Peter Doshi flu vaccine study – misused by anti-vaxxers

Peter Doshi

Anti-vaccine activists constantly look for any science that seems to support their beliefs about the safety and effectiveness of vaccines. Lately, they have gravitated to the writings of Peter Doshi, who has made a career talking about vaccines. Although Doshi lacks the credentials in any area of science related to vaccines – immunology, microbiology, virology, public health, epidemiology – the anti-vaccine forces embrace him like he’s a Nobel Prize winning scientist. Which he is not.

Let’s take a look at Doshi’s credentials and what he’s written about vaccines, specifically the flu vaccine. Continue reading “Peter Doshi flu vaccine study – misused by anti-vaxxers”

Influenza vaccine effectiveness for elderly – fewer hospitalizations

Influenza vaccine effectiveness

The world’s population is getting older, since people live longer as a result of our modern healthcare. As people age, their bodies become less able to respond to infections and develop immunity, a process called immunosenescence. One of the most dangerous infectious diseases for the elderly is the flu. Thus, influenza vaccine effectiveness is an important factor for protecting the health of our elderly citizens. Continue reading “Influenza vaccine effectiveness for elderly – fewer hospitalizations”

Flu vaccine ingredients – not so scary using simple math

flu vaccine ingredients

When dealing with those pushing pseudoscience, like the antivaccination cult, the most frustrating thing is that they tend to ignore and deny the most basic tenets of science. If denying the fact of gravity would further their goals of “proving” vaccines are neither effective nor safe, they would do so. And now that it’s flu season, they’re producing zombie tropes about flu vaccine ingredients.

If the antivaccination movement didn’t lead to epidemics of long-gone diseases, which can harm and kill children, the conversation would be over. I would just put the vaccine deniers in the same group as evolution deniers (creationists) or gravity deniers (there has to be some, somewhere). I would mock their pseudoscience, and move on. Of course, their denialism does lead to deaths of children, so we have to do what is right, and stop their lies, misinformation and ignorance in every forum we can.

We have to appeal to scientific values, and despite the fact that antivaccination pushers don’t share those values, we must continue to try. I have gotten enough emails and comments from people that they have started to vaccinate because of what I have written, so maybe some child’s life is better because all of us who support vaccines are heard.

Continue reading “Flu vaccine ingredients – not so scary using simple math”

Flu vaccine effectiveness – prevents pediatric deaths

flu vaccine effectiveness

When it comes to the influenza vaccine, there are a number of myths that surround the flu vaccine, pushed by vaccine deniers and, often, by vaccine supporters. The two most prevalent seems to be that the flu vaccine isn’t very effective, and the flu isn’t that dangerous. But a new peer-reviewed article has been published that focuses on these two myths. Based on the evidence, flu vaccine effectiveness prevents pediatric deaths. Period.

There have been numerous articles about flu vaccine effectiveness over the years – it’s rarely 90% or greater. The major reason for this is that all of the health organizations across the world have to meet 8-10 months before the flu season to determine what subtype(s) of flu virus will be most common in the northern or southern hemisphere. In some years, the flu virus will mutate between the time to decide on the right antigen and the vaccine is manufactured and shipped.

Generally, the vaccine is very effective against influenza B, mainly because this subtype of flu tends to mutate at a much lower rate than other flu viruses. On the other hand, the vaccine tends to have somewhat lower effectiveness against influenza A, mainly because of its higher mutation rate, and because it can infect (and mutate) in many other animals, especially birds, which have regular contact with humans.

But in no case is the effectiveness at 0. There seems to be a reliance on the Nirvana fallacy – if it’s not perfect, it’s worthless. Yes, the flu vaccine effectiveness is far from perfect, it ranges from 40-65% most years. But does that mean it’s worthless? Absolutely not. The flu vaccine prevents a lot of pediatric deaths, something we need to carefully examine.

 

Flu vaccine effectiveness – the publication

In a paper published in Pediatrics by Flannery et al., the authors reviewed laboratory-confirmed influenza-associated pediatric deaths since 2004 to determine the relationship with flu vaccination status. What they found was that the vaccine was much better at preventing pediatric death than not vaccinating at all – this may seem obvious, but it’s better to have statistically valid data published in a top rated journal.

