EDEB8 - Ultimate Online Debating
About Us   Debate    Judge   Forum
Views:
3921

That some vaccinations should be mandatory

(PRO)
0 points
(CON)
WINNER!
4 points
whiteflamewhiteflame (PRO)

Thanks to Larz for joining this debate, as I'm sure this will be a fantastic one for his presence participation! I'm looking forward to it.


I'll start with some housekeeping:


The topic is a little broad, allowing me to choose what vaccines I would define as “some.” I could defend multiple vaccines as important, but that would make my case rather complex and increase my burdens unnecessarily. As such, I will be advocating solely for the MMR vaccine.


So what is the MMR vaccine? The acronym stands for measles, mumps and rubella, three single-stranded RNA viruses, and the vaccine is meant to impart a protective immunologic response to those who take it. The vaccine is composed of live attenuated viruses, meaning that their virulence has been strongly reduced, but the virus is still viable. This ensures that the vaccine will have the strongest and longest-lasting effect, meaning that the vaccine only has to be taken in its two-shot series once over a person's lifetime.


But that only defines the two terms – some and vaccinations. What does it mean to be mandatory? I will define that contextually by providing a model.  


The U.S. Federal Government will require that all individuals before attending school receive the vaccination, which applies for home schooling by age 5. All individuals who are beyond schooling age and under the age of 65 would have to get the vaccine within 5 years. These will be subsidized on an as-needed basis, ensuring that it is broadly affordable. Failure to vaccinate oneself or one's family results in a fine that scales with income. There would be other exclusions based on allergies, pregnancies, and those individuals who are immunocompromised.


With that, I'll into some contentions.


1. Disease Spread


We must recognize that vaccination is not a choice that solely affects the individual being vaccinated. The decision to get the MMR vaccine affects everyone around you. Measles, mumps and rubella are all transmitted through droplets that are sprayed into the air, making them airborne pathogens with a high likelihood of transmission to those around the infected.[1, 2, 3] The mere fact that others are put at risk by people who refuse to take these vaccines creates a substantial societal harm in the status quo, as many are allowed to refuse to get the vaccine.


We're living this harm today, seeing a resurgence in these entirely preventable diseases in the U.S. and abroad.[4] This resurgence is most marked with measles, a disease that the U.S. had eliminated by the year 2000, but which returned in 17 outbreaks among 222 people just in 2011.[5] Mumps has had 4 reported outbreaks this year alone, and has had several small and two large outbreaks in the last 5 years, encompassing thousands of people.[6] Rubella has also returned from a long absence, appearing in three cases in the U.S. in 2012 after being eliminated back in 2004.[7] This change resulted mainly from a false public perception that vaccines have been linked to autism.[8]


In order to understand why vaccinating a large portion of the population is necessary, we have to understand the term “herd immunity.” This has been defined differently by different authors, but I will use the term in this fashion: “a particular threshold proportion of immune individuals that should lead to a decline in the incidence of infection.”[9] What that means is that if someone becomes sick with a given disease, herd immunity would ensure that that person is so much more likely to run into someone vaccinated against that disease than someone who is vulnerable that they would be extremely unlikely to infect other people. We cannot possibly vaccinate everyone and achieve absolute immunity because of the necessity of the exclusions I listed in my case, but we can seek to achieve herd immunity.  


What does that threshold look like for these diseases? For measles, this is 95%.[10] For mumps, it's at least 88%, though it “may need to be higher” than this previously established threshold.[11] For rubella, it sits at 90%.[12] Only through mandatory vaccination could we ever hope to reach those numbers.  


2. Disease Impact


My first contention established a threshold for harm in status quo, but I will now show that that threshold has a tremendous impact on society. In order to understand that, we have to know what the impact of these three diseases is.  


Measles:  


“Prior to the vaccine, 3-4 million people were infected in the U.S. each year, resulting in 48,000 hospitalizations, 400-500 deaths and approximately 1,000 who developed chronic disabilities.


Even with modern medical care, the disease can lead to serious complications, including blindness, pneumonia, otitis media and severe diarrhea. Despite the availability of a vaccine it remains a leading cause of death among young children worldwide, with deaths mainly attributable to the complications of the disease...


More than 90 percent of susceptible people, usually unvaccinated, develop the disease after being exposed. There is no treatment except to make the patient as comfortable as possible by keeping them hydrated and trying to control the fever. Unvaccinated young children and pregnant women are at the highest risk for measles and its complications, including death.”[13]


Mumps:


“Mumps is not normally a fatal disease, and up to 30% of mumps infections are asymptomatic. There can be serious complications, however, including aseptic meningitis, orchitis, oophoritis, mastitis, pancreatitis, and deafness. Meningitis occurs in up to 10% of mumps cases; it is usually subclinical and self-limiting. Symptoms of mumps-related meningitis include fever, headache, vomiting, and neck stiffness, which peak for a period of 48 hours before resolution and might appear up to 1 week before parotid swelling. More serious neurologic symptoms are rare and are due to encephalitis. Hearing loss following mumps infections is rare (1 in 2000 to 30,000 cases) and usually results in mild to moderate hearing loss.  


Orchitis [swelling of the testicles] occurs 4 to 8 days after the onset of parotitis and is a common complication, affecting 20% of men who develop mumps after puberty. Of those cases, 40% will develop testicular atrophy and 30% will have lasting changes in sperm count, sperm motility, and sperm morphology.”[14]


Rubella:  


While the disease usually only results in a light fever and small rash, this disease is mainly problematic for pregnant women. “In 1964-65, America had a major rubella epidemic, with more than 12 million cases and 20,000 babies born with congenital rubella; of these, 13,000 were deaf, 3,500 were blinded by congenital cataracts, and 1,800 more suffered severe cognitive impairment.”[7] Since pregnant mothers are among the few who cannot get the vaccine, every single person who decides not to get the vaccine is putting these mothers at risk.


Taken together, this means these three viruses present as enduring, broad threats to public health that are made dramatically worse in the absence of herd immunity.


I now leave it to Lars to present his case/rebut mine.


1. http://www.cdc.gov/measles/about/transmission.html

2. http://www.cdc.gov/mumps/about/transmission.html

3. http://www.cdc.gov/rubella/about/index.htm

4. http://www.npr.org/blogs/health/2014/01/25/265750719/how-vaccine-fears-fueled-the-resurgence-of-preventable-diseases

5. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6115a1.htm

6. http://www.cdc.gov/mumps/outbreaks.html

7. http://www.thedailybeast.com/articles/2013/03/30/why-rubella-s-scary-comeback-should-convince-vaccine-deniers.html

8. http://online.wsj.com/news/articles/SB10001424127887323300004578555453881252798

9. http://cid.oxfordjournals.org/content/52/7/911.full

10. http://www.theguardian.com/society/2013/apr/25/measles-mmr-the-essential-guide

11. http://jid.oxfordjournals.org/content/202/5/655.full

12. http://www.ncbi.nlm.nih.gov/pubmed/23099870

13. http://guardianlv.com/2014/07/measles-resurgence-in-u-s-after-development-of-vaccine-in-1966/

14. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135444/


 


Return To Top | Posted:
2014-10-10 16:08:27
| Speak Round
adminadmin (CON)
I'd like to thank whiteflame for opening this debate, and choosing a great topic.

Quick disclaimer. I'm not MMR vaccinated. I've had a polio vaccine, a tetanus vaccine and I think one or two others, but not MMR, flu or whooping cough. Importantly, I (or, while I was an infant, my mother) made the decision for me to be vaccinated or not to be vaccinated for particular things. In this debate, I'll start by talking about mandated medicine generally, and a few points regarding vaccination specifically. Then finally I'll talk about MMR and why this is probably the ONE vaccination which, if any, would be ridiculous to make mandatory.

To be clear: the contrary position in this debate is not no vaccinations. It's informed choice.

Mass medication
The idea of forcing everybody to take medicine to prevent disease is nothing new. Iodine is often added to salt, because people in inland areas where fish is not generally a big part of the diet often lack iodine (most of us used to get it naturally from the soil, but then we started over-fertilizing everything so we can't rely on getting iodine from there any more). The impact of that is that these populations find their average IQ drops about 10 points, and many become cretins. The idea behind using salt is that everybody generally eats it - it is not designed to target only those people who have insufficient iodine in their diet, but everybody. By no means am I trying to dismiss issues related to iodine being low in people's bodies - this is an issue that affects 40% of people worldwide.

Then people decided that human oral health isn't that great either. Water supplies are often fluoridated to ensure that we get enough fluoride even when some of us are too lazy to brush our teeth. And again - I don't want to dismiss the terrible harms to public health when even young children routinely require root canal work to be done. Ironically, fluoride makes it harder to use iodine.

One can go even further. Vitamin C is also required for living. Some people don't eat enough oranges and thus become sickly. This allows illnesses to spread more easily among the general population. Thank goodness there are convenient vitamin C tablets available that one could simply require the entire population to regularly take. Having sufficient Vitamin A in the diet is almost as good a defense against measles as the vaccination itself, and particularly in the third world has shown itself to be more effective.

More people are deficient in vitamin E than are deficient in iodine. This makes them more susceptible to disease. But on the other hand, too much vitamin E (or zinc, which is another mineral many are deficient in that this happens with) and your immune system becomes worse again (incidentally, if you take HEAPS of iodine then that's actually poisonous - Brazil recently had to lower the level of iodization in their salt because in Brazil they apparently eat heaps of salt). Unsafe sex often leads to the transmission of really serious, terrible diseases - but too much safe sex and you end up with a low birthrate.

One can also take the same principle even further. Our society's health problems are no longer all physical. Mental health issues are a big problem, and it's not just the lack of intelligence like iodine solves for. It would not be hard to imagine a society where everybody was sent a package from the government every week, containing antidepressants, supplements etc. One would get even better health results if the government just mandates a diet for everybody because some people are anorexic or obese. And even that is meaningless unless the government mandates a minimum and maximum level of exercise for everybody with strict enforcement.

It's true that one can make pretty much anything sound bad when you take it to extremes. But in principle at least, any kind of mass medication follows the same kind of model. It's the government deciding that they know best how everybody ought to treat their health. This is, of course, informed by genuine science identifying genuine problems. But that doesn't mean that it's good as a social policy. This is the same genuine science that tells us some genes are generally superior to other genes. There's no problem with that. But there might be a problem with replacing all humanity with genetically-modified super-humans made of the optimal gene combination (once we figure out exactly how all the genes work, of course). Or of course the original plan for how to do that - which, again, really came from genuine science - commonly known as "eugenics".

It is certainly possible to mass medicate every time somebody so much as sniffles a little. I'm even sure that if the plan was implemented perfectly, the average health of society would usually improve when you did so. In much the same way, eugenics would reduce certain genetic diseases, and I could even accept it would improve the capabilities of the human race slightly. It's certainly one way to run a country. But it's not the future that most of us really want to see. Hence why mass medication generally only comes around in response to certain alarmist outbreaks. For example - alarmingly high number of people are mentally retarded? Solution: give everybody medicine to cure the whole world. Lots of people with bad teeth? Make everybody drink one of the key ingredients of toothpaste.

This is the strategy that is unfortunately generally used by vaccine campaigners. They see an epidemic, develop a vaccine, and then make everybody take it. Hence why vaccines for Ebola are being trialed now, MMR came after the epidemics in the 60s and 70s, and so on. But let's consider the alternative. Is there no better way of running our society?

Human Rights
Ironically developed largely as a response to eugenics, human rights is all about the idea that because we're people, we get some basic entitlements. These are rights afforded to all humans equally (or at least, among those who come from nations signatory to the "Universal" Declaration of Human Rights). There's no real scientific justification for human rights. But in ethics they one of the most important ideas. You can read the UDHR here.

Now I'll start by acknowledging that the most basic of these human rights is the right to life. Depriving somebody of that right (at least directly) is called murder and is generally the most serious crime a person can commit. When people die, that certainly impacts upon the rest of society as well. I think my opponent and I will agree, therefore, that people have a right to live healthy lives, not get sick etc. An effective immune system is the best way to achieve that, and immunization's role is to get the immune system to a point where if it encounters a disease, it can deal with it. So we both agree that people should have every access to immunization that humanity can afford them. This is, in principle, enshrined in article 25 of the UDHR:
Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services...

The difference is that the right to life is different from an obligation to life. We are not required, in human rights analysis, to be maximally healthy. If we want to enjoy a delicious tub of ice-cream every so often, we can do that. The right belongs to us - we can choose to exercise it or to ignore it. When government bureaucrats make healthcare decisions on your behalf, they're really taking that right away from you. They're using it for their own purposes, and often to promote their own agenda (this becomes more so the case in less democratic countries, which might be further influenced to adopt such a model if it takes off in the USA). In a rights-based nation, the human rights belong to you. They are not the property of the government.

This could be a point of confusion for some people, so let me clear it up. I'm all for bringing medicine to the masses. What I oppose is forcing pills into their mouths and making them swallow. "Mass medication", though it probably literally means the former, generally means the latter, and it's in this sense that I'm using it in this debate.

Policy decisions made on the basis of rights as opposed to obligations are just as compatible with sound scientific research. It's simply a different approach. An example of a rights-based policy might be to provide free nurse visits for poor mothers, because they have the right to healthcare. Or you could oblige all poor mothers to visit a nurse whether they like it or not. In terms of practical outcome, the two are almost the same. One could argue that with rights you'd get a few uninformed people falling through the cracks, and with mass medication some people might be uncooperative or resentful. But in terms of the morality of it, respecting somebody's right to life is definitely the high ground. There's no real way to prove morality (at least until we invent the crystal ball), but we all tend usually to agree that life is a pretty great thing to have, and that in general we should make our own destiny.

This is called "bodily autonomy". Your life = your body = your decision.

Now, there are of course reasonable limitations to that in the context of a fair and just society. For example, people who are unable to make a decision (such as young children). It's also not unreasonable to impose certain kinds of limitations on it for people who enter into certain kinds of contracts (such as an actor who needs to dye his hair for a role). There is also an argument to be had - although even this is really controversial - for restricting the bodily autonomy of those who have broken certain laws (principally these arguments concern the death penalty). The reason such restrictions are perhaps warranted in a rights-based analysis is because the decision still rests with the individual and not the state - they can choose to not enter into the contract or break the law. Or alternatively, because they cannot make the decision they cannot exercise their rights to which they are entitled.

There is no such case that can be made, in a rights-based analysis, for mass immunizing everybody regardless of the decisions that they have made. It's effectively exactly like the state is presuming everybody guilty of the "crime" of being a possible carrier for the disease (that is to say, the crime of being human) and thus forcing them to undergo medical treatment, a rather unusual punishment. In times past, peoples diagnosed with certain illnesses (particularly mental illnesses) were often operated on or shipped off to asylums without anyone's consent being obtained. Hence a big part of the reason as to why such institutions have such a bad reputation in this day and age. We've moved beyond that as a society. Kings used to force their subjects to do stuff indiscriminately, but now we can do better.

One final point. To a certain extent, the UDHR is protected by international law, unlike the principle of mass medication which is generally only protected by big pharma vaccine companies accountable more to their shareholders than any given government (thanks in no small part to them actually being bigger than many governments). This demonstrates that even government doesn't really want power over people's lives, and wants them to generally handle this kind of stuff themselves. This legitimizes human rights as a moral framework for the debate, especially in the USA where the government is a democracy (pretty much), and thus reflects the will of the people.

As an aside, I chose the UDHR because of its universality. It is of course not the only model for human rights that exists, but the right to life is pretty broad in its adoption by practically every human-rights focused document on earth. In fact, it's also foundational to the declaration of independence of the United States (along with liberty and the pursuit of happiness), and of course over there such documents are pretty much the word of God.

We're not the same
This is one of those arguments I shouldn't really have to prove, not least because my opponent actually tacitly builds the presumption into his model, by providing some very reasonable exceptions to the "mandatory" vaccinations (which, incidentally, largely just so happen to be the very same people most at risk of actually contracting those illnesses). But the idea that the government is working only off a checklist to decide who is or is not to be vaccinated basically devalues our individuality. Even if - hypothetically speaking - doctor's could just use their professional discretion (which would probably be slightly preferable in that the government can hardly account for every single other medication or lifestyle factor a person may be involved with) - ultimately the presumption is that everybody deemed eligible carries the same risk and rewards.

Nobody - and I mean nobody - knows my body better than me. Just as nobody knows your body better than you. Let me take an obvious example - say somebody secretly indulges in a prescription drug, but their doctor doesn't know (in case your wondering, the reason the doctor wouldn't know about a prescription - of all things - is that people routinely take legitimately prescribed medication from their friends to abuse it). It may well be that whatever risky behavior you're dealing in could react poorly with the vaccination. Assuming doctors are, in general, reasonably competent, they would of course be able to recognize that right away. But they're not you. And you're not exactly going to admit to your doctor what you've been up to, perhaps partly because you're ashamed of it, but mostly because this doctor is literally acting as an agent of the government at the time. Conversely, there may also be perverse incentives to lie and get the vaccine even though it is not safe for you to do so, as society plays up the harms of the diseases. Or to not vaccinate and pretend you are vaccinated  based on the free rider principle, since proving a person is not vaccinated isn't easily done.

It goes without saying that these things do not occur when the system allows you to make these decisions yourself. But these implications only expose the underlying flaw of the entire system, and that's that it's based on a false premise. Mass medication relies on this idea that one treatment will work well on everybody, with a goal of achieving a universal standard of health. Not only does this not work, but it's not even a good standard. As distinct people, it's dehumanizing to be engaged in a ritual activity for the sole purpose of making us more similar.

There are alternative options that people have if they want to live healthy lives. It's not - by any means - a foregone conclusion that everybody who is not immunized will get sick and will die as a result of that. In fact, it's extremely unlikely. Even back when these diseases were epidemics across the world, you were still significantly more likely to die of something that WASN'T measles, mumps or rubella. And that's not because these diseases were ineffective at killing people or being terribly contagious. It's because one's risk level does not depend solely on the vaccine. I had measles once and recovered in a couple of days with nothing more than playing video games on my bed (I like to joke that Gran Turismo cured me). In fact there's a surprisingly strong correlation between dying from the complications of the diseases that this particular vaccine addresses, and being heavily malnourished. But the principle is the same for any vaccine. Don't want tetanus? Avoiding puncture wounds and cleaning needles in hospitals is an even better defense than immunization.

I need to stress once again that none of these is in any way exclusive with sound science. This isn't some quackery I'm just making up to sell you some snake oil. I'm just making the point that remedies are also, to a significant extent, lifestyle choices. Some random person could stop smoking to avoid cancer, or they could eat more fruit. There is real, scientific evidence I could link that both actions would reduce the risk of them contracting certain types of cancer. But the impact on their lifestyle would be quite different. One could choose to get an injection to combat M/M/R (plus a recommended booster shot every 10 years), AND/OR one could live healthily. The impact of each may have repercussions to you, and your life, other than just a doctor's visit. And these things will impact us in different ways.

This is the flaw with that assumption I listed earlier. We are all different. For the government to treat us as if this is merely just a magic cure to solve the problem of MMR once and for all is ignorant of the role that medicine plays in our society. I see this as a moral issue as well as a pragmatic one. The moment that we decide a one-size-fits-all solution is a great idea for solving a problem is the moment that we forget society is made up of real people with real lives. The decision to mess with any of our lives in any way the government wants, and the decision to medicate us in the way the government wants is the same thing. People should have the right to decide what means of avoiding sickness is right for them. Of course there should be sound advice from trusted doctors and research made available, but governments should not choose one option over any other and force that on people based just on arbitrary criteria that they define.

Fun fact before I finish this point. There is in fact a weak correlation between taking more vaccines and dying, popularly known as "vaccine overload". This cannot possibly be anything the vaccines are doing. There have been a lot of very good studies showing that vaccines, administered properly, pose no health risk at all even if you take a lot of them, despite some claims by alarmist health groups (many of whom go on to talk about autism, which is kind of annoying since that isn't even a direct correlation, but I'll talk more about this in my rebuttal). The much more likely explanation is really very simple: less-vaccinated kids are more likely to seek healthcare in other ways. The necessity for them to be health-conscious actually seems to make a difference to their health. Now like I said it's a weak correlation, and you can't establish anything definitely out of it, but it goes to show that vaccinations policies sometimes can have unforeseen social impacts as well.

Murphy's Law
Anything that can go wrong, will go wrong

I think this law is even more profound that E=MC2. It may well be that there's only a one-in-a-million chance of something going wrong, but eventually, it will. It doesn't matter how tiny the chances are. If there's a chance something will happen, you can't bank on it never happening. It so happens that the chance of a severe life-threatening adverse reaction to the vaccine in question is roughly one in a million, and indeed the US government has paid out in a few cases where somebody has clearly died due to a reaction to the MMR vaccine, such as in the famous case of Madyson Williams (non-life-threatening reactions can of course happen too and are more common - 1 in roughly 300,000 vaccines will have some other serious neurological complication, for example), but another point is at stake here too. One that has the potential to be even more damaging. Now to be fair, the USA does have the VICP, which pays money to the families of victims of vaccine-related injuries. But when vaccines cause serious problems to health, that's a real problem that no amount of money will solve. Most of the time vaccines are perfectly safe. Sometimes, they are not.

