zlacker

https://observablehq.com/@mbostock/the-impact-of-vaccines

That figure is real hard to refute, or square with any other cause of reduction of measles infections except vaccination.

>>hprota+(OP)
That's true -- though the figure you're linking focuses specifically on measles cases rather than overall mortality, which is what the OP article is focusing on.

(as an aside, it's really weird that the (first few) comments here on HN seem a little adversarial; I wonder if maybe some people looked at the headline only and assumed it was attempting some sort of anti-vax argument, which the article isn't doing at all.)

>>DanAnd+W1
The problem is that anti-vaxxers will use the headline as their entire justification for their opinion which is not supported by the content under the headline.

>>hprota+(OP)
You are talking a different time scale. Take a look at this figure from the article:

https://rootsofprogress.org/img/mckeown-1975-fig-6.png

Modern medicine and vaccines have undeniably reduced the occurrence and severity of diseases, but the occurrences of these diseases were already down over 90% by the time we came up with vaccines. It's not wrong to recognize that tremendous achievement.

>>dahfiz+fc
Furthermore, it indicates that we do not need to paint vaccine hesitant people as harbingers of societal collapse. That belief has been used to justify hateful rhetoric that is divisive, unproductive, and cruel to those who believe they were injured by vaccines.

>>DanAnd+W1
So there is something odd going on with measles. I haven't dug into the data, but from a couple of data points I've seen, it seems that measles mortality was declining for a long time even while measles cases were not. That is, there was a decline in the case-fatality rate, without a decline in cases. The disease was still around but getting less deadly. Then the vaccine actually reduced the number of cases.

So what was reducing the case-fatality rate? I don't know, but it might have been nutrition. There's evidence at least that Vitamin A makes measles less severe/deadly.

>>jasonc+Lo
> So what was reducing the case-fatality rate?

Sanitation, antibiotics, oral rehydration therapy, machine ventilation, nutrition, and so on.

It's not the measles itself that was the cause of most fatalities, it was the pneumonia, diahrrea, and other opportunistic infections that come with it.