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Discussion Starter · #1 ·
New study
http://www.cidrap.umn.edu/news-pers...flu-vaccine-doesnt-prevent-missed-school-days

The mean number of absences was not affected by flu subtype or strain, but children who presented with more symptoms, had higher fevers, and received a prescription for antivirals were more likely to miss school. But flu vaccination status had no effect on how many days, or if children missed school. Between 30% and 40% of the children testing positive for flu at the clinic had received a flu vaccine, said Huong McLean, PhD, MPH, lead author of the study and a researcher at the Marshfield Clinic.
"Our study confirms that flu is a major contributor to absenteeism, and vaccination status did not reduce this," said McLean. Also, surprisingly, results did not change when the 2014-15 flu season (a mismatched year for the vaccine) was excluded.
They do have a reasonable explanation for why these outcomes were seen. At least it sounded reasonable to me.

Interesting, however, that actually testing for flu made such a difference in the outcome. It almost sounds as though ARIs that are not flu are prevented more effectively by the vaccine than the real flu. Which would be quite curious. :wink:
 

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From the link:

The major flaw of the study, according to McLean, was that it did not include the vaccine status of children who had influenza but mild enough symptoms to avoid a clinic visit. It's unknown, McLean said, if these children had milder illnesses because they received the flu vaccine.

"If someone gets sick and is coming into clinic, they are probably already sick enough to be missing school," said McLean. "So their vaccine status doesn't seem to matter."
Seems like a pretty glaring oversight, and is not in agreement with other studies as your own link conceded.
 

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Discussion Starter · #3 · (Edited)
From the link:



Seems like a pretty glaring oversight, and is not in agreement with other studies as your own link conceded.
Absolutely.

Some possible considerations.

If this study had glaring oversights, on what basis are you assuming that other studies on the same topic were sound? They could also have glaring oversights. In fact they point out a glaring oversight in some of the other studies--that they didn't discriminate between ARIs in general and actual influenza.

There were significant numbers of children who had been vaccinated who got very sick with the flu. This is something that people should know about.

I'm okay with studies that raise interesting questions like this one. It sounds, perhaps I'm misinterpreting, that you would rather studies not raise questions of any sort about any vaccines at all. Please clarify.
 

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It is far better to supplement with Vitamin D during the so-called flu season than rely on lame vaccines that often fail to protect from the flu:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/
it is well known that there is a seasonality to influenza that correlates well with the seasonal drop in vitamin D or 25-hydroxyvitamin D (25[OH]D) levels.
A colleague of mine and I have introduced vitamin D at doses that have achieved greater than 100 nmol/L in most of our patients for the past number of years, and we now see very few patients in our clinics with the flu or influenzalike illness.
 

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I don't have any issue with studies looking at data like this. But when the study has a pretty glaring oversight in addition to being an outlier to the numerous other studies conducted over many many years and flu seasons that show the vaccine reduces the risk of hospitalization and severe illness in children, I think it's cherry picking and a mistake to put much stock into it. At least until another large study corrects for the issue and can replicate the findings.

Until then, I am going to have to agree with the assessment that not accounting for the vaccine status of children not sick enough to go to a clinic who may have been protected from the vaccine is a huge flaw of the study.
 

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Discussion Starter · #6 ·
I don't have any issue with studies looking at data like this. But when the study has a pretty glaring oversight in addition to being an outlier to the numerous other studies conducted over many many years and flu seasons that show the vaccine reduces the risk of hospitalization and severe illness in children, I think it's cherry picking and a mistake to put much stock into it. At least until another large study corrects for the issue and can replicate the findings.

Until then, I am going to have to agree with the assessment that not accounting for the vaccine status of children not sick enough to go to a clinic who may have been protected from the vaccine is a huge flaw of the study.
Whatever keeps you feeling comfy. Good luck with your vaccines.
 
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Whatever keeps you feeling comfy. Good luck with your vaccines.
Thanks I guess? And people wonder why pro-vaxers don't bother taking the time the respond in threads as much anymore?
 

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Until then, I am going to have to agree with the assessment that not accounting for the vaccine status of children not sick enough to go to a clinic who may have been protected from the vaccine is a huge flaw of the study.
I am not sure why you are hyper focusing on this.

If the study was designed to look at kids who were sick enough to need medical care, then that is its design.

