But, I would say that trying a different approach that acknowledges how patients feel could help rebuild public trust in healthcare institutions. Taking a broader viewpoint, this could save lives.
There are a lot of examples from the response to COVID: frequent early mixed messages around the effectiveness of masks for preventing infection and transmission not based on the actual understanding of said effectiveness but in order to manage supply shortages, arguable overstatement about the one-time long-term effectiveness of the initial vaccines against infection and transmission and not just severity of disease, overemphasis on ineffective measures like hand hygiene or six-foot-distancing over effective measures like air cleaning and masking based on the perceived willingness of the public to follow them, reduction of the stated duration of contagiousness without evidence of such.
It's one thing if it's genuinely not known what the best practices are, but knowing and misleading can confuse people who are willing to follow them and can further alienate skeptics who may seek out charlatans promising them the "real, unfiltered truth".
Policymakers could prioritize more or fewer vaccines, and the reasons to prioritize any particular vaccine would be expected to change over the decades.
Why the CDC isn’t prioritizing more vaccines might be seen as reckless to some. I think it’s a huge mistake that there isn’t a strep vaccine and a universal mandate for that, but it’s clearly not been historically prioritized. Strep has been known for decades to cause mental health conditions in children.
On the other hand, some infections might be better handled by vaccinating around where cases show up, a capability that is possible only now that we have electronic medical records, better tests, the information era, etc. Just-in-time logistics is a huge success story of the modern world.
Opinions of experts are important: expertise requires that opinions should change as the realities do.
An expertise that’s required of a policymaker is to maintain the effectiveness of their institutions by translating expertise into policies that are actually listened to. We have serious warning signs that public trust in healthcare is disintegrating, and that the vaccination campaigns are failing. Policies that are more focused could play out better.
If there are some illnesses we can handle with without universal vaccination, then including those vaccines as mandates means you’ll eventually get less compliance for high-priority vaccines too. This is what we’ve seen play out when the public distrusts medical authorities. We live in a democratic society and (not) listening goes both ways.
Public health requires over 95% vaccination. There has never been a realistic path to that other than requiring students to be vaccinated to attend school. Without that requirement, even well meaning parents forget or may not make it a priority.
It's not fair for kids and others vulnerable in society to die because certain parents are ignorant.
He wanted to make them unpopular, partially succeeded and now is trying to remove them.
The ability to have the public accept advice is a capability that has unquestionably eroded. However smart an expert may be, they aren’t helping anyone if people won’t listen when they speak.
The job of experts is mainly to provide information and the job of the public is to pay attention to relevant information. If the public decides to ignore advice (e.g. "no level of alcohol consumption is safe"), then that doesn't change what the advice should be.
The child vaccinations schedule is a step further than public advice due to its role in clinical practice and social expectation setting. Policymakers have a job that stands apart from that of both the medical experts and the general public, and the child vaccinations schedule is a policy document, not simply a medical one.
So with this approach, the US will be going the way of those developing countries.
Apart from the deaths, there will almost certainly be economic damage.
https://www.jpeds.or.jp/uploads/files/20240220_Immunization_...
Denmark doesn't do mandatory vaccines to the same degree as they catch early development of disease and treat it when it appears, consistently across the whole population.
The US has a case for mandatory multi childhood vacination as the data shows otherwise preventable childhood diseases will spread untreated and unchecked.
If you like Japan and Denmark and want the same - get onto improving the US health system for everybody regardless of employment status.
Abandoning a scientific approach and using whatever this administration is doing is what was voted for I guess.
The US requires 5-10 more vaccines for children by 5 years old than Japan does. Japan also has a much more spaced out schedule over those 5 years.
Given that the American health machine is largely driven by pharmaceutical companies, it seems likely that there is some fat that can be trimmed. Did they trim it here? Who knows.
Comparing the U.S. to Japan, or any other system for that matter, with a simple “well the vaccine schedule is different there” is simplistic and almost certainly not useful.
What is useful is to compare the U.S. with and without a certain vaccine or when delaying certain vaccines.
And we know how that plays out because all these vaccines have been added because of specific threats and actual diseases faced by Americans.
gnabgib•16h ago
Unrelated: MHRA approves self replicating mRNA Covid-19 vaccine (10 points, 5 days ago, 6 comments) https://news.ycombinator.com/item?id=46500392