will have reduced symptoms as a result of the vaccination, but still be able to pass it on. This can arguably be *worse* from a herd infection perspective because mildly sick people will tend to continue trying to work and otherwise do things that will infect others, while those who get a full bore case of the flu will tend to stay home and practice safe habits. That's the problem, specifically with the flu vaccine. For many other diseases, the concept works. For the flu? There's a pretty compelling argument that herd immunity just plain doesn't take place. At least not on a broad scale.

Edited, Oct 23rd 2014 7:21pm by gbaji
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#121 Oct 23 2014 at 8:17 PM Rating: Excellent
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gbaji wrote:
Yeah. Whoever wrote that article doesn't actually understand that immunity and vaccination are not one and the same thing.

Yeah, this guy doesn't know as much about it as you either:
The National Institute of Allergy and Infectious Diseases wrote:
Community Immunity ("Herd Immunity")

When a critical portion of a community is immunized against a contagious disease, most members of the community are protected against that disease because there is little opportunity for an outbreak. Even those who are not eligible for certain vaccines—such as infants, pregnant women, or immunocompromised individuals—get some protection because the spread of contagious disease is contained. This is known as "community immunity."

Or this guy
http://www.ncbi.nlm.nih.gov/pubmed/22414740 wrote:
The required percentage that would have been required to establish herd immunity against previous influenza viruses ranged from 13% to 100% for the 1918–19, 1957–58, 1968–69 and 2009–10 pandemic viruses, and from 30% to 40% for the 2008–09 epidemic virus. The objectives of vaccination coverage proposed in the United States — 80% in healthy persons and 90% in high-risk persons — are sufficient to establish herd immunity, while those proposed in Europe — only 75% in elderly and high-risk persons — are not sufficient. The percentages of vaccination coverage registered in the United States and Europe are not sufficient to establish herd immunity.

Or this guy
Science Decoded wrote:
Vaccination stimulates an immune response to a particular virus or infection. When unvaccinated people live in an area filled with vaccinated folk, in other words, a herd of vaccinated people, they may be protected by what is called the herd effect – since everyone else is vaccinated, they won’t get sick. Since they can’t get the infection, they protect the unvaccinated from infection with a ‘buffer’ of safety.

Or...

Look, you just aren't very well educated on the subject, ok?

Edited, Oct 23rd 2014 9:17pm by Jophiel
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#122 Oct 23 2014 at 8:29 PM Rating: Decent
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There's a difference between saying "we're trying to use vaccinations to achieve herd immunity" (which is what those quotes are talking about), and saying "Herd immunity ... describes a form of immunity that occurs when the vaccination of a significant portion of a population (or herd) provides a measure of protection for individuals who have not developed immunity"

Herd immunity is the state of a sufficiently high percentage of the population being immune to a disease that the disease cannot spread easily to those who aren't immune, thus preventing outbreaks. How the herd becomes immune is not relevant to the definition of herd immunity itself. Discussing the use of vaccinations further down in the article as a means to achieve herd immunity is appropriate, but defining herd immunity in the very first sentence as a byproduct of vaccination is incorrect.

Doesn't matter where you stand on the effectiveness of vaccinations, that's the wrong way to describe the thing being described.
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#123 Oct 23 2014 at 8:35 PM Rating: Decent
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My point is that the word "vaccination" in that first sentence should simply be replaced with "immunity". Herd immunity has existed (and had effects) long before modern science came along and created vaccinations. Much of the central and south American population was wiped out because they lacked herd immunity to diseases which Europeans did have herd immunity to. It's moronic (and incredibly incorrect) to define herd immunity solely within the context of vaccinations.

Edited, Oct 23rd 2014 7:38pm by gbaji
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#124 Oct 23 2014 at 8:48 PM Rating: Good
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Never had a flu shot, never get the flu. Maybe I am immune? Anyone want some blood?
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#125 Oct 23 2014 at 8:52 PM Rating: Excellent
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Much of the central and south American population was wiped out because they lacked herd immunity to diseases which Europeans did have herd immunity to.

Europeans did not have "herd immunity" to smallpox. Europeans died of smallpox on a pretty regular basis or even moreso when a major outbreak would occur. They simply had more overall resistances to it as a result of living with it for ages.

Want to know when we developed herd immunity to smallpox? When we started vaccinating for it. I know it makes you mad when people keep pointing out that you're not remotely the smartest guy in the room but quit while you're behind, ok?

Edited, Oct 23rd 2014 9:52pm by Jophiel
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#126 Oct 23 2014 at 10:34 PM Rating: Excellent
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Ok, a quick refresher course on herd immunity. The flu virus in particular typically lives less than 24 hours without a host, unless under cryonic conditions. Diseases go extinct when their vectors are reduced to zero. Partial populace immunity reduces potential vectors. Reduction in vectors can reach a criticality point where an outbreak ceases to be self sustaining, ie. replacement rate is less than transmission rate. If outbreaks are small enough they rarely spread to a vulnerable person. Thus, through no merit or fault of their own, that person isn't critically injured or killed by the disease. That effect is called herd immunity.
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