In the 1950s, with 0% vaccination rate, measles caused about 400-500 deaths per year in the US. Flu causes are about 20,000 deaths per year in the US, and smoking perhaps 200,000. If US measles vaccination rates fell to 90%, and we had 100-200 deaths per year, that would be pointless and stupid, but for public health effects the anti-smoking political controversies of the 1990s were >10 times more impactful.
US population in 1950 was about half what it is now, and population density in cities has probably increased even more. The counterfactual with a 0% vaccination rate today is surely much worse than 400-500 deaths per year.
Assessing, correctly, that the people now in charge of US vaccine policy are wrong, obviously wrong, pointlessly wrong, and causing grave harm from their wrongness.
Conflating, incorrectly, the magnitude of infuriating wrongness for magnitude of harm.
Matthew Yglesias wrote an article about how vaccine policy is the most shocking thing Trump has done. If you go by gut feel, that might seem like a reasonable guess. If you go by math, I don’t think it’s close to passing a fermi estimate[1].
Addressing your comment: yes, the US population is twice as high now as in the 1950s, and that’s a good point. But the case fatality rate for diseases like measles is >2 times lower in 2026 hospitals than 1950′s hospitals (1950s hospitals had few ventilators). City densities have not increased since the 1950s (we are more suburban), but doesn’t matter for measles because it’s R_0 is too high and ≈nobody escaped measles in the 1950s even in rural areas. If we ignore all of that and say at 90% vaccination 2,000 people die per year, 4 times as many as in the 1950s with 0% vaccination, that’s still less than one tenth the impact of smoking public health policy changes in the 1990s. I don’t guarantee I’m correct on all math and facts here but I think it’s overdetermined.
In the 1950s, with 0% vaccination rate, measles caused about 400-500 deaths per year in the US. Flu causes are about 20,000 deaths per year in the US, and smoking perhaps 200,000. If US measles vaccination rates fell to 90%, and we had 100-200 deaths per year, that would be pointless and stupid, but for public health effects the anti-smoking political controversies of the 1990s were >10 times more impactful.
US population in 1950 was about half what it is now, and population density in cities has probably increased even more. The counterfactual with a 0% vaccination rate today is surely much worse than 400-500 deaths per year.
My bigger point is I think people are doing this:
Assessing, correctly, that the people now in charge of US vaccine policy are wrong, obviously wrong, pointlessly wrong, and causing grave harm from their wrongness.
Conflating, incorrectly, the magnitude of infuriating wrongness for magnitude of harm.
Matthew Yglesias wrote an article about how vaccine policy is the most shocking thing Trump has done. If you go by gut feel, that might seem like a reasonable guess. If you go by math, I don’t think it’s close to passing a fermi estimate[1].
Addressing your comment: yes, the US population is twice as high now as in the 1950s, and that’s a good point. But the case fatality rate for diseases like measles is >2 times lower in 2026 hospitals than 1950′s hospitals (1950s hospitals had few ventilators). City densities have not increased since the 1950s (we are more suburban), but doesn’t matter for measles because it’s R_0 is too high and ≈nobody escaped measles in the 1950s even in rural areas. If we ignore all of that and say at 90% vaccination 2,000 people die per year, 4 times as many as in the 1950s with 0% vaccination, that’s still less than one tenth the impact of smoking public health policy changes in the 1990s. I don’t guarantee I’m correct on all math and facts here but I think it’s overdetermined.