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On the Efficacy of Flu Vaccine

kdawson posted more than 3 years ago | from the because-we-just-know-it-works-that's-why dept.

Medicine 430

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.

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A confession: I smell my own farts. (-1, Offtopic)

Anonymous Coward | more than 3 years ago | (#29779741)

It's true- I'll waft them up to my face, or fart on something then smell that. I've noticed a difference between smelling farts off my fingers and farting into a towel and smelling that. I prefer the towel. Sometimes, right before I take a shower, I'll wipe my ass with a towel or my underwear to smell my butt-perfume. I frequently pull the covers over my own head when I fart between the sheets. Oh, and I love the smell and frequency of my hangover farts. I love leaving my room for a few minutes and coming back to smell my still-lingering farts hanging in the air. To me its kind of like climing out of the swimming pool, getting in the hot tub for a few minutes, then going back into the pool. If I want to fart without making a lot of noise I'll reach into my pants and hold my buttcheeks apart with my fingers so the gas can leave my asshole unobstructed. it actually makes a very audible "pssssssssssssss" sound. Like if someone was in earshot but they couldn't see me, they would probably be wondering if i was farting with my fingers in my ass.

Sometimes if I'm in public I'll find "discreet" ways to indulge my fart-sniffing penchance. For example I'll try to pass gas as quietly as possible, then discreetly fan my thighs open and closed so the gas is wafted up to my face.

Re:A confession: I smell my own farts. (-1, Troll)

Anonymous Coward | more than 3 years ago | (#29779801)

I kind of enjoy smelling my farts, too. I'm not into it as much as you are, though.

Re:A confession: I smell my own farts. (-1, Offtopic)

Anonymous Coward | more than 3 years ago | (#29780103)

glad to have known you

All I have is an anecdote (3, Interesting)

rcolbert (1631881) | more than 3 years ago | (#29779757)

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.

Re:All I have is an anecdote (5, Insightful)

MichaelSmith (789609) | more than 3 years ago | (#29779773)

If its four or five days from two illnesses then its not Flu. Thats a cold.

The one crucial point (0, Informative)

Anonymous Coward | more than 3 years ago | (#29779879)

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.

That fact tends to get lost in the fear-mongering. It's probably the main reason why we're making such a big deal out of the swine flu when the regular flu still kills thousands more people per year than the swine flu. The explanation for that is pretty simple: popular panic about a virus sells vaccines for that virus. The more I see the media and others telling us how afraid we should be of the swine flu, the more convinced I am that they are using this angle because there is no rational reason for most people to buy this vaccine. This is like the security theater that Schneier warns us about, except this time it isn't about airports, it's about medicine.

Re:The one crucial point (5, Informative)

maxume (22995) | more than 3 years ago | (#29779961)

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)

Re:The one crucial point (1, Insightful)

Anonymous Coward | more than 3 years ago | (#29780083)

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)

I am the AC to whom you replied.

The problem is that this hysteria shouldn't occur anyway. If it does occur, it might be justifiable if we were talking about some deadly or crippling disease that poses a real danger. This H1N1 is nothing but a nuisance by comparison. There is no justification for the tremendous governmental and medical resources that are being devoted to it. Words like "global pandemic" should be reserved for something more dangerous than the sniffles and anyone who's ever heard of the "boy who cried wolf" understands that.

The lobbyists don't really have to be very good when you think about it. There is nothing government loves more than a panic that it can resolve, as if to say "see, aren't you glad you gave us those expanded powers, we can use them now to save you from this threat!" I cannot ignore that, especially not when new laws are being proposed to forcibly quarantine anyone who refuses vaccination against this or other threats. Whether it's to save the children, fight terrorism, or protect from a "pandemic", there is nothing the government loves more than a crisis that justifies the expansion of power, power that will not be given back once the crisis is over. So, they don't need much convincing to jump on this one.

So the government benefits because it stands to get more of what it wants: power and an excuse for the exercise of it. The pharmaceutical companies benefit because they stand to get more of what they want: money, and in this case with little or no liability. The media benefits because sensationalism sells. If you assume three entirely selfish entities who always act in their own interests, which is not exactly a leap of faith here, why wouldn't BOTH the companies AND the government jump all over this and view it as a golden opportunity?

The only people who don't benefit from this are the general public. But it's not like they had much of a voice in this process anyway.

Re:The one crucial point (2)

maxume (22995) | more than 3 years ago | (#29780109)

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.

Re:The one crucial point (4, Insightful)

jedidiah (1196) | more than 3 years ago | (#29780195)

You seem to be confusing the current seasonal flu with the pandemic of 1918.

They are by no stretch of the imagination comparable.

Re:The one crucial point (1)

maxume (22995) | more than 3 years ago | (#29780235)

Nope.

