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Health Care Workers, Flu Vaccines, and Work Place Discrimination

dorit-reissGuest blog by Dorit Rubinstein Reiss. Dr. Reiss is a Professor of Law at the University of California Hastings College of  the Law in San Francisco, CA. Dorit writes extensively in law journals about the social and legal policies of vaccination. This article discusses employer and employee rights regarding vaccination requirements in healthcare institutions.

In a previous post, I described a New Jersey Court of Appeals case in which Ms. Valent was denied unemployment benefits because she refused to be vaccinated against the flu without claiming the religious exemption. I explained that the hospital was not constitutionally required to provide a religious exemption, and that doing so was a losing proposition from a hospital’s point of view.

In the comments following that post, it was correctly pointed out to me that there is another claim I should have addressed: a claim that the hospital was required to provide a religious exemption under the Civil Rights Act of 1964. This did not come up in the case itself: the court reinstated the nurse’s unemployment benefits on constitutional grounds, though problematic constitutional grounds. But since I argue that hospitals should not offer a religious exemption, I need to address whether the hospital is required, under Title VII, to offer an accommodation. 
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Why we vaccinate–mandatory flu vaccines reduce risk of hospitalization

flu-shot-smiley-faceAccording to the unsurprising results reported in a new study, published in the Morbidity and Mortality Weekly Report, in areas where laws mandate that children receive a seasonal flu vaccination, before entering preschool or day care, the rate of flu-related hospitalizations drops significantly. In this study, after Connecticut enacted a law that mandated the vaccine, the rate of children requiring hospitalization because of the flu declined by 12%.

Connecticut’s regulation for flu vaccination (pdf), which took effect in 2010, increased the uptake of childhood flu vaccinations from 67.8% to 84.1%. According to Dr. James Hadler, the lead researcher for the study, “That difference, we feel, has resulted in children attending daycare being better protected against influenza and its severe complications.”

Even though Connecticut’s regulations for flu vaccination allows for some exemptions (the child has a scheduled appoint for the shot soon after the start of school, medical contraindication, or religious belief), it’s obvious that the effort was highly successful in driving up the level of uptake of the flu vaccination, a vaccine that is often ignored by parents for occasionally odd reasons.

Since 2010, the U.S. Centers for Disease Control and Prevention (CDC) has recommended that everyone older than six months should get a flu shot every year. Unfortunately, only New Jersey and New York City mandate the flu vaccine (along with all other vaccines recommended by the CDC at that age group). With this evidence, it is possible that other states will include the flu vaccine in the vaccination requirements for children entering school.

Parents seem to think that the flu is not very dangerous, so they tend to ignore the flu shot, even if they are strongly pro-vaccine for almost all of the other vaccines available for themselves or their children. Sadly, this year’s flu season is actually taking an larger toll on younger and middle-aged Americans, since so many of them neglect to get the vaccine. The influenza strain commonly known as “swine flu” is killing young and healthy people who typically don’t think they need to worry about this illness.

There is a belief that the flu is only dangerous to the very young, the very old or those with chronic diseases. However, many flu pandemics are not that particular about what age group is most affected. The infamous Spanish Flu Pandemic of 1918 is a case in point. Over 99% of the deaths were in individuals under the age of 65, and more than 50% of the deaths were in young adults, 20-40 years old.

Even though it’s late in the flu season, it’s not too late to get the flu shot, whether adult or child. And when the 2014 flu season starts, make sure you’re vaccinated then.

Oh, one more thing. This type of actual retrospective epidemiological data provides evidence that the flu vaccine is highly effective. Another trope of the antivaccination cult circling the drain of pseudoscience.

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Vaccines save lives–30K US adults die annually of preventable diseases

President Obama getting his flu shot.

President Barack Obama receiving his flu shot.

One of the consistent tropes of the antivaccination cult is that vaccine preventable diseases are not that dangerous, so why take the risk (mostly minor, although not in the cult’s mind) for little benefit. Except for one tiny issue–vaccine preventable diseases kill. Recent studies have shown that an average of approximately 30,000 adults die of these diseases every year, about 95% of the total deaths from vaccine preventable diseases.

Researchers at the University of Colorado at Denver surveyed USA physicians regarding adult vaccine delivery. The results and analysis were recently published in the Annals of Internal Medicine. The researchers found that rates for adult vaccination remain quite low.

