We will get into the details further in this post, but I do not want to bury the headline. This does not mean the 2017-18 flu vaccine is ineffective – the quadrivalent 2017 flu vaccine effectiveness against three of four flu strains is still fairly high. The flu vaccine is extremely important in stop lots of flu strains, and just because it may have an issue with one of the four strains, does not imply that it is useless.
It’s difficult to understand why parents seem to ignore the flu vaccine for themselves or for their children. Many people just don’t think the flu is that dangerous. Or they think the vaccine doesn’t work. Or they believe in some other myth that simply isn’t true.
Here we go again. Just like the popular zombie TV shows, the flu vaccine myths continue to rise from the dead, scaring people away from protecting themselves from a dangerous disease. And just like Rick Grimes, it’s my job to help my fellow skeptics stop this zombie outbreak and safeguard the innocent from the brain eating tropes of the antivaccine crowd.
The vaccine was introduced in 2009, and it has been part of many flu vaccines since that time. There has been some discussion about the effectiveness of the vaccine, but most studies showed it to be very efficacious.
A systematic review, considered the pinnacle of the hierarchy of scientific evidence, was recently published in the journal Vaccine, included well designed studies to examine the effectiveness of the H1N1 flu vaccine in both children and adults. The investigators identified 38 studies published between June 2011 and April 2016 that met the inclusion criteria for this meta-analysis – that is, any paper that focused on the H1N1 vaccine effectiveness during the 2009 pandemic. The data included data from over 7.6 million patient records derived from several different study designs.
This review also examined the differences between adjuvanted, that is, those vaccines that contain an adjuvant to boost the immune response to the flu antigens, and unadjuvanted (no adjuvants) versions of the H1N1 flu vaccine. The children’s version of the vaccine only included adjuvanted version.
The results of the study were clear. The pooled adjuvanted H1N1 flu vaccine efficacy in 1126 children was around 86% – this is an impressive number. In the pooled data for the adjuvanted and unadjuvanted versions of the vaccine, results showed that there was moderate protection of around 49% efficacy in people older than 18 years. Similarly, in individuals older than 50 years, the data showed the vaccine efficacy for the adjuvanted vaccines was approximately 46%.
This lower efficacy in older adults has been observed in other flu vaccine studies. Although there’s no conclusive reason why there is a lower efficacy, there have been several hypotheses offered including a less fit immune system for individuals, or that the population of older adults may have already have some immunity to H1N1 through previous pandemics or circulating H1N1 subtypes.
The authors concluded the following:
We further explained the overall inverse gradient between effectiveness and age by comparing adjuvanted versus unadjuvanted vaccines in each age band. Our results show that adjuvanted vaccines were significantly more effective in children than unadjuvanted vaccines in preventing laboratory confirmed influenza illness by almost a twofold difference in effectiveness. A similar pattern was also seen for hospitalization.
However, in adults there were fewer apparent differences between the performance of adjuvanted and unadjuvanted vaccines for both outcomes. The higher effectiveness in children of adjuvanted vaccines compared to unadjuvanted vaccines noted here has also been seen in efficacy studies of seasonal trivalent influenza vaccines (TIV) in young children up to 72 months of age, in whom efficacy against PCR-confirmed influenza was 92% for adjuvanted vaccines versus 45% for unadjuvanted vaccines.
The authors also asserted that this data is important for public health policy with respect to the H1N1 flu:
Evidence from modeling studies suggests that children are a credible target group for pandemic vaccination, along with patients who have high-risk conditions.
Once again, this is robust and exciting evidence of the effectiveness of the H1N1 flu vaccine against that flu subtype. The flu vaccine is often the ignored vaccine for children, probably because of enduring myths that the flu isn’t that dangerous or that the flu vaccine isn’t very effective. The H1N1 flu is dangerous, and it can be effectively prevented by the vaccine. So please, protect your children (and yourselves) with this vaccine.
