Resolved: The US should make vaccines mandatory

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Resolved: The US should make vaccines mandatory

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The debate is finished. The distribution of the voting points and the winner are presented below.

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After 1 vote and with 3 points ahead, the winner is...

whiteflame

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Publication date: 10.13.2018 09:59PM
Last updated date: 11.13.2018 06:39PM
Type: Standard
Number of rounds: 4
Time for argument: Three days
Max argument characters: 8,000
Voting period: Two weeks
Point system: Multiple criterions
Voting system: Open

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Description

--Topic--
Resolved: That the US should make vaccines mandatory

--Definitions--
Vaccinations: A biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe, its toxins or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as foreign, destroy it, and "remember" it, so that the immune system can more easily recognize and destroy any of these microorganisms that it later encounters.
For more info on vaccines see here http://www.who.int/topics/vaccines/en/
Mandatory: required by law or rules; compulsory.
Ought: indicates moral desirability

--Rules--
1. No forfeits
2. Citations must be provided in the text of the debate
3. No new arguments in the final speeches
4. Observe good sportsmanship and maintain a civil and decorous atmosphere
5. No trolling
6. No "kritiks" of the topic (challenging assumptions in the resolution)
7. For all undefined resolutional terms, individuals should use commonplace understandings that fit within the logical context of the resolution and this debate
8. The BOP is evenly shared
9. Rebuttals of new points raised in an adversary's immediately preceding speech may be permissible at the judges' discretion even in the final round (debaters may debate their appropriateness)
10. 8000 characters maximum
11. Violation of any of these rules, or of any of the description's set-up, merits a loss

--Structure--
R1. Pro's Case; Con's Case
R2. Pro generic Rebuttal; Con generic Rebuttal
R3. Pro generic Rebuttal; Con generic Rebuttal
R4. Pro generic Rebuttal and Summary; Con generic Rebuttal and Summary

== Additional Information ==
The vaccines schedule and vaccines that this debate is refering to are the vaccines recommended by the CDC. (see here https://www.cdc.gov/vaccines/vpd/vaccines-age.html). Obviously those who are medically unable to receive vaccines will be exempt.

Round 1

1. http://www.who.int/news-room/fact-sheets/detail/measles

10.15.2018 11:35PM

Pro

Thank you whiteflame for accepting this debate. I am running low on time so I apologize that my arguments aren't as well developed as I'd like them to be.

-----

1. Vaccines are safe and effective

Vaccinations prevent a number of serious diseases that cost billions of dollars and millions of deaths each year. Measles, for example, killed over 80,000 people last year. The measles vaccine resulted in an 84% drop in measles death between 2000-2016 (1). Sadly because people have failed to vaccinate themselves and their children measles has been on the rise again. The outbreak is a direct result of people failing to vaccinate (2).

Another example of the effectiveness of vaccines is smallpox. Smallpox once killed 300 million people in the 20th century alone (3) but has been completely eliminated thanks to vaccinations (4).

2. Failure to vaccinate puts others at risk

There are many people who cannot get vaccinated due to being too young to receive the vaccines, medical illness, and autoimmune disorders that cause people to be unable to receive the vaccine. By not vaccinating yourself and others you are putting those people in harms way. This is called herd immunity as WHO explains (5):

Efficacious vaccines not only protect the immunized, but can also reduce disease among unimmunized individuals in the community through “indirect effects” or “herd protection”. Hib vaccine coverage of less than 70% in the Gambia was sufficient to eliminate Hib disease, with similar findings seen in Navajo

populations.29,30 Another example of herd protection is a measles outbreak among preschool-age children in the USA in which the attack rate decreased faster than coverage increased.31 Herd protection may also be conferred by vaccines against diarrhoeal diseases, as has been demonstrated for oral cholera vaccines.32

“Herd protection” of the unvaccinated occurs when a sufficient proportion of the group is immune.33 The decline of disease incidence is greater than the proportion of individuals immunized because vaccination reduces the spread of an infectious agent by reducing the amount and/or duration of pathogen shedding by vaccinees,34retarding transmission. Herd protection as observed with OPV involves the additional mechanism of “contact immunization” – vaccine viruses infect more individuals than those administered vaccine.10

Thus failure to vaccinate puts those who cannot be vaccinated in harms way. An example of this (6):

A Colorado study last year showed that children of parents who refuse vaccinations against whooping cough are 23 times more likely to develop the disease than children who get the shots. Moreover, those in the anti-vaccine movement who insist that their actions do not risk harm to anyone other than their own unvaccinated children ought to take a closer look at those five California deaths to pertussis.

All five were infants younger than 3 months, too young to be fully vaccinated themselves, but terribly vulnerable to a highly contagious disease passed around by unvaccinated children.

Let's be very clear about this: Parents who skip vaccines for their own children are endangering the health and lives of other kids. And none of their justifications for such a selfish, short-sighted act stand up to scrutiny. Some parents pretend that their children don't need to be vaccinated because their friends and classmates have been vaccinated, claiming that this "herd immunity" will protect them all.

We have a duty and moral obligation to protect those around us. Drinking while driving is illegal because it puts others in harms way by deliberately driving drunk. Failure to vaccinate should be treated the same way. Failure to vaccinate causes significant harm.

3. Mandatory vaccination policy is good policy

A. Vaccines save money

One of the common tropes among anti-vaccine advocates is that big pharma companies are profiting billions of dollars off of vaccines and are corrupt. Whether or not that is true, failure to vaccinate costs far more than being vaccinated. Vaccinations saved $44 for every dollar spent which quickly adds up (7).

