JayB

Are you for real, JayB? A health care worker who has received a flu shot will not protect a patient if the worker got sick any way. The only protection is a clear policy that prohibits sick workers from working. So what if you have to pay them another day of PTO, at least they aren't infecting their coworkers. How many times have you had a coworker infect half your office? At my old work you were put on short-term disability if you were on sick related PTO for more then three days, with benefits based on tenure. When your business model revolves around seeing sick patients all day you have to build in the fact that your own workers are going to get sick as well. I find it interesting how virulent this years strain is, and I can't help but thinking that the virus, just like HIV, is creating escape mutations that circumvent the immunity created by the vaccine. In the case of HIV, the virus will constantly mutate to evade the immune responsive even if it poses a short-term decrease in fitness, but when given the opportunity will mutate back into it's prior form when protection to that particular epitope is lost. If there was a connection between immune escape and virulence wouldn't we have seen incrementally more virulent strains year after year? I'm not up to date on the influenza literature but I'd be surprised to see this idea represented there. Firing for refusing vaccinations - I think it's a great idea, long overdue, and I'd like to see it universally enforced immediately. Surgeons can still transmit infections despite having taken every precaution to prevent doing so. E.g. they've done all that they can to protect the health of the patient that they're working on. It's possible that one of their patients could still develop a post-op infection, but if they've taken all of the reasonable and customary measures to prevent it, that's something quite different than someone with no scientific or medical justification deciding that they aren't going to, say, wash their hands for whatever reason that they can conjure up. Anyone with direct patient contact has the same obligation with respect to vaccines. They're a standard precaution, and anyone who refuses them is willfully and negligently putting patients at risk. That's unacceptable.

"Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body." http://www.14news.com/story/20572905/nurses-fired-for-refusing-flu-shot Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights. "If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots - and they should ask them." Very glad to see this. If you work in a medical setting you are free to refuse any and all vaccinations, and your employer is free to fire you. Hopefully more firings will follow.

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Climbing was way down on the list this year but not totally absent. In no particular order. 1. Multiple powder days on big fat skis. 2. Moderate creeking in the Cascades: Ingalls, Peshastin, NF Teanaway, Rapid, Cooper, etc. 3. A couple of half-days of cragging at Squamish. 4. Fly-fishing infused week-long loop around the Olympic Pinensula in September. 5. The first round of triple-generation family trips to Whistler in the summer and the winter. I'll add a sixth and toss in taking the bambino out for multiple snowy XC outings in the ski-adapted-stroller thingy:

Good news. Brought to you in part by fracking and union concessions.... http://www.theatlantic.com/magazine/archive/2012/12/the-insourcing-boom/309166/?single_page=true

We watch the same movies in Canada, we watch the same TV shows in Canada, we play the same video games in Canada. Hell, a sizeable proportion of those movies and TV shows and video games are written and/or produced by Canadians, in Canada. And yet, despite spending our entire lives wallowing in exactly the same "culture" as our American brethren, we're no-where near as likely to kill one another. Guns, knives, baseball bats, hockey sticks, you name it, we just don't take up weapons against one another with anything approaching the enthusiasm of Americans. If the popular culture is responsible for the mayhem, then why isn't the mayhem rate just as high on this side of the border as on your side? Clearly there's something else going on: the "guns don't kill people - video games kill people" argument is BS. While there's no arguing with the murder stats, and that's not my intention, I do think that aggregating two populations with a vastly different size and composition into the same statistical categories - e.g. "Countries" - can distort as much as it illuminates. There are some pretty big patches of the US that are quite safe and have murder rates that are equal to or below the average for all of Canada. You could even stitch together a big, contiguous Chunk of territory in the coastal and intermountain West with ~35 million souls, give it a new name, and you'd have a very prosperous and peaceful geographic entity that looked quite a bit like Canada in everything from the murder rate to ethnic composition, etc - despite having vastly different laws and attitudes regarding private gun ownership. I think that the particular historical evolution of Canadian culture and identity has quite a bit more to do with Canada's murder rate than the particulars of its gun laws. I don't think that Canadians would suddenly take to murdering one another with significantly greater frequency if someone flipped a switch, instantly erased Canada's current laws, and imposed US gun laws. I'm sure there'd be an increase - but it's magnitude would probably be very small, and never get anywhere near the overall US average. Conversely - I don't think that even if we built walls around the US murder belt, confiscated all hanguns, and imposed Canadian gun laws I don't think that the variety of violent underclasses that commit and suffer the vast majority of murders in this country would see much if any decline. I think ending drug-prohibition would probably have a much larger effect, but that wouldn't be a panacea either. As a side note with regards to general mayhem - there is a difference once you cross the border, but all of the stats that I've seen suggest that the difference is less than one might expect when it comes to all other crimes.

