I got the flu vaccine, and you should too.

Today I took care of myself and my community by getting a flu vaccine.

Getting the jab!

I get one every year. I do it not just to protect myself (although that’s an important consideration–I don’t have time to get sick!), but also to protect my community from a serious health hazard.

A serious health hazard? Surely that’s an exaggeration, right? After all, haven’t we all gotten the flu at some point, been unpleasantly sick a few days, but recovered? Well no, actually. Some of us get very sick, and some haven’t recovered from it. Approximately 200,000 people have to go to the hospital each year because of the flu, and between 3,300 to 49,000 people actually die from it every year.

That range in severity is due in part to how effective vaccination programs are from year to year.

The seasonal influenza vaccine is critical for stopping the spread of the virus. The flu virus can mutate very rapidly, so every year public health officials have to try to anticipate which strain(s) are likely to be the most prevalent, so that vaccines can be designed against them. This year, there appear to be three strains of influenza that pose potential threats:

According to the CDC, this year’s vaccine is designed to provoke immunity against three strains of virus:

–an A/California/7/2009 (H1N1)pdm09-like virus;
–an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011;
–a B/Massachusetts/2/2012-like virus.

The CDC monitors outbreaks of influenza all across the country constantly, and publishes their findings in a weekly report called “Fluview”. They monitor to see if the strains that are spreading are the ones that the vaccine provides immunity against. This is extremely important in preventing an outbreak from becoming a pandemic.

For example, here are the data reported on flu cases across the United States for October 5-October 25th:

Subtypes of influenza reported (http://gis.cdc.gov/grasp/fluview/fluportaldashboard.html)
Subtypes of influenza reported (http://gis.cdc.gov/grasp/fluview/fluportaldashboard.html)

Right now, when levels of influenza infection are low, it’s a good time to get the vaccine and prevent the virus from spreading.

How it works: The seasonal flu  vaccine works by provoking the body’s natural immune response. With the vaccine, a person is exposed to small amounts of weakened (in the nasal spray version) or killed ( in the injected version) strains of the flu. The immune system recognizes the foreign bodies as a threat, and mounts an immune response against them by producing strain-specific antibodies  (just as they do in any type of infection). When a person is exposed to the actual live virus, these antibodies quickly destroy it.

Why does this matter?  There are some people who can’t get the vaccine. They may be allergic to components of it, immunologically compromised, or have bad reactions to the vaccine. Their only protection against the virus is not getting exposed. One of the best ways of preventing their infection (and that of other people who choose not to get the vaccine) is to stop influenza’s spread through herd immunity.

But what about the dangers? I don’t want to get the flu from the vaccine! 

No vaccine is 100% safe (no medical treatment is!!!). A very small number of people have adverse reactions to vaccines (such as Guillain-Barre Syndrome). However, these conditions are very rare. There is a LOT of misinformation and urban legends being spread about the flu vaccine (and vaccines in general). It’s vitally important that you familiarize yourself with these common mistruths, and what the science actually says about them. This is the best resource I’ve seen on the subject recently. The post debunks many of the myths about vaccines, including the most repeated one:

“Myth #1: The flu vaccine gives you the flu or makes you sick. (No, it doesn’t.)

This is by far the most common myth I hear – even though it’s scientifically impossible from the inactivated vaccine. Are there people who become sick right after having gotten the flu shot? Of course, and it’s an illness they had likely caught before the shot and it took a a few days for symptoms to appear, or it’s just coincidence (and it may or may not be the flu). The flu shot takes two weeks to confer protection, and it takes 2-5 days to incubate a flu virus. A person who does come down with the flu within a week of getting the shot was already infected when they got the vaccine.

Even with the live vaccine in the nasal spray, the weakened virus cannot cause the flu. However, it is theoretically possible to “shed” the virus after receiving the live vaccine, thereby infecting others, though no serious cases have been reported of this occurring.

Edit: One thing worth noting is that some people may feel “under the weather” or generally crappy for a few days after the shot or a week or two later. A headache, nausea, fever, etc. can be a result of the side effects of the vaccine, usually from the immune system ramping up and producing antibodies against those influenza strains. Some may consider this feeling “sick,” but you are not sick in the sense that the flu vaccine caused you to fall ill from a pathogen, and the vaccine certainly didn’t give you the flu.”

Let me reiterate that point: You CANNOT get the flu from the vaccination. It’s medically impossible. If you’re still unconvinced, I recommend you read their post in its entirety. For a discussion about vaccines and autism (another common myth), I invite you to read my post (and the comments) here.

And here are some more resources for you to get answers to your questions about the flu vaccination:

http://www.cdc.gov/flu/professionals/vaccination/virusqa.htm#effectiveness

http://www.webmd.com/cold-and-flu/features/top-13-flu-myths

 
EDITED TO ADD: Yet another reason to get the flu vaccine: a recent study has found that it lowers your risk of heart attacks and strokes.

So…what’s your reason for not getting vaccinated this year?

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53 thoughts on “I got the flu vaccine, and you should too.