B. Dangers of broad exemption

One of the common arguments opposed to vaccination laws is that we should have exemptions for philosophical or religious reasons. However broad exemptions hurt herd immunity (8):

The ease with which non-medical exemptions can typically be obtained has raised concerns among many that the benefits of widespread immunization are being compromised.[87] Because of the nature of medical exemptions, unvaccinated persons in a community with only medical exemptions would be expected to be few and dispersed. Herd immunity can be attained, and protection is ensured for both the vaccinated majority and the unvaccinated few.[88] Broadly granted philosophical and religious exemptions make herd immunity more difficult to attain and increase the risk to the community. This risk is exacerbated by the fact that many of those who apply for such exemptions “will cluster together in one geographic area.”[89] This cluster effect tends to increase the likelihood of serious outbreaks:

Recent studies have shown that clusters of exemptors, who are significantly more susceptible to contracting vaccine preventable illnesses, pose an increased risk of spread of diseases not only to their unimmunized peers, but also to the surrounding, largely vaccinated population.[90]

4. Summary

I have demonstrated here that vaccines are safe and effective at preventing costly and deadly diseases throughout the world each year. We have an ethical obligation to protect those from these deadly diseases. We cannot allow free choice or philosophical conscious to allow them to put others in harms way.

Please vote pro. Thank you.

6. Sources

2. https://www.cdc.gov/measles/cases-outbreaks.html

3. http://www.bbc.co.uk/history/british/empire_seapower/smallpox_01.shtml

4. http://www.who.int/csr/disease/smallpox/faq/en/

5. http://www.who.int/bulletin/volumes/86/2/07-040089/en/

6. https://www.oregonlive.com/opinion/index.ssf/2010/07/putting_other_kids_in_harms_wa.html

7. https://www.vaccinestoday.eu/stories/vaccines-save-lives-and-money/

8. https://dash.harvard.edu/bitstream/handle/1/8852146/Balding06.html?sequence=2

10.16.2018 02:52AM

Con

I. Liberty

To examine what the loss of liberty under Pro’s case looks like and why that loss matters, we have to answer a series of relevant questions.

1) What is being restricted? What rights are being challenged in those restrictions?

Pro is fundamentally restricting the capacity for individuals to make medical decisions for themselves and their family. By denying religious exemptions, Pro denies many their most basic exercise of religious freedom as it applies to their persons. The loss of medical autonomy in individuals who are psychologically capable of making their own decisions has never happened before, and the effect on parental rights is similarly unprecedented.

2) To what degree are those losses felt? What are the broader implications of that loss?

While few religions outright ban the practice, individuals can find that their religious beliefs conflict with vaccination, just as some take issue with transplantation or blood transfusion. Components of certain vaccines, such as gelatin derived from pigs [1], and the usage of chicken eggs and animal cells[2] and embryonic fibroblasts[3] to incubate vaccines also suffice as a source of disagreement strong enough for many to abstain. Many ideologically-driven people are also generally side against western medicine, or do not wish to support pharmaceutical companies. Pro is effectively denying them any capacity to act based on their beliefs, invalidating these concerns by establishing that all religious or ideological exemptions are insufficient.

Medical autonomy and parental rights both fall under the purview of consent, the former being individual and the latter as it applies to those who cannot legally consent. When the only meaningful source of autonomy is garnered by circumstances outside of your control (i.e. being physically unable to take them), Pro is effectively eliminating the capacity of their patients to select what treatments they seek. Note that this isn’t about engaging in a practice that actively harms other people; Pro is requiring every individual to seek out a doctor, make a series of appointments continuously over their lives, subject themselves to injections with materials they may not understand or trust, with the eventual goal of maybe preventing some diseases from spreading that are largely outside of the control of that individual.

3) Can an individual recover their liberty? Is there a way to opt out?

Pro is effectively making it impossible to recover their liberty. What he’s done is create a policy that will affect all citizens regardless of where they live and how they live their lives. A child schooled within a home is far less of a danger to society at large than one attending public school, yet Pro treats them the same. The only means Pro provides for opting out is medical, though that requires a doctor to agree that there is a clear risk for the patient. Relying on someone else to give you permission not to get vaccinated is not liberty in any sense of the word.

It’s also not always clear, even to medical professionals, when a patient is being harmed by vaccines. Particularly for parents who are getting their children vaccinated, they might see symptoms associated with the vaccines that providers simply don’t recognize as being vaccine-related. In a system that mandates vaccination, those parents are forced to continuously submit their children to those vaccinations, regardless of those consequences. There are cases, like this one with Caryn Tabor and her son, Gunnar, where treatment with the flu vaccine led to some serious consequences that doctors insisted had nothing to do with the vaccination.[4] In states like West Virginia, where there is already a mandate, these kinds of cases do happen and parents are justifiably concerned for their children, yet the case for medical exemption requires the support of the individual’s doctor and that can be incredibly difficult to acquire.

II. Health Risks

Much as vaccines are effective preventative measures, they can cause a great deal of problems. Common problems like fever and fatigue can exacerbate other medical problems. Less common problems, including seizures and high fevers, can cause a great deal of medical harm by themselves, and rarer concerns like comas, brain damage and even death can easily exceed the harms of the illnesses themselves.[5]

By increasing the number of people receiving vaccinations, Pro is increasing the number of people exposed to these risks, regardless of whether they are in communities with herd immunity. The risks that accompany vaccination would be spread across a far greater population than would the protective effects, as not everyone who gets vaccinated will be exposed to those illnesses, while everyone who is vaccinated is exposed to the risks of vaccination. And, while there is always some uncertainty with regards to causation, the Vaccine Adverse Event Reporting System (VAERS) suggests that the toll is striking: 1,737 cases, including hospitalization, disability, life-threatening cases and even deaths.[6] Note that this is only for current vaccines – Pro’s case would apply to all future vaccines as well, increasing the number of adverse events.

