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PaperclipPerfector  1d ago (text post)   1665 thread views

Small-Scale Question Sunday for February 23, 2025

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

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I’m also going to ask you to reconsider.

I realize I may have little credibility with you. Maybe this comes across like those cave diver signs. But I seriously think there’s nothing on this hill worth dying for. You’re accepting a mild risk for literally zero benefit.

The main differences between our and Denmark’s schedules appear to be COVID, Hep A and B, rotavirus, and varicella. I could make cases for most of those. Rotavirus is vaccinated in most countries; I don’t know why Denmark declined. Varicella has lower uptake, either because of cost or because it’s risky when only children are covered. On the other hand, I had it as a small child. It sucked, I still have a couple minor scars, and I get to be at risk for shingles in the future.

We’ve given ~84% of children immunity to Hep B worldwide. Between that and Universal Precautions, your child will probably be fine without such immunity. Though it’ll still be wise if he or she goes into medicine, works with the less fortunate, or wants to visit Africa or Southeast Asia. And it’s generally better to be prepared.

These vaccines aren’t novel. Everything except the COVID shots has been on our schedule since 2001. We have had decades to learn about potential side effects. We’ve also had significant political shifts. Assuming that it’s all fake and gay because of the Current Thing is a mistake. Assuming such because of a chatbot’s medical opinions is worse.

Skip the COVID shots if you want, especially if you don’t have any old or obese relatives watching the kids. But please stick with the rest of the standard schedule.

Assuming that it’s all fake and gay because of the Current Thing is a mistake. Assuming such because of a chatbot’s medical opinions is worse.

Once again, I ask people to actually read my post instead of assuming vaccine hostility. Grok 3 was incredibly PRO vaccine. In fact, it made better pro-vaccine arguments than this forum. But that's why I'm posting here, because I don't trust chatbots.

We’ve also had significant political shifts. Assuming that it’s all fake and gay because of the Current Thing is a mistake.

I don't assume that at all. But I do believe, with low confidence, that vaccine risk is higher than the official numbers. Still, I'm not going to self own just because the CDC was wrong about Covid.

You’re accepting a mild risk for literally zero benefit.

This is probably where we differ. I don't think vaccine risk is zero. Especially the cumulative effect of taking 35 shots (containing many more dosages).

Whoops. The original version of that sentence was

because a chatbot mentioned “socioeconomic conditions”

I understand that you’re suspicious that Grok fell back on PR-speak. I’d suggest that AI is unusually likely to give PR-speak even when there are compelling underlying reasons.

I don’t think vaccine risk is zero

Right, but if you’re scaling based off the COVID vaccine risk, I think you’re going to get an overestimate. At the same time, you’re definitely rounding the benefits down because you don’t see how your kid might be exposed. So I guess I’m arguing both ends. 40+ years of clinical data across a lot of the planet means the Hep B shots are safer than most medicine. But it’s not eradicated, and having the immunity gives your child more options regarding the medical profession and even foreign travel. I think a similar logic holds for the other differences from Denmark’s schedule.

For what it’s worth, my personal opinion is more about the categorical imperative. If everyone refused on free-rider grounds, the world would be a much worse place. Even if it was only your particular social stratum, you could do serious damage to our herd immunity. Vaccine risks are linear with number of people. Epidemics, though, are exponential.

I must point out that for Hep B, if you're advocating for shots on the grounds it's a good idea for a medical provider to have, then you need to keep in mind it can be given at pretty much any point in life.

You don't need it to be a med student. I don't think it's mandatory for doctors in most places, legally or otherwise. I remember when I came to the UK, I put "unknown" as my Hep B vaccination status, because I genuinely couldn't recall, and if I had it, it must have been well after my paediatric vaccinations. This wasn't flagged or followed up on, though I think it's a good idea for a medical professional to get the shot.

I assume the argument for infant Hep B vaccination is that infection during childbirth is a major transmission method; I think around 5-10% of the population in many Asian countries are carriers, most infected this way by their mothers. IIRC the liver damage cuts life expectancy by a couple years in women and by a decade or so in men, and it's incurable.

But it's also a sexually-transmitted disease (though not much of one in places where we're all vaccinated) for whatever stigma that holds, and it's a disease that can be asymptomatic, so I guess the thinking is that it's better to have 100% of babies vaccinated immediately (the vaccine response can "outrun" the disease!) than to rely on 100% of mothers to know and admit if they're carriers.

