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In a roundabout way, the C.I.A. has been blamed for the Pakistan killings.

The killings, with eerie echoes of attacks that killed nine female polio workers in Pakistan in December, represented another serious setback for the global effort to eradicate polio.

Since the vaccine ruse in Pakistan, she said, “Frankly, now, I can’t go to them and say, ‘The C.I.A. isn’t involved.’ ”

Rogobo, you make a welcome and important point. But reality is that this topic seems to give rise to insult because it has high stakes (precious cargo on board! kids! death and disease). If you think it's hard to hear a message while people are shouting insults, what's it like being deaf because your mummy got rubella while pregnant? I would put it like this: Notion 1: A world without effective serious infection vaccine is uglier and less pleasant than the alternative (polio, anyone?).  Notion 2: At a population level, vaccines improve outcomes more than they harm them.  Notion 3: At a population level, improved outcomes and the prospect of eradication is dependent on high individual participation. Notion 4: At an individual level, there is some risk associated with vaccination. Notion 5: Healthy people not taking the risks of vaccination are: (a) free riding on those who are taking the risks; (b) reducing the prospect of eradication; (c) increasing the prospect of passing infection to those medically incapable of taking the risk Notion 6: Individual liberty and freedom to choose might sometimes be trumped by requirements of public welfare Happy to have any of those notions challenged and discussed