  1. Jason Dick November 2, 2013 / 10:51 pm

    Nice post 🙂

    One thing I find interesting, however, is that apparently the dangers with vaccines and Guillain-Barre syndrome have been overblown:
    http://www.ncbi.nlm.nih.gov/pubmed/19388722

    It’s paywalled, but according to the abstract, there was one type of flu vaccine back in the 70’s that showed a significant reaction, but since then there hasn’t been any measurable reaction with the disorder. My suspicion is that this is a problem with the rarity of the disease making it difficult to do the statistics properly to test for an effect, and, in turn, leading to false positives for a connection between GBS and vaccine use.

    That or an indication that the weaker vaccines we use these days, which are made weaker so that people have fewer adverse effects such as cold-like symptoms, are just less likely to cause a reaction in those with GBS. Either way, it looks like this concern is overblown.

    • Jennifer Raff November 3, 2013 / 8:09 am

      How interesting! I knew someone with GBS, but he’d had it a very long time ago. I’ll have to check out that paper–thanks for the link!

  2. gewisn November 2, 2013 / 11:22 pm

    If I told you that all you have to do is deliver this medicine downtown and you’ll save 5 people from being seriously ill and there’s a 30% chance you’ll save someone’s life – you would do it.
    Now if I told you that there’s a one-in-a-million chance that you’ll be seriously hurt in the drive downtown, and a one-in-ten-million chance you’ll die on the way – would you still do it?
    If you said, “Yes,” then please get the vaccine every year, because other people’s babies and grandfathers and sisters with leukemia are depending on it.
    If you said, “No,” well, then you already know what kind of person you are.

  3. Brett November 3, 2013 / 12:23 am

    Finding them around here has been hard, since I idiotically didn’t get it when they had them at work (and when I finally went to get it, they were out).

    • Jennifer Raff November 3, 2013 / 8:11 am

      Oh that’s a shame! My campus had a big vaccination drive this year, but I missed it as well. I was lucky that the local pharmacy that I went to was able to give me one, and delighted that my insurance covered it completely. I hope you’re able to find a place to give you one!

  4. Ben November 3, 2013 / 12:23 pm

    ‘One thing worth noting is that some people may feel “under the weather” or generally crappy for a few days after the shot or a week or two later.’

    That’s my experience every time with the shots. It passes in about twelve hours. If you think that’s the flu, you’ve never had the flu.

    • ischemgeek November 3, 2013 / 1:15 pm

      Yes. When they say “fatigue” as a symptom of they flu, they don’t mean, “feeling a little groggy,” they mean “sleeping 16+ hours a day, exhausted when you’re awake”.

      • Jennifer Raff November 4, 2013 / 1:31 pm

        Oh yes. When I’ve had the flu in the past, I was so sick I wanted to die. Big big difference. I think a lot of people mistake colds for the flu, hence the idea that “it’s not so bad!”

        • ischemgeek November 4, 2013 / 1:43 pm

          I’m asthmatic. Last time I got the flu, my lung function plunged to about 36% of my normal. I couldn’t climb stairs on a good day, and I couldn’t walk across the room on a bad day. It took me two years to recover, and my asthma permanently worsened from mild intermittent to moderate persistent.

          My cough and asthma were so bad, the doctors at my university thought I might have pertussis. They were surprised when the flu test was the only thing that came back positive, and by then it was too late for Tamiflu.

          I’m not going to risk getting it again. Last time, I almost died. Next time, I might not be so lucky.

        • Adrienne November 8, 2013 / 11:55 am

          To me, the tipping point of knowing whether you have the flu is when the “I feel like I’m gonna die” part tips over into “oh my god, what if I DON’T die… What if I just linger in eternity forever running this 101 fever and this cough and feeling like my skin is going to fall off…”

  5. plasmarules November 4, 2013 / 8:22 am

    According to the Cochrane Collaboration’s most recent in depth reviews of available flu vaccine evidence pertaining to children, adults and long-term health care workers there is NO evidence that flu vaccines prevent complications such as pneumonia and NO evidence that flu vaccines prevent transmission. Therefore you are not protecting your community when you get a flu vaccine. The PMIDs for the Cochrane’s studies are 20614424 (adults), children (22895945) and HCWs (20166073). They also found zero evidence to support the recommendation of giving children at 6 months flu vaccines (no evidence for those under 2 years old) and no evidence of efficacy of flu vaccines in the elderly but noted that there may be wildly unscientific conclusions drawn over some of the studies that they reviewed, which we’ve already seen with the ridiculous stories from last year about flu vaccines lessening the risk of a heart attack!

    In an interview with Germany’s Spiegel, Cochrane’s head of vaccines, epidemiologist Dr. Tom Jefferson, had the following exchange:

    ******************************
    SPIEGEL: For a number of years, as part of the Cochrane Collaboration, you have been systematically evaluating all the studies on immunization against seasonal influenza. How good does it work?