But this isn’t just about the numbers game. Pro is changing the way people interact with these numbers by removing their capacity to consent to vaccination. His mandate takes the choice to vaccinate away from them, which means that any resultant symptoms are essentially forced on the patients, placing the fault entirely on those who required and/or gave them these vaccinations, i.e. the government and the medical establishment.

III. Backlash

Pro sews mistrust in the medical profession. Since doctors are the only ones who can provide this information to the government, vaccine skeptics are likely to avoid them altogether, especially for their children. Remember, many who are anti-vaccination believe that vaccines are a substantial threat to their health, which could lead many to avoid seeking help for themselves or their children until they are in an emergency. Pro wants more preventative care, but he’s pushing these people away from medicine altogether. Protests and resignations have already been sparked by several previous mandates, suggesting that Pro’s policy, which is far more extensive, will turn objectors into martyrs who would rather go to jail than accede to the demands of the government.[7-9]

And for those who do participate, whether it is individuals who feel their rights are being abused or are actively seeking damages for both potential and actual harms (both caused and perceived to be caused by vaccines), Pro is inviting a tremendous number of legal cases to be filed against both the government and the medical establishment. Many of the various side effects of vaccines are frightening, and patients experiencing them or watching their children experience them would have every reason to seek extensive damages. Without the consent of their patients to administer vaccines, doctors would have to contend with a great deal more lawsuits, increasing the cost of medical malpractice well beyond its current $55.6 billion a year and debilitating the medical system.[10] If our aim is to better manage health care crises, this is going to make that more difficult, increasing costs on patients to pay for defending against these lawsuits.

Conclusion:

Making vaccines mandatory sounds great in theory, but it does too much damage in the process. Destroying trust in the medical establishment, inviting massively costly distractions, guaranteeing human suffering from vaccine side effects, and doing irreparable damage to the basic rights and protections we rely on are simply not worth the purported benefits, which I will focus on next round.

1. https://pewrsr.ch/2k9RQ7L

2. https://bit.ly/2JFmUHG

3. https://bit.ly/2pJC47n

4. https://bit.ly/2E8crHr

5. https://bit.ly/2jxypnK

6. https://bit.ly/2QE9UGa

7. https://bit.ly/2yuRIHw

8. https://bit.ly/2OgnUcz

9. https://bit.ly/2RDShYr

10. https://bit.ly/2pMECBL

Round 2

2. https://abcnews.go.com/Health/DiabetesResource/story?id=4741254&page=1

10.18.2018 07:34PM

Pro

Thank you whiteflame for allowing the restart!

---

1. Loss of freedom

There are two fundamental things in conflict: the right to freedom and the right to be safe from vaccine-prevented communicable disease. Ultimately the right to be safe from communicable diseases must win out over philosophical and religious freedom. As I noted in round 1 unvaccinated people not only pose a significant threat to themselves, but also to others who cannot be vaccinated. It is immoral and wrong to put other people in harms way.

The US already restricts religious freedom in certain ways. For example in some cultures and religions female genital mutilation is required or expected. The US bans this practice because we recognize the female's right to be safe from the dangers and harms of FGM outweigh the culture and religion (1). In another example, JW's who refuse medical treatment for their children are often times legally liable for their deaths, and rightly so (2).

The American Academy of Pediatrics notes: "Because religious exemptions to child abuse and neglect laws do not equally protect all children and may harm some children by causing confusion about the duty to provide medical treatment, these exemptions should be repealed." (3)

Failure to vaccinate children is in every sense of the word child abuse. Do we really want a world in which parents can put their children and many others at significant risk all because of their beliefs?

2. Health Harms

Con's citing of the VAERs has several issues. First the VAERs database is self-reporting and just because someone reported something doesn't mean it's caused by the vaccine. As the VAER site notes:

When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event."

---

A report to VAERS generally does not prove that the identified vaccine(s) caused the adverse event described. It only confirms that the reported event occurred sometime after vaccine was given. No proof that the event was caused by the vaccine is required in order for VAERS to accept the report. VAERS accepts all reports without judging whether the event was caused by the vaccine.

Secondly con cites 1,737 cases, a minuscule number compared, many of which are not necessarily even related to the vaccine, as compared to the significant harms of communicable diseases. There were over 20,000 cases of whooping cough in the US in 2015 alone (4). There are over 100K deaths due to whooping cough world wide (5). Many of these deaths were from innocent infants who were too young to be vaccinated. Irresponsible people who choose to not vaccinated are directly causing theses deaths (6).

3. Backlash

This is con's only contention that holds any weight. There will undoubtedly be backlash, but the risks of communicable diseases outweigh the potential backlash. Gaps in safety knowledge is one of many reasons why people are against vaccines. Making vaccines mandatory could help bridge this gap. Sadly much misinformation and deliberate fearmongering has brought about a dangerous mistrust in the medical community.

Please vote pro, thank you!