I was one of the folks lined up at the gates on 12/18, and heard about this incident when I cycled through for another lap. Thankfully the victim survived, and there's a good thread on this at TAY that has quite a bit of detail from folks who were on the scene. I thought I'd cross-post it here for those that don't peruse that forum: [video:youtube] http://www.turns-all-year.com/skiing_snowboarding/trip_reports/index.php?topic=26573.0 Looks like the story also made national news: http://www.huffingtonpost.com/2012/12/20/emily-anderson-washington_n_2339748.html

http://en.wikipedia.org/wiki/School_shootings_in_the_United_States

http://marginalrevolution.com/marginalrevolution/2011/06/long-term-trend-in-homicide-rates.html Interesting note on the last blip, which is something that I've suspected was at least partially behind the declining murder rate: "BALTIMORE—The number of U.S. homicides has been falling for two decades, but America has become no less violent. Crime experts who attribute the drop in killings to better policing or an aging population fail to square the image of a more tranquil nation with this statistic: The reported number of people treated for gunshot attacks from 2001 to 2011 has grown by nearly half. "Did everybody become a lousy shot all of a sudden? No," said Jim Pasco, executive director of the National Fraternal Order of Police, a union that represents about 330,000 officers. "The potential for a victim to survive a wound is greater than it was 15 years ago." In other words, more people in the U.S. are getting shot, but doctors have gotten better at patching them up. Improved medical care doesn't account for the entire decline in homicides but experts say it is a major factor." http://online.wsj.com/article/SB10001424127887324712504578131360684277812.html

Completely agree. In most neighborhoods the fundamentals have all mean reverted and then some since the apex of the bubble. My best guess is that the bottom was last spring, the downside risk is pretty low at this point, and moderate price increases will probably be the trend going forwards. Inflation has been muted because credit contraction has negated the impact of monetary expansion (I think the best working definition of inflation is money-supply-growth+credit-growth/real-GDP growth), but when and if we start to see a significant private credit expansion then I'll be surprised if the Fed can/will be able to adjust the money supply quickly enough to keep inflation in check. I think we've passed the point at which our real output will be sufficient to repay our debts without inflating a substantial portion of them away, so the odds that the Fed will have the political will/incentives to keep a tight lid on inflation are quite small. Looks like a good time to buy, and housing looks like a good long-term inflation hedge.

what about one's daughter (the original topic)? (i haven't looked at incidence in males, so won't comment.) AFAIK the principal mode of transmission is via oral sex - but don't know if there are significant differences in the transmission rate based on which particular behavior one is engaging in - but I don't think there is any group other than the celibate, the partnered-for-life-and-HPV-negative, or the too-late-already-got-HPVE16 populations that can rationally conclude that the cost and risks associated with getting vaccinated aren't vastly exceeded by the benefits on an individual level. FWIW I think that most of the data that does the cost-benefit analysis in terms of population level cost-benefit aggregates finds that the population-level cost of vaccinating males exceeds the population-level benefits, but IIRC you don't seem to think in terms of broad-aggregates.

Just chiming in to note that the cancer risk from HPV isn't limited to women: Lancet Oncol. 2010 Aug;11(8):781-9. Epub 2010 May 5. HPV-associated head and neck cancer: a virus-related cancer epidemic. Marur S, D'Souza G, Westra WH, Forastiere AA. Source Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA. smarur1@jhmi.edu Abstract A rise in incidence of oropharyngeal squamous cell cancer--specifically of the lingual and palatine tonsils--in white men younger than age 50 years who have no history of alcohol or tobacco use has been recorded over the past decade. This malignant disease is associated with human papillomavirus (HPV) 16 infection. The biology of HPV-positive oropharyngeal cancer is distinct with P53 degradation, retinoblastoma RB pathway inactivation, and P16 upregulation...blah blah blah" IIRC the HPV virus encodes a protein (E6) that binds to a protein that normally regulates cell-division (p53) and basically tricks the cell into tagging p53 for destruction via the pathway that the cell normally uses to selectively destroy/downregulate proteins. Nasty. I think people have been working on drugs that will inhibit or reverse the binding of HPV E6 to p53 for a while but AFAIK the therapeutic repertoire is currently limited to surgery/chemo. Imperfect protection is better than no protection and unless you are confident that you can predict the character of all of your son's future partners and the precise range of his sexual behaviors the balance of risks is decisively in favor of vaccinating.

