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#1 of 81 Old 12-01-2012, 06:20 PM - Thread Starter
 
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I've seen the assertion several times lately that the flu shot is ineffective, and even the cochrane review says so. I just wanted to point out that the cochrane review says no such thing. They have done two review, one for healthy adults and one for healthy children. They did say that for children under two inactivated vaccine was similar to placebo, but that's a long way from a blanket statement saying flu vaccines are ineffective.

http://summaries.cochrane.org/CD001269/vaccines-to-prevent-influenza-in-healthy-adults

http://summaries.cochrane.org/CD004879/vaccines-for-preventing-influenza-in-healthy-children
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#2 of 81 Old 12-01-2012, 06:49 PM
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Thanks for posting this! Cochrane reviews are really the scientific gold standard.

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#3 of 81 Old 12-01-2012, 06:58 PM
 
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Since I'm guessing you haven't read either review in its entirety, why don't you find out from the author himself has to say about his own research? He could not find quality evidence that the flu vax was effective in the under-2 group.

http://focusonline.ca/?q=node/447

I'm questioning whether you'll read the link before replying, but at least it's there for someone else's reference.

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#4 of 81 Old 12-01-2012, 06:59 PM - Thread Starter
 
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Isn't that what I said?
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#5 of 81 Old 12-01-2012, 07:03 PM
 
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No. You said that it's a long way from saying that the flu vax is ineffective. The Cochrane scholar disagrees with you. He says they're ineffective.

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#6 of 81 Old 12-01-2012, 07:05 PM
 
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And actually, they've done more than 2 reviews. The flu vax is ineffective for the elderly, asthmatics, health care workers, and other high-risk populations.

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#7 of 81 Old 12-01-2012, 07:06 PM - Thread Starter
 
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Right, ineffective for children under two. That's not the same as a blanket statement that they're not effective across the board.
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#8 of 81 Old 12-01-2012, 08:02 PM
 
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From Cochrane:

 

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001269.pub4/abstract;jsessionid=6CB5626A8606B3497E397AD984676298.d03t03

 

"...Authors of this review assessed all trials that compared vaccinated people with unvaccinated people. The combined results of these trials showed that under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid one set of influenza symptoms. In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms. Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations."

 

Bolding mine.


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#9 of 81 Old 12-01-2012, 08:12 PM - Thread Starter
 
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But it is effective at preventing the flu.
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#10 of 81 Old 12-01-2012, 08:13 PM - Thread Starter
 
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Quote:
Originally Posted by Turquesa View Post

And actually, they've done more than 2 reviews. The flu vax is ineffective for the elderly, asthmatics, health care workers, and other high-risk populations.

I missed this the first time. I disagree with some of the characterization a here, but as they're more nuanced than a blanket state my that it's ineffective it's more a matter of opinion and interpretation.
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#11 of 81 Old 12-01-2012, 08:19 PM
 
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Quote:
Originally Posted by Rrrrrachel View Post

I've seen the assertion several times lately that the flu shot is ineffective, and even the cochrane review says so. I just wanted to point out that the cochrane review says no such thing. They have done two review, one for healthy adults and one for healthy children. They did say that for children under two inactivated vaccine was similar to placebo, but that's a long way from a blanket statement saying flu vaccines are ineffective.
http://summaries.cochrane.org/CD001269/vaccines-to-prevent-influenza-in-healthy-adults
http://summaries.cochrane.org/CD004879/vaccines-for-preventing-influenza-in-healthy-children

 

 

It seems the problem might be more than just the vax being ineffective for <2-yr old, at least from these links ...

 

-------

From the first link -  click on Abstract (click to read) at the bottom ...

 
Authors' conclusions: 

Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.

 

WARNING:
This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding.

 

 

 

-------

From the second link - click on Abstract (click to read) at the bottom ...

 
Authors' conclusions: 

Influenza vaccines are efficacious in preventing cases of influenza in children older than two years of age, but little evidence is available for children younger than two years of age. There was a difference between vaccine efficacy and effectiveness, partly due to differing datasets, settings and viral circulation patterns. No safety comparisons could be carried out, emphasising the need for standardisation of methods and presentation of vaccine safety data in future studies. In specific cases, influenza vaccines were associated with serious harms such as narcolepsy and febrile convulsions. It was surprising to find only one study of inactivated vaccine in children under two years, given current recommendations to vaccinate healthy children from six months of age in the USA, Canada, parts of Europe and Australia. If immunisation in children is to be recommended as a public health policy, large-scale studies assessing important outcomes, and directly comparing vaccine types are urgently required. The degree of scrutiny needed to identify all global cases of potential harms is beyond the resources of this review.

