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Sunday, January 29, 2012

Interna

Our two lovely girls have learned to walk!



Gloria has fallen in love with a plush moose that I bought at the Stockholm airport. When I was pregnant, I gave it to Stefan "for practice," and since then the moose has patiently waited for its cue. It came when Gloria learned to point with her index finger. If her Swedish friend is in sight, she excitedly points and says "Da! Da! Da!" and, if one lets her, she takes the plush moose everywhere.

Lara has learned to drink with a straw, but my efforts to teach Gloria the same have so far been futile. Gloria is generally more picky with things that go into her mouth; she clearly doesn't like vegetables, and every other day refuses to drink juice. On the upside, she has learned that cardboard isn't edible, a lesson that I hope Lara learns before she has eaten up all picture books. We upgraded Lara to the next cloths size; she is now noticeably taller than her sister.

Next week, the babies are scheduled for the meningococcal vaccination, and then we're through with the first round of all the standard vaccinations: diphtheria, tetanus, pertussis, polio, streptococcus pneumoniae, haemophilus influenzae type b, hepatitis b, measles, mumps, rubella and varicella.

I am always shocked when I read about parents who aren't vaccinating their children. I thought that's a problem which exists only in the USA, but our pediatrician puzzled me last year by beginning our first appointment with a forward defense against arguments we hadn't intended to lead.

After some reading, I learned that about 3-5% of Germans believe vaccinations are unnecessary or harmful. UNICEF estimates that in 2009 in Germany the national coverage with the first measles vaccination was 96%. In the USA it was 92%. The basic reproduction number R of measles is estimated to be 12-18. Measles are one of the most contagious diseases known. The percentage of people that have to be immune to prevent a spread of the infection is roughly 1-1/R, for measles that's more than 93%; for mumps and rubella about 80%. However, not everybody who is vaccinated becomes immune.

Too few people know that the reason why the measles, mumps, and rubella (MMR) vaccination is repeated at least once is not that an individual's immunization is improved, but that in at least 5% of all cases the vaccination fails entirely. Our pediatrician said, 5% is what the vaccine producers are claiming, what he sees in practice is 20-30%. One of the probable reasons is that the MMR vaccine has to be kept cold, and any mistake along the delivery line makes the vaccine ineffective. The follow-up vaccination is supposed to bring down the failure rate, 1-(5/100)(5/100) > 0.99, or so the idea. But more realistically 0.96 (1-(20/100)(20/100)) ≈ 92% in Germany, or ≈ 88% in the USA.

And so, measles are far from going extinct and smaller outbreaks still happen. Sadly enough, even in Germany, people still die from measles. The case reported in the article is particularly tragic: A young boy, whose parents refused vaccination, fell sick with measles and, in the doctor's waiting room, infected 6 children, some too young to have been vaccinated; one died.

Ah, I am lecturing again, even though this was supposed to be a family-update post, sorry ;o)

So back on topic, Gloria and Lara had only mild side-effects from the vaccinations. We have exchanged the backward facing baby car seats with forward facing seats, and the girls can now enjoy watching the cars go by, while we can enjoy watching the babies watching. I didn't know how much I hated the backward facing seats till they were gone.

And I should stop referring to Lara and Gloria as "the babies" because they are now officially toddlers.

19 comments:

  1. I had exactly the same experience here (the UK) about vaccinations- I got a load of persuasion from the health centre when I took my baby (babies) along for their automatic vaccinations. It is quite shocking to me how many intelligent people in the UK do not want to get their children vaccinated (the MMR vaccination is still treated with suspicion). These diseases are awful for child to experience; there have been quite a few cases of measles in the UK in recent years.

    Luckily, it is a requirement of pre-school nurseries etc, that you must be vaccinated if you want a place, a condition that most of the stragglers do accept.

