The Dish

It prevents outbreaks like this:

A spokesman for the California state health department has told Reuters that he believes “unvaccinated individuals have been the principal factor” in a mid-December measles outbreak at Disneyland that has infected more than 70 people in six western states and Mexico, including five Disney employees.

Sarah Kliff spells out how more individuals getting vaccinated could have protected the six infants who got sick:

The measles vaccine is not licensed for use on babies younger than 12 months. That means that, for the first year of life, babies depend on the fact that everybody else around them gets vaccinated. This essentially creates a firewall: if other people are vaccinated, they won’t catch the disease — and won’t spread it to young children who cannot get protection.

This is what scientists call “herd immunity,” and its a huge reason we get vaccines in the first place. The shots aren’t just about protecting ourselves from measles, mumps, the flu, or other diseases. They’re about making it really hard for those who are medically frail (like the elderly) and those who can’t get the vaccine (often babies and pregnant women) to catch a disease that could be devastating to them.

Another reason herd immunity is important is because vaccines don’t always work. Katie Palmer explains:

The measles vaccine is actually one of the most effective vaccines in the world. According to Greg Wallace, lead of the measles, mumps, rubella and polio team at the CDC, two doses are 97 percent effective against infection. (Compare that to 88 percent for two doses of the mumps vaccine from the MMR shot.) It’s a live version of the virus, just weakened—or attenuated—so it doesn’t cause severe symptoms. The vaccine replicates just like the full-on measles virus, inciting your immune system to produce antibodies against it. Those antibodies then protect against actual measles as well.

But in some people, that response just doesn’t happen. No one knows why. Either your body doesn’t produce enough antibodies, or the ones it does produce aren’t specific enough to latch on to the virus and kill it.

After reviewing recent court cases, Eugene Volokh finds legal support for requiring vaccinations:

Phillips v. City of New York (2d Cir. Jan. 7, 2015) reaffirms that the government may mandate vaccinations. It may mandate vaccinations for everyone, and it can certainly mandate them for everyone who goes to public school. Seems quite right to me; there may indeed be a presumptive constitutional right to be free from unwanted medical treatment, but such a right can be trumped by the very strong public interest in preventing people from becoming unwitting carriers of deadly illness. … Such statutes often do allow religious exemptions, but that’s not a matter of constitutional obligation. In Phillips, the one of the plaintiffs did try to claim the exemption, but the trial court found that her “objections to vaccinations were not based on religious beliefs,” and the plaintiff didn’t appeal that finding.

Genna Buck looks at where our vaccination rates need to be:

In California’s Santa Monica-Malibu school district, 11.5 per cent of parents refuse to vaccinate their kids. In nearby Orange County, the figure is 8.6 per cent. In Beverly Hills it’s five per cent—almost, but not quite, a safe level of vaccine coverage. In a large study that observed measles infections in the Netherlands over decades, scientists calculated that 95.7 per cent of a population needs to be immune to measles to prevent regular outbreaks. And since no vaccine is perfectly effective, even more than that number need to be vaccinated to protect the whole community.

Tara C. Smith notes that MMR vaccination is “at or close to 90 percent by age 3 and about 95 percent by kindergarten”:

However, national statistics obscure local trends. Those 5 percent who are unvaccinated aren’t randomly distributed throughout the country. Instead, they tend to cluster in location, with many unvaccinated children living in close proximity to others, creating anti-vaccine communities with high susceptibility to measles and other vaccine-preventable diseases.

Why this is so dangerous:

What many forget is that we had a massive outbreak of measles in the United States from 1989–1991. While our 644 cases in 2014 seems high compared with recent years, 25 years ago measles incidence spiked to 18,000 cases per year, with a total of more than 55,000 infections before the outbreak began to dwindle. It was the largest measles outbreak in this country since the 1970s. … Despite our advances and our modernity and our status as a developed country, we still saw 123 measles deaths during this epidemic—here, in the United States, where we get plenty of Vitamin A. There were also 11,000 hospitalizations—fully one-fifth of people infected with measles became sick enough to be hospitalized.

(Chart from the CDC)

This was to be the winter of their deep content. Having won the mid-terms on a platform of pure fear and panic, they had Washington DC in their pocket. The agenda was going to be theirs – even if they hadn’t run on much of a platform. They would prove to be a capable governing party again, get the Congress in order, and finally put an asterisk next to Obama’s name for two years.

And what has happened since? We’ve had an attempt to ban all abortion past twenty weeks, with an implicit claim that some rapes are not legitimate (because they weren’t reported to the cops). Critical Republican congresswomen balked, and a largely symbolic vote on a day devoted to pro-life activism collapsed in disorder. Before that, the House voted on the most draconian legislation yet that would require, by some analyses, deporting up to 10 million undocumented immigrants. Moreover, the polling of the base shows, as Aaron Blake argued, that

Although [Republicans] supported citizenship over deportation 43 to 38 percent in November 2013, today they support deportation/involuntary departure over citizenship, 54 to 27 percent. That’s two to one — a stunning shift.

