Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
In some ways I am with you, flu itself is not terribly fatal for the vast majority of healthy people. People routinely overstate the importance of flu vaccine for generally healthy people. But most of us interact with, closely, at least one person on a regular basis for who the flu would be expected to be more dangerous. Grandparents, ill family members or friends, classmates, etc.
That being said, temporary protection is what I expect from flu vaccine. Anyone who is expecting permanent immunity has been misinformed and should be talking to their doctor. But for my students who have cystic fibrosis, temporary immunity in those they interact with closely on a daily basis is better than no immunity and may literally save his life.
And your reasoning is flawed, we know that in a typical year most people won't get the flu regardless of vaccination, it is the nature of the illness after all. But to state that flu vaccines don't create immunity is a blanket statement that just isn't true.
Literally all of your complaints are that the flu vaccine works exactly as expected. You seem to expect flu vax to work like MMR or polio, that is unrealistic if you know much about how flu actually occurs and has evolved.
Additionally your own source absolutely confirmed that flu vaccine can prevent flu, it just take a lot of people being vaccinated (40:1) which is about what I would expect for someone like my student. The herd, aka the 40 (and really it was more like 200) got vaccinate in an attempt to prevent one particularly predisposed person from getting the flu. Sounds like herd immunity to me.
I fully support your right to not get flu vaccine for you or your child. I disagree with the notion that all vaccines are created equal so to speak and are of the same necessity from everyone. They are not. But you are drastically understating their importance.
Just wondering, hypothetically, if your daughter had a classmate who had a disease like cystic fibrosis, and she got ill (unvaccinated) with the flu, and then recovered but her classmate didn't, how do you think she would feel? Would you just console her that it was so and sos time to go?
Universal flu vaccination is now recommended because anyone, regardless of his general health, can get very ill, possibly requiring hospitalization, with a potentially fatal outcome. It is not just a matter of trying to establish herd immunity. With regard to protecting your student, what is being done in your school is probably more properly termed "cocooning": vaccinating those most likely to come in close contact with a vulnerable person to protect that particular person.
Having to vaccinate 40 people to prevent one case of flu is actually not a "lot" of people from an epidemiological point of view.
I doubt you will get an answer to your last question.
Quote:
Originally Posted by MissTerri
I don't expect the vaccine to work like the MMR vax or the polio vax. I'm simply pointing out it's limitations and those limitations show why the flu vaccine does not and cannot create herd immunity.
The flu is something that everyone is at risk from, vaccinated or not.
Your first statement is proved false by the sources you have quoted yourself. If enough people took the vaccine, we could achieve herd immunity for the strains of flu virus included in the vaccine. The problem is that people who do not want to take the vaccine, generally because they do not want to take any vaccines at all, try to discourage other people from taking them, too. They repeat myths like saying the vaccine causes flu (it does not) and hype up the risk of Gullain-Barre syndrome (which is tiny, tiny, tiny - and lower than the risk of GBS from flu itself).
Your second statement is a false equivalency that you keep repeating, implying that vaccinated and unvaccinated people are at the same risk to get flu. That is false. In a well matched vaccine year, those who are vaccinated are about 60% less likely to get flu than those who are not.
Quote:
Originally Posted by lkb0714
As someone who deals with stats frequently I find the 90% of children who died were unvaccinated, a somewhat misleading statistic, almost as it if were worded to generate fear. Typically a little under a hundred kids die from the flu. 90% of those kid were unvaccinated, but based on the fact that 60% of them had underlying health problems, it is entirely likely some statistically significant subset of those kids couldn't be vaccinated anyway. It is further confounded by the fact that the efficacy rate of the flu is only moderate, and sometimes even lower in those who are immune compromised. But yes the overall notion that if someone is unvaccinated they are more likely to die from the flu/flu complications is undeniable.
Unfortunately most of the kids with underlying health problems who are unvaccinated are eligible to take the vaccine. They have things like asthma or neurological problems, not immune disorders.
The 90% figure is stark fact. It is what it is.
Quote:
Also, the 40% had no recognized underlying health problems, its worth noting that sometimes underlying problems are not noticed until another illness brings them to the forefront.
No, these children had no identifiable health problems at the time they died. Obviously we can ask the question why do some people (kids or adults) get severe, even fatal, disease, and some do not. if we knew the answer to that, we could selectively vaccinate only those at risk for severe disease. Everyone else could just be sick for a week or two and get over it. We cannot do that now; if it turns out to be something genetic, then at some point DNA testing might be able to help us do that.