Some of the more interesting results from the study were:

  • Only 62% of adults above the age of 65 received the pneumococcal vaccine.
  • Only 65% of adults in the same age group received the flu vaccine
  • This group is at high risk of death from pneumonia and flu, and in fact, deaths from these diseases in this age group, makes up a significant portion of vaccine preventable deaths in this group.
  • Physicians also reported significant barriers to providing vaccines to adults including stocking vaccines (pediatric offices are better equipped for vaccine storage) and reimbursement from insurance companies. In addition, some patients cannot afford the cost of the vaccines if they are not reimbursed by a third party payer. According to the study authors, “Physicians in smaller, private practice often assume more risks from stocking expensive vaccine inventories and may be particularly affected by these financial barriers.”
  • The authors noted the Affordable Care Act addresses the cost barrier to vaccination for privately insured patients by requiring insurers to cover recommended vaccines with no co-pay when delivered by in-network providers. 

Setting aside the embarrassment that the USA doesn’t make vaccines easier to get for those who cannot afford them, it is clear that the low rates of adult vaccination has lead to higher rates of vaccine-preventable illnesses and death. Saving 30,000 lives through proper vaccination and following the new adult vaccine schedule (see figure below) will help reduce that number quickly.

©Centers for Disease Control and Prevention, 2014. Current adult vaccination schedule.

©Centers for Disease Control and Prevention, 2014. Current adult vaccination schedule.

The authors concluded that,

Vaccines provide an important but underutilized opportunity to reduce the burden of vaccine-preventable disease among adults. Although primary care physicians appear motivated to ensure that patients are up to date on vaccinations, many barriers exist. Implementation of system changes, including adopting practices that improve communication between primary care physicians and alternate vaccinators, more widespread use of effective tools (IISs and clinic decision support systems), and removing policy-related barriers, could improve adult vaccination in the United States.

Vaccines really do save lives.

 Visit the Science-based Vaccine Search Engine.

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Potential apocalyptic influenza pandemics-H2N2

Posting at the Brooklyn Navy Yard during the 1918 Spanish Flu pandemic.

Posting at the Brooklyn Navy Yard during the 1918 Spanish Flu pandemic.

From January 1918 through December 1920, humanity suffered through the one of the worst pandemics of infectious disease for the last 100 years or so. The world was hit by what was called the Spanish Flu (not because it started there, but because news of the flu was censored in most countries involved in World War I, but Spanish news wasn’t censored, so it appeared that Spain was being devastated by the disease). According to conservative estimatesdespite how antivaccination cultists portray flu pandemic estimates, nearly 500 million people worldwide were hit with this flu, and somewhere between 50 and 100 million people died, nearly 5% of the world population at the time. Moreover, the majority of deaths were amongst healthy young males, not, as antivaccination tropes often claim, just to those who are sick and weak already.

A recent article called the 1918 flu pandemic the “mother of all pandemics,” and not just for some rhetorical, literary effect. In fact, the 1918 flu, an H1N1 subtype, is the mother of nearly all subsequent influenza A (for avian) pandemics since 1918–in other words, the original H1N1 subtype has mutated into nearly all of the other subtypes of avian flu.

For example, H2N2 influenza A viruses, which derived from a mutation in the H1N1 subtype while it circulated in birds, were the cause of the 1957-1958 pandemic, which killed nearly 1.5 million people worldwide. Currently, the H2N2 subtype has disappeared from humans, but it persists in wild and domestic birds. Claims that the subtype is extinct are premature.

Unfortunately, a potentially dangerous reemergence of the H2N2 subtype in humans continues to be a significant threat due to the absence of immune system memory of the H2N2 within the adaptive immune system of individuals under the age of 50. In other words, those individuals who were born after 1963, have no immunity to H2N2, and may be susceptible to it.

Researchers examined the presence and potential risk of over 22 strains of avian H2N2 viruses isolated from domestic and wild birds over the past 60 years. Most of the strains replicated in mammalian cell culture, and three transmitted to ferrets, usually used a model for human infection from new flu viruses. The H2N2 virus remains highly pathogenic for mammals, including humans, and there continues to be a major risk for quickly moving from the avian reservoir to humans

The point of this story is not to say that a global apocalyptic event is just around the corner, but it could be. It’s just that if you speak with any infectious disease specialist, their greatest fears are HIV/AIDS and influenza, not some obscure novel pathogen arising quickly then dying out of existence. The influenza A virus mutates quickly, allowing it to avoid human humoral immune responses, it transmits from other species to humans easily, it spreads quickly, and it can be deadly. As recently as 2009, the H1N1 pandemic killed approximately 150,000-500,000 people worldwide.

