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Great post as always. Something that's interested me is whether we reeeally do need a second measles vaccine. Heres a chart showing UK cases before and after introduction of the measles vaccine, but also note that the second dose was introduced in 1996 despite cases already being at a low level:

https://www.semanticscholar.org/paper/Measles-and-the-importance-of-maintaining-levels.-Bedford/903044dd476ecbf5c5f128fd674013ed382148a4/figure/1

The same applies to Japan, who only introduced their second dose in 2006 (See Figure 1)

https://www.mdpi.com/1999-4915/15/1/171#fig_body_display_viruses-15-00171-f001

So is it a case of chasing diminishing returns to fulfil a policy objective of elimination?

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This reviews the problem - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2393424/ in the 1980s there were more outbreaks than there had been in the 70s, and whereas the latter had been in older but unvaccinated children, now cases were in vaccinated and unvaccinated of all ages. So the single dose didn't "work" even with universal school requirements in US, elsewhere.

A lot of vaccine recommendations are just 'social evolutions' to pragmatic and PR-type considerations. One dose measles didn't work due to the problem of vaccinating so early in life (potential screening by maternal antibodies, or other reasons for diminished immune response), people justifiably say that the eradication campaign was based on utopian assumptions that didn't pan out, so they shove two doses down society's throat to shut everyone up.

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Thanks for the study link, yeah the problem with eradication is that it can lead to a 'forever war' (zero covid anyone?) with coercive measures and when things start to 'fail' to eradicate the only solution is more and more doses.

I wonder what the IFR is for measles is in a single vaxed individual, or the SAE rate for the second measles vaccination? I've tried to google it with no luck, but it's key to making a proper risk benefit decision.

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The variation between the values for the various countries in that first table is something!

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Germany and Italy are not very far removed in time from the Bicycle Thief / Maria Braun era of total destitution. Japan perhaps in the same boat, though also less uniformly industrialized to begin with (hence leading role of drowning deaths in accidents), so I don't know if the American conquest is too relevant there.

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I have yet to meet a vaccinated person that I find interesting. Or at least intellectually challenging. The dead ones are of interest to me. But they are not interesting.

Plus they’re dead.

So there’s that.

That the vaccinated ...

Don’t find their own dead interesting

... I do find interesting.

.

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