Slashdot Mirror
On the Efficacy of Flu Vaccine
The Atlantic is running a major article questioning the received wisdom about flu vaccines and antivirals, for both seasonal flu and H1-N1. "When Lisa Jackson, a physician and senior investigator with the Group Health Research Center, in Seattle, began wondering aloud to colleagues if maybe something was amiss with the estimate of 50 percent mortality reduction for people who get flu vaccine, the response she got sounded more like doctrine than science. 'People told me, "No good can come of [asking] this,"' she says... Nonetheless, in 2004, Jackson and three colleagues set out to determine whether the mortality difference between the vaccinated and the unvaccinated might be caused by a phenomenon known as the 'healthy user effect.' Jackson's findings showed that outside of flu season, the baseline risk of death among people who did not get vaccinated was approximately 60 percent higher than among those who did, lending support to the hypothesis that on average, healthy people chose to get the vaccine, while the 'frail elderly' didn't or couldn't. In fact, the healthy-user effect explained the entire benefit that other researchers were attributing to flu vaccine, suggesting that the vaccine itself might not reduce mortality at all." Read below for more excerpts from the article.
The annals of medicine are littered with treatments and tests that became medical doctrine on the slimmest of evidence, and were then declared sacrosanct and beyond scientific investigation. ...
This is the curious state of debate about the government's two main weapons in the fight against pandemic flu. At first, government officials declare that both vaccines and drugs are effective. When faced with contrary evidence, the adherents acknowledge that the science is not as crisp as they might wish. Then, in response to calls for placebo-controlled trials, which would provide clear results one way or the other, the proponents say such studies would deprive patients of vaccines and drugs that have already been deemed effective. ...
In the absence of better evidence, vaccines and antivirals must be viewed as only partial and uncertain defenses against the flu. And they may be mere talismans. By being afraid to do the proper studies now, we may be condemning ourselves to using treatments based on illusion and faith rather than sound science.
The annals of medicine are littered with treatments and tests that became medical doctrine on the slimmest of evidence, and were then declared sacrosanct and beyond scientific investigation. ...
This is the curious state of debate about the government's two main weapons in the fight against pandemic flu. At first, government officials declare that both vaccines and drugs are effective. When faced with contrary evidence, the adherents acknowledge that the science is not as crisp as they might wish. Then, in response to calls for placebo-controlled trials, which would provide clear results one way or the other, the proponents say such studies would deprive patients of vaccines and drugs that have already been deemed effective. ...
In the absence of better evidence, vaccines and antivirals must be viewed as only partial and uncertain defenses against the flu. And they may be mere talismans. By being afraid to do the proper studies now, we may be condemning ourselves to using treatments based on illusion and faith rather than sound science.
It really seems the data can be massaged to draw any conclusion that is desired. In my case, up until three years ago I had never had a flu shot. During a typical winter I would be sick at least twice on average, usually missing about four or five days of work in total. Since I've started having seasonal flu shots I have not had any winter illness and missed no time from work. While hardly scientific, it seems to me that the downside/upside in my personal case weighs heavily towards receiving the vaccine. There are clearly other viruses in human history where vaccination has had a profound and measurable effect which is beyond debate.
The flu shot is not about preventing you from dying. It's to avoid you from getting sick and infecting other people who may have weaker immune systems and have higher risk of dying if they get sick.
I *thought* about getting a placebo, and didn't get the flu. I'm suggestible as hell.
Yes, today's placebo is almost twice as powerful as those used as little as 5 years ago.
While this does raise some questions about the efficacy of the vaccine. It doesn't prove conlusively it does nothing. Not that you would know that from the editorializing the author does.
... I became biased against any conclusion. Up here in the Pacific Northwest, the common nickname of this HMO is "Group Death". They're not exactly known for high quality care or cutting edge research - they're mainly known for denying treatments as "experimental" for years after those treatments have become the norm in most medical circles.
I remember an acquaintance (husband of a co-worker) who kept getting denied treatment for (IIRC) a persistent and very painful hydrocele. The Group Health doc told him nothing could be done - surgical correction of this was "experimental and dangerous". Finally out of desperation they consulted with an outside doc, who told them this was a very simple routine procedure! They paid out-of-pocket for the surgery, and the problem was quickly rectified.
I know nothing about the particular doctor who did this flu vaccine study - but, given her employer, I have very little confidence that she is particularly knowledgeable. I'm sure Group Health would love to save the 15 or 20 bucks per patient they're currently having to spend on this vaccine.
#DeleteChrome
I took a placebo and I didn't catch Flu.
