Michele,
It has been a while and my infection disease epi is rusty, but I believe there are some counties that still choose to vax for smallpox. Basically it is a tossup between universal vax, and having the infrastructure in place to deal with a sporadic case.

“way up in comments you talk about a baby being “Immuned” I can’t find a definition of that term anywhere, and have to answer “You keep using that word. I do not think it means what you think it means.” which seems to be the only answer I can come up with to most of your posts.”

Anybody with a brain stem knows that babies have natural immunity a.k.a. innate immunity and with the bonus natural passive acquired immunity from the mother.

Why? You didn’t have those when you were born?

“You seem to think that having your immune system respond to a vaccine is equivalent to being “infected”, ”

Yes, it is. Vaccination is an artificial infection derived from natural infection. Take smallpox vaccine for example. Instead of going to endemic areas to be exposed to ordinary smallpox, all you need is to sit tight, relax and this:

“The current formulation of smallpox vaccine is a live virus preparation of infectious vaccinia virus. The vaccine is given using a bifurcated (two-pronged) needle that is dipped into the vaccine solution. The needle is used to prick the skin (usually the upper arm) a number of times in a few seconds. If successful, a red and itchy bump develops at the vaccine site in three or four days. In the first week, the bump becomes a large blister (called a “Jennerian vesicle”) which fills with pus, and begins to drain. During the second week, the blister begins to dry up and a scab forms. The scab falls off in the third week, leaving a small scar.” http://en.wikipedia.org/wiki/Smallpox
——————-

“Kindly read the title again from your link: “One-dose immunization against paralytic poliomyelitis using a noninfectious vaccine.””

I actually wasn’t posting the link to the paper for any actual reference to the information contained therin other than to make the point that the IPV vaccine, contrary to your claims that it “infects” APC’s, is non-infectious. You are trying to make the point that the IPV is “infecting” people with the “infectious D antigen”. We have not actually moved into discussing actual poliovirus infection. I am simply pointing out that your use of terminology is incorrect. Try to stay on point. That paper isn’t useful for our particular discussion for anything beyond the fact that the IPV is labeled noninfectious. I used that paper as an example of how the definition you are using for “infectious” is incorrect.

You have made the claim that the IPV vaccine contains the “infectious D antigen” and therefore is infecting APCs when you vaccinate. I have pointed out that the antigen is rendered inactive by formalin treatment and therefore does not infect cells in the same manner as an normal active virus.

“There are no difference, it involves the same process, whether natural or artificial. Antigens in a particular vaccine or from the pathogen, are recognized by any APCs. They eat, ingest and process antigens to small molecules. And these processed small molecules are displayed to its surface. And a cell cannot be infected unless the molecules are presented to the surface.”

No, it doesn’t involve the same process. If you read the link I gave above you would see how the active virus actually infects cells:

Please show data showing how the inactive viral proteins can still act through the above mechanisms in order to “infect” a cell.

I don’t understand your rant about antigenicity versus immunogenicity, so why don’t you stay on the topic of determining whether an antigen from IPV can infect a cell. (That’s not an entirely true statement as I know the reason you have the rant….to distract from the actual issue….you are quite adept at subject changing).

But again, you are using your own definitions of words….so it is nearly impossible to have intelligent discussion with you….although I doubt that word usage is the only reason you are unable to engage in intelligent discussion.

I feel like I’ve fallen down the rabbit hole or walked through the looking glass when I attempt to talk to you.

“If I had a world of my own, everything would be nonsense. Nothing would be what it is, because everything would be what it isn’t. And contrary wise, what is, it wouldn’t be. And what it wouldn’t be, it would. You see?”” – Lewis Carroll

I have no doubt that a very regimented control policy could (and in fact did) halt the spread of smallpox.
However, it is doubtful that this was a feasible approach for all communities.
1880’s and 90’s? How do you think that would have gone down in the westward expansion for example?

RE Leicester: well, yes, one would expect that if people in surrounding communities got vaccinations and stopped contracting and transmitting smallpox, that an individual non-vaccinating community would be able to partially contain smallpox within it. According to your article, London (moderately well vaccinated) had a much lower incidence of smallpox than Leicester (very low vaccine uptake) did at the same time. Also according to your article, a 20.5 per 10,000 incidence of smallpox is “eradication.” (This is the rate achieved by aggressive quarantining in non-vaccinating Leicester when surrounding communities were vaccinating.) The rest of the world considers eradication to be 0 per 10,000 incidence. (This is the world-wide rate ultimately achieved by aggressive vaccination.)

This does not support your contention that quarantine is more effective than vaccination.

RE the current vaccine schedule (which you prefer to discuss) and smallpox (which I am discussing): yes, I am the one bringing up smallpox. Ok, you want to talk about rubella? Fine. It is infectious for seven days before a rash appears. It’s highly contagious. Vaccination is associated with dropping rates and vaccine refusal is associated with outbreaks.http://www.phac-aspc.gc.ca/im/vpd-mev/rubella-eng.php

Vaccinated carriers were not blamed for the 2005 Southern Ontario rubella outbreak that affected 309 people in an unvaccinated religious community because it was not caused by them. It was caused by unvaccinated religious people from the Netherlands, who had been unsuccessful in using quarantine to contain their rubella outbreak since 2004; 387 Dutch people contracted the illness.

Polio: in an unvaccinated population (US in the 1950s), the carrier:case ratio was about 100:1. Great effort was expended on isolation measures which were unsuccessful in containing it. Vaccination was. Unvaccinated carriers were the problem.

Measles: in the US, comes from unvaccinated people outside the US and is transmitted within the US by unvaccinated people to other unvaccinated people. The period of greatest contagiousness is the 2-3 day period before a rash appears. There is no ongoing carrier state.

Ok. Three diseases where unvaccinated people, not vaccinated people, are identified as those primarily responsible for transmitting a particular disease… because they are primarily responsible.

Now name me three deadly diseases where unvaccinated people are being unfairly blamed for transmitting the disease even though vaccinated people have been documented to be the primary vectors: that is, 100,000 vaccinated people transmit more disease than 100,000 unvaccinated people do.

(As Harriet Hall has pointed out, tetanus is irrelevant because it is a soil baterium and contracted from contact with the soil, not with other people.)

I said “We have seen over and over that when the vaccination rate drops, the disease rate rises, and when the vaccination rate rises again, the disease rate drops.”

Professional_lurker said: “Based wholly upon incidence reporting, and epidemiological data. In order to correctly diagnosis a person that is transmitting a communicable disease, you have to realize that they may not be presenting correctly due to their vaccination status and that just because they aren’t showing symptoms, it certainly doesn’t mean they are not contagious / infectious.”