Of course, the CDC constantly monitors when the virus jumps from the bird reservoir to humans, and if given enough time, can prepare a vaccine to help prevent it. Let’s hope people are smart enough to get it.

Visit the Science-based Vaccine Search Engine.

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Healthcare worker fist bumps–maybe it’s all about being cool

©ABC, 2014. Donald Faison and Zach Braff give each other a fist bump in the TV show, Scrubs.

©ABC, 2014. Donald Faison and Zach Braff give each other a fist bump in the TV show, Scrubs.

This article is all about fist bumps. And diseases. And bad science.

For the handful of you who are culturally naïve, let’s quickly describe the fist bump itself. It is a greeting, in lieu of a handshake, which is performed when two individuals acknowledge each other with a closed fist gently tapping each other. There are, of course, all kinds of flourishes and embellishments added to a fist bump, which are unique expressions of individuality. I like the hand explosion after a fist bump, but that’s probably uncool.

If you thought fist bumps are a recent cultural creation, you’d be wrong. Apparently, Greek charioteers did it. And motorcycle riders who pulled up next to each other at red lights have been doing it since the 1940′s. The gesture has been relatively popular in the American game of baseball for at least 50 years. President Barack Obama regularly fist bumps instead of offering a handshake, even with his wife, Michelle. Researching this story, I always thought it was modern and fashionable, but I find out it’s antiquated, but possibly still fashionable.

During the 2009 H1N1 flu pandemic, many medical professionals recommended that healthcare workers greet each other with the fist bump with colleagues and patients rather than the traditional handshake. My anecdotal observations are that I’ve done more fist bumps in the last two or three years during visits to hospitals and physicians than I had in my whole life before (which may have included approximately 0 fist bumps , but I’m not cool). I had a 5 day stay in a hospital a couple of years ago, and not one single nurse, physician, surgeon, attending, resident, janitor, or nutritionist shook my hand. Not one. But I certainly got the fist bump every time, even when I extended my hand for a handshake (I was bored in the hospital, so I started to experiment). 
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Student Nurse Perspective: The Flu Vaccine.

Nurses attending to soldiersIngvar Árni Ingvarsson, a student nurse in the UK, wrote an excellent perspective on vaccines from his nursing eyeballs, which he graciously allowed me to re-post here.  

Little intro might be handy for this. This post has been on my mind for a long time now and finally I decided to pull my finger out and actually write it. What is to follow will be a mixture of factual, scientific and anecdotal writings. Because that is the way I roll. I have been itching to write something, anything about vaccinations for a little bit now, but so far decided not to because there are so many out there who do it and do a better job of it then I would dream of, so I’ll list some. Skeptical Raptor, Respectful Insolence, Red Wine & Apple Sauce, Just The Vax and many many more. 

Prior to starting my nursing course I was very much into my slightly alternative medicine. I was on the fence regarding vaccines, not just the flu vaccine but all vaccines. Now that I think back on it I’m not really sure why. It was never really something that I thought about properly until I started my university course. What was probably a turning point for me was the amount of patients over 70 I came across who had to use callipers and wheelchairs because they contracted polio when they were kids. I have never come across a patient under 70 who has had polio. Never. This sort of got me thinking about the importance of vaccination, and if there is one thing that I have learned since starting uni is that evidence is the key.
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Why we vaccinate–the cost of catching the flu

Syringe with moneyThe tropes of the antivaccination horde would be laughable if it weren’t for the seriousness of the diseases that are prevented by vaccines. Even among those people who vaccinate their children for everything, they’ll make up all kinds of lame excuses for not getting the flu vaccine, all easily debunked. And someone will call you a “dumbass” if you use any of those worthless excuses. 

One of the most annoying tropes of the vaccine deniers is that somehow Big Pharma (even though some vaccines are sold by Baby Pharma) is forcing dangerous, expensive, and highly profitable vaccines on the market because Big Pharma is nothing more than greedy, unethical executives sitting in their huge offices figuring out which Ferrari they’re going to purchase next week. Setting aside the fact that most Big Pharma execs are far too conservative to drive a Ferrari, does this even make any sense whatsoever? 

