kunaltyagi comments on RFK Jr tells US families to vaccinate children against measles amid outbreak

[–] kunaltyagi@programming.dev 4 points 2 months ago (7 children)

The numbers you're using are nowhere even close. You need to severely increase the ratio by 2 or 3 orders or magnitude.

Mortality rate for some diseases is close to 1 in 3 (measles in infants with co-morbodities) to 1 in 100. With vaccines, we have changed that to 1 in 10k or better (with co-morbodities).

For the live virus polio vaccine, 3 out of a million kids would get polio DUE to the vaccine itself. That is peanuts compared to 50k kids (per million) who get polio despite the vaccine. That's also peanuts when we see that reported polio cases fell from 350k around 1990 to 30 around 2010 despite a huge increase in population.

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[–] thebestaquaman@lemmy.world -1 points 2 months ago* (last edited 2 months ago) (6 children)

The "trolley problem" is a philosophical dilemma regarding the morality of allowing harm caused by inaction versus causing harm by direct action. In a common form of the dilemma, you are faced with a situation where a train trolley is headed to hit a number of people. You have the option to pull a lever that will direct the trolley to hit a smaller number of people, thus actively condemning that smaller number.

The argument can be made (though I disagree with it), that you are "more responsible" for deaths caused by pulling the lever than those caused by inaction. Whether or not you agree with this argument, plenty of research has shown that humans are typically very averse to causing known harm by direct action, even though they know that inaction will cause greater harm. That is: "Human instinct" in the trolley problem seems to be to not pull the lever, even though a majority of people agree that it is the morally correct decision.

Finally, the above discussion is more or less completely independent of the number of people on the two tracks. Whether it's 1:2, or 1:1 000 000 doesn't really change the moral argument of action vs. inaction. If you get into the kind of numbers where the number of deaths would have global secondary consequences, you have a new kind of dilemma though. However that's not the case here, hence my choice of pulling two arbitrary numbers out of a hat, rather than using actual numbers for vaccine side effects and infection lethality.

What I'm doing here is noting that the question of vaccinating or not is philosophically equivalent to the trolley problem. Therefore, we can use research of the trolley problem to understand how vaccine sceptics think, and to learn something about how people can be convinced that pulling the lever is the morally correct choice.

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[–] kunaltyagi@programming.dev 0 points 2 months ago (5 children)

Trolley problem is just a pros and cons list made visceral. If the pros don't outweigh the cons there's no point. Before we even bring morality and mortality into this the amount of pros are different for different people to make a decision (even as non visceral as changing a job).

By using much smaller numbers, you are giving a false impression of vaccines. Instead of 1 vs 10k, saying 1 vs 100 is similar to me asking if someone would switch jobs if salary is 100$/year difference when it might actually be 10k$/year.

I'm not arguing against your premise of Trolley Problem but against the numbers. As humans, we can still fathom the difference between 10, 100 and 1000. These aren't big numbers which get washed out into nothingness of 'big'.

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[–] thebestaquaman@lemmy.world 1 point 2 months ago (4 children)

Trolley problem is just a pros and cons list made visceral.

I fundamentally disagree with this, and it seems to me that many others do as well. The trolley problem is fundamentally about the morality of allowing something bad to happen through inaction, versus actively choosing a lesser evil.

While it's true that the numbers can influence what people answer here, the numbers are not the core point of the thought experiment. The core point of the thought experiment relates to whether you are personally responsible for the consequences of inaction, versus your responsibility for the consequences of direct action.

Crucially, as discussed in depth in Daniel Kahnemans' "Thinking Fast and Slow", humans appear to be instinctively averse to taking actions with known negative consequences, even when they know that the consequences of inaction are worse. This is supported by the experiment referenced in the wikipedia page linked above.

The point here is that we can try to understand vaccine sceptics line of thought by understanding why humans appear to have this aversion. As mentioned in my first comment, I'm well vaccinated, and know fully well that statistically, both for myself and others, getting relevant vaccines is the right choice. Regardless, I felt a twinge of doubt when getting my initial covid shots. Not due to any logical reasoning, but an instinctive gut feeling: It felt more risky to actively expose myself to a vaccine rather than do nothing, even though I know the opposite is true. I very quickly overcame that twinge of doubt because I try to make decisions based on facts rather than feelings. While anecdotal, this is a concrete example of how human intuition does not always match actual statistics and logically sound decision making.

I think that if we want to prevent vaccine scepticism from spreading, one place to start is trying to understand why people think along these lines: That direct action infers a heavier responsibility than inaction. The first place to start in that regard is recognising that the trolley problem is a very real dilemma for many people, and that surveys have consistently shown that not all people make the same choice in trolley problem situations, even though the correct choice seems obvious to many of us.