This would not explain the data, and you have presented no evidence to support the idea that immunized people are actually spreading disease. If more than a tiny minority of the immunized were able to spread infection, that wouldn’t fit the observed facts. It wouldn’t explain why the rate of spread in a community decreased when immunization rates rose, and vice versa. I’m afraid you are grasping at illogical straws.

Re the speeding analogy: “Getting vaccinated does not allow the vaccinee to control whether or not they are injured from the vaccine, it is not comparable.”

Whaaat? Getting vaccinated allows the vacinated to control (not perfectly, but to a high degree) whether they are protected from the disease, just as controlling whether they speed determines whether they are protected from speeding accidents. I don’t understand why you brought up injuries from vaccines: the analogy would be with injury from the disease, not injuries from the vaccine. Someone might be injured by a vaccine just as someone might be injured by not speeding (for instance, not getting out of the way of a dangerous situation in time), but that would be a rare occurrence.

My point was that if all drivers chose not to speed, there would be no accidents due to speeding. If all people chose to accept vaccination, every disease that is only spread person-to-person could be eradicated like smallpox. If all drivers chose not to speed, they would not only protect themselves but others from injuries due to speeding accidents.

“babies have natural immunity a.k.a. innate immunity and with the bonus natural passive acquired immunity from the mother.”

You keep saying this and I’m still not clear on exactly what you mean. Do you think a baby is naturally immune to diseases like pertussis or measles or smallpox and will not catch them if exposed? And you do realize, don’t you? that passive immunity from the mother can only provide antibodies to diseases she herself has developed active immunity to, and she can only provide them for a short period. Healthy, breastfed babies do catch vaccine-preventable diseases despite whatever “natural immunity” they have.

backer, the information you wanted is available, but it should not help you in answering my question. Something you have still not done months after it was first asked.

What happened between 1960 and 1970 to affect measles incidence? Pat provided a paper from 1980 that shows a nice graph where the incidence remains pretty level (even though the death rate decreases), but both plunge during that decade.

I am annoyed at that comment from Th1Th2 on the natural immunity from diseases should exist for babies. My daughter was only on breastmilk when she got chickenpox as a baby. And he has not responded to why the two newborns I mentioned died from pertussis. If one checks the data, more and more infants under three months are dying from pertussis.

It is disgusting that Th1Th2 is ignoring that data.

Though not as disgusting as a commenter (Food Magick) on the Bad Astronomer blog that blames the parents for not eating the proper diet.

“It is unknown whether immunizing adolescents and adults against pertussis will reduce the risk of transmission to infants? ”
True, let’s test this and see. Seems plausible, but needs verifying. Then we will know. Well, those who really want to know, will; those who don’t, will never know.

Since Th1Th2 seems to be absent at this hour, I will deign to answer for them. *Ahem*

Do you think a baby is naturally immune to diseases like pertussis or measles or smallpox and will not catch them if exposed?

Yes, but only until such a time that they are infected from an environmental source or forced penetration into the body by way of an unnatural vaccination.

I don’t know if it’s sad that i know that or not. He’s just going to use his alternate, illogical, definition of “immunity” by weakly referencing everyone’s innate immunity through barriers like the skin and mucosa. “Acquired immunity isn’t immunity though, it’s the bastard brother of the innate immune network,” and whatnot. And then go on to apply the term “infection” towards non-replicating proteins, totally disregarding germ theory.

“He’s just going to use his alternate, illogical, definition of “immunity” by weakly referencing everyone’s innate immunity through barriers like the skin and mucosa.”

He does like his own definitions. Still hasn’t answered my question about how well an AIDS patient survives with a fully intact innate immune system, only lacking one component of acquired immunity (CD4 T cells). But acquired immunity isn’t important, right?

What happened between 1960 and 1970 to affect measles incidence? Pat provided a paper from 1980 that shows a nice graph where the incidence remains pretty level (even though the death rate decreases), but both plunge during that decade.

thanks for the data, i looked but couldnt find it anywhere. My simple answer to your question is i dont know what happened. I am assuming you think vaccines are the cause for the drop. which might seem to be the case on the surface, however when we look at the data from scotland you do not see the same drop in cases. This tells me something else is going on, and the vaccine isnt the only reason for the drop. If it were we should see the same results no matter where it is implemented. The drop in cases in scotland between the 60’s and 80’s was effectively zero, yet the vaccine coverage in both countries was virtually equal. When i asked harriet about this she responded with…

“You can think all you want, but the drop was not greater because the vaccine is not 100% effective and the coverage was incomplete.”

She seems to be distorting the data to fit her case. the vaccine coverage was virtually the same in both countries yet we see a dramatic drop in one country and not the other? To me this is a clear example of bait and switch.

There is such thing called innate immunity, and it is what you are born with. It is indeed important.
But immunity in this context refers to ‘that of the immune system’ and not being actually immune like in the sentence ” TH is immune to learnin'”

You can think all you want, but the drop was not greater because the vaccine is not 100% effective and the coverage was incomplete.”

She seems to be distorting the data to fit her case. the vaccine coverage was virtually the same in both countries yet we see a dramatic drop in one country and not the other? To me this is a clear example of bait and switch.

This is where epi comes into play. Not knowing anything about the case in Scotland I can think of lots reasons why Scotland had different outcomes.
A longer cold/wet season in which there is more close (indoor) contact, perhaps Scots are sicker, or their immunity is affected by alcohol consumption (broad stereotype here) just to name a few. I don’t know. But they are plausible reasons.

So your assumption that vax rates being equal, all societies should respond the same is just false. T

Vaccines are vitally important. And they do reduce disease/death. However other factors can and do come into play, as evidenced above. And I don’t see anyone on her suggesting otherwise.

the concern about scotland is that the vaccine seems to have had little effect in the decline there. It was a slow gradual decline. not the sharp decline we see in the US. The only logical explanation is that the vaccine isnt the only reason for decline in the US. If it was we would see similar results in scotland.

Vaccines are vitally important. And they do reduce disease/death. However other factors can and do come into play, as evidenced above. And I don’t see anyone on her suggesting otherwise.

are you kidding,? the initial article blatantly suggests this.

My whole point is that vaccines are not reliable enough to hang your hat on, so why are you all doing it?

I have never said that they don’t have a role in help stopping infection. We just rely on them too much, i personally think they should stop using them all together except in the case of dire emergency.

“the vaccine coverage was virtually the same in both countries yet we see a dramatic drop in one country and not the other”

This fact does not prove that vaccines were ineffective. It is compatible with the possibility that vaccines are effective and that some other factor caused a discrepancy in disease rates between the two countries. I can think of many confounding factors that might have caused this situation. Can’t you? Use your imagination.