Actually it sounds like you caught a nasty case of placebocitis, a nasty flu-like infection that has no perceivable symptoms including a lack of high fever, no stomach ache or GI irritation, soreless throat, non-inflamed tonsils, and pounding migraine headaches not being reported.
W
-------------------
This is my SIG. There are many like it, but this one is mine.
The live attenuated flu vaccine, FluMist is substantially more effective than the inactivated injected vaccine (something that's blindingly obvious to those of us who've studied basic immunology). It provides a potent T-cell response, and a large pool of memory cells. Furthermore, it has been shown to be effective against viruses that have undergone some genetic drift.
For anyone who is old enough, has no respiratory problems, and who isn't immunosuppressed, the live nasal spray vaccine is a much more sensible choice.
For additional data refer here: http://www.cdc.gov/flu/professionals/acip/efficacycomparison.htm
I don't whether to laugh or cry.
Also a second situation which would lead to the similar results. That people who got the shot...*gasp* likely got the shot the previous year and *shock* have some built up immunity due to the previous years shot.
This physician... not a biologist. Sounds like shes not very good at what shes supposed to be doing. The information she presented proves nothing. She randmly concludes just 1 or many possible scenarios based on her predisposition. Poor poor science.
Randomized, controlled trials have shown the effectiveness of flu vaccines, contrary to the claims of the article. (Example: Wilde et al., "Effectiveness of Influenza Vaccine in Health Care Professionals.")
In addition, research into mortality reduction already takes into account comorbid conditions and age. (Example: Nordin et al., "Influenza Vaccine Effectiveness in Preventing Hospitalizations and Deaths in Persons 65 Years or Older in Minnesota, New York, and Oregon: Data from 3 Health Plans.")
The article is at best poorly researched and at worst intentional FUD.
Due to a long history of unethical behavior in the medical field, there are stringent requirements that require one to show a need for research and to demonstrate safety concerns before one can begin an investigation.
This often means that simple experiments that could show benefit and harm of an intervention will not be done because of a large body of circumstantial evidence.
There has to be a fairly even view of outcomes on both sides of a trial before it will be approved - or other studies showing possible efficacy of the side that is under question will need to be done first.
When these situations arise, one can often perform the experiment in a subset of the population in which vaccine efficacy is questioned and benefits are unknown.
The population of HIV infected individuals is one such population and there are double-blind placebo controlled trials done in this group.
The annals of internal medicine (an American College of Phyicians publication) http://www.annals.org/cgi/content/full/131/6/430 published an investigation showing the efficacy of the influenza vaccine in a population that was least likely to benefit from it. While mortality data is not available here, its results stand on their own as a testament to the clinical efficacy of the vaccine.
When all else fails, try.
36,000 die of complications from the flu annually in the US. That's very nearly as many as die from car accidents.
There is a very simple way to test the effectiveness of a vaccine and that is to carry out a double blind study utilising placebos alongside the active vaccine. Any effect that is solely due to the "healthy user effect" would be virtually eliminated.
further problems: the article has no references, no real hard data from relevant studies and several studies contradict the article's assertions.
Sigs are too short to say anything truly profound so read the above post instead.
I think it's commendable that folks still challenge received wisdom, and are actually attempting to answer difficult questions, as opposed to merely sweeping them under the carpet.
However at the same time, we need to be super, super careful that we don't encourage the fringe extremist nutters in the antivax movement, who are sure to seize upon doubts of the efficacy of the swine flu vaccine as PROOF that all vaccination is bad, and that we should protect our kids by going to flu and chickenpox parties because it's "natural".
And I would need convincing that this isn't some kind of stunt by Group Health or other elements of the private health industry to wriggle out of paying for flu shots. Gotta love profit-focused private "health" care, and its useful idiot defenders on the Right.
The WHO and CDC are driving the H1N1 vaccines, not the vaccine companies. No matter how good the lobbyists for the vaccine companies are, they aren't good enough to get the government to step in and bear the liability without some government agency agreeing that there is actually something there to address.
(The issue with H1N1 is not its lethality once it has infected a person, but how good a job it does of infecting those who are exposed)
Nerd rage is the funniest rage.
I'm all for testing the conventional wisdom, and when combined with my tendency to avoid medicine where it isn't necessary it appears that I should support this kind of article. But when it comes to vaccines there's a problem - antivaxxers. Regardless of the chance that one particular vaccine might not really be worth taking, it's frankly irresponsible to put out this kind of article without firm proof. Show me where the clinical trials for the vaccines went wrong and how everyone else who looked at the efficacy of the flu vaccine missed it. Otherwise... and I really hate to say this... shut up. There are people out there who will use this as ammunition in their irrational campaign against vaccines in general, and those people will get other people killed. Not just people who choose not to get themselves vaccinated for the flu, but their children, and the children of other people who for are unable to get the vaccine due to an allergy, or for whom the vaccine had no effect. Those people would normally be protected by group immunization that kept them from ever being in contact with the virus in question, but when there's a real movement in our country to avoid vaccines... well we start to slip below the threshold in some places.