Suppose - just suppose - that the actual manufacture of the vaccine itself is botched. Now usually, when something goes wrong and this isn't discovered until later, there's a product recall that gets put out by the store, warning customers that there's a danger. With vaccines, or other injections, you can't do that. You have to live with the consequences of whatever that injection did to your body. This actually happens from time to time. For example, roughly a decade ago, two clinics in the UK gave out botched MMR vaccinations after the manufacturing process changed. In most cases, as it was in this case, this simply means that the vaccine doesn't work. There's not necessarily a harm to public health. But sometimes, the vaccine can be botched in such a way that it's actually poisonous, and everybody dies. While far, far more rare, it's possible. And remember Murphy's Law. We know this is true because it's happened before - one of the first batches of smallpox vaccine was contaminated with syphilis.

Now this is actually true of almost all medicine. Manufacturing processes have indeed been improving, but will never be perfect. The difference is that vaccines are given to the healthy. At worst, a failed curative medicine will only amplify an existing illness. A sudden outbreak of illness among otherwise healthy people due to a vaccine issue is not just ironic. It actually has a real potential to overload the health system in much the same way as a sudden onset of any other illness.

The most dramatic example of this kind of thing happening came just recently, in 2011, when 47,500 people - mostly children - were killed or paralyzed probably from a polio vaccine. Let me set the stage for you. India is a really big country where polio should not exist, but it does. And polio vaccination is an awesome way to stop it spreading. Investments to make polio vaccines as available as possible are really great, and so Bill Gates decided to help the Indian people out. Now there are several ways to get this vaccine. The Gates Foundation decided to give it to people orally, which is banned in most of the first world (including the USA) because it's incredibly dangerous and likely to give a lot of people pretty much the same symptoms as polio itself. Despite the government trying to cover it up to save themselves the embarrassing truth, some independent investigators worked out what was going on and forced the government to admit their mistake in allowing the vaccine and pull it in favor of an injectable vaccine, which is much, much safer. By that point, however, the number of deaths was already staggering.

Now let's be clear about some things. First of all, they did NOT die of polio. A few very good studies were done specifically to confirm this fact. The vaccine has been incredibly effective at reducing polio, which is fantastic because India has had practically NO polio since the vaccine drive in 2011. 47500 compared to the millions who are now protected against polio is still an OK success rate. But the baseline for NPP was only about 4000, not 47000, so there was an epidemic for some reason. Although there was a clear, observable correlation between number of polio doses and cases of paralysis, and although the oral vaccine has been proven in the lab so dangerous that we wouldn't use it in our part of the world, it's still only very strong evidence as opposed to absolute proof that that's exactly what happened here. But I think "probably" is to say the least in this case, especially since there's nothing else that looks anywhere near as plausible as the reason for the spike. You can read more about it all here. Or search around on Google; it was well-reported.

Funnily enough, India still can't get it right, as doctors then began over-zealously injecting the vaccines, but that's another story.

There's a well known and well established principle in medicine. It's called "do no harm". Medicine is not there for us to harm, but to cure. Harming somebody without curing them is an affront to medicine. Could something like this happen in the USA? Probably not in the same way. There's more quality control checks there and such. But that doesn't mean the same kind of thing couldn't happen in another way, and that's really worrying.

To be clear: I'm not saying that on the basis of this risk, everybody should avoid all vaccinations. The risk of contracting the disease despite vaccinating against it is far greater (0.1% of cases according to the manufacturer, for each of the 3 diseases = 0.3% in total). Heck, the chance of you having an allergic reaction and dying is also probably greater, even if the potential damage is much more localized. I'm saying that there are real risks with vaccines. They're not magic. The way my opponent puts it makes it seem like vaccines can only lead to one possible outcome. The fact is that all vaccines carry risks and rewards which need to be carefully considered. When somebody takes a vaccine they are literally putting their body on the line and gambling with their health. If this model is implemented, then a day will come when a lot of people are force-killed by the government even though they have committed no crime. It will be a tragic mistake, but if the chance is there, it will happen, regardless of how slim that chance is.

A lot of the time people just say "vaccines are safe". That kind of statement is not supported by science or history. It's dangerous. It should be "most of the time, vaccines are safe". Which is a nice segue into my next point:

MMR: The Diseases
First of all, nobody has ever died from measles, mumps or rubella alone. They've actually died from some other complication that was possibly brought on by those illnesses. Having measles is a bit like smoking a cigarette - it won't kill you directly, but it may cause some kind of cancer or something that will kill you (in fairness, some evidence does show that rubella may be involved in increasing the chance of miscarriages in pregnant women, but the issue of whether a fetus is alive yet is a bit different).

Measles can't be cured with medicine, but is almost always cured with a few games of Gran Turismo, mumps is cured by not drinking Coca-cola for a few days, and rubella is cured by getting as comfortable as possible. The last two are actual scientific advice. Cures are simply not needed for these diseases because they are actually that mild and easily fought off by the immune system anyway. The MMR vaccine helps create antibodies to help the body fight diseases that the body can already fight perfectly well on its own. Of course there are things one should NOT do when one has these illnesses that could introduce some complication - for example, most people know not to take aspirin while they have mumps (and if you didn't know that, you're in luck because if you had done that you probably would have come down with Reye's syndrome and died swiftly).

In many ways, the three diseases are a bit like the common cold. They are not significantly harmful, they are self-limiting, and they won't kill you. One could contrast it with other illnesses that will kill you, like tetanus. Of course healthcare's role is to some extent also to ensure quality of care, but the MMR vaccine doesn't save people from anything more than mild discomfort for a few days. A small supply of paracetamol (NOT ASPIRIN!) is always easily able to handle this. And unlike the common cold, measles, mumps and rubella rarely come back. There have been a small number of isolated cases where somebody has had one of them twice, but it pretty much never happens (and is always even more mild when it does).

While the infection rate is pretty high in some areas, there is a very effective defense: a healthy immune system. The healthier you are, the lower your chance of contracting one of these illnesses, and the better your immune system's chance of saving you from another day of discomfort. 

Immunization was largely developed as a response to smallpox. Smallpox is eradicated now, but back in its heyday it was one of the most terrifying diseases by a long shot. Half a billion people died of smallpox in the last century, despite the fact it was eradicated completely from the face of the planet roughly three-quarters of the way through that period. And the death was painful and terrible. There was no treatment and a 30% death rate for all infected. While smallpox is gone, of diseases one could possibly work on eradicating next through herd immunity or such, something like mumps is a frankly foolish target. Really terrible diseases do indeed exist, but measles, mumps and rubella are not among them. (This is not to suggest that the smallpox vaccine was perfect - largely due to poor manufacturing processes in the early years it killed a fair number of people too and such - but rather to point out that at least it was trying to defeat a serious threat).

Let's talk about those complications for a moment. First thing is that the chance of you developing a complication, should you get the disease, is extremely small. We're talking about roughly a third of cases developing any kind of complication at all, however small. Of these, as you might guess, the vast majority are really minor issues (this holds true for all three). For rubella, the most terrible thing that can possibly happen to you is that you get chronic arthritis for a couple of weeks. Not only is that super-rare, but it goes away on its own. Mumps can lead to encephalitis, in extraordinarily rare circumstances. The chance of you contracting encephalitis from mumps, and then have that encephalitis prove fatal, is smaller than the chance of you having a serious reaction to the vaccine for mumps. The only one of the three that has any complications even worth talking about is measles, where fatality rate in the US is roughly 0.3%. That includes people who had compromised immune systems.

Weirdly enough, though, the chance of getting a complication from any of the 3 illnesses, but particularly measles, is really strongly correlated to how healthy that person is otherwise. Back in the great depression, if you got measles, there was a good 1-in-3 chance of death. The same thing is still true today in many countries where people don't have enough food or a vitamin deficiency. And these issues are not really specific to the third world. The US, too, has kids who go hungry. It might not be quite as common, but this is another one of those times Murphy's Law comes into play. Thus explaining the fatality rate. The fact is that if you're healthy now and you contract any one of measles, mumps or rubella, the chances of you getting a serious reaction are virtually zero.

So the low impact of the diseases is important. Here's why. The more serious the harm, the more serious the response should be. Making vaccinations mandatory is a really serious response. It's perhaps justified in response to a really serious problem. But the fact of the matter is that in the case of MMR, there is no serious problem. The vaccine solves no problems as there is practically no problem to solve.

There is an exception to this. For pregnant women, rubella will seriously damage your child to say the least. As such, I think it would be advisable for women looking to get pregnant to get a vaccination. But that's one very specific subset of the general population, not representative of people as a whole. Even they need to be careful because the effects of the rubella vaccine itself on children have never been properly studied, hence why it's not recommended to be vaccinated around the time of pregnancy itself.

In America!
My opponent has set this debate in the USA. I have no idea why this is, but I'm happy to accept it because the US has a great, inspiring healthcare system. If there's one country in the world that knows how to botch a new medical program at a federal level, it's probably you guys.


I've always wanted to make an argument that had a pre-made meme I could use

All of the above arguments would be true even IF the plan works absolutely successfully. We all know now, from the experience of "Obamacare", that such plans can have real failures that really impact the lives of hundreds, if not thousands, of people. In this particular case, we're talking somewhere around 3 million problems identified by an independent audit, though the exact figures aren't really relevant. Basically I think that, as a general principle, if something is so laughably stupidly implemented that people make memes out of it, there's probably something wrong somewhere. So there's real precedent for America screwing up on some level.

The fact is that not every doctor in the USA is competent. There, I said it. Don't believe me? Just look at Dr Mercola, Dr Ron Paul, Dr Phil, and Dr Dre. I can guarantee you that not a single person among the billions living on this planet would trust all four of those people, and that at least a quarter or so wouldn't trust any of them. In fact you'd probably be hard pressed to find somebody who'd trust three of them, yet these four are each highly respected doctors who make frequent public comment about health and lifestyle. Not every bureaucrat in the US government is competent either. There's literally millions of people working for it, so I take you won't need much convincing that it's not implausible to suggest that they won't be able to pull this off perfectly.

The consequences of that are hard to predict and definitely bad. From the costs spiraling out of control on an already indebted government, to there actually being harms to people's well-being as a result of government or medical incompetence or negligence, there's a substantial risk built into any sort of government-mandated healthcare solution.

With that in mind, let's examine my opponent's case more carefully.

Brief Rebuttals 1: Herd Immunity
I say brief because I fully intend to attack my opponent's case more closely in the next round, but I'll answer his claims here.

The first myth I want to dispel is that the choice not to vaccinate is not unscientific. The majority of my opponent's case is quoted material from various scientific sources, and combined with my opponent's phrasing of certain things that probably gives the impression that the science is all on his side. This isn't even a scientific debate. It's a moral issue. This issue is this: should you force vaccination on people, especially when that vaccination delivers little to no benefit? That's the issue that this debate should be focusing on. Science doesn't answer questions about what we should do, but rather informs them based on things we have found out in the past. Let me be on the record as saying right now that all of my opponent's data is accurate, but it only informs this debate, not decides it. That's important because the same evidence supports both of our cases in the same way.

Let me address the autism issue then, since I'm trying to be completely fair and balanced in my overview of the vaccine as a whole. There is a really well established link between GI issues and autism. In 1998, some researcher fudged some numbers that suggested a correlation between MMR vaccination and GI-related autism in a small sample group (the sample size was literally 12). Scientists quickly found other sample groups for whom this was not the case, and later worked out the study was wrong entirely. Even the study itself showed nothing definitive, the study was wrong, and let's be frank, the vast majority of autism is fairly mild. There is no evidence to suggest a link between GI autism and the MMR II vaccine, and some evidence of there being no link. BUT - and this is important - the MMR vaccine DOES have other known side effects. Some of them do affect the brain in other ways. The autism scandal has unfortunately distracted from far more important risks that are actually borne out by real science. Some of them are far more damaging. Like with all medicine there are risks and rewards. (Fun fact, in theory anyway, there's an extremely tiny chance that the MMR vaccine could cause another form of autism, via encephalitis, but let's not get sidetracked).

Pro is absolutely right that his model won't achieve herd immunity (the other reason why this is, that he didn't tell you, is that the vaccine itself is only 90-99% effective according to the manufacturer, which they have had to revise a few times before after outbreaks in the real world proved them wrong - see here for all the official details about the vaccine). Ironically there have been US outbreaks even in populations with 100% immunization coverage. But more importantly the question is whether herd immunity is a good ideal at all. What herd immunity really means is that on average, somebody with the disease will infect less than one other person, so the disease will quickly die out among the herd (that's the theory anyway). MMR (all three of them) are currently regarded by scientists as "endemic", meaning that every infected person infects about one other person on average. In other words, the entire world is really, really close to herd immunity already. The various "outbreaks" my opponent has mentioned have all been very localized and caused nothing more than moderate discomfort among a very small number of people. The number of serious complications caused by MMR (again referring to all three at once) is ironically enough comparable to the number of serious complications caused by the MMR vaccine (this is not to imply that the vaccine is equally dangerous, only that the vaccine is much, much more prevalent than MMR itself).

But the bigger problem with herd immunity is that we're not really a herd that necessarily needs immunizing. Put aside the moral issue that I talked about before about the government literally thinking of all of us like a herd of sheep. There's also the fact that for some diseases it's actually more effective to just let the disease run rampant. There are numerous cases where the cost and impact of treating an illness are actually lower than the cost and impact of preventing it (here's some examples). It also includes the word "immunity", which implies immunization but not other forms of preventative care. We have scarce resources. We could be, instead of immunizing, making children starve to death significantly less. That's just an example, but it's an important one because that in turn would also reduce illnesses. Roughly 95% of people developed measles immunity in childhood in the great depression era (and that's probably an understatement given that non-vaccine immunity is inheritable). 95% is also how many are roughly protected by a shot of measles. If you ignore children, the degree of "herd immunity" hasn't changed at all due to immunization.

The actual reduction in serious complications from MMR appears, as I was saying earlier, to be mostly correlated with improving health in the population generally, as opposed to the vaccination rate specifically. If this were true, we would expect the rate to have already been dropping prior to vaccination and to have remained more or less the same (over the long term) when vaccination was introduced. In fact this is more or less borne out by the data.


Can you guess in which year the MMR vaccine was introduced?

Herd immunity disguises the real issue, which is ensuring that we are protected against the most serious health issues. The two are not necessarily the same thing. As a matter of fact, some research exists that suggests that up to a third of all non-immunized children have measles infections so mild that nobody even notices they have it, since the level of antibodies is significantly higher than would otherwise be expected. EXACTLY the same trend, by the way, can also be observed in other, similar illnesses (in that they are strongly affected by the health of your immune system generally) even though those illnesses have no vaccination (scurvy being one example).

As an aside, there is no evidence that the MMR vaccine lasts a "lifetime", only that it lasts a very long time. If you get it when you're 5 and live another 100 years, I certainly wouldn't be counting on it. Antigens are always naturally being taken out of circulation, and although the vaccine does usually cause the body to make quite a few, they do always get taken away over time. There is also some evidence that the exact rate varies from person to person for various reasons.

Brief Rebuttals 2: The Impact
I have already talked about this in some depth, but there's another myth I want to dispel, and that's that these diseases are actually dangerous. Imagine if somehow, somebody developed a vaccine for salmonella poison. All of a sudden, that would become public health issue #1. People would be crying for it to be made mandatory. The media would tell you all these sad stories about salmonella victims, and scientists would be interviewed explaining how millions get food poisoning every year. They'd correctly point out the danger is many times greater than MMR in that salmonella can actually kill you quite easily, with over half a million deaths every year worldwide. No longer would they advise you to simply not eat uncooked chicken. No more would they worry about the cost or pragmatic concerns regarding mass vaccination. And any moral issues would immediately go out of the window.

You know what nobody's talking about all this time? The elephant in the room - smoking. Smoking literally kills more people than MMR, salmonella, tetanus and pretty much anything else that gets vaccinated against. The figure is only expanding as our understanding of second and third hand smoke has increased. So people are not allowed to put their lives at risk by eating uncooked chicken or living within a kilometer of a person who might have measles (fat chance of dying from that one), but they are allowed to put their lives by literally flooding their lungs with tar. It's disgusting. There are real health harms, like smoking, that the government COULD be banning outright but are not. Instead they create all these imaginary health harms by (mis)using genuine science to overstate the impact of a disease largely to fulfill the desires of their lobby groups, two of the big ones being pharmaceuticals and cigarettes. Just speaking personally, this angers me, and it should anger you too.

I'm telling you now - this will all happen in a few years. A salmonella vaccine is already being trialed. Exactly the same debate will be had.

There are hardcore anti-vaccine campaigners out there. I'm not one of them. I'm just telling you that you should evaluate each vaccine's risks and benefits, and get as informed as possible - as I'm sure you would with any other medicine. I think it's a moderate position. But then there's also hardcore vaccine campaigners, to whom all diseases are the same. They will talk up the harms of the disease, talk about "potential" impacts, contraindictions and complications a lot because their aim is to find things that make the disease look bad in a media report, not to present a full and balanced view of the disease. When you say "eating this cake may kill you", that doesn't really fully represent the fact that just because you may choke on the cake, or just because you may have an allergic reaction to some ingredient, does not mean it's amazingly likely you'll die from eating the cake. One could also say "not eating this cake may kill you" - maybe you're really starved or something and that cake is the only food in reach. But if you wanted to make cake look super-dangerous then you could definitely use the same technique.

Like I said earlier, all the science is genuine. Just as one may die from complications related to tripping over a banana peel (ban bananas!), one can indeed die from complications of measles. Just as rats used to be major plague carriers (kill all rodents!), rubella was once a major health problem. But each of these statements is really meaningless in the context of this debate. I'd call it a misuse of science, because it's framed in such a way as to suggest that these complications would be major problems if the vaccination were to stop entirely (which, it goes without saying, is NOT actually supported by the science). And furthermore, nobody is even suggesting that in this debate! Like I said at the very start, the contrary position in this debate is pretty much the status quo of (largely) voluntary vaccination. If largely voluntary vaccination has already achieved a society where serious complications are down to less than 1% of cases, and the incidence rate is already down to such an absurdly low percentage figure that my calculator writes it as an exponent, and if, even when the disease is contracted, it's generally really just mild discomfort for a few days - is it really fair to say I'm advocating for, as my opponent put it, "an enduring, broad threat to public health"? I personally don't think so.

This is all the rhetoric of the hardcore vaccine campaigners. They treat all diseases as enduring, broad threats to public health. To some extent I suppose they are, rather like the common cold is an enduring, broad threat to public health. But it is NOT a problem. MMR vaccines may have reduced the incidence rate, but they have not reduced the harm. THE HARM HAS BEEN REDUCED INDEPENDENTLY. The reason why vaccine lobbyists don't see that is that they attribute basically every health benefit of the last 200 years to vaccines, and not to a generally improved standard of living. Likewise they attribute all disease to a lack of vaccination, pretending it's a magic cure-all. They scaremonger people, telling you that you COULD DIE if you don't get immunized, rather like you could die from not eating cake.

I think we as a society need to realize that there must be a point where the claims of a vaccine become ridiculous. Would you accept a vaccine against the common cold? Even if you knew it was totally benign? Or would it not be fair to assess the evidence - look at the risks and benefits for yourself, and make a personal decision to immunize or not to immunize? I hope that everybody decides for themselves at what stage the claims become ridiculous and at what stage they are really warranted. Ultimately, putting aside any personal prejudice, for this vaccination there is no clear answer as to what side of the fence it falls on. My point is this: I'm not advocating for anything worse than the status quo, and the status quo is working just fine.

I look forward to my opponent's rebuttals, and apologize that this came out so long.