If the rate of vaccination had been 100% and the vaccine had been 100% protective, the disease would have vanished in both countries. It did not vanish in either country because susceptible people were able to pass it on to others. Chance alone could mean that a chain of disease got established in one country but not in another. Reporting could have been different in the two countries. A more virulent strain could have been circulating in one country. There are any number of factors that could have led to a discrepancy in disease rates. Before you can cite these figures as evidence that vaccines don’t work, you would have to rule out confounding factors.

When you weigh data like these against the mountain of other data showing a correlation between higher vaccination rates and lower disease rates, the anomalous data become insignificant.

And if you wanted to prove that vaccines didn’t cause the “dramatic drop” in one country, you would have to come up with some other explanation for the drop, and that explanation would have to be tested.

What if an antibiotic were used for strep throat in two populations and in one population 99% of the followup cultures were strep-negative and in the other population only 70% were negative. Would you conclude from that data that the antibiotic didn’t work? I don’t think so!

backer said “This tells me something else is going on, and the vaccine isnt the only reason for the drop”

I say “This tells me something else is going on, and a lack of efficacy of the vaccine isn’t the only reason for the lack of drop.”

“You have made the claim that the IPV vaccine contains the “infectious D antigen” and therefore is infecting APCs when you vaccinate. I have pointed out that the antigen is rendered inactive by formalin treatment and therefore does not infect cells in the same manner as an normal active virus. ”

The infectivity of poliovirus is determined by D antigen because it contains complete viral particles. Therefore, to be able to neutralize the infectiousness of a live virus, the D antigen is required in the vaccine. The more infective vaccines are, the better immunogenicity. I will quote this again from the CDC so you’ll know that they do not agree with you:

“The more similar a vaccine is to the disease-causing form of the organism, the better the immune response to the vaccine.”

Formalin is used to inactivate the live virus in order not to replicate in the cells, but it does not alter the viral structure nor prevent it to infect the cell (i.e. attachment and penetration to APCs.)

Can live viruses replicate OUTSIDE of the cell?
Can they replicate INSIDE without infecting the cell (i.e. attachment and penetration)?

Figure 2 from your link, it states, “Infection is initiated by attachment to receptor”

So for you to claim that IPV does NOT infect people with poliomyelitis virus is like you making an assertion that paralysis is the only symptom of poliomyelitis.

This fact does not prove that vaccines were ineffective. It is compatible with the possibility that vaccines are effective and that some other factor caused a discrepancy in disease rates between the two countries. I can think of many confounding factors that might have caused this situation. Can’t you? Use your imagination.

I can think of some confounding factors too, again you miss my point. My point is that this article implies that vaccines did indeed “save” us. A true savior works regardless of confounding factors, it works every time with equal efficacy.

Dogmatic assertions about vaccines is what bothers me, not that they exist.

This fact does not prove that vaccines were ineffective. It is compatible with the possibility that vaccines are effective and that some other factor caused a discrepancy in disease rates between the two countries. I can think of many confounding factors that might have caused this situation. Can’t you?

I can think of some confounding factors too, again you miss my point. My point is that this article implies that vaccines did indeed “save” us. A true savior works regardless of confounding factors, it works every time with equal efficacy.

Dogmatic assertions about vaccines is what bothers me, not that they exist.

Th1Th2 said “to claim that IPV does NOT infect people with poliomyelitis virus…”

There is no such thing as “poliomyelitis virus.” Poliomyelitis is a disease. The disease is caused by infection with the polio virus. IPV doesn’t contain polio virus so it couldn’t possibly infect anyone with polio virus and it couldn’t possibly cause the disease poliomyelitis. It contains antigens derived from the polio virus. The body produces antibodies against those antigens and is then able to respond to either the antigens alone or the entire virus.

yeah, call me crazy, but I’m going with the folks who don’t want to wait for a dire emergency…In fact, in my mind, that’s kinda the whole point to medicine. (Although it’s pretty cool what doctor’s can do in a dire emergency sometimes, but that is besides the point.)

backer said “A true savior works regardless of confounding factors, it works every time with equal efficacy.” Then he said “Dogmatic assertions about vaccines is what bothers me, not that they exist.” His comment about “a true savior” is a dogmatic assertion, but for some reason that particular dogmatic assertion doesn’t bother him.

No one has claimed that vaccines work every time with equal efficacy. Some people have an exaggerated idea of what vaccines can accomplish, but that only means they are misinformed. Backer could have simply said that and we would have agreed with him. Instead, he tries to battle a straw man. I don’t know who may have called vaccines “a true savior” but that amounts to an opinion, not a scientific statement. It seems a bit silly to argue about how a “true savior” would work. Angels, pinheads.

Even if you don’t want to call it a true savior, the smallpox vaccine indisputably did truly save humankind from ever having to experience smallpox again. And every vaccine for a disease that lacks a non-human reservoir has the potential to send that disease the way of smallpox.

“There is no such thing as “poliomyelitis virus.” Poliomyelitis is a disease. The disease is caused by infection with the polio virus.”
——————–
Poliomyelitis
The words polio (grey) and myelon (marrow, indicating the spinal cord) are derived from the Greek. It is the effect of poliomyelitis virus on the spinal cord that leads to the classic manifestation of paralysis.

I stand corrected. I mis-spoke. IPV does not just contain antigens, it contains the whole virus but it has been killed and is incapable of replicating or causing disease. Although for all practical purposes, you could say it contains polio antigens in the form of a killed virus rather than an infective organism. OPV has caused cases of paralytic poliomyelitis, but
there has never been a case of poliomyelitis attributed to IPV.

As for the “poliomyelitis virus” the site you linked to does indeed incorrectly use that term once, but the rest of that article correctly refers to the “polio virus.” The fact that you can find an incorrect usage of a term does not make it correct. In the scientific classification of viruses, “poliomyelitis virus” is not listed. Polio virus is.

“The words polio (grey) and myelon (marrow, indicating the spinal cord) are derived from the Greek. It is the effect of poliomyelitis virus on the spinal cord that leads to the classic manifestation of paralysis.”

That is the incorrect terminology whether the CDC has it in a brocheure or not. Poliomyelitis is the disease, not the virus. The taxonomy of the virus is

“The infectivity of poliovirus is determined by D antigen because it contains complete viral particles.”

As I said before, the IPV does not contain intact and active viral particles as the virus produced is inactivated using formalin which then renders it non-infectious. If you have some evdience that the IPV vaccine is still infectious, then please present it. For example, you could link to a report showing that the use of the IPV vaccine in a plaque assay results in plaque production (indicating virus infection). I don’t believe such a report exists, but if you link to such a report then I will concede the point.