4. Sources

1. FGM has been a crime since 1996 although it's sadly rarely enforced. https://thehill.com/opinion/immigration/373090-female-genital-mutilation-is-a-crime-in-the-us-so-why-is-it-rarely

3. http://childrenshealthcare.org/wp-content/uploads/2013/11/AAP-policy-statement.pdf

4. https://www.cdc.gov/pertussis/outbreaks/trends.html

5. https://www.cdc.gov/pertussis/fast-facts.html

6. http://www.vaccineinformation.org/infants-children/testimonies/whooping-cough/serena-king.asp

10.19.2018 05:57AM

Con

Pro's argument largely assumes a better world, one where vaccines are plentiful and easily affordable. It's those assumptions, as well as his assumptions about human nature, that doom his case. By far Pro's biggest mistake is not presenting a clear plan text. Without said plan text, Pro’s case amounts to the following: make all vaccines mandatory for everyone within the US, with the two caveats that vaccines will be taken on the schedule stated by the CDC and that medical exemptions will exist.

So, what’s missing?

A) Who pays?

By mandating vaccinations, Pro is forcing citizens to become unwilling customers. Everyone will have to pay, regardless of qualms and regardless of their finances. Pro does not subsidize these vaccinations, which makes his case inherently classist; those who can easily afford the vaccines will be fine, and those who can’t will have to do choose between necessities and vaccination. The cost to fully vaccinate a child who has private health insurance was $2,192 in 2014, and that’s for someone with insurance.[11] That number doesn’t include any adult vaccines, boosters, or repetitions, which require people to pay continuously over their lifetimes. These prices will increase, as pharmaceutical companies have every incentive to raise them when the public has no choice but to purchase their vaccines. Pro also isn’t giving any kind of timeframe in which people must get vaccinated, so we must assume that the mandate takes effect immediately, meaning even those who are cash poor in the short term have no choice but to pay up. That is, of course, unless they can refuse…

B) What will happen to dissenters?

About 9% of the population is comprised of “anti-vaxxers,” i.e. people that refuse to vaccinate out of fear and mistrust.[12] Telling them they must do it will not sway them - in fact, reducing rates of these diseases will likely entrench their beliefs.[21] Add to that the numerous people who lack the means to afford vaccination, and you’ve got a large portion of the population that will refuse or fail to vaccinate. What happens next? Pro doesn’t provide any enforcement mechanism.
That leaves two options. One, Pro’s case has no enforcement. That leaves his case without any solvency; since issuing a mandate means absolutely nothing if no one has any incentive to adhere to it. Two, Pro’s mandate is enforced, at minimum, via fines and jail time. The poor would be fined for their inability to cover the costs of vaccinating, and then be jailed for not paying the fine. Pro is also turning every vaccine skeptic into federal criminals who will wield their imprisonment for civil disobedience. Parents are already being pushed away from the public school system and into protests due to far less daunting mandates.[13] This will lead to wide-scale protests, overburdening the court and prison system for as long as the federal government continues to prosecute them, and additional sentences every time they missed their boosters or yearly flu shot. Pro’s case also doesn’t address shortages, like those seen with the flu vaccine year after year.[14] With only the medical exemption left, anyone who gets to their flu shot too late would be prosecuted.

C) Who enforces this? How will they monitor patients? What information can they access?

Several different agencies could be in charge: the FDA, CDC, NIH, and PHS, at least, would have a stake. Their aim would be unprecedented: maintaining medical records for the entire US population and forcing unnecessary medication on them. They would have to monitor every single individual to ensure that they a) get every vaccine, b) get booster shots, c) achieve sufficient immunity, d) maintain conditions sufficient to justify medical exemptions, and e) do not suffer severe side effects. That’s going to require a lot of patient records, meaning Pro is eliminating their medical privacy. You don’t have to be an anti-vaxxer to have a problem with the loss of doctor-patient confidentiality and physician-patient privilege. Pro is upending legal and ethical concepts that are essential to establishing and maintaining trust between a patient and their treating physician. This will do far more harm to health care than any of the disease epidemics Pro purports to prevent.

But let’s get into Pro’s arguments.

1) Disease Burden/Vaccine Effectiveness

Pro cites global death tolls. Pro’s case only applies to the US. There has been a total of one deaths in the US that has been definitively linked to measles infections in the past decade.[15] The smallpox vaccine example also doesn’t apply, since none of these diseases result in anywhere near the same level of harm. Vaccines also have differing rates of effectiveness, with as many as 10% of vaccinated healthy individuals failing to mount sufficient responses, meaning that the effectiveness of vaccines are always limited and reaching herd immunity for some diseases may remain impossible.[16]

2) Herd Immunity

The threshold for herd immunity is mostly around 80-85%, with only two diseases exceeding that number.[17] Across the US, 95% of children in kindergarten are vaccinated, and even in states with high exemption rates like Colorado, 82% of children still have this vaccine.[18] Without any federal mandate, we already have herd immunity for every vaccinable disease. As such, spread of these illnesses will always be largely contained, preventing large scale outbreaks and protecting vulnerable populations. Even Pro’s source claiming that it makes vaccinated individuals more susceptible provides no evidence that herd immunity fails to protect vaccinated individuals, only that the failure to mount sufficient response leaves some vulnerable, which I have also argued. In fact, there’s “surprisingly little evidence that tough laws make a big difference to vaccination rates. European countries that are similar in most respects (such as the Nordics) may have similar rates for jabs that are mandatory in one country but not in another—or very different rates despite having the same rules. Rates in some American states where parents can easily opt out are as high as in West Virginia and Mississippi, which have long allowed only medical exemptions.”[19]

3) Putting Others at Risk

If Pro truly feels that anyone who gets sick and spreads that illness to others is reprehensible enough to warrant fines and imprisonment, then why isn’t he mandating the use of face masks when one feels ill? Why not fine someone for failing to sneeze or cough into their elbow? Why is someone who chooses to go to work sick with a cold or the flu less responsible for that behavior simply because they got vaccinated before they did it? If anything, these individuals look a lot more like drunk drivers: they are engaging in risky behavior knowing full-well that they can injure and even kill other people. Pro pretends to be acting on moral obligation but targets an inaction that by itself causes no harm to others.