    Jefferson: Not particularly good. An influenza vaccine is not working for the majority of influenza-like illnesses because it is only designed to combat influenza viruses. For that reason, the vaccine changes nothing when it comes to the heightened mortality rate during the winter months. And, even in the best of cases, the vaccine only works against influenza viruses to a limited degree. Among other things, there is always the danger that the flu virus in circulation will have changed by the time that the vaccine product is finished with the result that, in the worst case, the vaccine will be totally ineffectual. In the best of cases, the few decent studies that exist show that the vaccine mainly works with healthy young adults. With children and the elderly, it only helps a little, if at all.

    SPIEGEL: But aren’t those the exact groups that influenza immunization is recommended for?

    Jefferson: Indeed. That’s one of the contradictions between scientific findings and practice, between evidence and policy.

    SPIEGEL: So, what’s behind this contradiction?

    Jefferson: Of course, that has something to do with the influence of the pharmaceutical industry. But it also has to do with the fact that the importance of influenza is completely overestimated. It has to do with research funds, power, influence and scientific reputations!

    SPIEGEL: So, at the moment is it reasonable to keep vaccinating against seasonal influenza?

    Jefferson: I can’t see any reason for it, but I’m not a decision maker.
    ******************************

    • Jason Dick November 4, 2013 / 10:26 am

      From the text of the paper:
      “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%). These differences were not likely to be due to chance.”

      I.e. 75% protection in the case that the influenza virus in circulation matches the vaccine, 50% protection otherwise. This is well-known and broadly-reported. I don’t think their conclusion that the flu vaccine is therefore worthless is supportable. They claim, for example, that 33 adults need to be vaccinated to prevent one case of the flu. I don’t understand why they think that is a problem, considering the extremely low risk of complications, low cost, and ease of administering the vaccine.

      • plasmarules November 5, 2013 / 8:38 am

        Jason, the first number is irrelevant which is why they put “relatively uncommon” – find out how many years in the last 29 years the vaccine has matched the circulating strain. In addition you should look at what the 95% CI 0% to 3% means. It could mean that 100 people vaccinated prevents 0 influenza symptoms. Wording it as “50% protection” when less than 3% of people will contract influenza to begin with is pretty misleading, I could say you need to not vaccinate 100 people to prevent 97.3 cases of influenza, so not vaccinating is almost 98% effective!

        They think it’s a problem because there is no evidence that the vaccine is effective in the elderly, whom it’s most pushed on, and because there is no evidence that it prevents transmission or complications it’s simply a money grab to recommend it for healthy adults.

        There is simply no reason for healthy adults to take a flu vaccine and there is no evidence to support the elderly taking a flu vaccine, nor is there any reason for health care workers to take a flu vaccine. If you want a common sense flu vaccine program then you’d only recommend it for those who are a) not elderly and b) not healthy adults. This would be somewhat similar to the UK’s recommendations on chicken pox vaccination which is, don’t get it until you’re approaching the end of your teenage years because it’s harmless.

        If you support vaccinating healthy adults with influenza vaccine then basically you should support renaming the vaccine campaign “may reduce 1~2 work days lost due to influenza in 1% of the population” given that less than 3% get influenza to begin with.

        • Jason Dick November 5, 2013 / 3:52 pm

          Because apparently a significantly reduced chance of puking your guts out isn’t sufficient reason to get the shot. Why?

          I’d also like to see a more detailed look at the evidence that transmission is not reduced, because that seems incredibly unlikely.

          • plasmarules November 5, 2013 / 4:22 pm

            Reducing your risk of puking, or from missing 0.4 days of work, from 2% to 1% (statistical chance and as stated could be 0~3%) is definitely NOT a sufficient reason to implement a vaccine policy. What’s next, a vaccine to reduce your risk of getting a headache from 0.9% to 0.2%?

            You are now saying that the largest collective body of independent peer review on the planet’s conclusions are “incredibly unlikely” – this is the power of the pharmaceutical industry’s influence that Dr. Tom Jefferson speaks about in the Spiegel interview. Interestingly Dr. Tom Jefferson as per the Cochrane text owned shares in GSK and has received consultancy fees from Sanofi-Synthelabo (2002) and Roche (1997 to 1999). All other authors have no COIs.

            Cochrane analyzed approximately 300 reviews with only approximately 50 studies matching the inclusion criteria. All the studies included and excluded are listed in detail in the full text outlining why they excluded studies, in every case due to missing data, bias, no outcomes of interest, no original data, no adequate control, etc.

            You can take a look through each of the studies they analyzed to discover for yourself whether the conclusion that there is no evidence flu vaccines affect complications or transmission is supported by the evidence.

          • Jason Dick November 5, 2013 / 4:25 pm

            Why not? That’s a 50% reduction. For an illness that is as unpleasant as the flu, and with an intervention that is almost entirely side-effect free, it’s a no-brainer.

            • plasmarules November 5, 2013 / 4:40 pm

              Yes, it’s “unpleasant” so it taking a dump after a good vindaloo sometimes but I’m not seeking out a vaccine for it. You don’t understand statistics or disease if you think a vaccine is a good idea to reduce the risk of an unpleasant day at home from 2% to 1%, a statistically insignificant difference. It’s clear that you are not a student of science but a student of pseudoscience but nevertheless I look forward to your presentation of the excluded studies that would have demonstrated flu vaccine efficacy and why they should have been included in the Cochrane’s analysis.