Return To Top | Posted:
2014-10-15 13:03:33
| Speak Round
Cross-Examination
admin: You quote plenty of figures of how things were prior to vaccination. Can you explain to me the relevance of these figures to the debate?
whiteflame: They tell a story regarding the likelihood of certain complications. I'm establishing a numerical link between incidence of disease and incidence of each complication.
whiteflame: Where did you get the "scientific advice" that Coca-Cola and comfort are cures for mumps and rubella, respectively?
admin: Would you say that complication rates are the same today as they were prior to vaccination? If not, would you say vaccination was primarily responsible for the change?
whiteflame: Just a note: neither of those "treatments" are cures, as Lars initially professed them to be. They ameliorate the symptoms, they do not affect the ability of the virus to replicate or interact with any given cell type.
admin: Wait - I said they're not cures. I said they're advice by scientists for people who have the disease. In the next sentence I say there are no cures.
admin: Now stop arguing in the CX and answer my question
whiteflame: You did use the word "cure," but fine, I'll move on.
whiteflame: I'd say the complication rates are higher. We've both agreed that they happen mainly among those who are immunocompromised, and as, even today, each of these individuals represents a larger subset of the population without vaccinations, they are more likely to be infected in any given outbreak. I'd say that vaccination has altered the rate of complications among the infected by shifting the population that's able to become infected.
admin: Not sure I get the logic but let me clarify this first: if I was to check, as a proportion of all infected, the death rate for MMR in the last ten years, you're telling me it will be higher than it was a century ago in the USA?
whiteflame: No. My claim is that a higher proportion of the infected population today would experience complications. A great deal more of the population today is immunized, so no, the epidemics wouldn't be as large. But each epidemic is more likely to include immunocompromised individuals than it was previously, as a result of their inability to be vaccinated. If it's going to spread, it's more likely today to spread to someone who is immunocompromised.
admin: Other than to substitute "complications" for "death rate", is there any material difference between that and what I said? If not, do you not see the death rate as a complication?
whiteflame: I realized after I wrote it that I didn't read the question correctly. My answer would be a qualified yes. I see death as a complication, but one we can better control for today than we could 10 years ago.
admin: OK cool. So the first half of this year the USA has seen almost 300 measles cases and no deaths or serious brain complications (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm). Is this just a freak statistical accident to you?
whiteflame: It's 300 people. If you look at the numbers I provided in my first round, 300 cases isn't enough to see serious complications. You're still talking about a relatively small population. I wouldn't characterize it as a "freak accident," but rather as lacking in statistical significance.
whiteflame: Do you consider the possible side effects that someone suffers as a result of mandatory vaccination a loss to their rights?
admin: Yes.
admin: In your rounds, you cite a death rate for measles above 1% immediately before vaccination. So I'd assume from that you'd expect more than 3 to have died this year. How do you explain the lack of measles deaths at all in the US for some many years now?
whiteflame: Three is a very small number and not statistically distant enough from 0 to be measured and evaluated as changing how we should view measles infections in the U.S. We're talking about data gathered among millions of infections and trying to make conclusions based on 300 is unreasonable.
admin: Do you know when the last time is somebody died of measles in the USA?
whiteflame: I have it at 2005, though I think it's unreasonable to assess the impact of measles on the U.S. solely on the basis of recent deaths, especially when the number of infections is on a substantial uptick.
admin: I have it at 2003 but that's fine. So roughly a decade of no deaths. Would you say that whenever the rate of measles rises in the general population, the death rate from measles should then also rise?
whiteflame: Two things. One, I already mentioned that our ability to respond to complications and prevent deaths has improved substantially over the past 10 years, so no, I don't suspect it would rise. That doesn't mean that those complications don't occur, they're just tackled early and strongly in most cases. Two, I also already mentioned that the numbers we're dealing with are still relatively small. We're not dealing in numbers sufficient for statistical significance to be evaluated.
admin: OK, look at this graph. Notice the LARGE sample size and HISTORIC data from prior to a decade to. Prior to vaccination, would it be fair to say measles rates were rising while deaths were falling?
whiteflame: Do you consider the spread of a disease through negligence to other people to be a loss of rights?
admin: No
whiteflame: ...Lars, I understand where you're going with this, and I've already given you my response multiple times - changes to medical care affect the number of deaths that occur. Antibiotics became much more widely used during that same time period. It's no surprise that the bacterial infections that so often accompany these viral infections started being less of a problem when patients are being treated for the bacterial infection. Death rates fell prior to vaccination, but complications were the same.
whiteflame: What makes the second circumstance substantially different from the first?
admin: Mandatory vaccination is different from mandatory infection in that the infected couldn't help it. Both have a loss of power, but only in the former do you give up your rights to somebody else.
admin: So what complications would you say are a significant enough threat today from MMR that will affect everybody?
admin: (*sorry, probably should have said "could affect" and not "will affect")
whiteflame: It's alright, I understood it :)
whiteflame: I'd say most complicating infections are problematic enough to be significant. Pneumonia would top my list. I would also have a problem with permanent disease states incurred like hepatitis. The major blood diseases would as well, though less so.
whiteflame: So the only loss of rights that matters is one in which rights are lost to someone else? On that basis, who are you losing rights to when you get a side effect from vaccination?
admin: You are losing rights whenever the vaccination is mandatory. The side effects are irrelevant to the question. There you're losing rights to the government. Rights analysis is about obligations people hold towards one another. To say viruses have human rights is absurd.
admin: Looking at pneumonia. If I get measles, what's the chance I will develop pneumonia?
whiteflame: Based on the CDC's numbers, 1 in 20 children get pneumonia, though I can't find specific numbers for adults. http://www.cdc.gov/measles/about/complications.html This year, between January and May, there have been 5, which represents slightly less than that. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm
whiteflame: I guess I didn't get as clear of an answer to this as I'd thought earlier. You now say that the side effects are irrelevant to the question. Are you now saying that those side effects that result from mandatory vaccination are not abrogations of the rights of those individuals who acquire them?
admin: Any effects resulting from mandatory vaccinations are abrogations of rights. Even if the vaccine were 100% effective and had no side effects, making it mandatory would abrogate people's rights.
admin: Do you agree with the WHO that the best way to avoid getting pneumonia is through nutrition, environmental factors, and getting a flu jab?
whiteflame: I would agree that those are beneficial, but insufficient. Measles specifically makes a person more vulnerable to pneumonia. That's actually the same purpose of the "flu jab," which is meant to prevent you from getting influenza, another major virus associated with pneumonia infections. Nutrition and environmental factors can certainly have an effect, but merely changing circumstances for the better is insufficient. It's also not possible for everyone to change those factors.
whiteflame: Alright, I'm still confused by your answer. I understand that your view is that people's rights are harmed by mandatory vaccination independent of side effects. What you seem to be saying is that the side effects are a further abrogation of rights. But you said earlier that surrendering rights was the concern. Who are those rights surrendered to?
admin: Side effects are not a further abrogation of rights. If somebody chooses between two medications, they do not inherently limit their human rights by choosing one that may have side effects.
admin: I guess my point though, is, isn't pneumonia also rather easily treated and prevented, compared to other illnesses?
whiteflame: Not always. Pneumonia can be caused by a wide variety of bacterial diseases, many of which require different treatments and not all of which are easily distinguished. There's also the reality that antibiotic resistance is becoming more and more of a problem, and specifically pneumococcal pneumonia has presented with a great deal of concerns in this regard. http://www.cdc.gov/pneumococcal/drug-resistance.html
whiteflame: I feel like I'm not getting a consistent answer here. You said "any effects resulting from mandatory vaccinations are abrogations of rights." Now you're saying that side effects are not a further abrogation of rights. Is there something unique to side effects that ensures that they do not represent a loss of rights? Or are you saying that only in the instance where the vaccine is mandated is there a further abrogation of rights that results from side effects?
admin: They're not further abrogations of rights, but part of the same abrogation. The vaccine and all its effects abrogate your rights because of the mandate.
admin: OK, I'll save most of my analysis on this for my round. Moving on. Why do you think there's a measles outbreak in the US this year?
whiteflame: I'd say the likeliest explanation is two-fold %u2013 one, there's a major outbreak in the Philippines, which is spreading to this country, and two, there's a reduced level of vaccination across the U.S. population. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm
whiteflame: Alright, I think that answer is straightforward, so I'll go with that. Next question: is approaching herd immunity beneficial, even if we don't achieve it?
admin: No
admin: What makes you believe the level of vaccination in the US is reduced?
whiteflame: The CDC's data indicates as much. http://deadstate.org/new-cdc-report-thanks-to-anti-vaccine-hysteria-u-s-measles-cases-have-tripled-in-2013/ Individual state analysis has at least been done for Texas. healthblog.dallasnews.com/2014/08/vaccination-rates-for-kids-are-down-rates-of-infectious-diseases-are-up.html/
whiteflame: So increased of immunity are not beneficial if they don't reach herd immunity levels?
admin: Yes
admin: (can you repost your link? leads to a page not found page for me)
admin: (sorry, my fault)
admin: OK - just read both of them. What I don't understand is - are those sources not aware that there's been a consistent upward trend in MMRII vaccine uptake since 2003?
whiteflame: I'd like to see your source for that.
whiteflame: So you contend that a larger portion of the population taking the MMR vaccine isn't beneficial if that population doesn't cause the country to herd immunity?
whiteflame: to reach* herd immunity
admin: Yes
admin: Will provide my sources in round. What proportion of people do you think would be the ideal proportion to have immunized?
whiteflame: I've already given idealized numbers on the basis of what is required for herd immunity. I recognize that those aren't currently achievable.
admin: So roughly 95%?
whiteflame: Optimally, yes.
whiteflame: So what is the purpose of immunization, then, from your perspective? Does having sub-herd immunity levels of vaccination harm a population, or do you view it as a net 0? And please, explain this perspective with more than a few words.
admin: I think it depends on the vaccination. Different vaccinations have different risks and benefits that different people have to individually evaluate; its purpose just like any other medicine. In my own personal evaluation, I don't consider the MMR vaccine to be a good enough medicine to justify its cost.
admin: If I were to provide a credible source, in round, showing that the current MMR vaccination rate is roughly 94.5% for all kindergarten-age kids, would you give up?
whiteflame: As that is still sub-optimum and we should be attempting to reach that optimum in any case, that point would not force me to surrender. If anything, that would provide proof that it's possible to reach that threshold of 95%, unless you could show that my policy wouldn't increase the number of vaccinated individuals.
whiteflame: Alright, but that means you're factoring other aspects into your answer. Imagine that there were no side effects, and that people were choosing to get the vaccine instead of being required to get it. Would you say that there's a benefit to a more substantial portion of the population receiving that optimized MMR vaccine?
admin: In terms of public health, there's a benefit. The same kind of argument could be made for eugenics if you factor no other aspects into your answer.
admin: So that 0.5% would be enough to convince you that you need to introduce a mandatory program for everybody?
whiteflame: Yes. It would tell me that 94.5% of the population would be practically unaffected by the mandate and receive benefits from the subsidies, while the remaining 5.5% would be affected, bringing the country to the level of herd immunity in the process.
whiteflame: Alright, that's enough for that line of questioning. Was mandating vaccination for smallpox a net harm?
admin: I don't think so. It was an early experiment and a lot went wrong, but ultimately in my personal view the good outweighed the harm. I would defend the right of others to see that differently if they wanted.
admin: Do you believe it was OK for Hitler to force-medicate Jews, gypsys etc?
whiteflame: What makes mandatory medication for smallpox a net benefit?
admin: I didn't read your question right, sorry. If it was mandatory it would be a net harm. What makes it a net harm is that it's mandatory. If you're just looking at the vaccine itself, I'd say it was a net benefit because although the vaccine had its problems it cured a really bad threat.
admin: Why is it OK for you to force-medicate but not Hitler?
whiteflame: ...If you really want a list of reasons, we can go there. 1) I'm not force medicating. I'm not strapping anyone down and making them take a shot in the arm. 2) Hitler didn't force medicate solely under the auspices of public health. 3) The basis for his force-medication was pseudoscience. 4) I'm not singling out racial groups. This list could go on and on, but I'll stop there.
whiteflame: Would you contend that smallpox would no longer be a problem today if no one had ever mandated vaccination for it?
admin: No. Smallpox was eradicated in numerous countries with no mandates.
admin: In your answer, I note that you DON'T say the Nuremberg principle of consent. Do you believe that Hitler violated any medical ethics by failing to obtain consent?
whiteflame: Hitler violated multiple codes of ethics, and yes, I'd say that his choice to force people to be medicated entirely against their will without recourse and therefore completely without any level of consent is problematic. I would also say that those moral failings don't appear in my case.
whiteflame: I'm noticing that's not really an answer to my question. Would smallpox have been eradicated from the world as a whole if there had never been any mandates that people take the vaccine?
admin: Yes. The vaccine wasn't the only reason it went away, and although it definitely helped, the mandates were not required to ensure high uptake.
admin: Is it true that your model imposes a cost on people for doing nothing?
whiteflame: It imposes a cost on people who negligently put others at risk, so no, I wouldn't say it's for doing nothing.
whiteflame: By what means, and please be specific, would smallpox have been eradicated worldwide in the absence of vaccination?
whiteflame: (sorry for the double posts... don't know why that happened...)
admin: I never said it would, but that the vaccine was not the only reason. It could not have been done without the vaccine, but better nutrition, better public health, improvements to sanitation and a better understanding of the disease all contributed. Would be happy to expand on all that in my round.
admin: Does an unvaccinated person really inherently put other people at risk, or is that only if they actually catch the disease?
whiteflame: I'd argue that in the case of these diseases, unvaccinated persons cannot reasonably assume that they will never be exposed to at least one these diseases in their lifetimes. These are airborne viruses with a simple route of transmission that anyone but the most isolated persons risks acquiring.
admin: Can a government reasonably assume a person will never jaywalk in their lifetime?
whiteflame: No. That's why states have laws against it.
whiteflame: (I'll get back to asking more questions later. Right now, I'm just interested in seeing where you're going with this)
admin: They have laws against it when you do it, they do not presume in advance that you will and punish you for that. Is my understanding of the law accurate?
whiteflame: If you would like to argue that the better alternative is to punish people for getting and spreading these diseases, I will be happy to address that, though I'd like you to flesh out how you would apply a similar method to an infectious disease. I don't think the transition is straightforward and that it creates more problems than it solves.
admin: I take it then that it's accurate. Are there not laws in force already restricting the rights of people with diseases like measles, such as rules preventing them from going to school?
whiteflame: I don't recall any such laws being pervasive in the U.S., nor are they binding for all schools. Such laws would also be ineffective at preventing the spread of disease, only cutting off one route of transmission. I'd say they're incapable of solving for the problem, and their presence only masks the problem.
admin: Do you agree that immunization has a 1-10% failure rate? And further, do you agree that staying away from the disease has a 0% failure rate?
whiteflame: Yes, though I would say that the failure rate trends towards the lower end. And yes, if you could tell me a way to completely avoid any chance of transmission of these diseases, "staying away from" them would be more effective, if exceedingly unlikely.
whiteflame: You mentioned botched production systems for vaccines. How commonly do incidents occur in the U.S. where vaccinations are manufactured poorly, leading to illness/injury?
admin: Nowadays, extremely rarely. The chance has been reduced significantly over the past century. As I established in my case, however, the smallness of the chance is actually irrelevant.
admin: If somebody has a compromised immune system, would they not avoid people who have measles etc (literally) like the plague?
whiteflame: You seem to be making a few basic assumptions here. One, that someone who has the measles is going to present with symptoms that are obvious while they are infectious. Two, that those symptoms are obviously separate from other common illnesses. Three, that they can avoid all individuals who might be sick without placing themselves in a large plastic bubble. And four, that even if they take intense precautions, that they can avoid indirect infections. It is not simple even if one is taking the fewest risks possible.
whiteflame: I read the Murphy's Law contention. Why should voters prefer huge impacts that are extremely unlikely to substantial and still likely impacts?
admin: Judges should be free to make up their own mind as to whether potential risks outweigh potential benefits for any medication. I'm simply showing science-supported valid justifications also exist for not taking the vaccine. Many will not accept that argument, and that's fine. I wish them well. It's not me in this debate who is trying to force my opinion on other people.
admin: What other "common illness" looks like measles or mumps symptoms-wise that an immune-compromised person would NOT want to avoid like the plague?
whiteflame: We've been through the symptoms, I don't think I need to repeat them. Yes, an immunocompromised person would want to avoid them as well. But there are two problems. One, this dramatically increases the number of people that those who are immunocompromised have to avoid, making the process all the more impossible. Two, we're talking about basic symptoms like "fever," "dry cough" and "sore throat," which are simulated quite well by several non-disease states. These aren't necessarily hallmarks of disease, and so aren't so simple to recognize as signs of someone to stay away from.
whiteflame: Nice jab. Still, could you tell me the most recent date when a poorly manufactured vaccine led to illness/injury in the U.S.?
admin: No because the VICP does not usually make rulings as to what exactly was wrong with the vaccine, only whether the vaccine was at fault at all. Usually there's no real way of telling. It's safe to say that it's rare.
admin: What's more likely today - that an immune-compromised person will die from a shark attack or that they will die from measles, mumps or rubella?
whiteflame: I won't speculate, though if they're immunocompromised, the process of leaving their home, heading to the beach, getting settled and entering the water all present as opportunities to be infected by those around them. It seems rather unlikely that an immunocompromised individual would further compromise themselves by swimming out far enough to put themselves at risk.
admin: If they're not willing to go out to sea, assuming that's true, then can we agree that they'll definitely try to not go near people showing symptoms of those illnesses?
whiteflame: We can assume what they'll try to do. We cannot assume that they would be capable of achieving it without encasing themselves in plastic.
whiteflame: You mentioned that deaths that occur as a result of measles tend to come from complicating infections. How do most die from influenza and the human immunodeficiency virus?
admin: They ALWAYS come from complicating infections. Even in immune-compromised persons - the virus itself is extraordinarily benign. The mechanism for death is similar to influenza or HIV when it occurs in that there are complicating infections, but the virus is far less deadly than either.
admin: Do you agree that among the 0.3% killed by complications related to measles among infected in the decade before last, there were only (roughly) 0.045% were immune deficient? Do you further agree that in the last decade, 0% of immune deficient persons who have contracted measles have died?
whiteflame: I'm not going to agree to numbers without seeing the sources themselves and validating their findings, so while that may be accurate, I would need to see the support behind them.
whiteflame: Is it your contention, then, that the complicating factors that accompany these virus infections are not enhanced significantly (especially in immunosuppressed persons) by the viral infections themselves?
admin: Not significantly. The enhancement is minor at best.
admin: Since you're making the claim that the harm is particularly strong to immunosuppressed people, do you have any statistics that support that claim in relation to MMR specifically from the past two decades or so?
whiteflame: I'll be all too happy to provide primary and secondary evidence in the next round that shows that measles, in particular, presents a tremendous risk to the immunosuppressed, and further that it can and does induce immunosuppression.
admin: But are these sources statistics from the past two decades relating to MMR in immunosuppressed people specifically?
whiteflame: Would you also say that measles does not have a significant immunosuppressive effect?
admin: Yes
whiteflame: Would you say that influenza has a higher immunosuppressive effect? And, if so, what differentiates the two?
whiteflame: Yes. If these studies did occur before 20 years ago, though, the effects remain the same. We may be better able to address the resulting fallout today, but that immunosuppression still occurs because we have limited or no understanding of the mechanisms involved.
admin: Yes, but not much. Their respective RNA and how that causes them to behave is what differentiates them for the most part, as with pretty much any RNA viruses. I kind of don't understand the point of the question.
admin: You say the effects are the same as 20 years ago. Does this mean you believe that the environment plays no difference in how the disease affects people, or are you saying the environment is the same today as 20 years ago?
whiteflame: "Environment" is a pretty broad term and can encompass a number of very different variables. Of course there's differences in the environment. Whether those differences are substantial enough to dramatically affect disease progression for the majority of the population that gets measles is another story. If it's your view that there's a substantial environmental difference between the 1990's and the 2010's that is likely to do this, then you should make that difference clear.
whiteflame: I'm pretty well versed on viral RNAs myself, so I'll go with what you've given me on that front. Has vaccine-derived illness ever been characterized in people receiving the MMR vaccine? Similarly, has there ever been an instance of transmission of a separate disease to patients receiving the MMR vaccine?
admin: Yes, quite frequently. A small outbreak of measles from the vaccine, for example, is observed in about 5% of people who get the MMR vaccine. One of the side effects is literally getting the very disease you're immunizing against. Can provide more on that in round. Other illnesses are also possible side-effects of the virus even when the manufacturing etc is perfect.
admin: And I should clarify that the 5% is not necessarily the same 5% or so who receive no measles protection after a dose of the vaccine.
admin: Do you believe that adequate nourishment significantly increases the chances of surviving measles?
whiteflame: Of course. Malnutrition is practically a disease in its own right, depriving the body of necessary nutrients. A virus has a more difficult time depriving the body of nutrients through its replication when those nutrients are already above the floor level. It's at least partially the same reason why opportunistic organisms can become infectious after a viral infection takes hold.
whiteflame: I suppose I phrased that question poorly (though I'll be interested to see your data on that, because it doesn't match my numbers). Let me rephrase: you said in the previous round that the polio vaccine in India had engendered an infectious disease that was separate from polio. Is there any instance of a disease of similar origins resulting from the MMR vaccine? And have there been any documented instances of non-MMR diseases spread by the vaccine?
admin: Not on the same scale, but isolated cases do exist. For example, a dirty needle used in vaccination of MMR has given people HIV before. That wasn't the point of the story though. I was just showing that things can go wrong when humans make errors, which is certainly very possible with the MMR vaccine.
admin: Has malnutrition been reduced overall in the past 20 years? If so, is it any surprise that death rates from measles have reduced?
whiteflame: Based on trends I'm seeing of underweight children and food security over the years, I'm not seeing that trend. Even if it does exist, though, the effect is at least ameliorated by the increased prevalence of obesity, which also causes a number of immunological concerns. I'd say the main reason for the reduction in death tolls is a) much smaller epidemics, and b) improved of medical tools and techniques.
admin: So you're saying people have more or less the same nutritional health as 20 years ago? Wow. What about 100 years ago when MMR records began? How far back does your claim extend?
whiteflame: I'd like to see your support for that HIV infection. I understand that humans can make errors, but what you were talking about in your post was the incidence of a new and potentially more dangerous disease resulting from polio vaccination. Is there any incidence of such a disease resulting from MMR vaccination?
admin: To be clear: the problem in India wasn't the vaccination. The side effects of that were known and documented. The problem was the method of administration. And yes, MMR vaccines have been mis-administered before. It's just never been a massive problem.
whiteflame: I'm not making the claim, I'm merely interpreting what I'm seeing. I'd actually say nutritional health is probably worse on the basis of increased obesity, which started surging upward in the 1970's. I have no doubt whatsoever that, worldwide, nitrition has improved in the last 20 years. I don't believe that to be the case in the U.S.
whiteflame: Did mis-administration of the MMR vaccine result in any detectable disease that was markedly different from the three viruses themselves?
admin: Yes. Any time you poke a needle in somebody there are inherent risks that have nothing to do with MMR. That's in addition to possible complications from the vaccine itself.
admin: I deliberately didn't limit my question to the USA because you were complaining about a very small sample size of MMR incidents there, but would you agree that around the world, nutrition, sanitation and healthcare standards have all to some degree contributed to reducing the impact of diseases like MMR? Or do you believe that it is just medicine and vaccination alone?
whiteflame: I would agree that improved nutrition has produced a beneficial effect for many societies worldwide with regards to their immune function, and that, yes, this has resulted in a reduced impact of all diseases. I didn't realize you were asking that question, and I apologize for not recognizing it, though it seems like an obvious answer.
whiteflame: So you have documented evidence to the effect that this specific vaccine has produced said infection? If so, I'd like to see it.
admin: 1 in 3 vaccine injections, including the MMR injection, is unsafe in four out of six regions of the world, which has contributed significantly to HIV and Hepititis (http://www.who.int/injection_safety/toolbox/Miller.pdf). There's more analysis I want to give on this point, though, than is possible to type here.
admin: Just to help me draw a graph here - can you name me some countries where you believe that the environment (encompassing all those things I've been asking about) is generally a healthy one? And for comparison, some countries where generally the environment is not that healthy?
whiteflame: Healthy: France, the UK, the U.S. Unhealthy: Sierra Leone, Zimbabwe, Haiti.
whiteflame: Does that link provide any data on vaccinations done in the U.S.? It mentions that the biggest problem by far is the reuse of needles by health professionals due to severe cost woes. Is this practice occurring anywhere in the U.S. currently?
admin: I never said it happened in the US. You might want to qualify some of your questions a bit. That isn't to say it couldn't be a problem. Certainly in the past, before much was known about how diseases spread, injections in the US not unlike the MMR vaccination had similar problems.
admin: Alright, final set of questions. Why do you think the price of recieving the MMR vaccine has doubled in the last ten years?
whiteflame: That assumes that it has doubled. I'd like to see evidence to that effect before I can answer that question.
admin: Well then, does this look accurate to you?
whiteflame: So that price is solely for the MMR II vaccine? Is that price increase consistent with GSK's product, Priorix, as well?
admin: Priorix isn't sold in the US. It obviously depends a lot on the market in question, but the general trend has been an increase in price over time. That price is solely for the MMRII vaccine. Given this, can you now answer my question about why the price of getting an MMR vaccine in the US has risen so significantly?
whiteflame: I asked my question that way for a reason, I'm just trying to establish something. I think I'm satisfied on that front as well.
whiteflame: I can speculate based on my knowledge of the pharmaceutical market and vaccine sales, but no, I don't have a definitive answer.
admin: Did you know that when the polio vaccine was invented, the inventor refused to take out a patent, specifically so that as many people as possible could get the treatment inexpensively?
whiteflame: Ah, I figured you were going there. Yes, I've heard that story. If you want to discuss the necessity of drug patents, that's a very large and complex issue.
admin: Do you think it's fair, in general, for the US government to mandate payments, primarily from the middle class, to a private company making millions in profits for their primarily wealthy investors?
whiteflame: I'd say that answer is contingent on a number of factors. I can't say that it's fair in every instance, but I also can't say it's unfair in every instance. I think I've provided a lot of the reasoning already for why society requires this mandate, and I'll be happy to defend it on other levels if you could narrow down the question.
admin: Alright then, final question. Is this really the biggest public health issue for the US to solve right now? Like compared with all the other problems the US faces, and mandates they could be making, do you honestly believe the US has nothing better to do than mandate an MMR vaccination?
whiteflame: Of course not, though I do think it's a substantial problem that is capable of being solved much more cleanly and clearly than the bigger health issues in the U.S. I'd say heart disease, cancer and diabetes are bigger problems, but they're rather large health problems with no solid solutions. Same for obesity, Alzheimer's, and COPD. Even if these were things we could solve for in some reasonable fashion, I don't see why there's a need to be overly selective in regards to what we're solving for. Whether this is the biggest issue or not, it's still a worthy one.
admin: OK then, I look forward to reading your last round! Feel free to ask me any other questions you may have too.
whiteflame: I think I'm good. I appreciate the spirited cross-x, Lars. Haven't ever done it before (beyond that one time with RM, which I don't count), and it's been enlightening to me.