Re:The one crucial point (2, Insightful)

khallow (566160) | more than 3 years ago | (#29780067)

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.

Re:The one crucial point (1)

Daniel_Staal (609844) | more than 3 years ago | (#29780177)

Also, almost no one has any natural immunity or resistance to H1N1, and it would take quite a chunk out of the economy if ~1/4 of the workforce were to have to take two to three weeks off sometime this winter...

Re:The one crucial point (0)

Anonymous Coward | more than 3 years ago | (#29780289)

On the other hand, since it is marginally more serious than regular flu to the healthy workforce, it could do wonders for Social Security and Medicare...

Re:The one crucial point (3, Insightful)

westlake (615356) | more than 3 years ago | (#29780249)

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 [bc.edu]

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.

 

Re:All I have is an anecdote (1)

nedlohs (1335013) | more than 3 years ago | (#29779811)

If you missed 2-3 days work then it wasn't the flu anyway. So it must have been coincidental.

Personally, I've never ever had a flu vaccine. But I don't think I've ever had the flu either, certainly not in the last 15 years. Sure, flue-like-symptoms but only for a few days at a time.

Well one time went for longer, but that turned out to be sinusitis, and my god did those headaches hurt.

Re:All I have is an anecdote (2, Insightful)

Brian Gordon (987471) | more than 3 years ago | (#29779825)

What else changed when you started getting the flu shot? If you now have a mind to protect your health by getting the shot, then you're probably also doing more things like washing your hands, eating better, etc

Re:All I have is an anecdote (1)

larry bagina (561269) | more than 3 years ago | (#29779837)

If you had the flu, you wouldn't confuse it with a standard cold.

Re:All I have is an anecdote (1)

rubycodez (864176) | more than 3 years ago | (#29779851)

I have an anecdote for you, the four years I received a flu shot I didn't get the flu until the next March or April. And it happened all four times! So I consider them useless for me, just postpones influenza until the weather is much nicer. I'd rather have my flu when the snow is piled high and its below freezing thanks

Re:All I have is an anecdote (1, Insightful)

Anonymous Coward | more than 3 years ago | (#29779907)

I have an anecdote for you, the four years I received a flu shot I didn't get the flu until the next March or April. And it happened all four times! So I consider them useless for me, just postpones influenza until the weather is much nicer.

If you reliably get influenza every year (and can reliably postpone it with a vaccine too) then you might want to ask the doctor if he can prescribe anything for hypochondria. I hear there's promising results from carbon monoxide.

Re:All I have is an anecdote (0)

causality (777677) | more than 3 years ago | (#29780213)

I have an anecdote for you, the four years I received a flu shot I didn't get the flu until the next March or April. And it happened all four times! So I consider them useless for me, just postpones influenza until the weather is much nicer. I'd rather have my flu when the snow is piled high and its below freezing thanks

I used to work at a place that offered the flu shots for free. The workplace saw it as an invetment, in that they'd rather pay for the vaccine than pay for the flu in the form of lost productivity and sick days. N.B. - this is the regular flu, not H1N1.

I had opportunity to question some of the nurses and doctors who gave the presentations on that program. They specifically told me that there are many different strains of the flu virus, and the vaccine only protects against a few select strains. You can call this the death of common sense due to overspecialization, or whatever you like, but it isn't difficult to apply a little logic to foresee the result. Given that information, it should be obvious that the vaccine will not stop the flu and will not protect you from getting the flu. It will only determine which strain you get.

There is, after all, a type of natural selection in effect here. If you change the virus's environment (by vaccinating the hosts) to select against a few strains, then those strains will decline and other strains will become dominant. When I politely pointed this out and asked if they could clear this up for me, the smooth-talking doctors and nurses who were advocating vaccination were suddenly unable to continue answering my questions. It was as though I was the first person who ever asked them what was, to me, a very obvious question about the effectiveness of the vaccine. I was amazed that from the proposal, to the creation, to the testing, to the manufacturing, to the marketing and finally to the dispensing of this vaccine, not one person in that entire chain of events thought that this question should have a ready answer.

That they don't seem to have considered such concerns tells me that this is a marketing effort.

Re:All I have is an anecdote (0)

Anonymous Coward | more than 3 years ago | (#29779977)

I got my first ever flu shot last winter and a month later I had a continuous cold for about 30 days (yes, cold, not flu) and another really bad one (again cold, not flu) a month later.

Scientists don't get to say "we don't know" (2, Interesting)

OeLeWaPpErKe (412765) | more than 3 years ago | (#29780005)

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.

Re: my anecdote (0)

Anonymous Coward | more than 3 years ago | (#29780121)

I can't really explain it, but I usually only die when I get a flu shot.