Okay. Sounds like the best we can do is wave across the chasm. If you read the IOM report - I'd be curious to know which particulars/specifics you don't accept/disagree with.

Basically just the weighing of the relative magnitudes of the risks and the benefits on both the individual and collective levels. I know you picked this up - but just to belabor the point a bit more, the "obese-chain-smoking-engineer-in-suburbia" who's more worried about dying from street-crime than getting cancer or having a heart attack was just quick analogy to illustrate what's puzzling to me about your perspective. All of the facts and evidence demonstrate that he's way (like millions of times) more likely to suffer from the obvious, common, and easily controlled risks from obesity and smoking, but for some reason he ignores those and has a vastly higher level of concern and anxiety about exotic threats that have a vanishingly small chance of ever affecting him. Change smoking and obesity to "transmissible diseases that you can fully or partially protect yourself and the vulnerable people in the population from via vaccination" and street crime to "exceptionally rare and overwhelmingly non-lethal adverse reactions to vaccines" and we get to me not understanding your thinking or conclusions on this issue. Maybe that's too great a bridge to cross? If that's the case, that's fine - but whatever the limitations of this format - it's given me an opportunity to have an exchange that (in my experience) it's very difficult to have in person with folks who seem to share many of your conclusions, if not all of your particular reasons for arriving at them.

what sort of intelligence are we talking about? the ability to decipher a set of inter-related variables and their interactions and predict the optimal outcome? if we are to use this game theory model, there would be only one "intelligent" course of action for an american living an exclusively domestic life today: no vaccinations. when one computes the odds of contracting ANY of the illnesses we currently vaccinate for, then further computes the odds of having ANY serious side effects, and contrasts these with both the known and the possible side effects of vaccinations, the "intelligent" course of action is quite obvious. (this model assumes current disease prevalence in the US.) any change in the variables above would potentially affect the optimal strategy of course. ayn rand endorsed this approach, therefore you will too. btw it was the pnas.org post that i found really interesting. - I had more of the lucid, articulate, witty, able to understand complex material and formulate a logical argument sort of intelligence more in mind in your case than asperger's-type formal/computational/symbolic-logic/parameter optimization type intelligence but maybe you're good at that stuff too. Speaking of which - what I feel like I'm seeing in your case, with regards to vaccination, is the same sort of relentless focus on particulars without either an ability or willingness to place them in the appropriate contexts. It feels like listening to a morbidly obese chain-smoking mechanical engineer living in a suburban neighborhood who has invested an enormous amount of time and energy researching street-crime and the particular threats that it poses to his life. He's clearly got a fairly high level of intelligence since he'd never have made it through the weed-out courses, let alone his degree program if he weren't, the facts he's rattling off may be correct, and to some degree or another the risks are something that an informed person should be aware of, but the chasm between the real risks to his life arising from street-crime vs obesity and smoking are so vast and profoundly at odds with reality that it's difficult to comprehend how he can fixate on one and largely dismiss the significance of the other. I can't help but think that in your case, the more you understand the basic biological phenomena in ways that say, practicing immunologists do the more likely you are to arrive at the same conclusions that they do regarding the safety, efficacy, and risks-vs-benefits of vaccination. Maybe not - but since you're a smart guy and seem to have a high level of interest/curiosity about this stuff it seemed like a suggestion worth making. Speaking of which - if you liked the PNAS paper you'll probably enjoy at least one of these that I post below. The first touches on the role that viral recombinases seem to have played in the emergence of adaptive immunity, the second is on the role that viral integration into our pre-mammalian ancestor's genome played in the emergence of placental mammals, and the third is an overview of horizontal gene transfer mechanisms at work in plants/plant-evolution. 1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823946/ 2. http://www.pnas.org/content/106/29/11827.full 3. http://www.uky.edu/Ag/Agronomy/Chappell/Courses/Papers/Review%20-%20Bock%20-%20TIPS%202010%20%282%29.pdf

Last one. Here's a gem - a boiling vat of conceit resting precariously atop a logical fallacy, the rare but particularly-apt-for-Seattle inverse argumentum ad populum: "I wonder what would be your comments if an anti-vaccine writer had posted an article with "Stupid Fucking Pro-Vaccine Zombies"? But it happens that anti-vaccine views are held by people who are way too educated, well-read and intelligent to express themselves in this way. At least there is an internal coherency between the title and the Mississippi argument. So we should follow the example of the people with the worst health, education and socio-economic level, instead of the people who are more learned and did better in life in general? Well, well.. If only more people would use their own brains, get informed, and just do the math. You may not be knowledgeable enough to understand all the medical facts and terminology, or to analyze statistics - but you can at least look at the populations defining both trends. Who do you trust more?"