There were certainly unvaxxed children with the flu who also did not seek medical care. My family of five had the flu a few years ago - we only sought medical care for one person.

I would say this is a limitation of the study, but not an oversight or flaw.
 

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But when the study has a pretty glaring oversight in addition to being an outlier to the numerous other studies conducted over many many years and flu seasons that show the vaccine reduces the risk of hospitalization and severe illness in children, I think it's cherry picking and a mistake to put much stock into it. At least until another large study corrects for the issue and can replicate the findings.
.
I am not so sure about this.

I have read a lot of flu studies over the years and most are extremely underwhelming in terms of evidence for the flu vaccine. We could exchange studies all day long (let's not, lol) but the bottom line is not a slam dunk for the flu vaccine for kids. I say this as someone who is willing to admit vaccine efficacy when I see it. I think the measles vaccines, for example, is reasonable to highly effective. I do not think the flu vaccine is - in any demographic.

Let's keep in mind:

-in many years, there is a mismatch between vaccine strain and circulating strain
-the vaccine mist, which was given to millions of kids, was recently dropped for being ineffective.
-there is no downward trend over a long period in paediatric flu fatalities. One would expect one if the vaccine worked. This is a glaring problem.
 

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http://www.cochrane.org/CD004879/ARI_vaccines-for-preventing-influenza-in-healthy-children

"We included 75 studies with about 300,000 observations. We included 17 RCTs, 19 cohort studies and 11 case-control studies in the analysis of vaccine efficacy and effectiveness. Evidence from RCTs shows that six children under the age of six need to be vaccinated with live attenuated vaccine to prevent one case of influenza (infection and symptoms). We could find no usable data for those aged two years or younger.

Inactivated vaccines in children aged two years or younger are not significantly more efficacious than placebo. Twenty-eight children over the age of six need to be vaccinated to prevent one case of influenza (infection and symptoms). Eight need to be vaccinated to prevent one case of influenza-like-illness (ILI). We could find no evidence of effect on secondary cases, lower respiratory tract disease, drug prescriptions, otitis media and its consequences and socioeconomic impact. We found weak single-study evidence of effect on school absenteeism by children and caring parents from work. Variability in study design and presentation of data was such that a meta-analysis of safety outcome data was not feasible. Extensive evidence of reporting bias of safety outcomes from trials of live attenuated influenza vaccines (LAIVs) impeded meaningful analysis. One specific brand of monovalent pandemic vaccine is associated with cataplexy and narcolepsy in children and there is sparse evidence of serious harms (such as febrile convulsions) in specific situations." <2012>
 

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Discussion Starter · #12 ·
Sorry that you found my response offensive @teacozy. I find your faith in the "big pile of studies" a bit silly, but not worth yelling about. As @kathymuggle points out, Cochrane's analysis of the big pile of studies found a lot of weak studies with glaring shortcomings.

I didn't claim that the study in the OP was conclusive evidence against the use of the flu vaccine for children. I just thought it was an interesting study and worth discussing.

What I got back from you was a very strong and complete dismissal of the study and this statement:
...being an outlier to the numerous other studies conducted over many many years and flu seasons that show the vaccine reduces the risk of hospitalization and severe illness in children, I think it's cherry picking and a mistake to put much stock into it. At least until another large study corrects for the issue and can replicate the findings.
The evidence for the efficacy of flu vaccines is weak. It is based largely on studies with glaring problems of various sorts. The recommendations for yearly flu vaccinations for everyone rest on a bed of mud. Just my opinion.
 

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I don't have any issue with studies looking at data like this. But when the study has a pretty glaring oversight in addition to being an outlier to the numerous other studies conducted over many many years and flu seasons that show the vaccine reduces the risk of hospitalization and severe illness in children, I think it's cherry picking and a mistake to put much stock into it. At least until another large study corrects for the issue and can replicate the findings.

Until then, I am going to have to agree with the assessment that not accounting for the vaccine status of children not sick enough to go to a clinic who may have been protected from the vaccine is a huge flaw of the study.
That seems an odd point to find comforting.

What you would establish is something like, "vaccinated children, who experience milder flu symptoms due to their vaccination, are more likely to attend school and risk spreading active flu."

It seems to contradict that whole "protect the community by getting your shots" message, doesn't it?
 