Return To Top | Speak Round
whiteflamewhiteflame (PRO)

Alright, thanks again to Con for engaging with me in one of the most interesting debates I've had. I do apologize for the tremendous amount of text to follow – Con gave me a rather long round himself and a large amount to cover from cross-x, and I'm sure his final round will be similarly verbose. Thanks to the voters in advance for taking the time to go through these posts; it may be only two rounds, but with this amount of text, it seems more like 6.

Fundamentally, this is a debate weighing the aggregate utility of the MMR vaccine to public health and the lost liberties that result from its being mandated. The reality is that neither of these should be preferred in every case. I'm not going to sit here and argue that every measure we can take to address a given public health threat is worth the loss to liberty it may engender, nor do I think my opponent would argue that those lost liberties should always outweigh any benefit to public health that could occur. So really, what this debate is about is how we strike that balance, and where MMR comes out when that balance is struck. So there are a few questions that this debate comes down to by the end that need to be thought through as I go through Con's points:


1) Do the MMR viruses present a substantial risk to the public health of the United States?

2) Can that risk be ameliorated to a significant degree by mandating vaccination?

3) Does that risk reduction outweigh the potential loss of rights that accompanies it?


By the end of this round, I plan to show that the answers to all of these questions is an emphatic “yes!” A big part of the reason why is that Con is continuing to treat vaccination as an individual choice on the basis that their purpose is for their own protection. And this is the problem – a vaccine isn't solely meant to protect the person receiving it. Voters, this is the main point you must keep in mind as I go through this rebuttal and conclude; Con's arguments for individual rights just miss the basic point, and treat commonly dangerous viral infections as little more than nuisances without cause.

But onto the rebuttals.


Mass Medication

1. Con does a good job ginning up fear of mass medication without any real explanation of harm. Note that nowhere in this point does he ever state why mass medication is wrong. He says that mass overmedication is harmful, but the sole reason he provides is that it's like eugenics. The problem is that a) he never says why eugenics is wrong, merely insinuating that there's an inherent harm to all of eugenics (recognize that genetic counseling could be considered “eugenics,” as it's also the “practice of improving the genetic quality of the human population”)[15] and b) changing genetic structures, thus altering traits inherent to a person, is substantially different from providing basic nutrients, which only alters what they eat and drink. Con provides no analysis on why any given vitamin shouldn't be packaged more commonly in foods and drinks to improve public health.

2. Most of this has absolutely nothing to do with my case. A person neglecting or refusing to take a vaccine puts others at risk by their inaction, as the spread of a disease to them could consequently increase the chance of its spread to others. If a person neglects or refuses to take a certain nutrient, the harm is solely their own. One could argue that some of these vitamins are important for staving off disease, but the sole diseases that are definitively linked to vitamin deficiencies aren't infectious.

3. The sole piece of this contention that is applicable to my case misrepresents both the purpose of vaccines and my case. In the former case, vaccines are much better as a preventative measure. Yes, vaccines are pursued largely in instances where there are large outbreaks in order to prevent the spread. However, the main purpose is to prevent those outbreaks. The most effective usage of vaccination prevents any epidemic, it's not responsive to one. As for my case, I'd say I'm not responding to outbreaks (as these are usually sporadic in the U.S.), but rather responding to a changing mentality, which has pushed people to fear vaccines that functions mainly on the basis of pseudoscience.


Human Rights

1. This appears to be at least part of the impact story for the previous point, but it still lacks anything definitive. He essentially just asserts that there's a harm to obligating people to receive the necessary medications to be healthy, but never states what that harm is beyond this general assertion of “human rights.” He never provides any specific analysis as to why people should have the right to refuse treatments that are proven to be beneficial to them and those around them. Why is it moral to allow a person to refuse care on the grounds of personal autonomy? It sounds nice, but Con is going to need to provide more than just his assertion that it's wrong, especially when he admits that many schools can and do already require incoming students to be vaccinated, and when many jobs require a wide variety of vaccinations.[16]

2. Con uses the Universal Declaration of Human Rights to support his argument, but never points to anything within it that specifically upholds this principle. If anything, the one aspect he quotes points towards the necessity for each person to have this right to health and medical care, something that's only realistically possible in a world where herd immunity protects those individuals who are most susceptible to these diseases.  

3. I take issue with this presumption of guilt argument. I'm not presuming guilt any more than tax policy assumes people are cheapskates. I'm assuming that it's negligent to ignore one's capacity to easily spread a dangerous disease when one has the capacity and the means to prevent it.

4. Con's argument seems to apply to practically any instance in which autonomous actions are restricted for the benefit of the general public. It could just as easily be applied to taxation policies, requiring automobile insurance, and obeying road signs. Con has provided nothing specific to choice of treatment that makes it special, except to equate body autonomy to a nebulous “right to life” that apparently has to be exercised through medical decisions, but can be abrogated in other areas for the benefit of the general public. Why should I be able to “make [my] own destiny” when it comes to vaccinations, but not able to engage in these other risky behaviors?

5. Let's look at the sole example of a vaccination that resulted in eradication of a disease: smallpox. It was mandated for the first time in the U.S. in 1809.[17] It was upheld there in Jacobson v. Massachusetts. The justices compared it to the Civil War, “saying that a community has the right to protect itself both from disease and from military invasion...'there are manifold restraints to which each person is necessarily subject for the common good.'”[18] The British government followed in 1853.[19] These procedures led to complete or nearly complete elimination of the disease over the next century in these countries. People like Frank Fenner are responsible for the eradication of smallpox in Africa, which often went against the will of native populations.[20] And that's not even what I'm seeking here. The alternative of accepting the fine for those who do not wish to be vaccinated, which is also upheld by that USSC decision, makes my case far more reasonable.[18]  

If that's not enough, we could take a look at current policies. There are dozens of countries that require the yellow fever vaccine.[21] Saudi Arabia requires meningococcal disease and polio vaccines, mainly because of a large influx of pilgrims to the country.[21] These are recognitions of broad public harms that many countries have agreed need to be prevented using a consistent mechanism, and that mechanism is vaccination.


We're not the same

1. This is generally just an obvious point. Of course we're not all the same. However, each of us is vulnerable to the spread of these diseases on the basis that we are human beings without immunity to them. That doesn't change on a person-by-person basis. Unless you've built up the highly specific antibodies to the virus that you need to combat it, it's exceedingly unlikely that you could fight off any of these viruses before getting any symptoms. People will generate those antibodies and mount an immune response at different rates, changing how long the infection lasts and how strong of any effect it has, and other immune defenses come into play, but to my knowledge, there is no population of humans that is immune to any of these diseases before being exposed to them.

2. My plan would be implemented using doctors' discretion, as that keeps medical records confidential.

3. Con says that there are possible health complications that could result from something that the patient doesn't want to reveal to their doctor. That's true enough, but if the patient is aware of this source of complication, then they can either choose to reveal that to their doctor, or choose to pay the fine. They are not forced to put themselves in a medically dangerous state, and doing so would be their choice. If the patient is unaware of this problem, then mandatory vaccination isn't the concern, but rather a lack of education on the matter is. They would be put in the same danger if they chose to get vaccinated under those circumstances. If they've chosen not to discuss it with a medical professional or look up prescription drug interactions online (they're not that hard to find [22]), then the state should not be deemed responsible for those consequences. The harm is something they brought on themselves.

4. Much of this can still be solved by a basic blood or urine test before vaccination. This doesn't have to be mandatory – it can be linked with vaccination, and patients can sign off if they don't wish to have these tests. This provides them with an option that can further improve the safety of their vaccination, and afford them an opportunity to exercise their bodily autonomy if they wish. It's a way for doctors to ensure that there's no possible concerns in their system, and essentially know them as well as they know themselves in this regard. If a given drug doesn't appear in these tests, then it probably is no longer at perceptible levels, and therefore is not a concern.

5. Note that Con never provides any examples of this happening. An attenuated vaccine of the sort I am discussing is not a chemical. It's virus particles. To my knowledge, there are no dangerous chemical interactions with vaccines. Problems like vaccine overload are the result of excessive challenges to the immune system, and are prevented by ensuring that patients aren't given too many vaccines at once.

6. I'm not sure what's dehumanizing about ensuring a higher standard for public health. Con simply asserts that this is “a ritual activity for the sole purpose of making us more similar,” but that's not even part of the purpose. The purpose is disease prevention, not similarity. You and I will likely have dissimilar reactions to the vaccine and produce dissimilar antibodies to different viral proteins/nucleic acids or different parts of the same viral protein/nucleic acid. I don't even see why medical similarity (or for that matter, any similarity) is inherently dehumanizing. Con doesn't explain.

7. The comparison to tetanus is absurd. Tetanus is not an airborne disease with the ability to spread easily from person-to-person. The whole idea of “liv[ing] healthily” is similarly bogus. If I eat all my vegetables and exercise every day, I'll still be able to contract measles from my next door neighbor if I don't have the vaccine and have never been exposed to the virus before. Con's claim that we “should have the right to decide what means of avoiding sickness is right for” us is entirely empty – the only means he provides are only partially effective at best. Choosing one of them over vaccination represents an unsound decision that puts the well-being of others at risk.

8. I don't understand this argument that not being vaccinated somehow makes you more health conscious. Con barely warrants this statement and says it's, in his own words, “a weak correlation.” That's the best case scenario for him. The truth is that there's likely no correlation. In fact, I would argue that a society that is built around a public consciousness of an ongoing healthcare threat is going to be the one in which more people are health-conscious. Hearing about this in the news and having constant discussions on viral infections and staying healthy is going to inform people of the health risks involved and push them to improve on behaviors that would otherwise be treated as unimportant, like a healthy diet, exercise, and hygiene. This discussion is far less prominent in status quo.


Murphy's Law

1. This entire contention is non-unique to any case that modifies away from the status quo. Murphy's law is essentially an elegant way of saying “shit happens,” a pessimistic comment on how many view the world and anything that happens in it. Actually I take back what I said – if Murphy's law is right, then anything can and will go wrong in the status quo as well, so it doesn't just apply to alterations, but to the status quo itself. And I don't need an adage to show that it is going wrong, not with all my epidemiologic evidence. Con will need to provide some exceptional support for his statement here to match that. All he's done is express a generalized negative view with insufficient warrants.

2. The reality is that Murphy's law is incorrect, and it doesn't take much in the way of examples to show this. When the Space Shuttle Challenger exploded, NASA quickly figured out the culprit was the O-rings that had already been under suspicion in 25 previous Shuttle missions. If we run with Murphy's law and its implications, those flights should have blown up as well. They didn't, but they also didn't pass on their lessons, as engineers already knew that charring and hot-gas “blow-by” were problematic in these previous missions. That failure is what led to theChallengerexplosion, not Murphy's law.[23]

3. Moreover, the U.S. has learned from the past – we have disposable needles, we have the Food and Drug Administration and the Center for Biologics Evaluation and Research as a monitoring agencies, and we require multiple quality controls and assurances to be certain that vaccines are safe. Past sources of harm are now vanishingly small concerns. These aren't O-rings, they are problems that have been addressed.Con has basically built this entire contention on a very low probability set of outcomes that, I would argue, are negligible in this debate. We could discuss doomsday scenarios all day long (like how every human being these diseases get into is a possible source of mutation into something extremely deadly), but what we're concerned with is likely outcomes. Con needs to show that the risks he's presenting for the MMR vaccines are a reality, not just claim that they're part of some possible dystopian future. He can't just assume that the risk is present solely based on the existence of human fallibility, especially when he cannot present a single instance of botched vaccine production in the U.S., fails to present any examples in the U.S. that support the incidence of unique disease resulting from vaccination or any transmission of separate disease by vaccination here, and claims a false incidence rate of these three diseases resulting from the vaccines.[24]

4. Con discusses the possibility of adverse reactions, actually providing some of my rebuttal for me through the VICP. However, that's not all. According to the Vaccine Adverse Events Reporting System (VAERS), there have been just over 6,000 adverse events associated with MMR between 1990 and 2012.[25] That's with much of the population receiving these vaccines. One might notice that it attaches a death toll onto that as well, which I'm sure Con will attempt to belabor. However, that misses the reality that these deaths have never been linked directly to taking the MMR vaccine, especially given an extensive (1.5 million person, 11-year) post-marketing, controlled surveillance study that showed no deaths or permanent damage.[26] Con will no doubt point back to Madyson Williams, but this will do him no good, as the problem here was that she had taken two live virus vaccines – MMR and varicella zoster – at the same time, something advised against by Merck itself, partially for this reason.[25] Also note that the age of the child was just 1 year, and that the majority of the VAERS-reported issues occur among children of 3 and younger, none of whom are required to take the vaccine at that age. Doctors can and do recommend that this should come later in life.

In any case, Con will have to establish a scientifically sound link between MMR vaccination and a death toll if he wishes to prove this. Merely pointing to past failures of adherence to clear guidelines is insufficient, as is his correlative analysis of the more severe side effects of taking the vaccine. I've shown a causal relationship between getting these viruses and the outcomes I've described, he will have to show that same relationship between the vaccine and its purported outcomes. While vaccines have and will continue to become safer, these diseases will continue to be extremely dangerous to the immunocompromised, as well as the very young and old.

Still, that's 6,000 adverse events over 22 years, and while most of those may not have been caused by the vaccine itself, those events are still worrisome. Let's compare that to the harms I cited for these diseases earlier. With 3-4 million people infected by measles, 48,000 were hospitalized, 1,000 developed chronic disabilities, and 400-500 deaths occurred. That's 1 in 84, 1 in 4000, and 1 in 10,000, respectively. 10% of patients with mumps end up with meningitis, and 1 in 2000-30,000 cases develops hearing loss. Out of 12 million cases of rubella, 20,000 suffered complications. That's 1 in 600. Notice how each of these numbers is far higher than the 1 in 300,000 and 1 in 1,000,000 my opponent provides. Something goes wrong far more often with these diseases than it does with the vaccines.

5. Con points to the possibility of a botched production system, but seems to have little knowledge of how a vaccine is approved and just what procedures a company has to go through to produce, store and deliver a vaccine. They have to be manufactured consistently under current good manufacturing practices (cGMP, which you can find extensive details on here [27]), each product characterized, and lots are tested before release to the public.  

Con backs this claim up with the bold assertion that smallpox vaccines were once contaminated with syphilis. What he fails to realize is that a) this only occurred during the days of arm-to-arm transfer, b) it occurred well before scientists developed the basic molecular detection systems used today to screen vaccines, and c) is only occurred in 750 cases out of 100 million vaccinations, making it incredibly low likelihood.[28]  

Con's second attempt to back this claim is through the example of India in 2011. This is flawed as well. Con will need to show evidence that the MMR vaccine leads patients to shed communicable and virulent virus, something he has so far failed to do. The few sites that I can find arguing that this is the case are all strongly anti-vaccine, and lack any proof to support their assertions. Con is also comparing two very different countries with very different circumstances. India suffers from “poor sanitation, including open sewage in underdeveloped countries, where drinking water is too often also used for bathing and disposal of human waste,” which “can make it easy for vaccine strain polio virus to be transmitted...especially among those, who are immune compromised, malnourished or suffering from serious health problems.”[29] Not only does my model not take place in India and therefore doesn't suffer nearly so greatly from these problems, but it would allow many of those who are most seriously affected outs from getting the vaccine, not to mention ensure that they are less likely to contract these illnesses in general. Even Con admits that there are substantial differences between the two countries in terms of quality control, but he understates those differences markedly.

6. I would argue exactly the opposite – botched batches of vaccines are far less likely in a country where vaccination is required. Many of the groups who are anti-vaccine are likely to launch extensive campaigns to make sure what they are taking is not contaminated, and measures by the FDA are likely to be stepped up to ensure that companies like Merck put out the best quality stuff. A failure on the part of the FDA or any of these companies would be a dramatic harm to either one, and so they would endeavor to prevent such errors to the greatest extent possible.

7. Generally, I disagree with the way my opponent phrases his disagreement with my case here. He says that taking a vaccine is “putting their body on the line and gambling with their health,” but he hasn't proved that MMR creates any substantial threat, focusing instead on other, unrelated diseases and low-risk impacts. The idea that “people are [going to be] force-killed by the government” is simply Con trying to make it sound far more dramatic than it is. He will have to do more than quote Murphy's law to make this stick.

MMR: The Diseases

1. By Con's logic, no one ever died of HIV either. This is just a ridiculous point – most illnesses don't kill people by themselves. Death is the result of multiple illnesses, but the immunosuppressive effects of one are often necessary to allow the others to infect. Since measles can't be cured by medicine, there is a severe problem here that can't always be cured by Gran Turismo. If a person's immune system is not capable of defeating the virus, then it can easily lead to complications. Coca-Cola and “getting comfortable” aren't cures or treatments, just ways to ride out light symptoms.

2. Con has a rather large burden that he's building for himself here by claiming at these diseases are minimally important. I've shown that, yes, even rubella has terrible consequences for pregnant mothers. I don't think that it's reasonable to put any of them at risk of contracting this airborne disease. I showed that mumps causes meningitis, which can read to a number of neurologic symptoms, as well as encephalitis and even hearing loss. Con ignores orchitis as a plausible harm as well, something both of us could easily appreciate. Con similarly ignores every complication beyond death for measles, which results in a tremendous number of hospitalizations and an admittedly smaller number of chronic disabilities, as well as numerous serious complications that I listed.

3. I don't need to present a disease with a high death rate to show that vaccination is worthwhile. I've already explained how damaging each of these diseases is to large populations, and what complications can arise. The fact that they're not significant enough for my opponent to care doesn't make them insignificant. If anything, smallpox showcases just how effective a program like this can be. There may be other diseases that are more deserving of these efforts, but all of them (including tetanus) aren't easily transmissible between patients.  

