[mhandley]

Not being from the US, I find it odd that the article didn't mention anything about vaccination. Until 2005, pretty much everyone in the UK received the BCG vaccine. After that the TB rate fell too low to merit routine vaccination, but even today it's still given routinely in a few areas where the rate merits it, or if there's elevated risk of exposure via family from abroad, etc. Has vaccination in general become such a divisive topic in the US that articles about diseases for which we used to routinely vaccinate don't even mention that a vaccine is available and greatly reduces the risk of the most severe forms of TB, such as TB meningitis?

[danw1979]

Kind of related to your point… I remember my maternal Grandmother was looking after me one day and I’d either missed or skipped my earlier vaccination appointment in school (which, I think was a BCG or booster, it was in the early 1990s). She was raised by her maternal Grandmother after her mother died from TB when she was 2 years old. Her father died of… something infectious when she was teenager

(the oral history is obviously a bit sketchy, but she used to tell me her father also caught TB - cholera maybe ? - when he was removing bodies from the flooded Balham tube station in 1940 - https://www.ianvisits.co.uk/articles/75th-anniversary-of-the...)

Well, I got quite the scolding about missing my jabs and a stern lecture about how many awful diseases have been cured because of vaccination. I could never forget how emotional she was about it.

To people born in the early 20th century, seeing the effects first hand of the vaccination programmes of the mid 20th century (not to mention antibiotics) must have seemed miraculous. I think we’ve lived without these diseases for so long that some people (stupid, selfish people) simply think they don’t exist or pose a threat any more.

[close04]

> I think we’ve lived without these diseases for so long that some people (stupid, selfish people) simply think they don’t exist or pose a threat any more.

This is true beyond just vaccines. All too often hardships are forgotten, history is just old pictures and stories, and people who are too far disconnected from those real events and don't learn from history will just walk the same path, leading to the same hardships.

They all think that the world is better today so they're smarter or better than the old generations, that the world evolved so they're intrinsically prepared, so the pains of the past can't harm them. Ironically they're ignoring all the lessons and the tools that made the world better and are needed to keep it like that, and instead think things are better because they just are.

They'll skip any vaccines or support extremist regimes because they think the modern world is just immune to this, it's intrinsically and permanently "fixed". We have freedoms or don't get sick because we "just" have freedoms and don't get sick.

Having close family spending a lifetime paralyzed by the polio virus before a vaccine was widely available, or spending some of my life in the cold embrace of dictatorship really drove the point home for me about learning the lessons of history.

[nobodyandproud]

Tried-and-true vaccines are like plumbing or city infrastructure: Once established, it’s taken for granted and the true value can’t be intuited.

[amluto]

BCG, sadly, is not really in that category.

[noneeeed]

What's the issue with the BCG? My understanding was that it had been sucessful, is that a bit of a myth?

[amluto]

It’s not very effective, and it’s apparent efficacy is bizarrely variable.

[noneeeed]

Thanks, I had no idea. It was the standard when I was growing up in the UK.

It looks like it is no longer standard issue here.

[rightbyte]

I think it was just some small anti-culture (like healing stones or whatever. Same people initially) that got dragged into the with us or against us political landscape of the US.

[ksenzee]

It’s a valid question, but I don’t think the current vaccine-unfriendly climate in the US is the reason why the BCG vaccine wasn’t mentioned. BCG wasn’t routinely given in the US even in the last half of the 20th century when vaccines were universally popular. I was surprised to learn a TB vaccine even existed when I started a public health−adjacent job in the 2000s. Our public health establishment just isn’t convinced it’s worth giving here.

[Animats]

The BCG vaccine does exist, but it's an 90 year old live-virus vaccine with short-term side effects. Because it's a live-virus "natural" vaccine, it can't be used on people who are immunocompromised or have HIV. There's work on more modern vaccines.[1] No big successes yet.

The safety record of the BCG vaccine, in terms of permanent harm, is pretty good. But a normal side effect is "The usual expected reaction to BCG vaccination is redness and/or a small lump at the injection site, followed by a small ulcer (open sore) a few weeks later (usually less than 1 cm in diameter). The ulcer may last from a few weeks to months before healing to a small flat scar."[2] Mass vaccination will have parents screaming "my perfect baby has an open sore from the vaccine" on Instagram, with pictures.

The classic live-virus smallpox vaccine has similar side effects, by the way, plus a death rate of 1-2 per million.

Huge political problem. Remember all the screaming about the COVID vaccines, which are pure RNA, can't replicate, and have fewer side effects.

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC3349743/#s6

[2] https://www.rch.org.au/uploadedFiles/Main/Content/immunisati...

[gambiting]

>>Mass vaccination will have parents screaming "my perfect baby has an open sore from the vaccine" on Instagram, with pictures.

That's so weird to me given that literally everyone where I'm from(Poland) has this on their left arm. Nothing to post on Instagram about. It's as universal as having a belly button - not having a vaccine scar on your arm would be the thing to post about if anything.

[noneeeed]

Likewise. I grew up in the UK and there was no pushback at all from what I remember.

Although I do remember school being very strict about anyone whacking someone elses BCG arm.