We killed smallpox outright, but every vaccine since then has been prevented from achieving its final goal through the effort of anti-vax forces of one kind or another. That's the reason I have to be against this sort of article - even the chance that it might be correct isn't worth the near-certainty that it will be another blow for vaccination in general. If they had any sort of actual firm proof, it would be different, but this sort of conjecture *is* dangerous - and not to the person doing the conjecturing.
Does a line appended to your comment give your post meaning in and of itself, or only in relation to those without?
Not that the medical establishment even gets trained to do this. The last thing a sick person wants to hear is "we haven't got a clue what's happening".
Anecdotes are all we have in everything except the exact sciences. All other sciences is based on anecdotes and stories, or their similar, but more systematic brother : data. Only things confirmed by controlled and direct experiments is real, trustworthy data, only such things lend themselves to real predictions. And most sciences, like medical science, climate science, social science, and any part of the humanities just doesn't allow experiments. We can't infect people with designed viruses to see what they do, we can't inject masses of gasses into a planetary athmosphere and see what happens and we can't run experiments on humans, never mind the issue that repeating any experiment on a thinking creature can obviously only result in a manipulated result.
But the problem is more general. People abhor the answer : "we don't know this" or " we couldn't change this". Science has long since become a sort of religious status, where it's claims are total. Details like that the scientific method just doesn't work like this are not mentioned. You can see the headlines : "does the earth warm ? Scientists doubt it" (that would be what the scientific method dictates : that you doubt it, and the more you believe it's warming the more thoroughly you should go looking for any indication that you're wrong. Some scientists actually still do this, but it's an ever shrinking group, especially in the politicized sciences)
But the issue of not knowing is problematic. Take the economic crisis for example : the basis of the problem is that nobody expected the cascade effect that failing mortgages would have. The problem is : the scientific reasoning for concluding that it couldn't happen was, statistically, very sound : it never happened before. In 50, and for some banks 200 years of data, the statistical algorithms never encountered that situation, so they concluded it to be impossible. You can wine all about it, but that's an entirely correct conclusion.
Whatever your position about climate change, it is a science that will encounter the same problem : It has very limited data at the moment, real, quality (calibrated and double-checked), first hand data is limited to less than 200 years, and the list of huge energy reserves that are not considered is very likely to be a long list. The list of how they respond to different climatic events is likewise limited : we don't even know how half of them reacted in the past. Even if we did know that, there is the possibility that we are in a new situation, and things could react very differently to a very different situation. If such were true all statistical inferences would be 100% correct, and yet they would not match reality at all. You cannot test for this (despite how much people like to think that if "variance is explained 100%" that it can't happen, even though the variance in the financial data was 100% explained, it failed to predict the cascade failure). Yes humans put (a bit, compared to the ocean) of co2 in the athmosphere, they also put a few million other gases in the athmosphere. What will happen ? The pedantic, information theoretically correct answer is : "we haven't seen this before, we don't know. If we saw this one gas rise in concentration due to natural causes, a million years ago we would have seen a tempearture rise". Of course nobody likes that answer.
Evolution theory dictates that training everyone's immune system before infection will result in one of 2 things :
a) either viruses die
b) they learn to bypass it entirely, making vaccines entirely ineffective
So far, every success by science in finding some way to fight disease has ended in option b. It just never was vaccination, the human immune system, our last line of defence, that was manipulated by science. And it's a defensible position that a number of incidents came close to b), like the spanish flue of 1930 for example.
You joke, but there's mounting evidence that the placebo effect is indeed getting stronger.
(Of course, conducting a double-blind test to confirm this would create numerous paradoxes)
-- If you try to fail and succeed, which have you done? - Uli's moose
Sounds like you're having a devil of a time figuring it out.
rewriting history since 2109
We also ignore here that there actually is a valid fear behind the hysteria. This H1N1 strain can mutate to a much more lethal strain (and in my view is more likely to do so than a regular human flu strain). A vaccine now might retain enough effectiveness to save lives in that situation. Last time, I played a flu FUD spreader on Slashdot, someone pointed out that society is much more resistant to flu than before, better hygiene, flu vaccine, etc. But it remains that we get a flu season every year. The flu gets around despite the better hygiene, the flu shots, etc.
I'd be pissed if the doctor didn't tell me there was a very slim chance that it might be a more serious form. The Doc did the right thing, as it emphasized that the patient should come back if things get worse, indicating that it might be a bacterial caused menegitis.
