What are the right questions to ask about any vaccine? As Thomas Pynchon noted in his subversive novel Gravity’s Rainbow,

If they can get you asking the wrong questions, they don’t have to worry about answers.

I claim the key queries solicit the risks and benefits of a potential inoculation, because the consumer should prospectively and subjectively weigh the risks and benefits of a proposed vaccine to make an ultimate informed decision.

I shall evaluate the Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccine, which is typically given sometime between the 27th and 36th weeks of pregnancy but also can be given immediately postpartum (after pregnancy), to illustrate this process. The Centers for Disease Control and Prevention (CDC) website provides detailed information about the Tdap vaccine, which is given “to reduce the burden of pertussis in infants”. Pertussis is commonly known as whooping cough.

When do infants receive their first pertussis vaccination? Current pediatric guidelines recommend that infants receive their first pertussis inoculation — via the DTaP vaccine — at the age of 2 months. This means that the advocates of the Tdap vaccine are attempting to prevent infant pertussis-related cases, hospitalizations, and deaths for an approximate time period of 2 months (the elapsed time from birth to date of DTaP inoculation).

What are the benefits of the Tdap vaccine, assuming 4 million births per year in the United States and 100% effectiveness of the vaccine? Based on the data listed on the CDC website, the benefits are as follows:

No Tdap vaccine

Infant risk in first 2 months of life

Developing pertussis                                    0.107450%

Hospitalization due to pertussis                  0.048450%

Death from pertussis                                    0.000875%

Tdap vaccination during pregnancy

Infant risk in first 2 months of life

Developing pertussis                                    0.072000%

Hospitalization due to pertussis                  0.030050%

Death from pertussis                                    0.000450%

Tdap vaccination immediately postpartum

Infant risk in first 2 months of life

Developing pertussis                                    0.085950%

Hospitalization due to pertussis                  0.039725%

Death from pertussis                                    0.000725%.

To summarize, the burdens of infant pertussis are tiny without the Tdap vaccine, the Tdap vaccine statistically minimizes this burden in the first two months of life, and Tdap vaccination during pregnancy works slightly better than Tdap vaccination immediately postpartum.

Further research, however, reveals that the CDC currently estimates that the Tdap inoculation is only effective approximately 70% of the time. Again, the calculations I performed previously assume the vaccine is 100% effective. Thus, the true potential benefits of the Tdap inoculation are tiny * 0.7.

What are the risks of the Tdap vaccine? The CDC website lists the following potential recipient side effects:

Mild

Pain (66%)

Redness/swelling at injection site (20%)

Fever >= 100.4 degrees Fahrenheit (1%)

Headache (30%)

Fatigue (25%)

Nausea/vomiting/diarrhea/stomach ache (10%)

Chills/body aches/sore joints/rash (rare)

Moderate

Pain (1%)

Redness/swelling at injection site (4%)

Fever >= 102 degrees Fahrenheit (0.4%)

Headache (0.33%)

Nausea/vomiting/diarrhea/stomach ache (1%)

Severe

Pain (rare)

Redness/swelling at injection site (rare)

Bleeding (rare)

Allergic reaction (0.0001%).

To summarize, for adult recipients of the Tdap vaccine, the risk of mild side effects is likely, the risk of moderate side effects is unlikely, and the risk of severe side effects is rare.

Should an American female receive the Tdap vaccine? I don’t know. I cannot logically evaluate the prospective, subjective decision of a female in an “objective” manner to deliver a judgment of the “rightness” or “wrongness” of the ultimate choice. Why not? The definitive libertarian statement on this issue is Robert Higgs’s seminal paper, entitled “Banning a Risky Product Cannot Improve Any Consumer’s Welfare (Properly Understood), with Applications to FDA Testing Requirements”, in which the author demolishes the idea of an external observer arbitrarily substituting an ex post subjective analysis for the ex ante subjective analysis of the decision-making individual.

In the final analysis, the risks and benefits of the Tdap vaccine are scientifically small. Regardless of the data, however, any individual decision about receipt or rejection of the Tdap inoculation cannot be objectively applauded or criticized by others. These specific facts mean, in general, for the contentious overall vaccine debate, that vaccine proponents and opponents should stop characterizing each other as lunatics, consumers need to review the relevant scientific data before receiving any vaccine, and State-mandated vaccination is a bigger crime than you think.