Consider religion: a system invoking various things taken on faith, together with vaguely related rules for behavior. Historically, people who violated the rules were punished by society, society acting as enforcers for the possibly-present invisible forces believed to exist. However there have always been skeptics, who either disbelieve the various things and so the linked rules, or dislike the rules, or distrust the motives of the religious authorities who enforce the rules.

With this definition, many aspects of western medicine require some religion. Various statements are made with authority, followed by rules for behavior. Societal punishments for violating these rules have become less severe but still exist: try smoking on a playground.

Consider now vaccination. Parents are told that scary monsters (measles, whooping cough) will get their kids if the kids are not vaccinated. Some parents are drunk and not paying attention, some may disbelieve in the scary monsters but I think most nonvaccinators just dislike being told what to do: they distrust the authorities and so do not vaccinate their kids. Then the scary monsters get the kids and then go on to kill any tiny babies the carrier kids are exposed to.

How to divorce vaccination from authority? I propose vaccines be made over the counter. People could use them to treat arthritis or hyperactivity, or rub them on as a balm. Skeptical parents could use them as they saw fit, on themselves, kids, or whatever. The sort of parents who care for their kids but do not vaccinate out of distrust may be more likely to vaccinate when they personally can decide the where, how, when and how much. When it comes to childhood disease vaccines, anything is better than nothing.

The only problem is the needle aspect, which I will work on.
-- bungston, Jul 30 2010

The Masque of the Red Death http://en.wikipedia...ue_of_the_Red_Death
Do you want buboes with that ? [8th of 7, Jul 31 2010]

Where's your sense of Darwinian loyalty? Stupid parents >> non-vaccination >> fewer stupid children >> fewer stupid parents.
-- MaxwellBuchanan, Jul 30 2010


[MB] Wrong, I think. If the smart parents' children are in the majority, the stupid parents' children benefit from herd immunity, while avoiding whatever low risk of complications the vaccine entails. So the stupidity gene enjoys a survival advantage up to some equilibrium frequency. Hence: in the long run, non-vaccination doesn't reduce the number of stupid people, and, in the short run. may even increase it, depending on starting conditions.

(Of course the *really* smart parents will switch strategies according to whether the current percentage of stupid people is above or below the equilibrium point.)
-- mouseposture, Jul 31 2010


False logic, I think. Herd immunity protects everyone to some degree, but vaccination protects completely.

For example, suppose you have a community of 100 smart and 100 dumb people, and a disease infects 10% of them at random; that's 10 smart and 10 dumb people infected.

Now the smart people get vaccinated (50% of all people), and you might reasonably expect the disease to decline by 75%, so that only 5 people get infected. But those 5 people will all be dumb.
-- MaxwellBuchanan, Jul 31 2010


//vaccination protects completely//
There's where your assumptions differ from mine. In this model, death-prior-to-reproducing from a vaccinatable disease has the same effect (no progeny) as death-prior- to-reproducing from a complication of vaccination. You're assuming the latter is zero, and I'm not (//whatever risk of complications the vaccine entails//). (We're both assuming vaccination protects completly against disease, which is probably unrealistic.)

Under some simple assumptions, I think the stable ratio of smart to dumb people will be exactly the ratio between risk of dying from disease (given unvaccinated and given herd immunity) and risk of dying from vaccination (given vaccinated). The effects of differential fertility among smart & dumb people are left as an exercise to the reader.
-- mouseposture, Jul 31 2010


/make vaccines over the counter/

In the future, it may very well be like this - deposit a fluid sample, an get an auto vaccine while you wait. A bit like taking a colour sample, and getting some paint mixed.
-- Ling, Jul 31 2010


//whatever risk of complications the vaccine entails//

Yes, you're right if there are significant risks from the vaccine, and if the non-immunised people are in the extreme minority. In this case, the risk from the vaccine would outweigh the very small risk of disease in a mostly- vaccinated population.

However, the majority of vaccines are so safe that the level of herd immunity has to be overwhelming to balance the risk of not taking the vaccine.

Given that some diseases have animal reservoirs, and given that many children will mix with overseas visitors who may not be vaccinated, there are very few cases where it's not worth getting vaccinated.

Having said all that, there's reason not to make vaccines more readily accessible, if a safe delivery system exists.
-- MaxwellBuchanan, Jul 31 2010


OPV would be practical OTC now. Others would need to be altered in such a way that they would in any case become more popular even if not OTC. Having said that, i think this is a good idea.
-- nineteenthly, Jul 31 2010


as well as parents that wouldn't bother getting their offspring vaccinated, there would also be those who would drag the kids into the drugstore once a month just to make sure. Currently vaccinations do require some, if even minimal, supervision from a medical authority.

As well, some have rather short shelf-lifes.
-- FlyingToaster, Jul 31 2010


If you strike it down, it will become more powerful than you can ever imagine...

We consider that a "Masque of the Red Death" <link> apporach may be more appropriate.
-- 8th of 7, Jul 31 2010



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