Influenza beginning to scare me... thoughts on the vax? - Page 3

[LongIsland]

Originally Posted by dymanic

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?

No Dymanic, I very clearly implied that they're EXAGGERATING the threat of a H5N1 pandemic.

Definition of hype: Excessive publicity and the ensuing commotion; to publicize or promote using inflated claims

Nobody's telling you not to get the seasonal influenza vaccine. If it makes you feel safer . . . by all means.

[blessed]

Originally Posted by dymanic

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...

No, I don't really think that or care whether the reason you feel like crap for days after the flu shot is because you have a clinical influenza infection. Doesn't matter much to me - I reject feeling like crap on general principle, regardless of which of the constituents of the shot leave us feeling that way.

The world is full - chock full - of truths which are not reflected in medical or scientific literature. And the world is full of truths which are facticiously discounted or misrepresented by medical or scientific literature. But since you favor medical literature, here is justification to which you may assign some degree of crediblity (or more likely not, I suspect) for my own decision not to have the flu vaccine.

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

Cochrane Database Syst Rev. 2004;(3):CD001269.
Update of:
Cochrane Database Syst Rev. 2001;(4):CD001269.
Vaccines for preventing influenza in healthy adults.
///
REVIEWERS' CONCLUSIONS: Influenza vaccines are effective in reducing serologically confirmed cases of influenza. However, they are not as effective in reducing cases of clinical influenza and number of working days lost. Universal immunisation of healthy adults is not supported by the results of this review.

[mamakay]

Dymanic doesn't like the Cochrane folks. Err...at least not when they talk about flushots.

Whenever I hear about people supposedly catching the flu from their flushot, I always think of this...
http://www.fda.gov/cber/ltr/park092700.pdf

For every situation like that that the FDA catches, I wonder how many slip through the cracks...

[mamakay]

Originally Posted by dymanic

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"?

You know they were talking about seasonal flu (the one we've all had several times) and not the pandemic that might be, right?

So how is this analogy in any way appropriate?

[Deborah]

Originally Posted by mamakay

Dymanic doesn't like the Cochrane folks. Err...at least not when they talk about flushots.

Well, if Cochrane screwed up in their analysis on the flushots, it ought to be possible to figure out why and point to their errors.

[dymanic]

Originally Posted by Deborah

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?

I don't see how putting information in the hands of an intelligent person can ever be wrong, provided that it is not done in a way that might decieve, and with deliberate intent to do that. I strongly believe that the sort of precautions your SIL takes are at least as important in preventing the spread of flu as any vaccine, and I wish I could feel confident that such diligence was typical among healthcare workers.

We could go back and forth over Cochrane till the cows come home (and have done so before), but I'm not going to have time for that now. Briefly, I'd say that while the numbers quoted in the review you linked don't look that much different from the CDC's, the conclusions reached by the authors appear... a bit subjective. For instance:

"There is not enough evidence to recommend universal vaccination against influenza in healthy adults".

Yet:

"This review found that vaccinating healthy adults not at risk of complications reduced their chances of developing flu-like illness by only a quarter."

That appears to have been written by a person who does not believe that 25% would have much impact as far as herd immunity is concerned, but I find it hard to agree.

I'll also comment on this:

"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."

So... for sure, vaccinating under 60's reduces cases of flu, but whether reducing cases of flu in HCW's (the bulk of whom are presumably in the under 60 group) reduces the likelihood of them passing it on to patients "cannot be proven without better studies". Sick people pass flu to well people; how much proof of that do we need? And, pending such proof, would it be reasonable to base vaccination policy among HCW's on the assumption that if infected with flu, they won't pass it on to patients?

And I can't resist the temptation to toss in one more quote from that review:

"Vaccination had no reported relevant adverse effects."

Originally Posted by LongIsland

I very clearly implied that they're EXAGGERATING the threat of a H5N1 pandemic.

Now we're getting somewhere. Exaggerating the threat then. Do you feel that they are exaggerating the likelihood of the threat, or the projected consequences (or both)? And (if you don't mind me asking again): why is it that you think they would want to do that?

Originally Posted by mamakay

You know they were talking about seasonal flu (the one we've all had several times) and not the pandemic that might be, right?

From the OP:

"Wondering what your thoughts are on preparing for an influenza pandemic, and about the flu vaccine."

Long Island's response:

"Part of the pandemic flu hype is designed to scare people into vaccinating for seasonal influenza."

further rendered the two inseparable as far as this thread is concerned.

So how is this analogy in any way appropriate?

When a large body of evidence points to a looming threat, one about which there is some uncertainty, but which has the potential to cause massive suffering on a global scale, it would seem to me that those scientists who become aware of it incur a moral responsibility to bring the matter into public view. (Again in Gore's words: "Scientists have an independent obligation to respect and present the truth as they see it.") But if it isn't an imminent threat, getting anybody to pay attention is likely to be a difficult task. This is the challenge of risk communication. You've spoken numerous times of "risk communication" as though you viewed it as morally flawed in principle ("extremely deceptive in function"); but I don't think you really believe that, and offer the global warming analogy as a way of encouraging you to take a closer look at this inconsistency in your arguments.