“Formalin is used to inactivate the live virus in order not to replicate in the cells, but it does not alter the viral structure nor prevent it to infect the cell (i.e. attachment and penetration to APCs.”

Formalin alters protein structure. Virus coat proteins are not immune to the chemical effects of formaldehyde.

“As with foot-and-mouth disease virus (FMDV), poliovirus which had been inactivated with formaldehyde did not release its RNA on extraction with phenol-SDS and the capsid proteins were also cross-linked.”

Cross linking of virus capsid proteins = protein structure changes.

The fact that protein structure of the virus capsid changes is part of the reason why an inactivated vaccine is not always as good as an attenuated vaccine. The epitopes that your immune system would use to generate neutralizing antibodies can be dependent on native protein structure. Destroy that structure and you remove that epitope from existence in the vaccine, potentially leading to reduced capacity to generate neutralizing antibodies. This is why the CDC makes the statement that you quote above:

“The more similar a vaccine is to the disease-causing form of the organism, the better the immune response to the vaccine.”

Attachment to PVR on APCs is not infection, but it is also likely that the viral capsid structure is sufficiently altered so as to not bind to its normal receptor. Virus penetration is infection, but again virus penetration requires native virus and does not occur with inactivated virus. The process by which the virus enters the cell is either phagocytosis (if virus capsid no longer binds the virus receptor) or receptor-mediated endocytosis (if virus still binds receptor, but is no longer capable of normal virus penetration mechanism).

“Figure 2 from your link, it states, “Infection is initiated by attachment to receptor””

Of the wild-type virus. The formalin inactivated virus would not act by the same mechanism due to the effects of formalin on protein structure. Furthermore, by saying “infection is initiated” they are not implying that the initiation of the infection process means that cells are infected. A cell would be infected at the end of the infection process. If the virus binds the receptor and then releases the receptor (as some would be expected to since all ligand/receptor interactions have certain kinetic on/off rates) then the cell that the virus attached to, but let go of would not be an infected cell.

By way of analogy, if I start the breakfast process (get out cereal and milk from cabinet/refrigerator), but stop and leave my house prior to pouring the cereal/milk into the bowl and eating it, I would not still say, “I ate breakfast this morning”. I started the process and did not finish it, therefore the end result did not occur.

“Can live viruses replicate OUTSIDE of the cell?
Can they replicate INSIDE without infecting the cell (i.e. attachment and penetration)?”

As far as I know, viruses can accomplish neither of those tasks. Viruses require a cell’s machinery to replicate. It is possible to bypass true viral infection and cause viral replication by injecting viral DNA/RNA into a cell and allowing for gene transcription/translation and production of virions.

I was referring to this dogmatic statement: “A true savior works regardless of confounding factors, it works every time with equal efficacy.” That is not “a factual statement” but an interpretation of what “a true savior” means to you.

“the OP implies this as a given”
It does? Sez who? Again, this is just your interpretation.

Why should we not use vaccines to eliminate every disease that has no non-human reservoirs?

Agreed. Polio is just short for poliomyelitis so I think they can be used interchangeably to denote disease, virus, infection, symptoms, death, vaccines, cases etc. In fact, there are publications and studies that still uses the term ‘poliomyelitis virus’ and I do not think it was erroneously done. Likewise, I do not think it’s wrong to say that influenza is caused by influenza virus (colloq. ‘flu virus’)

“OPV has caused cases of paralytic poliomyelitis, but
there has never been a case of poliomyelitis attributed to IPV.”

This is the intended effect when the viruses are not replicating; they are less infectious and the inoculee has fewer serious symptoms compared to that of live vaccines. Of course there are non-specific symptoms caused by IPV and these symptoms reflect the symptoms of the disease (subclinical and/or abortive poliomyelitis). Therefore, the vaccinated have had the disease without the paralysis.

That is not “a factual statement” but an interpretation of what “a true savior” means to you.

uhhh, no. the technical definition of a savior is…

savior- one who saves, rescues, or delivers

I don’t see anything here about….”unless there are confounding circumstances”

But maybe i am being nit picky

“the OP implies this as a given”
It does? Sez who? Again, this is just your interpretation.

harriet, seriously? It is obvious just by the title that Dr Gorski is taking the stance the vaccines DID indeed save us. This is not my interpretation, there is only one logical answer that follows from such a statement/tone.

Why should we not use vaccines to eliminate every disease that has no non-human reservoirs?

because we know so little about the long term effects of these vaccines. They could actually be doing more harm than good. No one knows

“no kidding, we should be more concerned with their water than vaccines”

Which is like saying we should be more concerned with their food than their water. Or we should be more concerned with political stability than the food or water supply. Which do you do first? Well, one thing we know, even after aid organizations have been kicked out of the country by the current regime, the vaccines are still going to keep working for their allotted time.

And are you sure you know more about the long term effects of the chemicals used in water treatment v.s. the effects of vaccination? Me, I’m for both. But I’m not sure why one would except chemicals in their water, but not vaccination.

A kid was drowning. The only one nearby was the town drunk, who jumped in and saved him. If a town drunk can be a savior, so can vaccines.

“because we know so little about the long term effects of these vaccines. They could actually be doing more harm than good. No one knows”

Again, you are the expert on this? What you are saying is that because you know so little that no one else could possibly know more than you. And your ignorance tells you that it’s possible they could actually be doing more harm than good, then they must be doing harm so we should stop vaccinating. That’s pretty arrogant of you, pec. I mean, backer.

And are you sure you know more about the long term effects of the chemicals used in water treatment v.s. the effects of vaccination? Me, I’m for both. But I’m not sure why one would except chemicals in their water, but not vaccination.

“Of course there are non-specific symptoms caused by IPV and these symptoms reflect the symptoms of the disease (subclinical and/or abortive poliomyelitis). Therefore, the vaccinated have had the disease without the paralysis.”

No, the vaccinated only have non-specific reactions. Your statement doesn’t even make sense because non-specific means the reactions are not specific to the particular vaccine but to general effects of any injection, from mechanical disruption due to needle insertion and introduction of liquid into the tissues. In other words, they get sore arms. Rarely someone will have an allergic reaction. They don’t get symptoms of the disease polio.

It is correct to point out that some people have an exaggerated belief in the efficacy of vaccines. It is ridiculous to quibble about the meaning of savior.