A few billion dollars spent on vaccines is going to save hundreds of thousands or millions of lives. That's a fucking fantastic cost-benefit ratio for public health dollars.
Nerd rage is the funniest rage.
"Let's pray that science wins out over irrationality."
That's what the article's point is! It's not saying "vaccines don't work" it's saying "they say vaccines reduce the death rate by 50% and the numbers don't bear that out. What's the real number?"
And that's a fair question. We know the virus isn't 100% effective, it damn near killed this girl: http://www.google.com/search?pg=q&fmt=.&q=dystonia+flu+vaccine
Neither though is anybody saying the vaccine is zero percent effective or universally toxic, what happened above is a rare edge case (but as an aside it would be nice to be able to predict when this was going to happen, this is a fairly *catastrophic* edge case).
But the examples brought up in the article do suggest there is sustantive argument that the claimes reductin of 50% reduction in martaliry rate is indeed in question, that's all.
Nobody's actually measuring people who have anti-bodies of a specific type, the data gathered is fairly meaningless by lumping a lot of things (rhinovirus, coronovirus etc) as "flu", also the cohort factor and related effects do have a demonsterable non-zero effect on the mortality rate.
So, it's not a question of is the vaccine useful or nor, more like a plea for more accurate analysis and gathering of the data in question.
Need Mercedes parts ?
You seem to be confusing the current seasonal flu with the pandemic of 1918.
They are by no stretch of the imagination comparable.
A Pirate and a Puritan look the same on a balance sheet.
LOL.
When you regurgitate silly right-wing talking points SCREAM AND YELL and STAMP YOUR FEET LIKE THIS, set up straw men and knock them down, it makes you look like the paragon of sensible, common sense, level headed conservatism.
Really!
By the way, all health authorities, public and private, have to ration. I've got no idea where people got the idea that one should pay for an average health plan (whether private or single payer), and then expect to have millions spent on cutting edge, experimental, and extremely expensive medicine when they get sick.
Believing that paying for a bargain-basement health plan in the US and believing that you'll get Herceptin when you get breast cancer, is extremely naive.
Oh, and by the way: even in the SOCIALIST COMMUNIST NAZI government run health systems, if you don't like the basic plan, you're free to go private. Of course, they'll ration too. I've never heard of a country with a single-payer or government run health system not let people go private and pay for gold-plated health cover.
Of course, if were weren't listening to fat, drug-addled idiots on AM radio or FOX News, and actually spent time in the real world, you'd already know this, wouldn't you?
You get nothing for nothing in this world, dumbarse.
>The flu shot is not about preventing you from dying. It's to avoid you from
>getting sick and infecting other people who may have weaker immune
>systems and have higher risk of dying if they get sick.
It's been a long time since biology classes in high school.
Even if I'm immunized, can't I be a carrier?
A work that expires before its copyright never enters the public domain and thus enjoys eternal copyright protection.
Anytime there's a controversy over vaccines or prescription drugs, there is only one thing that needs to be widely understood by everyone: pharmaceutical companies cannot make money from healthy people.
Of course they can.
Between 1900-02, the life expectancy at birth was 49.24. In 1997, the life expectancy at birth was 76.5. Statistic
Keeping your customers healthy now pays big dividends later.
Healthy people age into old age. Well, duh.
They have families. They have pets. They work longer and have more discretionary income.
That makes it worthwhile to invest in a broad spectrum of products that would have had little meaning to the industrial laborer of 1920 who was unlikely to see his fiftieth birthday.
"Words like "global pandemic" should be reserved for something more dangerous than the sniffles"
No, it shouldn't. Pandemic refers to the number of people infected and how quickly it spreads, not how deadly it is. People should fucking learn what this term means, rather than assuming it means "AMAZING DEADLY SUPER VIRUS". We should NOT redefine it to mean "SUPER DEADLY SUPER VIRUS".
Swine flue IS a pandemic. It's not super amazingly deadly, but it IS a pandemic. The paranoia is not the fault of the government. This paranoia is the fault of the dipshit idiot populous that elects idiots into the government and then ceases to think for themselves.
-1 disagree is not a modifier for a reason. -1 troll, flaimbait, redundant, overrated are NOT acceptable substitutes.