This review includes trials funded by industry. An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry-funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favourable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in the light of this finding.

 

 

 

I'd be interested to know if they provide the same warnings for other flu studies for other age groups or demographics ...


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#12 of 81 Old 12-02-2012, 05:06 AM
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Originally Posted by MamaMunchkin View Post

 

 

 

-------

From the second link - click on Abstract (click to read) at the bottom ...

 
Authors' conclusions: 

Influenza vaccines are efficacious in preventing cases of influenza in children older than two years of age, but little evidence is available for children younger than two years of age. There was a difference between vaccine efficacy and effectiveness, partly due to differing datasets, settings and viral circulation patterns. No safety comparisons could be carried out, emphasising the need for standardisation of methods and presentation of vaccine safety data in future studies. In specific cases, influenza vaccines were associated with serious harms such as narcolepsy and febrile convulsions. It was surprising to find only one study of inactivated vaccine in children under two years, given current recommendations to vaccinate healthy children from six months of age in the USA, Canada, parts of Europe and Australia. If immunisation in children is to be recommended as a public health policy, large-scale studies assessing important outcomes, and directly comparing vaccine types are urgently required. The degree of scrutiny needed to identify all global cases of potential harms is beyond the resources of this review.
 

 

 

Well, if they conclude that the flu vaccine is ineffective for kids under 2 based on only one study, I'm not really convinced by that either way.  Rather than concluding that the flu vax is ineffective for kids under 2, I think you'd have to conclude that we are currently unaware of whether the flu vax is effective for kids under 2.

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#13 of 81 Old 12-02-2012, 05:36 AM - Thread Starter
 
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Sure, thy bring up a lot of issues with the flu vaccine, and in particular with public health policy. Absolutely. There's lots of good stuff to talk about in there. But you know what they never say? That the flu vaccine is ineffective.
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#14 of 81 Old 12-02-2012, 05:39 AM
 
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Well, if they conclude that the flu vaccine is ineffective for kids under 2 based on only one study, I'm not really convinced by that either way.  Rather than concluding that the flu vax is ineffective for kids under 2, I think you'd have to conclude that we are currently unaware of whether the flu vax is effective for kids under 2.

That is not what it said.

 

it said, and you bolded:

 

 It was surprising to find only one study of inactivated vaccine in children under two years, given current recommendations to vaccinate healthy children from six months of age in the USA, Canada, parts of Europe and Australia.

 

The above quote does not talk about effectiveness.  It simply mentions that they find it surprising that the inactivated flu vax is given to children under two on the strength of only one study. 

 

It is the responsibility of the vaccine community to prove a particular vaccine is safe and effective before dispersing it to a community.  If there is only one study of inactivated flu virus in kids under 2, it seems they failed to do that.

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#15 of 81 Old 12-02-2012, 06:01 AM
 
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Sure, thy bring up a lot of issues with the flu vaccine, and in particular with public health policy. Absolutely. There's lots of good stuff to talk about in there. But you know what they never say? That the flu vaccine is ineffective.

To say the flu vaccine is ineffective across the board they would probably need to find zero or very close to zero levels of effectiveness.  

 

From the report on adults:

 

"In the relatively uncommon circumstance of vaccine matching the viral circulating strain and high circulation, 4% of unvaccinated people versus 1% of vaccinated people developed influenza symptoms (risk difference (RD) 3%, 95% confidence interval (CI) 2% to 5%). The corresponding figures for poor vaccine matching were 2% and 1% (RD 1, 95% CI 0% to 3%)"

 

It is not good enough for me - but it is not "nothing."

 

Flu vaccines  do not seem to affect hospital admissions at all, and the summary I found showed no affect of work loss, while mama munchkins showed mild effect on work loss (odd - because both of us were quoting the same study - her the authors conclusion, me the plain language summary…)

 

If people are saying "not effective at all in healthy adults" I suppose it is fair to call them on it.  If people are saying "highly problematic, not as effective as we are lead to believe, not overly useful in certain populations….."  that would be a correct statement.  


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#16 of 81 Old 12-02-2012, 07:15 AM
 
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The issue is not just whether the flu vax is effective/not, but also the nature of the studies/data the conclusion is based on ...

 

Quote:
The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies.  The content and conclusions of this review should be interpreted in the light of this finding.