Let’s get this out first. Big Pharma corporations are generally public, and as such, their shareholders expect them to make profits. But corporations don’t generate profits by turning on a cash printing machine, they must invent, develop and manufacture products, distribute it to the market, and do it well enough to actually generate profits to not only pay their shareholders, but also to invest in the next round of invention, development and manufacturing for the next set of products. Big Pharma has an extremely complex relationship with its market because bringing new products to their customers requires a huge investment in resources (from research to engineering to manufacturing). And Big Pharma has a wide variety of customers including the patient, the physician, the hospital, the insurance company (or government versions of insurance, like Medicare), the government and its regulatory arms, and many others.

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Dumb Asses who don’t get the flu vaccine

flu-shot-mythsThe 2013-14 flu season is just getting started, and early data seems to indicate it could be tough one. One of the best ways, if not the only real way, to prevent catching the flu virus is by immunization with the seasonal flu vaccine.

By now, flu vaccines have been delivered to hospitals, physician’s office, health clinics, and government health departments. And it’s time for intelligent, reasonable, and rational people to get their flu shots. We’ve dispensed with many of the myths that are cherished by vaccine refusers, and many reseachers have shown that getting the flu vaccine can improve health outcomes

A couple of years ago, Infectious Disease specialist Dr. Mark Crislip published A Budget of Dumb Asses which righteously states that healthcare workers who refuse to get a flu vaccine are Dumb Asses. Yes, complete and utter Dumb Asses. Even though this broadside against vaccine deniers is about the flu vaccine, it’s all right to search and replace flu with say meningitis, pertussis, measles or anything. And just because it’s about healthcare workers, it’s all right to replace that with your neighbor, co-worker, or some other anti-scientific antivaccination Dumb Ass.

So every few months, I like to resurrect this article, just to remind everyone how much of a dumbass they are if they don’t get the annual flu shot.

Warning: this is funny (unless you’re a vaccine denier, in which case you have no sense of humor, irony or sarcasm, something probably gained by getting vaccinated). So, if you’re reading this list while sipping on coffee, I take no responsibility for damage to your computer, smart phone, or tablet if you snort out your drink. Them’s the rules. 
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Why we vaccinate–because the flu can be deadly to healthy people

flu-shot-coolThe Centers for Disease Control and Prevention has published its most recent weekly report for the current flu outbreak in the United States (note: this link is to a non-static website where the numbers are updated weekly, so they may not match what is posted below). Here’s some of the most important data:

  • 2,622 laboratory-confirmed influenza-associated hospitalizations have been reported since October 1, 2013. This represents a cumulative rate of 9.7 hospitalizations per 100,000 people in the United States.
  • Of the 2,622 influenza-associated hospitalizations that have been reported this season, 61.6% have been in people 18 to 64 years old, much younger than typical flu outbreaks where most flu hospitalizations occur in people 65 and older. This pattern of more hospitalizations among younger people was also observed during the 2009 H1N1 pandemic.
  • Widespread influenza activity was reported by 35 states.
  • Ten pediatric deaths have been reported for the flu since the beginning of the flu season–traditionally the peak numbers for deaths of children from the flu happens in the first three months of the year.

So, based on this information, flu doesn’t just send the elderly or those with chronic diseases to the hospital. Influenza related hospitalizations have hit healthy young adults in higher proportions. And the flu kills children. Despite all the garbage that’s placed on the internet, the black hole of accurate, scientific data, there is only one way to boost your immune system to prevent getting the flu–the seasonal flu vaccine.

In case you believe in some myth about the flu vaccine, here’s some real science about the flu and the flu vaccine for you:

If the science of flu vaccines doesn’t convince you, then you really are a dumbass.

Use the Science-based Vaccine Search Engine.

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Boosting the immune system–sorting science from myth


For New Year’s Day, I’m republishing the top 10 articles I wrote in 2013. Well, actually top 9, plus 1 from 2012 that just keeps going.

#8. This article was published on 26 September 2013, and has had nearly 6000 views. This was one of the most difficult articles I’ve ever written. Anyone who thinks that the immune system is so simple that they can make broad proclamations about what does what to the immune system simply lacks any real education in immunology. And only vaccinations can really boost the immune system.