4. Financial Outlook

Once again, Pro inflates his numbers by misapplying them. That $44 figure comes from low- and middle-income countries, which do not include the US.[20] The article does state that developed nations also benefit, but provides no numbers to support it. Reaching herd immunity is likely to result in diminishing returns on any gains. The authors also don’t take into account the repercussions I discussed in my case, and as such do not include the costs of lawsuits (both for taking those who refuse to court and for those who seek damages from the medical establishment/government), costs of imprisonment in an already overcrowded prison system (as well as lost wages of those imprisoned), and the total medical costs of side effects caused by vaccination. These costs will likely outweigh any potential gain.

11. https://nyti.ms/2MwaAft
12. https://wapo.st/2A7TikR
13. https://bit.ly/2Eij8GO
14. https://bit.ly/2ynNL8H
15. https://bit.ly/2yE3PCb
16. https://bit.ly/2RJQyRn
17. https://to.pbs.org/1tKxYdQ
18. https://cnn.it/2EigqRS
19. https://econ.st/2CGvvuN
20. https://bit.ly/2ygHxat

21. https://cnn.it/2Pe1DvS

Round 3

1. https://www.precisionvaccinations.com/measles-management-costs-range-over-25000-patient

10.19.2018 11:01PM

Pro

It appears that con has dropped their entire opening case and instead chosen to create new arguments in their speech. Unfortunately con's new case is even far weaker than his old one! Let's dive in!

== Con's New Case ==

1) Cost

Let's first compare the price of vaccination to the price of hospitalization. Let's assume for a moment that con's figure of $2194 is correct. The cost of one case of measles is $4875 per person (1) and the public cost is even higher. In 2013 one case of measles spread do over 50 and cost New York City over 300,000 (2)

Now in an ideal world and an ideal plan, the government will pay. I believe access to medicare is a human right. I would love to see a medicare for all system implemented which would provide free vaccinations and medical cost. Since this debate is not about medicare for all, I'll just leave it at that.

2) Dissenters/Enforcement

Since these two contentions are intertwined I will answer them both here. I completely disagree that mandatory vaccinations would require the government and multiple departments to have access to everyone's health records. As it currently stands, all states in the US currently require vaccinations in order to attend public school (3). Because most states allow for personal and religious exemption, my plan will close that loophole. In other countries like Australia they offer financial incentives to vaccinate by giving A$129 per child who's up to date on their vaccines (4).

Thus to answer the dissenters: their children will be barred from attending schools (both public and private) unless they are fully vaccinated. They'd also lose possible financial incentives for each vaccinated child.

== My Case ==

1) Disease Burden/Vaccine Effectiveness

Con's criticism is that my case cited global statistics and not US only statistics. Since con wants some US-specific stats, I will provide some here (5):

In 2014 there were 2791 cases of hepatitis B resulting in over 500 deaths.
In the same year there were 10,000 cases of chicken pox resulting in 4 deaths.

Con cites only one case of measles death in the US and their source backfires entirely (7):

"We know that Washington state is a state with one of the highest percentages of religious and philosophical exemptions for vaccines in the country," he said. "It seems a reasonable conclusion that this death occurred because of inadequate immunization levels, but more epidemiological investigation will have to take place to find out."

The article also states that this woman was immuno-compromised and thus could not be vaccinated. This is why it's so vitally important for people to be vaccinated. The article also states that measles was declared eradicated in the US in 2000 meaning "it is not endemic, or no longer circulates on its own." Unfortunately that has changed in recent years. This is why it's vitally important to close these loopholes.

2) Herd Immunity

Con does not question the value of herd immunity but rather argues that there already exists a high level of herd immunity. This is true because of the school mandate laws (see enforcement above). Before CA passed a tough legislation on vaccines, some schools had less than a 50% vaccine rate, far below any rate of vaccine herd immunity. (8)

Con also stated that vaccines have different rates of effectiveness, which is true. It is true that 2-10 percent of individuals fail to mount a response. Conversely though that means 90-98 percent of vaccines are effective! Con's own word backfires here: "herd immunity for some diseases may remain impossible." All the more reason to make sure that your child is safe from those diseases.

3) Putting others at risk

Con's "where will this end" is a slippery slope fallacy.

Pro pretends to be acting on moral obligation but targets an inaction that by itself causes no harm to others.

This statement is false and I've proven that beyond reasonable doubt in this debate. The fact that parents will allow their children to be exposed to these deadly and terrible diseases is morally reprehensible.

4) Financial outlook

Con makes several errors in his response. Most absurdly no one will go to jail for failing to vaccinate (see enforcement). Con repeats his assertion of side effects which was utterly destroyed in the round above. Since con wants a more US-specific number than the $44 figure, the CDC noted that vaccines prevented 21 million hospitalizations and millions of children from diseases which adds up to huge savings (9).

Sources

2. https://www.beckershospitalreview.com/quality/2013-measles-outbreak-cost-new-york-city-395k-cost-analysis-shows.html

3. https://www.cdc.gov/vaccines/imz-managers/coverage/schoolvaxview/requirements/index.html

4. Between 18-24 months of age https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216445/

5. https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/E/reported-cases.pdf

6. https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/E/reported-cases.pdf

7. https://www.forbes.com/sites/tarahaelle/2015/07/02/first-u-s-measles-death-in-more-than-a-decade/#4f6981e8a196

8. https://www.nytimes.com/2015/07/13/opinion/californias-tough-vaccination-law.html

9. https://www.cdc.gov/media/releases/2014/p0424-immunization-program.html

10.22.2018 07:01AM

Con

To start, I did not drop my opening case. R2 was the first round I could rebut Pro (as per the rules) and I used it to do just that. This round will cover everything.