Re:All I have is an anecdote (1)

w0mprat (1317953) | more than 3 years ago | (#29780169)

I have +1 anecdote. My employer has started providing flu shots to staff some years ago. There has been a dramatic reduction in time off due to illness in winter on the order of about half the number of sick days used accross the board. Interesting when there's a good third of staff that don't get the jab. Since I've had flu jabs myself I haven't had a serious flu in years other than mild symptoms that clear in a day or two.

Already Vaccinated. (1)

Bad Labrador (922836) | more than 3 years ago | (#29779767)

My understanding is that vaccines are around 70% effective.

Re:Already Vaccinated. (1)

nedlohs (1335013) | more than 3 years ago | (#29779781)

And since they apparently haven't done the studies needed to show that your understanding is wrong. Or the article is wrong, of course.

FluMist (5, Informative)

TheMeuge (645043) | more than 3 years ago | (#29779857)

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 [cdc.gov]

Re:FluMist (4, Insightful)

tehdaemon (753808) | more than 3 years ago | (#29780089)

TFA implies that "anyone who is old enough, has no respiratory problems, and who isn't immunosuppressed,", will have a strong immune response to the flu whether or not the get the vaccine. Those who do not fall into this category don't have a strong enough immune system to react to the vaccine anyway and receive no benefit. The studies to confirm or deny this have not been done.

T

Re:FluMist (2, Informative)

ThousandStars (556222) | more than 3 years ago | (#29780229)

Did you read the site you linked to? It says: "However, data directly comparing the efficacy or effectiveness of these two types of influenza vaccines are limited and insufficient to identify whether one vaccine might offer a clear advantage over the other in certain settings or populations."

You say, "Furthermore, it has been shown to be effective against viruses that have undergone some genetic drift." But there's nothing about that in the CDC site.

Re:FluMist (1)

TheMeuge (645043) | more than 3 years ago | (#29780317)

I read quite a lot beyond that site. I did not, however, have time to link everything I've ever read about that vaccine in my post (having worked for one of the virologists consulting for the project) at the time the vaccine was going through trials and getting FDA approval.

Good article (1, Funny)

Anonymous Coward | more than 3 years ago | (#29779775)

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.

Let's pray that science wins out over irrationality.

Re:Good article (1)

sakdoctor (1087155) | more than 3 years ago | (#29779779)

I took a placebo and I didn't catch Flu.

Re:Good article (5, Funny)

jsellens (760992) | more than 3 years ago | (#29779803)

I *thought* about getting a placebo, and didn't get the flu. I'm suggestible as hell.

Re:Good article (5, Funny)

soconn (1466967) | more than 3 years ago | (#29779817)

Yes, today's placebo is almost twice as powerful as those used as little as 5 years ago.

Re:Good article (4, Interesting)

moosesocks (264553) | more than 3 years ago | (#29780031)

You joke, but there's mounting evidence that the placebo effect is indeed getting stronger [wired.com] .

(Of course, conducting a double-blind test to confirm this would create numerous paradoxes)

Re:Good article (2, Funny)

VValdo (10446) | more than 3 years ago | (#29779841)

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

Re:Good article (0)

Anonymous Coward | more than 3 years ago | (#29779935)

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.

Best cure I know of is going into work for a few days. The pounding headaches return in no time.

Re:Good article (4, Funny)

noidentity (188756) | more than 3 years ago | (#29779859)

Let's pray that science wins out over irrationality.

I don't whether to laugh or cry.

Re:Good article (2, Funny)

JustOK (667959) | more than 3 years ago | (#29780049)

Sounds like you're having a devil of a time figuring it out.

Re:Good article (4, Interesting)

rs79 (71822) | more than 3 years ago | (#29780135)

"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 [google.com]

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.

Then not taking the vaccine safer? (0)

Anonymous Coward | more than 3 years ago | (#29779783)

At least we know that not taking the vaccine does not have side effects (contamination (Baxter), coadjuvants (some vaccines), etc.) or does it?

Re:Then not taking the vaccine safer? (1)

mysidia (191772) | more than 3 years ago | (#29779827)

Not taking the vaccine may have some side effects: side effects similar to sugar pill, and flu-like symptoms, which can occur at any future date.

Re:Then not taking the vaccine safer? (0)

Anonymous Coward | more than 3 years ago | (#29779885)

Only at first. Once it kills off the weak, everyone else will be strong enough to tolerate its effects, making the world a healthier place.

Re:Then not taking the vaccine safer? (1)

maxume (22995) | more than 3 years ago | (#29779983)

The same line of reasoning applies to a 9mm slug to the forehead.

It's not you, it's who you'd infect (5, Insightful)

Anonymous Coward | more than 3 years ago | (#29779793)

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.

question for you: (2, Interesting)

maillemaker (924053) | more than 3 years ago | (#29780245)

>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?