Read the Atlantic article. The researchers' data set was specific to seasonal flu in people 65 and older!!! Yet did the article highlight this or confine the discussion to efficacy against seasonal flu among people 65 and older? No--it mentioned it once and then made general statements about the potential efficacy of vaccination for ALL PEOPLE for both seasonal flu and H1N1! Even if vaccination against seasonal flu doesn't reduce the death rate of people over 65 at all, H1N1 flu is demonstrably lethal to children, healthy young adults, and people under 65 with common preexisting health conditions like asthma or HIV. By getting vaccinated against H1N1, you not only reduce YOUR risk of death, but also the risk that you'll contract and pass on H1N1 to someone else who will then die of it. Get vaccinated!!! Also, look at how the article selectively hypes the credentials of the vaccine skeptics. They say Jefferson "knows the flu-vaccine literature better than anyone else on the planet." Really? There are 7 billion people on the planet; that's a bold statement. They say the Cochrane Collaboration is "a highly respected international network." That may be true, yet they fail to apply corresponding adjectives to Dr. Anthony Fauci, who was highly respected and the director of the NIAID the last time I checked. Selective, arbitrary hyping of the credentials of skeptical researchers on one side of the debate only is a classic pop science writing technique to sell magazines and create controversy. Where have I seen this before? Cecilia Farber's horrendous Harper's magazine article promoting HIV denialism (and nearly all other HIV denialist writing, incidentally). Selective credential hyping makes me doubt the authors' impartiality and trustworthiness on the whole topic. The article also states that young, healthy people "aren’t the people who die from seasonal flu." That's a wild overgeneralization. Young, healthy people have a lower risk of dying from seasonal flu but no guarantee it won't kill them. Many will read that statement and forget that (a) it excludes pregnant women, who are young and otherwise healthy but not defined as "young, healthy people" because they are immune suppressed during their pregnancy and highly vulnerable to death from the flu, and (b) the statement is about seasonal flu, not H1N1 which is already killing healthy young people today! The researchers are reasonable in calling for more studies on this question and pointing out the problem in rolling out treatments not tested in controlled trials, but Fauci is right in pointing out that giving people a placebo in a traditional prospective, double-blinded trial could be unethical. There is a potential perfect solution to this problem alluded to already by ColdWetDog. Since we have a shortage of the H1N1 vaccine at this time anyway, set up a study that looks at the death rate of people depending on what date they are vaccinated, before and after vaccination. The people waiting for vaccination (due to the shortage) become the controls for themselves (after vaccination) as well as for the people who get vaccinated earlier. Since we're UNABLE to vaccinate everyone right away due to insufficient availability of the vaccine, there's no ethical problem. This is called a "waiting list control." This would require a large study size and more statistical care than a traditional treatment/placebo protocol, but would be an ethical way to get the data we want for H1N1. I'd fully support doing such a study. Popular magazines should either stop covering science or should get scientists to review their articles written by lay journalists for scientific and statistical accuracy before they publish. The editors at magazines like The Atlantic and Harper's clearly do not have the scientific or statistical literacy to do the job themselves. I'm sick and tired of seeing popular magazines make selective and incorrect use of data and invalid logic to draw incorrect conclusions that mislead the public and cause people to doubt that HIV is the cause of AIDS, fear and doubt vaccines when they should welcome them, etc. Creating FUD and misconceptions is harmful to public health, leads to the deaths of innocent people who can't decipher misinformation, and drives up health care costs for us all.
In 1968 and 1997, the vaccine produced was the wrong one, it didn't match the prevalent strains for the following winter. People who got vaccinated were effectively receiving a placebo for the strain that they were most likely to come in contact with. There was not a corresponding spike in the number of deaths. It could be argued that those strains were less deadly than usual, but it would be an amazing coincidence if it just happened to correspond to the two years no one got an effective vaccine.
If the flu vaccine reduces the number of deaths by 50% as is claimed, there should have been a 33% rise in deaths when no one was immunized. There wasn't.
More of the people most at risk are getting vaccinated, 15% of people over 65 vaccinated in 1989, 65% today. That should have caused a significant reduction in mortality. But the number of deaths is rising. Again, an amazing correspondence is claimed, that the strains are more deadly every year.
These are the two reasons that further study is needed, regardless of how strong your faith in vaccination is.
This sentence no verb.
But, that's not the scenario that we're in. We're looking at billions for the vaccines, and tens or hundreds saved. Not thousands. not millions. With the incomplete testing done, and many assumptions being made (hey, it's similar to something else, it oughta act the same).
According to the CDC, the vaccine can cause Guillain-Barré Syndrome in 1 of 100,000 treated, or roughly 3,000 people in the United States (by the 2008 US Census population estimate).
The CDC also shows a relationship between egg allergies and possibly fatal side effects from the vaccination. They simply state that if you have an egg allergy, do NOT take the vaccine. That's approx 2.5% of the population under 5 years old. That's ok, the population under 5yo is only 21,000,000 (again, 2008 US Census est), which would bring the possible death toll to 525,000.
