Influenza beginning to scare me... thoughts on the vax? - Page 2

[mamakay]

Yeah...the one nobody's wanted to fearmonger about because it's better to just not say anything and have people assume it's actually genetically realted to the deadly chronic liver disorder viruses.

[LongIsland]

Originally Posted by mamakay

Yeah...the one nobody's wanted to fearmonger about because it's better to just not say anything and have people assume it's actually genetically realted to the deadly chronic liver disorder viruses.

Ah yes, the ole "word association" tactic.

Remember a few weeks ago when it was revealed that restauranteur Wolfgang Puck's employee had Hepatitis A? All the rag mags were headlining:

Does Beyonce Have Hepatitis?!


The articles made it sound like she was going to have to live with Hepatitis A for the rest of her life and she was going to die.

[mamakay]

Lol!

[dymanic]

Originally Posted by mamakay

Epidemiologists shouldn't be the ones determining what viruses are about to emerge as serious pathogens.
It should be cell biologists and virologists figuring that out.

Now there's a quibble. "Epidemiologists/virologists" gets a little awkward; I hoped that using "the epidemiological community" (which certainly includes virologists) would cover it.

"They" being "epidemiologists"? Like the ones at the Cochrane Collaboration?

Flu vaccines are accepted as being at least reasonably effective by the overwhelming majority of the professionals in the relevant fields. You may argue that they are wrong to believe what they believe, but that's not the same as saying that they're lying about what they believe.

Going back to the media, it's the CDC that sends out packages to the media. Do you disagree that that is what they do?

No. I believe that the folks at the CDC are VERY concerned about the threat, and highly motivated to convey the risk to as many people as possible. I also believe that journalists come in many flavors. Some lack the expertise to report on the issues they cover, and some are not above taking whatever creative liberties they feel will inhance the entertainment value of their product. I've seen headlines proclaiming "Bird Flu Found in U.S.", and upon reading the articles, found them to be referring to commonly circulating strains of low-path influenza other than H5N1. The media sells news as entertainment. Do you disagree that this is what they do?

Originally Posted by LongIsland

I mean, why else would the CDC universally recommend and push mandates for these particular vaccines if they weren't gravely threatening America's children, right?

You seem to be implicitly claiming to have a keen insight where their motives are concerned. If you'd like to show your work, that would be great -- but only if you are so inclined, of course; I can't suggest that you are a conspiracy theorist, or (apparently) even ask you to clarify your position without crossing some line of decency here.

And just to clarify for the reader, there is no imminent threat of a bird flu pandemic.

In the same sense, on (say) August 23, 2005, there was no imminent threat of a major hurricane hitting New Orleans. Nonetheless, there were those who were insisting that the likelihood of such an event was sufficient to warrant serious concern, and that the city was very vulnerable.

[mamakay]

Flu vaccines are accepted as being at least reasonably effective by the overwhelming majority of the professionals in the relevant fields

.

I'm not so sure about that. I personally know several "scientists" who don't "believe" that flu vaccines are very effective. And "health care workers" often don't get flushots, citing "lack of effectiveness" as a primary reason.

You may argue that they are wrong to believe what they believe, but that's not the same as saying that they're lying about what they believe.

I never said lying.
Even "risk communication" isn't technically lying, although it's extremely deceptive in function.

[LongIsland]

Originally Posted by dymanic

No. I believe that the folks at the CDC are VERY concerned about the threat, and highly motivated to convey the risk to as many people as possible.

I wonder why the folks at the CDC are not highly motivated to convey the risks of Congenital Cytomegalovirus (CMV) to as many people as possible? Forty thousand ( 40,000) babies are born with the virus every year. It's the second leading cause of birth defects, including blindness, in newborns. In fact, the CDC states that "every hour, congenital CMV causes one child to become disabled."


Now why isn't this on the news every other night?

I mean the chances of handling a bird flu-infected chicken must surely be FAR greater than catching and spreading cytomegalovirus or else the CDC would be "VERY" concerned. Although from my research cytomegalovirus is widespread and almost everyone gets it by the time they reach adulthood.