The researchers conducted a case-cohort epidemiological study that compared vaccination uptake among laboratory-confirmed influenza-associated pediatric deaths with estimated vaccination coverage among pediatric cohorts in the United States. The study design allows the researchers to determine the actual flu vaccine effectiveness in preventing pediatric deaths.

Using data from July 2010 through June 2014, there were 358 laboratory-confirmed influenza-associated pediatric deaths reported in children aged 6 months through 17 years. The researchers were able to determine vaccination status for 291 of these deaths. Here are their results:

  1. Of the 291 deaths with known vaccination status, 75 (26%) received the vaccine before onset of the flu, and 216 (74%) were unvaccinated.
  2. The overall vaccine effectiveness against death was 65%, which means the vaccine prevented pediatric death in 65% of the population.
  3. The vaccine effectiveness against death in children with high-risk conditions was 51%

This data clearly shows a difference between vaccinated and unvaccinated groups with respect to pediatric death.

Flannery et al. conclude that,

Influenza vaccination was associated with reduced risk of laboratory-confirmed influenza-associated pediatric death. Increasing influenza vaccination could prevent influenza-associated deaths among children and adolescents.

Flu vaccines save lives

This is robust and high quality evidence that the flu vaccine prevents pediatric deaths. Most children who die from the flu are unvaccinated, that is clear from this analysis. The job of vaccines is to prevent infectious diseases that harm our children (and adults) – the flu vaccine isn’t perfect, but for minimal risk, it prevents a lot of deaths. It does save lives.

 

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Adult vaccines – the CDC wants to save adult lives too

adult vaccines

Generally, when I write about vaccines, it’s about protecting children’s lives from vaccine preventable diseases. That itself is a noble goal for vaccines. But in case you didn’t know, there is also a CDC schedule for adult vaccines, which is as important to adults as they are to children.

Vaccines have one purpose – to protect us and those whom we love from potentially deadly and debilitating diseases. Many of us in the blogosphere have talked about the children’s schedule a lot, often to debunk claims of people who are ignorant of science, and think that the children’s vaccine schedule is causing undue harm. Yeah our intellectually deficient president, Donald Trump, thinks he knows more than the CDC, but that’s a problem shared by many vaccine deniers.

One adult vaccine I push regularly is the flu vaccine. It protects adults, pregnant women, the elderly, children, and healthy young adults from a severe infection that hospitalizes and kills more people every year than you’d think. Because flu is not really a serious disease, in some people’s minds, a lot of people decide that they don’t need the vaccine. They’d be wrong.

Just in case you were wondering, there is more to adult vaccines than just flu vaccines. There are several other vaccines indicated for adult use, including those adults with underlying health issues like diabetes, HIV and heart disease – unfortunately, the uptake for adult vaccines is depressingly low. Let’s take at the low uptake and the recommended adult vaccines schedule.

Continue reading “Adult vaccines – the CDC wants to save adult lives too”

The useless flu vaccine – a dangerous and sad myth

useless flu vaccine

Go ahead and Google “useless flu vaccine.” You’ll see over 100,000 hits for that search term, some from reliable sources on vaccines. However, the vast majority are from anti-vaccine websites, some trying really hard to appear legitimate. Sure, the flu vaccine is not perfect (no vaccine is), but it’s effectiveness is not 0. I don’t get the argument that vaccines are in some fake binary world – it’s either 100% perfect or it’s useless.

There are reasons why flu vaccine effectiveness varies from year to year. Part of it is that various national public health agencies, like the CDC, meet 10 months before the flu season to determine which influenza subtypes will be prevalent during the winter. It’s not guesswork, it’s based on epidemiological models and new mutations in the virus, but it’s not 100% perfect.

To classify it as the “useless flu vaccine” betrays one essential fact – the flu is dangerous, and any protection against the disease is critical.

This year, the hospitalization rate for laboratory confirmed flu is around 15.2 per 100,000 population, mostly for children under 5 and adults over 50. But that doesn’t mean health young adults and teens are excluded – there is still a high rate of hospitalization for those age groups.

During the first week of January 2017, there were 141 deaths from flu in the USA. And there’s been over 500 deaths from the flu since the start of the flu season. If you think a useless flu vaccine does nothing to prevent a harmless disease, you’d be wrong on both points.

Not to be overly dramatic, but maybe it’s time to put some names and faces to individuals who have died recently from the flu. Because these senseless deaths should make you stop. They should make you feel sad. They should motivate you to get yourself and your loved ones vaccinated.