Meanwhile, Obama’s ratings among Latinos have sky-rocketed and Jorge Ramos is now unrelenting in his attacks on the GOP. On economic policy, the Republicans have focused on the Keystone Pipeline and free trade treaties. And that may be it. Dave Camp’s real tax reform proposals fizzled. Cutting Medicare or social security in today’s climate is a very heavy lift. Reform conservative policies have not found a compelling advocate. On foreign policy, the decision to invite Binyamin Netanyahu to address the US Congress (again!) over the head of the sitting president is a grotesque blunder. That’s particularly so as the speech will take place two weeks before the Israeli elections – a piece of meddling that really will hurt the US-Israel relationship.

But don’t take it from me, take it from Fox News:

And what is the argument the GOP wants to make on Iran? That it should be the US that derails the critical last stage of the talks? And that, after doing that, we should respond with a new war in the Middle East to prevent what would then be a rush to get the bomb in Iran? Makes. No. Sense. If the GOP wants to fight the next election on the basis of re-entering the Iraq War with ground troops or a huge bombing campaign against Iran, they’re welcome to try. But the American public is not as obsessed as Sheldon Adelson and AIPAC with the Middle East. And the Iraq war was not a Clint Eastwood fantasy. Even Americans haven’t forgotten that.

Then we had the spectacle of last weekend’s Steve King confab in Iowa. In Roger Simon’s words, the clown car became the clown van. The crowd egged on the far right to go further over the edge. The one candidate who might begin to appeal to more than the base – Bush – was a no-show. By all accounts, Scott Walker gave a bravura performance, which may be the only salient thing to last once the vapors have lifted (and he’s worth watching). But to have so many wackos deliver such red meat to a far right base – with Palin and The Donald delivering random strips of steak tartare – is not a basis for appealing to the broader middle any major party has to, if it wants to govern and not merely scream.

The Palin speech was truly a wonder – an Allen Ginsberg-style Republican “Howl”. I know that with respect to her, I’m an alcoholic who shouldn’t go near a bar – but I couldn’t help myself. Watching the stream of narcissistic, delusional consciousness was like downing three shots of Jäger at once. And there were times when it seemed as if she’d done the same thing (just pick any three minutes at random):

A party that nominated a deranged fantasist like this for vice-president – and still lets her rally its base – is, to put it mildly, a joke. Her one political strength – her ability to channel populism – is undermined by the fact that the GOP has a much less appealing set of proposals to address that, compared with the Democrats. This is an era when cultural populism may finally be weaker than economic populism. Obama’s SOTU was simply a reminder that in this moment, with growth returning but all of it going to the very top, the left-of-center party has the advantage. And a right of center party that refuses to raise any taxes on the extremely rich is at a steep disadvantage. There are some reform conservative ideas that are worth airing in that respect – but they are not stirring the base and do not have – as of yet – a plausible GOP proponent or candidate. The only one who might pull it off has the Bush name hanging like an albatross around his neck. And Romney? All he will do is generate energy against him from the base.

Of course, this could change. Events could intervene; the economy might falter again; Putin could do something very reckless. One candidate may surprise us. But right now, the GOP looks to me like a party unable to see any enemies to the right, with few policies to address soaring inequality, deeply alienated from Latinos and African-Americans, and with a foreign policy that looks increasingly like Cheney’s.

That’s not a party headed back to government. If it stays the course, it’s headed toward oblivion.

(Photo: Muhammad Mahdi Karim from Wiki)

Over the weekend, Greek anti-austerity party Syriza, lead by firebrand Alexis Tsipras, claimed a resounding victory. Matt Schiavenza contemplates the sizable implications:

Tsipras’ victory presents the troika—a consortium consisting of the European Central Bank, the European Commission, and the International Monetary Fund—with a series of unappetizing options. If the troika gives in and writes down Greek debt, then other, larger countries—such as Spain—will have an incentive to negotiate a similar deal, triggering a major financial headache in Brussels and Frankfurt. If the troika refuses, then Greece is likely to default on its debt obligations this year and be forced to exit the eurozone—a fate that neither Tsipras nor the European leadership say they want.

Either way, the events in Greece signal that Europe’s long, failed experiment with austerity is cracking. In addition to Syriza, anti-austerity parties have grown popular in Spain, where opinion polls show Pablo Iglesias’ Podemos with 20 percent support. And Euroskeptic parties gained heavily in last years’s European parliament elections, particularly Marine Le Pen’s National Front Party, which has campaigned against fiscal austerity in France.

