[extropy-chat] Are vaccinations useless?

[Hal Finney]

Rafal Smigrodzki writes:
> The term "insignificant" is quite vague. If five years is
> insignificant, compared to thirty years, then yes, medicine as defined
> above (or let's say, as delivered by doctors and nurses) indeed played
> an insignificant role in extending life. Mysterious factors, perhaps a
> combination of better nutrition with public health measures and
> changes in hygiene played a vastly greater role. If five years sound
> like a good deal you get for your insurance premiums, then no,
> medicine does not play an insignificant role.

Perhaps my word "insignificant" was too strong.  The textbook I quoted
states "The consensus is fairly clear over the minor role of medical
practice" (in reference to the historical declines in mortality rates).
Would you agree with that characterization?

> I took issue with Robin's claim that smallpox vaccination played a
> thoroughly insignificant role in the reduction of its prevalence, and
> so far Robin did not point me to any evidence in favor of this claim.
> The larger issue, that is the total impact of our current and future
> medical spending on our own survival is something we discussed last
> year primarily on wta-talk, although the last part of the exchange was
> posted to exi (at that time the peans to the North Korean way of doing
> things convinced me to unsub). Robin claimed that medicine does not
> have any definite positive net effect on survival. I hope that when he
> comes back he will give us some more arguments.

It seems that the widely cited reference to the history from 1750-1900,
when smallpox vaccination came into widespread practice in England and the
U.S., is McKeown.  His book was not available at the library but I ordered
a used copy from Amazon.  I will describe his arguments when I get it.

> BTW, the Rand study he quotes is junk. I am busy today but I'll try
> find my critique of that study somewhere in the archives.

I did read the Rand book, too, a few months ago.  I would be interested
to hear your comments.

> I think that it is much more important to talk about the usefulness of
> today's medicine to us (the subject of the discussion between Robin
> and me last year), than the usefulness (or uselessness) of 19th
> century medicine to our great-grandparents (the subject to which this
> thread seems to have drifted). The consensus among economists and
> historians is that medicine was not very useful two hundred years ago
> but is clearly useful now, although there are huge differences in the
> economic efficiency of various therapies. Robin's ideas on the history
> of medicine are mainstream but his extrapolation of these notions into
> present is far out of it.

Keep in mind that it was you who asked to focus on smallpox vaccinations!
That inherently requires us to discuss the 19th century.  What do you
think about the evidence I quoted claiming that 20th-century vaccinations
provided only a limited benefit, totally around 18 months of added lifespan?
http://lists.extropy.org/pipermail/extropy-chat/2006-March/025701.html

Hal