[mamakay]

Originally Posted by the OP, LI, dymanic, and myself

Originally Posted by mamakay
You know they were talking about seasonal flu (the one we've all had several times) and not the pandemic that might be, right?

From the OP:

"Wondering what your thoughts are on preparing for an influenza pandemic, and about the flu vaccine."

Long Island's response:

"Part of the pandemic flu hype is designed to scare people into vaccinating for seasonal influenza."

further rendered the two inseparable as far as this thread is concerned.


Quote:
So how is this analogy in any way appropriate?

When a large body of evidence points to a looming threat, one about which there is some uncertainty, but which has the potential to cause massive suffering on a global scale, it would seem to me that those scientists who become aware of it incur a moral responsibility to bring the matter into public view. (Again in Gore's words: "Scientists have an independent obligation to respect and present the truth as they see it.") But if it isn't an imminent threat, getting anybody to pay attention is likely to be a difficult task. This is the challenge of risk communication. You've spoken numerous times of "risk communication" as though you viewed it as morally flawed in principle ("extremely deceptive in function"); but I don't think you really believe that, and offer the global warming analogy as a way of encouraging you to take a closer look at this inconsistency in your arguments.

Let's really break this down.

You admit that
1) the best evidence says that flu shots top out at 33% effective in the years that the strains match, which isn't always, or even usually.
2) the CDC uses fear to promote seasonal influenza vaccination

Now when I said this:

Originally Posted by me

So how is this analogy in any way appropriate?

I was referring to the CDC's open use of creating fear and worry to promote seasonal influenza vaccination. But you're extrapolating that to fearmongering about a hypothetical pandemic with the global warming analogy.

I'm talking about fearmongering to get folks to get their probably-won't-even-work-seasonal-flu-vaxes each year.

You know this. That's what the "risk communication" quote was talking about. Fear of seasonal flu. The art of frightening people into going along with seasonal flu vaccines.

But then you say :

When a large body of evidence points to a looming threat, one about which there is some uncertainty, but which has the potential to cause massive suffering on a global scale, it would seem to me that those scientists who become aware of it incur a moral responsibility to bring the matter into public view.

The "looming threat" of seasonal influenza???
The one we all have had several times????

So I don't know if you're just not following the thread, or if you're just being totally full of...illogicalness.

But unless we get on the same page, this discussion is pointless.

[LongIsland]

Dymanic - are you stockpiling food and Tamiflu?

[dymanic]

Originally Posted by mamakay

I was referring to the CDC's open use of creating fear and worry to promote seasonal influenza vaccination. But you're extrapolating that to fearmongering about a hypothetical pandemic with the global warming analogy.

We did get tangled up there then. Sorry about that. Maybe you could point to something you see as a good example of the CDC using fear to promote seasonal influenza vaccination, and we could consider how far over the top it should be regarded.

Originally Posted by LongIsland

Dymanic - are you stockpiling food and Tamiflu?

I'm pretty much all stocked up on food and water. I could go eight weeks no prob, and being very conservative, maybe twelve. Quite some time back, I also started ordering my meds by mail, 3-month's supply at a time, and since the reorder date arrives well before the last order is exhausted, the surplus has built up, so I'm in great shape there. Private hoarding of Tamiflu isn't something I'd encourage, and I haven't made an effort to aquire any (and my understanding is that it currently isn't very easy to get). I wouldn't count too much on it being effective anyway. I do have a modest supply of Amantadine (which, btw, has an exceptionally long shelf life), but I'm even less optimistic about that being very effective. My strategy would be based mostly on isolation (which I'm pretty good at by nature). I'm currently looking at ways to improve my ability to handle power outages.

None of these need be viewed as exclusively a matter of pandemic preparedness, though. Our modern lifestyles make us so heavily dependent on long supply lines of just about everything (and so blissfully unaware of that fact) that huge segments of the population would be rendered helpless within hours by even relatively small-scale events.

[mamakay]

Maybe you could point to something you see as a good example of the CDC using fear to promote seasonal influenza vaccination, and we could consider how far over the top it should be regarded.

How about the CDC looking for pediatric deaths, and sending the media info packets about it to report, to give the impression to parents that it's very common, and that it's not the rare occurance that it is.

[Sotevenn]

I've had the flu vaccine 3- 4 times & won't do it again.

About 9 years ago I was pretty rundown & caught the flu - several days of fever, cough & running nose that took weeks to go away. That ran me down further & I caught a stomach bug & then a cold. To top it off, if I get sick with a high fever, several weeks later I go thru a bad bought of rheumatoid arthritis. I ended up missing lots of work & had so much pain & misery for two months.

The next year I got the flu shot. I got a mild cold/low fever a few days after the shot. A few weeks later, the arthritis kicked in, pretty mild, but I was still uncomfortable for several weeks.

Next year, same thing.

The next year, I skipped it, didn't get the flu, felt great.

Next year, I got the shot, got a mild cold/low fever, missed a day or two of work. Ended up with the arthritis acting up a few weeks later.

Started thinking about it & decided I seem to catch the flu every ten years or so, when I"m extremely run down (like working full time, school full time, eating only junk food, not getting anywhere near enough sleep etc). When I get the flu shot I get the arthritis reaction every time even if I was in a healthy state beforehand. Just considering which was worse for my joints, I decided not to get the flu shot again.