Wow ladies-great, common sense ideas. I am beyond thrilled that we will now have people in positions of power to actually put these ideas into reality.
As someone who has been a pediatrician in a community with a high level of antivaxx belief, and as one who has treated patients during an outbreak of vaccine-preventable illness in that community, I'm not at all happy with this article, and I fear that it is going to feed the flames of the vaccine-avoidance problem we already have. A few thing to point out:
-The US has a much larger and more economically-diverse population than Denmark. Our poor are poorer than Denmark's, and have consequently less access to healthcare when they are ill (as well as having less access to good nutrition--"food deserts" are very real). Children being hospitalized for RSV can bankrupt their parents, so prevention of hospitalization is very much a long-term health issue. Children with chickenpox can easily pass it to their grandparents, who end up in intensive care with varicella pneumonitis (not theoretical--I've seen this more than once) , which, again, leads to an obviously bad outcome. If the US did not have a significant subset of the population that is Fox News propagandized and more interested in actually educating themselves about their health beyond "one weird trick" approaches, I'd be all in favor of a robust public discussion about the relative benefits of immunization. As it is, we all saw the response to COVID-19 (in which regions with higher rates of immunization against SARS-CoV-2 had lower mortality rates than those with low rates) and the rise of Robert F. Kennedy, Jr's scare campaign (which has given us, among other things, an unnecessarily high death rate from the 2019 Samoa measles outbreak). If the US had a much smaller wealth gap, universal access to healthcare when needed, and nutrition education that was not dominated by the same agricultural corporations that provide us with high-fructose corn syrup- and palm oil-laden treats, we might have the basis for comparison. As it is, the US immunization system--flawed as it is--is designed to prevent the transmission of disease, and less to benefit the individual patient.
I have patients who are entirely unimmunized, and they attend school with children undergoing treatment for leukemia and autoimmune illnesses. That is a recipe for catastrophe, but that is the price of the absence of vaccine mandates. When--not if--one of these immune-suppressed kids falls ill with a vaccine-preventable illness that threatens their life, I'll deal with that, and so will that child's parents. The parents of the unimmunized kids will read them "Maisie's Marvelous Measles" and go on with their lives.
I expect to see significant changes in policy and transparency of information over the next 6-12 months. The FDA will evolve from a clandestine operation to a real public health agency. It will be refreshing the watch the transition in real time.
I think we would both love to have him on. I know him personally; he and I have talked on the phone. Maybe he would agree to joining the show once his is confirmed. I agree it would make for a good, hopefully constructive, conversation.
Not fair to compare a homogeneous, long maternity leave, socialized medicine country to a VERY heterogenous, anti government, ZERO maternity leave nation.
Of COURSE vaccine recommendations, requirements and buy- ins will differ!!!!! Imagine that.
Hi Annie, thank you for your comment. I absolutely agree the countries are very different. I think the point we are trying to get across is neither should make non evidence -based recommendations. For example, just because American children are less healthy on average, should it just be assumed without supporting data that the benefits of a yearly covid vaccine outweigh the risks? (We are arguing no) And each vaccine should be looked at individually in terms of the benefits and harms so parents can be empowered to make informed decisions. I'm curious if there is a vaccine you think definitely SHOULD be given in the US but not in Denmark and why.
At what point does the prevention of the spread of disease (and thus the health of the community), rather than the health of individuals enter your analysis?
I guess my take is "chance of prevention of disease to others" should be part of the information that is provided to parents/vaccine recipients so the choice is in their hands. As in: what is the chance it will benefit them? What is the evidence we have that it will benefit others and what are their risks if they take the vaccine?
Personally, I don't think mandates should be used because, it's consistent with basic medical ethics that patients should have the right to decline or consent to taking any medical product without coercion.
Parents have the right to style their children's hair with peanut oil, but I wouldn't try to sell that to the parents of peanut-allergic children. Schools are basically compulsory, so the immune-suppressed are forced to attend alongside the vaccine-avoidant.
Dangerous topic to discuss. Appreciate the leveled approach (the fact it is so taboo suggests that vaccination has become a sacred cow...which isn't every sciency) Maybe we need to start with the vaccine schedules we keep for pets and livestock and go from there.
Hmm not sure the pet vax schedule is the place to start. Pet vaxes have some 7 way vaccines eg that to me seem like a bad idea (I am a vet). Also vaccinating every 3 years for rabies? Why? The CDC says the rabies vax lasts at least 20 yrs but admit they don't really know. Maybe the human rabies vax is different but some of what goes on in the pet world is most certainly a money grab.
I'm saying start the fight there. Run a study on pets where owners get to choose if they vaccinated or don't and monitor general health. Seems like it would get around the ethics issue for the human vaccines.
This article intrigues me... Infant mortality in developed nations is correlated with vaccine doses... The more vaccines, the more kids die... And this is in developed nations!