By using much smaller numbers, you are giving a false impression of vaccines.

Sure, I could have used more realistic numbers here, I won't argue that. However, I hope I've been able to convince you that my point is not related to the numbers, but to the underlying psychology of making these choices, regardless of the numbers. Therefore, I just pulled some numbers out of the air to construct the example in the OC.

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[–] kunaltyagi@programming.dev 1 point 2 months ago (3 children)

I see the angle. Thanks for explaining.

I find the fact that "vaccines as a voluntary action that comes with a twinge" to be very weird.

Both parts: (a) Voluntary action for something that should be legally mandated like wearing a seat belt or using specific construction materials or layouts or an engineer to pass the house design: all the rules that are written in blood. (b) Twinge of doubt for something that has been so successful in the past. Choosing to drive a car (with or without a seat belt) isn't seen as something that comes with a twinge of doubt that an accident will happen (though statistically that's more likely)

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[–] thebestaquaman@lemmy.world 0 points 2 months ago* (2 children)

Thanks for being understanding and engaging in good faith :)

I think making vaccines legally mandated is an interesting discussion. On one hand, I think they should be mandated for reason that they are, statistically, proven to reduce overall harm to people. On the other hand, it think it's a bit scary to go that way, since we are then putting a lot of trust in whatever political body will decide which vaccines have a risk/benefit profile that should make them mandatory. It's a lot easier with seat belts or construction practices, since there are literally no downsides to either.

I've had a thought experiment with others about a hypothetical autonomous car that is guaranteed to never end up in (or cause) any accident, but has an astronomically small probability of spontaneously combusting at any given moment. Let's make that probability small enough that the number of deaths and injuries caused by cars every year is reduced to 1 % of what it currently is, with the remaining incidents being caused by the spontaneously combusting cars. Now, for any individual, it's statistically safer to drive this car. As a society, everyone is safer if these cars are mandated (no pedestrians are killed, we don't need to spend healthcare resources on car-related injuries, etc.).

From a utilitarian perspective, these cars should be mandated. From a purely logical risk-minimisation perspective, everyone should be jumping at the opportunity to use this much safer car. However, when you ask people, it turns out that most don't want the car. Despite knowing that this car would (statistically) drastically reduce their probability of being hurt or killed in traffic, the idea of getting into a vehicle that can spontaneously combust at any given moment seems absurd to them.

That brings us to the "Twinge of doubt for something that has been so successful". We humans are generally terrible at risk assessment. We tend to heavily over emphasise extreme outcomes (the car combusting) while also under emphasising "mundane" outcomes (people crash and die every day, but it surely won't happen to me), and overestimating our own skills (by far most drivers think they're above average, and can therefore avoid collisions). The analogous vaccine-related line of thought would be that people hear that 1 / get severe complications from vaccines, which is over emphasised, while "hundreds of people in the US are killed by tuberculosis every year, but it surely won't happen to me", and overestimating our own immune system.

Basically, a lot of fear is simply irrational, and that's linked to the human nature of being crap at intuitive risk assessment. I think fear of vaccines also falls into this category of irrational fear, and I don't really think it can be rationalised away. That's why I think programs to counter vaccine scepticism need to be based in how to make the rational fear of disease win out, rather than trying to completely dispel the irrational fear far too many people have related to vaccines.

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[–] kunaltyagi@programming.dev 2 points 2 months ago

Some Tesla models have a higher than 0 chance of driving you into a truck or median in auto mode (or catching fire or trapping you inside due to malfunction door but that's just the design language of the car) as compared to you controlling the car. People still jump at driving one with FSD (the marketing term)

I think the phrasing and giving statistical info might be the problem? Eg: if I wetr yo give you a choice between a fresh tomato and a slightly less fresh, but all-natural tomato. Ofc, the other tomato might also be all-natural but the mere fact that I gave extra info changes the deal, as if I'm giving you a secret.

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[–] kunaltyagi@programming.dev 1 point 2 months ago

On the side of legally mandated vaccines, lots of countries mandate vaccines without religious or personal exemptions. Only health based contra-indications can be used an excuse to not have them (for kids/mothers).

Other countries even have legal requirements of vaccination to work in certain high risk professions (health/child/communal/elderly care) or travel (eg: meningococcal for Hajj)

Having a govt which makes only good decisions is not just important for vaccines but also other parts of life. Your doubt of seatbelt having no downside is not completely correct. It has a well-documented and unaddressed substandard to negative impact on people with non-standard size/weight/shape.

Your doubt is what make me think this vaccine hesitancy is deeply social, not just personal. It is not seen in several societies

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