Nonetheless, Con is entirely right that the most common symptoms of these diseases is akin to the common cold. Unfortunately for him, that's a big problem for Con's case. What this means is that most people will treat them like a cold – some may stay home, but many will go out and fight through their illness, treating it like a minor impediment to their day. This is why diseases like Ebola are insidious – most of the symptoms one experiences early on don't look like anything special: basic headache, fever, and muscle pain, which one might attribute to having a bad day and perhaps an early flu. It's during these early symptoms, and not the excessive bleeding stages, that one is most likely to spread the illness. At this stage, they're contagious, and it's not obvious what they have. People experiencing these symptoms would be tempted to just walk it off, and would thus continue their usual interactions. This is all the worse for MMR, where most people never experience the more damaging and obvious complications, and therefore may continue to spread the disease over the entire time they're infected.  

Maybe Con would stay home if he's infected, but many would just try to move on with their day. Unlike Ebola, these diseases have less common complications. However, also unlike Ebola, they're highly contagious to everyone sharing the same space, especially if it's enclosed like a subway train or crowded office. Avoiding direct contact isn't enough, as these diseases are airborne. The chances of them spreading broadly are far higher, putting more people at risk of developing these complications.


In America!  

1. The fact that Con can present problems with our health care system is non-unique – every system has problems (and incompetent doctors, for that matter), and he hasn't shown these to be excessive or pervasive, only providing evidence of an audit that found unspecified “inconsistencies” in the system, and those only appear to be in regards to information submitted online. He doesn't show any actual problems with Obamacare as a system, just claiming that the failures of data submission reflect huge problems with the system as a whole.

2. I don't understand the choice to lampoon Obamacare, as it has nothing to do with my policy. Implementation is done by the health care professionals doing it, not how insurance is provided.

3. Con never actually shows where the problems are that would affect implementation. He says “there's probably something wrong somewhere,” but that doesn't suffice as proof that my system will fail, in part or in totality. He points to 4 doctors who are not currently practicing in public health nor at all likely to participate in the distribution of vaccines, and then claims that they're representative of how terrible our public health care system is. If, as he claims, “they won't be able to pull this off perfectly,” then Con has to state specifically where the deficiencies are, how they are likely to affect the system, and how that will lead to failures. He can't just generalize this and say that he doesn't know where, he doesn't know when, he doesn't know how, but something bad is going to happen.  

4. Failures of public health occur now with regards to controlling outbreaks like those resulting from these viruses. There have been multiple outbreaks involving hundreds of people over the last several years. Those failures far outdistance any of the probable failures with regards to vaccination.

5. Con never warrants his predictions, particularly on the cost issue. Either a lot of people will pay fines, a lot of people will be vaccinated, in which case health costs (for diagnosis, treatment, quarantines, epidemiological tracking, etc.) will decrease, or it will be some permutation of the two. In any case, these ameliorate if not eliminate cost burdens.


Brief Rebuttals 1: Herd Immunity

1. I didn't realize I needed to link the numbers to the suffering experienced by those numbers, but I'll do the basics. The human body normally exists in a homeostatic state, meaning that the system is regulated to a stable point. Viruses like these chuck that state into uncertainty by causing disease, and cause people harm. Whether that harm is through the basic fever, chills, stuffy nose, cough, etc., or if it's through more dramatic complications like encephalitis, there's an objective harm to experiencing them, though how bad the experience is is subjective. Nonetheless, we can make rational assumptions about what is a worse experience for victims of a given disease and make conclusions as to how strongly those experiences affect them. This is a utilitarian argument – health and wellness are better for society than disease.

I'd say that this suffices as a strong link between the science and the morality – individuals may be able to select for themselves which experiences they will willingly engage in, but they should not be able to make those decisions for others, let alone strangers. When disease spread can be reduced or eliminated, utility says that that public health outcome should be preferred.  

2. I'm glad my opponent and I agree that the link between MMR and autism has not been established, and that it is therefore unimportant to this debate.

3. Part of the problem here is that Con's making assumptions based on what I've said. The reason why I don't believe herd immunity is possible is because I think it's likely a substantial portion of the remaining population will choose to pay the fine or manage to avoid the law. However, going off Con's own claim that 94.5% of the population is vaccinated (as he hinted in cross-x), then this makes it very much a possibility. Con's link shows that 95% of vaccines are effective against measles, 96% are effective against mumps, and 99% are effective against rubella, and that's just the first dose.[26] Taken together, that might lead to the figures Con claimed, but then, this ignores the second dose, which induces an immune response in 99% of recipients.[27] If the numbers are as close to 95% as Con seems to believe, then my case could certainly achieve herd immunity with those numbers.

4. Con assumes that outbreaks will never become more substantial than they have been over the last few years. The data bears out a very different trend.

Note that, in years with substantial epidemics in other countries that lead to large amounts of imported cases. The larger the amount of imported cases, the larger the outbreaks in the U.S. The size of the outbreaks in the U.S. have increased substantially as well by comparison in recent years, revealing a widening disease spread.  

In case that's not enough proof, we can see the trend playing out this year as a result of a large outbreak in the Philippines.[30] The point being that any epidemic abroad threatens to do tremendous harm in this country, and those epidemics aren't going away anytime soon. Since the level of protection in the U.S. appears to be going down, which I would argue is the result of reduced vaccination levels. While the country as a whole appears to have a vaccination rate among kindergarteners of 94.5%,[31] the vaccination rates in many states are well below that number, with 5 states (Colorado, Arkansas, Pennsylvania, Idaho, and North Dakota) below 90%.[32] In case that's not enough proof that the trend is downward, here's a CDC report to that effect, as well as a study showing that vaccination rates are down in Texas.[33, 34]

5. Con makes the argument that cost of allowing these diseases to run rampant is lower than the cost and impact of preventing it. Con's own link, however, doesn't bear this out. The link points to the Haemophilus influenzae and Pneumococcal vaccines barely reduce the incidence of these bacterial diseases, are expensive, and put those who take them at substantial risk. I agree on both fronts, but these do not apply to the MMR vaccine. The article itself only mentions measles once, and does so in the context of “the 6 basic vaccines” that they deem at least as beneficial. 

6. If Con had wanted to present a counterplan regarding feeding starving children, he could have. All he's done here is present it as a nebulous alternative to the putative costs he sees as coming from my case. The reason he didn't is probably because it's not mutually exclusive to my case. We can both mandate immunization and improve governmental programs aimed at feeding starving children. He provides no reasoning for why U.S. resources are so scarce that we can't do both, especially when he hasn't proven that there's any deficit of funds resulting from my policy.

7. Note that Con's chart solely addresses the mortality of measles in England and Wales, not its incidence. I agree that mortality has reduced due to a variety of factors that have changed since the early 1900's. There has probably been a reduction in measles outbreaks as well resulting from those factors. But I would argue that this can only take us so far, and that we're basically at that point already, yet we're still experiencing major outbreaks that correlate strongly with reduced immunization and outbreaks from other countries.

8. Con argues that non-immunized children have mild infections. His data comes from India, so it seems difficult to apply to the U.S., but if we did, this would be really problematic for his case. It shows that there are likely many sub-clinical infections in the U.S., which could easily be prevented from spreading by the vaccine. Con might see this as a sign that measles is effectively harmless in the majority of those infected, but this only lasts so long as they have sufficient immunity to ensure that the virus doesn't transition from a latent stage (where cells are persistently infected, but lie dormant) to a lytic stage (where there is active virus replication an d spread, resulting in cell death). If the immune system is sufficiently challenged by practically any other infection or sufficient injury – hell, even depressed by a strong bout of anxiety [35] – these patients can experience full-blown, infectious measles as a result. All Con has managed to prove here is that the generated resistance that results from getting the infection is often insufficient, leaving open the possibility for viral reactivation. Preventing the infection from becoming latent in the first place only becomes a near certainty with the vaccine. Note that the link also showcases only a 2% measles contraction rate following vaccination, which shows that the vaccine is 98% effective at preventing the infection.

9. Con's point that it may not last a lifetime, is really just mitigation. We're still talking highly likely, long-term resistance to infection.


Brief Rebuttals 2: The Impact

1. Con just seems to use much of his rebuttals here to distract from the issues at hand, and he starts it off with several fallacies. First, there's an appeal to the emotions of the voters, even going so far as to say that his points here should breed anger. Of course, he never gets around to discussing the impacts of any of these bans, assuming that they're harmful solely because they make us angry. Then, he engages in a slippery slope fallacy, emphasizing how the idea of protecting everyone from everything is problematic, and failing to provide any analysis of how my case leads to this extreme and peculiar outcome. I've made it quite clear what makes MMR dangerous, and why it is an important concern. My case doesn't include any of these bans, nor would they be organic offshoots of my case.

Finally, Con engages in an appeal to ridicule, essentially stating that I'm “scaremonger[ing]” and that my argument is an attempt to paint vaccines as supernatural. Maybe he's just talking about others who hold similar views to mine, but this is still meant to paint my argument in an absurd light with no reasoning. Presenting the data as I have isn't scaremongering. I'm making basic conclusions from the data I've presented and provided both the data and conclusions for my opponent and the voters to peruse. I'm not treating vaccination as “a magic cure-all,” and I don't appreciate that kind of embellishment of my case for Con's benefit. I'm not making claims I can't support about what the vaccine does. What these “vaccine lobbyists” Con discusses have done has no bearing on my argument. Con seems to simply be attempting to malign my case by making it sound like I'm peddling snake oil, despite recognizing that it's not earlier in his post. There's no magic here and no attempts to scare people into submission (an interesting take from someone who used several appeals to emotion).

2. Con points to a number of possible medical concerns that could come from everything from the common cold to smoking to eating cake. It is not my burden in this debate to show that these things are insufficient concerns to warrant further action. I will, however, address Salmonella, as he spent a good deal of time there.

He starts by talking about an imaginary vaccine that specifically addresses toxins made by Salmonella, assuming all the responses that would come from it.

First off, just the absence of Salmonella toxins wouldn't mean the absence of disease.Salmonella could still infect you, still alter your gut microbiota to the point that you suffer ill effects, still deprive you of many beneficial nutrients, and, without the toxin, would take longer to clear from your system (the toxin is there to ensure that it gets excreted). 

Second, there are multiple toxins coming from two different species, “six subspecies and innumerable serovars.”[36] Any vaccine would only address a subset of these.  

Third, there are a large number of diseases that can also come from uncooked chicken that wouldn't be addressed by this vaccine. These include, but not limited to, Campylobacter, various Clostridia, and Staphylococcus.[37] So even ifSalmonella was completely addressed, eating uncooked chicken would be dangerous. 

Fourth, there already exist best practices for reducing the incidence of these infections since they are solely ingested and can be killed by cooking. This isn't spread simply by contact between individuals who are infected and those who are uninfected.  

Fifth, it's not my burden to defend every single instance of vaccination. I'm defending a single one, and I'm limiting its applicability mainly on the basis of how it is transmitted, not how potent its symptoms are. That's because one person presents a risk to another, rather than a piece of chicken. Distinguishing the two is important, as your ability to choose what happens to you medically is different from your ability to make a medical choice that can directly affect others.  

Sixth, Con never actually presents a harm to doing this, so even if it is somehow a consequence of my policy, he never points to any specific moral concerns that arise as a result. Why would mandating this specific vaccine be problematic? He might say “loss of freedom bad,” but that's not enough of an answer. Freedom in this case is, at best, a nebulous benefit and cannot compare to the benefits of protection against a potentially deadly disease. 

3. I take strong issue with the following statement made by Con (and no, saying it in all caps doesn't make the point better):

“MMR vaccines may have reduced the incidence rate, but they have not reduced the harm. THE HARM HAS BEEN REDUCED INDEPENDENTLY.”

The only harm Con has proven has been reduced independently is death tolls. Yes, that harm has been reduced, just as the harm for any illness or disease state has been reduced by the advent of indoor plumbing, better nutrition, less poverty, and dramatically improved medical care. But the problem here is that Con can't just assume that these independent factors are sufficient for erasing the problem, as he has argued in the previous round and repeatedly in cross-x. The complications still happen in countries with the best possible circumstances, and the basic disease states are still the same. Cross-apply this to all the times Con mentions nutrition.


Points stemming from Cross-X

1. Con often argues that there are other effective preventative measures, but each of these is just a mitigating factor. The best he's managed to prove here is that these diseases have vastly reduced effects in the U.S. as compared with the third world. He's right, but my case has shown quite clearly that the effect is still substantial enough to matter. Con would have to show that these diseases are effectively of null importance in order for this point to win him the debate.

2. Con never really explains his view that increasing levels of vaccination are essentially worthless without actually reaching herd immunity, though from cross-x, that seems to be his contention. I don't know how he could defend this. He says that herd immunity is potentially beneficial because of a reduced spread of disease (the likelihood of spreading it to less than 1 person). He doesn't say why it's beneficial or negligible that that number increase above 1 to a significant degree, as is the case in the states I listed. It seems obvious to me that reduced spread of disease is generally beneficial because less disease/complications is beneficial – Con hasn't argued that it isn't. It seems obvious to me that the more people who are vulnerable to a given disease, the more likely they are to get it and come into contact with a person who is immunocompromised and therefore far more likely to suffer complications – Con hasn't argued that that isn't the case. He'll need to explain and warrant this view if he plans to win it.  

3. Con can't reasonably claim that everyone should adhere to his views of what is and is not damaging to their rights structures. Just because he thinks that one can only lose their rights in the instance where those rights are taken and abused by another person or group of people doesn't mean rights can't be lost in any other instance. I would argue that governments have a duty to ensure that their people don't suffer, and that the reason that duty exists isn't just utility. A person can take your rights by coughing on you and transmitting his/her disease, even if they garner nothing from it. A virus can take your freedoms from you by forcing you to stay home for several days or putting you in the hospital. Con's argument that there's essentially no rights lost in these instances seems strange when someone's freedom of action is very much threatened by both the person and the virus involved. Con's entire argument for why mandatory vaccination is harmful to our rights is based entirely off of a similar loss of freedom.

When Con said in cross-x that side effects from vaccination are “part of the same abrogation” of rights caused by requiring those vaccinations, he's essentially admitting to this. He says that they are “not further abrogations of rights, but part of the same abrogation.” I'm still not quite certain what he's trying to do with this, but I can only interpret this one way. He's saying that the abrogation doesn't increase as a result of the side effects, in which case he's simply erasing any rights loss disadvantage that he might have garnered here because it's a part of the same rights abrogation caused by mandatory vaccination. In the process, he's still saying that this is a part of a rights abrogation, which it cannot be without being a rights abrogation itself. He's therefore admitting that the harms of disease do contribute to rights losses, thereby admitting that there's a rights loss that results, while just trying to wave it away as unimportant by comparison. Maybe that's not his goal, but that's certainly how it appears. If he attempts to gain any sort of rights loss from side effects, though, he's effectively admitting that a similar rights loss occurs as a result of illness of any sort.

However, even if you agree with Con that there's no rights loss here, there is most certainly a loss of bodily autonomy, which is the whole basis for Con's contention regarding the rights losses from mandatory vaccination. If loss of bodily autonomy is a harm in and of itself, as Con insinuates, then a disease is the more insidious harm, lacking any alternatives and requiring a substantial and physically demanding sacrifice.

4. While we can establish the physical impact of a disease, we cannot establish that, for all people, each physical impact is just as harmful. Con often tries to brush off a day or two in bed, a fever and a cough, yet each of these requires that the person be out of work for a certain period of time, that they not interact with family members or friends, or that they miss important social events. The impact of even the lowest levels of disease is something that Con cannot assume is so small as to be insignificant.

In fact, Con seemed to spend a lot of time in cross-x trying to show that these diseases have low death rates in the U.S. The truth of the matter is that they do have low death rates, though Con makes no efforts whatsoever to show that complication rates have substantially reduced with time. The complications I presented in R1 are still very problematic, with ear infections in 1 out of 10 and pneumonia in 1 out of 20 children.[38]

If Con's concern is that these complications aren't common today, I showed evidence in cross-x that shows that any change in their incidence has been minimal. And that's not just for pneumonia – hepatitis and blood disorders like pancytopenia and thrombocytopenia are also appearing, even in the relatively small populations being infected.[39]

This isn't a small issue, though I'm sure Con will attempt to characterize these diseases as unimportant as well. Pneumonia is anything but, resulting from a wide variety of possible causes ranging from bacteria to viruses to fungi. This means that they have to be specifically diagnosed before they can be treated effectively. It is still the leading cause of death among children, the vaccine is minimally effective, and, like all bacterial diseases, the bacterial pneumonia is causing tremendous concern as a result of the antibiotic resistance it's generating (most notably with regards to Streptococcus, Mycoplasma, and Klebsiella-caused cases), making other forms of treatment far less certain.[40] In case that's not enough, the spread of bacterial pneumonia is also associated with more severe symptoms in adults as well (often with Klebsiella), meaning that each infection enhances the other.[41] These bacterial diseases play at least as large of a role in the deaths of those who are infected with measles as nutrition (along with many of the basic symptoms of immunodeficiency caused by measles, like peripheral lymphopenia and T-cell depletion).[42]

5. Con is wrong on the immunosuppressive effects of measles.

“[Measles virus] infection produces an immune system paradox. MV infection, while inducing lifelong immunity, also suppresses the immune system leading to an increase in susceptibility to other, secondary infections.” This article actually includes quite a bit of the data that supports this, as it's essentially a review of numerous primary research papers that established this immunosuppressive aspect and several models for immunosuppression that I won't describe here. Just to give a basic idea, though, of what infections can and do occur:

“Secondary bacterial, protozoal, or viral infections occur because of immunosuppression by MV infection. These infections can result in pneumonia, chronic pulmonary disease, otitis media, laryngotracheobronchitis, adult respiratory distress syndrome, hepatitis and diarrhea.”

These are admittedly more common in underdeveloped countries, but less common doesn't mean non-existent in the U.S. This data are still pertinent here.[43]

I mentioned influenza in cross-x. The reason I did that is because much the same concerns exist with regards to this disease, which has caused one of the most, if not the most, severe pneumonia pandemic in world history. Con may want to write that off as unique to influenza, but this is the kind of immunosuppressive effect measles has as well.[44]

Con is similarly wrong regarding the effects of measles on immunosuppressed individuals. He says that it's a minor enhancement. That isn't held up in the literature, where these individuals are far more likely to suffer terrible complications.[45] I can't find a free copy of this study, but it's outlined pretty clearly in the abstract. There are numerous other studies that support it as well, making it clear that complications, including death, are far more common among these individuals.[46]

If you need a list of the types of people put in danger, here's a list: those undergoing chemotherapy and/or radiotherapy, those with organ or bone marrow transplants, those with high dose steroids, those with HIV, and those with severe combined immunodeficiency.[47] All of these people present with substantial concerns, and they can't just “avoid people” with the illness, especially when Con himself presents data that a large proportion of the population infected with the virus carries it at sub-clinical levels, but may still be shedding the virus. Hell, considering how many times I'm using Con's source, I think I should really include it in my citations.[48]

5. Con is just blatantly wrong regarding his view that scant few of those who become infected with measles will experience complications, and he proves this in the last section. He shows that a great deal of measles infections are never cleared from the body.[48] That means that some 30% of patients are infected for life, and in the process, they're put at great risk every time their immune system is depressed. This is a huge problem, since this means that for this subset of the population, they're especially likely to experience the complications of the disease at some point over their lives any time they're immunosuppressed.

6. Con makes the claim that mandatory vaccination was not necessary in order to eradicate smallpox, a disease that he admits in his previous round was one of the biggest scourges of human society. This is a completely unwarranted and entirely false statement, providing no evidence for other methods by which smallpox is consistently prevented from infecting others. The symptoms of smallpox may have improved and its spread may have reduced, but we're talking about elimination here, and of a very deadly disease that spread very rapidly. And this is a disease that was primarily spread in a similar manner to MMR, through airborne transmission. It is factual that mandates occurred in many nations, including a number of African nations, and were instrumental in the elimination of the disease. Use of vaccines would have been far too minimal in many African nations to accomplish such a goal. Much as I disagree with the methods used to enforce this particular mandate, and I'm not arguing for international enforcement, the effects speak for themselves.

The eradication of a disease is of no small importance, and in this case, I'm addressing 3. Con is entirely right that “every infected person infects about one other person on average.” Even if the U.S. doesn't manage to get below 1, getting as close to it is a start to a trend of elimination worldwide, and if the effect does occur, even just in the U.S., the benefits there are stark. Disease eradication means minimal disease resulting from these viruses and little to no need to dedicate resources from control programs like the CDC or NIH (and therefore to put those resources towards other issues). This article even shows that we could save as much as $4.5 billion as a country if vaccination were able to be discontinued in the U.S. as a result of the eradication of measles alone, and other industrialized nations could save hundreds of millions “if measles were eradicated, even assuming that measles vaccination would continue.”[49]


Voting issues:

I know it's been a long round, so I'll post those questions I started out with again to ground it.

1) Do the MMR viruses present a substantial risk to the public health of the United States?

I've shown that these 3 viruses represent a systematic threat to our utility through our public health, that that threat is growing and very likely to continue doing so, and that it persists most strongly in a society that is further away from herd immunity. Whether it's the viruses themselves that cause the harms or the complicating and difficult to treat infections that commonly accompany them, these are diseases that present with exponentially higher dangers as the number and size of their epidemics continue to grow.

2) Can that risk be ameliorated to a significant degree by mandating vaccination?

I've shown that vaccination is the most broadly effective means of lowering the risk of infection and, therefore, both the short- and long-term harms of that infection. Any other means merely delays complications and places many others in danger of more severe outcomes.

3) Does that risk reduction outweigh the potential harms that accompany it?