Lies! (1)

gmuslera (3436) | more than 3 years ago | (#29779797)

Ok, maybe just statistics, that sometimes are worse if not interpreted correctly. That 'healthy people', the one that takes seriously enough prevention to, between other measures, get the vaccine, are less exposed to disease risks in general, and even when they get the flu (seasonal or not) they usually take measures to make it less deadly. The point is, between equaly exposed people vaccine lower the risks? In a widely spread pandemy we all could get a chance of exposion, and there is where vaccines will make a difference.

Just like when a programmer is sure his code works (0)

noidentity (188756) | more than 3 years ago | (#29779821)

This is like when a programmer is sure his code works, doesn't need any unit tests, but when such tests are written, they find all sorts of problems. Apparently medicine is full of beliefs that aren't backed by tests; fortunately there's a movement against this, evidence-based medicine [wikipedia.org] .

In this case it seems lots of people believe that vaccines are good, that anything that reduces use of them is bad, and since testing them could cause reduction in use, testing is bad. Never mind that they might not be as good as imagined; this is beyond question, and it's simply a matter of getting others to accept the same belief, no matter what means is used. It really makes me sick to read question-and-answer documents that constantly avoid direct answers to questions of whether a given person gets a benefit from an injection.

Re:Just like when a programmer is sure his code wo (1)

Pinky's Brain (1158667) | more than 3 years ago | (#29779881)

My unit tests don't generally kill people though.

Re:Just like when a programmer is sure his code wo (1, Insightful)

noidentity (188756) | more than 3 years ago | (#29779967)

It's not easy to account for the lives lost due to waste of limited resources on medicine that doesn't help. If flu vaccines don't help most people, then let's find out so we can spend time doing things that do help.

Re:Just like when a programmer is sure his code wo (1)

tehdaemon (753808) | more than 3 years ago | (#29780117)

Nor do your bugs. Medical 'bugs' can, and often do.

T

It's not that simple (0, Troll)

Rix (54095) | more than 3 years ago | (#29780305)

Flu vaccines do save lives, just not necessarily the lives of the people who get them. By not getting the vaccine you expose other, more vulnerable people to higher risk.

Not getting vaccinated is highly irresponsible, and anyone who doesn't should be quarantined.

Editorializing (4, Insightful)

Gudeldar (705128) | more than 3 years ago | (#29779831)

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.

Re:Editorializing (0)

Anonymous Coward | more than 3 years ago | (#29779869)

While this does raise some questions about the efficacy of the vaccine. It doesn't prove conlusively it does nothing.

For example, it could be doing more harm than good. Raising questions over the efficacy of a vaccine is pretty important when there isnt a clear answer of "yeah, injecting that stuff into you is helping".

Re:Editorializing (4, Insightful)

Threni (635302) | more than 3 years ago | (#29779979)

All you have to do is look up Vaccine on Wikipedia to see some people don't like vaccines for whatever reason ("it's god's will that we die" or whatever). Not worth giving those freaks any more attention, really, unless these claims are different in some way.

San Diego testbed (0)

Anonymous Coward | more than 3 years ago | (#29779833)

H1N1 in San Diego is a KILLER... three atypical deaths recently...

The vaccine isn't even available due to a Federal faux paux that failed to ship to hospitals.

San Diego is your test bed for determining whether it works unless the Feds ship soon.

Re:San Diego testbed (1)

jedidiah (1196) | more than 3 years ago | (#29780239)

A real pandemic looks like something out of a bad sci-fi film about the end of the world.

3 unusual deaths in San Diego does not.

As soon as you mentioned "Group Health"... (5, Informative)

93 Escort Wagon (326346) | more than 3 years ago | (#29779835)

... 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.

Re:As soon as you mentioned "Group Health"... (3, Insightful)

pdabbadabba (720526) | more than 3 years ago | (#29780045)

But bear in mind that if she's wrong the company's costs, on balance, will be much higher when their insured start showing up in the hospital not having gotten the vaccine. The vaccine, if it works, should be a cost saving measure for them.

It seems to me that they'd want to get this right.

(This is all subject, of course, to speculation on my part regarding the cost of the vaccine, versus the cost and likelihood of hospitalization in its absence. Though I'd point out that, if the vaccine isn't cost effective for the insurer, they could elect not to cover it regardless of its effectiveness.)

Re:As soon as you mentioned "Group Health"... (0)

Anonymous Coward | more than 3 years ago | (#29780297)

For the record, the whole "Group Death" nickname was started in the 50s by outside physician's groups who were calling cooperative healthcare "communist" and were worried that group health would hurt their own bottoms lines. While you an find horror stories at any healthcare group, grouphealth is well respected not just here in the pacific northwest but nationwide as model for quality, price-conscious healthcare that is responsive to its customers. The research arm is connected with UW and the Hutchinson research institutes in the area- the days of research happening in a bubble are long gone. If anything, Group Health appears to be growing its research arm rapidly as it adds to quality of care.