Maryland – A 17 year old high school was battling the flu when she died of cardiac arrest.

Oklahoma – A young child died from the flu.

Ohio – A six year old kindergarten student died from the flu.

Snohomish County, Washington –  At least 26 people have died from the flu this season.

San Diego, California – At least 21 people have died from influenza in the 2016-17 flu season.

Of course, there are hundreds of other stories. Yes, many who died have underlying medical conditions, or are very young or elderly, but are their lives less precious than all others? Maybe your child, whom you failed to vaccinate, passes along the flu to her grandmother – is that acceptable?

There are dozens of individual stories about children, teens, parents, grandparents, diabetics, healthy young adults, and little babies who have died from the flu this year. It’s a serious and dangerous disease that many of you dismiss as “nothing more than a little sniffle.” The flu isn’t the common cold, which isn’t dangerous – they are two different diseases.

Yes, we all admit that the flu vaccine is far from perfect. But it is extraordinarily safe, and if it reduces your risk of catching the flu by 70% or 50% or even 30%, it’s worth getting, not only for yourself and those whom you love, but also to protect those who are at risk from the flu.

So is it a useless flu vaccine? Only if you think 500 deaths is acceptable – most rational people wouldn’t.

 

 

 

Flu vaccine during pregnancy – unrelated to autism

flu vaccine during pregnancy

There has been a general misconception that flu vaccine during pregnancy was not safe. Whether this was based on the general concerns about vaccines or something specific is difficult to determine. One of the worries was that getting a flu vaccine during pregnancy may cause a higher risk of autism in the baby.

We have tons of data that show us that vaccines are not related to autism spectrum disorder. Now we have another robust, large scale research study that establishes that autism is not link to flu vaccine during pregnancy.

Continue reading “Flu vaccine during pregnancy – unrelated to autism”

Flu vaccine study does not show it causes 5.5X more respiratory infections

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.

Continue reading “Flu vaccine study does not show it causes 5.5X more respiratory infections”

Influenza vaccine mandate – court strikes down regulations

influenza vaccine mandate

On 6 October 2016, the Appellate Division of New York’s Supreme Court held invalid an influenza vaccine mandate that required that children attending certain child care, prekindergarten and kindergarten programs in the city receive an influenza vaccine each year in order to attend. While the decision may appear, on first glance, as a loss for public health and the children of New York City, in reality it gives city health authority broader powers to act for children’s health than did the decision appealed, and offers the board guidance – albeit confusing, and somewhat tricky guidance – for future actions that can withstand scrutiny. If the board chooses to take advantage of this opportunity, it can pass a much more far-reaching regulation.

Continue reading “Influenza vaccine mandate – court strikes down regulations”

Flu vaccine cost – reason for some millennials to avoid it

flu vaccine cost

The 2016-2017 flu season has commenced in the Northern Hemisphere, and your best choice to avoid the effects of the flu is the seasonal flu vaccine. Despite the known dangers of the flu, even for healthy young adults, and the overall safety and effectiveness of the flu vaccine, the uptake of the flu vaccine has been stubbornly low. As we’ll see later, maybe some of the reasons may be the flu vaccine cost.

During the 2015-2016 flu season in the USA, the CDC estimated the flu vaccine uptake for children, 6 months to 17 years old, was around 59.3%. And for adults, greater than 18 years, the uptake was estimated to be 41.7%. Both numbers are well below the 80-90% uptake required for herd immunity against the flu.

There are a lot of excuses for not getting the flu vaccine, even amongst dumb ass health care workers, but most of them are complete nonsense. However, there might be one excuse that can be hard to criticize – the flu vaccine cost.

Flu vaccine cost – the millennials

 

In September, the Harris Poll found that 52% of millennials plan to avoid getting the flu shot during the 2016-17 flu season. The poll, done on the behalf of the CityMD urgent care center network, showed that the millennials (the generation born between the early 1980s and the early 2000s) gave the following reasons for not getting the flu vaccine:

  • 49% said they don’t trust that it will keep them from getting the flu
  • 29% said they think it could make them sick
  • 25% don’t want to spend the money
  • 23% don’t think they need it because they’ve never gotten the flu
  • 4% don’t know where to get the flu shot

Let me quickly debunk these reasons (except for the flu vaccine cost which we’ll examine later). First up, the flu vaccine does vary in effectiveness from year to year. However, given the seriousness of the flu, that most individuals probably can’t work for over a week, especially if you have one nanogram of concern about contaminating your co-workers – even if the flu vaccine’s effectiveness is only 50%, that reduces one’s risk by that amount. Remember, there are complications from the flu, even to healthy adults, that include death. And if you are in any risk group, such as a diabetic, complications from flu can be much worse.