Current Thing

If vaccination science ends up in the dustbin of history, just because of its complicity in the house arrests, it would hardly be the first field to be discredited to a great extent due to a single policy miss. Eugenics enjoyed widespread among high-information voters, before it got tied up with the nazis. Race science had its own experts, now they exist only on the margins.

Personally I am not a vaccine skeptic like OP, but he lives in a world where reasoning I explained is considered mainstream. I can hardly blame him for applying it to his own pet issue.

I don’t think eugenics had a single policy miss. With the technology of the day, basically every eugenic intervention was draconian. There was no PGS, no embryo selection. Governments settled for banning miscegenation and sterilizing undesirables.

The big exception would be immigration restrictions. I’d say those are still widely accepted with some caveats.

Vaccines aren't my pet issue. I just have to make a decision soon on Hep B.

And, yes, I think it's important not to throw out the baby with the bathwater. Vegetarianism is fine even though Hitler advocated it, etc... I find myself having to take an unpopular stance here mostly for rhetorical reasons. And it seems to have gotten one person in particular very fired up. But, unquestionably vaccines are good on net, even the Covid vaccine (for people at highest risk). But every vaccine is not for everybody.

Hep B can be given at any point, so you don't need to make a decision 'soon'. You can refuse at birth and get it later.

Excellent comment. One thing I'd like to add is that opting out of vaccination is, to an extent, mooching off the commons.

Herd immunity doesn't work, if parents look at the existing vaccination rates, reasons that their kids will be fine without vaccination as "everyone else" does it, and thus defects.

opting out of vaccination is, to an extent, mooching off the commons.

More than the commons mooches off of us? Citizens don't owe the commons one damn thing by default, and the balance seems tipped pretty far in the other direction lately what with all the accomodations we're expected to make around "living in a society".

If you think that citizens have no positive obligations towards improving the commons, I don't see why you'd want to make them worse off.

I don't know what you're pointing at when you say something like:

what with all the accomodations we're expected to make around "living in a society".

Hence I can't really engage with it.

At the very least, KMC's stated reason for opting out of vaccinating their kids, namely because other people are doing so too, and because of a minor drug reaction are terrible on merit alone. The COVID vaccine? I'm well past caring about it, or asking people to, but most others are recommended for very good reason, even for a person who doesn't care about the well-being of others.

I don't know what you're pointing at when you say something like:

what with all the accomodations we're expected to make around "living in a society".

I'm talking here about vaccines that are on the schedule with no clear benefit to the recipient -- COVID for kids, HPV for boys. 'Society' wants these administered for herd immunity reasons (I guess); 'society' also taxes us to the bone and provides pretty marginal access to services that we do want. (ADD drugs, for instance)

What has society done for me lately, that I should bend to its will?

HPV for boys

Hold up. Below covered it but HPV related cancers are absolutely skyrocketing in men.

I won't defend covid shots for kids. Marginal risks for marginal benefits.

HPV for boys? Infection with high risk strains can increase risk of anal, oropharyngeal and penile cancers. I have no idea if the risks are particularly high in absolute terms, at least not without doing more work than I want to this late. But unlike covid vaccines in kids, it strikes me as plausibly a good idea, even if I suspect that a lot of the net benefit is spreading herd immunity and protecting girls, where HPV actually is a big deal to my knowledge.

HPV for boys? Infection with high risk strains can increase risk of anal, oropharyngeal and penile cancers.

I have no idea if the risks are particularly high in absolute terms

Total incidence rate of those I'm getting something like 1/100k/a (https://www.mcgill.ca/hitchcohort/hpvfacts) -- no idea what percentage of those would be HPV related, but that is already well, well within the OOM that I'd find plausible for unnoticed/rare serious adverse vaccine side effects.

You and @Throwaway05 may have some new news on these rates -- but then the question is raised as to why anyone would believe doctors about this sort of thing after having seen how fast & loose the relationship with facts has been, once public health gets on some hobbyhorse.

HPV

I don't know what McGill is smoking.

https://www.cdc.gov/cancer/hpv/cases.html

The rate changes are a bit odd as sexual habits change (go men on finally eating women out!) and at the same time its getting a bit more controlled as more people are vaccinated. However some of the other causes (like smoking) are going down.