> This means that vaccine hesitancy will likely continue to increase until adequate studies have been performed, and for each and every vaccine - both those already in use and those under development - there is clear and unequivocal data that shows that the vaccine is overall beneficial.
I think this is the key point and it'll be an uphill battle to convince those that need to be convinced but great on you all for trying with evidence-based arguments.
Overall the point is taken about improving research to better understand the greater health impact of vaccinating a large population. But in the absence of such data, we are left to use the available data on “target disease” and “short term side effects” to guide our policies. Also I would imagine it is very hard and expensive to get “overall health impact” data - so many potential confounders. I don’t envy the public health officials that have to make these decisions by any means.
I have conversations fairly often with parents about Hep B and why we recommend it when the mother tested negative.
Also interesting that 2 of the reasons mentioned in the article for fewer vaccines recommended in Denmark are “poor uptake” (flu) and “fear of increasing hesitancy”. On face value these seem like poor reasons not to recommend a vaccine, but they show the value they place on public trust and the reality of implementing health policies in the real world.
This article is very concerning to me. As a new mom living in a heavily anti-vax community (and currently recovering from Whooping cough), my thoughts are:
- we can’t cherry pick what we care about in healthcare. If we want to reduce vaccines, then we need the healthcare infrastructure to support it. The incoming administration has no plans to fix this.
- vaccines are not about “improving overall health”, they are about preventing death from deadly diseases. We live in a generation who never saw people die of polio, TB, etc BECAUSE we have been fortunate to live in a world with vaccines. We have short-term memory as a nation and are forgetting how terrible these illnesses are. There are other ways to improve overall health, which we should promote. But reducing vaccination rates won’t solve our overall health.
- Americans don’t care about the research. We pick a side we agree with and argue it until we’re blue in the face, research be damned. You can do all the studies in the world to show that vaccines are good or bad, and people will still stick to their beliefs.
Point of clarification - Number 5 on this list is non-negotiable and will happen no matter what anyone in the public health community does or says. No setting can have any sort of mandate.
Wow ladies-great, common sense ideas. I am beyond thrilled that we will now have people in positions of power to actually put these ideas into reality.
As someone who has been a pediatrician in a community with a high level of antivaxx belief, and as one who has treated patients during an outbreak of vaccine-preventable illness in that community, I'm not at all happy with this article, and I fear that it is going to feed the flames of the vaccine-avoidance problem we already have. A few thing to point out:
-The US has a much larger and more economically-diverse population than Denmark. Our poor are poorer than Denmark's, and have consequently less access to healthcare when they are ill (as well as having less access to good nutrition--"food deserts" are very real). Children being hospitalized for RSV can bankrupt their parents, so prevention of hospitalization is very much a long-term health issue. Children with chickenpox can easily pass it to their grandparents, who end up in intensive care with varicella pneumonitis (not theoretical--I've seen this more than once) , which, again, leads to an obviously bad outcome. If the US did not have a significant subset of the population that is Fox News propagandized and more interested in actually educating themselves about their health beyond "one weird trick" approaches, I'd be all in favor of a robust public discussion about the relative benefits of immunization. As it is, we all saw the response to COVID-19 (in which regions with higher rates of immunization against SARS-CoV-2 had lower mortality rates than those with low rates) and the rise of Robert F. Kennedy, Jr's scare campaign (which has given us, among other things, an unnecessarily high death rate from the 2019 Samoa measles outbreak). If the US had a much smaller wealth gap, universal access to healthcare when needed, and nutrition education that was not dominated by the same agricultural corporations that provide us with high-fructose corn syrup- and palm oil-laden treats, we might have the basis for comparison. As it is, the US immunization system--flawed as it is--is designed to prevent the transmission of disease, and less to benefit the individual patient.
I have patients who are entirely unimmunized, and they attend school with children undergoing treatment for leukemia and autoimmune illnesses. That is a recipe for catastrophe, but that is the price of the absence of vaccine mandates. When--not if--one of these immune-suppressed kids falls ill with a vaccine-preventable illness that threatens their life, I'll deal with that, and so will that child's parents. The parents of the unimmunized kids will read them "Maisie's Marvelous Measles" and go on with their lives.
I expect to see significant changes in policy and transparency of information over the next 6-12 months. The FDA will evolve from a clandestine operation to a real public health agency. It will be refreshing the watch the transition in real time.
Outstanding article! Thoroughly enjoyed reading and am 100% supportive of all 7 points! Well done.
Thank you, Stephen!
Time to have RFK on the podcast?
I think we would both love to have him on. I know him personally; he and I have talked on the phone. Maybe he would agree to joining the show once his is confirmed. I agree it would make for a good, hopefully constructive, conversation.
Thank you both so much for your work. I uploaded the video and article to my community health course.
