I haven’t digested your entire reply yet, but I’ll respond to this part.
Avoiding the fallacy of the one-sided wager. The post talks about cost-benefit analysis, but in a complete cost-benefit analysis one has to consider the risks of both choices under offer, not just one. The post takes specific notice of the default course of action’s risks (money, tears, side effects) but focuses less on the risks of the alternative (e.g. toddlers winding up in the ER because they’re shitting themselves half to death from rotavirus).
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So we have a mundane explanation for most of the newly introduced vaccines for healthy young children; today’s vaccines weren’t ready before the ’80s.
The unstated (but I thought implied, my mistake) other-side of the wager was: I got many fewer vaccines growing up, and I’m fine.
Less anecdotally, I haven’t found a lot of evidence that adults are suffering horribly from diseases that children today are routinely vaccinated against. Is the cost-benefit of the added vaccines as good as the cost-benefit of the 80s era vaccines? Some arrows point to the US having a lower threshold for recommending them, given the variance between nations.
Less anecdotally, I haven’t found a lot of evidence that adults are suffering horribly from diseases that children today are routinely vaccinated against. Is the cost-benefit of the added vaccines as good as the cost-benefit of the 80s era vaccines? Some arrows point to the US having a lower threshold for recommending them, given the variance between nations.
A lot of the big childhood vaccines are things that kill kids (MMR, rotavirus, Hib). So you’ve got survivorship bias there.
As for the other stuff, a lot of the diseases that adults are suffering from that children are vaccinated against today don’t manifest as obvious infectious disease. If you know anyone who has ever had shingles, you know someone that had suffered from a disease that children today are routinely vaccinated against (varicella). If you know someone who has had cervical cancer or genital warts, you likely know someone who has suffered from HPV (highly recommended vaccine for preteens). If you know someone who has had liver cancer, there’s a chance it’s because of Hepatitis B (no vaccine for HCV yet :/).
Part of the cost benefit change is also due to the fact that we can actually treat a lot of these cancers now, instead of just “sorry, nothing we can do, go home and get your affairs in order.” For example, even though mortality rates from liver cancer might still be similar, 1-year survival rates have increased. So now, each case of a preventable cancer might cost us a lot more, so we’re much more motivated to prevent it.
Even if the cost benefit is not as good as the cost benefit of the 80s era vaccines, the fact that many not only have a favorable cost-benefit ratio, but are even cost saving should make them an strong choice for implementation.
I haven’t digested your entire reply yet, but I’ll respond to this part.
[...]
The unstated (but I thought implied, my mistake) other-side of the wager was: I got many fewer vaccines growing up, and I’m fine.
Less anecdotally, I haven’t found a lot of evidence that adults are suffering horribly from diseases that children today are routinely vaccinated against. Is the cost-benefit of the added vaccines as good as the cost-benefit of the 80s era vaccines? Some arrows point to the US having a lower threshold for recommending them, given the variance between nations.
A lot of the big childhood vaccines are things that kill kids (MMR, rotavirus, Hib). So you’ve got survivorship bias there.
As for the other stuff, a lot of the diseases that adults are suffering from that children are vaccinated against today don’t manifest as obvious infectious disease. If you know anyone who has ever had shingles, you know someone that had suffered from a disease that children today are routinely vaccinated against (varicella). If you know someone who has had cervical cancer or genital warts, you likely know someone who has suffered from HPV (highly recommended vaccine for preteens). If you know someone who has had liver cancer, there’s a chance it’s because of Hepatitis B (no vaccine for HCV yet :/).
Of course, you don’t have to look anecdotally for that.
Part of the cost benefit change is also due to the fact that we can actually treat a lot of these cancers now, instead of just “sorry, nothing we can do, go home and get your affairs in order.” For example, even though mortality rates from liver cancer might still be similar, 1-year survival rates have increased. So now, each case of a preventable cancer might cost us a lot more, so we’re much more motivated to prevent it.
Even if the cost benefit is not as good as the cost benefit of the 80s era vaccines, the fact that many not only have a favorable cost-benefit ratio, but are even cost saving should make them an strong choice for implementation.