I've shown that there are rights issues on both sides of the house in this debate, and that the rights arguments presented by Con fail to present any meaningful impacts that can be weighed against those I have provided. I've shown that vaccination presents a minimal and comparatively negligible risk to those who receive it under the stated guidelines, and that any outcomes for societal perception of health are likelier to be beneficial than harmful.

Based on these three questions and their answers, I've shown why you should vote Pro. I now yield the floor to Con to finish out the debate.


15. http://en.wikipedia.org/wiki/Eugenics

16. http://www.cdc.gov/vaccines/imz-managers/laws/state-reqs.html

17. http://www.immunizationinfo.org/vaccines/smallpox

18. http://en.wikipedia.org/wiki/Jacobson_v._Massachusetts

19. http://en.wikipedia.org/wiki/Smallpox

20. http://www.nytimes.com/2010/11/26/world/26fenner.html?_r=0

21. http://www.who.int/ith/vaccines/en/

22. http://www.drugs.com/

23. http://ieeexplore.ieee.org/xpls/abs_all.jsp?arnumber=993764&tag=1

24. http://www.kidshealth.org.nz/measles-immunisation

25. http://www.nvic.org/vaccines-and-diseases/Measles.aspx#Injuryv

26. http://www.merck.com/product/usa/pi_circulars/m/mmr_ii_pi.pdf

27. http://www.fda.gov/Drugs/DevelopmentApprovalProcess/Manufacturing/ucm169105.htm

28. http://en.wikipedia.org/wiki/Smallpox_vaccine

29. http://articles.mercola.com/sites/articles/archive/2012/08/28/polio-eradication-campaign.aspx

30. http://www.ibtimes.com/measles-outbreak-2014-592-cases-reported-us-after-disease-eliminated-2000-1681352

31. http://www.cdc.gov/nchs/fastats/immunize.htm

32. http://www.advisory.com/Daily-Briefing/2013/08/08/The-states-with-the-best-and-worst-vaccine-coverage

33. http://www.deadstate.org/new-cdc-report-thanks-to-anti-vaccine-hysteria-u-s-measles-cases-have-tripled-in-2013/

34. http://healthblog.dallasnews.com/2014/08/vaccination-rates-for-kids-are-down-rates-of-infectious-diseases-are-up.html/

35. www.publichealthreviews.eu/show/p/92

36. http://en.wikipedia.org/wiki/Salmonella

37. http://healthyeating.sfgate.com/risks-undercooked-chicken-2327.html

38. http://www.cdc.gov/measles/about/complications.html

39. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm

40. http://www.cdc.gov/pneumococcal/drug-resistance.html

41. http://www.ncbi.nlm.nih.gov/pubmed/10065681

42. http://www.academia.edu/1462060/Factors_associated_with_fatal_cases_of_measles

43. http://www.ncbi.nlm.nih.gov/books/NBK2487/

44. http://www.nih.gov/news/health/aug2008/niaid-19.htm

45. http://www.ncbi.nlm.nih.gov/pubmed/1538561

46. http://cvi.asm.org/content/13/4/437

47. http://www.adhb.govt.nz/starshipclinicalguidelines/Measles%20Infection%20Control%20and%20Guideline.htm#Appendix_3

48. medind.nic.in/ibl/t03/i1/iblt03i1p8o.pdf

49. www.cgdev.org/doc/millions/MS_case_1.pdf


Return To Top | Posted:
2014-10-25 00:44:19
| Speak Round
adminadmin (CON)
I'd like to thank my opponent for what's been a fun debate. Sorry if my typing is poor - my keyboard decided to die.

When I was a kid, nobody stressed about the MMR vaccine. It was the most optional of all of the regular set of vaccines young people receive. And there was a good reason. People of my parent's generation grew up at a time when measles, mumps and rubella were not endemic, but they were epidemic. Still they knew that these were not dangerous diseases. Instead, when I was a baby, the vaccine lobby were calling for mandatory hepatitis B vaccinations because the number of cases in my birth year was slightly above the norm (worth noting that probably due to less small exposure to hepatitis B following the vaccination drive, there was a subsequent serious outbreak of hepatitis A). The test that my mother used in deciding what vaccinations to get me was this - is this just an alarmist response to something that is highly unlikely to be a serious problem, or is this actually a significant public health harm. I think that's justified, and I see nothing in my opponent's analysis that negates that.

A few years ago there was a huge meningococcal vaccine drive. Today people are harping on about the new MMRV with chickenpox protection. Soon it will be ebola and salmonella. The reason why I keep bringing this up is not to downplay the genuine scientific harms that these illnesses can have, but to point out that there's an exploitative industry out there playing on people's fear. Like many industries they push out a new vaccine every couple of years and then play that illness up as if it's the one thing the world really needs right now. While my opponent, to his credit, has not quite gone that far, he has bought into this narrative that basically any disease that has a vaccine is inherently significantly harmful, and that vaccines are pretty much always great outside of a few narrowly-defined exceptions. Throughout his entire case he never acknowledges the possibility that it may not be a bad idea to refuse a vaccine. The fact is, I refused a vaccine and I hurt nobody else. I've had measles so it's scientifically implausible that I'll cause any serious health harms to anyone else at this point in my life, and my refusal has never hurt anyone in the past. His idea that the government should just assume little baby me is going to harm somebody in future and issue me a fine for that is as crazy as my jaywalking example.

But I'll get to that later. I'll begin by extending my case on the basis of points I put to my opponent during CX. Then I'll finish by a few more rebuttals and a conclusion.

Measles danger: a case study
My claim has always been that measles is a more significant problem in places that have a poorer environment. My opponent's claim has been that the vaccination has been the key driver in changing the outcomes of measles in different places. So let's examine the two theories with some quick science. I made a quick graph based on data from the WHO and the US CDC. It shows measles vaccination coverage as a percentage, year by year over the last few years, for children starting school (the WHO normalizes this data from different countries' reporting systems). Countries my opponent considered to have a good environment are marked green, while countries with a poor environment are marked red:


The notable outlier is Haiti, and there's a good reason for that. See, they kind of suffered this great big earthquake thing around where this graph starts somewhere. As such, resources were diverted away from vaccination and towards things that were more important at the time. This isn't a problem at all though, because Haiti is the only country in the sample to be declared free of measles. There hasn't been a measles case there in decades and there are expected to be no measles cases ever again. Also worth noting that the CDC disputes the WHO figures from Haiti because it funded a vaccination program and thinks it got more people than were registered by the WHO, I've just decided to take the most conservative figure to be safe. Worth noting that in studies conducted after Haiti's main immunization drive, socioeconomic status had a much greater effect on public health outcomes than the vaccine, but hey, that was 20 years ago.

Excluding Haiti, it would be fair to say the rates for all countries are pretty much the same. The poor countries have been a little more variable - both higher and lower - than the wealthier countries. But it isn't like vaccination coverage rates are significantly different between countries with a poor environment and a rich environment. It follows, then, that differences in number of measles cases etc are due to other factors than the vaccine alone. These are what I call, the environmental factors. So let's see how great the difference is between the rich and poor environments in terms of measles impact.

You can read more about my primary dataset for this brief little study here, and the CDC data (used for the US) is here. Fun fact: the Philippines is acknowledged by my opponent to be the source of the recent measles outbreaks in the USA, yet they have a 90% measles-vaccination rate. The key thing that makes them different is that they're poorer. Hence why the epidemic was so much worse there and why it went away so fast in the USA with no significant problems. But anyway, just bear that in the back of your mind for now.

During the same period of the graph above, France has had 8 measles deaths. The USA had zero, as did the UK. France has an unusually high number of measles cases largely because they get a lot of immigrants, many illegal, from Africa. Often these have developed the disease in poorer conditions and not been able to treat it in France without giving away their illegal status, so that poses a very unique challenge for that country. In total, that makes for 8 deaths in highly developed environments. Now let's contrast that with Sierra Leone and Zimbabwe. The graph below shows what proportion of all the deaths of infants (did I mention that a very high proportion of measles fatalities in the world today are too young to get the vaccine anyway?) are caused by measles in those countries:

There aren't any amazingly recent figures available but this should give an idea:


This comes from a 2012 GHO study (see here). Green is Sierra Leone, red is Zimbabwe.

Sierra Leone, as you can see, has had NO problems at all since roughly 2004, but had huge problems before that. Why? The major cause was identified in many studies, time and time again, as the ongoing famine, not a lack of vaccination (here's one such study). Vaccination has long been as high as in the first world, but nutrition has been poor. So what changed in 2003-04? Basically - the civil war ended. Sierra Leone was in this huge civil war (appropriately enough called the Sierra Leone Civil War) that was really terrible. You can look it up anywhere; it's well-documented. What few doctors had not fled or been killed since fighting began way back in 1991 were more concerned with tending to the many dead and wounded. Food was definitely hard to come by, and wholesome food more so. NOTHING changed about vaccination.

Zimbabwe, as you can see, is more problematic. The percentage may look low, but it's a real harm, with hundreds of deaths in some years (measles is typically cyclic - hey, here's a conspiracy for you - notice how the spikes roughly correlate to Mugabe's elections lol?). This indicates that whatever it is cannot be changing - much like the fortunes of Zimbabwe's healthcare system are not changing, which is due to a lack of food, which is due to a poor economy. They are consistently bad. Since the 80s and 90s, studies (such as this one) have shown that vaccination is very high, but measles remains endemic due to poor nutrition. Worth noting also: Zimbabwe stopped nationwide measles immunization back in 2010 and so far as I can tell the death rate has not changed significantly at all.

You will recall that in the last round, as well as the CX, I provided substantial evidence that there is no correlation between measles fatalities and measles  vaccination. What I prove here is that there is often a strong correlation between poverty and measles fatalities.  The same holds true, if you read the studies, for hospital admissions generally that are connected to measles.  And the science actually supports this - it's not just a theory that I hold. Roughly 55% of all deaths that are attributed  to measles are actually caused by malnutrition (study). In the remainder it's easy to point to poor care, poor sanitation, pre-existing conditions etc. Since my opponent likes to hark back to the old days of prior to widespread measles vaccination, the same conclusion has been reached by EVERY SINGLE study going back decades - the reason why measles deaths occur only in the developing world is  because of the environment those nations are in.

This also destroys my opponent's claim that the world pre-vaccination is predictive of how things would be, in the US or anywhere else, if the vaccination were to stop. It all depends on the environment.

I focus on measles because there are no health harms of mumps and rubella that have been measurable in any of these countries in the past decade. Often in debates I will devil's advocate, meaning I'll sometimes blatantly make up or misrepresent "facts" to support an ideology that I'd usually consider untenable. Not in this debate. I've made a conscious, strategic decision to only use scientific practical claims, not conjecture and conspiracy. And so I want to emphasize once again - the decision not to vaccinate is not at odds with science.

Final thing I'm going to say about this. You might be wondering why Haiti has eliminated measles despite poor conditions (big earthquake) and low vaccination. Haiti is literally the worst country in the world for healthcare according to the World Bank. And yet the last case of measles in that country was literally caused by the vaccine itself. How? Because Haiti has a smart way of dealing with it: keeping away people with measles. Staying away from people with measles is validated time and time again as  the best way to avoid catching it, and it's the main thing Haiti does. They've had some close calls over the years  but each time their policy of not letting people with red spots run rampant all over the country is the best defense.

Vaccine industry
I write this bit with apologies to all those who I've already bored with all those numbers and graphs.

In CX I talked about Merck a little bit, and I pointed out that they're a monopoly supplier to the US. Pro quite rightly pointed out that another company, GSK, has another vaccine. Actually, both vaccines are pretty much the same. Every MMR vaccine is basically some measles viruses put through animal cells, so the measles virus is "weakened"  by becoming better at multiplying across animal cells, and (hopefully) less good at multiplying through human cells as a  trade-off. This process is used throughout all vaccine manufacture - only the specific strain  and animal cell used varies slightly and will be protected by patent. This is then put into various preservatives and injected into your body.

The principle comes from the ancient ritual of innoculation - you give people a little bit of a disease and they can fight it off better when it next comes. You still really do get infected with measles when you get the MMR vaccine, and you do shed the virus, meaning recently vaccinated individuals need to stay away from, say, immunocompromised people too (but they show fewer symptoms, making this a much greater danger). This is how measles can arise "spontaneously"  in vaccinated populations. The  key difference is that it's probably a weaker strain, although of course you can't easily prove that for each batch of the vaccine.

All this is no secret. As  such, you might imagine that vaccines are not actually that hard to make - and you'd be right. It's effectively a more clinical alternative to infecting a cat with measles and living with it for a few days while the cat recovers, while offering roughly the same protective benefit. Which begs the question - where does the high, and increasing, price come from for the MMR vaccine?

This is a company that makes roughly $50 billion in sales revenue per year. Their cost of goods sold (taking out depreciation and amortization) is only roughly $9 billion. Therefore, a little over 80% of their goods, including vaccines, are now profit for the fat cat investors who own the company. They declare all this on their annual financial statements. It's a company roughly comparable to  Microsoft, who have roughly $70 billion a year in sales, but only have a 60% mark-up for profit. It's still a lot, but nowhere near the level of Merck. It's no speculation like my opponent claimed it was. The reason for the price increase is simply that Merck made more profit. In 2001 their profit was 19.87 billion.

In part, that profit has gone to developing new vaccines that nobody needs, to sustain Merck's business model (after all, if the MMR vaccine cures everybody in the world of MMR, Merck loses an important income stream). But a huge chunk has gone away as dividends:



As you can see, Merck has almost never dropped their dividend payout rate. The orange line is more variable due to the share price being variable. For example, you can see them slumping during the '08 recession in between those two big spikes there. But the point is that it's outrageously high. In fact the company's own records show that the only time they've decreased their rate per share has been when they've split their stock, which isn't really a decrease at all. Over the past 20 years Merck has given shareholders a 100% higher total return than the Dow Jones Industrial index (source).

If there was a real genuine health necessity here, surely the most important thing would be to force these companies to produce their vaccines as cheaply and efficiently as possible, to enable them to be sold as broadly as possible. I think whether a company seeks to make more and more profit out of a vaccine every year ought to be the litmus test for assessing a vaccine's credibility as a pharmaceutical marketing gimmick or a genuine desire to make the world a healthier place. As I mentioned in cross-examination, alternatives do exist. Hence why the polio vaccine is effectively the medical equivalent of open-source.

But many of you may be scratching your heads at this. If GSK has their own vaccine and Merck is making supernormal profits, then why isn't GSK flooding the market with their vaccine and stealing market share? From a business perspective that would be an incredibly smart business strategy, and a very obvious one too. Plus, there are other suppliers of MMR vaccine too around the world. The answer may surprise you - they are suppliers of the vaccine created by Merck! Merck really makes the vaccine, then sells it on to GSK, Aventis Pasteur MSD etc, and then basically every pharma company gets a cut of the profits (for more details on how this works, see the Daily Mail article cited below). This anti-competitive and collusive system's development, coupled with the need to raise dividends constantly to maintain shareholder confidence, has basically seen the profits of big pharma from vaccines double in the past decade.

So why doesn't the government do something about that? Well, technically they should. Big pharma breaks anti-trust laws all the time. The reason they don't is that the regulatory agencies use big pharma almost exclusively as their "experts" (source) who form the basis of their decisions. This is also the case for other big pharma in other developed nations, such as the UK where a recent investigation basically linked almost everybody in their government pharmaceutical regulatory services to one vaccine company or another. In turn, Merck gives members of the CDC jobs making vaccines (here's a great example). Lawmakers once tried to change this with a balanced proposal that would also see more funding for vaccine research, but the vaccine lobby opposed it. Numerous scientific investigations have revealed that vaccine research is particularly affected by these conflicts of interest. Indeed corruption in the CDC was the main reason autism even became an issue with the MMR vaccine, because nobody could objectively trust their counter-narrative (source).

In fairness, GSK and others have been occasionally fined over this and related crimes - including bribery of CDC officials - in the past, but the fines have been minor compared to the damage and there have been no prosecutions (source). Merck has been sued over the MMR vaccine's efficiency specifically but the US government, advised by the aforementioned experts, chose not to pursue it.

So what's the impact of this on the debate? First, if the health benefit of the MMR vaccine is minor, then that needs to be weighed against the harms of legally entrenching a broken system that will see costs rise forever until the greedy fat cats who run the show check their money and run. If, on the other hand, this is a major benefit that will somehow save hundreds of lives, then there are more important things that the US government could be doing that would arguably be much more effective, including: breaking apart the monopoly of convenience, using the lawsuit money to subsidize vaccines to maximize coverage, using only fair and balanced advisers etc. Because frankly, I and hundreds of others have never, ever been convinced of the benefits of immunizing against something like MMR.

Allow me therefore to move on to some brief defenses of my case. I'll try to keep them short because my opponent won't have an opportunity to respond.

Mass medication
You will recall that I did explain why eugenics is wrong - people don't want it. The future that entails disturbs us. It's a moral issue that the science won't prove either way - it's not a scientific question. The same is true of me showing that people don't want the government mandating the vast majority of their lives, but to protect free choice in most instances. The harm of mass medication is that in principle it is indefensible - nobody wants some random government bureaucrat who doesn't know them mandating what they do and even what they consume, forcing them to put stuff into their bodies. This principle has been met with no opposition from my opponent.

I'll deal with the idea that vaccines harm others in the appropriate section. If the idea is that anything that might be a harm to other people must always be stopped by the government, the government must be set on destroying human life because people are a pretty big threat to other people. Pro has failed to put forward any justification for why it's the role of the government to mass medicate. He's simply assumed that they should because diseases are bad, without engaging with my analysis on the principle behind that and where government could take it. It's a very 1984-esque scenario.

Human rights
I don't know why my opponent is inviting me to restate my points in a debate with unlimited characters, but you will recall that I did explain the harm - that without human rights, we're left with a system people don't want (as explored in the previous point). Human rights are essential and foundational both to medical ethics and social policy, so I'm surprised pro is so dismissive about them, especially without warrant. The idea that I have to do more is nice, but what? A moral issue can't be proven with facts. Schools and workplaces that have such requirements, and where attendance at such a school or workplace is mandatory, find these very rights diminished which is a moral problem.

Pro's claims against the UDHR etc all fall short because they confuse rights for responsibilities. Access to medicine is not the same as being forced or coerced to take it. Hence why the nations pro talked about which force vaccination, such as Saudi Arabia, all score fairly low on their civil liberties generally by any reasonable measure. The smallpox vaccine is a special case in America because it was pretty much entire eradicated from the USA already at the time when human rights law was developed. I'll probably talk more about the smallpox vaccine a little later.

It's a shame my opponent failed to give much analysis on these first two arguments. I really wanted to know what he believed to be the role of government in making medical decisions, but his case seems to have been to legitimize the notion that government can make any medical decision they believe to be in the public interest without limitation. And that justifies just about any law to restrict civil or political liberty.

Finally, I did describe in my case what makes an abrogation of rights legitimate in certain narrow cases - for example, the death penalty. It's that there was a decision made where a person gave up their rights, or a decision needs to be made but cannot. My opponent apparently didn't read this part of my analysis. He also didn't seemingly get the fact that human rights are protected internationally by law, by medical authorities, and by democratic mandate. It's universal. Pro further does not contest that this point would be true even if, on science alone, pro carries the rest of the debate.

We're not the same
Pro claims we're all equally susceptible to diseases like measles, but then he also says some of us are immunocompromised, and does not contest that some people are born with measles immunity. The fact is we are all different in terms of our immunological response to measles as well (as well as mumps and rubella, for that matter). The antibodies for measles are also not highly specific - if you are immunized against one strain of measles, then I'm sure pro would agree your antibodies will be good against other strains too (and there's quite a few).

My opponent adapts my suggestion for his model of using doctor's discretion but provides no counter-analysis to the various problems I bring up that come into play in that case. Leaving it up to doctor's discretion and keeping medical records confidential also has the harm that your doctor could force you to pay the fine and not get the vaccination if he so chose, a legal form of blackmail. Whether vaccines are added to the population by force or extortion, the potential for damage to a person's system is immense. He's also added a costly blood or urine test to his system, which nobody would voluntarily take. Seriously. If you don't want to admit to your doctor you've been abusing your mate's prescription drugs, you're not going to reveal it to your doctor by stabbing a needle in your arm and showing him or her what's in your blood either.

Medical similarity is inherently dehumanizing because humanity is all about celebrating differences - different bodies and different choices. Whatever the purpose, the government should not force people to adopt a single characteristic in any respect, be that to force everyone to dye their hair blue, or to put antibodies into their blood. If quality control is indeed sufficiently high, there should be no significant variations between people's antibodies after taking the vaccine.

I told you about alternative choices that work. They're not perfect, sure. The vaccine isn't 100% effective either, and even if it was, the vaccine can have side effects. There are rational alternative choices that are 100% effective with no attributable side effects, including staying away from people with measles. These choices do not necessarily have third party harms either. Like I said, even if infected, the best road to a quick recovery is simply to have your immune system in good shape. A normal immune system has never had any problems dealing with any one of measles, mumps or rubella. Only other immune complications can cause that, and there are ways of avoiding those too. Oh, and that correlation pro didn't get about unvaccinated children being more health conscious under the status quo? It exists. His response that under his model things may, hypothetically, change is reasonable - I don't know, I can't predict the future - but that doesn't mean it's unreasonable that it exists right now, because it does.