One of the most ubiquitous pseudoscientific claims that I keep hearing from the junk medicine crowd is that this supplement or that food “boosts” the immune system. These type of claims ignore one basic physiological fact: the immune system is a complex interconnected network of organs, cells, and molecules that prevents invasion of the body by hundreds of thousands, if not millions of pathogens every day. And no matter how much individuals try to trivialize how complicated the immune system is by claiming that downing a few tablets of echinacea will boost the immune system to prevent colds (it doesn’t), it doesn’t make it science.

And it isn’t that simple.

Using the Graham Coghill’s Science Red Flags, which are indicators of either bad science or unscientific nonsense (and which I’ve used with respect to GMOs), let’s do a quick review of a few outlandish claims of the junk medicine horde. I just cherry picked a few, because their pseudoscience is not the focus of this article. I don’t have that much time to find all the “immune system” rubbish on the internet!
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Deadly viruses

The original infographic had a glaring error that I missed. It also had a potentially confusing bit of information. Although someone with a critical mind would quickly figure it out, I don’t think I should be pushing out an infographic that has glaring inaccuracies. I’ve contacted the author to correct, and if they respond with a better one, I’ll repost.

I apologize for this error.

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Save children from risks–vaccinate and keep them away from guns

child-gun-deaths-01_0Vaccine deniers are basically clueless about science. They invent stuff about the immune system, while missing how a vaccine induces a long-lasting immune response. They conflate correlation with causality, an important distinction if you’re going to understand epidemiology. They deny the germ theory of disease, one of the fundamental pillars of modern biology, which states that many diseases are caused by microorganisms. They simply ignore what makes science a logical and repeatable process, called the scientific method, preferring anecdote and cherry-picked data over randomized clinical trials and peer-reviewed systematic reviews. 

But one of the more important scientific failures of the antivaccine gang is an unsophisticated lack of understanding of basic mathematics, specifically the measurement of risk. Using 2010 USA numbers only, let’s look at the top mortality risks for children aged 1-14:

  • Unintentional injury (motor vehicle accidents, bathroom falls, etc.): 53.75 (out of every 100,000 Americans between the ages of 1-14)
  • Malignant neoplasms: 22.33
  • Congenital anomalies (commonly called birth defects): 14.25
  • Homicides: 11.43
  • Firearms (number broken out from the numbers for all homicides): 3.68
  • Heart disease: 6.09
  • Suicide: 4.85
  • Chronic respiratory disease: 3.26
  • Influenza and influenza-related pneumonia: 2.87
  • Benign neoplasms: 2.50
  • Meningitis: 0.58
  • Meningococcal infection: 0.25

The average risk for “serious” complications from vaccines range from 0.1 to 1 in 100,000, with the risk of death from vaccines found to be so small, it can be barely measured as a risk. By the way, those of you who think that VAERS (Vaccine Adverse Event Reporting System) should be used to estimate risk, the best I could say is that VAERS is pretty much useless, since it cannot establish causality, it is gamed by those with an antivaccine agenda, and the rate of adverse events is frequently below the background rate for these events in a typical populations of Americans. VAERS is an incredibly useful tool to spot potential new adverse events that might arise from vaccination, but the numbers themselves cannot be used to determine risk.

The risk of a serious reaction, like an allergic one, from getting the flu vaccine is less than 0.1 in 100,000, far far less than the actual death rate from influenza at around 2.87 per 100,000. Moreover, meningitis (and meningococcal infection) have risks of death far higher than the risks of vaccines. 

The saddest thing about these numbers is that I’m spending so much time defending vaccines, which are as safe as drinking a glass of filtered water and clearly save lives from preventable diseases. The antivaccine activists, who claim to be worried about children, don’t focus on the things that actually kill children. Motor vehicle accidents, some portion of which are probably a result of drunk drivers. Or firearm homicides? Where is the outrage, that young children are dying from gunshots? Or that the risk of a child dying of suicide is thousands of times higher than the infinitely tiny risk of death from vaccines (if it even exists)?

Why is it that these vaccine deniers show incredible outrage over an indefensible belief that vaccines are dangerous, yet not try to stop homicides, especially with guns? Or safer cars? Or something that actually will help kids live longer.?

Actual guns kill more actual kids than the antivaccine myth that vaccines harm actual children. You see, vaccine deniers don’t actually care about children, or they would be yelling and screaming about guns. And drunk drivers. And the lack of mental health care for teenagers.