General

You believe doctors because it's retarded to throw out the entire field of medicine because of one misstep.

I could respect it if it was "okay fine I will never listen to a doctor again, clearly everything they say is wong" but the situation is very clearly picking and choosing what things to be mad about purely depending on how someone feels about it.

General vaccinations are already different enough from what happened with COVID, but now you are saying "lets just not listen to any public health recommendations in general," "why anyone would believe doctors about this sort of thing?" <- your own quote.

Great now go light up using somebody with Ebola's vomit as bong water.

No? That doesn't seem reasonable? Well it's also a public health recommendation!

At best people are using uninformed opinions and intuitions as laymen without doing any research at all to decide when to listen to expert advice, and ignoring it otherwise, and as we see elsewhere in this thread those opinions and intuitions are absolutely trash and often can be invalidated with the slightest, minimum possible research. See in other subthreads here the comically ill-informed takes on hepatitis, chickenpox.

Agree. And I'm willing to vaccinate myself for purely pro-social reasons with no benefit to myself, provided they are safe and effective.

That said... don't you think this reasoning makes it more likely that people are lying about vaccines risks? For example, let's say you had data that suggested vaccines are 1) good for society but 2) bad for individuals, you might lie for the greater good.

This isn't something I've given much thought before, but even on reflection, I don't think it makes much difference.

The most controversial vaccine is that for Covid. Even then, my impression (memory fades) is that the vaccines were lauded as being more effective than they turned out to be. I don't recall seeing evidence back then, that people were lying out of their teeth, they interpreted unclear, insufficient or ambiguous evidence as proof that vaccines would cut the pandemic short. They didn't, they reduced mortality, but not the spread of Covid.

I can't think of any other vaccine that was remotely as controversial, and my presumption is that the FDA and medical associations, normally do a decent cost-benefit analysis before advocating them. I know NICE does, in the UK.

my impression (memory fades) is that the vaccines were lauded as being more effective than they turned out to be

The vaccines were lauded as being more effective than they had already turned out to be. Pfizer's efficacy was something like 93% in the initial study, and e.g. Biden oversimplified that as badly as "You’re not going to get COVID if you have these vaccinations."

They also turned out to be less effective than thought, with that 93% dropping to like 68% after only 6 months, which was enough to take us from "well some vaccinated people still get it but as long as we can push R<1 we can..." to "screw it, it's endemic now", even before Omicron changed the math further.

I'm not sure if this is "people were lying out of their teeth" rather than "voters aren't smart enough to avoid black-and-white thinking so they don't insist their president be smart enough either", but I think the takeaway is that you can probably trust independently repeated and reviewed studies of vaccine effects and you probably can't trust most popular interpretations of those studies.

Thank you.

I'm not sure if this is "people were lying out of their teeth" rather than "voters aren't smart enough to avoid black-and-white thinking so they don't insist their president be smart enough either", but I think the takeaway is that you can probably trust independently repeated and reviewed studies of vaccine effects and you probably can't trust most popular interpretations of those studies.

That seems like an eminently sensible take, though I can only reiterate that COVID was uniquely politicized, and by the time the typical vaccine reaches market (let alone when it becomes part of a national schedule), the evidence is very strong.

by the time the typical vaccine reaches market (let alone when it becomes part of a national schedule), the evidence is very strong.

Flu vaccines? Even people wanting you to take them usually stick to a pitch like "it doesn't work every year, but... can't hurt, can it?" IME. (possibly moving on to "you wouldn't want to kill grandma, would you?")

Flu vaccine? Well, if you want to single it out, then I'd be obliged to say that unless you're sickly, old, or work in healthcare, the benefits are largely a wash when compared to the minimal risk the typical annual flu strain otherwise presents. That would be the case even if the vaccine was perfectly safe. I'm on record saying the same thing, if someone wants to dig years deep into my profile.

If someone doesn't want to get it, no biggie. Hell, even I've missed shots that were offered to me for free because I didn't think it mattered enough.

Sure, that's a reasonable position -- thing is, it's not really aligned with what the public health people say. Hence the burnt credibility.

Don't know if we have data on this (because it's ultimately small potatoes by expensive research standards) but healthcare lore and anecdote in the U.S. is that the flu vaccine 100% reduces severity of illness and down time.