I must say, at the end of this debate, I still have a lot of lingering questions about pro's model. The big one being that, as I've pointed out before but pro never answered - how exactly can this possibly be enforced? If somebody gets measles that doesn't mean they haven't been vaccinated, a low antibody count doesn't mean no vaccination (very old people, for example), a high antibody count doesn't mean vaccination (could be inherited) and a lack of measles doesn't mean vaccination. There is no test that I know of that can definitely establish whether a given person has had measles or not. Even if there was a national registry of measles vaccinators (even the CDC isn't sure how many people in the US are immunized exactly every year) then there would be inherent problems with that, rather like the current criminal registry has problems. The lack of specificity in my opponent's case is troubling.

As a final side-issue, pro says vaccines are just virus particles. This is false. Check the ingredients list. It's mostly various preservatives and holding chemicals so the virus can be nicely transported. Some of these can cause reactions - you can read more about all the ingredients here. This is why thimerosal is no longer generally contained within vaccines, for example (although thank god it was never in the MMR vaccine - despite the CDC still having research linked on their website on their MMR page about it for some weird reason). Vaccine overload being related to the immune system being overloaded is not supported by any science - regardless, it helps neither of our cases. There are far better explanations that I provided in round that show it's more a correlation than a causation, showing my opponent does not understand the science he is talking about. You can read more about that here if you're interested. The point was to demonstrate that not every social impact of medical policy is foreseeable, a point which my opponent drops.

Murphy's Law
The law is inherently limited to things that can go wrong. The more people get a vaccine, the more can go wrong, disproving pro's point #1. The law does not state possible failures will ALWAYS go wrong, disproving pro's point #2 (pro's summary here of the Challenger mission is slightly incorrect but it's not important).

I talked in my case about recalls being the solution, and how that is not possible once injected. You might also be interested to learn that nonetheless, vaccines are the most recalled kind of drug in the US. They get recalled dozens of times per year in the US due to faulty batches. It is literally only dumb luck that none has caused a serious incident so far (more details). Quality control is too slow so distributors just launch the batch while it is still being tested for safety. It's even worse in the third world. The thing is though that botched vaccines will almost always be ineffective, but not necessarily harmful, if they are in fact used. So it's unlikely that post-use, an injection that affects many will cause some serious ailment. But due to the way the system works, it's also far from an impossibility. Pro claims also, especially in the cross-examination, that different diseases cannot be spread by a vaccination, or at least that this has never happened. This is blatantly false. In one campaign in Oman, one-third of all vaccinated developed a different, also highly serious condition. This is why doctors, scientists, the WHO and the CDC all recommend against injections that are not necessary. In other words, unless you believe the MMR vaccine will have a significant positive impact on your health, almost every doctor agrees you should not take it. Hence why they recommend you don't take the vaccine while pregnant, for example. And yes, these risks are real, even if not likely from any given batch, given sufficient time they are certain to occur at some point.

Of course this is contrary to the cGMP, which no company actually follows. Don't even get me started on how many lawsuits and such there have been over that.

If past sources for harm are incredibly small concerns then that must be true of measles, mumps and rubella also - diseases that were once harmful but are now no longer. The VAERS is optional and many avoid it, since it leads in to the VICP which is adversarial and thus costly, especially for the poor who are most likely to live in a poor environment where one might imagine such difficulties arise more frequently. As such, it probably grossly under-estimates the exact numbers of people who have had a reaction to the vaccine. Because these have gone through a tough adversarial and rigorous scientific testing process to be allowed on to the register, you can be pretty confident that anything on there was indeed vaccine induced. The post-marketing study was, as you might guess, run and funded by the manufacturer. As to this idea that the vaccine should come later in life, this goes against the CDC's own schedule, which recommends you get your first dose of MMR vaccine after just 12 months (the same as a certain Miss Williams, although it's beside the point). Also, if delaying the vaccination is an acceptable way of avoiding the fine, doesn't this create another rather obvious loophole in pro's model? I'd really like to know what doctors told pro otherwise.

Pro states "I've shown a causal relationship between getting these viruses and the outcomes I've described" - this is exactly my problem, HE HASN'T. He has not shown at any point that the vaccine reduced the measles death rate (it didn't) or is reducing it right now. He has not shown that measles incidence has ever been inherently problematic either. These things were his burdens to prove, not mine to disprove. Pushing the onus on to me is blatantly unfair.

The silver lining that pro neglects to mention is that many of the VAERS entries are not for serious reactions but minor ones. Nonetheless he admits the vaccine can have serious harms. Even if the vaccine only caused a single death in the past decade, that's still infinitely more than the 0 deaths from MMR. MMR related deaths, as I showed in the previous round, have decreased in every single decade since records began, and you can't get lower than 0. It's a pretty reasonable extrapolation to assume the US will soon, like Haiti, be declared free of measles. I suspect the discrepancy in our figures is because of different definitions - for example my 300,000 figure related specifically to neurological complications, but of course there are other complications that are not nearly that unlikely too. He didn't provide a source, and yet again, it's his burden to prove. The fact is that something NEVER goes wrong with the vaccines if the person is healthy. Healthy people - those with no other diseases - always recover from measles, mumps and rubella. But a healthy person can plausibly not recover from the vaccine and die.

This is important. Pro likes to brandish around this 0.1% death rate figure. In the past 20 years, the UK has had over 100,000 measles cases, but only 3 deaths, and in none of those 3 deaths was measles shown to be the cause because the individuals had so many other illnesses it was really hard to tell (source). The same kind of story is played out throughout the developed world.

"Con will need to show evidence that the MMR vaccine leads patients to shed communicable and virulent virus, something he has so far failed to do" - I don't actually see why this should be the case - but ok, here you go. Note how the source has a pro-vaccine bias and is based on expert findings from Merck themselves. Again, this is why Merck tells recently immunized people to stay away from the immunocompromised. I do thank pro, though, for agreeing that the key difference between India and the USA is the sanitation and other environmental factors, NOT the rate of vaccination (though to be clear, over-vaccination has indeed subsequently become an issue in India). Also, am I the only one that finds it ironic that pro hates anti-vaccine sources as biased but roughly half of his sources come from organizations that are on the record as being pro-vaccination, such as the CDC?

Companies producing something mandatory have no accountability at all. If they produce a bad batch it doesn't matter - people still are coerced to buy their product. Additional oversight from the anti-vaccine lobby already exists under the status quo.

MMR: The Diseases
Just saying - smallpox could kill people on its own. Polio can kill people. Tetanus can kill people. The damage these diseases can do, coupled with the seriousness of their transmission, makes them significantly more appropriate targets for any mandatory vaccination program than MMR. The fact my opponent ignores significantly more important vaccinations in favor of less important ones is kind of a sure symptom of icaremoreaboutbigpharmaprofitsthanactualhealthoutcomesitis. I'm not downplaying the harms of HIV. HIV has a high complication rate because it has a strong immunosuppressive effect - in measles, the effect is very weak, so the complication rate is low - hence, nobody has actually died from measles in the last decade in the US, but tens of thousands die every year due to AIDS. And before you say "oh, but that's not really aids that kills them but something else" - EXACTLY. That's what makes the comparison so valid. As I said in the CX, more people have died from shark attacks over this period (roughly 10 people) than measles (0 people).

Pro's burden is not to show that these diseases can be risky for a few people. He must demonstrate that there is a sufficient enough harm to warrant a mandate for every single person to be vaccinated. So let's look into non-death harms. Once again pro only conveniently provides statistics on a totally different environment than modern America (and besides, the CDC makes this weird assumption that prior to vaccination 9 out of 10 measles cases would go unreported, so the figures reported are really roughly 10 times lower - causing some to argue that measles was probably on a downward trend in terms of incidence also prior to vaccination). Pneumonia and major blood diseases were the issues highlighted by my opponent as significant harms. When pneumonia is not deadly, however, it generally leaves behind no long-term issues. It can be easily treated with both modern medicine and, like measles itself, typically goes away on its own. If one is really concerned one could simply vaccinate against pneumonia without needing to vaccinate against measles. Yes, a pneumonia vaccine does exist, and it works much better than the MMR vaccine. And pneumonia is not even that likely - and blood diseases aren't even a complication of measles. Pro just made that up. Based on actual science conducted in the 1960s (as opposed to US government reporting), the rate of long-term complications at roughly the time pro is talking about was only 1 in 15,851 - while today one can extrapolate based on voluntary vaccination ALONE it has gone down to 1 in almost 16 million (source) - and the death rate is LOWER than that (put another way, in today's world you are many times more likely to die or suffer a long-term injury from the vaccine than from measles). Environmental factors are harder to quantify, but as my previous analysis has shown, they are significant nonetheless. Factoring those in with any index you get an absurdly low complication rate for measles. Despite my previous protests over the use of the figures that he does, pro does not justify them.

To pro's claim that "I showed that mumps causes meningitis" - no he didn't, he just asserted it. Meningitis is indeed a possible complication of mumps but the specific form is extremely mild and isn't anything like the kinds of horror stories from meningitis that the term typically evokes. It causes no permanent damage. I talked about this and the other symptoms in my case and feel no need to repeat it here further. I also want to remind people that I'm not downplaying the risks. Murphy's law works two ways - some people will still die of measles so long as it exists, even if the risk seems impossibly small. Some will get other harms, and those are really bad. There are definitely arguments for getting a vaccine as well, but these need to be weighed appropriately in the proper context.

Pro offers no response to my various responses to his smallpox point, such as that numerous countries eradicated smallpox despite a lack of a mandate. Tetanus may not be as transmissible but it is a much less manageable threat nonetheless, because it does not need a human host to survive like MMR or other viral infections. And finally, if people don't recognize the symptoms of these diseases then that's the problem, not a lack of vaccination. The best solution to a lack of knowledge is simply to teach people stuff.

In America!
Pro accepts that problems exist with America's health system - his only real defense is ultimately that these problems are not unique. That's actually fine by me, because I wouldn't support mandatory vaccination anywhere else either. Thanks Obama.

Herd Immunity
We both agree with a model of maximizing freedom to design their own life experiences while minimizing the limits that those would impose upon other people. So let's work on that assumption. First of all, uncomplicated measles is not at all a significant issue for the person who has it. It's just another opportunity to play video games. Indeed pro admits that without some other complication measles shouldn't even go beyond a latent stage. Second, I have already shown that the complications rate is low in the context that we're talking about. And third, we know that this is true despite what my opponent said about immunocompromised people being particularly vulnerable. 85% of all complications from measles are NOT in those that are immune deficient (source), and they haven't been particularly over-represented in deaths or anything. If those who have these conditions will be careful about avoiding swimming with sharks as my opponent claims - which, by the way, is more likely to lead to complications - then they'll definitely be extra careful about measles. Pro has fundamentally not shown that health and wellness are not features of the status quo. The USA recently had a small measles epidemic, as pro noted, and there were no deaths or long-term injuries that resulted from it. Anything more has just been fear-mongering by vaccine fundamentalists.

The fact that even 100% vaccinated communities have seen spontaneous outbreaks of both measles and mumps should prove that the theory of herd immunity is rather overhyped. When the MMR vaccine was first developed the magic number was not 95% but roughly 65%. This has been gradually revised upwards over the years. As indicated earlier, Zimbabwe and Sierra Leone both have a coverage rate of 95%+, yet they hardly see any effects of herd immunity. Frankly, there is no exact threshold and the entire concept has always felt unscientific to me. There's no study that confirms it really holds true. In any event, I cited my US data earlier to confirm what I wrote. My opponent in round 2 provided a source that gives the exact same figure. Oh, and just 2 years ago, the US rate was above 95%. Some herd immunity you guys had then, right?

Yes the incidence rate of measles has gone up in the last few years. At the same time, the rate of complications has gone down. That's not less protection or less vaccination, that's just more disease imports from countries US people frequently travel to. But since my opponent is arguing the trend, let's look at what the trend really is for the US:



This data comes from my awesome Excel skills and the same data WHO data from earlier. It's a little lower because it uses a different model in its estimation - the CDC's will be slightly more accurate, but the trend is the same. In blue is the exact percentage each year, while red is a simple linear trend line (the logarithmic trend line looks exactly the same). What it demonstrates is, over time, a pretty good fit for a linear upwards trend. Now my opponent makes a fair point that the nationwide trend, which I think is pretty clear-cut, does not reflect any individual community specifically - and I think that's great! It shows America's communities are divergent. If, say, the Amish don't want to be immunized, the worst that can happen is that their community all die of measles, right? And those who wish protection from the vaccine can get it. If people can't due to pre-existing conditions, their choice under the status quo is either to leave the community or to stay away from people in the community who have measles (a far less risky option).

My argument was not that the cost of measles is less than the cost of vaccination - although under the status quo, it blatantly is because the cost of measles is pretty close to zero to the US right now, since it isn't really resulting in a level of complications significant enough to register anywhere. My argument was that after this program is implemented it might be. I effectively challenged my opponent to show that his model could work cost-wise. He couldn't meet that challenge. Additionally, pro now also adds feeding starving children to his model. At this point, I'd say his model is starting to veer quite a bit from what it was in round one. It sounds like whenever I put forward a shortcoming, the idea that "we can do that too!" must eventually run out of steam. There is a finite limit to how much can be done given finite time and resources.

The Impact
Just because an argument evokes emotion does not mean it's wrong. Quite frankly, a society that makes us angry, that we would not wish on other people - is not the kind of society we should aspire to. Likewise, slippery slopes are legitimate concerns when there are no clear limits. Just because I point out the lack of limits to a principle does not make it the slippery slope fallacy. What I was actually trying to show here is how the immune lobby works and why they're pushing MMR so hard right now as opposed to any of their other vaccines. It's because they're opening up the market to the idea of upgrading to the new MMRV from the old MMRII. It's just a marketing gimmick, as it always has been. Not every medicine ever made is legit. Some are just medicines for things people don't need.

The Salmonella vaccine is not imaginary. Like I said, it's currently actually being actively developed especially in light of this recent finding. I completely agree with pro that this vaccine is more of a marketing gimmick than genuine public health issue. It's a personal, medical decision that pro and I both agree on. If somebody did want to get such a vaccination, then hurrah for them, but they shouldn't force that gimmick on me. The fact that not all medicine is made equal is important to establish - we've got to get out of this mentality that it's all "doctor's orders" when it comes to vaccines and more "look at the science/facts and reach a rational conclusion". And to reiterate, I don't believe my conclusion has been irrational. The moral concern here is not a loss of freedom but a loss of rights, specifically human rights. But more importantly, I'm pointing out a pragmatic concern of encouraging governments to collect revenue from those who don't buy a service that doesn't necessarily provide a significant benefit. I was more challenging the attitude towards immunization presented by pro in round one, specifically the fact that his case was literally nothing more than "these diseases are bad so you'd better immunize your kids! Here's a few scientific papers to back that up".

The problem I have with the impact of these vaccines, other than the points I've discussed elsewhere, is that for the rights taken away, only a small number will see their vaccination status change if everything works out great, but everybody will lose their rights. Meanwhile there are simple things that the government could be doing that would make a far bigger difference as they'd solve crises that actually matter right now. Once again my position is not anti-vaccine, but pro-informed-choice/consent.

If there's two things I hope you remember from this debate today, it's these two things:
1. There are genuine reasons why people choose not to take vaccines that are actually well-supported by the scientific literature
2. By focusing on statistics obtained from the worst possible circumstances, drug companies will make any disease, however minor in reality, look like the bubonic plague

Pro's CX Issues
I take exceptional issue with this statement from my opponent: "It seems obvious to me that the more people who are vulnerable to a given disease, the more likely they are to get it and come into contact with a person who is immunocompromised". It suggests immunocompromised are like dead meat waiting around to get infected. This could not be further from the truth. If you're a porn star, you go to extreme measures to prevent the transmission of an STD to your body. If you're a stunt guy, you'd better make sure there's a medical staff on set. Pro agrees immunocompromised people take extreme measures even against shark attacks - one of the rarest ways for anybody to die - and he claims they're just sitting there waiting to get infected? No. They take extreme precautions. Thus they're not like other members of the general population and can't validly be compared like this. Just because complications are more common in this group does not mean they represent the plurality of complications, or even a more significant degree pre and post immunization.

If people are shedding a virus at sub-clinical levels, it's pretty certain that it's not a very strong strain of the virus. While no exposure is definitely best, the weaker the strain the less the chance of complications in the bodies of immunocompromised people. As for the idea of measles not being cleared from the body, his study (which he stole from my sources) actually refers to the antibody level, not viral level. I encourage people to read the study and try to find any way it supports my opponent's twisted conclusion. Or I can just save you some time and tell you that after looking at it for ages, I'm certain it doesn't.

On rights, my claim is that government should not take them away. It would be nice if viruses didn't take them away, but the least we can do is not compound the harm by taking away even more rights. The same is true for bodily autonomy. Rights analysis as a moral framework guides our actions, rather than provides a moral solution to what the natural world may throw at us. I don't see that as being very inconsistent at all and have no idea why my opponent has this obsession with making my argument about side effects when I never mention them, and he never relates side effects to my point. In fact in CX I flatly told him that side effects were not a relevant issue, yet in this last round he still spent 2 paragraphs pushing the idea. I'll come back to these issues once I've burned through the remainder of the points here.

I am totally capable of interacting with family and friends without being in the same room for more than a couple of seconds. I can still text or call them. We can play multi-player Gran Turismo together. I can still do my work remotely, study for a big test, or build an awesome robot. There is a physical impact to any illness, but the fact that people sometimes need to be alone for a few days on medical grounds is hardly the huge harm that pro needed to show to win this debate.

Finally pro has not shown that measles eradication would be desirable, but I did provide several warrants for why smallpox eradication was not solely caused by the vaccine. Note how my opponent's counter-analysis is entirely anecdotal. One thing I am sure of though, and that is that you won't save $4.5 billion from eradicating measles, mumps and rubella (and now also chickenpox, which Merck has tagged on to the vaccine). Merck will find some other vaccine to sell at a higher price to earn more dividends.

My CX Issues
I'm going to miss one or two issues from the CX. This isn't because they're not relevant and I encourage anyone interested in this topic to read more about them, especially about the influenza epidemics, but ultimately I've decided they won't be important in determining this debate.

My opponent began by guessing that complication rates are higher today than in the 1950s. The only evidence he has cited for this used small, selective samples from third world countries. Any large-scale study in the first world - like the one I cited - shows the opposite effect. It also isn't played out in his own evidence from the US, despite the fact that he keeps referring to the 1950s CDC estimates as if that's the harm my case can deliver. He claims 300 people lacks "statistical significance" but many of his studies have somewhat smaller samples.

He claims a healthy environment is not enough to fight pneumonia, and that MMR vaccines are needed for that. Not even the WHO agrees with this. Indeed despite a lot of searching I have found no reputable source that backs up pro's claim here.

He then claims 94.5% would be completely unaffected by his model. If so, then presumably their won't have to prove their vaccination status - another huge loophole if anyone can avoid the fine simply by claiming to have been vaccinated.

I asked why he can force-medicate and Hitler can't. His answer was basically 1) it's ok because it's only extortion, 2) I have fewer reasons to do it, 3) Hitler used pseudoscience, and 4) I want to force medicate more people. I consider 1,2 and 4 rather unethical answers, and I have no idea how 3 can even be connected to the question. I asked specifically about consent, and pro agreed that consent is important in medicine especially, but he can't justify where the consent is in his program.

The way I see his model, it punishes people for a crime they have not committed. Is it moral to charge the tax on me even if I got the more dangerous virus and didn't infect anyone else? I don't think so, and despite my challenge, pro didn't warrant this either.

I gave analysis in the CX about the MMR vaccine commonly being unsafe in much of the world. I thought my opponent would challenge this but he's apparently dropped it, so consider that and everything else extended.

One last thing I want to say before I end the substantive issues of this debate. I still get this undercurrent from pro that I must be the exception or something. That most people who don't get the MMR vaccine are alarmists who are worried about autism etc, and this couldn't be further from the truth. You'll find that the smallest voices scream the loudest, but most people who refuse one vaccine or another reject those kinds of arguments and do it for the more sensible kinds of reasons offered here. As I was researching for this debate, I came across a vast number of well-written articles online calling for the kind of moderation I want to see in the vaccine debate. And I want to close with this statement, because it's kind of stuck with me. The full article is interesting too, though you'll find a few of the arguments this mom makes are essentially the same as mine, and can be read here: why we declined the MMR vaccine.

"the next time a media article blames the “anti-vaccination movement”, or uneducated parents, do a little more research. And remember: people used to think the world was flat, people were imprisoned for suggesting that the earth revolved around the sun (instead of the other way around), and doctors used to doubt the relationship between tobacco and disease."

And it's so true. At its core, this debate is really about whether we should just trust the doctors, or have the freedom to make up our own minds.

So... did I win this debate?
Short answer: yes. Long answer: in this debate, pro had to prove 4 things. He had to prove all four of these - if he failed to prove one or more of these points, then I win the debate.