        • Jason Dick November 5, 2013 / 4:11 pm

          Looked a bit in more detail. The paper about the vaccine for persons with ages 65+ is found here:
          http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004876.pub3/abstract

          They don’t present evidence of “no benefit” for the elderly. Instead, they claim:
          “The available evidence is of poor quality and provides no guidance regarding the safety, efficacy or effectiveness of influenza vaccines for people aged 65 years or older. To resolve the uncertainty, an adequately powered publicly-funded randomised, placebo-controlled trial run over several seasons should be undertaken.”

          This is unfortunate, but it isn’t the same as the claim you presented. Meanwhile, we have studies like this one that demonstrate other significant benefits:
          http://www.health.harvard.edu/blog/flu-shot-linked-to-lower-heart-attack-stroke-risk-201310236795

          • plasmarules November 5, 2013 / 4:19 pm

            As I stated in my first post which you previously responded to yet didn’t heed the warning it gave – “no evidence of efficacy of flu vaccines in the elderly but noted that there may be wildly unscientific conclusions drawn over some of the studies that they reviewed, which we’ve already seen with the ridiculous stories from last year about flu vaccines lessening the risk of a heart attack!”

            You seem to care more about conclusions that evidence. Have you read any of the full texts of the cochrane studies? I have read all of them. Have you read that ridiculous study about heart attacks? Please, read it and see what you think afterwards. Here’s a Q&A with TJ after that study was published.

            Q: On Feb. 16, the Cochrane Library published your updated review of all major studies on the efficacy of flu vaccines for the elderly, some of the results of which you believe to be preposterous. Can you explain?

            A: We looked at studies on vaccines in the elderly and in health care workers who work with the elderly, and we found an implausible sequence of results. We have studies that claim up to 90% effectiveness against death from all causes [in inoculated patients compared with the nonvaccinated]. If you were to believe that evidence, you would believe that flu vaccine is effective against death not only from influenza, but also from heart attack, stroke, hypothermia, accidents and all other common causes of death among the elderly. That is quite clearly nonsense.

            This is not to say that these and other studies, taken together, suggest that vaccines don’t work for the elderly. The answer is a question mark. We don’t know what protection, if any, vaccines offer. I don’t think that’s a bad thing. Uncertainty is the motor of science. We need large studies to find out.

            Q: Why do you think such studies have not been done?

            A: I don’t know. We’ve known for years that we needed proof one way or the other, and governments have not taken any notice of this. It’s an extraordinary situation.

            Q: One argument I’ve heard is that it would be unethical to compare vaccines against a placebo because you would be withholding crucial treatment from patients. Do you agree?

            A: No. We don’t know these vaccines work, so you can’t make that claim. But if you really find placebos to be unethical, then why don’t you randomize against masks, hand-washing, gloves, distancing — public health measures that have proven to be effective?

            Q: You are a big fan of these so-called physical interventions. Why?

            A: There is solid evidence that they work against all [flu viruses], not just specific strains [unlike the flu vaccine, as it is designed]. They are culturally acceptable and cheap, and they reduce transmission rates of other viruses too. A great American called Stephen Luby of the CDC has published a study from Karachi, Pakistan, that found that physical interventions are lifesavers. He should receive a Nobel Prize for his work, but I’m sure he never will.

            Q: Why do you think your reviews have not filtered down to policymakers?

            A: In a separate study we looked at the science that policymakers use, and it’s disturbing how large the gap is between policy and evidence. We looked at the World Health Organization, CDC and U.K., Australian and German authorities — they have what it is called a “citation bias.” They cite some studies that support vaccines, but other studies that find no effect are left out. Most importantly, there is no critical appraisal of the methods. [Cochrane reviewers examine the methodology of all studies they include in their systematic reviews.] It’s disturbing. I think with influenza there’s a feeling in governments that “we have to do something.” Well, you can do something: you can better promote cheap public health measures such as hand-washing. They work.

            Q: Do you have trouble getting people to believe you?

            A: There’s no way that the Cochrane Collaboration can compete with governments. It’s David vs. Goliath. When Obama promotes vaccines, I have no chance. I can’t take on Obama.

            Q: So what would you recommend that people who are over 65 do to protect themselves from flu?

            A: If they want to base it on good evidence, they should wash their hands. I would also encourage them to write to their Congressman or Senator, asking them to put pressure on the U.S. government to run a proper trial and get an answer to whether these vaccines actually work.

            Q: Are you skeptical of the efficacy of all vaccines?

            A: People always ask me if I am against other vaccines. I am not. I have five children. They have all been vaccinated against the major diseases as part of the standard childhood-vaccination program. Those vaccines have strong evidence to back them up. I am not antivaccine. I am anti–poor evidence.

          • Jason Dick November 5, 2013 / 4:24 pm

            Except for the little niggling detail that the Cochrane Review ignored most of the evidence for flu efficacy. They didn’t find any evidence, because they threw out most of it when making the review.