On my case:

Loss of Freedom/Backlash

Pro concedes the inherent loss of freedom and drops all its impacts. Pro is forcing individuals who have strong fears of vaccination to receive said vaccinations, effectively invalidating their religious freedom. At minimum, this applies to 9% of the US population.[9] That’s over 29 million people, all of whom are being told that their freedom of religion cannot be applied to their own bodies or those of their family. That population is far larger than all the epidemics Pro has cited, and the damage far deeper than any of these short-term illnesses is likely to cause.
Pro also drops consent. Everyone who gets vaccinated because of this mandate does so without consent. 16% of the population either thinks vaccines are safe or is unsure of their safety.[9] That’s over 52 million people, all of whom lose their right to consent. Nothing destroys trust in the medical system so thoroughly than having basic decisions about your own body taken away. Pro also drops the story of Caryn Tabor where a vaccine was causing harm to a child and refused medical exemption.[4] If not vaccinating is always child abuse, as Pro claims, then what would he call situations like this where vaccinating is causing clear and ignored harms? If anything, subjecting a child to this is far more abusive.
Taken together, this means that a huge swath of the population will justly feel that their rights have been violated. Pro concedes the points I made under backlash, and if harm to self, children and others is what makes something immoral, then the impacts of this point far outweigh any harm Pro ascribes to any lack of vaccination. The small protests that currently occur for local mandates will become massive, country-wide efforts, some of which may turn violent as many of these people believe the vaccines being forced on them are actively damaging them and their families. Those tens of millions of people will flee from their doctors, failing to seek treatment for a variety of diseases and increasing their spread. That includes diseases that aren’t vaccine preventable but are treatable, which Pro’s case does nothing to ameliorate. Those that do submit are far more likely to sue their providers, increasing the cost of care for everyone and decreasing access to that care as a result. Each illness will do more harm in Pro’s world, and many will spread far more easily.

Health Risks

Pro drops the first link on this point, which provides clinically-established incidence numbers for every vaccine that he is mandating, and therefore establishes that a portion of the population that is directly being harmed by vaccination. This means that many of the patients who seek lawsuits for damages will have convincing cases, costing the government and medical institutions tremendously in malpractice lawsuits. This supercharges my backlash impacts.

On Pro’s case:

Putting others at risk

Even with everyone taking every vaccine, diseases will still spread by bad behaviors. Pro is continuing to allow directly dangerous behaviors, revealing his willingness to allow people to put each other at risk. Clearly, he recognizes that some liberties matter more than doing everything possible to prevent disease outbreaks, so when he tells you that safety outweighs freedom when it comes to disease spread, he’s more than willing to cherry-pick applications of that principle.

Dissent/Enforcement

Before this round, Pro never said that that only applied to a specific group (i.e. children going to school); all he said was that everyone must be vaccinated, with only a medical exemption available. Now, he wants to apply his case only to public school kids, automatically granting exemptions to others. He’s also providing a financial incentive to vaccinate. He never even suggested these planks before, and it is grossly unfair for Pro to be able to alter his case so late in this debate. Pro is trying to shift out of my arguments by presenting what is basically a brand-new case because he made a bad choice not clarifying in R1. I should also note that, in the rules, Pro states that both of our cases are confined to the opening round. Clarifying his case later is against the structure Pro himself established. Voters, hold Pro to his opening case and take a stand against this abuse.
If you buy that this tactic is abusive, extend both arguments: the pervasive damage to the doctor-patient relationship that will push many away from the health care system completely, as well as the massive jailing and court costs, both of which compound the backlash harms. Even if you’re considering Pro’s new case, it’s still subject to much the same backlash in the form of widespread protests and distrust of medical professionals.

Cost

Pro concedes this point, failing to challenge any of the costs I cited. Pro ignores the fact that that $2,194 figure only applies to child vaccines for families with insurance, so that number does not include what insurance covers, and will continue to increase rapidly as companies raise their prices due to the requirement to purchase them. Note that Pro’s case provides absolutely no recourse for people who cannot afford these costs (the financial incentive he talks about covers less than 1/17th of the lowest possible cost), so that means poor patients will have to pay for vaccination in place of necessities like food and housing. Pro admits that there is no recourse in status quo or in his case, and everyone is paying these costs, whereas comparatively few are seeking treatment of vaccinable diseases. Even if the overall cost is higher now, the government can afford those costs. The poor cannot.
However, make no mistake: costs are higher with Pro’s plan. Without secure housing and continuous access to food, the poor will suffer greater burdens of disease from exposure and malnutirion, costs the government will pay through ER visits. Also, the numerous costs of lawsuits and imprisonments, plus the costs of increasing vaccine production ($600 million per new facility [22]), will ensure that costs rise.