  • A problem
    Pro had to show that measles was actually problematic. At best he showed that it may be problematic in some parts of Africa and historical US, but not present US. Or if you're being really generous to pro, you might say he showed what would happen if vaccines were to disappear, but nobody is suggesting that in this debate, and that ignores my mountain of scientific evidence that it's the environment that affects measles health outcomes the most. He mentioned herd immunity but never proved why it was desirable when health impacts are already so negligible. Pro failed to show that the status quo had a significant enough harm.
  • A solution
    Even supposing his problem had stood up, pro failed to show a coherent model to solve that problem. I think in this second round I counted five times where pro changed their model to add in more things as he realized the problems I was pointing out, but it's still fraught with loopholes and difficulties. Notably, he never actually was able to tell you how his model would actually work in terms of checking whether somebody had the vaccine or not - which I would consider probably the most important part to get right.
  • That the solution solves the problem
    Obviously since pro had neither a solution nor a problem. His tenuous attempts to link his solution to his problem have failed and seemingly relied entirely on a small sebsection of the population who are the most vulnerable - without recognizing that these were also the most careful, too. His consistent overestimation of the harms of these illnesses made this difficult too. At absolute best, he showed this only for measles, and never connected the problem to the solution for mumps or rubella when he had to show all three.
  • That the good impacts of the model outweigh the harms
    This is the point on which most of my analysis has been directed, and which I believe to be the most important. Pro had the burden to show this but his only substantive analysis was basically that it solves the problem. He never weighed that problem against the huge number of harms, just kept asserting that his model "trumps" mine. That's not enough. For example, I talked to you about third-party medical harms, a corrupt vaccine industry etc. Most of this has just been an assertion of denial from my opponent in response.

A few final, personal thoughts on this topic. Yes I'm trying to win a debate, but I've tried to do it in the most balanced way I can, consistent with my real beliefs. You'll see that I've cited science even when it doesn't fully agree with what anti-vaccine lobbyists usually argue. Vaccinations is an industry with a problem, and we need to clean it up and force them to focus on creating real cures, not huge profits. Unless we're selective about what vaccinations we pick, nothing will change. What we can do, however, is vote with our wallet and not buy vaccines we don't believe in. In this debate, I'm proud to have defended your right to say no.

If you or somebody you know are about to get an injection, vaccination or any other medicine PLEASE get informed. Don't just read the pamphlet your doctor gave you, and don't just do what the TV newscasters say the ministry of health recommends. Just spend an hour or so of your time, at least, doing some quick research. Find out all the sides to the story, look it up on Google Scholar. Get as informed as you can. No matter what you find out, I can promise you that you won't ever think that hour of your life was wasted.

Thanks whiteflame, and good luck with the votes!

Return To Top | Posted:
2014-10-29 23:52:45
| Speak Round


View As PDF

Enjoyed this debate? Please share it!

You need to be logged in to be able to comment
BlackflagBlackflag
I think that nickname will stick
Posted 2014-12-01 20:08:44
9spaceking9spaceking
oooooooooooooooooooooooo snap
The Beast Slayer slayed the Beast once again!!!
Posted 2014-12-01 19:42:55
BlackflagBlackflag
I think everyone on this site needs a lesson in flow. Me foremost.
Posted 2014-11-04 23:25:49
BlackflagBlackflag
Lots of information is okay if it is well organized and relevant.
It is also important to maintain a flow of logic.
Posted 2014-11-04 22:42:08
adminadmin
Yeah, thanks nzlockie. Got to admit spreading was definitely part of my strategy here.
Posted 2014-11-04 22:38:59
whiteflamewhiteflame
nzlockie, I completely understand. This was an extensive debate that happened in two rounds, and I realize it got pretty messy, not to mention complex. I appreciate all of your feedback, as well as your thoughts on the debate and on our rounds, as it is still invaluable. If the worst that happens is that I lose this debate because we only have one voter, I have no complaints losing to Lars, especially not in a debate of this caliber.
Posted 2014-11-04 21:42:30
nzlockienzlockie
Guys I'm sorry, I can't do it.
I've made four separate attempts to judge this debate and I just can't do it fairly. I'm going to abstain.

I have a little feedback for you though:
CON: It seemed that in this debate, right from the first round, your goal was to overwhelm me with examples. I don't know if this was your intention, but that's how it came across. You would often use four or five examples, where one or two would have sufficed. The positives of this was that I was left with the feeling that there was a mountain of evidence on your side. The negatives of this, was that I was left with a feeling that you were a little desperate and maybe even trying to distract me from something. Your impassioned speech against smoking for example had only the smallest relevance to the actual resolution.

Your graphs in the second round, especially the second one, needed labels. The explanation of them helped, but I shouldn't have to work so hard to figure out what the graph is showing. Graphs are supposed to make things easier, not harder.

The net result of all of this was that I constantly lost the thread of the debate. By the end of the CX I was scoring this a clear win for CON, but then PRO's second round argument came and he offered rebuttal for the hundred points CON had made. That's where I keep getting lost.

Final critique was that in your final round you submitted a LOT of new evidence which PRO would obviously have no chance to contest. I don't feel like this was fair, especially considering how close this had been.

On the positives, your case was very strong. If your intent was to swamp PRO's contentions, then you succeeded. That was definitely the impression I was left with.
I also appreciated your writing style which made long arguments easy to read.

PRO: Really the only critique I had for you was your second round argument. As mentioned above, this was where I got lost every time. I've thought about this a fair bit, and I THINK it comes down to your formatting. For every numbered point you put, I would go back and try and find that argument in CON's case. It would have helped if you'd have had a heading or something that got me there faster.
I typically HATE those rebuttals that are full of quotes, but in THIS case, that might have helped.
You DID give me the disclaimer at the beginning of that round, and I appreciated that.

On the positives, you deserve credit for pulling it back in the second half. Many times I felt like just writing this debate off as a win for CON based on the first half, but there was enough meat in your second round argument that I decided that a no-vote was the right way to go.


Sorry again for the no-vote guys!
Posted 2014-11-04 21:01:10
nzlockienzlockie
Despite the fact that this is only a two round debate with CX, this must surely be a candidate for the longest debate...
Posted 2014-10-30 03:20:51
BlackflagBlackflag
This is going to be.... legendary
Posted 2014-10-08 23:51:18
whiteflamewhiteflame
Oh, it's on!
Posted 2014-10-08 14:02:44
whiteflamewhiteflame
Alright, I would certainly be interested to see your case. I think there's a decent case to be had for Con, even there, just not a case I'd be all that excited to argue.
Posted 2014-10-07 15:28:56
adminadmin
Actually I think I might have an ok case for con on reflection. Medicine topics aren't usually my thing but I don't have an MMR vaccination, so I feel like I ought to be able to answer for why that is. Time's not on my side though, so I won't take it unless it's still open at the very last moment.
Posted 2014-10-07 06:36:25
whiteflamewhiteflame
;P
Posted 2014-10-07 05:27:24
adminadmin
I hope this gets taken. You know you've got a seriously cool debate on when whiteflame starts pulling out acronyms before it even begins.
Posted 2014-10-07 04:51:52
BlackflagBlackflag
I was concerned about a valid line of argument, but I've had tougher resolutions
http://www.edeb8.com/debate/That+our+acquirement+of+knowledge+is+in+part+a+priori/
Posted 2014-10-06 02:24:40
whiteflamewhiteflame
Learning by doing is very helpful. Tell you what - this topic is really easy for me to exploit by just running MMR, so I'll take a harder tack and argue for HPV vaccination being mandatory. Makes it a lot more even.
Posted 2014-10-06 02:19:16
BlackflagBlackflag
I really want to accept this debate, but I'm worried since you're also coaching me...
Posted 2014-10-06 00:53:05
The judging period on this debate is over

Previous Judgments

2014-11-02 01:05:23
BlackflagJudge: Blackflag    TOP JUDGE
Win awarded to: admin
Reasoning:
Introduction
-----------------
I'm glad that this debate happened, and have always wanted to study into this field further. I understand both sides of the argument, and recognize the clear points of distinction on each one. I've determined to use the legend judging system for this debate, and under the impression of the new site judging guide, I'll also apply some of the given advice there.

Let me commend both debaters on creating a truly amazing debate, and it is my privilege to read and vote on it. You should be proud, regardless of the outcome.

Informational Source Presented Throughout the Debate
------------------------------------------------------------------------------
http://www.merck.com/product/usa/pi_circulars/m/mmr_ii/mmr_ii_pi.pdf
http://www.cdc.gov/measles/about/transmission.html
http://www.cdc.gov/mumps/about/transmission.html
http://www.cdc.gov/rubella/about/index.htm

Hegemony Argument (5)
-------------------------------------
- Vaccine Mandate over Option of Care

Dependent Arguments
--------------------------------
- Measels, Mumps, Rubella (proposed mandatory vaccine)
*As such, it is the only one liable for determining the winner of this argument

Medium Impact Argument (3)
------------------------------------
- Disease Spread (conceded, but made irrelevant to LOA)
- Danger of Disease Spread (Contested, but only partially relevant to LOA, therefore the argument is submissive to the outcome)
- Herd Immunity

Analyzing the Governments Proposal
----------------------------------------------------
The Government's case was dependent on a lot of factors, but minimized into one dominant argument. That the MMR vaccine should be mandatory, because the impairment of disease on others validates the use of a vaccine mandate for MMR. Additional dependent arguments...
- Disease Impact

There was an additional argument made from the government that furthers the BOP, but wasn't quite dependent on the dominant argument. That being herd immunity, or the claim that immunity in numbers prevents the growth of further disease.

Analyzing the Opposition Case
-------------------------------------------
Con conceded that the spread of MMR was detrimental, but contended that people have the right to pursue their own treatment options. This was equated to a human right issue, and an issue of morality. This was noted as being a counter argument to the governments case.

Additionally, the opposition took one minimalist stance on herd immunity, and one minimalist stance on the impact of MMR.

Dependent Argument: MMR
------------------------------------------
Contended by Government R1....
- "Prior to the vaccine, 3-4 million people were infected in the U.S. each year, resulting in 48,000 hospitalizations, 400-500 deaths and approximately 1,000 who developed chronic disabilities"
- "blindness, pneumonia, and otitis media"
- "Despite the availability of a vaccine it remains a leading cause of death among young children worldwide, with deaths mainly attributable to the complications of the disease"
- "More than 90 percent of susceptible people, usually unvaccinated, develop the disease after being exposed"
- "Mumps is not normally a fatal disease, and up to 30% of mumps infections are asymptomatic"
- "While the disease usually only results in a light fever and small rash, this disease is mainly problematic for pregnant women"

Contended by Opposition in R1
- "First of all, nobody has ever died from measles, mumps or rubella alone. They've actually died from some other complication that was possibly brought on by those illnesses"
- " Cures are simply not needed for these diseases because they are actually that mild and easily fought off by the immune system"
- "They are not significantly harmful, they are self-limiting, and they won't kill you"
- " The healthier you are, the lower your chance of contracting one of these illnesses, and the better your immune system's chance of saving you from another day of discomfort"
- " roughly a third of cases developing any kind of complication at all"
- "Measles fatality rate 0.3%"

Non Conflicted Arguments in R1
- MMR is only fatal with complications
- MMR has low transmit rates (see herd immunity)
- MMR causes several uncomfortable effects

Anaylzing R1 Impact Contentions
---------------------------------------------
While some of the information here was most certainly refuted in R2, I think the key points of R1 were summarized nicely above. Alone, and without looking ahead to R1, I would say that the opposition won the impact case, which is dependent on the opposition argument that "people have a right to choose their treatment".

The hegemony argument is largely coexistent with the effects of the diseases themselves, and the opposition didn't oppose the fact that MMR is bad to spread, but did try to minimize the harms. Granted, this did give more support to his argument that people do have a right to choose their treatment.

It was conceded that Pregnant Women should get a vaccine, but I don't think this has signifigant impact on the debate itself, but it is interesting to note.

Herd Immunity R1
-------------------------
Contended by Government
- More immunity to the disease means less spread
- Wont fully achieve herd immunity

Contended by Opposition
- Wont achieve herd immunity
- " some diseases it's actually more effective to just let the disease run rampant."
- This.... http://s14.postimg.org/ack2epclt/0707275measleslog.jpg
- " there have been US outbreaks even in populations with 100% immunization coverage"
- Verified source from government, therefore I determined the information reliable
http://medind.nic.in/ibl/t03/i1/iblt03i1p8o.pdf

Herd Immunity Analysis R1
---------------------------------------
Considering it was a concession by the government, I found it interesting that the opposition took 4 paragraphs drilling and solidifying this point. The actual significance of this argument was later revealed, when I connected it to his morality argument, and impact argument.

The uncontested attack on this concession revealed that....
A) Full Immunization is impossible
B) There are other paths to immunization (healthier populace)
C) Allowing the disease to actually spread increases the chance that more people will gain immunity...
(See last source R1 opposition and contention "Sometimes its better to let diseases run rampant)

It's in America
--------------------
While not actually relevent to the judgement, it does emphasize a good point (despite most of the argument itself being full of sarcasm and nonsense)

Unless specifically specified, a debate never can be assumed to center in a specific country, and the tactic really backfired on both sides. Arguing that something is the case because it happens in X is an appeal to probability. It was a little worst on the government's side, because the arguments were extremely one sided on the US. All the sources came from US health organizations as well.

The more wordy statistics had more impact on the debate than the one's that concluded in appeal to probability fallacies.

Cross Examination
--------------------------
People familiar with my experiment, Legend Judging System, are aware that I reward and deduct points based in cross examination. I am mostly looking for participation. Not only do you need to answer questions, but you need to ask them. Both sides participated well in cross examination, and I was set on giving both the special point, until this....

"Lars, I understand where you're going with this, and I've already given you my response multiple times - changes to medical care affect the number of deaths that occur. Antibiotics became much more widely used during that same time period. It's no surprise that the bacterial infections that so often accompany these viral infections started being less of a problem when patients are being treated for the bacterial infection. Death rates fell prior to vaccination, but complications were the same."

NEVER do this. I mean never. I will always deduct points for arguing in cross examination. While my decision to deduct the special point was based on vague intentions, I did see this replicated three times in CX, and as a judge, it absolutely drives me crazy to see. Don't do it. Never do it. No.
+ 1 Opposition
- 1 Government

Mass Medication R2
-----------------------------
I have to disagree with the government here. The opposition, conceded, proved that mass medication is harmful, like conceded. As a judge, I don't care if it is called harmful or wrong, both words resonate bad. Of course, the claim is free to be challenged, but the government didn't do that. I tend to ignore semantics.

I'm also bewildered on why the government thinks the argument is irrelevant. It might be irrelevant to the government's case, but looking at the opposition's, it is perhaps the core of the morality argument. Saying it is irrelevant, to me, was a sign that the government wasn't looking forward into the opposition case.

I think the government completely missed the mark of what the opposition was trying to prove, and was arguing "why this argument doesn't affect my case", and not looking into how the argument bolstered the oppositions.

This point was argued the least, despite it being the most important

Human Rights R2 (Pro)
------------------------------------
Seeing as the government missed the point on the previous opposition argument, I'm not to surprised to see it carried over here. The opposition was actually establishing a LOA. If vaccines are harmful, and kill, then that's a human rights violation on behalf of the government.

That actually falls under democide in the Universal Declaration of Human Rights.

Murphy's Law (Pro)
---------------------------
From the governments 8 paragraph anaylisis of Murphy's law, I would have to agree. The argument is very weak and is also a logical fallacy. The point could of been proven in one paragraph, but it wasn't, and that's okay. I don't deduct points for to much, but I do have some debater's criticism that I will bring up in the feedback section.

I didn't add any weight to the Murphy's Law argument, and in my own interpretation, it is a logical fallacy, but I'm sure I can debate that resolution later.

MMR Impact R2
----------------------
Government Contended...

- " most illnesses don't kill people by themselves".
This initial statement was seen as a concession, and although it was juiced up with that more illness results in more illness, I still saw it as a concession. Ridiculous or not.

Government Argument Anaylisis
--------------------------------------------
I feel like the opposition's main point is being ignored. The disease impact argument is a dependent argument of the opposition's morality over vaccine argument. Therefore, the main point the opposition is making, is that MMR isn't bad enough to make it a forced mandate. As I interpreted, there was a silent affirmation that vaccines would kill more people than the disease itself.

That, and the concession, sealed this argument for the opposition, before I even really got a chance to review his rebuttals. There was a lot to say, but not a lot was relevant. Since I feel Con's R1 arguments stood against Pro's R2 rebuttals, it isn't necessary to supplement the judgement with his R2 rebuttals.

Points Extending from CX
-----------------------------------
I didn't consider anything in this section. Questions aren't points, or else that would be a "Begging the question" fallacy. You can't refute a question, it simply isn't possible. I would consider factoring in what was being said, if the opposition actually said any of these things.

Herd Immunity (Pro)
---------------------------
I was displeased with the AOE seen this round, but here are the main points brought up.....
- The first three paragraphs were irrelevant because the basically summarized what was said in round one.
- This... http://www.cdc.gov/mmwr/preview/mmwrhtml/figures/m6236a2f1.gif

Government Argument Anaylisis
---------------------------------------------
The opposition argument keeps being clouded. The government is constantly trying to refute each trivial fact, most of which aren't relevant to the judgement. This is detrimental all together. Yes, the government can prove 90% of the facts the opposition brought up are false, but if you can't drill that solid 10% point, then you've failed to captivate your argument, or fill the BOP.

How to judge this debate
------------------------------------
I never take advice from the debaters on how to judge a debate. I do feel this is why the government lost the debate. The opposition's RFD were outside the bounds of Pro's three reasons to decide the winner. Con conceded everything the Government said, he just added additional reasons beyond that proposed in R1 of why Vaccines might be bad. These were dropped.

My Decision
-----------------
I decided that the opposition's R1 arguments were strong enough to not factor in the R2 Con rebuttals. Therefore I awarded the Hegemony and Submissive Argument points to the opposition.

Good Conduct
--------------------
ATE is a terrible strategy. I hate when debaters dismiss the opposition argument by calling them ridiculous, or non worthy, ect. It is disrespectful, and I feel a good amount of character assassination was coming from the Government side.

Speaking
--------------
Nothing to deduct and nothing to add. Con had more philosophical arguments and Pro had more factual arguments. The problem with Pro was that he only refuted factual arguments, and completely dropped all the philosophical one's, like ethics, human rights, and paths to prevention. The argument that there was multiple ways to avoid MMR was completely dropped.

Presentation
-----------------
Pro had a nice presentation, and it was divided into sections, which was nice. I'm not rewarding the special point because the debate was hard to follow on both sides. Bad presentation means two deductions.

Calculating the Score
------------------------------
0(0+0) - 3(11+1) - (1-2)

Final Score
----------------
-36 = Con



Feedback:
- Presentation is key. It is easier for the judges to review a debate when arguments are clearly organized, colored, and presentable. Both debaters failed miserably at doing this. I would have had an easier time implementing legends if I could of organized the flow of arguments with more fluency. This made me take twice the time than I had to for this debate.

- Never argue in cross examination

- Review all your fallacies with this handy page
(http://en.wikipedia.org/wiki/List_of_fallacies)

- More isn't always better. In the case of this debate especially. Arguments were mostly taken against things irrelevant to the debate anyways.

- Pro, read the opposition argument carefully. You completely missed the central idea and counter plan presented, and this hurt you case.

- Always use a thesarus when writing your arguments, especially if you want me to give the speech point. I look towards intellectual speech. In English, there are two times of terminology. Specific and Non-Specific. A Non-Specific word would be "damage", whereas a specific word would be "devastation". The more specific words you use, the clearer your point will be. Simple english isn't always the most understandable.

- Thesaurus.com has the best thesaurus on the internet (http://www.thesaurus.com/)
1 user rated this judgement as exceptional
3 users rated this judgement as constructive
8 comments on this judgement
BlackflagBlackflag
Sorry, I'm still writing the vote. This shouldn't reflect my final outcome and decision.
Posted 2015-11-04 03:14:56
adminadmin
Do let us know when your vote is finished; am excited to read it.
Posted 2014-11-02 01:42:08
BlackflagBlackflag
I'm challenging myself to give weight to everything said in the debate, while still delivering an accurate judgement, so I'm updating it periodically, so I can recieve periodic reminders if I missed something.

If you think I missed an argument in R1, now is the time to tell me.
Posted 2015-11-04 03:14:56
adminadmin
If you have missed an argument my assumption would be that it's my fault for not making it well enough, which I take as useful feedback. I'm just interested in reading your vote.
Posted 2014-11-02 01:53:31
BlackflagBlackflag
I will bring up that more information isn't always better. There were a lot of facts in this debate, which I personally love, but when some of them don't further the case, it can be seriously hard for the judge to pick up on the main point.

Lately I've been skimming large debates to find relevant material and statements, and it turns out that nearly half of what's said can't actually be factored into my judgement.
Posted 2015-11-04 03:14:56
BlackflagBlackflag
Anyways, I'll come back to this in like an hour.
Posted 2015-11-04 03:14:56
adminadmin
Interesting feedback. I was definitely concerned in this debate that the language would become too technical because there's a lot of potential for that in a debate like this. I hope that I didn't sound *too* boring as a result.

I'll definitely work on my structure for the next few debates. Particularly in R2 things did get kind of messy. I also freely admit that I have no idea how to use structure in CX.
Posted 2014-11-02 03:20:11
whiteflamewhiteflame
Well, I disagree with quite a bit of what you said here, and I feel you're putting some words in my mouth at times, but nonetheless I feel the vote is mostly reasonable, that I did make the mistake in CX, and that you're thorough. Disagree as I may, it's still a constructive vote. I appreciate it.
Posted 2014-11-02 03:22:24

Rules of the debate

  • Text debate
  • Individual debate
  • 2 rounds
  • No length restrictions
  • No reply speeches
  • Uses cross-examination
  • Community Judging Standard (notes)
  • Forfeiting rounds does not mean forfeiting the debate
  • Images allowed
  • HTML formatting allowed
  • Unrated debate
  • Time to post: 5 days
  • Time to vote: 1 week
  • Time to prepare: 12 hours
This is a random challenge. See the general rules for random challenges at http://www.edeb8.com/resources/General+rules+for+random+debates+%28version+2%29