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http://www.cochrane.org/CD004879/ARI_vaccines-for-preventing-influenza-in-healthy-children

"We included 75 studies with about 300,000 observations. We included 17 RCTs, 19 cohort studies and 11 case-control studies in the analysis of vaccine efficacy and effectiveness. Evidence from RCTs shows that six children under the age of six need to be vaccinated with live attenuated vaccine to prevent one case of influenza (infection and symptoms). We could find no usable data for those aged two years or younger.

Inactivated vaccines in children aged two years or younger are not significantly more efficacious than placebo. Twenty-eight children over the age of six need to be vaccinated to prevent one case of influenza (infection and symptoms). Eight need to be vaccinated to prevent one case of influenza-like-illness (ILI). We could find no evidence of effect on secondary cases, lower respiratory tract disease, drug prescriptions, otitis media and its consequences and socioeconomic impact. We found weak single-study evidence of effect on school absenteeism by children and caring parents from work. Variability in study design and presentation of data was such that a meta-analysis of safety outcome data was not feasible. Extensive evidence of reporting bias of safety outcomes from trials of live attenuated influenza vaccines (LAIVs) impeded meaningful analysis. One specific brand of monovalent pandemic vaccine is associated with cataplexy and narcolepsy in children and there is sparse evidence of serious harms (such as febrile convulsions) in specific situations." <2012>
This is the problem with not digging deeper into those kinds of conclusions. Jefferson's review has been criticized by many in the scientific community. There are many studies that, for example, show effectiveness in children under two:

The lancet:
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70255-3/fulltext

Trivalent inactivated influenza vaccine was effective in preventing influenza in young children, including those younger than 2 years. Our findings suggest that influenza vaccine recommendations should be reassessed in most countries.
Pediatrics journal:
http://pediatrics.aappublications.org/content/116/1/153.full
To our knowledge, this study is the largest study evaluating the effectiveness of influenza vaccine among children 6 to 23 months of age and the effectiveness of 1 vs 2 doses among children 6 months to 8 years of age. Our findings suggest that both doses are needed for previously unvaccinated children 6 months to 8 years of age, to provide maximal protection against influenza. In addition, despite the suboptimal antigenic match between the influenza vaccine and the circulating virus strain in the autumn of 2003, influenza vaccination was found to be effective in preventing medically attended ILIs among children 6 to 23 months of age, as well as all children 6 months to 8 years of age."
JAMA:
http://jama.jamanetwork.com/article.aspx?articleid=197348
In the first cohort, efficacy rates against influenza in children aged 6 to 12 months, 13 to 18 months, and 19 to 24 months were 63%, 66%, and 69%, respectively.
And others.

Wonder how the cochrane reviewer came to the conclusion he did?

The reason you might hear a flu shot refuser claim the vaccine is ineffective in kids under two is because of language used in a recent Cochrane Review of influenza vaccine efficacy, which states, "Inactivated vaccines in children aged two years or younger are not significantly more efficacious than placebo." http://www.ncbi.nlm.nih.gov/pubmed/22895945

How is that conclusion reached, given the above data? Well, meta-analyses like this one necessarily don't look at all the data, but only studies that meet certain parameters for inclusion. For whatever reasons, none of these were included in the review. The only study that was included in the review was from 1976, which looked at a whopping 16(!) infants, and used a single-strain, highly reactogenic influenza vaccine, a far cry from the trivalent and quadrivalent vaccines used today. This is completely irrelevant to modern policy-making, and no basis to declare the vaccine similar to placebo.
Clearly, that is weak evidence to base that conclusion on as I hope you'd agree.

There is a lot more information here for those interested (https://www.facebook.com/notes/chil...are-effective/623004464430148?hc_location=ufi)
 

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This is the problem with not digging deeper into those kinds of conclusions. Jefferson's review has been criticized by many in the scientific community. There are many studies that, for example, show effectiveness in children under two:

The lancet:
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70255-3/fulltext



Pediatrics journal:
http://pediatrics.aappublications.org/content/116/1/153.full


JAMA:
http://jama.jamanetwork.com/article.aspx?articleid=197348


And others.

Wonder how the cochrane reviewer came to the conclusion he did?



Clearly, that is weak evidence to base that conclusion on as I hope you'd agree.

There is a lot more information here for those interested (https://www.facebook.com/notes/chil...are-effective/623004464430148?hc_location=ufi)
I wonder whether that study compared fully vaccinated families with vaccinated small children to fully vaccinated families with unvaccinated small children.