Not fair to compare a homogeneous, long maternity leave, socialized medicine country to a VERY heterogenous, anti government, ZERO maternity leave nation.
Of COURSE vaccine recommendations, requirements and buy- ins will differ!!!!! Imagine that.
Hi Annie, thank you for your comment. I absolutely agree the countries are very different. I think the point we are trying to get across is neither should make non evidence -based recommendations. For example, just because American children are less healthy on average, should it just be assumed without supporting data that the benefits of a yearly covid vaccine outweigh the risks? (We are arguing no) And each vaccine should be looked at individually in terms of the benefits and harms so parents can be empowered to make informed decisions. I'm curious if there is a vaccine you think definitely SHOULD be given in the US but not in Denmark and why.
At what point does the prevention of the spread of disease (and thus the health of the community), rather than the health of individuals enter your analysis?
I guess my take is "chance of prevention of disease to others" should be part of the information that is provided to parents/vaccine recipients so the choice is in their hands. As in: what is the chance it will benefit them? What is the evidence we have that it will benefit others and what are their risks if they take the vaccine?
Personally, I don't think mandates should be used because, it's consistent with basic medical ethics that patients should have the right to decline or consent to taking any medical product without coercion.
Parents have the right to style their children's hair with peanut oil, but I wouldn't try to sell that to the parents of peanut-allergic children. Schools are basically compulsory, so the immune-suppressed are forced to attend alongside the vaccine-avoidant.
Dangerous topic to discuss. Appreciate the leveled approach (the fact it is so taboo suggests that vaccination has become a sacred cow...which isn't every sciency) Maybe we need to start with the vaccine schedules we keep for pets and livestock and go from there.
Hmm not sure the pet vax schedule is the place to start. Pet vaxes have some 7 way vaccines eg that to me seem like a bad idea (I am a vet). Also vaccinating every 3 years for rabies? Why? The CDC says the rabies vax lasts at least 20 yrs but admit they don't really know. Maybe the human rabies vax is different but some of what goes on in the pet world is most certainly a money grab.
I'm saying start the fight there. Run a study on pets where owners get to choose if they vaccinated or don't and monitor general health. Seems like it would get around the ethics issue for the human vaccines.
This article intrigues me... Infant mortality in developed nations is correlated with vaccine doses... The more vaccines, the more kids die... And this is in developed nations!
https://pmc.ncbi.nlm.nih.gov/articles/PMC9897596/
> This means that vaccine hesitancy will likely continue to increase until adequate studies have been performed, and for each and every vaccine - both those already in use and those under development - there is clear and unequivocal data that shows that the vaccine is overall beneficial.
I think this is the key point and it'll be an uphill battle to convince those that need to be convinced but great on you all for trying with evidence-based arguments.
Overall the point is taken about improving research to better understand the greater health impact of vaccinating a large population. But in the absence of such data, we are left to use the available data on “target disease” and “short term side effects” to guide our policies. Also I would imagine it is very hard and expensive to get “overall health impact” data - so many potential confounders. I don’t envy the public health officials that have to make these decisions by any means.
I have conversations fairly often with parents about Hep B and why we recommend it when the mother tested negative.
Also interesting that 2 of the reasons mentioned in the article for fewer vaccines recommended in Denmark are “poor uptake” (flu) and “fear of increasing hesitancy”. On face value these seem like poor reasons not to recommend a vaccine, but they show the value they place on public trust and the reality of implementing health policies in the real world.
I live in Texas and avoid vaccines like Bubonic plague
Umm, most of europe does not do Hep B at birth, but does in the first year. Denmark is the outlier there. In a good chunk of europe it's even mandatory. https://vaccine-schedule.ecdc.europa.eu/Scheduler/ByDisease?SelectedDiseaseId=6&SelectedCountryIdByDisease=-1
This article is very concerning to me. As a new mom living in a heavily anti-vax community (and currently recovering from Whooping cough), my thoughts are:
- we can’t cherry pick what we care about in healthcare. If we want to reduce vaccines, then we need the healthcare infrastructure to support it. The incoming administration has no plans to fix this.
- vaccines are not about “improving overall health”, they are about preventing death from deadly diseases. We live in a generation who never saw people die of polio, TB, etc BECAUSE we have been fortunate to live in a world with vaccines. We have short-term memory as a nation and are forgetting how terrible these illnesses are. There are other ways to improve overall health, which we should promote. But reducing vaccination rates won’t solve our overall health.
- Americans don’t care about the research. We pick a side we agree with and argue it until we’re blue in the face, research be damned. You can do all the studies in the world to show that vaccines are good or bad, and people will still stick to their beliefs.
Point of clarification - Number 5 on this list is non-negotiable and will happen no matter what anyone in the public health community does or says. No setting can have any sort of mandate.
Americans love their fakedemics. It’s part of the fear-submission-invasion paradigm that rules the society