Quote:
I suppose the notion that walking around in the grocery store, mall etc. also rankles. Most modern strains of the flu have a low enough attack rate that that sort of casual contact is unlikely to make people ill. When that is overstated though, I think it feeds into people's perception that they aren't going to get sick since it actually supports their personal experiences. Realistically we are only going to be getting our friends, family, and classmates ill. And isn't that enough anyway?
As has been pointed out, that is not entirely true. People do not just go out in public when they are in the pre-clinical stage of the disease, they go out when they are actually pretty sick, though flu can knock you down to the extent that you may not be able to get out of bed even if you want to. For it to spread among friends, family, and work contacts someone has to get it first. Your circle of friends, family, and coworkers overlaps with many other such circles, which in turn overlap others ....
Quote:
As for HCPs, I do understand the need to be vaccinated, especially as you are much more likely to actually interact with someone shedding virus than others but part of the antivax backlash has been to lump flu vaccines in with other vaccines and I think that is a mistake. Look at MissTerri's posts, all of her complaints about flu vaccines are normal limitation due to the very nature of influenza itself. I get that we want people to be vaccinated but I think we need to acknowledge that the flu is different than other diseases. If nothing else it undercuts the arguments the antivax crowd makes about flu and then tries to apply to other vaccines.
Her main argument is that since the vaccine is not perfect, it's a "crap shoot" to take it. From other threads, we know she feels that she can treat flu with herbs if someone in her family gets sick.
We all know the vaccine is not perfect, due to the peculiarities of the virus, as you say. My view is that if I am offered two lottery tickets and one has a 60% better chance of winning, I'll take that one, thank you.
Quote:
Originally Posted by MissTerri
Regarding herd immunity and the influenza vaccine in the US:
Roughly half of the population gets the influenza vaccine in any given year. The vaccine has various rates of effectiveness from year to year. We do not have herd immunity for the flu in the US.
Again, I'm not complaining about the flu vaccine. I'm simply pointing out it's limitations which I agree, are in fact due to the very nature of influenza itself.
We do not have herd immunity because too few people take the vaccine. Even with an effectiveness rate that is lower than with some other vaccines, getting 80% of the people in the country vaccinated would allow herd immunity to develop.
Quote:
Originally Posted by lkb0714
This is exactly what I was referring to with deliberate overstatement. You, as a HCP, know that people who are ill with other illnesses are frequently not given flu shots or are given them at a later date (during which they could become ill and potentially die)
People with mild illnesses can be vaccinated. Those who are moderately ill or worse should not be. A temp of over 99.5 might result in deferring the vaccine.
Quote:
"If you ever had Guillain-Barré Syndrome (a severe paralyzing illness, also called GBS). Some people with a history of GBS should not get this vaccine. Talk to your doctor about your GBS history.
Remember that flu vaccine is not the only factor associated with GBS. It most commonly follows certain respiratory (including influenza) and intestinal infections. If the episode of GBS was not associated with flu vaccine, consideration can be given to taking the vaccine. Even if the GBS did follow the flu vaccine, people have subsequently received the flu vaccine without a recurrence of the GBS.
From 2004-5 season to 2015-6 season the trimmed mean was 93.3, that is well with in the range of statistical "typicality.
I am not sure the point you are trying to make. Each season is an independent event. You cannot average them.
Quote:
Really, this is exactly what I was talking about. Its fear mongering. For example the notion of "modern strains of flu" being more aggressive. That varies from year to year and season to season as evidenced by 2015-6 being a mild flu season and 2009 being a more serious one. But a blanket statement that implies the flu is becoming more dangerous is JUST fear mongering and feds into the notion that people are hyping up disease worse than they need to.
Emerging strains of flu really can be more aggressive, particularly when they jump species. That's what happened with H1N1, and there are others that are being closely monitored.
"Avian influenza viruses present an emerging epidemiological concern as some strains of H5N1 avian influenza can cause severe infections in humans with lethality rates of up to 60%. These have been in circulation since 1997 and recently a novel H7N9-subtyped virus has been causing epizootics in China with lethality rates around 20%."
Quote:
You seem to have an issue with scale. For example in 1918 over 600,000 people died from flu in the US. In 2009 12,000 people died. Now sure other factors are at play but that is well over an order of magnitude difference and yet you characterized modern strains as more "aggressive". Same with flu vaccine vs other vaccines. Compared to other vaccines the flu vaccine is much less effective. Polio is something like 99%, MMR 99.8%, those are very effective vaccines. Likewise, flu typically has a very low death rate, something along the lines of 30K or so according to the CDC. With an attack rate of 5-10% for adults that death rate is something like 0.01%. That is really low, polio had a death rate of approx 2-5%, small pox was 30%. The flu is a very different disease, and its vaccines is a very different vaccine, lumping them all together just feeds the antivax hysteria.