See, if this "cocoon" thing has any merit, one would expect that the families who got two shots for infants would be super fans of vaccination, right? And everyone the babies came into regular contact with would be vaccinated to the max...parents, siblings, caregivers, etc.

But a second group would be people who were supportive of vaccination, generally, but a little cautious about vaccines for babies. So, like the group above, all the parents, siblings, caregivers would be fully flu vaccinated, and the babies not.

Such a comparison might enable us to test the theory of community immunity and cocooning, as well as getting a fairly accurate read on flu vaccine efficacy in young children.
 

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This is the problem with not digging deeper into those kinds of conclusions. Jefferson's review has been criticized by many in the scientific community. There are many studies that, for example, show effectiveness in children under two:

The lancet:
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70255-3/fulltext



Pediatrics journal:
http://pediatrics.aappublications.org/content/116/1/153.full


JAMA:
http://jama.jamanetwork.com/article.aspx?articleid=197348


And others.

Wonder how the cochrane reviewer came to the conclusion he did?



Clearly, that is weak evidence to base that conclusion on as I hope you'd agree.

There is a lot more information here for those interested (https://www.facebook.com/notes/chil...are-effective/623004464430148?hc_location=ufi)
Jefferson came to the conclusion through meta-analysis. COVRAC would do well to learn exactly how meta-analysis is performed at Cochrane because he sounds ignorant when he states that studies are excluded "for whatever reason."
 
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Did you look at these links/study?

numbered for ease.

1. This study was industry funded. I do not put a lot of stock in industry based studies

2. This article is behind a paywall

3. This article is a really good read. While it did find some effectiveness in preventing influenza, it found vaccines were of no benefit in preventing respiratory illness and little to no benefit in prevent AOM among very young children.

Respiratory Tract Infections. In the first cohort, no differences in rates of febrile respiratory tract infections were noted between the influenza vaccine and placebo groups during the influenza season (0.23 vs 0.25 episodes per person-month, respectively, P = .71) or during the respiratory season (0.21 vs 0.22 episodes per person-month, respectively, P = .66). However, in the second cohort, rates were actually higher in the vaccine group than in the placebo group during the influenza season (0.23 vs 0.17 episodes per person-month, respectively, P = .03) and during the respiratory season (0.22 vs 0.17 episodes per person-month, respectively, P = .10).

Episodes of AOM. Table 3 shows that in the first cohort, there were no differences overall between the vaccine group and the placebo group in the proportions of children who had at least 1 episode of AOM during the ensuing influenza season (30.5% vs 29.9%, P = .89), during the respiratory season (49.2% vs 52.2%, P = .56), or during the entire 1-year follow-up period (57.3% vs 61.9%, P = .35).

The difference between the vaccine and placebo groups in the proportion of children with AOM during the respiratory season was 3.0% (95% CI, −13.4% to 7.4%). Within the subgroup of children in the first cohort aged 19 to 24 months, the proportions who had at least 1 episode of AOM during the ensuing influenza and respiratory seasons were suggestively lower in the vaccine group than in the placebo group (19.4% vs 34.3%, P = .10; and 36.8% vs 54.3%, P = .09, respectively), and during the 1-year follow-up period, significantly lower (44.1% vs 65.7%, P = .04). Nevertheless, tests for interaction between vaccine effectiveness and age group produced nonsignificant results. In the second cohort there were no significant differences between the vaccine and placebo groups in the proportions who had at least 1 episode of AOM."
 

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Did you look at these links/study?

numbered for ease.

1. This study was industry funded. I do not put a lot of stock in industry based studies

2. This article is behind a paywall

3. This article is a really good read. While it did find some effectiveness in preventing influenza, it found vaccines were of no benefit in preventing respiratory illness and little to no benefit in prevent AOM among very young children.

Respiratory Tract Infections. In the first cohort, no differences in rates of febrile respiratory tract infections were noted between the influenza vaccine and placebo groups during the influenza season (0.23 vs 0.25 episodes per person-month, respectively, P = .71) or during the respiratory season (0.21 vs 0.22 episodes per person-month, respectively, P = .66). However, in the second cohort, rates were actually higher in the vaccine group than in the placebo group during the influenza season (0.23 vs 0.17 episodes per person-month, respectively, P = .03) and during the respiratory season (0.22 vs 0.17 episodes per person-month, respectively, P = .10).