So, we're up to 528,000 possibly dead from the vaccine.
The CDC also indicates "Life-threatening allergic reactions to vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the shot is given." No numbers are included here, and I wasn't able to find any.
"Very rare" is a wonderful number. They use the same term for the Yellow Fever vaccine, which is estimated to be fatal in 1 in 400,000.
The US has started using a combined number in reporting H1N1 cases, so their national number of 928 doesn't give a good indication of how many were really H1N1 related. Still, 928 untreated and dead, versus hundreds of thousands who could die from the vaccine (a small percentage of the total population, but still more than necessary) makes for an unjustified number.
I'm not gathering these numbers from any fear mongering source. I've researched these numbers from trustworthy sources (hmm, like the CDC themselves). The answer of "shut up and trust the government" is never a good answer. Question everything, and you won't be made a fool of. Well, in this case, you may not end up dead from the cure.
Serious? Seriousness is well above my pay grade.
"Pharma doesn't make a dime from healthy people."
Well, that's a myth. Pharma makes big dollars *even* from healthy people. All you need to consider is that "cosmetics" is another name for "pharma".
"They want you in poor health, but not quite ready to die."
That's not exactly true. An overall ill society is not a society that will pay for expensive treatments. Pharma needs a healthy mixture (pun intended) of long-term ill people and healthy people to pay for the treatment; that's why you see a lot of investment on first world-low impact illnesses (when treated) like obesity, hypertension or diabetes or, the best of all, cosmetics (where the "illness" is only in the mind of the buyer) but so little on, say, malaria.
No matter how good the lobbyists for the vaccine companies are, they aren't good enough to get the government to step in and bear the liability without some government agency agreeing that there is actually something there to address.
Huh?
The US Government backstops liability for all vaccines, except where it grants outright immunity from lawsuits.
1986: http://en.wikipedia.org/wiki/National_Childhood_Vaccine_Injury_Act
The liability is otherwise so big that no private insurer will touch it.
(Same thing goes for nuclear power.)
Both the USA's dept of Health and Human Services (HHS) and the European Union's Parliment have granted pharmaceutical companies immunity from lawsuits relating to H1N1 vaccines. The USA's HHS Secretary went one step further and granted immunity for all future swine flu vaccines.
I'm not sure how Europe normally handles vaccine liability, but I'm sure a /.er can fill us in.
You're right though that the WHO and CDC are driving the H1N1 vaccines.
They're so desperate to get out ahead of the flu that they're accepting calculated risks.
[Fuck Beta]
o0t!
"H1N1 flu is demonstrably lethal to children, healthy young adults, and people under 65 with common preexisting health conditions like asthma or HIV."
What you seem to forget is that seasonal flu -*any* year's seasonal flu, is demonstrably lethal to children, healthy young adults, and people under 65 with common preexisting health conditions like asthma or HIV.
Certainly all this issue seems to be poisoned by sensationalist press beyond repair, one way or another but, to-date, all objective measures seems to point that while H1N1 *could* have been a tragic deathly pandemia it will be no significantly worse than any other seasonal flu (and even its very highly contagious rates owes a significant percentage to the fact that it is actively seeked and diagnosed), but Pandora's box is already opened and it's in no one interest (press, pharma, government) to try to close it now.
"I'm sick and tired of seeing popular magazines make selective and incorrect use of data and invalid logic to draw incorrect conclusions that mislead the public"
That's the way the go with everything, so no surprise there.
According to Webster's New World Medical Dictionary:
Pandemic: An epidemic (a sudden outbreak) that becomes very widespread and affects a whole region, a continent, or the world.
Influenza A Virus Subtype H1N1(commonly called the swine flu) erupted suddenly, became widespread, eventually being found on all continents(save Antarctica).
Therefore, yes, H1N1 is, by definition, a pandemic.
I don't like Linux. This doesn't make me a troll.
INDIVIDUALS making FREE-AS-IN-SPEECH decisions on THEIR OWN health care..
Raise your hand if your employer picked your insurance for you.
You forget that people apparently lived to be over 900 years old back in those days. I'm sure that their calendars were perfect, right? Why would they write 70 when they should have written 900 or 400(I know, I know, post Flood vs. pre Flood and all that).
Basically, what I am saying is that you cannot trust the Bible(a religious, not scientific, book) to tell you the average age of people.
I don't like Linux. This doesn't make me a troll.
gr8_phk: Considering your personal experience with the individuals you happen to have known is not a scientifically valid way of determining the severity of the threat that seasonal flu or H1N1 pose to different demographic groups. Only scientific studies of large groups and retrospective studies of particular groups (e.g. reviewing the demographics of those who die of flu/H1N1 vs. demographics of the population as a whole) can accurately determine risk levels. See http://www.flu.gov/individualfamily/parents/pregnant5tips.html, which notes "Pregnant women, even ones who are healthy, can have medical complications from the seasonal and H1N1 (Swine) flu."
