Re: Vaccine efficacy

From: Robin Hanson (
Date: Mon Feb 07 2000 - 11:47:28 MST

"ct" wrote:
> > The US polio death rate was ~1/500 of the total US death rate when
> > the vaccine was introduced. Not a negligible factor, but surely much
> > smaller than many other influences on health. And the other vaccines
> > had even smaller effects on total mortality.
>"Every year, up to three million children's lives are saved by immunization.
>But almost three million more lives worldwide are lost from diseases that
>are preventable with existing vaccines. "

Worldwide 54 million people died in 1998. So even the highest estimate
of a pro-vaccine advocacy group were right, that would only be 5.5% of
total mortality. I am looking up the academic sources that site cites
to see what evidence there is for this claim. Of course preventing
5.5% of deaths is a good thing, but it is far large enough to be a big
part of the ~x3 decrease in total mortality over the last century or so.

>"The two public health interventions that have had the greatest impact on
>the world's health clean water and vaccines. ...
> > Medicine overall seems to have very little effect on health. This is
> > the usual answer from statistical analyses, and from the few controlled
> > experiments we have.

Yes, you can find a lot of advocacy groups making strong claims.
But quotes from these groups are not an adequate response to my directly
citing evidence from the academic literature on this topic.

On the effect of medicine overall in the US, I point you to:

Joseph P. Newhouse And The Insurance Experiment Group,
Free For All? Lessons from the RAND Health Insurance Experiment,
Harvard University Press, 1993, ISBN 0-674-31914-1

On medicine outside the US, I point you to:\workpapers.nsf/View+to+Link+WebPages/

On the effects of water/sanitation, I point you to:

The effects of improved nutrition, sanitation, and water quality on child
health in high-mortality populations, by Leng-fei Lee, Mark Rosenzweig and
Mark Pitt, J. of Econometrics, 77:209-235, 1997.

> >The mortality rates of most diseases treated by antibiotics didn't
> >change noticeably upon the introduction of that treatment. ...
>"Deaths from infectious diseases have declined markedly in the United States
>during the 20th century (Figure 1). This decline contributed to a sharp drop
>in infant and child mortality (1,2) and to the 29.2-year increase in life

This quote doesn't contradict my statement. And did you notice that the
US death rate doesn't seem to fall any faster after the major medical
events the graph indicates?

Robin Hanson
Asst. Prof. Economics, George Mason University
MSN 1D3, Carow Hall, Fairfax VA 22030
703-993-2326 FAX: 703-993-2323

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