            • plasmarules November 5, 2013 / 4:30 pm

              Ah, okay Jason, here is the challenge for you: please look through the full text of the review and let us know which studies regarding efficacy were thrown out and why you think those studies should not have been excluded. You’ve made a statement here, let’s see you back it up with sound scientific reasoning.

          • plasmarules November 5, 2013 / 4:27 pm

            No Jason, that is not the paper, that is the abstract. This is some of what Cochrane says about looking at only the abstracts:

            The content and results of previous versions of this review have
            been extensively misquoted especially in public policy documents
            (Jefferson 2009c). Two types of common misquotes are the generalisation of evidence from this review to all age and risk groups and the generalisation of estimates of effect to all outcomes (especially complications and deaths). The misquotes then assume that the performance of influenza vaccines is uniform across all age groups and from symptom prevention to all outcomes. Both generalisations are not supported by any evidence and seem to originate from the desire to use our review to support decisions already taken. The misquotes appear to be based on both the abstract and Plain language summary (which is what you would expect from a superficial reading of the review by people with a specific agenda).

            It is for these reasons that in this 2010 update we have tried to
            minimise the risk of being misquoted by presenting effects on
            major outcomes both in RR and RD format and have inserted a
            general warning on the quality of evidence in the field of influenza
            vaccines. Recent examples of misquotes of this review come from
            page 11 of the 2009 ACIP document (ACIP 2009). The 2007
            version of the review is indicated as reference 121: “When the vaccine and circulating viruses are antigenically similar, TIV prevents laboratory-confirmed influenza illness among approximately 70% to 90%of healthy adults aged < 65 years in randomised controlled trials (121, 124). Vaccination of healthy adults also has resulted in decreased work absenteeism and decreased use of health-care resources, including use of antibiotics, when the vaccine and circulating viruses are well-matched (121, 123). Efficacy or effectiveness against laboratory-confirmed influenza illnesswas 47%- 77% in studies conducted during different influenza seasons when the vaccine strains were antigenically dissimilar to the majority of circulating
            strains (117,119,121,124).However, effectiveness among
            healthy adults against influenza-related hospitalization, measured
            in the most recent of these studies, was 90% (125)”. There are
            three subtle manipulations in the text. First, the review is cited
            with single study references. Second, the impression reading the
            text is that vaccines have effect against all outcomes when the evidence quoted refers to cases (or symptoms as we call them in this latest update of the review). Third, our review (which only includes RCT evidence of effectiveness) shows no effect on hospitalisations, CDC quote reference 125 which is a 2007 observational study. The CDC authors clearly do not weight interpretation by quality of the evidence, but quote anything that supports their theory.

          • Kevin November 5, 2013 / 4:49 pm

            plasmarules

            We all understand that you can copy and paste information. I have found your very same post on several other sites word for word.

            Please provide a source for your information. Nobody likes a plagerist.

            • plasmarules November 5, 2013 / 5:17 pm

              Kevin are you having trouble reading? The sources were posted in the initial post, you can find the PMID numbers, download the full texts and then take up the challenge I issued to Jason who asserts that Cochrane excluded all the studies that would have shown just how great the flu vaccine is at preventing transmission. Is it your first time on teh interwebz?

              It’s impossible you’ve found my same posts word for word on other sites because the parts of the posts that are mine are being typed out, not C&Pd. Sorry darling.

            • plasmarules November 5, 2013 / 5:24 pm

              Kevin do you understand that when one types “this is what Cochrane says about looking only at abstracts:” that given the subject of the conversation being the Cochrane reviews on flu vaccines logically the text that follows will be from said Cochrane full review text?

              Seems a quick Google search demonstrates that others can copy and paste from the same full text. Pretty obvious what the source is.

              http://www.beijing-kids.com/magazine/2010/10/18/The-Doc-Is-In-The-Flu-Files

          • Jason Dick November 5, 2013 / 6:05 pm

            So, your argument here is that the authors of the paper willfully misrepresented themselves by making their own abstract misleading?

            And the quoted response really has nothing whatsoever to do with my claim that the paper didn’t find any evidence of gain from vaccines for older people because the paper threw out a lot of evidence. The essential criticism of the Cochrane reviews is that they focus overly-much on randomized control trials which tend to be sparse due to ethical considerations.

            Your case on using Tom Jefferson as a source is also questionable, as he’s outed himself as a rather rabid anti-vaccine loon.

          • Kevin November 5, 2013 / 11:09 pm

            plasmarules it’s a matter of integrity. However, that being said I will apologize. You only copy and pasted the portions of a abstract/report without providing a link to the actual study/report, and you only copy and pasted portions of the article without providing a link to the article itself.

            Even though everyone else was able to link to the information they provided so others could read the entire content themselves.

            Also to be clear Beijing kids is not the source. There author says no such think. Rather it is one of the commentors who is picking random quotes from an article she has read. The organization itself actually says the exact opposite of what the commenter has stated.