I think Dr. Gorski’s point (he can correct me if I’m wrong) was that when anti-vaccine activists argue that vaccines didn’t save us, they are attacking a straw man, because we didn’t say “they saved us.” What they really mean is that they think the statistics don’t support our argument that vaccines lower the risk of disease and death. And they are wrong.

Science does not claim that vaccines “save” us, it only provides the evidence that vaccines markedly reduce the burden of illness and death from specific diseases. Smallpox vaccine is the one exception where a vaccine might be said to have “saved” all humanity from a disease. Some vaccines like polio would be able to save us all from ever getting the disease again if only people accepted polio vaccination as they accepted smallpox vaccination.

So while “accepting polio vaccination” maybe one barrier to polio eradication, it may not be fair to say that the acceptance of vaccination would eliminate all barriers. War and lack of political, communication and transportation infrastructure would be other significant barriers.

An the other hand conspiracy theorists, folks with paranoid delusions and those who want you to prove a negative don’t HELP a heck of a lot either.

I certainly didn’t mean to imply that vaccine refusers were the only barrier to eradicating polio. There are many barriers, including the paranoid lies that were spread in Nigeria that allowed polio to break out again to other countries.

Let me rephrase: if we could get enough people vaccinated, we could eradicate polio.

I am hopeful. There were many of the same barriers to smallpox vaccination, and it took a long, expensive, cooperative worldwide campaign to reach the goal, but it eventually succeeded.

Does anyone deny vaccines have side effects? You cite one flawed study about IDDM and HIB and expect us to abandon a vaccine? Puhleeze! Here’s something useful you could do. Try and find the flaws in that study. Here is another to check out.

Do you believe that risk/benefit ratios are only contemplated by people who are scared of vaccines? Or do you think that perhaps scientists, doctors and epidemiologists also consider risk/benefit ratios?

You cite one flawed study about IDDM and HIB and expect us to abandon a vaccine?

No i expect you to abandon it because there are only about 1000 cases per year, even before the vaccine. If you are REALLY that concerned with your child getting HIB then you should not drive around with them in your car. They have a better chance of dieing in your car than HIB 10 times over

“No i expect you to abandon it because there are only about 1000 cases per year, even before the vaccine. If you are REALLY that concerned with your child getting HIB then you should not drive around with them in your car. They have a better chance of dieing in your car than HIB 10 times over”

backer on whether they think scientists, doctors and epidemiologists think about risk/benefit ratios:

“No I do not”

Ok. So let’s see if I understand your logic.

1) Doctors do not attempt to balance risks and benefits before recommending a course of action.
2) Doctors are bound by the hippocratic oath not to kill people or to advise them on methods of suicide.
3) Doctors are fully aware that vaccines have the ability to kill a child.

We have just logically proven that no doctor has ever vaccinated a child, even if the potential benefits clearly outweighed the risk!

Doctors know that any vaccine has a tiny possiblity of harm, so they are bound not to administer them. Since they never balance harms and benefits, the benefits are irrelevant.

Since risks are the only thing that count, I guess no doctor has ever prescribed any kind of drug either, because no matter how beneficial it might be, somebody might suffer a side-effect. Surgery has never been performed.

Wow. The entire field of medical science… an illusion! There is no such thing as a doctor!

“If you are REALLY that concerned with your child getting HIB then you should not drive around with them in your car. They have a better chance of dieing in your car than HIB 10 times over”

I must admit I find this difficult to understand. Are you saying the child has a 10 times over risk of dying from HIB because they are driven in a car? That doesn’t make sense. They get HIB because they are driven in a car? Do you have studies showing that? I’m not aware of any. Do you mean a child that has HIB, if driven in a car, is 10 times as likely to die than if not driven in a car? I don’t know. Is this when you drive them to the hospital? Then an ambulance might be more appropriate. Someone really did a study about this?

(1) backer’s numbers are wrong. The CDC estimates 4,700 cases of invasive disease and 675 deaths a year.
(2) The numbers are low – way lower than they used to be – precisely because vaccination works! backer’s claim of low current risk proves exactly the opposite of what he is trying to prove. That’s actually pretty funny!

According to the CDC website “Due to routine use of the Hib conjugate vaccine since 1990, the incidence of Hib disease in infants and young children has decreased by 99% to fewer than 1 case per 100,000 children under 5 years of age. In the United States, Hib disease occurs primarily in underimmunized children and among infants too young to have completed the primary immunization series. In developing countries, where routine vaccination with Hib vaccine is not widely available, Hib remains a major cause of lower respiratory tract infections in infants and children.
Sequelae 3%-6% of cases are fatal; up to 20% of surviving patients have permanent hearing loss or other long-term sequelae.”

We protect our children in cars with car seats; we protect them in the community with Hib vaccine.

“surely doctors know that when they give a vaccine it could potentially kill the child.”

Yes, and surely they know that omitting vaccines could potentially kill the child. And surely they know that children are less likely to die with the vaccines than without.

I see you’ve tried to construct your strawman accordingly by continuing to address smallpox as if it bears some significance on the current schedule. It doesn’t. I said Leicester would be interesting reading… I hope it was. I see you’ve not taken this away from the article though:

Dr. Millard wrote and spoke extensively on smallpox and vaccination. He emphasized the protection given by recent vaccination, and argued that the Leicester Method was of value in protecting a community from an epidemic. He stressed the hazard to society of a person vaccinated in infancy subsequently developing “modified smallpox”. This person’s illness was (and still would be) difficult to identify and
capable of spreading true smallpox before diagnosis. Following his conversion to Leicester and its ways, he advocated the Leicester Method combined with his use of selective vaccination. He also campaigned for repeal of the Infant Vaccination Acts from 1912-1914 onwards.

Irrelevant to your interpretation I suspect. Round and round we go? Sorry, I get off…. right here.

RE the current vaccine schedule (which you prefer to discuss) and smallpox (which I am discussing): yes, I am the one bringing up smallpox. Ok, you want to talk about rubella? Fine.

Using an argument out of context (like you did with smallpox) is not going to further discussion. If I make a statement as it refers to the vaccine schedule as it is currently administered, obviously, smallpox is not on the list. There are at least 100 points of view on this vaccine, the disease and the disease eradication. I’ll repeat again, that I have no desire to discuss the circular arguments contained therein, no matter how hard you try Bringing it up, is a distraction from what is actually a valid concern regarding the schedule. It is a diversionary tactic, no more.

Polio: in an unvaccinated population (US in the 1950s), the carrier:case ratio was about 100:1. Great effort was expended on isolation measures which were unsuccessful in containing it. Vaccination was. Unvaccinated carriers were the problem.