Next on the hit parade is the belief that the flu vaccine causes the flu. This is one of the most inane, ignorant and thoroughly debunked myths about the flu vaccine. It is biologically implausible, if not completely impossible, for the inactivated, or attenuated, viruses in the vaccine to become infectious in a human. There is simply no evidence that the flu vaccine causes the flu.

The next point, that they have never gotten the flu, is also ridiculous. I suppose, by some random combination of events, someone may have avoided the flu, possibly because everyone around them got the flu vaccine. But as they say in those financial adverts on TV, past performance is not an indicator of future results. No one is inherently immune to the flu, so there is a strong random probability one will eventually catch it if they are not immunized. Every year brings new flu virus subtypes, and unless one is vaccinated against them, they are at risk of catching it.

The last point about not knowing where to get the flu shot is laughable. Just about every pharmacy chain in the USA provides the vaccine. Many health departments have flu clinics. Every physician gives the vaccine. That’s the lamest excuse ever.

Now let’s get back to the point I skipped – the flu vaccine cost. I know a lot of millennials are shouldering a huge amount of student debt, can’t find decent jobs, and probably living on handouts or “loans” from their parents. And maybe on the list of life’s necessities, a flu vaccine ranks down near the bottom. But are you millennials looking at these financials decisions in rational manner? I say not.

  • Generally, the flu takes 7-10 days for recovery and to be past the contagious stage. The cost of missing work, if you are hourly or don’t have sick leave, can reach hundreds of dollars.
  • Treating the flu, from prescription drugs like Tamiflu to over-the-counter flu symptom relievers of limited efficacy, probably costs more than your typical flu shot.
  • The risk of complications is high. If the flu develops into pneumonia, one might have to go to an emergency department somewhere, which will also cost more than the flu.

In other words, avoiding the cost of the flu vaccine may actually cost you more in the long run. I know that many of us make short-term economic choices, but in this case, the risk of spending much much more far exceeds the relatively low cost of the vaccine.

In general, the flu shot runs from $14.99 to around $30 at many places in the USA (and now, the 4% of you millennials who don’t know where to get the flu shot, here you go):

  • Costco Flu Shots: Costs $14.99 for standard trivalent (protection against 3 strains of flu). No quadrivalent (protection against 4 strains). If you don’t have health insurance, Costco is, by far, the cheapest. So when you’re picking up a case of Cheetos, get your flu short for less than a six pack of craft beer.
  • CVS Flu shots: No trivalent (though possibly they will later). Costs $39.99 for quadrivalent. You get a 20% off one-time coupon valid on non-sale merchandise and non-pharmacy purchases up to $50 (maximum value $10).
  • Walgreen’s Flu Shots: Costs $31.99 for standard trivalent. $39.99 for quadrivalent.
  • Rite Aid Flu Shots: Costs $32.99 for standard trivalent. $39.99 for quadrivalent.
  • Meijer Flu Shots: Costs $27.99 for standard trivalent. $50 for quadrivalent.
  • Wal Mart Flu Shots: Costs $27.88 for standard trivalent. $32.54 for quadrivalent.
  • Sam’s Club Flu Shots: Costs $15 for standard trivalent. $25 for quadrivalent.
  • Kroger Flu Shots: Costs $30 for standard trivalent. $40 for quadrivalent.
  • Target Flu Shots: No trivalent (as of now). $39.99 for quadrivalent. Note that CVS now runs Target pharmacies (prices are the same), but you do get a $5 Target gift card if you get a flu shot at a Target CVS pharmacy.

But you really can get these vaccines for free. If you have health insurance, especially under Obamacare, you can get the vaccine for free, or for a small co-pay. Like I mentioned previously, most county health departments give away the vaccine for free, so contact them. Even if they have rules which say they’ll only vaccinate kids or the elderly, most will make exceptions if it’s hard to afford.

Yes, there might be a reason to fear the flu vaccine cost, but really, there are no excuses. It might take some work, go get the flu vaccine, and maybe save your life.

 

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