Episodes of AOM. Table 3 shows that in the first cohort, there were no differences overall between the vaccine group and the placebo group in the proportions of children who had at least 1 episode of AOM during the ensuing influenza season (30.5% vs 29.9%, P = .89), during the respiratory season (49.2% vs 52.2%, P = .56), or during the entire 1-year follow-up period (57.3% vs 61.9%, P = .35).

The difference between the vaccine and placebo groups in the proportion of children with AOM during the respiratory season was 3.0% (95% CI, −13.4% to 7.4%). Within the subgroup of children in the first cohort aged 19 to 24 months, the proportions who had at least 1 episode of AOM during the ensuing influenza and respiratory seasons were suggestively lower in the vaccine group than in the placebo group (19.4% vs 34.3%, P = .10; and 36.8% vs 54.3%, P = .09, respectively), and during the 1-year follow-up period, significantly lower (44.1% vs 65.7%, P = .04). Nevertheless, tests for interaction between vaccine effectiveness and age group produced nonsignificant results. In the second cohort there were no significant differences between the vaccine and placebo groups in the proportions who had at least 1 episode of AOM."
1) Roche is a Swiss company who does not even sell flu vaccines AFAIK. Do you similarly dismiss all studies for bias from known anti/non-vaccine authors or funding?

2) Here is the abstract: http://pediatrics.aappublications.org/content/116/1/153

3) I do know why we are derailing the thread to discuss ear infections, but the study found that "...efficacy rates against influenza in children aged 6 to 12 months, 13 to 18 months, and 19 to 24 months were 63%, 66%, and 69%, respectively." That is not nothing.

The cochrane looked at a single study from the 70s that included a total of 16 infants who were given a vaccine we do not use anymore. That is not a good basis to conclude that the current vaccine is ineffective in children under two. Especially when we have other studies that do show a protective effect (which is why it is recommended for babies as young as 6 months).
 

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Discussion Starter · #19 ·
This is getting funnier all the time.
@teacozy, at least once, perhaps several times, you have presented a meta-analysis which excluded all sorts of stuff for not necessarily good reasons, and claimed that it was really solid evidence of this that and the other.

The double standard strikes again.

To return to the original study, this was not looking at infants. It was looking at school age children.

It discovered something interesting. It found that vaccinated children can still end up quite ill from the flu and that when they do they miss just as much school as do unvaccinated children who are ill from the flu.

I wouldn't say that one bit of data is useless. It doesn't try to settle whether the flu vaccine is really great or really awful. But I think the data they did collect is perfectly valid within the limits described and should not be tossed just because it makes the vaccine look less than perfect.

Real science doesn't toss inconvenient data...
 

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1) Roche is a Swiss company who does not even sell flu vaccines AFAIK. Do you similarly dismiss all studies for bias from known anti/non-vaccine authors or funding?

2) Here is the abstract: http://pediatrics.aappublications.org/content/116/1/153

3) I do know why we are derailing the thread to discuss ear infections, but the study found that "...efficacy rates against influenza in children aged 6 to 12 months, 13 to 18 months, and 19 to 24 months were 63%, 66%, and 69%, respectively." That is not nothing.

The cochrane looked at a single study from the 70s that included a total of 16 infants who were given a vaccine we do not use anymore. That is not a good basis to conclude that the current vaccine is ineffective in children under two. Especially when we have other studies that do show a protective effect (which is why it is recommended for babies as young as 6 months).
Roche is a pharmaceutical company and involved in making flu anti-virals (which might itself decrease its credibility). To answer you question: I take the claims of Mercola and the like on natural healthcare products with a grain of salt and I take pharmaceutical companies with a grain of salt with regards to pharmaceuticals.

Thanks for the abstract.

I asked if you had read the 3rd study (about ear infections) because I thought it was quite odd you would post a study that was somewhat vaccine critical (even though it tried to dance around why it did not get the results it expected). Many people worry about the complications of diseases more that the disease itself. You might not think the fact the study showed that ear infection rates and respiratory infection rates were similar in both the vaxxed and unvaxxed is relevant but I suspect it is indeed relevant to many posters and readers....it is even somewhat on topic: complications from diseases are what often send people to the doctor more than the disease itself.
 
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