Oh dear me, as if polio is so simple. The shift that occurred (and still does occur) in diagnostic criteria for this disease and its clinical symptoms are almost a joke. Erasing disease incidence with the stroke of a pen (or broadening it) seems to be an acceptable measure of ‘scientific adjustment’ to evolving data. If you care to be more specific, I’m happy to further the discussion. At present, you are regurgitating a talking point with no evidence.

Measles: in the US, comes from unvaccinated people outside the US and is transmitted within the US by unvaccinated people to other unvaccinated people. The period of greatest contagiousness is the 2-3 day period before a rash appears. There is no ongoing carrier state.

How curious that you would choose a disease for which I have conceded value in the vaccine designed to prevent it? I’ve read that a carrier state “has not been observed”. It was certainly observed in the case study I posted previously in this thread. In order to observe with significance, you must look. I’ve given you reason to look.

Three diseases where unvaccinated people, not vaccinated people, are identified as those primarily responsible for transmitting a particular disease… because they are primarily responsible.

No. If you are only looking at unvaccinated people, exactly WHAT are you trying to tell me? That the unvaccinated people transmitted disease because they showed symptoms and we didn’t look at the vaccinated… because they were vaccinated? I’m not accepting this position. I’m sorry.

Dr. Hall,

This would not explain the data, and you have presented no evidence to support the idea that immunized people are actually spreading disease.

Really? You are asking me to present you with data (in your acceptable form) that no one will quantify because no one is looking, though the notion is totally and completely possible? Bout right, yes? Seems it’s you that needs to tailor your response to include the “what if”, not me that need provide you with ‘data’. It’s biologically plausible, and you know it. You cannot, with no equivocations, continue to say that “vaccines prevent disease and you must vaccinate to ensure herd immunity”. You will need to be specific, and far more convincing, if you are intending to convince the professional lurkers.

If more than a tiny minority of the immunized were able to spread infection, that wouldn’t fit the observed facts.

But it does. From the same Corpus Christi outbreak you and Th/1-2 quibbled about above:

Only 4.1 percent of these students (74 of 1806) lacked detectable antibody to measles according to enzyme-linked immunosorbent assay, and more than 99 percent had records of vaccination with live measles vaccine. Stratified analysis showed that the number of doses of vaccine received was the most important predictor of antibody response. Ninety-five percent confidence intervals of seronegative rates were 0 to 3.3 percent for students who had received two prior doses of vaccine, as compared with 3.6 to 6.8 percent for students who had received only a single dose. After the survey, none of the 1732 seropositive students contracted measles. Fourteen of 74 seronegative students, all of whom had been vaccinated, contracted measles. In addition, three seronegative students seroconverted without experiencing any symptoms

ff

I’m totally convinced that there were no carrier states, since we’re measuring the rate of infectiousness with seriopositivity and symptomalogy.

It wouldn’t explain why the rate of spread in a community decreased when immunization rates rose, and vice versa. I’m afraid you are grasping at illogical straws.

If the local health department spreads bulletins throughout the community, what kind of impact might this have? I’m afraid it’s you, that are tying on vaccination to every possible, positive variable and riding their coat-tails into the night until we are all blinded by the light.

I said: Re the speeding analogy: “Getting vaccinated does not allow the vaccinee to control whether or not they are injured from the vaccine, it is not comparable.”

You responded with: Whaaat? Getting vaccinated allows the vacinated to control (not perfectly, but to a high degree) whether they are protected from the disease, just as controlling whether they speed determines whether they are protected from speeding accidents.

I disagree, and you have totally ignored adverse reactions which do not result from stepping on an accelerator. In order for you to properly assess risk and benefits, we must first agree on what that risk is. They are not comparable.

According to the CDC website “Due to routine use of the Hib conjugate vaccine since 1990, the incidence of Hib disease in infants and young children has decreased by 99% to fewer than 1 case per 100,000 children under 5 years of age. In the United States, Hib disease occurs primarily in underimmunized children and among infants too young to have completed the primary immunization series. In developing countries, where routine vaccination with Hib vaccine is not widely available, Hib remains a major cause of lower respiratory tract infections in infants and children.
Sequelae 3%-6% of cases are fatal; up to 20% of surviving patients have permanent hearing loss or other long-term sequelae.”

Correct. We have shifted this demographic of disease to the older populations (like we have with other diseases) and increased the frequency of nontypeable strains since we’ve plucked Hib out of the environment.

Nontypeable H. influenzae disease accounted for the greatest proportion of cases (35.8%-61.5%) in all but 1 age group. The number of cases of invasive nontypeable H. influenzae disease increased by 657%, from a low of 7 cases in 1996 to a high of 53 cases in 2004; as a proportion of annual cases, nontypeable H. influenzae disease increased from 17.5% in 1996 to 70.7% in 2004.

Yes, and surely they know that omitting vaccines could potentially kill the child. And surely they know that children are less likely to die with thevaccines than without

I’m asking you politely, for the sixth time, please do NOT classify all vaccines as one and the same. They are all different. The diseases are all different. You know this. You are either being intellectually dishonest, or you you think no one is paying attention.

“I’m asking you politely, for the sixth time, please do NOT classify all vaccines as one and the same. They are all different. The diseases are all different. You know this. You are either being intellectually dishonest, or you you think no one is paying attention.”

I must have missed where Dr. Hall classified all vaccines as one and the same.

” We have shifted this demographic of disease to the older populations (like we have with other diseases) and increased the frequency of nontypeable strains since we’ve plucked Hib out of the environment.”

This is another example of epistemic arrogance. Your misunderstanding of the article is laughable to people who know what they are talking about. You could actually learn something if you try to figure out what the article really means. But that would mean acknowledging that others may know more than you. Some egos can’t take that. You are like the kid telling another that you can multiply. When asked to prove it you say “2×2=7″. Your fellow kid will be amazed with your proven knowledge. No one who knows math, will.

“I’m asking you politely, for the sixth time, please do NOT classify all vaccines as one and the same. They are all different. The diseases are all different. You know this. You are either being intellectually dishonest, or you you think no one is paying attention.
Don’t pull the mea culpa here either. Just stop it.”

Oh, no, mommy has spoken really harshly this time, and she has even stomped her feet, so she must be REALLY serious….

So, all you little children, beware now.

But, as for the adults….
…well, doesn’t she look just a little silly all upset and red and stomping for no good reason.

“As I said before, the IPV does not contain intact and active viral particles as the virus produced is inactivated using formalin which then renders it non-infectious. If you have some evdience that the IPV vaccine is still infectious, then please present it. For example, you could link to a report showing that the use of the IPV vaccine in a plaque assay results in plaque production (indicating virus infection). I don’t believe such a report exists, but if you link to such a report then I will concede the point.”

