> At school: "Sacha your kids are not vaccinated and we do not admit any students not vaccinated."

I thought this would perpetuate social stratification. But my hypothesis, that poor families are less likely to vaccinate their children than rich families, was incorrect. The National Network for Immunisation Information finds that "compared to fully immunized children, unvaccinated children were more likely to be non-Hispanic white and live in larger households. Educational levels, family income and other factors did not differ" [1].

Removing the philosophical exemption, at the federal level, seems a prudent first step. "States that allowed philosophical exemptions to immunization laws in schools had many more unvaccinated children than states that do not have philosophical exemptions."

[1] http://www.immunizationinfo.org/science/demographics-unvacci...

Alternate theory: "Poor families" are more likely to be aware (either directly or "institutionally") of the impact of the various preventable diseases or conditions.

Reminds of of a Bujold quote. The character is referring to how over time people forget how hard things were:

> "They like to play dress-up and pretend being [noble-class] ladies of old, rescued from menace by romantic [noble-class] youths. For some reason they never play 'dying in childbirth', or 'vomiting your guts out from the red dysentery', or 'weaving till you go blind and crippled from arthritis and dye poisoning', or 'infanticide'."

> "Well, they do die romantically of disease sometimes, but somehow it's always an illness that makes you interestingly pale and everyone sorry and doesn't involve losing bowel control."

I think that may be fairly dead-on. My step-grandfather had polio as a child, and as a result, had his growth stunted, and severe nerve damage in his lower legs, requiring him to wear orthotics throughout his life. As a result, when the polio vaccine was announced, he made damn sure that my stepfather and his siblings all were properly vaccinated.

Alternate theory 2: "Rich families" are more likely to have seen that there is reason to distrust the government and medical establisments.

Poor families trust the government, you say?

> But my hypothesis, that poor families are less likely to vaccinate their children than rich families, was incorrect

Indeed. The Waldorf School of the Peninsula, an expensive private school ($20k/year tuition for kindergarten and elementary school, $21k/year for middle school, and $28k/year for high school), full of the children of very well off people from top Silicon Valley companies, had a 23% immunization rate a few years ago (I haven't seen what the current rate is). Compare to 90% for the public schools in the same city, and 94% for the public schools in the county.

Do you want people to read up on the science, or to accept what's "settled"?

As a professional scientist, there are few things more anathema than the idea that a scientific theory is "settled". Experiments can only falsify theories; they can never be proven to be correct. The best a theory can hope for is to remain consistent with observation.

Once upon a time, it was well-settled in large communities that the universe spun about the Earth.

Yeah, but we're talking about not vaccinating your kids, here. It might be that we're all living in a computer simulation and none of this matters but we should still act on what we observe.

I'm personally convinced that vaccination is worthwhile; I've been convinced of that by my education, my experience, and my understanding of the scientific literature. The benefit to the individual and to society of vaccines is, to me, well-established.

I'm willing to compromise part of my herd's immunity for those who wish not to receive a vaccine, even if it increases my risk somewhat. I don't think that anti-vaccine activists are correct, but it's a hell of a thing to inject stuff into their children that they think could bring them harm. Though we do it every day as a society, I don't want to be a part of a herd that resorts to compulsion on ethical questions.

Inextricable from this discussion is the fact that the children won't reach majority before the decision must be made. If we could wait until people turned eighteen before presenting them with the choice of vaccination, this debate would be different.

As a final thought -- if everyone else is immunized, it may be to your advantage to skip vaccination to avoid a tiny risk of side-effects. There's an equilibrium here, and it's not at 100% vaccination rates, even if 100% vaccination could yield eradication.

There's the rub: it's not about you or what you want. There are already enough people who cannot be vaccinated -- people with egg allergies, people with compromised immune systems, etc. Furthermore, vaccines don't always take, so there may be more unvaccinated people out there than we actually know of. Herd immunity works by everyone who can participate participating; the more, the better.

What irritates me about anti-vax more than anything is the selfishness and privilege that goes along with it. "I don't need to put a vaccine in my child's body; if herd immunity really works, then my children won't be the problem!" Never mind the fact that every person this child comes in contact with now has a greater risk for infection, or even transmission of diseases.

Lastly, your usage of "convinced" really rubs me the wrong way. Granted, you have a "right" to believe whatever you want, but if you trust that evidence-based science is correct, it's really not a "take it or leave it" kind of situation.

> Do you want people to read up on the science, or to accept what's "settled"?

You're assuming that both of these things are possible / likely. I want people to stop killing each other but that's not necessarily realistic.

It's an interesting problem, trying to achieve the theoretical best situation (everyone understanding and accepting science) vs 'tricking' people (just getting them to accept what you say).