You are correct that infants do get a partial immune boost from antibodies they receive from the mother. However, you are not correct in concluding that infants therefore have "very good immunity" to seasonal flu, H1N1, or pathogens in general. In fact, infants younger than 6 are both more generally vulnerable to disease (because they have not yet been exposed to germs and developed the diverse immunity of an adult) and also particularly vulnerable to seasonal flu and H1N1. That is why cdc.gov notes that "people who live with or care for children younger than 6 months of age" are one of the priority groups for H1N1 vaccination: not to protect them, but to reduce the risk of transmission to their infants under 6 months who are especially vulnerable. See http://www.cdc.gov/media/pressrel/2009/r090729b.htm
It's true that you could volunteer to participate in a study, and I'm glad you're willing to help advance science in that way. However, consent from the subjects is not (alone) sufficient to guarantee that conducting a study is ethical. Scientific ethics guidelines require that the study be deemed inherently ethical by a Human Subjects Research review board. Regardless of what level of risk the subjects are willing to accept, it's only ethical to conduct a study that exposes them to a level of risk that is commensurate with the scientific benefit to be achieved, and not in excess of some absolute limits as well. For example, even if there were human subjects willing with full informed consent to allow their syphilis to go untreated, it would not be ethical to conduct a study that studied the long-term effects of untreated syphilis by deliberately denying available treatment to participants with syphilis (a la the infamous Tuskegee study, which of course compounded the injustice further by using prison inmates as subjects, not getting their informed consent to boot, and selectively using subjects from a particular ethnic group rather than others, among other issues).
"What you seem to forget is that seasonal flu -*any* year's seasonal flu, is demonstrably lethal to children, healthy young adults, and people under 65 with common preexisting health conditions like asthma or HIV." I didn't forget that at all. I simply pointed out that even if it's true that seasonal or H1N1 flu vaccination doesn't reduce the mortality rate of people over 65 (which I'm not saying is the case), that's still not a valid reason to conclude that seasonal/H1N1 flu vaccination doesn't reduce the mortality rate or have other benefits for other groups--which is the invalid deductive leap the article makes. (The article doesn't rely SOLELY on this single study; they do try to selectively pull in some other evidence from other studies. But primarily, this article is driven by the study of mortality rates among people over 65.)
It's also worth pointing out that mortality rate is only one of many metrics that can be used to evaluate the efficacy of vaccination. For example, productivity gains from preventing or minimizing the duration/severity of seasonal/H1N1 flu infection are another benefit. Flu can lead to complications like pneumonia, which even if not fatal can lead to additional complications like liver, kidney, or heart damage, etc.
H1N1 is a particular strain of influenza A that has made its way around the world and vaccination against this strain is being done separate from the seasonal flu shot. Concern over this strain is related to its virulence and early reports of death amongst young, immunocompetent individuals - people normally not adversely affected by influenza.
The common cold and the flu are not the same thing - there is a believed to be a high mortality from influenza ( http://aje.oxfordjournals.org/cgi/content/full/163/2/181 ) as compared to the cold (corona virus (with exception of SARSCoV, rhinovirus - deaths generally related to asthmatic patients). 40,000+ deaths per year is a significant mortality rate. Morbidity from influenza would be much more. It makes it difficult to believe that it should be overlooked.
When all else fails, try.
All you have to do is look up Vaccine on Wikipedia to see some people don't like vaccines for whatever reason
It's stupid to inject yourself with something that does nothing. Especially when the thing that may not do anything for you, also has a non-zero chance of side effects that are much less pleasant than the original thing you were trying to prevent. That's a pretty good reason.
This article points out that we don't really know if the flu vaccine (any flu vaccine) does anything.
Since there is no good evidence either way, "better to be safe than sorry" can apply either way too. Which makes your heavy-handed dismissal of those questioning the flu vaccine every bit as faith based as the "freaks" you look down on with such contempt.
Meet the enemy, for he is you.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
During a typical winter I would be sick at least twice on average, usually missing about four or five days of work in total. Since I've started having seasonal flu shots I have not had any winter illness and missed no time from work.
Since we're going into anecdotes I can say I used to get a bit more sick than that, about three times a winter with usually one incredibly bad illness lasting about a week.
I stopped drinking soda, and drink water instead, and now I might get one mild cold a winter but sometimes not. I get about the same level of exercise and eat about the same (i.e. whatever the hell I want) with perhaps a touch more vegetables.
