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Edited on Tue Aug-05-08 12:29 PM by HamdenRice
In other words, I think both sides are arguing past each other, because they are using the wrong standards for evaluating each other's positions. With any vaccine, the choice as to whether to take it (or administer it to one's children) is rooted in behavioral economics and not simply in the technical question of safety.
Most vaccines have small, statistical risks. Most provide great benefits to the public health and individual health. But if most people in society are vaccinated, one can get much of the private benefit without also being vaccinated.
If I'm not public spirited, this "free riding" seems to be acceptable behavior, even though the more people who take the free riding position, the less effective the vaccine becomes to the public health.
Imagine if instead of vaccines, we were taking about participating in a war of looting (kinda like what Iraq could have been). The state says: participate in this war, and everyone's income will quadruple as a result our stealing Country X's oil. Oh, yeah, there's a one in one million chance you will be killed in the war.
That's a classic economic problem, not a problem of warfare. If I participate and everyone participates, then I will be very well off. But also, I don't want to risk getting killed, even if the risk is very low. Ahaa! If everyone else participates, and I don't, I'll still get my quadruple income.
The reason the war analogy is apt is because the main interest in full vaccination by government, is in the public health, not in the risk/benefit calculation of the individual. People feel (rightly) manipulated in the vaccine debate, because the public health establishment has to get people to do something that in terms of behavioral economics actually is not in their interest -- kind of like rallying people to go to war for the nation, not the individual.
The vaccination debate is based on that paradigm and for one side to tell the other that they are stupid, a shill or a woo woo, is missing the point. From the perspective of economic rationality, the risk of vaccine looks much bigger than it is to most people, because most of the benefit (against which the risk is measured) will be available to an individual anyway if that individual doesn't take the risk -- but only if few other individuals make the same decision.
This is only heightened in the case of Gardasil, because most parents and indeed most sexually active people, over-estimate the ability of sexuallly active people to practice safe sex. In other words, balanced against the perceived risk is the thought (perhaps unrealistic), "if I'm not promiscuous and make my boyfriends wear condoms until I'm in a committed relationship, why take even the tiny risk that any vaccine presents?" Or to put it another way, I cannot control whether I will get measles, but I have some control over whether I get this virus.
The risk seems so big because the benefit appears easily obtainable by other means -- free riding, safe sex, or abstinence.
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