You don't only get vaccinated for yourself. (0)

Anonymous Coward | more than 3 years ago | (#29779847)

You don't only get vaccinated for yourself. You also get vaccinated so that you don't transmit the virus to those with compromised immune systems.

I am really so tired of all of the anti-vaccination propaganda being put out, and those same people will probably warp studies like this one to fit their absurd ideas about how vaccines are almost as bad as chemtrails.

Re:You don't only get vaccinated for yourself. (1)

pclminion (145572) | more than 3 years ago | (#29780059)

You don't only get vaccinated for yourself. You also get vaccinated so that you don't transmit the virus to those with compromised immune systems.

If the vaccine doesn't reduce mortality, as this study suggests, then that indicates that the vaccine doesn't do anything. If it doesn't do anything, how it taking the vaccine helpful to other people?

Re:You don't only get vaccinated for yourself. (0)

Anonymous Coward | more than 3 years ago | (#29780311)

If the vaccine doesn't reduce mortality, as this study suggests, then that indicates that the vaccine doesn't do anything.

That's a nice bit of fallacious reasoning there...

It is entirely possible that even if the vaccine is ineffective at reducing the mortality rate, the vaccine is still helpful.

i.e. an infirm person (young, old, or otherwise weakened already) may still die from the illness even if vaccinated due to their body's inability to produce sufficient immune response; whereas in a reasonably healthy person the immune system can respond to the vaccine and produce sufficient anti-bodies to prevent a significant infection from occurring.

Or.... (4, Insightful)

plague911 (1292006) | more than 3 years ago | (#29779861)

There are so many conclusions which can drawn from those statistics its silly. Here is another example. Healthy people dont die as often period. If you are sickly you are more likely to still get a disease even if you were given the immunization short. Followed by the fact that sickly people die more often when they do get sick.

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.

Re:Or.... (1)

noidentity (188756) | more than 3 years ago | (#29779909)

There are so many conclusions which can drawn from those statistics its silly. Here is another example. Healthy people dont die as often period. If you are sickly you are more likely to still get a disease even if you were given the immunization short. Followed by the fact that sickly people die more often when they do get sick.

So you run a test where you randomly choose people, then randomly divide them into three groups: one which receives no shots, one which receives placebo shots, and one which receives the vaccine. Measure illness rates before and sometime after, then compare the three groups. You could further divide each group into the already-healthy and already-sickly, and see how each sub-group responded. Then you know whether the vaccine is useful in each sub-group.

But I'm not a doctor and hardly study medical stuff...

Re:Or.... (1)

genericpoweruser (1223032) | more than 3 years ago | (#29780057)

Seriously, is that so complicated? I would have no problem participating in that study (assuming I was compensated for getting the flu--that stuff sucks). It's not like the flu is exceptionally dangerous, so where is the opposition coming from?

There are randomized controlled trials (4, Informative)

Anonymous Coward | more than 3 years ago | (#29779873)

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." [ama-assn.org] )

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." [uchicago.edu] )

The article is at best poorly researched and at worst intentional FUD.

Re:There are randomized controlled trials (1)

Ender_Wiggin (180793) | more than 3 years ago | (#29779915)

Mod parent up! This is better data than a magazine article

Re:There are randomized controlled trials (-1, Troll)

ahabswhale (1189519) | more than 3 years ago | (#29779929)

rofl...so the Nordin study you reference is well researched but the one by the OP isn't? Interesting...based on what fucking information? I have news for you...seasonal influenza vaccines are bullshit. They are guesses as to what researchers think people will run into. In many cases, they don't protect against anything going around because they guessed wrong. Not to mention the fact that these viruses are constantly mutating. Sorry, but there's really no evidence that a seasonal vaccines does fuckall. Meanwhile, they are injecting mercury and other poisons into your body with the vaccine that are definitely harmful to your body.

Re:There are randomized controlled trials (2, Informative)

herpchick (1489679) | more than 3 years ago | (#29780079)

I'm feeding the troll, but the one plague911 cites is researched because it has stood up to peer review. This is how science works. You can't just watch three cars go by, note that all are red, and write a paper saying all cars are red. I saw it. In science, we subject papers to peer review, where we look at the methods of a study, and if the study is not done well, if the methods do not hold up to a rigorous standard, then the paper is rejected and it is not published. This woman tried to publish her paper and it was rejected. It's hard to give much cred to her paper if she can't even get it published in a journal like PLoS, which evaluates strictly on the methods, not at all on the significance. PLoS does no value judgements. So if her argument is that her methods are sound and JAMA doesn't like it because it is too "against the grain" then send it to one of these type journals. I note however, that it is still not published. In addition, only some of the flu vaccines have thimerosol in them; if you are concerned about trace chemicals entering your body, do you eat all organic, too?