People who are inclined to actually study the issue, form an informed opinion, and be willing to change that opinion in the face new evidence, they absolutely should read up on science.

But everyone else, no, they should just accept the opinions of the experts if the issue is reasonably settled. They're not going to engage in the scientific process anyway, so their uninformed opinion really doesn't matter.

I would love it if schools and nurseries started to disallow children who were not vaccinated.

Unfortunately there are enough parents to make "no vaccinated children allowed" (you are not allowed in if you've been vaccinated) schools viable. See "Measles parties" and the sending of items infected with chicken pox through the post for examples.

There are really measels parties? I've heard of chicken pox parties, which makes sense because there's no vaccine and the adult form is vastly worse than the infant form. But measels parties, that's just medieval.

EDIT: apparently there is a chicken pox vaccine, but it isn't administered to the general population in the UK, only NHS workers. Interesting.

That's interesting, the MMR vaccine is a normal vaccine here in the U.S. as part of the normal shots infants get. There's usually a booster shot as a young adult and again in middle-late age.

edit apparently I forgot reading comprehension, I see now that you were talking about Chicken Pox vaccines.

I didn't know either, I just know the MMR. AFAIK people just have Chicken Pox parties for their kids and make sure they get exposed. I remember when I was about 4 or 5 my mother was so thrilled when the lady who owned a store down the way had two kids who got Chicken Pox. The next day she took me out of school and I "met" their kids for about 30 minutes. Got the Pox sure enough right after that.

My Uncle somehow missed it and ended up getting it in his 40s. I think he spent part of it in the hospital. The difference between adults and children's responses to it is quite remarkable.

MMRV only became available in 2005. Source: http://www.webmd.com/children/vaccines/chickenpox-varicella-...

Chicken Pox used to be a seperate shot, and in the 80s there was a well-publicized round of them that were defective.

I got hit by that one... I got chicken pox at 15 despite vaccination, and it was miserable, I was on by back for about 5-7 days.

I'm talking about the chicken pox vaccine. Everyone gets MMR in the UK, except the hippies.

IIRC it's fairly common nowadays to administer the vaccine to children in Canada/US.

The main trade-off I've seen is that a small percentage of people who get the vaccine end up with pox at the age of 20-30 where the complications (pox on internal organs) can require hospitalization and/or cause death. The flip side being, of course, that a small percentage of people infected with chicken pox as kids also require hospitalization and/or die.

Are you talking about something other than shingles? This study seems credible enough (the Web MD article even manages to discuss how they dealt with several obvious confounding factors):

http://www.webmd.com/children/vaccines/news/20131202/chicken...

The CDC says shingles is less common in vaccinated individuals (under "Other safety information"):

http://www.cdc.gov/vaccinesafety/vaccines/varicella/

My impression is that shingles is technically "reactivation" of the pox virus; i.e. you need to have had chicken pox first.

I was referring to cases where someone has received the chicken pox vaccine but still gets sick with the chicken pox later in life.

Granted, it also looks like the vaccine is made from actual virus? So maybe it is shingles after all. I don't science enough to say.

It's definitely worse to get your first infection of the virus as an adult.

In the looking I've done today, I haven't seen anything real definitive about whether the vaccine makes this more likely or not.

Yeah, there are measels parties, just like the old days. Though regarding Chicken Pox, to be honest, I'm real surprised that chicken pox isn't on the list of mandated vaccines at this point. I had them a tiny bit on the late side -- at age 8 -- and I still had a pretty miserable time with them, with a 104 degree fever, etc. Making the vaccine just available to health workers seems silly; it's a dangerous disease, even in childhood.

I generally agree, but some people really are allergic to some vaccinations. They present the same exposure risk as somebody who chooses not to be vaccinated for stupid reasons. Should they also not be allowed in?

That would be a viable medical reason, and could probably be exempted with a doctor's note or some other documentation of a medical condition (at least it should be). That's not comparable to deliberately denying otherwise-healthy children the means to stay healthy and not die of horrible and easily preventable diseases.

Well yeah, but from a disease vector standpoint, they're exactly the same.

The number of people genuinely allergic to vaccinations is small. This means that herd immunity remains.

The number of people choosing not to immunise is larger, and herd immunity is at risk.

So, they're sort of the the same but the risks are different.

As a population, the people who legitimately cannot be vaccinated -- or who get vaccinated but a certain vaccination just doesn't take -- are small enough that the rest of us protect them. When people start voluntarily adding themselves to that group without medical reason things start to break.

>I bet there will be much more incentive to really read up on the Science.

You mean capitulate to a forced perspective?

If she learned fundamental statistic, pored through paper after paper, found errors and miscalculations, would she get her money back? No, so ignorant or not is irrelevant.

Your utopia is terrifying.