Yes, we have different definitions of "good data."

"Good data" for me is enough to establish if there's a public health need. "Good data" for you is much, much higher.

"the test indicates that the last X vaccination was ineffective"

And perhaps impossible. Do these tests even exist? In the various papers I read, there are tests for given antibodies, but the only hard numbers I saw are the infection rates. What's the false positive/false negative rate for these tests? How much do they cost? Who should pay for them, and what's the effective benefit?

Also, the test doesn't need to be 100% effective in everyone in order to be useful. That's the logic behind herd immunity.

"Look at pretty much any vaccine label for evidence to support that."

I did look at the Vaccine Information Statements for several vaccines. I pointed you to one as well.

DTaP: Severe Problems: 1) Serious allergic reaction (less than 1 out of a million doses), 2) Several other severe problems have been reported after DTaP vaccine ... These are so rare it is hard to tell if they are caused by the vaccine.

Hepatitis B: Severe Problems: Severe problems are extremely rare. Severe allergic reactions are believed to occur about once in 1.1 million doses.

MMR: Severe problems: 1) Serious allergic reaction (less than 1 out of a million doses), 2) Several other severe problems have been reported after a child gets MMR vaccine ... These are so rare that it is hard to tell whether they are caused by the vaccine.

Then there's the ones that don't even have numbers, which I assume puts it in the "greater than 1 in a million" probability.

Meningococcal: Severe problems: Serious allergic reactions, within a few minutes to a few hours of the shot, are very rare.

Pneumococcal Conjugate (PCV13): Life-threatening allergic reactions from any vaccine are very rare.

Haemophilus Influenzae Type b (Hib): The risk of Hib vaccine causing serious harm or death is extremely small

Since I couldn't find one with < 1e6 probability of severe problems, perhaps you can point it out to me?

If your clinic has done 100,000 shots, then that's still under a 10% probability that any of their patients have had a problem. But the math doesn't work out as simple as that. If someone isn't allergic to DTaP the first time then that person likely isn't allergic to it the next 4 times. I estimate more like a 2% rate.

> there was a "Massive Pertussis (fear mongering) Outbreak"

Which was an outbreak mostly among those who have not been vaccinated. Your child had been vaccinated. (Well, you didn't say if this was after the 2 month, 4 month, or 6 month shot. If it started the day after the 2 month shot then the immunization wouldn't have started being effective. I don't have enough data to go on.)

> the main thing that any ped. can do to inspire confidence is not to be dismissive of parents' concerns or questions

Agreed. You have every right to make that decision. It is a proper one.

My argument is that your demands on the quality of the information you expect - personalized tests after every vaccination, for example - is not possible. It's expensive, even if feasible, and the major benefit seems to be that it makes people like you more confident.

But that data will also have vague and uncertain parts. It won't be a simple statement of "the last vaccine did not provide enough immunization" but "the number of antibodies is 10% lower than the recommended level. This may increase the risk that your child will be infected in the future by between 1% and 15% compared to full immunization. Enough other children have been immunized so the overall probability is very low, unless <list of circumstances>. Should you wish a booster shot, please contact your physician."

You complained about "waving more CDC pamphlets at us" -- interpretation of this additional data leads to still more CDC pamphlets.

"I question the claim that in practice, vaccines are manufactured, distributed, and administered with a near miraculous failure rate."

Why do you think it's 'near miraculous' any more than having potable fresh water come out of your tap? A clean water supply has probably saved more lives than all the vaccinations ever done in the US. We bathe in drinking water!

The vaccines which have the higher failure rates, like anthrax, aren't part of the normal schedule. The allergic reaction rate to the anthrax vaccine is ">100,000" so 10x higher than those children get.

The yellow fever vaccine lists "Severe allergic reaction to a vaccine component (about 1 person in 55,000)" and "Severe nervous system reaction (about 1 person in 125,000)" and "Life-threatening severe illness with organ failure (about 1 person in 250,000). More than half the people who suffer this side effect die." That's much higher than anything I saw on any of the childhood vaccines.

Let's look at some less successful vaccines.

The RTS,S malaria vaccine only reduced the chance of infection in children by 31%, which it lower than the 50% that the researchers had hoped for, and much lower than the 90+% from the best childhood vaccines.

The RV 144 HIV vaccine is estimated to be 31.2% effective, but "there is no more than a 71 percent chance that the vaccine was effective at preventing HIV." There are of course many AIDS vaccines which just plain didn't work.

The attenuated form of the polio vaccine would sometimes revert to a more virulent form, which caused vaccine-induced polio in about 1 in 750,000 cases. The US switched to the less effective inactivated form, because those rare polio cases aren't worth the advantage.

And so on.

The first vaccine was for smallpox in 1796. The first compulsory vaccine law was in England in 1853. The rabies vaccine was in 1885. The first polio vaccine in 1955. There's a lot of work behind that "near miraculous failure rate." Why are you so astonished?

For that matter, there are failure rates, just not at the level where you're looking. People get the wrong shots, last year "160,000 doses of the Novartis vaccine, Agrippal, [were] recalled after 'particles' were found in the vials", and this year Merck recalled "1 lot [27,000 vials] of Recombivax HB hepatitis B vaccine (adult formulation, 10 μg/mL) because some of the vials may be cracked."

And so on.

Why does any of this require you have "unreserved faith in the manufacturers of vaccines, and the government", any more than you have faith in the builders of your car, the maintainers of the traffic lights, or the pilots and builders of the plane you fly?