 

It'd be great if they share this evidence with the public ... anyone has sources/links ...?


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#17 of 81 Old 12-02-2012, 07:31 AM - Thread Starter
 
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Actually, mama, the issue is whether it's effective or not. If you'd like to discuss something else maybe start another thread. This one is to address the specific claim that the cochrane review said the flu shot is not effective.
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#18 of 81 Old 12-02-2012, 07:51 AM
 
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nm ...


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#19 of 81 Old 12-02-2012, 08:13 AM
 
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I'm very interested to know whether the flu vax is effective or not, however Cochrane provides a warning on how to interpret this finding.

I do not have time to do it right now - but it might be interesting to compare whether Cochrane usually provides a warning like the one they did for flu studies:

 

"The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding."

 

If they don't, it might mean they think flu studies are somehow more prone to widespread manipulation than other vaccines.


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#20 of 81 Old 12-02-2012, 08:18 AM
 
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Kathy, we x-posted.  I edited the post you quoted above ... but am still interested ... anyway ... 


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#21 of 81 Old 12-02-2012, 08:26 AM
 
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double post ...


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#22 of 81 Old 12-02-2012, 10:53 AM
 
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Actually, mama, the issue is whether it's effective or not. If you'd like to discuss something else maybe start another thread. This one is to address the specific claim that the cochrane review said the flu shot is not effective.


The statements about the evidence of widespread manipulation and that the conclusion should be interpreted in light of this finding are quoted - directly - from the - same exact - articles linked in the initial post.  I see no need for another thread.


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#23 of 81 Old 12-02-2012, 10:56 AM - Thread Starter
 
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Yet in spite of all that they still found that the flu vaccine was effective in reducing cases of flu.
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#24 of 81 Old 12-02-2012, 11:13 AM
 
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Yet in spite of all that they still found that the flu vaccine was effective in reducing cases of flu.

So go get the flu shot.  wink1.gif

 

Effectiveness is hardly the only factor in deciding whether to get a shot.  There is safety of the shot, prevalence of the disease and harshness of the disease.

 

I don't feel the need to risk (and yes, there are risks) a shot on a yearly basis for something, that according to Cochrane,  will lower my chances of getting the flu by 1-4%  Moreover,  if I do get the flu (given my health profile) I will most probably spend a week on the couch and recover fully.


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#25 of 81 Old 12-02-2012, 11:21 AM - Thread Starter
 
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I already did.

There are certainly lots of other issues involved here. They are worthy of discussion. However this thread was for one specific purpose, which is that claiming the cochrane review says the flu shot is ineffective is a lie.
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#26 of 81 Old 12-02-2012, 01:22 PM
 
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Yet in spite of all that they still found that the flu vaccine was effective in reducing cases of flu.

 

 

 

But the Cochrane authors also said:

 

Quote:
The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in the light of this finding.

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#27 of 81 Old 12-02-2012, 01:24 PM
 
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I already did.
There are certainly lots of other issues involved here. They are worthy of discussion. However this thread was for one specific purpose, which is that claiming the cochrane review says the flu shot is ineffective is a lie.

 

We're discussing the contents of - exactly the same - articles.   


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#28 of 81 Old 12-02-2012, 01:44 PM
 
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Call me crazy but isn't this, Quote:
The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in the light of this finding.

Saying that even though the studies conclude that the flu shot is effective in reducing chances of getting the flu a measly 1-4%, which would mean that they are a little effective..that we should basically take these results with a huge bag of salt consedering that there may be rampant data manipulation and the like? I could be interpreting this way off and if so I will certainly go back in my hole..and continue lurking...

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#29 of 81 Old 12-02-2012, 01:44 PM - Thread Starter
 
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This thread is not about discussing the cochrane review in general. It's about correcting the lie that the cochrane review said the flu vaccine was ineffective.
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#30 of 81 Old 12-02-2012, 01:46 PM - Thread Starter
 
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Quote:
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Call me crazy but isn't this, Quote:
The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in the light of this finding.
Saying that even though the studies conclude that the flu shot is effective in reducing chances of getting the flu a measly 1-4%, which would mean that they are a little effective..that we should basically take these results with a huge bag of salt consedering that there may be rampant data manipulation and the like? I could be interpreting this way off and if so I will certainly go back in my hole..and continue lurking...

Ultimately they said it reduced flu incidence by 6%, but they woul like better evidence and they think public health policy places like the us is out of sync with the existing evidence. At least that's how I took it.
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