It's really not possible to compare 1918 and 2009 because there were not the antibiotics to treat secondary infections in 1918 and nowhere near the level of general medical support we have now. In addition, we do have flu vaccine now. Without the vaccine, antibiotics, and intensive medical care, the number of deaths in 2009 could be easily an order of magnitude higher. In addition, the 1918 virus was at that time an emerging virus.
Quote:
Originally Posted by lkb0714
This is something I have refrained bring up because it is a topic that is currently being explored. There is evidence (and more studies are evaluating just how much evidence there is) that actually getting the flu, confers longer/stronger immunity vs. vaccines for SOME strains. There is quite a bit of statistical evidence to suggest that people who had the flu in the 1960s had residual immunity to H1N1.
The flu vaccine is a relatively new vaccine, and unlike many other vaccines carries no hope of eradicating the disease due to the nature of the flu virus itself. It is interesting to see how the natural vs acquired immunity studies play out over the next couple of decades.
Sure, there will always be some people who have residual immunity due to previous infection. They had to get sick to achieve that immunity, though.
"The flu vaccine is a relatively new vaccine, and unlike many other vaccines carries no hope of eradicating the disease due to the nature of the flu virus itself. It is interesting to see how the natural vs acquired immunity studies play out over the next couple of decades."
Actually, the first flu vaccine in the US was licensed in 1945, well before (in chronological order) DPT, 1949 (though single diphtheria [1923] and tetanus vaccines [1937] were available earlier); polio 1955; measles, 1963; mumps, 1967; rubella, 1969; Hep B, 1982; Hib, 1985; chickenpox, 1995; Hepatitis A, 1995; Prevnar, 2000; Menactra, 2005; rotavirus, 2006; and HPV, 2006. There are some other vaccines but they are not routinely used in the US. 71 years is not "relatively new". We have a lot of experience with flu vaccine. http://www.immunize.org/timeline/
Last edited by Katarina Witt; 09-10-2016 at 11:38 PM..
So why aren't promoting the pneumonia vaccine, if the pneumonia is what KILLS people, not the flu?
If the flu is so horrifying and so deadly, I think if someone I knew had it I would know, right? I mean, I'd have to go visit then in the hospital and attend the funeral, too, wouldn't I?
*crickets*
I had one friend who got the flu vaccine about 8 years ago. Perfectly healthy individual. She then got Gullien-Barre and was hospitalized for 10 days. But hey, it's safe. Really.
Pneumonia isn't just "one" thing. It can be a secondary infection from many illnesses. My mother caught Chicken Pox from my brother and I and developed pneumonia and meningitis. Her primary illness was Chicken Pox. Pneumonia can be viral, bacterial... . Flu CAN be deadly, it isn't always. I've had it, my kid has, people you know have as well. In your obstinance you are coming off as ignorant.
I'm not an anti-vaxer, but I've polled a number of friends and parents in this area, and found that many who get the vaccine get the flu anyway, while the majority of those who don't get the vax never get the flu. So it seems quite ineffective. For that reason, my children, husband and I never get vaxed, and we've never had the flu. It's not a philosophical position, more of a "why bother?"
Well, you don't have to do your own polls, because the CDC monitors these things. Effectiveness of the vaccine varies. Last year, it was about 60%, meaning you were about 60% less likely to get the flu if you were vaccinated compared to an unvaccinated person. The flu mist didn't give much protection, especially in children. That's why the CDC and American Academy of Pediatrics are recommending the injection this year rather than Flu Mist. At the end of the day, no one really knows how effective the flu vaccine is going to be until late in flu season. Some years it's 70% effective, and I've seen years as low as 20 something percent. If we could know ahead of time how well it would work, people could make informed decisions about whether to get it. Without a crystal ball, the numbers say you are better off getting it and hoping it's a good match, while still being careful to wash your hands frequently and stay away from sick people as much as you can during influenza season.
Her main argument is that since the vaccine is not perfect, it's a "crap shoot" to take it. From other threads, we know she feels that she can treat flu with herbs if someone in her family gets sick.
It is a crap shoot. It's interesting to hear comments from people on here who get their flu shot every year and who have admittedly gotten the flu more then once in the last few years, even through casual contact. Yet people who haven't gotten the vaccine have managed to avoid it somehow for decades, even with intense contact (taking care of a sick child or spouse who has it). Crapshoot. The truth is that flu does not pose a great risk to healthy individuals. And it is true that the symptoms and duration of illness can be lessened via some herbal remedies such as elderberry. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. - PubMed - NCBI I'm aware that this is an abstract from 2004 and it notes that further studies are needed but no one has funded further studies since that time probably because there is no real money to be made with something like this.