"here are two very valid sides to this argument. On the one hand, you have pretty much the entire scientific community. On the other hand, you have Jenny McCarthy's boobs. At the end of the day, it's hard to know who to trust. I would usually say err on the side of boobs, but when we're talking about kids dying from wholly preventable illnesses, I might have to go with the doctors. And for those saying vaccines aren't effective, please tell me how many people you know who've had polio. How about measles? How many infants have you watched die from pertussis? Or maybe those diseases were just made-up, and it's just a big pharma conspiracy. Riiigghhht.."

http://www.thestranger.com/seattle/stupid-fucking-anti-vaccine-hippies/Content?oid=8526583 [img:center]http://cdn.uproxx.com/wp-content/uploads/2011/01/measles-yes_jim-carrey-279x300.jpg[/img] Love the back and forth in the comments there: " Other strong correlations re: Autism. The rise of autism strongly correlates with the rise of automobile usage. The rise of autism strongly correlates with increased lifespans. The rise of autism strongly correlates with the rise of cancer rates. The rise of autism strongly correlates with the rise of commercial airline travel. The rise of autism strongly correlates with increased diagnostic techniques, increased attention to mental disabilities, and better access to health serves. The annual rise and fall of drowning deaths strongly correlates with the rise and fall of sales of popsicles."

Not sure if this was in response to my post - but if it was - there's a condensed version of the report here: http://www.iom.edu/~/media/Files/Report%20Files/2011/Adverse-Effects-of-Vaccines-Evidence-and-Causality/Vaccine-report-brief-FINAL.pdf I haven't read the longer report because I'm convinced the benefits of vaccinations vastly outweigh the risks for all but an exceptionally small percentage of the population (I'd guess something like 0.001%<), but if you read the entire report let me know if it influences your thinking in any way. I have an easy time understanding how stupid people reject vaccines (one of whom proceeded to tell me that she doesn't microwave food because "it's been exposed to radiation," just after explaining why she doesn't vaccinate her children - 1)Toxins 2)Doesn't want to "overload" her child's immune system"), but you seem like quite an intelligent fellow and I have a harder time understanding how people I put in the "intelligent-non-expert" category wind up refusing to vaccinate themselves or their children.

The genesis of the current drug shortage is controversial. Seems like a simple and direct consequence of the price control formulas introduced in the Medicare Modernization Act of 2003 - but evidently that's controversial so perhaps its more complicated. http://aspe.hhs.gov/sp/reports/2011/DrugShortages/ib.pdf

By that logic any sort of infection that would activate the adaptive immune system would cause an immune response and B-cell replication, therefore unleashing your said cancer making virus. Not saying your logic is wrong, just that its not specific to immunizations, which goes back to the point I made earlier in my previous post. Every cell in our bodies is rife with self-replicating DNA elements (they constitute roughly half the DNA in our genomes) that resemble viruses (some of them encode their own reverse-transcriptase and integrase, others use the RT and integrase expressed by other "retroelements") that could theoretically exploit the mechanisms of normal cell division to propagate themselves every time any cell of any type divides. Good but slightly out of date review here: http://www.pnas.org/content/101/suppl.2/14572.full Thankfully this is not a new problem, and each cell also has mechanisms that keep them in check. Most of them are also active against exogenous viruses. The APOBEC and TRIM families of proteins are good examples of this sort of innate host defense. Which is a long way of saying that this is one of the many reasons I join you in *not* worrying about the potential for B-cell division in response to immune activation causing cancer, and would be astonished if there's any evidence to suggest that the risk posed by lymphomas derived from B-cell activation in response to vaccines (as opposed to "natural" infections)is even a billionth as likely as getting cancer secondary to infection by an oncogenic virus that could have been prevented by getting vaccinated (HPV is the first that comes to mind). If living organisms with adaptive immune systems didn't have elaborate mechanisms to keep every infection that activates B cells from turning into a lymphoma, or even making it appreciably more likely - they wouldn't have lasted very long. The simple fact that we're here and most of us live to a ripe old age despite our B-cells getting activated roughly a gajillion times is the single strongest proof that these mechanisms are quite robust.