James Forsyth fixates on Syriza’s forming “a coalition with a party that takes just a robust view as it on the need to renegotiate the terms of the Greek bailout, The Independent Greece party”:

Independent Greece and Syriza have little in common other than their view on the bailout, Independent Greece sits in the same group as the Tories in the European Parliament. That Alexis Tsipras has chosen to do a deal with them rather than the leftist Potami who favour a less confrontational approach to the troika is telling. It shows that he has no intention of blinking first in his negations with the IMF, the rest of the European Union, the European Central Bank and the European Commission. ​

George Magnus is unsure how this ends:

Negotiations will start very soon because there are outstanding loan tranches and repayments to be sorted out by 1 March, and larger repayments to the IMF in July and August. Most likely, technical agreements will be reached to extend or reschedule payments due. The crux, however, is that the troika creditors will come face-to-face with a Greek government that is quite different from its predecessors, which included factions and groups whose political interests were almost indistinguishable from those of creditors and of the policies they espoused.

Greece and its creditors could forge some kind of mutually face-saving compromise over the terms of the debt so as to manage debt servicing better, and offer Greece some relief. But it will be much harder to reach agreement regarding the policies of austerity and structural reform, and the more radical changes to living conditions that Syriza has campaigned on.

Daniel V. Speckhard foresees major hurdles:

The need to get agreement across the members of the European Union, and in some cases, parliamentary approval, makes it a tall order, particularly if one is under a tight time frame. And the populist rhetoric that the far-left government can be expected to adopt in its early months combined with no experience in managing international relations or public messaging for foreign audiences, is likely to complicate negotiations further.

Bloomberg View’s editors want the troika to give ground:

Europe’s leaders have to clearly understand the meaning of Sunday’s vote in Greece. Germany, Finland and the EU institutions that have lent Greece money must now negotiate with Tsipras in good faith — as they refused to do with more co-operative governments that preceded his — to soften the destructive economic policies they have imposed. Although this will encourage Syriza-like protest parties in Spain and elsewhere, such is the cost of ignoring the political dangers of Greek austerity for so long.

Yves Smith highly doubts Syriza will get what it wants:

[W]hat happens when Syriza comes to realize that the Troika is deadly serious, which I believe it is? Whether the Eurocrats are right or not, it seems that at least the Fins and the Germans see Greece as disposable. Their leaders believe that throwing it out of the Eurozone or simply taking radical punitive measures if Greece does not do a deal by the summer rollover date will be at most disruptive but not fatal to the Eurozone; indeed, they may believe any short-term [crisis] would be to the Eurozone’s long-term benefit, since making Greece a demonstration case of how costly it is to defy the Troika would serve to cow the rest of the periphery countries.

Hugo Dixon tries to imagine a way forward:

[T]here might be a way of cutting a deal. The snag is that doing so would involve a massive somersault – or what Greeks call a “kolotoumba”. Many of Tsipras’ backers would then accuse him of betraying their cause. It is still far from clear whether he is prepared to do that. But if the Syriza leader is not prepared to compromise, Greece will default and will have to impose capital controls to stop the banks collapsing. If the people then forced the government to backtrack, there would be one final chance to stay in the euro. Otherwise, the drachma would beckon.

Tom Rogan fears Syriza has lost touch with reality:

Syriza’s platform is, in fact, delusional. Alice in Wonderland comes to mind. “If I had a world of my own,” Alice says, “everything would be nonsense.” The Greek voters who brought Syriza to victory are asking for nothing less. After all, what are German taxpayers to make of Syriza’s proposals? Having already spent many billions to save Greece from a fiscal meltdown and preserve its euro-zone access, Germans are now being asked to give up on getting their money paid back. Syriza’s debt-forgiveness plan is fundamentally unserious.

But Dan Hough’s research suggests that Syriza will be more moderate in office:

In terms of Greece’s immediate future, a Syrzia-dominated government is unlikely to live up to the often radical pre-election rhetoric.  Syrzia is likely to take decisions that supporters find very difficult; but it will take them nonetheless.  Whether it gets any credit for them when Greece next goes to the polls is an altogether different matter.

However, Spyros Economides warns that “Greece is entering a period of deep uncertainty”:

Syriza’s victory may indeed turn out to be pyrrhic. It is confronted by the immense task of governing at a time when Greece may be ungovernable, while also facing a potentially divisive internal struggle. International partners have also made it clear that the new Greek government, whatever its makeup, will have to honour the country’s existing agreements and commitments.

If Greece’s international creditors don’t come through with quick concessions, or if radical opposition rears its head against Syriza’s more moderate approach, this could trigger an uncontrollable reaction based on fear of uncertainty. That could lead to an accidental default, which would have disastrous consequences for Greece.

(Photo: A sign is held up stating ‘We start from Greece-We change Europe’ as supporters of Syriza react as exit polls showing their party is set to win the election on January 25, 2015 in Athens, Greece. By Matt Cardy/Getty Images)