Herd Immunity/Disease Burden/Vaccine Effectiveness

Pro drops that the threshold for herd immunity for almost every disease Pro is vaccinating against is already met without any mandate. Pro also drops that states with mandates have similar rates of vaccination to many that don’t. Both points vastly undercut his solvency, since they suggest that a) people can and do voluntarily seek vaccinations, b) they do so in large enough numbers to obtain herd immunity to most diseases, and c) mandates do not necessarily result in substantial alterations to those numbers. Chickenpox exemplifies this, as even low levels of vaccination appear to impart herd immunity.[23] Pro’s new plan further limits the effectiveness of his vaccinations, as parents may forge vaccination certificates,[24] it makes home schooled kids and those attending private schools completely exempt, and provides no means to track boosters and adult vaccinations. All of this allows for the same pockets of the population to avoid vaccination, perpetuating the very problems he aims to solve.
Even if none of this factors in, Pro concedes that we cannot reach herd immunity with diseases that require above 90% vaccination rates. What diseases are these? Pertussis (whooping cough) and measles, the two diseases for which Pro keeps citing numbers.[17] Without herd immunity, these outbreaks continue in Pro’s world, regardless of how effective the mandate is. Even Hepatitis B, the other disease Pro cites this round, appears to require 98% immunity to see effective protection.[25] This makes Pro’s harms with these diseases non-unique – outbreaks continue in his world and those with weak immune systems remain vulnerable.

22. https://nyti.ms/2MwaAft
23. https://bit.ly/2yM1oO0
24. https://bit.ly/2R1Ev0E
25. https://bit.ly/2S7iwab

Round 4

10.24.2018 12:10AM

Pro

Con and I agreed to waive this round due to a death in my family. I ask voters to vote according to the arguments presented

10.24.2018 12:44AM

Con

As Pro says, this round is mutually agreed to be waived by both of us. Thank you to Virtuoso for the debate, and my best to him and his family.

11.13.2018 06:39PM

#31

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@Tejretics

And I agree. I do, however, think there's an argument to be made about these restrictions being overly onerous. Protecting third parties from harm is not the overriding principle in all cases, since there are many actions or inactions that we largely agree should be allowed to persist despite the harms they cause to others. Whether that's true of vaccination is an open question, I'm just saying that the line isn't clearly drawn.

11.13.2018 05:08AM

#30

I'm not contesting the value of freedom in general, though. I'm just saying there are legitimate restrictions on the right to choice to protect third parties from harm.

11.13.2018 04:07AM

#29

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@Tejretics

Perhaps not the best way to explain it, but I meant to reemphasize the difference between the link story and the impact. Explaining why the loss of these freedoms is important requires linking it to some solid impacts, which I've always found somewhat difficult. I don't think it's hard to explain why certain freedoms should exist or why the government taking those liberties away steps on some toes, but that doesn't really get down into the nitty-gritty of why their loss is very damaging. The problem, as I see it, is that you either keep it nebulous and focus on why freedoms are important, or you peel away from the issue of freedoms and focus on reactions to their loss. I'm not really a fan of either approach, and I can't do the first one well at all.

11.12.2018 05:52AM

#28

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@whiteflame

"It’s much more about examining why this matters than it is about explaining why these freedoms should exist." I don't understand what this means.

11.12.2018 04:19AM

#27

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@Tejretics

That’s usually the response I bring, but it has limitations. The other side can just say that the same argument can be used to justify much vaster and more debilitating restrictions. If it’s justified to prevent individuals from harming others by potentially acquiring a given illness or set of illnesses, then you could use that same point to force people to wear masks, take antibiotics, sneeze into their elbows and generally stay home from work when they get sick. All of those would arguably have a much larger effect on disease burdens than mandatory immunizations, but we recognize that we cannot reasonably police such actions in everyday life, and it’s not just because of backlash. There’s an inherent value to our basic freedoms, particularly when they come at the cost of certain securities. Countries have built the backbone of their constitutions on recognizing that policing the actions of the people needs to be substantially limited based on certain criteria. We might disagree about what those criteria are and about how well they apply to these cases, but I don’t think we can disagree that there are many freedoms that should not be abridged just because there’s a security benefit that could result, no matter how substantial it might be. Admittedly, I think I’m doing a bad job of explaining why these freedoms matter, and particularly if we’re speaking outside of the context of a given country’s Constitution and history, these impacts may always be largely based on how different populations view the issue, but I don’t think the link is what’s at issue on this point. It’s much more about examining why this matters than it is about explaining why these freedoms should exist.

11.10.2018 02:25PM

#26

"Admittedly, the argument is somewhat difficult to counter, especially if you're going full bore and requiring everyone who can to get vaccinated."

Honestly, I didn't find the liberty argument compelling one bit. The really simple response seems to be the harm principle: it's completely okay to restrict liberty to prevent third party harm. If liberty were absolute, there's no argument against legalizing murder or assault. Clearly, we restrict liberty to protect public health all the time. I dunno if it's just me, but I thought it was a really weak argument.

11.09.2018 06:10AM

#25

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@David

I'd say my main problem with your case is that you didn't go hard enough. I get that there's a strong incentive to roll with a case that causes the least possible harm to liberty (I'll come back to that), but I feel like you either need to go full bore and argue that vaccinations need to be the main priority or else you just don't gain enough solvency. Despite what I said in this debate, I think the case can be made that we can either reach herd immunity with many of these diseases or get so close to herd immunity as to not matter. Trumping up the importance of essentially eradicating these diseases within the US is a lot stronger than stating that we're getting some minor improvements to childhood vaccination rates. The main barrier to making that kind of argument is the generally low level of harm caused by these diseases individually, and I think the main way to get around that is by talking about trends and the potential for much higher death tolls and other harms. But to do that in enough detail, you really need to focus on a specific vaccine or set of vaccines rather than hitting them all at once. Doing that made your case sound overly generalized, and the impacts didn't sound as solid. You really need those points to counter issues of side-effects, which are honestly not that huge given the potential scope of the problem with diseases like measles and pertussis (incidentally, I find that MMR and TDaP are the easiest to argue for on debates like this), particularly as they apply to the immunocompromised.