That's also all without ever having a flu vaccine shot. You have to wonder if just a few simple lifestyle changes across the U.S. would not totally eclipse any benefit from flu shots. And since I am not getting sick as often, I'm also not getting other people sick as often - the exact same benefit some claim for the vaccine approach. Only my overall health in all other matters is better too, unlike a flu vaccine which prevents only one thing, and temporarily at that (I have nothing against things like polio vaccines which make a ton of sense because they last forever).
"There is more worth loving than we have strength to love." - Brian Jay Stanley
A recent Time article about the virus and vaccination said that the 2 billion for this round of H1N1 vaccines may very well have saved the vaccination companies. The big drug companies don't usually want to make vaccines, not sexy enough or profitable enough. The few small players in it do a steady business but don't get big chunks of money for R+D. This vaccination for everyone changes this a bit. It also may encourage the big pharm companies to get back into the game, I heard a recent radio news bit about that happening.
In a way I can see encouraging companies that can help combat a pandemic to stay in business. But really this H1N1 strikes me as a 2 billion bailout for the vaccine makers.
Actually, if anyone bothered to look into it, rather than listening to the media outlets, 'the swine flu' is less than half as likely to kill you as the average seasonal flu. By 'average seasonal flu' I mean take the past 50 years worth of deaths related to seasonal flus and you'll find about 0.12% of the infected people die. By contrast, 0.05% of those infected with 'the swine flu' have died.
It is a pandemic, but the flu has been a pandemic forever, as is the common cold. The media just doesn't have anything else to get our attention so this is what they exaggerate into being scary.
Persistent Volume manager for Kubernetes - https://github.com/dwimsey/openshift-pvmanager
No, H1N1 is not a pandemic. H1N1 is a CLASS of influenza viruses, and its not a new class. 'The swine flu' is a member of the H1N1 class. The class is the most common, by a land slide.
You've had a H1N1 infection before unless you're a few months old.
'The swine flu' is by definition a pandemic.
Persistent Volume manager for Kubernetes - https://github.com/dwimsey/openshift-pvmanager
pandemic (from Greek pan "all" + demos "people") - an epidemic of infectious disease that is spreading through human populations across a large region; for instance a continent, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic. Further, flu pandemics exclude seasonal flu.
It doesn't have to be serious. Hell, it doesn't even have to be deadly. H1N1 is nether infectiously stable nor seasonal, thus it qualifies as a pandemic.
The word only raises fears among the ignorant who think they know what it means.
--- Keep the choice with the user..
You probably shouldn't worry about dependency with the vaccine. Unlike a chemical medication which augments or replaces your natural response to influenza, the vaccine "tricks" your body into thinking you have the flu and spurs your immune system to learn how to destroy the infection. It's actually providing a small exercise for your immune system.
I get the vaccine each year primarily because I can't be out of work for a week. Because I happen to be an employer, rather than employed, I can expect to lose about $8000 in income if I get the flu. Small business has it's down side. I also happen to have a pragmatic minimalist view of medication. I have about 8 different head/chest/cold medications in my cabinet. Each does one specific thing - I don't buy "combination" medications like Nyquil or Contac Cold & Flu. On the rare occasion I don't feel well, I take what I need to ensure that I get a good night's sleep and avoid sinusitis (to which I'm sensitive) - no more, no less.
As an engineer, I look at the problem logically and find the most efficient solution I'm aware of. The vaccine has a very low incidence of problems. The payback is cutting my chance in half (or better) of losing $8000 for a $10 copay with my insurance. I figure the possible complications from actually getting the flu are just as bad - and more likely to occur - as complications from the influenza vaccine, so the worst case is it's a wash. Plus, it reduces the chance that my wife and daughter will get it, though they get vaccinated as well - no sense in them feeling like crap for a week. It's not perfect, but it's better than the alternative.
As soon as we get H1N1 in my area, I'm getting it. My local school system is offering it free of charge to students (note: not requiring it). Smart, if you ask me, as the schools and school age children are the number 1 vector for local spread of the virus (business travelers are the number 1 vector for spread between localities, imho).
Is it just my observation, or are there way too many stupid people in the world?
The problem is that H5N1 is rattling around out there, and it can cross-breed with H1N1 strains. So far H5N1 doesn't spread well in humans, but it *is* quite deadly. If someone gets two strains of flu at the same time, they're likely to hybridize. So it's important to keep flu infections to a minimum. Given time, H5N1 will become less deadly as it evolves to live with people, but it needs to have it's numbers kept down until it does. And that means don't give it the genes that H1N1 uses for spreading.
I think we've pushed this "anyone can grow up to be president" thing too far.