I suppose we'll just have to wait until the CMV vaccines get closer to licensure before it becomes worthy of a proper and continuous warning like the currently more profitable bird flu "pandemic."

[Plummeting]

Originally Posted by dymanic

I can't suggest that you are a conspiracy theorist, or (apparently) even ask you to clarify your position without crossing some line of decency here.

Dymanic, you are so obvious. I had thought you would act a little more politely when you had time to post again, but now you're just back to the same old same old. You were wrong in that thread and it was hard to even follow your logical gymnastics. Don't attempt to bring up all that nonsense in this thread. This just another attempt of yours to skirt the UA by posting sarcastic, baiting references that the mods probably won't notice, because you phrase it as though you're a baffled man who just doesn't understand what's happening around here. You have a history of referencing other threads in a dishonest manner, misrepresenting conversations to make it appear as though everyone is so unreasonable to you, when in actuality everyone has been more than fair to you, given your behavior. You're not subtle, although you seem to feel you are. Your methods are quite obvious to anyone that's been paying attention. Don't misrepresent our conversation. It's rude and it's childish.

[dymanic]

Originally Posted by mamakay

I'm not so sure about that. I personally know several "scientists" who don't "believe" that flu vaccines are very effective.

The same approach has been used to make a case against anthropogenic global warming. I've even seen it used in an attempt to discredit evolutionary theory, arguably the most fundamental concept in modern biology: "see these 'scientists' who don't 'believe' in evolution". The opinons of several scientists don't carry the same weight as do the opinions of thousands of scientists.

And "health care workers" often don't get flushots, citing "lack of effectiveness" as a primary reason.

Anecdotally then (for what that's worth, which isn't much), my experience is that many "health care workers" aren't significantly more knowlegeable than anyone else. Next one you meet, ask them for their thoughts on why it is that the gene for neuraminidase is more highly conserved in the influenza genome than is the one for hemagglutinin.

I never said lying.

No, but LI did (implied it, anyway) by saying: "Part of the pandemic flu hype is designed to scare people into vaccinating for seasonal influenza."

Originally Posted by LongIsland

I wonder why the folks at the CDC are not highly motivated to convey the risks of Congenital Cytomegalovirus (CMV) to as many people as possible?

Here again, your comments are absolutely dripping with implication, yet you do not come out and say precisely what you mean.

[LongIsland]

Originally Posted by dymanic

No, but LI did (implied it, anyway) by saying: "Part of the pandemic flu hype is designed to scare people into vaccinating for seasonal influenza."

Here again, your comments are absolutely dripping with implication, yet you do not come out and say precisely what you mean.

Dymanic, we've been over this a million times and have provided you with several links EACH time you've tried to deflect reality by accusing the board of "conspiracy theory."

For instance, this is what the director of the CDC's communication department said about creating demand for influenza vaccines:

Focusing on the important role in mitigating pandemic influenza of both annual immunization (to build demand for flu vaccine, and therefore supply in the event of a crisis) and prompt vaccination against a pandemic strain, the chapter continues with a consideration of strategies to increase immunization uptake before and during a pandemic.

[mamakay]

The same approach has been used to make a case against anthropogenic global warming. I've even seen it used in an attempt to discredit evolutionary theory, arguably the most fundamental concept in modern biology: "see these 'scientists' who don't 'believe' in evolution". The opinons of several scientists don't carry the same weight as do the opinions of thousands of scientists.

Yes. Looking at the rather compelling evidence and siding with the gold standard of evidence based medicine is just like not believing in evolution. The inactivated influenza vaccine debate is just like that.

No, but LI did (implied it, anyway) by saying: "Part of the pandemic flu hype is designed to scare people into vaccinating for seasonal influenza."

But that's actually true. It's # 7 of the "recipe" for creating demand for influenza vaccines.

[LongIsland]

Originally Posted by mamakay

But that's actually true. It's # 7 of the "recipe" for creating demand for influenza vaccines.

They even discussed it at one of the ACIP meetings -- one of the justifcations they used for expanding seasonal influenza vaccine recommendations to cover more pediatric age groups was to "prepare" for the pandemic.