If you need to search for accurate information and evidence about vaccines try the Science-based Vaccine Search Engine.

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How vaccine deniers abuse the appeal to authority

flu_badge_cdcScience is built upon the scientific method, which is a logical process of observation, experiment, analysis, and publication. It is simple, but it requires work. Over time, after numerous experiments, nearly always published in peer-reviewed journals, followed by frequent repetition (and sometimes failure) of the experiments and results by other scientists, scientists arrive at a consensus about the evidence that supports a particular set of principles about the science being researched.

As the evidence accumulates and becomes more predictive, it is declared, through scientific consensus, a scientific theory, which is a series of statements about the causal elements for observed phenomena. These theories explain aspects of the natural world. They are predictive. And they can be tested through the scientific method.

Arriving at a scientific consensus is not something that happens overnight–the development of this consensus is rather glacial in pace. That’s a good thing. It keeps out poorly supported ideas, but gives strength to ideas that are supported by a large quantity and quality of evidence. From basic scientific ideas, the scientific method expands or improves these ideas over time. And, one does not simply decide that the consensus is wrong through a debate or argument–changing the consensus requires as much research based in the scientific method, as many peer-reviewed publications and as much critique, repetition, and review as the evidence that built the original consensus.
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Why we vaccinate–debunking flu vaccine myths in 25 easy steps

flu-shot-mythThe seasonal flu is associated with an estimated 54,000 to 430,000 hospitalizations and approximately 3,000 to 49,000 deaths annually in the USA. So anyone who thinks that the flu isn’t a serious disease, needs to look at those numbers again. People die. And not just the old or sick–healthy people and children are killed by the flu. And let’s not forget about more serious pandemics, like H1N1, that can kill many more people.

We’ve all heard the excuses and myths about the flu vaccines. They’re repeated over and over again not only by those who are vaccine deniers, but more often by average people who just refuse to get the vaccine. This week, a fellow blogger and someone whom I’ve gotten to know over the past couple of years, Tara Haelle, spent numerous hours putting together the Top 25 Myths about the flu vaccine, which she published here. Read it. Please. 

So, below is her list of 25 myths about the flu vaccine, with links back to her article (and in some cases, to this blog too) that debunk the myth. After you read this, share it with everyone. Your neighbor who won’t get the flu vaccine. Your spouse. Your parents. Your coworker. And one more person–yourself.
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Why we vaccinate for the flu–to save children’s lives

flu-vaccine-facts-mythsSeasonal flu is associated with an estimated 54,000 to 430,000 hospitalizations and approximately 3,000 to 49,000 deaths annually in the USA. It has been reported that influenza infection rates in the community are highest among children–even though influenza is usually a self-limiting illness, severe complications, including pneumonia, encephalitis, myocarditis, and death, can occur in children.

We’ve all heard the excuses and myths about the flu vaccines. They just aren’t trueNo, they really really really aren’t true. By the way, Mark Crislip, MD, thinks those of you who make up whiny excuses for not getting the flu vaccine are dumbasses.

Because of the serious consequences of the annual flu, the CDC recommends the flu vaccine for all children aged 6 months. A recent study published in Pediatrics revealed that the flu virus can have significant repercussions for children. The authors described serious complications from the flu for children including deaths. And many of those deaths occurred in children without underlying medical risk factors.
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Why we vaccinate-flu vaccine reduces cardiovascular risks

senior-flu-vaccineIn addition to preventing the infection, the flu vaccination may have a more important benefit for those who get the shot. A new systematic review, published this week in the Journal of the American Medical Association (JAMA), found that individuals vaccinated against the flu had a significantly lower risk of a major cardiovascular events, such as a heart attack or stroke, compared with those who received no flu vaccine.

In the meta-review, researchers from the University of Toronto analyzed five published studies and one unpublished study. They then rolled-up the data to investigate the connection between those who were vaccinated against the flu and various cardiovascular events. Altogether, the studies included approximately 6000 patients. Moreover, the patients had an average age of 67, while about one-third had a medical history of heart disease.

The results were dramatic–individuals who were vaccinated against the flu had a 2.9% risk of having a major cardiovascular even with the next eight months. The risk for those who were not vaccinated (or received a placebo) increased by 150% to 4.7%, a statistically significant difference.