11.09.2018 06:10AM

#24

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@David

When it comes to tackling my case, I think the first thing you have to do is nip the liberty argument in the bud. Admittedly, the argument is somewhat difficult to counter, especially if you're going full bore and requiring everyone who can to get vaccinated, but I think I've come up with an effective response by simply stating that it's impossible to quantify, especially compared with a quantifiable loss of life and quality of life. I think also clarifying from the outset what makes an instance where loss of liberty is acceptable and why is important. You kind of did that later with the comparison to drunk driving, but I feel like the link was tenuous. I’ve gone with traffic laws, the allowance of drug tests, and taxation in general, all of which reflect a shared responsibility that overrides personal liberties for the common good. All of this does a pretty good job at least introducing doubt into the liberty argument, and provides a basis for supporting a policy that may seem severe and a huge step beyond what’s been done before. All of this is also somewhat necessary to counter the backlash point, because a lot of the liberty argument is building up an important link story: that the negative response is justified and righteous. Challenging that underlying assumption knocks at the backlash point by allowing you to say that these are just a bunch of people who are too self-interested to see the basic facts of how they’re harming others, and that their threats of retaliation are no better than retaliating against any supposedly oppressive laws that are there for a basic public good. Admittedly, there’s the medical aspect to it, but I’ve found that that’s easy enough to get around by just fining anyone who is actively afraid of or otherwise unwilling to get vaccinated. Fines go to medical subsidies and therefore improve access to medical care. Sure, there will still be some backlash, but this doesn’t force anyone to get vaccinated just because they see their doctor.

11.09.2018 06:09AM

#23

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@David

Lastly, on the lack of a case, your best bet would have been to present something in R1, but lacking that, I think there were some available outs in R2 and R3, though all of them would have required that you stick by generally making vaccination mandatory. You could have argued that the same system currently used in schools (i.e. doctors notes) could be used by the government to monitor vaccinations, and that updates on vaccinations would be required at the usual times (e.g. tetanus after 10 years). That would have knocked out my point about enforcement, as the only thing remaining would have been which agency would be in charge, which really doesn’t have any weight to it. You could have argued that the fine I mentioned above was obvious enough that it should have been assumed, meaning that dissenters won’t get jailed to nearly the extent I’m suggesting, and those that do get imprisoned for failing to pay the fine deserve it for willingly putting others at great risk. That just leaves the “who pays?” argument, and I think you could have argued that there are enough governmental and non-governmental organizations that would step up to help with this, particularly as it’s such a huge public good, which means most of the poor would be covered through subsidies from one source or another. It would have been better to simply state that the government was covering everything from the outset, but that requires it be stated in R1.

11.08.2018 09:21PM

#22

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@whiteflame

Sure definitely!!

11.08.2018 09:17PM

#21

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@David

Realized I never offered this, but as I said, I’m actually solidly for your side in this resolution, and I’d be happy to discuss what you could have improved, both in your case and your responses.

11.07.2018 05:44AM

#20

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@Tejretics

Me to! I'd hate to see a good debate go tied

11.07.2018 05:43AM

#19

I'm so glad that this got voted on.

Sorry I couldn't vote.

11.07.2018 03:55AM

#18

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@bsh1

Thanks a lot for the vote and the feedback! I had a plan for how to capitalize on the liberty impacts, though honestly, I still struggle with weighing more philosophical arguments like these.

bsh1

11.06.2018 06:03PM

#17

OMG. So many spelling errors. Gonna delete and fix and repost.

11.06.2018 05:58PM

#16

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@bsh1

Thanks for the vote and feedback!!

Death23

10.25.2018 02:09AM

#15

Is the resolution for childhood vaccines only? It's worded broadly and would seem to encompass adult vaccines as well (e.g. annual flu vaccine).

Alec

10.25.2018 12:10AM

#14

If vaccines should be mandatory, what should the punishment for not having one be?

I'm okay with some vaccines, but not ones that contain unborn baby parts.

10.23.2018 11:57PM

#13

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@David

If that helps you, I would accept that. I would completely understand.

10.23.2018 11:49PM

#12

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@whiteflame

If you want we can make this a 3 round debate and just waive the fourth round

10.23.2018 11:26PM

#11

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@David

You have my condolences. I'm very sorry to hear about that. I wish you the best in your time of mourning.

10.23.2018 10:55PM

#10

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@whiteflame

My grandfather passed away this evening. I will try to get my arguments in on time.

10.19.2018 11:02PM

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@David

Alright.

10.19.2018 11:01PM

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@whiteflame

please wait till sunday to post response if you can

10.16.2018 05:09AM

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@David

It is certainly difficult at first, though I have to admit, those are the most rewarding instances. With a few exceptions, I've garnered the most from trying to understand the other side on topics that I feel very strongly about. I learn quite a bit from the experience. Strange thing, though, is that I can usually find a solid repository of arguments for that side. Most of the sites I've looked at on the topic have made pretty awful arguments, so I had to mostly derive my own.

10.16.2018 03:03AM

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@whiteflame

I respect that. It can be difficult playing devil’s advocate especially when you’re passionate about the topic

10.16.2018 12:28AM

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@Death23

Agreed. I think this is a fascinating debate. I'm actually taking devil's advocate for this one because I'm solidly on the "Pro" side of this debate, but I do feel there's a lot of good ground to cover on my side.

10.15.2018 12:45AM

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@Death23

Thank you!!

Death23

10.15.2018 12:23AM

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@David

@whiteflame

great topic! sounds like parents' rights vs the best interests of children. look forward to the arguments

10.14.2018 11:51PM

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@whiteflame

Will post after work. Thanks