And let's not forget the CDC's recent drive to vaccinate more healthcare workers for seasonal influenza to prepare for a pandemic -- they feel that ensuring health care workers (from the doctors to the cafeteria workers) are seasonally vaccinated has "taken on greater importance with the spread of H5N1 avian influenza and its potential to create a pandemic."

[blessed]

Originally Posted by dymanic

Anecdotally then (for what that's worth, which isn't much), my experience is that many "health care workers" aren't significantly more knowlegeable than anyone else. Next one you meet, ask them for their thoughts on why it is that the gene for neuraminidase is more highly conserved in the influenza genome than is the one for hemagglutinin..

I think, like everyone else, we'd be more inclined to tell you about our healthcare colleagues who got the flu shot and then walked around moaning about how crappy they felt (or else just staying home) for the next five days. And about then seeing those same people missing just as many days that season due to 'flu'. Or maybe about the three cases of patients hospitalized for confirmed influenza I saw this year, all of whom had received their flu shot. Oh, and that case of Guillain Barre...

The healthcare workers I know who opt out of the flu shot are doing it for the same reasons as everyone else: we see firsthand that it makes you sick to receive it, it doesn't protect you as promised, and just like all other sanctioned vaccinations, side effects and longterm outcomes are poorly characterized or not known.

[mamakay]

The healthcare workers I know who opt out of the flu shot are doing it for the same reasons as everyone else: we see firsthand that it makes you sick to receive it, it doesn't protect you as promised, and just like all other sanctioned vaccinations, side effects and longterm outcomes are poorly characterized or not known.

And that includes "scientists".

I'd really like to see some kind of statistic on what % of cell biologists actually get flushots each year.

[LongIsland]

Originally Posted by mamakay

But that's actually true. It's # 7 of the "recipe" for creating demand for influenza vaccines.

From Glen Nowak, CDC Director of Communications:

#7 - References to, and discussions, of pandemic influenza–along with continued reference to the importance of vaccination.

[mamakay]

Originally Posted by LongIsland

#7

References to, and discussions, of pandemic influenza–along with continued reference to the importance of vaccination.

Yeah...it comes right after the discussion on how to scare the sh*t out of people with videos of sick kids.

Your tax dollars at work! Woo hoo!

[LongIsland]

Just in case the reader hasn't seen the "recipe," here is a link: http://www.ama-assn.org/ama1/pub/upl..._flu_nowak.pdf

The actual "recipe" begins on page 27 (it should open up right to p 27).

[LongIsland]

Originally Posted by mamakay

Yeah...it comes right after the discussion on how to scare the sh*t out of people with videos of sick kids.

Your tax dollars at work! Woo hoo!

After Thanksgiving, I gave an interview to a local paper about how well things were going. Best year yet for patients in flu death prevention.

The very day AFTER I gave the interview, the announcement from the CDC and the announcement from vaccine company came out stating that all the vaccine had been distributed. This combined with the reports of children dying from the virus, particularly in Colorado, started the phones ringing.

Our supply was used up in a matter of days.

From one of the other presentations given at the 2004 influenza summit:
http://www.ama-assn.org/ama1/pub/upl..._bangasser.pdf

[mamakay]

http://hcrc.missouri.edu/events/nowak_files/nowak.pdf

Fostering demand, particularly among people who
don’t routinely receive an annual influenza
vaccination, requires creating concern, anxiety, and
worry (e.g., Dr. Poland’s pronouncement).

• It’s a lot harder to create a motivating level of
concern and anxiety when a) influenza isn’t yet
present and b) disease severity and impact are in
line with expectations.

"But I got the flu, and it was....the flu."



I think this is my all time favorite:

http://www.iom.edu/Object.File/Master/21/674/Nowak.pdf

Health literacy is a growing problem

When the risk communicators are considering health literacy a problem...something is very, very wrong with what thier "message" is.

[dymanic]

Originally Posted by LongIsland

one of the justifcations they used for expanding seasonal influenza vaccine recommendations to cover more pediatric age groups was to "prepare" for the pandemic.

To me, that would suggest that they are genuinely concerned about the pandemic threat. But earlier, you implied that they fabricated the pandemic threat in order to increase demand for the seasonal vax. That you might have it both ways may make perfect sense to you, but it looks completely circular to me. Would you like to pick one or the other?