Just to be clear, the study did not show that getting the flu virus caused the development of cardiovascular disease. However, patients with diagnosed cardiovascular disease (or who have had cardiovascular events, such as myocardial infarction) are at a significantly greater risk of another one if they catch the flu. As the authors state, “the greatest treatment effect was seen among the highest-risk patients with more active coronary disease.”

According to the study, less than 50% of people under the age of 65 with high-risk conditions (such as cardiovascular disease) receive the flu vaccine, which puts them at risk of complications like heart attack and stroke. Older individuals, who often have existing health problems, appear to be more likely to be vaccinated, although up to one third still skip their annual flu shot.

One last point–getting the vaccine, whether the patient has underlying cardiovascular disease or not, does not increase the risk of any cardiovascular effects.

We’ve all heard the excuses and myths about the flu vaccines. They just aren’t trueNo, they really really really aren’t true. By the way, Mark Crislip, MD, thinks those of you who make up whiny excuses for not getting the flu vaccine are dumbasses. His words, but quite apropos.

So, if you have had cardiovascular disease, or are at risk from it (like those who have type 1 or 2 diabetes), then get a flu vaccination no matter what your age is. If you have any other risk factors, like being under the age of 5, pregnant, or other important chronic conditions, get a flu immunization. If you’re a healthy adult, and you’re going to visit your parents or grandparents who could catch the flu from you, get vaccinated, even if they’ve been vaccinated (because there is some small chance that the vaccine didn’t give them full immunity). Just get vaccinated for the flu.

The clinical value of preventing the flu is huge. The mythical risks of getting the vaccine are invisible.

If you need to search for accurate information and evidence about vaccines try the Science-based Vaccine Search Engine.

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Why we vaccinate–the dangers of the flu

Courtesy of Families Fighting Flu

Courtesy of Families Fighting Flu

Madison “Madi” Allen was your typical active and healthy 12 year old girl in St. Louis, Missouri. She was in the 7th grade, playing basketball and soccer. Unfortunately, according to her family’s personal account, things went terribly wrong on a Monday morning back in February of 2011. On that day, Madison and her family’s lives were to be struck harshly.

On the Friday before, she was not feeling well, but decided to go to a friend’s birthday party. However, when she got to the party, she didn’t feel well, and texted her mother to come get her. Throughout the night, Madi was coughing badly, and had a high fever. her mother gave her some over-the-counter medications for the cough and fever. But by Monday morning, she was having trouble breathing, so her mother was going to take her to her doctor’s office as soon as they opened. 

Apparently, her mother put Madi in the shower to cool her down before going to the physician, when her mother noticed that Madi’s face was sunken in and her lips were blue. At that point, Madi’s parents made the appropriate decision to bring her to the emergency room.

At the hospital, the doctors put her on oxygen, and determined that she had double pneumonia (both lungs). The treatments at the ER weren’t working, so the ER physicians decided to transfer Madi to a hospital that had more specialists and facilities for her illness. By the time she arrived at the new hospital, she was in respiratory distress, so she was intubated. The physicians then, after consulting with Madi’s parents, placed her into an artificial coma so that they could use powerful antibiotics in an attempt to treat her illness. She wouldn’t be able to speak or interact with her parents for the next 5 weeks.

By 10PM that evening, Madi had 14 different IV’s, her kidneys were failing, and she was on a ventilator. The ER at this second hospital decided she needed to be transferred to a hospital with a pediatric ICU better qualified to handle Madi’s illness, so after putting her on ECMO (essentially, life support for individuals whose heart and lungs can no longer support the patient), she was flown to St. Louis Children’s Hospital. Immediately after arriving at the hospital, she went into surgery to begin attacking her disease.

She was on ECMO for two weeks. She was intubated and on dialysis for five weeks. Madi had other related issues and setbacks, spending 5 weeks in the PICU. After that, she spent another month in rehabilitation–eventually she was discharged after 93 days at St. Louis Children’s Hospital. 

Madi went back to school and played basketball and soccer. She still has a chronic cough caused by the scar tissue that formed her lungs from the infections, which impacts her endurance. She is at risk from pneumonia. And she will likely have all of these issues for the rest of her life.