            I also hope you understand why posting a single line than copying an article word for word and not providing a link to the source raise some red flags for people. It provides the impression that you have something to hide when you make them go hunting for the information that you have right in front of you.

          • Kevin November 5, 2013 / 11:50 pm

            For those of you who are interested here is a link to the actual report the Plasmarules is quoting. Sadly it’s being hosted by the whale.
            http://www.whale.to/v/2010+coch+adult.pdf

            Based upon my understanding of the conclusion it appears that the author has lumped in all types of flu vaccination, Including Aerosol ones together. (who on earth would include a new method like aerosol vaccines in such a study?)

            They noted significant things to take note of.
            “1. None of the live aerosol vaccines included in the review
            were registered. (aka they are not used)
            2. Methods of vaccine standardization have changed
            significantly.
            3. Recent vaccines present significant differences in purity
            when compared with older ones. (many of the studies cited are from 1970, 40+ years out of date, method and vaccine being used to draw conclusion on current vaccines?)
            4. Different doses and schedules were pooled in the analysis”

            Also from what I can tell the report is talking about overall flu vaccines most notable with the use of Aerosols and NOT talking about seasonal flu vaccines and there ability to stop the seasonal flu.

            the author T. Jefferson the same guy that was as noted is an anti-vaxin loon.

            and one of his major criticisms is that the studies he’s reading do not cite specific examples of working days saved or health costs differed and from that he seems to conclude that there not enough evidence in his randomized studies. (keep in mind this was a random selection, he did not search for studies that had results)

            The CDC quoted this review but in reality they should have been quoting a specific study as opposed to the review itself.

            Long story short as much as the author believed the CDC was misquoting it’s also pretty obvious that anti Vaxiers are also mis-quoting the study. Since the study seems to be more about about universal mass immunization as opposed the seasonal flu shot that we all currently get.
            (of course I’m not expert on the topic but that seems to be the focus of the discussion.)

            • Jennifer Raff November 7, 2013 / 9:25 am

              I swear that I will read the study in its entirety after I get done reviewing another one for work 🙂

  6. Kevin November 5, 2013 / 4:41 pm

    The CDC authors clearly do not weight interpretation by quality of the evidence, but quote anything that supports their theory.

    The pot calling the kettle black.

    • plasmarules November 5, 2013 / 4:47 pm

      Feel free to explain your comment, as it stands it has zero substance.

      • Kevin November 5, 2013 / 10:12 pm

        Sorry I thought it was a more common phrase. The pot calling the kettle black is a literary idiom.
        http://www.urbandictionary.com/define.php?term=pot+calling+the+kettle+black
        This is a phrase that states that the person you are talking to is calling you something that they themselves are (and generally in abundance)

        On many occasions you have supported and posted from anit-vaxer site while at the same time knowingly ignoring other more credible sources from across the globe and the rebuttals of other posters. Focusing only on information that agrees with you. For instance how you continually ignore morbidity stats and other information that disagrees with you.

        You have usually done so by copying and pasting large portions, when other posters have been able to explain and reference information in there own words showing how they understand the information. You on the other hand are just parroting what some site told you word for word. (I found the exact same wording on 20+ sites)

        In this case you continue to ignore what the researchers have said about the flue shot and the elderly. That it is the weakened immune system that has more cause than effect. Remember vaccines just teach the immune system, they do not replace it.
        You also forgot the researchers conclusion that that it doesn’t mean the shot is ineffective just that new strategies need to be worked out.
        http://www.nytimes.com/2008/09/02/health/02flu.html?_r=0

        for example There were also similar studies that show the best methods for limiting flue transition was to vaccinate school aged children since they had the strongest immune system and would benefit the most from the vaccine and thus be able to prevent the spread through the population.

        Of course this is something you would have known by dong a simple google search as opposed to running to your nearest anti-vaxier site so they could provide you the answer to cut and paste.

        • plasmarules November 6, 2013 / 8:31 am

          “More credible sources”, that’s a laugh, let me guess…credible by Wikipedia standards right? Repeaters, not reporters? Cochrane is not credible, but NY POST is, honestly?

          Tom Jefferson is now an antivax loon despite his children all being up to date on their vaccines because he questions the seasonal flu vaccine campaigns, is there no limits to the absurd when it comes to vaccine apologists like yourself? Clearly not.

          As for the FULL TEXT of the article, you have the PubMed IDs linked in the VERY FIRST POST I made, from there you can access the full text from the Wiley online library, sorry that I didn’t hold your hand, I didn’t think you needed to be an expert to know how to use PubMed.

          • Kevin November 6, 2013 / 12:39 pm

            Plasmarules
            With respect I NEVER said that Cochrane wasn’t credible. I said that the study has been misquoted and misused by people with an agenda. That it was a conclusion drawing mostly on information from outdated studies, with an inconsistent base and that its conclusions are more than a little vague. Something the actual report says fairly clearly if you have read it. Something that other users have already told you and you ignored them. So once again is the report wrong about itself or is your interpretation wrong? (it should be noted that there were several other authors besides your favorite one)

            As to the NY times. I Quoted the author of the study and there opinion of the results that clearly flies in the face of your interpretation of their results. Did the author misunderstand their own results or did you? I wasn’t quoting them for the study but rather the author.