“Formalin alters protein structure. Virus coat proteins are not immune to the chemical effects of formaldehyde.”

Two words. Cutter Incident.

“Furthermore, by saying “infection is initiated” they are not implying that the initiation of the infection process means that cells are infected. A cell would be infected at the end of the infection process. ”

That’s what I’ve been saying. A cell cannot be infected unless it expresses the viral molecule to its surface. If the cell is not infected with vaccine antigens and not able to display the molecule to the surface would you be expecting antibody production? (Hint: vaccine failure)

@Backer: OK. So the Denmark study showed in mice BRED to be diabetes prone, the HIB vaccine caused clusters of them to develop diabetes. Are you saying that humans are also bred to be diabetes prone? That all humans are diabetes prone? I don’t follow you here.

@Th1TH2: OH NOES!!!! Back in 1955 polio vaccine was contaminated with live polio virus. As a review finds, “Cutter was and was not responsible: tests for detecting live virus at the time were simply not sensitive enough, but Cutter departed from Salk’s safe production protocols”. Somehow, I think we have improved things in 50 years.

BTW..you STILL haven’t answered my question. I am going to guess that the answer is yes, since you have ignored me several times. However, just in case you missed it, I’ll type it in capslock so it stands out: WERE YOU FULLY VACCINATED AS A CHILD SO YOUR PARENTS DIDN’T HAVE TO WORRY ABOUT VACCINE-PREVENTABLE DISEASES?

PL – I’m not sure why you are railling at Dr. H. for presenting all vaccines as the same when she was only responding to Backer’s reference to vaccines as a “lethal dose”. In the context of the original comment it makes sense to generalize vaccines…I mean we have a word “vaccines” because they have a common attribute.

Perhaps if you follow the whole discussion it will make more sense to you.

“I certainly didn’t mean to imply that vaccine refusers were the only barrier to eradicating polio.” etc

Sorry, Dr. H. In retrospect I should have clarified that I did not assume you believed that. I was more concerned with how some might read the statement. I my area, I have encountered folks who seem to believe that most misfortunes in other countries or even in urban areas are caused by the residents/citizens rejecting help. These people then throw up their hands and say “There’s nothing to be done!”.

I sincerely don’t believe you are one of these people. But, when I read that statement I could hear them saying “see!” And I felt the need to response to those (phantom/real) people.

I asked for an example of an inactivated virus that can infect cells. You gave me an example of an incident where live viruses were not completely inactivated, leading to residual live virus particles capable of infecting. You do see that those are not the same, correct?

Obviously live viruses can infect cells, but that is not your claim. Your claim is that, in general, the inactivated polio vaccine is capable of infecting cells. The Cutter Incident does not prove your point, it argues against your point. The other vaccine manufacturers that followed the correct procedures and completely inactivated the virus did not have the same outbreaks of polio since there was no live virus present (i.e. the virus did not “infect” anyone). If the virus is not inactivated, then it is capable of infection. If it is inactivated, then it is not capable of infection.

“A cell cannot be infected unless it expresses the viral molecule to its surface.”

And what I am saying is that it is more complicated and subtle than that. Expression of viral antigen to the cell surface is not equivalent to infection. As you said above, infection consists of attachment and penetration with penetration being the critical point under discussion. Virus penetration is infection, but again virus penetration requires native virus and does not occur with inactivated virus.

An inactivated virus will not be incapable of bypassing cellular processes and inserting its genetic material into the cell. Therefore, since penetration cannot be completed, the cell is not infected. Such a still could still potentially display viral antigens on the cell surface as external antigens are taken up and attached to MHC Class II leading to activation of an immune response.

However, the immune system would not consider such a cell to be “infected” as viral antigens would not be presented on the cell surface by MHC Class I leading to activation of CD8 “killer” T cells. Expression of proteins on MHC Class I requires cytoplasmic proteins which, in the case of viral infection, requires that the virus has taken over the cellular machinery and is transcribing and translating its own viral proteins. This does not occur with an inactivated virus.

As I have said before, by your definition, any antigen that is taken up is “infecting” a cell. Since that occurs with everything according to you, then term “infection” no longer carries with it any connotation of pathogenicity since anything taken up by the cell is “infecting” the cell from the most harmless protein to the most virulent virus.

Since risks are the only thing that count, I guess no doctor has ever prescribed any kind of drug either, because no matter how beneficial it might be, somebody might suffer a side-effect. Surgery has never been performed.

one distinction needs to be made here. Treatment is different than prevention. My opinion is that doctors should TREAT not advise/administer drug induced prevention. Vaccines arent their field, they are taught to treat illness. Therefore treating illness falls under a different category, the “harm” is already done you are trying to heal, if this means a doctor has to do some drastic things…fine.

Vaccines on the other hand arent treatment. A perfectly healthy child may never come in contact with any of these diseases. So let say a child who dies as the result of a vaccine reaction would have never come in contact with the disease that they were being vaccinated against. would it have been better to not do it?

“My opinion is that doctors should TREAT not advise/administer drug induced prevention. Vaccines arent their field, they are taught to treat illness. Therefore treating illness falls under a different category, the “harm” is already done you are trying to heal, if this means a doctor has to do some drastic things…fine. ”

What arrogance. Now you are the world expert and what doctors are taught and on preventing diseases too. Amazing.

I must admit I find this difficult to understand. Are you saying the child has a 10 times over risk of dying from HIB because they are driven in a car? That doesn’t make sense. They get HIB because they are driven in a car? Do you have studies showing that? I’m not aware of any. Do you mean a child that has HIB, if driven in a car, is 10 times as likely to die than if not driven in a car? I don’t know. Is this when you drive them to the hospital? Then an ambulance might be more appropriate. Someone really did a study about this?

No i am saying that Hib is so rare (4700 cases according to harriet, i will admit i just threw the 1000 cases number out there, i was too tired to actually look it up last night, but i knew it was a relatively low number, so 4700 it is) that your child is MUCH more likely to die in a car accident over their life span than actually get Hib. But you put your kids in the car everyday and don’t even give a thought that it will die in a wreck.

let me give you another scenario…

When i buckle my child seat belt i am under no illusion that it will actually save their life should we be in an accident. Sure in some cases it will help and in others it won’t help at all. So lets say you have a 50/50 chance of the seat belt not working at all. Now lets take that same example and apply it to vaccines. If i went to the doctor and they said you have a 50/50 chance of this vaccine not working at all, i would think a vast majority of people would just skip them all together. I even have friends that are doctors who have told me they don’t get the seasonal flu shot for that exact reason.