i'm evidently interested in this stuff, so i'll read your recommended link. curious about your own readings? and what you said earlier is a big piece of the puzzle: "some" are susceptible to vaccine injury. some are seemingly not. what the difference is, we aren't entirely sure of, are we? and we aren't sure of the degree of injury that might occur, right? some are obvious: death, loss of limb, brain damage, tissue loss; if there are such overt injuries, are you really willing to say that there might not be more subtle injuries that are harder to connect to vaccines? what do you say about the thousands(?) who have been reimbursed billions by the federal vaccine court, and the many more who have had their claims denied (and have no further recourse) as they grapple with either the loss of their child, or permanent injuries? do you say "well sorry, this is the price we pay as a society. we must sacrifice a few to the gods every year to protect everyone else. i know it seems barbaric, but it's what we must do. there is NO OTHER WAY." the above rings hollow when basic research into safety, comparative studies between vax and non-vax kids, isn't done. i'd LOVE to see vaccines safe, and i do truly believe we can do more to ensure that, but it seems the priority right now is to put the blinders on (maybe that's the agency's pr face?) and deny deny deny the need for doing anything. Re reading: I'm light years away from being an expert, but it's been part of the background noise in places where I've been working for a long time so I can generally connect the jargon/lingo/acronyms with the biology. If someone tosses out terms like opsonization, adjuvants, MHC, TLR, titer, etc I understand what they are talking about. Having said that - I've "Work my way through a immunology textbook" on my to do list for years, and could certainly stand to benefit from following my own advice and refreshing the picture by picking up the textbook I linked. Having said that - that's enough to know that virtually all of the "toxins" that I hear people I consider less than knowledgeable becoming alarmed about, like aluminum salts - are adjuvants that basically amplify the "intruder alert" signal generated when the immune system detects a non-self antigen, and allow the vaccines to generate a higher level of immune protection with less of the specific antigen, etc. As far as vaccine-injuries are concerned, they do occur and there can be legitimate reasons for people with known adverse reactions to them to carefully consider their vaccination practices. The best information I know about regarding the incidence and severity of vaccine injuries is here: http://www.iom.edu/Reports/2011/Adverse-Effects-of-Vaccines-Evidence-and-Causality.aspx IMO the data supports the medical consensus that the cost benefit calculations overwhelmingly favor vaccination, and they are probably the single most cost effective way to save lives and money that medical science has ever devised - but I am not in favor of making being vaccinated a government enforced condition of existence. People should be able to refuse them, but the rest of society is within their rights to refuse them admission to public schools, etc. As far as the claims are concerned, I think that there's probably relatively little connection between the dollar value of claims paid via the NCVIA and the actual incidence and severity of injuries due to vaccination, but I'd have to look at the data first.

the situation is a bit bigger than wakefield and his role. it's bigger than merck falsifying data on a vaccine administered to millions. link it's even bigger than gerberding, former cdc director, leaving her post and going directly to work for merck as head of their vaccine department! i don't think we even need to get into the whole pfizer atrocity in africa, do we? (and people wonder why dem forners are so ignorant and can't just take their (our) meds!). to me, the above are distractions. ok maybe they show that both pharma and some anti-vax researchers will falsify data (surprise surprise), but the bigger problem is that vaccines haven't been studied in ways they could, and there are known problems with them already. i think until this happens, we will continue to have public trust issues, with the accompanying problems undervaccination can lead to (as mentioned in your earlier post). somewhat interesting read for the science types (scroll down to View from the other side and "scientific proofs": link What's puzzling to me is that I haven't ever encountered anyone who actually works in vaccine development who claims that vaccines are entirely riskless for all people. What they believe, and what the data supports, are that the risks from getting vaccinated are miniscule both in absolute terms (e.g. so rare that it takes a massive sample size for any to be detectable, but they can and are detected with robust statistical techniques) and and relative to the risks presented by the diseases themselves, on both the individual and the population level. If I had to offer one suggestion - it would be to translate some of the energy you've got around vaccination into acquainting yourself with the scientific knowledge that mankind has amassed about how the immune system actually functions. Starting with a review paper that addresses the evolution of innate and adaptive immunity is a great way to put all of the different players and their function in context. When you're done with that, then move onto a textbook that addresses their function in fine detail. If you can do both of those things and maintain your current positions - I'd be surprised - but that would be a much more interesting and constructive discussion than a mano-y-mano link-off. -Very good review article on the evolution of adaptive immunity: http://www.ncbi.nlm.nih.gov/pubmed/20651744 Textbook: -http://www.amazon.com/Janeways-Immunobiology-Immune-System-Janeway/dp/0815342438/ref=pd_bxgy_b_text_y