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  3. Hi Bee,

    And now the real fun begins as it’s evident that Gloria and Lara have the bipedal locomotion thing down pretty well; in fact you might be thinking too well;-) I can also appreciate your sentiments regarding people refusing to be immunized, as it seems the only thing which change these people’s minds are the tragic consequences such thinking eventually has come to pass. It’s often said that one can’t invoke laws to eradicate stupidity, which to be honest doesn’t bother me much and yet when stupidity takes down the innocent that’s where society must step in to at least try to mitigate its effect.

    "You have attributed conditions to villainy that simply result from stupidity"

    - Robert A. Heinlein, “Logic of Empire”

    Best,

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  4. Hi Phil,

    The weather here has not been very inviting lately, so the girls have not yet been for their first walk outside. But it seems about time to buy them shoes and then we'll see who runs faster ;o)

    Regarding the vaccinations, the problem is summarized very nicely in this quotation

    “The very success of immunizations has turned out to be an Achilles’ heel,” said Dr. Mark Sawyer, a pediatrician and infectious disease specialist at Rady Children’s Hospital in San Diego. “Most of these parents have never seen measles, and don’t realize it could be a bad disease so they turn their concerns to unfounded risks. They do not perceive risk of the disease but perceive risk of the vaccine.”

    Best,

    B.

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  5. Hi Bee,

    I look forward to the results of the Gloria and Lara races; now we will see as to why Zeno was wrong as witnessed when a bee needs to make ground on those who flee;-)

    As to those who choose not to immunize, the stupidity lies with assigning greater weight to a small and disputed possible danger, than to a well documented and therein demonstrated one. Then again if more people were better able to evaluate risk the casinos would be practically empty; come to think of it perhaps this could serve as a metric to be used to measure for signs of improvement. It’s also kind of ironic in a way as the expressed craps player’s wish when they roll the dice is often “baby needs a new pair of shoes”.

    Best,

    Phil

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  6. Yes, unfortunately in the good old USA religiosity breeds ignorance. There are all sorts of strange and wacky beliefs that people here are prone to. In the past we were better able to keep them on a short tether but now they have become unleashed and are wandering off the path. We need some good barriers like you have for Gloria and Lara, but unfortunately they don't work as well for adults.

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  7. Hi Eric,

    In my experience the new age pseudo -scientific are even more prone to make such misguided decison than those that you dub as the ignorant religious.

    Best,

    Phil

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  8. Phil, this is true that they are also a strong contingent of people who don't use logic. But overall I find there is one thing common to both groups. They come in with a belief and then amend the facts to fit their beliefs.

    BTW, I hope you are not including me among them simply because I believe in conservation of energy in the universe?

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  9. Swedish, German, and maybe English. Their "terrible twos" will be the stuff of YouTube legend. Then... world dictators. Who could resist?

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  10. Hi Eric,

    No I was simply pointing out that being religious as you agreed is not the root cause, as simply lacking the ability to recognize what logic is and to have it applied. That is I have difficulty with the current call of some from the scientific community promoting the expansion of atheism to the general public without recognizing that ignorance is ignorance and perhaps worse in the case where it requires study and thought to be guided completely without need of something simply to be believed. So if give a choice between living in a world filled with the stupidly religious or stupidly atheistic logic dictates I must choose the former as being the lesser of two evils.

    As for your own conviction I have no reason to be convinced either way as I've never given it much thought, while I do know that in the main you to be a person of reason.

    Best,

    Phil

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  11. Hi Phil,
    Good to hear that in the main you don't consider me among them. Despite my vituperative nature I actually do care what others think of me.

    As far as leaning too far in the religious or atheistic direction: I'm an agnostic. I know that there isn't enough information yet ( for me) to make a decision yet. As far as taking sides is concerned,I liken the atheists to believers in the old testament god where you are damned if you do and damned if you don't. You WILL be fucked if god is in a bad mood that day. So in that sense i would prefer the outcome you do and hope there actually is a religious sensibility to things in that there is some kind of justice and truth to things, if not on an individual scale but averaged over the entire universe.

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  12. Few things as delightful as watching a gleeful toddler toddle!