One important point though, inherently a seat belt does no harm to use it while it is in use, prior to an accident. the jury is still out whether or not the same can be said for vaccines.

backer on the domain of medical science:“Vaccines arent their field, they are taught to treat illness.”

Horse poopy. Vaccines are exactly their field. Doctors are trained to treat and prevent illness: primary, secondary and tertiary prevention.

“Therefore treating illness falls under a different category, the “harm” is already done you are trying to heal, if this means a doctor has to do some drastic things…fine.”

No, it is not different. You never know for sure that a sick person will die of their illness or not die of the treatment. For instance, there is a small chance that a frail person with severe pneumonia might live even if you don’t treat them. And if you give them antibiotics, there is a tiny chance they will die of anaphylactic shock. You are balancing risks and benefits. The person will probably die of pneumonia if left untreated; they will almost certainly not die of the treatment; therefore we usually estimate that the risk is worth the benefit even though we never know for sure what the outcome would have been of the other course of action.

However, if we interpret the hippocratic oath the way you do, and reject balancing risks and benefits because we are never 100% sure of anything and only the risks count, then we never prescribe antibiotics (or any other medication) for any indication. Ever. Because there might be a harm and we don’t know for absolutely certain what the benefit will be in any individual case.

In fact, you have shown that you do accept the concept of balancing risks and benefits, just the way any doctor does. You distinguish between the way risks and benefits of an intervention for a healthy individual are weighed and the way risks and benefits of an intervention for an ill person are weighed. Just the way any doctor does.

Medical science does indeed accept that the benefits of an intervention directed towards a healthy child must far outweigh any risks. Doctors, scientists, makers of health policy all demand an extraordinarily high ratio of benefit:risk for vaccines precisely because they are given to currently healthy individuals. And vaccines do meet that standard. They prevent far more harm than they cause, by many orders of magnitude.

Horse poopy. Vaccines are exactly their field. Doctors are trained to treat and prevent illness: primary, secondary and tertiary prevention.

from what i remember of the curriculum there was not a class called “vaccines”. Would you go to get a knee surgery from a general practitioner, after all they did have to go through gross anatomy.

For a doctor to be qualified to “know” about vaccines i would say we should have vaccine doctors that study only vaccines for a minimum of 2 years, and then they might be qualified as experts.

No, it is not different. You never know for sure that a sick person will die of their illness or not die of the treatment. For instance, there is a small chance that a frail person with severe pneumonia might live even if you don’t treat them. And if you give them antibiotics, there is a tiny chance they will die of anaphylactic shock. You are balancing risks and benefits. The person will probably die of pneumonia if left untreated; they will almost certainly not die of the treatment; therefore we usually estimate that the risk is worth the benefit even though we never know for sure what the outcome would have been of the other course of action.

you made my point quite nicely here. the “harm” IS the pneumonia. From this point on i think a doctor is well within their rights to do whatever they see fit, even if it does end up killing the person.

Not true, they can indeed cause harm. It is just that the harm they cause is less than (or less probable than) not using them

backer – “how many cases can you show me that a child simply riding around in a car with a seat belt on was harmed?”

Well the reason you wear a seat belt is because you can not control when you are “just riding around” vs being involved in a car accident. Just as you can not control when you are exposed to a communicable disease.

You believe that seat belts never do more harm than good in an accident? That is not the case. It is only that a seat belt is more likely to do good than harm. It’s all playing the odds, just like vaccination… In vaccination your odds for no harm are extremely good.

I don’t see anything in your comment that clarifies whether you believe that a seat belt can do more harm than good in an accident.

You say it may do no good. That is not what I’m saying. The fact is, it can do harm, but it is more likely to do good. That is why the are recommended (or mandated in some states.)

And your hypothetical of vaccines working 50 percent of the time is not factual. You can’t make a real decision based on a made up efficiency ratio. You look at stats for HIB infections, but do not consider that the 4700 is in a population WITH HIB vaccinations.

Your logic, it does not hold together. It looks like you are starting with a conclusion and looking for rationales to support your conclusion. It is like building a house from the second floor down.

“4700 cases according to harriet, i will admit i just threw the 1000 cases number out there, i was too tired to actually look it up last night, but i knew it was a relatively low number”

He admitted that he is just making things up and presenting them as fact. That destroys any credibility he might have had.

“My opinion is that doctors should TREAT not advise/administer drug induced prevention. Vaccines arent their field, they are taught to treat illness.”

I was taught to prevent illness whenever possible, and that prevention is more effective and more important than treating illness once it has occurred. It’s really ironic that we are now being criticized for prevention, when the usual (undeserved) criticism is that doctors only treat symptoms and don’t pay any attention to prevention. If vaccines aren’t the field of doctors, whose field are they?

“For a doctor to be qualified to “know” about vaccines i would say we should have vaccine doctors that study only vaccines for a minimum of 2 years, and then they might be qualified as experts.”

I see, you mean like an MD doing a postdoctoral fellowship in Microbiology and Immunology? Would you consider that such a person might know as much as you do about vaccines? What if they thought that the status of current research fully supports the idea that currently approved vaccines do more good than harm? Would you still think they were knowledgeable, or would you require even higher qualifications?

“the “harm” IS the pneumonia. From this point on i think a doctor is well within their rights to do whatever they see fit, even if it does end up killing the person.”

No, because it is only potential harm. We don’t actually know if the person is going to die from the pneumonia; we just think it’s fairly likely. And we don’t actually know that antibiotics won’t kill them; we just think that it’s very unlikely. What if the person who was killed by antibiotics would have lived if they hadn’t been treated? It happens.

When healthy people are vaccinated, it’s because we judge that if they aren’t vaccinated they are fairly likely to come to harm from wild viruses (and to cause harm to others by transmitting the wild viruses) and extremely unlikely to come to harm from vaccines.

Similarly, when people wear seatbelts (even if they are still currently uninjured right now) it’s because we think that the potential benefits of seatbelts are greater than the harms. If you really believed that it is always better to treat afterwards than to incur the risks of a preventive measure, then you would not wear seatbelts. They do carry a level of risk of harm and you aren’t in an accident yet. You would wait until you were in the middle of an accident and then put on your seatbelt, or you would choose the uncertainty of a trauma team trying to revive you after you had been skinned by being thrown through your windshield and then slammed onto the road.

But if you are not currently having an accident right now, then the a seat belt offers no benefit at all and it does cause harms. It gets in the way, it may chafe your neck, press your bladder; it might even get stuck and you wouldn’t be able to get out of your car until someone cut you out. What if you were having a heart attack and your seatbelt was stuck so couldn’t get out to get help? You would die! Plus, it raises the price of the car. Completely unnecessary.