They are *not* free. good point. flu vaccines are a multi-billion dollar industry, and pharma isn't into charity work. http://briandeer.com/mmr-lancet.htm Worth reading through all of the material there in full. Wakefield wasn't engaged in a charitable enterprise either. "“Science is at once the most questioning and . . . sceptical of activities and also the most trusting,” said Arnold Relman, former editor of the New England Journal of Medicine, in 1989. “It is intensely sceptical about the possibility of error, but totally trusting about the possibility of fraud.” Never has this been truer than of the 1998 Lancet paper that implied a link between the measles, mumps, and rubella (MMR) vaccine and a “new syndrome” of autism and bowel disease. Authored by Andrew Wakefield and 12 others, the paper’s scientific limitations were clear when it appeared in 1998. As the ensuing vaccine scare took off, critics quickly pointed out that the paper was a small case series with no controls, linked three common conditions, and relied on parental recall and beliefs. Over the following decade, epidemiological studies consistently found no evidence of a link between the MMR vaccine and autism. By the time the paper was finally retracted 12 years later, after forensic dissection at the General Medical Council’s (GMC) longest ever fitness to practise hearing, few people could deny that it was fatally flawed both scientifically and ethically. But it has taken the diligent scepticism of one man, standing outside medicine and science, to show that the paper was in fact an elaborate fraud. In a series of articles starting this week, and seven years after first looking into the MMR scare, journalist Brian Deer now shows the extent of Wakefield’s fraud and how it was perpetrated. Drawing on interviews, documents, and data made public at the GMC hearings, Deer shows how Wakefield altered numerous facts about the patients’ medical histories in order to support his claim to have identified a new syndrome; how his institution, the Royal Free Hospital and Medical School in London, supported him as he sought to exploit the ensuing MMR scare for financial gain; and how key players failed to investigate thoroughly in the public interest when Deer first raised his concerns."

They are *not* free. good point. flu vaccines are a multi-billion dollar industry, and pharma isn't into charity work. 1. Most infectious diseases that we vaccinate against aren't lethal or even particularly dangerous to healthy adults. If you are a healthy adult with a normal immune system and catch them - you'll likely feel bad for a few days and recover. Protecting yourself from feeling bad for a few days is one reason to vaccinate, but not the only one, and far from the most important one. If you are a normal human you'll interact with lots of people who interact with lots of other people - a certain percentage of whom are very young, very old, or have an immune system that is suppressed because they've recently received an organ transplant and are on immunosuppressants, they have a chronic medical condition which requires that they take medicines which suppress their immune function to some degree or another, they have HIV, etc. The most important reason to vaccinate is to break the chain of transmission that would otherwise lead to vulnerable infants, elderly, or immuno-compromised people getting infected with the flu, etc, and becoming severely ill or dying. 2. If we are going by a consistent standard, then the motives of everyone engaged in *any* productive activity that they are paid for are suspect since it isn't by definition, charity work. Judges, nurses, park rangers, professors - run right down the roster and you won't find more than a handful of people who would continue to pursue a particular line of work if they weren't being paid, because they couldn't. So - not into charity work...compared to which industry? "The Conference Board surveyed 211 of the largest companies and corporate foundations, and found that they gave $9.78 billion in 2005, up more than 18% from the previous year. Most of that money was spent in the U.S, with only $2 billion going overseas. More than half of all donations were products, rather than cash. But that doesn't necessarily mean companies have become more generous; they're simply making more money. As a percentage of pretax income, companies in the survey actually gave less to American charities in 2005--1% of their U.S. earnings, compared with 1.6% the year before. In Pictures: The Most Charitable Industries Pharmaceutical companies, however, are far more generous than others. Perhaps because they're fighting an increasingly negative public image, drug firms in the survey reported donating 13% of their U.S. income to American charities. The global numbers give a slightly different picture, but drug firms still come out on top. Pharmaceutical companies donated 1.51% of their worldwide sales to charity; no other sector gave more than 1%, and many gave less than one-tenth of 1%." http://www.forbes.com/2007/01/16/leadership-philanthropy-charity-lead-citizen-cx_hc_0116charitable.html