The ignorance of the anti-vaccine cult is so annoying, because I have to spend valuable time trying to clear up their myths, tropes, and outright lies. An anti-science website, Health Impact News, recently published an article discussing a flu vaccine study from 2012. I don’t know why it took them this long to use this as an “anti-vaccine” study, but I don’t think keeping up with primary research is high on their list of goals.
I’m going to look at a few of the points the anti-vaccine crowd tried to make, refuting them one by one, by looking at the original article published in the relatively high impact factor journal, Clinical Infectious Diseases. The TL;DR version is that they didn’t get anything right. so, here we go into the fray.
As I mentioned previously, I got the flu vaccine a few days ago. As of today, I do not have a fever, febrile seizures, Epstein-Barr, a reptilian tail growing out of my back, sudden desire to eat durians, or abrupt inclination to watch English Premier League soccer.
But I know I am protected against the flu, and that’s a good thing. I haven’t had the flu since the 1980s, not because I am a superior human being with the most powerful immune system in the world. It’s because I make sure I’m vaccinated against the disease every single year.
Part of the reason I got the flu jab was because my employers demanded it. They needed me healthy when I passed out bribes to physicians and surgeons–oops, I mean when I was visiting top physicians and surgeons to plan clinical trials.
Of course, my employers demanded I wear lead aprons when training physicians on imaging and diagnostic procedures in cardiac cath labs, so maybe they actually cared about me.
Every flu season, I resurrect this hysterical and snarky by Infectious Disease specialist Dr. Mark Crislip which was originally published in A Budget of Dumb Asses, a list of the different types of flu vaccine refusing dumb asses. This list is a tradition that goes back to the early days of this website.
And it’s that time of year to get your flu vaccine, so I resurrect this fine piece of snarkfest.
Yes, complete and utter Dumb Asses. Even though this broadside is about flu vaccine refusing dumb asses, it’s all right to search and replace flu with say meningitis, pertussis, measles or any other vaccine. 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.
The upcoming 2015-2016 flu season is just starting, and many physicians and clinics (along with many pharmacies, government flu clinics, and other places) have this season’s flu vaccine. One of the best ways, if not the only real way, to boost your immune system against the flu is the seasonal flu vaccine.
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.
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. Continue reading “A list of flu vaccine refusing dumb asses”
Every month, there are generally 10-20 new papers published in prominent biomedical journals about vaccines. I try to read most of them, but they’re generally boring. Blah blah blah, vaccines are relatively safe and effective.
I mean how many times am I forced to read an article that supports the scientific consensus about the incredible advantages to human health derived from vaccines. Enough already. Let’s publish something more interesting like the overwhelming safety profile of GMO foods. Oh, we’ve done that.
To be fair, occasionally there are published articles that try to provide evidence that vaccines are dangerous or ineffective. Almost always, those articles are almost always published in very low impact journals, some of them with, at best, cursory peer review.
Given all of the mountains of data that support the safety and effectiveness of vaccines, a dues-paying member of the anti-vaccine world has little choice but to cherry pick articles, though they know that the ones they do pick are often poorly done and published in obscure, very low ranked journals.
Generally, their next step is to then cherry pick a sentence or tiny piece of data out of a larger positive article, so that they can say “see, there’s a conspiracy going on, they’re hiding data.” Let’s take a look at a recent published article where some of this nonsense is happening.
Every flu season, I resurrect this hysterical and snarky by Infectious Disease specialist Dr. Mark Crislip which was originally published in A Budget of Dumb Asses, which accurately 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.
The upcoming 2014-2015 flu season is just starting, and many physicians and clinics (along with many pharmacies, government flu clinics, and other places) have this season’s flu vaccine. One of the best ways, if not the only real way, to prevent contracting this year’s flu is by immunization with the seasonal flu vaccine.
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.
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. Continue reading “Dumb Asses refusing flu vaccine – humor from Dr. Mark Crislip”
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 estimates, despite 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.
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.