Re:There are randomized controlled trials (1, Insightful)

Anonymous Coward | more than 3 years ago | (#29780115)

This "I have news for you" fellow seems like a legit guy, I think I can trust him. Wait, no, it's some dime-a-dozen anonymous fucktard on the Internet who thinks the big evil vaccines are out to get him. The source in the summary is a fear-mongering piece of shit from a popular magazine. The *multiple* sources provided by the OP are peer-reviewed scientific journals. I think that's a pretty damn good basis to prefer them.

Yes, they do have to "guess", but it's not just "throw darts at the influenza strain dartboard" guessing like you try to pass it off as. They are well-researched "guesses" that take into account much information. No, it's not perfect, but it's better than nothing. Yes, they're constantly mutating, so what? Yes, there is plenty of evidence [wikipedia.org] , of which the OP provided some. Just because you ignored it doesn't mean it's not there; it just means you are freely engaging in selection bias. Lastly, thiomersal has been removed from plenty of vaccines and still has no evidence for it being harmful [wikipedia.org] anyway.

Your sig is amusingly fitting here.

Re:There are randomized controlled trials (4, Informative)

dmoore (2449) | more than 3 years ago | (#29780119)

The article acknowledges this:

Only four studies were properly designed to pin down the effectiveness of flu vaccine, he says, and two of those showed that it might be effective in certain groups of patients

The article seems to be primarily advocating double-blind, controlled clinical trials among the elderly, since that is the group where death is the primary concern rather than just getting sick.

There are many obstacles to overcome (3, Informative)

irtza (893217) | more than 3 years ago | (#29779875)

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 [annals.org] 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.

article is BS (4, Insightful)

wizardforce (1005805) | more than 3 years ago | (#29779895)

Influenza causes only a small minority of all deaths in the U.S., even among senior citizens,

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.

Re:article is BS (1)

nedlohs (1335013) | more than 3 years ago | (#29779923)

And that study is exactly what they proposed doing, but it was declared to be unethical and hence can't be done.

Re:article is BS (2, Informative)

wizardforce (1005805) | more than 3 years ago | (#29779957)

nonsense. These kind of studies are done all the time, there is absolutely nothing unethical about them! Now it would be a different story if you were to force people into studies but that is a separate issue entirely.

Re:article is BS (1)

genericpoweruser (1223032) | more than 3 years ago | (#29780085)

It might also be a problem if you intentionally exposed the patients to the flu virus but that is not necessary considering how widespread the virus is. I, for one, would be willing the be a guinea pig in such a (double blind) study.

Re:article is BS (1)

nedlohs (1335013) | more than 3 years ago | (#29780199)

Have you got a reference to a double blind study done on high risk people comparing placebo and a flu vaccine?

http://www.ncbi.nlm.nih.gov/pubmed/10498559 [nih.gov] and http://www.ncbi.nlm.nih.gov/pubmed/7966893 [nih.gov] are the best I can find, which do seem to contradict the claims in the article.

Note, I have nothing against vaccines. My kid got a flu vaccine this year and is up to date on all his other ones. I'm not an anti-vaccine nut who think that all our health issues are caused by vaccines :)

Re:article is BS (1)

clarkkent09 (1104833) | more than 3 years ago | (#29780261)

Not sure if this is the case here, but something to keep in mind is that there are limited resources for conducting medical studies and sometimes they are simply rejected on the grounds of being superfluous or not well thought out or unnecessary for whatever other reason, in which case the proponents sometimes like to claim some sort of conspiracy to hide the truth etc. Few posts above somebody posted links to perfectly good studies that show efficacy of the vaccines in question.

Re:article is BS (1)

blaster (24183) | more than 3 years ago | (#29780133)

Influenza causes only a small minority of all deaths in the U.S., even among senior citizens,

36,000 die of complications from the flu annually in the US. That's very nearly as many as die from car accidents.

It is entirely accurate to say flu deaths are a minority of all deaths. According to the CDC [cdc.gov] in 2006 there were 56,326 deaths from Influenza and Pneumonia, out of a total of 2,426,264 deaths. If we assume all of those 56,326 deaths were from the flu, that is a grand total of 2.3% of all deaths from the flu. If the number is actually 36,000 (which sounds reasonable once you factor out Pneumonia) then it is only ~1.5%.

Of course that has nothing to do with the accuracy of the story, but lets not jump on the parts where we actually have reasonable data.