Worth it in my book for a mild owie.

All it takes is one real visit by the flu and then you get the point.

More comments

Yes, it is absolutely being a freeloader, and that's one reason why I have opted out for my own children. I don't think enough other people have bought in to the common good, and so I don't see any reason to subject my children to autoimmune disease for some supposed public good that I see constantly denigrated by others. Another casualty of lowering the trust of society. I don't think it's worth it, but that trade has already been made without anyone asking me.

My kid had very bad eczema due to the oral rotavirus vaccine, and after that I simply said no thank you.

RV is one of the ones that they don't do in Denmark. Grok 3, in the awkward position of defending both the US and Danish recommendations, tried to say it was because Denmark has better healthcare and Danes take better care of their children so there was less risk of untreated RV.

Fair enough. But, using that logic, my kid won't need the RV vaccine.

This comment is a travesty. If it wasn't clear, it is the majority of parents opting-in for scheduled vaccinations that's what creates the commons for you to free-ride off.

Even in a purely disinterested cost-benefit analysis, the odds of your child getting an autoimmune disease from vaccines is so low that the general benefit of them getting sick less often outweighs it. The number of people avoiding vaccination isn't at the point where you're benefiting from opting out, or pointing to others doing so as an excuse. The majority of vaccines are net positive in expectation, regardless of what others do.

Meta-rationality is a hard art to practice. You point to a minority of people hitting defect to defect just as hard.

It was very clear, and I know about the free rider problem from undergraduate economics. I am actively choosing to be a free rider, and relying on others to do what I am choosing not to. That's what free rider means. Other people are paying, I'm choosing not to.

I'm doing that because I am an individual, not a herd animal, and the things I do must actually benefit me in order for me to do them. I have no shepherd who owns me and is responsible for the herd to which I belong. There exists the possibility of a world where I do things for others altruistically, but that world is not this one, and the conditions for such a world are far from being met.

Defect is the rational response to defection, and tit for tat wins iterated prisoner's dilemmas.

the odds of your child getting an autoimmune disease from vaccines is so low that the general benefit of them getting sick less often outweighs it.

I don't trust your calculations, mostly because I don't fear the diseases or believe in their prevalence. I see the risks as miniscule, but deliberately overblown in order to create a far response and enforce compliance. There is no guarantee I even encounter measles or hepatitis or haemophilic influenza b, but if I take the vaccine there is a 100% exposure rate to the contents of the shot.

Furthermore, my children can simply get the shots later in life, when they are grown and have a much larger body mass with which to accommodate, after development has been mostly completed.

The eczema finally went away, and there's no way to know the counterfactual, but I think if we were on schedule I'd still be seeing rashes all over the back and legs and ankles.

I don't trust your calculations

You can't trust what I haven't presented. I could do so, and I strongly expect to be correct, but I already do enough trawling of medical literature when I'm being paid for it.

It's your child, and I have some respect for your right to make decisions on their behalf, even if I think they're bad decisions.

Furthermore, my children can simply get the shots later in life, when they are grown and have a much larger body mass with which to accommodate, after development has been mostly completed.

My man, you're going from wrong to confused. There's good reason why you don't see doctors or nurses pull out dose calculators to account for body weight when giving every vaccine I can think of it. It's because it doesn't matter. If little Tommy is 4'6 and 35 kilos or 4'9 and 45 makes next to no difference, and this holds true once you're past the size of a premature infant on death's door, going to a land whale who needs a mobility scooter. Vaccines aren't like paracetamol, the dose-response curves are VERY different when it's the immune system we're talking about. Someone with a peanut allergy isn't twice as likely to die if you give them two peanuts versus one.

The eczema finally went away, and there's no way to know the counterfactual, but I think if we were on schedule I'd still be seeing rashes all over the back and legs and ankles

You're not doing a good job at probabilistic reasoning, but an eczematous rash is a minor vaccine reaction, and of very little consequence. If it was life threatening, I presume you'd have pointed that out, and even then, you'd be better off consulting your pediatrician about whether they could narrow it down to a particular constituent of the two common rotavirus vaccines in the States (fetal bovine serum or porcine circovirus, if I had to guess from looking at composition), and take precautions when administering future vaccines with similar compositions. Believe it or not, most doctors would be happy to answer those questions and offer reassurance if warranted, especially if you're paying them.

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