[_heimdall]

> the COVID vaccines, which are pure RNA

This is misleading. Vaccines, including those for covid, generally include adjuvants to stimulate the immune system [1]. While I understand the point your making here, the covid vaccines were not syringes with pure RNA in them.

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC10222622/

[xyzzy123]

An interesting aside to this is the MIS BAIR study in Melbourne, which is looking at whether the BCG vaccine reduces the incidence of food allergies, eczema and asthma. https://www.mcri.edu.au/research/projects/misbair

[lazide]

Yeah, when it’s dress/tank top weather, you can see what part of the world people grew up in by the upper-left-arm scar.

[https://www.health.nsw.gov.au/Infectious/tuberculosis/Pages/...]

[mark-r]

My upper left arm scar wasn't made by TB vaccine though, it was Rubella vaccine. I didn't associate it with aftereffects of the vaccine itself, it was the unique method of delivery - an airgun instead of a needle. Never seen that before or since.

[lazide]

The MMR vaccine doesn’t cause that type of scar. I’ve found nothing saying air vaccination guns do either.

Smallpox and TB vaccines both do though.

Perhaps you got a combo?

[mark-r]

They made a big deal of it, our entire elementary school got it at the same time. And they specifically said it was for German Measles, I don't think MMR had been invented yet. This would have been before 1970.

[BeetleB]

The US medical community never accepted the effectiveness of that vaccine. They don't think it does a good job at prevention and it makes it harder to detect as anyone whose had that vaccine treats positive with the skin test.

[ksenzee]

All of the above, as well as the fact that the incidence of TB is already so low that the vaccine could cause more harm than it prevents.

[rob74]

Aside from TB, you could also call this "the tragedy of vaccination": vaccination causes the incidence of a life-threatening disease to become so low that people consider the vaccine to cause more harm than it prevents - until the vaccination rate becomes so low that the life-threatening disease is back.

[sitkack]

You know, if everyone wrote a predator prey simulation from scratch, they would understand those oscillatory dynamics.

[DoctorOetker]

But if they also wrote genetic algorithms from scratch, and understood natural selection, they would also understand the concepts of selection pressure, and use it or lose it.

If they then also understood that 90% - 95% of the population effectively has natural immunity, they would seriously question the ethics of vaccination.

Should a number of generations be allowed to profit from the benefits of vaccination at the cost of a loss of natural immunity in the group? Are future members of the group less entitled to this ~95% immunity, because the current generations prefer ( 100% minus epsilon ) artificial immunity?

Its easy to win a referendum in the advantage of the existing population at the cost of future populations, if those future populations aren't born yet to contest and vote against it.

From Wikipedia page on Tuberculosis:

> Roughly one-quarter of the world's population has been infected with M. tuberculosis,[6] with new infections occurring in about 1% of the population each year.[11] However, most infections with M. tuberculosis do not cause disease,[169] and 90–95% of infections remain asymptomatic.[87]

From the above it is clear that vaccination programs for TB should be strictly considered private healthcare since it can help specific individuals at the cost of collective fitness vis-a-vis TB. Governments collectivizing private medicine at the cost of group fitness ranks among the most populistic things in existence. Think of how communist systems justify their methods by emphasizing doctors and medical systems.

What exactly does the ethical axiomatization of a collective thought system look like when they look down on the ~95% natural immunity handed to them from the prior generations and simultaneously have no qualms to hand down a lower percentage of natural immunity to the next generations!

I believe they have this mistaken gut feeling that their decisions can be rationally axiomatized, more out of group think and delegation "others smarter than me are choosing this so it is probably rational"; and they are simply unaware of the fundamental inconsistencies they manifest.

Tax payer money ought not be spent on reducing the natural immunity of its taxated population, regardless of how confronting it may be to explain to the population how a lot of methods in medicine were started long before the consensus on natural selection as the origin of life and fitness took hold.

[gtgvdfc]

You got the BCG vaccine in the UK? Are you sure?

I got it when I was a toddler in the late 80s and I still remember the excruciating pain and have the scar to show for it.

I grew up in the third world. I have never met a Westerner with this scar unless they got it in the sixties.

[mhandley]

Yes, I'm sure, and have the scar on my arm to show for it. Everyone in my school had it. Would have been around 1980.

[gtgvdfc]

How interesting. The UK is the only western country Ive encountered that gave this shot to kids in the 80s.

Why is this?

[clarkdave]

As a British millennial, I got it at school, I guess sometime in the 90s. Still have the scar

[poulpy123]

I just checked and it's not mandatory anymore in France, which probably absurd because there is a surge of tuberculosis due to migration and international travel

[Yeul]

In the Netherlands people who travel to non Western countries can get their vaccinations.

There's an old Dutch fort in Ghana with a graveyard. Prior to modern medicine white people dropped like flies in Africa.

[exe34]

natural selection also applies to memes. memes that cause their host to fail to raise children to reproductive age will get weeded out, but it can take many generations.

[jjk166]

Memes don't need to be passed on hereditarily. It is entirely possible for a meme which absolutely prevents the host from reproducing to persist indefinitely so long as it spreads to new hosts at around the same rate hosts die out. See clerical celibacy. It is also possible for memes to lie dormant and then resurge after an extended period of time by which all the original hosts are dead.

[exe34]

good point!