So what happened? She contracted influenza B (as determined by diagnostic tests), which lead to necrotizing pneumonia (a form of pneumonia that causes substantial necrosis of lung cells, and sometimes even lung abscess) and Methicillin-resistant Staphylococcus aureus (MRSA), a bacterium responsible for several difficult-to-treat infections in humans. The CDC has noted an increase in flu and Staphylococcus aureus (S. aureus) co-infections among children who had died or were hospitalized with influenza infection. All of this happened, despite her being a healthy, active young girl. And that year Madi had not been immunized with the seasonal flu vaccine.

For those of you who think that the flu vaccine is dangerous or ineffective? That is just plain nonsense. And you’re a dumbass. And the vaccine is safe. And 3,000 to 49,000 people die every year in the USA from complications from flu, many who are healthy and without other risk factors. 

Guess what? Now Madi and her entire family get vaccinated against the flu every year and encourage all their friends and family members to do the same.


If you need to search for accurate information and evidence about vaccines try the Science-based Vaccine Search Engine.

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Supplements to treat the common cold–myth vs science

cold-cureIt’s getting colder outside, and if you go into any pharmacy, grocery store, chemist, or superstore, you will find literally a dozen or more homeopathic, herbal, or other unproven lotions and potions to prevent or treat the common cold, or rhinovirus. These supplements are a significant part of the annual US$108 billion dollar supplement/nutraceutical industry. 

These alternative medicine (so named because there is no scientific evidence supporting their efficacy, let alone safety) products make claims that are so wonderful, many people take them. Then they themselves tell their friends how fast they got rid of their cold. Or that their cold wasn’t as bad after taking the supplement.

The problem is that determine the length and severity of the course of the common cold is entirely subjective. Since the disease is rather mild with few serious complications, it’s hard to determine when it exactly stopped and started, and how bad it was.  The common cold tends to resolve itself without external help, but there really isn’t much you can do to make your immune system attack that cold faster.


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Mandatory flu vaccinations cause healthcare workers to quit–a myth

Bones fluOne of the many myths of the vaccine denialism movement is that healthcare workers will quit if there is a mandatory vaccination, usually the flu. Many of the healthcare worker vaccine deniers base their opposition to vaccines based on thoroughly debunked lies about vaccinations. Their invented opposition to vaccines is in direction contradiction to their obligation to protect the health of patients. However, more and more healthcare systems are mandating the flu vaccine for their employees.

A four-year analysis of mandatory influenza (flu) vaccinations, which are a condition of employment at Loyola University Health System in Chicago, IL, showed no statistical increase in voluntary terminations of employees. In the first year of Loyola’s mandatory policy (2009-10 flu season), 99.2% of employees received the vaccine, 0.7% (yes, 0.7%) were exempted for religious/medical reasons, and 0.1% refused vaccination and chose to terminate employment with Loyola. In 2012, the last year of the study, the vaccination uptake rate at Loyola remained steady: 98.7% were vaccinated, 1.2% were exempted and 0.06% refused vaccination.

According to Dr. Jorge Parada, study author and professor of medicine at Loyola University Chicago Stritch School of Medicine, reported that “in reality our numbers were even better than that, of the 5 persons who refused vaccination in the mandatory period, 3 were unpaid volunteers, who later reconsidered, received vaccine and returned to Loyola. The two other persons were part-time staff, each with only 10% time commitment at Loyola…truly reflecting a 0.002 vaccine refusal rate” reports Parada. The study showed that, over the course of four years, less than 15 staff, including volunteers, out of approximately 8,000 healthcare workers in the system, chose termination over vaccination. Loyola has sustained a 99 percent compliance average since adopting the mandatory flu vaccination protocol four years ago.
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Flu during pregnancy is associated with bipolar disorder in children

pregnant-flu-vaccineA recent article published in a leading psychiatry journal, JAMA Psychiatry, has shown that pregnant mothers’ exposure to the influenza (flu) was associated with a nearly 4X increase in risk to their child eventually developing bipolar disorder in adulthood. These findings add to mounting evidence of possible shared underlying causes and illness processes with schizophrenia, which some studies have also linked to prenatal exposure to influenza. Bipolar disorder, historically called manic depressive disorder, is a mood disorder where the sufferer can experience episodes of a frenzied state known as mania (or hypomania), typically alternating with episodes of depression. It can be treated with medications and psychotherapy (especially cognitive therapy), but more difficult cases require the individual to be voluntarily or involuntarily institutionalized until the mood changes can be reduced or eliminated.

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