The selfishness of anti-vaxxers may well be dealt with by technology

chip

The appalling, incoherent selfishness of Chris Christie’s vaccine ‘choice’
[Via The Week]

On CBS’s Face the Nation last Sunday, Tom Frieden, the director of the Centers for Disease Control and Prevention, said he is “very concerned” about the possibility of a massive, sustained outbreak of measles in the United States. A growing number of parents are deciding not to vaccinate their children, resulting in 100 cases of measles in 14 states in the latest outbreak. Frieden argued that it is extremely important to prevent measles from re-establishing itself as an endemic disease, after it was eradicated at great expense and effort around the year 2000.

New Jersey Gov. Chris Christie (R) chose the very next day to downplay the threat, a reply of sorts to President Obama, who strenuously recommended vaccination in an interview. At a press conference in England, part of a trip that is widely considered to be a rehearsal for a presidential run, Christie said that while he has vaccinated his own children, he did not expressly recommend vaccination for others. Instead, people “should have some measure of choice.” (The libertarian Sen. Rand Paul (R-Ky.) went further, saying of vaccines, “Most of them ought to be voluntary.”)

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Like all denialists, I do not expect anti-vaxxers to stop their selfish approaches. Humans have exquisite abilities to rationalize even the most egregious behavior.

In a few years, this may be moot. People shedding virus will simply not be allowed into public venues or private businesses. For both public health and liability reasons.Technology will permit rapid detection of the shed virus.

So refuse to get your vaccine. Fine. But if anyone becomes infectious, they will not be allowed to move about in the public. We put up with having our bags searched at football games. I expect we will also put up with these public health issues.

Measles may be the most contagious infectious disease. One person with measles can infect up to 18 others if there is nothing to stop it. And people can continue to shed virus for two months after getting the disease. Getting over the disease may not mean you can no longer spread it.

Being shunned in public for 2 months may change people’s behavior.

It appears that one infected person at Disneyland is responsible for hundreds of subsequent cases. Someone can be infectious with measles without showing symptoms.

Because of the selfishness of anti-vaxxers, several infectious diseases are well on the way to becoming endemic again in the US. Places like Disneyland may well respond to this by checking everyone entering the park for disease, using rapid detection approaches coming on the market.

The chip in the picture above is already being used for detecting tuberculosis. Other approaches are in the pipeline.

It will be more than a public health issue. They will have to for liability reasons. They will be opening themselves to lawsuits from the public and from their own employees if they do not. Anyone shedding virus will be denied entrance.

How will anti-vaxxers respond to that? Probably in a selfish manner.

People concentrate on deaths, which can range from 30% to 0.1% depending on the quality of medical services. But measles can leave a person alive but greatly disabled, with damage to the eyes or ears.

We are in the middle of the largest outbreak of measles in some time, a disease that was eradicated from America just a decade ago. Why is it back?

Because of herd immunity. Or its lack.

Vaccines do more than just protect the people who receive them. It protects those not able to receive the vaccination, or for whom the vaccine is not fully protective. At high enough levels, it stops the spread of the disease cold because it can find no one to infect.

In a perfect world, this would require rates close to 04%. But this is not a perfect world, because selfish people who refuse to vaccinate do not occur randomly in the population. They tend to cluster, greatly lowering the local threshold.

This clustering means that if one child in the anti-vaxxer community gets sick, it is highly likely that many others in the social network will also.

This results in things like this:

After the measles outbreak at Disneyland, CNN talked to a family whose 10-month old baby had contracted the disease. They’re terrified he’ll pass it on to their 3-year-old daughter, who has leukemia and can’t get the vaccine — but might be killed by the disease. 

The 10 month old is too young to be vaccinated. So the 3 year old is now at risk. Because of the selfishness of anti-vaxxers.

And it is not just measles, pertussis is also doing the same thing. We are in the middle of the largest pertussis outbreak in decades, which has sickened almost 50,000 people (10,000 in California just in 2014) and killed 20. 

Infectious diseases spread rapidly once they take root. Nebraska had over 200 cases of pertussis just in January. There was an large scale breakout of mumps in the NHL. Mumps in adults can have some severe complications.

Even if there is not a death, huge amounts of medical expenses and time lost at work accrue. Money and time which did not have to be lost.

Herd immunity has pretty much failed in the anti-vaxxer communities. Many infectious diseases were on the wane not simply because people were individually protected but because herd immunity protected those most at risk.

Now the selfishness and self-centered attitudes of some people have allowed these diseases to regain a foothold. Today, it is measles, mumps and whooping cough. Tomorrrow it might well be Ebola or dengue fever.

All of us have to put up with restrictions in order to maintain a sustainable social order. As we see, the attitudes of anti-vaxxers put many people at risk while costing the rest of us a lot of money.

I expect that in a few years, it will be relatively easy to rapidly determine if someone is shedding virus. I would expect that Disney and others will not allow anyone shedding virus into the park. 

The same with schools. Shedding virus? Get sent home. Can’t go to the mall. Can’t go to the grocery store. Or the movie theater. Or the football game.

Private businesses will be able to prevent the movement of people infected with the disease.

That should stop a lot of the spread. The effects of selfishness could be greatly reduced.