Re: Vaccine efficacy

From: hal@finney.org
Date: Mon Feb 07 2000 - 12:55:24 MST


Robin's thesis is provocative and challenging, and I don't have suggestions
for resolving the mystery of the root causes of declining mortality.
However one comment: Robin writes:
> >http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4829a1.htm#fig1
>
> And did you notice that the
> US death rate doesn't seem to fall any faster after the major medical
> events the graph indicates?

While this is true, it is still possible that the medical advances were
necessary for the decline to continue. We could draw an analogy with
Moore's Law. The introduction of integrated circuits, and later of very
large scale integration, did not increase the rate of improvement in
electronic densities. Moore's Law has been roughly constant for many
decades. But we would not conclude that the various advances played
no part in the improvement; rather, they were a necessary element in
continuing the improvement.

In the same way, we don't know what would have happend if vaccines and
other medical technologies had never been developed. But I think it is
plausible that these played a role in continuing the decline of mortality.
If we did not have these technologies, it is possible that the factors
leading to the earlier improvements in health (nutrition, or education,
or whatever they turn out to be) might have reached a limit in their
effectiveness.

Hal



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