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  13. Hi Phil,

    The (German) article that I linked to above (it's from the RKI website, something like the German center for disease control) lists the most common reasons why people reject vaccination, though it doesn't explain how the list was assembled. Religious reasons don't play a big role, at least not in Germany. These reasons are only important in subgroubs of subgroups. Most of the reasons are new-agey (you need to have the "true" virus and lie in bed for 3 weeks and really suffer, it's important for your inner development) or conspiratory (big pharma just wants to make money, there are toxins in the vaccines) or just plainly wrong scientific information (vaccines are useless, vaccinated people die younger, vaccination doesn't work, or doesn't work as well as having the disease).

    Most of the people (allegedly) only make their decision after giving it a lot of thought (one hopes that the doctors insist). I believe one of the main problem is the difficulty to recognize what is scientifically reliable information. One of the first German Google hits for vaccination is for example a website where people can submit (alleged) side-effects they observe on their children after vaccination. It is full with stories from upset parents whose children could walk, but then they were vaccinated, and "unlearned" it, or children who never slept again through the night, etc. If you have any familiarity with scientific literature it's not difficult to see what are the obvious shortcomings of this site (control group? double-blind?), but I guess that without that background this site must be seriously scary. Best,

    B.

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  14. In Germany, and perhaps also in the UK, the whole anthroposophy/Steiner/Waldorf crowd is probably responsible for most of the vaccine woo, with there being a large overlap with the homeopathic folks. (Interestingly, vaccination is one area where it really is the case that something which is harmful in big doses is helpful in small doses, though of course via a different mechanism than that claimed by the homeopaths.)

    The state-run Kindergarten (capitalized since I'm using it in the German sense; often, what is Kindergarten in German is a pre-school in English while what is a kindergarten in English is a Vorschule (literally, preschool) in German) where my middle son (the older is too old; the younger is too young) is requires immunizations of all children. Unfortunately, there is not a law requiring vaccinations. I think there should be a law requiring vaccinations, with the only exceptions being people which cannot be vaccinated for medical reasons. Of course, adults have the right to kill themselves however they like. However, they shouldn't have the right to kill their children nor to endanger those who want to be vaccinated but can't (the people who can't be for medical reasons and children before they are old enough).

    This seems to be one area where Sweden is more sensible than Germany.

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  15. Hi Bee,

    The data in Germany seems to similarity project what I have witnessed here in Canada. That is in this country there isn’t much evidence of a religious component primarily guiding ill considered public opinion. However there is a growing number of what I call the new age pseudo scientific, which do place great faith in what they consider to be reliable sources. This of course takes us back to what stands as simply information and what represents to be knowledge. That is information being a thing which needs only to be taken in and thereafter believed; while knowledge is what’s discerned with having information being distilled through the filter of logic based reason.

    Sadly based on my own personal experience the latter is not something which is easily taught and I suspect it has always been this way. This may also give a hint as to why religion has remained for so long, with my contention being what is considered to be new age thinking is not thinking at all, yet simply being a substitute for religion as to have it to continue to not be required. That is I still remain convinced we need to place more emphasis and with it our focused attention on the decision maker, more so than on the source(s) being accessed. However this is admittedly a long term project, while as for now it seems only laws can have the innocent to be spared from the dire consequences of stupidity.

    ”A stupid man's report of what a clever man says can never be accurate, because he unconsciously translates what he hears into something he can understand.”

    -Bertrand Russell “The History of Western Philosophy” p. 90

    Best,

    Phil

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  16. Hi Arun,

    just the other day, I was thinking of your comment how the babies' "cuteness" changes when they learn new skills. The girls are much more interactive now, and try to take care of each other (like Gloria just tried to give Lara a pacifier). I guess one would need different categories of "cuteness" ;o) Best,

    B.

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  17. Bee - I see you now have two self propelled autonomous units! Please advise once they have enjoyed their first snowfall - never too early to get them started snowboarding.

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  18. Hi Snowboarder,

    The total snowfall here this winter amounted to about 1cm the week before Christmas and another cm this week, gone by noon the next day. I'm afraid there won't be much opportunity for snowboarding here. Best,

    B.

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