Quote:
We do not have herd immunity because too few people take the vaccine. Even with an effectiveness rate that is lower than with some other vaccines, getting 80% of the people in the country vaccinated would allow herd immunity to develop.
We could possibly have very temporary herd like immunity for the strains of flu that are covered by the vaccine if more people took it and if the rate of effectiveness was high for that particular season year. The flu virus can and does rapidly mutate though and we could see more dangerous strains as a result of our effort to suppress certain strains.
As has been pointed out, that is not entirely true. People do not just go out in public when they are in the pre-clinical stage of the disease, they go out when they are actually pretty sick, though flu can knock you down to the extent that you may not be able to get out of bed even if you want to. For it to spread among friends, family, and work contacts someone has to get it first. Your circle of friends, family, and coworkers overlaps with many other such circles, which in turn overlap others ....
So true! The sickest people I ever saw as a vaccine provider were at the businesses I went to as a visiting nurse. People will go to work when they can barely get out of bed and get dressed. That's about the only place I had to turn down a willing recipient.
People with mild illnesses can be vaccinated. Those who are moderately ill or worse should not be. A temp of over 99.5 might result in deferring the vaccine.
Exactly! At the office where I worked, we tried very hard to avoid "missed opportunities". Not only did we give the vaccine to kids at their well-child visits, but we gave it at many "sick" visits as well. We did pretty much say "no" if the child had a temperature; we didn't have a specific cut-off but 99.5 sounds reasonable. Some examples of when we did vaccinate-mild cold; mild cough; ear re-check if the infection was gone, re-check of other conditions, ditto; UTI symptoms but no evidence of actual UTI (happens a lot in little girls); mild sore throat that is not strep; kids in for behavior consults, acne, other non-illness conditions, and so forth.
In the case of immune-suppressed kids, it's important for the rest of the family to get vaccinated.
The reality is that flu-shot season occurs with the start of school which brings about cold (URI) season. If we only vaccinated those at the tip-top peak of health, hardly anyone would get immunized.
Remember that flu vaccine is not the only factor associated with GBS. It most commonly follows certain respiratory (including influenza) and intestinal infections. If the episode of GBS was not associated with flu vaccine, consideration can be given to taking the vaccine. Even if the GBS did follow the flu vaccine, people have subsequently received the flu vaccine without a recurrence of the GBS.
Yes, and the CDC's recommendation is to talk to your doctor. GBS within 6 weeks of a flu shot is a precaution. Someone who has a lot of occupational exposure, e.g. teacher, health care provider may need to get the vaccine anyway, someone else may be advised to not get it.
I am not sure the point you are trying to make. Each season is an independent event. You cannot average them.
Again, yes. Last season was quite mild. The season before was pretty rough.
Emerging strains of flu really can be more aggressive, particularly when they jump species. That's what happened with H1N1, and there are others that are being closely monitored.
"Avian influenza viruses present an emerging epidemiological concern as some strains of H5N1 avian influenza can cause severe infections in humans with lethality rates of up to 60%. These have been in circulation since 1997 and recently a novel H7N9-subtyped virus has been causing epizootics in China with lethality rates around 20%."
It's really not possible to compare 1918 and 2009 because there were not the antibiotics to treat secondary infections in 1918 and nowhere near the level of general medical support we have now. In addition, we do have flu vaccine now. Without the vaccine, antibiotics, and intensive medical care, the number of deaths in 2009 could be easily an order of magnitude higher. In addition, the 1918 virus was at that time an emerging virus.
Sure, there will always be some people who have residual immunity due to previous infection. They had to get sick to achieve that immunity, though.
Mine in teal.
Last edited by Katarina Witt; 09-11-2016 at 07:20 AM..
It is a crap shoot. It's interesting to hear comments from people on here who get their flu shot every year and who have admittedly gotten the flu more then once in the last few years, even through casual contact. Yet people who haven't gotten the vaccine have managed to avoid it somehow for decades, even with intense contact (taking care of a sick child or spouse who has it). Crapshoot. The truth is that flu does not pose a great risk to healthy individuals. And it is true that the symptoms and duration of illness can be lessened via some herbal remedies such as elderberry. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. - PubMed - NCBI I'm aware that this is an abstract from 2004 and it notes that further studies are needed but no one has funded further studies since that time probably because there is no real money to be made with something like this.
We could possibly have very temporary herd like immunity for the strains of flu that are covered by the vaccine if more people took it and if the rate of effectiveness was high for that particular season year. The flu virus can and does rapidly mutate though and we could see more dangerous strains as a result of our effort to suppress certain strains.
