[extropy-chat] Are vaccinations useless?

[Rafal Smigrodzki]

On 3/14/06, "Hal Finney" <hal at finney.org> wrote:
> 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?
>
### Yes, I would agree with this claim, at least when talking about
the nineteenth century and before.

--------------------------
> > 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.

### We'll be very curious to hear your summary.

---------------------

>
> > 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.

### Can't write more today... but I hope I can find my previous post
and link to it. It's possible it is on wta-talk and as such I couldn't
link to since I am not subscribed there.

------------------------

>
> > 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
>
### I would tentatively accept it. Most of the diseases for which
vaccines were developed in the last century were either not very
common (symptomatic polio), or do not kill often (chickenpox). I
focused on smallpox after Robin indicated he doesn't think
vaccinations made much difference in the change of frequency of
infectious disease, and smallpox makes in my opinion a great example
to the contrary.

Rafal