I find the simplest explanation to be that the CDC really believes (rightly or wrongly) that the effectiveness of flu vaccines is about what they say it is, and that recommending vaccination is therefore consistent with the agency's mission: to control disease. If you wanted to argue that the yearly promotion of the seasonal vax is inspired by a desire to keep at least a few pharmaceutical companies making the vax so as to provide at least some hope of defense against a pandemic, that would at least be consistent -- and while I'd agree that this is certainly an element, I'd continue to insist that they also do it because they believe that the seasonal vax actually works (and controlling seasonal flu is well within their mission as well, after all). There have also been thoughts about limiting the number of opportunities for reassortment through better control of seasonal influenza, but there is not enough certainty about whether the greatest risk is from "shift" or "drift" (or even "recombination") to make this a prime objective (let alone practical from the standpoint of implementation).

Originally Posted by blessed

I think, like everyone else, we'd be more inclined to tell you about our healthcare colleagues who got the flu shot and then walked around moaning about how crappy they felt (or else just staying home) for the next five days.

If what you're getting at is that the flu shot can give you the flu, it needn't involve consultation with one of your esteemed colleagues; that little gem of wisdom is widely available on the street. Now try to find some clinical evidence to support it.

Originally Posted by mamakay

Even "risk communication" isn't technically lying, although it's extremely deceptive in function.

It’s a lot harder to create a motivating level of
concern and anxiety when a) influenza isn’t yet
present and b) disease severity and impact are in
line with expectations.

I wonder: have you had a chance to see Al Gore's documentary, "An Inconvenient Truth"? Until I saw it, I didn't really appreciate just how long and hard the "former next president" has been trying to convey the message about global warming. You might say that he has had a hard time "creating a motivating level of concern and anxiety" about the issue. Watching the documentary was deeply unsettling for me, and this even though I was by no means unfamiliar with the basic science. It was the images, I guess. Seeing the satellite maps animated to show huge areas of densely populated land that would be inundated by rising sea levels and thinking about the disruption and loss of life this would cause; the "before and after" pictures of rapidly receding glaciers; the melting permafrost, the dried-up lakes, the vanishing ice shelves -- it's downright scary. I can only imagine how it would affect someone just being introduced to the problem. Now you tell me: is Gore a "risk communicator", or a "fearmonger"?

[Deborah]

Question for Dymanic--where did I go wrong?

A few months ago I was approached by a medical worker who also happens to be my son-in-law. The hospital where he works was offering influenza vaccine to their employees and he wanted to know if he should go ahead and get one. He works with elderly and frail patients at the hospital and at a couple of nursing homes and he also works with children.

I put on my medical librarian hat, cast my mind back to library school and remembered, Jim Henderson, Life Sciences Librarian at McGill University, recommending the Cochrane Reviews as top quality information on the effectiveness of various treatments.

I dug up the following reviews:
http://www.mrw.interscience.wiley.co...269/frame.html

http://www.mrw.interscience.wiley.co...187/frame.html

Plain language summary
There is no high quality evidence that vaccinating healthcare workers reduces the incidence of influenza or its complications in the elderly in institutions

There is evidence that vaccinating the elderly, particularly if the vaccine is well-matched to the circulating strains, has a modest impact on the complications from influenza. There is also high quality evidence that vaccinating healthy adults under 60 (which includes healthcare workers) reduces cases of influenza, especially if the vaccine is well matched to the circulating strains. Both the elderly in institutions and the healthcare workers who care for them could be vaccinated for their own protection, but an incremental benefit of vaccinating healthcare workers for the benefit of the elderly cannot be proven without better studies.

Based on the reviews, and on the fact that he takes very good precautions in terms of not coughing or sneezing on his patients, washes his hands constantly and does not work when ill, he decided to skip the vaccine. He hasn't gotten the influenza and it looks like he hasn't given the influenza to any of the folks he works with.

Dymanic, did I make the wrong choice in giving him Cochrane reviews? Why? What would have been a better source of information on the effectiveness of the influenza vaccine in a healthcare setting? Why?

Thanks for your input!