            Because I will fully agree the seasonal flu shot is not as effective as other shots. I’ve done some research on it myself. That is a no brainer. To suggest it’s completely ineffective and everyone including the doctors who recommend it are all incompetent is more than a little farfetched.
            What I disagree with is your continued cherry picking of information and attempting to draw conclusions that the authors often do not agree with. You have done this many times in the previous vaccination thread and you were quickly rebutted by people who actually read the study that showed you that the study said no such thing. Meaning that either someone lied to you about the study or you are lying to us. I don’t think you are that evil but you are cherry picking information, misusing and purposely misinterpreting stats. Something users have pointed out to you many times only to have you copy and paste something again while ignoring/dismissing there actual rebuttal.

            You even continue to defend Wakefield. Despite the mountain of obvious evidence and motive against him. Instead of accepting that this obvious fraud occurred you’d rather dismiss all the evidence in favor of some imaginary conspiracy.

            What I’m saying is simple….. There is no conspiracy. There are just thousands of good hard working people out there doing good honest studies. And then there are people with an agenda that don’t fully understand the results, never read the actual study and who are looking for anything to prove that the very same people they are happily use when they agree with them are apparently inhuman monsters when they don’t.

            • plasmarules November 7, 2013 / 9:59 am

              Trying to find out where I said that the doctors recommending it are all incompetent. I don’t see that post, did I delete it? Doctors do what they’re taught to do, just like most people with jobs who went to school to learn how to do them do. You give out flu shots, that’s what you learn in school and that’s what you’re asked to do by pharmaceutical reps as well. You’re sad? You give out SSRIs. Got a sore throat? Here’s some antibiotics just in case. This is what you’re trained to do. If anything according to most educational institutions you’d be called incompetent if you did follow the science and stopped recommending flu shots.

              The report does say pretty clearly that the PREVIOUS outdated reports were widely misinterpreted by institutions that set vaccine policy and the 2010 amendments sought to correct that, they note as much in their comments about the CDC. And please, you can download the full text from Wiley, you don’t need to bandy about on Whale.to which is as bad as quoting from Orac like Jason has done.

              I’m quoting directly from the author’s conclusions in many cases, that there is no evidence flu vaccines prevent transmission or affect complications, hence Jennifer’s opening statement that she is protecting her community is not very accurate. If you base your opinions off a single study you can probably make any assertion, which is why the Cochrane report is a vital tool due to how many studies it combed through. You don’t honestly think, like Jason does, that Cochrane’s team got together and said, “let’s comb through and find all the studies that support seasonal flu vaccine’s effectiveness and throw them out regardless of the veracity of the science” do you, because that’s the line that Jason has clearly taken.

          • Jason Dick November 6, 2013 / 12:53 pm

            Here’s a blog post showing where Tom Jefferson has essentially outed himself as an anti-vaccine loon:
            http://scienceblogs.com/insolence/2013/01/25/cochranes-tom-jefferson-on-gary-null-show/

            Now, to be fair, he’s far less of a loon than many of the crackpots out there (and certainly less than Gary Null, whose show he appeared on). But it’s clear that his views are rather divorced from the evidence, and the fact that the conclusions of the Cochrane papers divorce so wildly from their contents is a manifestation of that.

            • plasmarules November 7, 2013 / 9:52 am

              Jennifer’s rather predictable response aside, did you read Gorski’s rant? I did, reluctantly though as his offal is usually vomit-inducing in how off topic it gets even in the best of cases and the multi-million dollar pharmaceutical chair he sits on is always on the back of my mind. However he takes more exception to Jefferson calling pregnant women healthy than addressing anything to do with the Cochrane’s various reports, that you find that some sort of rebuttal when you were quested with explaining which studies Cochrane deliberately dismissed for demonstrating flu vaccines are either effective in the elderly, prevent complications or prevent transmission is quite telling of whether you’re capable or not of continuing this conversation.

              Again, you made the statement that Cochrane deliberately excluded studies which you feel are examples of good scientific methodology that would demonstrate that flu vaccines prevent transmission and complications, will you be forthcoming with several examples? As stated, all the studies they excluded are listed in the full text which you can download from Wiley’s online library…you don’t have to go to Whale.to and get a migraine in the process from the awful formatting of that website to access the full study.

              We wait with baited breath.

