The pediatric flu death study, not to debate, but sources? - Mothering Forums
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#1 of 16 Old 11-08-2013, 01:42 PM - Thread Starter
 
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I don't know where else to post it. I see articles around on the webs today about 40% of the pediatric flu deaths occurred in healthy children. Does anyone have access to the data or a link? I'm short on time. What age, what complication occurred? Which strains did they have?

At the same time I just read an article by the STIKO of the RKI (Robert Koch Institute, Germany, like ACIP) who insists that only risk groups should get the vaccine/would benefit from it. Their reasoning is that healthy people will have mild forms.

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#2 of 16 Old 11-10-2013, 07:06 AM
 
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No idea, but since the Cochrane Review found that the flu shot is not effective in pediatric populations, one has to wonder why so many people are accepting without questioning the fear-mongering about flu deaths.

I'd also wonder how healthy the supposed 40% are, when such a huge percentage go children have what are now common medical conditions, like asthma, diabetes, food allergies, etc, and how many are on medications.

I'd also wonder what percentage of children who develop severe complications from flu received any kind of vaccination in the weeks preceding onset of the flu, and what percentage of unvaxxed children developed complications from flu.
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#3 of 16 Old 11-10-2013, 07:33 AM - Thread Starter
 
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Well that is what I wonder. What exactly did  they die of? And did they have allergies, were on meds? I'm trying to find the real data/

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#4 of 16 Old 11-10-2013, 10:38 AM
 
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Correction: Cochrane found flu vaccine ineffective in under 2s and flumist best choice otherwise for children.

Mother of two living in UK. Daughter (2007) born in USA, son (2010) born here. I'm pro natural birth, midwife care, breastfeeding, co-sleeping, baby wearing and a keen advocate of cloth diapering. I'm a full time working research scientist (physical sciences) and I'm pro-vaccine.

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#5 of 16 Old 11-10-2013, 01:47 PM
 
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@nia82 can you link to one of the articles you've read stating this and I'll see what I can find.  Are they citing a recent study?  Or are they presenting it as common knowledge?

 

Quote:
 At the same time I just read an article by the STIKO of the RKI (Robert Koch Institute, Germany, like ACIP) who insists that only risk groups should get the vaccine/would benefit from it. Their reasoning is that healthy people will have mild forms.

 

As far as this, I don't know enough to have an opinion; but I did read an epidemiological paper last year that suggested influenza cases in elderly are effectively decreased by vaccinating children.  I also don't remember if it was just a modelling paper or if it was based on real data.  Healthy people might have mild symptoms, but that doesn't mean they're less infectious.  Although they could be!  I can probably find that article again if you are interested.

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#6 of 16 Old 11-10-2013, 02:59 PM
 
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I think this is the study you guys are talking about http://pediatrics.aappublications.org/content/132/5/796

 

"The median age was 7 years (interquartile range: 1–12 years). Thirty-five percent of children died before hospital admission. Of 794 children with a known medical history, 43% had no high-risk medical conditions, 33% had neurologic disorders, and 12% had genetic or chromosomal disorders. Children without high-risk medical conditions were more likely to die before hospital admission (relative risk: 1.9; 95% confidence interval: 1.6–2.4) and within 3 days of symptom onset (relative risk: 1.6; 95% confidence interval: 1.3–2.0) than those with high-risk medical conditions.

CONCLUSIONS: Influenza can be fatal in children with and without high-risk medical conditions. These findings highlight the importance of recommendations that all children should receive annual influenza vaccination to prevent influenza, and children who are hospitalized, who have severe illness, or who are at high risk of complications (age <2 years or with medical conditions) should receive antiviral treatment as early as possible." 


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#7 of 16 Old 11-10-2013, 07:10 PM - Thread Starter
 
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Is that all there is? I read that part. I want more info. Age more closely, exact complication, what happened. There seems to be little to be learned. The AAP thing doesn't say much in my opinion.


Cwill I read that RKI report. It says that while it might decrease elderly deaths, they still don't see enough evidence to recommend it.

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#8 of 16 Old 11-10-2013, 07:41 PM
 
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Quote:
Originally Posted by prosciencemum View Post

Correction: Cochrane found flu vaccine ineffective in under 2s and flumist best choice otherwise for children.

No, I was correct in stating the flu shot (SHOT,not flumist) was ineffective in children.  http://www.ncbi.nlm.nih.gov/pubmed/22895945

 

"Twenty-eight children over the age of six need to be vaccinated to prevent one case of influenza (infection and symptoms)."

 

"Extensive evidence of reporting bias of safety outcomes from trials of live attenuated influenza vaccines (LAIVs) impeded meaningful analysis."

 

"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."

 

Also from CIDRAP:

http://www.cidrap.umn.edu/news-perspective/2011/10/strict-meta-analysis-raises-questions-about-flu-vaccine-efficacy

" the authors found no RCTs [Randomized Controlled Trials] demonstrating TIV [Trivalent Inactivated Vaccine) efficacy in adults 65 and older or children aged 2 to 17."

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#9 of 16 Old 11-11-2013, 06:25 AM - Thread Starter
 
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If anyone has access to the full paper I'd appreciate the insight. I just don't have the time right now to do all the digging but I know many people are great at digging here and at finding stuff out/ :D I'd like to know sample size, and what happened exactly to those kids.

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#10 of 16 Old 11-11-2013, 10:17 AM
 
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Nia, the full paper is available at the link teacozy posted.
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#11 of 16 Old 11-11-2013, 10:48 AM
 
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@cwill I was just about to say that.  Here's a table anyway, though.