I cannot let that bold go. That is untrue. Especially with "novel" flus, the affected are often the young and healthy. http://www.flu.gov/pandemic/history/
Conspiracy theories, e.g. "no real money to be made" are not credible. Many universities and other research centers now have departments that study Complementary and Alternative Medicine. Keep in mind the saying, that "alternative medicine that works is called. . . medicine."
Last edited by Katarina Witt; 09-11-2016 at 07:22 AM..
"The flu vaccine is a relatively new vaccine, and unlike many other vaccines carries no hope of eradicating the disease due to the nature of the flu virus itself. It is interesting to see how the natural vs acquired immunity studies play out over the next couple of decades."
Actually, the first flu vaccine in the US was licensed in 1945, well before (in chronological order) DPT, 1949 (though single diphtheria [1923] and tetanus vaccines [1937] were available earlier); polio 1955; measles, 1963; mumps, 1967; rubella, 1969; Hep B, 1982; Hib, 1985; chickenpox, 1995; Hepatitis A, 1995; Prevnar, 2000; Menactra, 2005; rotavirus, 2006; and HPV, 2006. There are some other vaccines but they are not routinely used in the US. 71 years is not "relatively new". We have a lot of experience with flu vaccine. Historic Dates and Events Related to Vaccines and Immunization
Seriously? You talk about good faith and then misconstrue my words deliberately.
Flu vaccine is absolutely one of the ne vaccines to come on the market in the US as part of a wide spread public health policy and to receive recommendation by the cdc for use in everyone. Despite what you posted above the first time it was used with any widespread vaccination was 1979 and then only 25% of the public got it. And only become recommended for everyone in the last decade or so.
If you get to the point that you have to latch on to wording of a sentence to feel you've made your point and ignore literally everything else I have brought up about the flaws in your math and logic, than your no longer having a rational discussion.
Seriously? You talk about good faith and then misconstrue my words deliberately.
Flu vaccine is absolutely one of the ne vaccines to come on the market in the US as part of a wide spread public health policy and to receive recommendation by the cdc for use in everyone. Despite what you posted above the first time it was used with any widespread vaccination was 1979 and then only 25% of the public got it. And only become recommended for everyone in the last decade or so.
If you get to the point that you have to latch on to wording of a sentence to feel you've made your point and ignore literally everything else I have brought up about the flaws in your math and logic, than your no longer having a rational discussion.
Flu vaccine is NOT new. Sorry if that doesn't fit with your biases. The recommendations have expanded over the years, but the vaccine is not new. I've been giving flu vaccine since the 70s, and not just the old Swine Flu vaccine in 1976, not 1979, either. https://en.wikipedia.org/wiki/1976_swine_flu_outbreak
To repeat, flu vaccine has been around since 1945, 71 years now. We have lots of experience with it. It's been given to military personnel for many years.
Try reading this Medscape article. http://www.medscape.com/viewarticle/812621You may have to sign up for Medscape, but that's free. Here is a highlight that might interest you, or not. "This bivalent vaccine started to be used widely in 1944, particularly for the American troops in Europe, and was then extended to civilians in 1945." Now that is 72 years ago!
The ACIP has been making recommendations on who should be vaccinated for flu since 1964, a mere 52 years ago now! http://www.vaccination.english.vt.ed...edia-kit-4.pdf
Now can the personal attacks, or this thread will get closed.
Katrina, all news to me. If there was a flu shot around when I was a kid in the 50's, why didn't my doctor "recommend" that I get it??? I had the flu just about every year; this flu epidemic and that flu pandemic. I lived in NYC with some of the biggest hospitals in the country. This pediatrician never heard of flu shots in those days? Maybe they were still testing it (military?) and did not want to give it to children back then because they did not think it was safe for them? Perhaps if parents, and doctors, in those days did not think that measles, mumps, or chicken pox were deadly diseases, then the flu really would have been no big deal at all. Please don't put polio in the same category as chicken pox, OR the flu. I am sure you probably think that. You know it was a totally different mindset in those days.
After I got too old to go to a pediatrician in 1958, I only went Dad's to Union clinic when I was very sick. I never went to a doctor for the flu ever. Stay home from school or work. My OB/GYN in the 60's, 70's, and 80's never said anything about flu shots either. Pregnant women weren't given flu shots then. Today you cannot go anywhere without seeing signs for flu shots.
While flu shots were probably around for 71 years, they weren't pushed on the general public, or children, like today.
Just one old lady's experience from those days. Katarina and Suzy, were you given flu shots as children or young adults?
Last edited by Jo48; 09-11-2016 at 09:26 AM..
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