          • Jason Dick November 7, 2013 / 12:29 pm

            Only randomized control trials were considered in the review. Most studies on flu vaccine efficacy are not RCT’s for ethical reasons, as I explained previously. So while their findings of the efficacy of the flu vaccine for prime-age adults are reasonable, any conclusions about a lack of evidence for older adults are not reasonable. And I’ve already pointed out a review that showed a significant reduction in heart attacks among those who take the flu vaccine. This review was primarily among older people (average age was 67). Here’s the link again:

            http://www.health.harvard.edu/blog/flu-shot-linked-to-lower-heart-attack-stroke-risk-201310236795

            • plasmarules November 7, 2013 / 1:01 pm

              And I’ve already pointed out how utterly ridiculous that study’s conclusions were to begin with. As Jefferson explains to TIME magazine – We looked at studies on vaccines in the elderly and in health care workers who work with the elderly, and we found an implausible sequence of results. We have studies that claim up to 90% effectiveness against death from all causes [in inoculated patients compared with the nonvaccinated]. If you were to believe that evidence, you would believe that flu vaccine is effective against death not only from influenza, but also from heart attack, stroke, hypothermia, accidents and all other common causes of death among the elderly. That is quite clearly nonsense.

          • Jason Dick November 7, 2013 / 1:07 pm

            You know, it helps to not make shit up when trying to take down a study. That study only looked at cardiac events, and found an effectiveness well within reasonable levels. Yes, the flu vaccine can reasonably protect against cardiac arrest in some patients because the flu is one significant cause of cardiac arrest.

            • plasmarules November 7, 2013 / 1:10 pm

              Complete and utter bollocks.

            • plasmarules November 7, 2013 / 1:11 pm

              Those getting flu vaccines are less likely to die in car crashes too! There’s a whole host of idiotic things you can conclude when looking at studies.

          • Jason Dick November 7, 2013 / 1:12 pm

            This would be known as “poisoning the well”. The studies mentioned have nothing whatsoever to do with car crashes.

            • plasmarules November 7, 2013 / 1:43 pm

              You gleefully miss the point, but that’s not unusual for one of Orac’s minions.

  7. gewisn November 6, 2013 / 9:13 pm

    I’m actually finding this whole discussion helpful.
    Let me be clear: I got the vaccine and I recommend it to my patients. However, I do think physicians (and lots of other professions) tend to accept some questions as “settled” long before they really are. And the science should never stop. “The best evidence we’ve got” is sometimes pretty thin. And the rejoinder that “everybody knows,” should be a read as, “we’re fairly sure, but honestly, we have stopped looking.”
    Physicians become so comfortable making decisions based on partial evidence, that sometimes we forget that the margin of the evidence for or against something is much thinner than anyone would like. And sometimes that margin in flipped when we choose to look a question from a different angle, using the same evidence. Other times we become suckered into thinking an answer is clear just because we see the same bad evidence presented over and over.

    So, thank you all for this discussion and the reminder that the amount we don’t know is almost always enormously greater than what we do know.

  8. LabRat001 November 8, 2013 / 6:48 am

    “plasmarules
    November 7, 2013 at 1:10 pm
    Complete and utter bollocks.”

    How to lose the scientific discussion 101

  9. Josh November 16, 2013 / 7:49 am

    I have not read all replies to this so it may have been asked. What about relying too heavily on vaccines to bolster our immune systems and not just letting nature build up antibodies by itself? Can’t flu vaccines and things like antibiotics ultimately weaken our ability to fight sickness?

    • Jason Dick November 16, 2013 / 10:37 am

      The only thing that vaccines do is present the immune system with something to build a defense against. They are ineffective if the person’s immune system isn’t robust.

      Antibiotics, on the other hand, directly kill the organisms in question, and thus work whether or not the person’s immune system is robust. You might think that this could potentially pose a problem down the road, as more people survive with weaker immune systems.

      But that will take centuries, and there is a much more pressing problem right now: the evolution of antibiotic resistance. Over-use of antibiotics leads to more and more bacteria developing resistance to them. And as bacteria pass their genes around quite frequently to other bacteria, this problem compounds over time. We are running out of useful antibiotics, and are not developing new ones fast enough to keep up. If we don’t shape up and start using antibiotics responsibly, we’re not going to have any useful antibiotics left in a few decades.

      • plasmarules November 18, 2013 / 9:18 am

        “The only thing that vaccines do is present the immune system with something to build a defense against.”

        Seems the vaccines in India are doing much more than that, responsible for over 100,000 cases of non-polio acute flaccid paralysis over the last 2 years, 47,500 in 2011 and over 60,000 in 2012. (PMID 22591873)

        And yes we need to start using antibiotics responsibly, but there has been no single factor more responsible for the current situation than the industrial farming chain, unlikely you’ll see something like this investigated on this pro-GMO blog.

        • Jason Dick November 18, 2013 / 1:13 pm

          Well, that’s a rather special case. You can read some more detail here:
          http://www.cdc.gov/vaccines/vpd-vac/polio/dis-faqs.htm

          What happens with the oral Polio vaccine is that it makes use of a live attenuated virus. Every once in a while, this virus mutates to actually start causing the Polio disease again (the injected vaccine doesn’t have this issue).

          So if you have low vaccine coverage and use the oral Polio vaccine, you may end up with a situation where in some vaccinated individuals the virus mutates to a disease-causing form. The vaccinated individuals are unlikely to have problems, because it takes time for the virus to mutate and their immune systems have strong head start, but others nearby who aren’t vaccinated may suffer.

          Thus the answer is to either:
          a) Use the injected form, or
          b) Make sure that your immunization has high coverage.

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