Swine Flu--Vaccine Efficacy

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This lengthy Atlantic article outlining the views of flu-vaccine skeptics provides much food for thought:

This is the curious state of debate about the government's two main weapons in the fight against pandemic flu. At first, government officials declare that both vaccines and drugs are effective. When faced with contrary evidence, the adherents acknowledge that the science is not as crisp as they might wish. Then, in response to calls for placebo-controlled trials, which would provide clear results one way or the other, the proponents say such studies would deprive patients of vaccines and drugs that have already been deemed effective. "We can't just let people die," says Cox...

In the absence of such evidence, we are left with two possibilities. One is that flu vaccine is in fact highly beneficial, or at least helpful. Solid evidence to that effect would encourage more citizens--and particularly more health professionals--to get their shots and prevent the flu's spread. As it stands, more than 50 percent of health-care workers say they do not intend to get vaccinated for swine flu and don't routinely get their shots for seasonal flu, in part because many of them doubt the vaccines' efficacy. The other possibility, of course, is that we're relying heavily on vaccines and antivirals that simply don't work, or don't work as well as we believe. And as a result, we may be neglecting other, proven measures that could minimize the death rate during pandemics.

I added the italics there. the next time somebody hates on you for not getting the flu vaccine, mention to them that more than 50% of medical professionals agree with you.

Oh and also, relying on vaccines ad Tamiflu probably makes the situation worse because we don't emphasize proven preventative measures enough:

"Vaccines give us a false sense of security," says Sumit Majumdar. "When you have a strategy that [everybody thinks] reduces death by 50 percent, it's pretty hard to invest resources to come up with better remedies." For instance, health departments in every state are responsible for submitting plans to the CDC for educating the public, in the event of a serious pandemic, about hand-washing and "social distancing" (voluntary quarantines, school closings, and even enforcement of mandatory quarantines to keep infected people in their homes). Putting these plans into action will require considerable coordination among government officials, the media, and health-care workers--and widespread buy-in from the public. Yet little discussion has appeared in the press to help people understand the measures they can take to best protect themselves during a flu outbreak--other than vaccination and antivirals.

"Launched early enough and continued long enough, social distancing can blunt the impact of a pandemic," says Howard Markel, a pediatrician and historian of medicine at the University of Michigan. Washing hands diligently, avoiding public places during an outbreak, and having a supply of canned goods and water on hand are sound defenses, he says. Such steps could be highly effective in helping to slow the spread of the virus. In Mexico, for instance, where the first swine flu cases were identified in March, the government launched an aggressive program to get people to wash their hands and exhorted those who were sick to stay home and effectively quarantine themselves. In the United Kingdom, the national health department is promoting a "buddy" program, encouraging citizens to find a friend or neighbor willing to deliver food and medicine so people who fall ill can stay home.

In the U.S., by contrast, our reliance on vaccination may have the opposite effect: breeding feelings of invulnerability, and leading some people to ignore simple measures like better-than-normal hygiene, staying away from those who are sick, and staying home when they feel ill. Likewise, our encouragement of early treatment with antiviral drugs will likely lead many people to show up at the hospital at first sniffle. "There's no worse place to go than the hospital during flu season," says Majumdar. Those who don't have the flu are more likely to catch it there, and those who do will spread it around, he says. "But we don't tell people this."

All of which leaves open the question of what people should do when faced with a decision about whether to get themselves and their families vaccinated. There is little immediate danger from getting a seasonal flu shot, aside from a sore arm and mild flu-like symptoms. The safety of the swine flu vaccine remains to be seen. In the absence of better evidence, vaccines and antivirals must be viewed as only partial and uncertain defenses against the flu. And they may be mere talismans. By being afraid to do the proper studies now, we may be condemning ourselves to using treatments based on illusion and faith rather than sound science.

I didn't even quote the part where the man who knows more about flu vaccine research than anybody in the world says we have no clue whether vaccines make a difference.

It's important to note that these authors have no quarrel with vaccines in general, and readily admit the vaccines are effective in combating diseases such as polio.

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Our culture and our economy are built on centralization. We take folks from homes throughout a region and send all the adults each day into office buildings or large stores together and all the kids into school buildings together, then send them back home at the end of the day.

If you think about it, this is about the worst thing you could do if what you are going for is limiting the spread of infectious disease.

So we rely on vaccines and other medicines to prevent and treat illness and epidemic.

What bugs me is that we act as if we don't have a choice. When this whole thing started out, we could have seriously stunted the progress of the disease by sending kids under 10 home. Closing colleges for a month, that sort of thing. Now, maybe the way our country is set up that would have been a huge burden, and maybe we would choose not to do that, fine. But it chaps me that people act as if immunization is the only way to combat disease.

Our school has a rule -- no coming to school if you are throwing up or have a fever over 100. This does absolutely nothing to stop the spread of swine flu, or much of anything else. But they'll be pushing the vaccine on us, even though most of the kids at the school have already had swine flu at this point.

Thanks for the post, I'll be using the Atlantic next time someone calls me a dangerous nut for questioning the CDC.


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This page contains a single entry by Papa-Lu published on November 1, 2009 9:55 PM.

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