Re:article is BS (1)

wizardforce (1005805) | more than 3 years ago | (#29780191)

It just seems to me that the only reason for the article to have mentioned it would be to imply how "worthless" these vaccines supposedly are. As if 36,000 people aren't worth the trouble just because the flu virus isn't the top killer. I mean, you could use the exact same argument for car accidents and it wouldn't detract from the need for car accident safety testing any more than the article's assertion does for flu vaccination and testing.

Re:article is BS (1)

izomiac (815208) | more than 3 years ago | (#29780259)

Actually, there is a famous study that did exactly that. In the thirties syphilis treatments were dangerous and questions were raised about their efficacy. So a large study was conducted in Tuskegee. Google it if you haven't heard about the results.

For that reason, modern medical ethics require that your placebo group be given the current standard of care. That's getting the vaccine. If we practiced pure science, this wouldn't be accepted (science is amoral and if everyone in your control group dies that's irrelevant). But, since the point of medical research is to improve upon existing treatments we do this because any treatment that's better than nothing but worse than the current standard is clinically useless. Of course, this raises the question of how the flu vaccine became standard of care without sufficient research evidence backing it up, but that's a different issue.

Beware of antivaxxers (4, Insightful)

benjfowler (239527) | more than 3 years ago | (#29779897)

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.

Beware of starry-eyed, pie-in-the-sky liberals (-1, Troll)

Anonymous Coward | more than 3 years ago | (#29780123)

who think that the US government is the best solution to any and all problems that can be found in US health care.

The same ones who can't see how many Canadians show up in US hospitals.

The same ones who fail to understand the the US health care "system" is the sum total of millions and millions of INDIVIDUALS making FREE-AS-IN-SPEECH decisions on THEIR OWN health care.

The same ones who start babbling when informed that the only way a government on a budget is going to control the cost of health care is with RATIONING and LIMITING ACCESS TO HEALTH CARE just like the UK does when the marginal cost to an indivudial or family of any one health care decision by that individual or family covered by a government-run, single-payer system is zero. FREE HEALTH CARE FOR EVERYONE JUST MEANS GOVERNMENT RATIONING!

The same ones who want to FORCE down our throats their weird pulled-from-the-asshole idea that a government that can do no right in any other endeavor short of handing out "free" benefits (or in any endeavour when any Republican happens to be President...) will suddenly get all competent when it's put in charge of health care.

Re:Beware of starry-eyed, pie-in-the-sky liberals (2, Informative)

benjfowler (239527) | more than 3 years ago | (#29780233)

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.

Re:Beware of antivaxxers (1)

farnsworth (558449) | more than 3 years ago | (#29780293)

some kind of stunt by Group Health or other elements of the private health industry to wriggle out of paying for flu shots.

Presumably if vaccines were either effective or ineffective the insurance companies would want to know which is which, right? Or is there some sort of calculus that says that vaccines could be effective for a given individual, but not cost effective for a larger group? I, a lay, would assume that "effective" and "cost effective" are the same, but I may be missing something.

Clinical trials (1)

Ender_Wiggin (180793) | more than 3 years ago | (#29779905)

The flu shot is tested annually through peer-reviewed clinical trials. The shot is compared to its protective factor year over year. I believe the data shows it works.

Define "flu" (1)

chill (34294) | more than 3 years ago | (#29779955)

Part of the research I've read recently claims we have no solid definition of the mortality rate of the "flu". The problem is unless you take a culture and analyze it in a lab, you can't tell if the disease is really influenza or one of a hundred or so others that cause similar symptoms. But people who report to their doctor about symptoms aren't always lab tested to see exactly what they have. It'll get noted as "the flu", when it may not be influenza at all, skewing all the statistics.

The article I was reading [theatlantic.com] in Atlantic Monthly makes the claim that people who die from flu-like symptoms aren't always lab tested, either. Thus, the mortality rates for "the flu" may have little to do with influenza.

While we as a society have had great success with vaccination campaigns against diseases like the measles, mumps, rubella, polio and small pox, the same can't convincingly be said about influenza.

The Scientific Method (5, Insightful)

PieSquared (867490) | more than 3 years ago | (#29779995)

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.

Of course mortality is unaffected: it's still 100% (0)

Anonymous Coward | more than 3 years ago | (#29780003)

Although with the taxes we're going to have to pay to get out from under the drunken sailor spending sprees of Bush and Obama, we're all going to feel like we've died twice.

Vaccine still good, even if study is accurate. (1)

GryMor (88799) | more than 3 years ago | (#29780013)

Even if the flu vaccine does nothing to reduce mortality directly, it would still be a societal benefit if it, on average, delays infection by a few days as it would spread out the infections over time giving the medical infrastructure a better chance of not being overwhelmed during a pandemic.

Additionally, retrospective studies (as opposed to randomized trials), really suck at identifying the magnitude of conflating factors (but can be good in indicating that there ARE conflating factors).