 

TABLE 1 Selected Characteristics Among Children With Influenza-Associated Death: United States,
October 2004 Through September 2012
Characteristic Value
Male gender 442 (53)

 

Age, median (IQR), y 7 (1–12)
,6 months                      94 (11)
6 to 23 months              114 (14)
24 to 59 months            117 (14)
5 to 8 years                  167 (20)
9 to 12 years                112 (13)
13 to 17 years              226 (27)
 

So about 75 percent of deaths were in children over the age of two. 


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#12 of 16 Old 11-11-2013, 10:53 AM
 
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And type of complication for those without pre existing medical conditions: 

 

Type of complication
Pneumonia                                       130/320 (41) 
Acute respiratory distress syndrome  82/320 (26) 
Shock or sepsis                               104/320 (33) 


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#13 of 16 Old 11-11-2013, 11:21 AM - Thread Starter
 
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Thanks. I'm only in my phone and it's a busy week so I appreciate the breakdown. I jugs wonder what else there is to know. Meds involved and such. It said somewhere some didn't see a doctor but pneumonia and sepsis - who would have stayed at home with that? Rather strong symptoms would have been apparent. Still is there more individual data available? I'll have time to read and dig more by Friday.
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#14 of 16 Old 11-11-2013, 11:42 AM
 
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I'll try to post some of the answers to the questions I've seen in this thread, although I don't have much time either.  

 

1) What was considered high risk? 

 

"The ACIP high-risk medical conditions include the following: asthma, neurologic/neurodevelopmental disorders, chronic lung disease, heart disease including congenital heart disease, blood disorders, endocrine disorders, kidney disorders, liver disorders, metabolic disorders, immunosuppression, and pregnancy.20"  Approximately one-third or more of children who died each season had no known high-risk medical conditions, and during the 2006–2007 season the majority (62%) of children had no high-risk medical conditions (Table 2).

 

2) What were the strains?

 

"Overall, 649 (78%) children with influenza-associated death had influenza A virus infection, 165 (20%) had influenza B virus infection, and 1 (<1%) was coinfected with influenza A and B viruses; 15 (2%) children had influenza virus infection for which the type was not distinguished. Except for the 2009–2010 season during which only 1% of viruses identified were influenza B, influenza B virus infection was identified in 23% to 38% of deaths each season (Table 2)." 

 

3) What medications were given? 

 

Among 126 children who died during the 2010–2011 and 2011–2012 seasons whose treatment status was known, 56 (44%) received influenza antiviral treatment. When limiting those deaths to the 74 that occurred after hospital admission, 46 (62%) received antiviral treatment; and when limiting further to the 65 children ≥1 year of age, 43 (66%) received antiviral treatment. 

 

All I have time for now...sorry.....


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#15 of 16 Old 11-11-2013, 12:03 PM
 
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Oh, forgot about the vaccine status of the children that died : 

 

4) What percentage were vaccinated for the flu?

 

"Of 511 children ≥6 months of age whose vaccination status was known, 84 (16%) had been fully vaccinated with seasonal influenza vaccine. During the 2009–2010 season, of 66 children ≥6 months of age whose pH1N1 vaccination status was known and who died on or after November 1, 2009, 2 (3%) had been fully vaccinated with pH1N1 monovalent vaccine.

 

Among those who were ≥6 months of age whose vaccination status was known, 19 of 203 (9%) children without high-risk medical conditions and 64 of 290 (22%) children with high-risk medical conditions had been fully vaccinated with seasonal influenza vaccine." 

 

So overall, 84% of those who died whose vaccine status was known had not been vaccinated for the flu.  During the 2009-2010 97% of those who died had not been vaccinated. 

 

Of the children without medical conditions who died whose vaccine status was known 91% had not been vaccinated for the flu.  Of the children with high risk medical conditions, 78% of those who died had not been vaccinated for the flu. 


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#16 of 16 Old 11-11-2013, 12:21 PM - Thread Starter
 
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Thanks I finally was at a computer to look up the link (my phone is being crazy). I'd love to know which strains were involved and how many kids overall were confirmed to have had the flu. I know I have to look at the CDC website to see all the confirmed cases (e.g. we all had the flu in Jan but only DD and I were confirmed, DS and DH never saw a doc; and I only saw a doc because I tested neg and suspected a sinus infection and wanted meds; DD I felt at the tender age of nearly 2 should be checked out but did great) and then it's only a guess how many real cases there were.... I need to see it put into that perspective but will have time do look at the numbers this weekend. Thanks for posting the links and highlights.

I see it's a cumulative number for many years. And they stated that at the beginning 24% of kids were vaccinated for the flu and the number is still relatively low (compared to MMR coverage). So many kids aren't vaccinated to begin with, it puts things into perspective, kwim? A cross analysis of each strain contained in the yearly vaccine vs. which strain the kids had would be quite interesting combined with efficacy rates for every year. That would render useful data for me. Maybe a weekend project (at least for the information potentially available).

Also, does anyone know if I can find the strains of streptococcus pneum. that were involved in the pneumonia cases? Seeing the exact strains involved might shift my stance on Prevnar for DD&DS (2 and 5 years old). That was my concern with DD and the urgent people basically called me paranoid for being worried about pneumonia. Odd experience.

And on top of all that, we need to look at the efficacy for the vaccine last year. I think I'm only interested in the group 2 and older as the vaccine does little do nothing in kids younger than 2....

I'll also discuss this with our pediatrician. She's very conservative when it comes to vaccines (only one at a time and she orders only certain brands).

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