Call for vaccine opt-out penalty

[Pammy]

Originally Posted by Muffin2

get lost.

i'm not about to write a full critical appraisal of the paper. as a student nurse i imagine you've never had to do this because you are obviously unaware of the process and how long it takes to critically appraise a paper. if you want an idea, i had to do one as a piece of coursework, we were given 6 weeks and it was worth 40% of the overall module mark.

Gosh I think you owe Varied A an apology...That is such a mean thing to say! I think none of us seem to know enough about the MMR story to comment authoritatively (I can also only repeat the general comments that I got from reading Nature's News & Views and the like).
And in this case, critically appraising a paper takes a long time, because any one of us would have to do an awful lot of background reading to get to grips with the facts. If one is, however, an expert in a field, it is quite easy to critically appraise a paper. I can read a paper from the field of my PhD research in an hour and comment on it. So what you're really saying is that you don't know much about the MMR story either and would need 6 weeks to research it...To critically appraise a paper is not really a long "process" if one knows the stuff. In fact my supervisor could look at a paper, absorb it and within about 5 min summarise it and critique it (always correctly...)!

[Muffin2]

sweet jesus. you've all spat your dummies out haven't you.

we disagree, thats fine. i think it should be compulsory, you guys don't, simple as. its merely my opinion, which everyone is entitled to. 469er (what do you do by the way out of interest?) doesn't agree because of something to do with her childrens genetics, varied A i presume doesn't because he's just made sarcastic comments about everything i've said and i gather you don't either pammy.

i think the report on MMR and autism was a load of crap and has single handidly thrown doubt over all vaccines, not matter what they are, resulting in outbreaks.

and your supervisor pammy has probably critically appraised reports all their life, many more than the rest of us have done. plus in doing your PhD research you obviously have experience in appraising articles and so are much quicker than the rest of us.

and incase you didn't notice pammy, i found what varied A said very sarcastic, which is why i said get lost, which was supposed to be taken in the same way. chill.

anywho. i'll leave you all to rip apart the next person who dares to disagree with you. toodles.

[Varied A]

How utterly bizarre! The more words you type the more certain I become that actually you have no idea what you're talking about!

[Muffin2]

How utterly bizarre! The more words you type the more I loose respect for you.

[Pammy]

I think we should probably end this discussion :-)
It started off so well! Just for the record, I actually also believe that vaccinations should be compulsory - but I disagreed with the style of the arguments - I don't see why from "the MMR study was wrong" (for whatever reasons) it follows that "vaccines should be compulsory". Also, there is no reason why even if it's compulsory there shouldn't be a few exceptions, if they are clearly laid out. I presume there would have to be exceptions for, for example, immunocompromised individuals, and I don't see why there couldn't be other exceptions, if clear links (e.g. genetic) could be proven. So the key should be to improve vaccine testing, and the procedures for reporting adverse incidents, so these types of reactions can be quickly established...

[469er]

Originally Posted by Pammy

I think we should probably end this discussion :-)
It started off so well!

Yeah, what a shame. I think it's such an interesting subject. I've never considered a career in immunology, but, thinking about it, I wonder if it's something I'd really enjoy... Still, early days...

BTW, Congrats on your Magdalen offer, Pammy, you must be thrilled.

[Pammy]

Originally Posted by 469er

Yeah, what a shame. I think it's such an interesting subject. I've never considered a career in immunology, but, thinking about it, I wonder if it's something I'd really enjoy... Still, early days...

BTW, Congrats on your Magdalen offer, Pammy, you must be thrilled.

Congrats to you too - have you decided where you will go? I might PM you one of these days as I'm really impressed by the fact that you will combine studying med with having a family...I keep being told that I'm too old to start med and that I won't be able to have kids etc etc...I try to not let that bother me but it would be great to get some first-hand advice on how it can be handled :-)

You're right mmunology is cool! Infectious diseases would be even better :-) This debate has now driven me to the library where I'm reading a book on epidemiology (should have done that ages ago...)!

[469er]

Yeah, I think I've made up my mind, though I still have a couple of weeks to dither. Gonna make them sweat! Do PM me, though I doubt I have anything constructive to say about studying and parenthood, except perhaps: "Take refuge in the library" or "Leave them with their father at every opportunity."

[Touche]

Ooooh, I'm late to the party

I do feel giving families a nudge into getting their kids vaccinated is a good idea. I like the way France approach it... vaccination is voluntary, schooling is not... to go to school you need vaccinations If you don't wanna get your kids vaccinated you could always leave the country :P

I'm not going to spend hours digging into Wakefield's paper, partly because it's so far from my area of interest, but also because other cleverer people have already done it (eg. Chen et al(1) etc). Epidemiological studies have been unable to show a relationship between MMR and autism/IDB(2-4 etc). 10 of Wakefield's 11 co-authors (with the last co-author apparently uncontactable) published a retraction of their interpretation(5).

I'm interested in why people object to vaccination so much?

People die from measles. That is a fact. Vaccine uptake is not good enough to give us herd immunity, by not getting vaccinated you put your kids and others in danger.

1. Chen RT, DeStefano F. Vaccine adverse events: causal or coincidental? Lancet. 1998 Feb 28;351(9103):611-2.

2. Taylor B, Miller E, Farrington CP, Petropoulos MC, Favot-Mayaud I, Li J, et al. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet. 1999 Jun 12;353(9169):2026-9.

3. Taylor B, Miller E, Lingam R, Andrews N, Simmons A, Stowe J. Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. BMJ. 2002 Feb 16;324(7334):393-6.

4. Fombonne E, Chakrabarti S. No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics. 2001 Oct;108(4):E58.

5. Murch SH, Anthony A, Casson DH, Malik M, Berelowitz M, Dhillon AP, et al. Retraction of an interpretation. Lancet. 2004 Mar 6;363(9411):750.

[Touche]

Originally Posted by Pammy

I think we should probably end this discussion :-)
It started off so well! Just for the record, I actually also believe that vaccinations should be compulsory - but I disagreed with the style of the arguments - I don't see why from "the MMR study was wrong" (for whatever reasons) it follows that "vaccines should be compulsory". Also, there is no reason why even if it's compulsory there shouldn't be a few exceptions, if they are clearly laid out. I presume there would have to be exceptions for, for example, immunocompromised individuals, and I don't see why there couldn't be other exceptions, if clear links (e.g. genetic) could be proven. So the key should be to improve vaccine testing, and the procedures for reporting adverse incidents, so these types of reactions can be quickly established...

Herd immunity is the goal of the MMR vaccination program. If you have loads of people vaccinated against measles, the chances of someone with measles coming into contact with an unvaccinated person and passing it on gets smaller. There is a vaccination threshold at which transmission of the disease effectively stops. At that point you can pretty much wipe out the disease. We've already wiped out Smallpox and Polio has almost dissapeared (although there are still some remote places where vaccination did not happen as it should have).

We need around 90% of people to become immune to achieve herd immunity to measles. Around 5% of people vaccinated will not become fully immune, so we really need a 95% uptake. In 1995-6 we hit 92%... almost there! Then we had the Wakefield paper and uptake fell dramatically. We hit a low of 80% in 2003-4. In parts of London uptake rates fell into the low 60s...

Suprisingly we've had big outbreaks in the past few years...