MDs should be experts in stastics (-1, Troll)

virtualXTC (609488) | more than 3 years ago | (#29780027)

This is yet another reason the health care system is broken. To get an MDs you only need to memorize and regurgitate little application of science or statistics. Beyond the mess of the efficacy of the vaccine, patients are given false information all the time. FTA (a doctor diagnosing meningitis):

There is a tiny chance, says Newman, that the illness is caused by a bacterium, which can be deadly, but he is almost positive that’s not what the tourist has. He says to his patient, “I can’t tell you with 100 percent certainty that you don’t have it...

He's not 100 percent certain, yet he tells the patent that anyway!?! How f-ed up is that? Is it any wonder heath insurance cost so much with all the malpractice going on? Malpractice suits don't even help. MDs are insured and only have to spend a few days in court if some one calls them out on it then if they are proven wrong the Hospital insurance takes the fall and all our costs go up while the MDs pay stays the same. What we really need to do is hold each physician criminally responsible for what they say and do in a clinical setting.

Re:MDs should be experts in stastics (2, Insightful)

fluffy99 (870997) | more than 3 years ago | (#29780099)

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.

Problem with clinical trials (1)

One_Minute_Too_Late (1226718) | more than 3 years ago | (#29780035)

The problem with a clinical trial for H1N1 vaccines is that they take too long to set up and analyze. By the time the data collection closed, we'd be into the summer of 2010, and then what good would have come of it? To accumulate enough data, it would have to be a multicenter trial (i.e. conducted in many different cities). Given the public policy enforcing vaccination, it would be extremely difficult (impossible) to get approval from a hospital research ethics board to even run the trial.

Unfortunately medicine is not a 'hard' science, in spite of our best efforts the systems are too complex and difficult to completely control (unlike physics or chemistry). Not to mention the fact that most doctors trained in the life sciences and do not understand the mathematics well enough to analyze a clinical trial, so unless they have sought out additional training in epidemiology/statistics, their grasp of numbers is always suspect.

That being said, if most doctors are numerically challenged, journalists tend to be both numerically and scientifically illiterate, which I suppose is even worse.

Re:Problem with clinical trials (1)

fluffy99 (870997) | more than 3 years ago | (#29780111)

But there is still no excuse for not properly verifying the efficacy of the seasonal flu vaccine. As pointed out earlier, most of the data used to support the flu vaccine is of poor quality. In particular, flu deaths are never verified as actually being the flu and not one of several other flu-like illnesses, plus the trend that healthy people get the vaccine more than vulnerable people.

Sounds like it worked (0)

Anonymous Coward | more than 3 years ago | (#29780077)

Failing to reduce the mortality rate doesn't mean it didn't work. That data point alone is meaningless. If it reduced the infection rate by 100 times, but the mortality rate was slightly higher, then it was still a HUGE help!

Waiting for input (1)

EsJay (879629) | more than 3 years ago | (#29780143)

I'm not acting until I here what world-renowned scientist Jenny McCarthy has to say.

Morbidity vs Mortality (1)

Harlan879 (878542) | more than 3 years ago | (#29780183)

Reading the article, it seems as if the flu vaccine is reasonably effective in reducing morbidity (incidence of infection) among the majority of the population, who are healthy and have noncompromised immune systems. But, the evidence is unclear as to whether it reduced mortality (death) among people who are old or otherwise have weakened immune systems. Even if the vaccine does nothing at all for the elderly per se, it doesn't mean immunization of the healthy is a bad idea, for two reasons. First, as mentioned in the article, herd immunity effects can reduce the incidence of flu in the elderly, thus indirectly reducing mortality. Second, influenza sucks and reduces productivity by knocking people out of work for 3 days. In an economic sense, it is totally worth doing, even if it doesn't reduce deaths at all. The conclusion of the article should be "flu vaccinations are worthwhile, if not exactly for the reason you thought they were."

Illness vs mortality (1)

ChrisWong (17493) | more than 3 years ago | (#29780271)

I read that article before. The fatal weakness of its reasoning is that it only focuses on fatalities. The reality is that even if you got ill with the flu, you almost never died (under 0.1% fatality rate). Even the super-fatal pandemic flu of 1918 was about 5% fatal among those sickened. I doubt if it is feasible to get a statistically significant count of fatalities in a controlled study sample.

But even if you do not die, flu is pretty costly. It is costly in the time you spend miserable, sick and out of action. It is costly to the colleagues, friends and family that you in turn sicken. It is costly to society as a whole. Vaccines either prevent that sickening altogether or reduce its severity. That makes vaccination campaigns valuable to society as a whole -- even to the unvaccinated -- because any flu case prevented or shortened will eliminate yet another infection source. Since flu spreads, well, virally, stopping even one source is significant. That's why govt agencies tend to be on board, because they are worried about the health of the overall society.

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