Tracking the next pandemic: Avian Flu Talk |
Flu Jab Mandatory For Some Medical Staff in NSW |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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Posted: March 24 2018 at 6:18pm |
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The weird thing about TB (st least the old strains) is how many people DON'T get it. Only about 10% of those who catch it go on to develop it. Without genetic succeptability, malnutrition, co-infection or co-morbidities it goes nowhere. The rise of HIV has been very instrumental in its massive return.
Before antibiotic multitherapy, about a third of sufferers recovered - if well fed, exposed to lots of sunshine and fresh air and given sufficient rest. For the poor, who had no such luxuries of course, there was absolutely no hope. The "sunsine" bit makes me think that deficiency of vitamin D was one of the big factors in those who recovered. That and a tendency to scarring - which aids in the development of fibroses - which themselves walled of the infection. We were never poor throughout my childhood, but my mother almost never went outside and ate a very restricted diet: all by her own choice. I on the other hand, almost lived outside and frequently ate at my best friends house. My mum and I were probably exposed at the same time, visiting her relatives in Ireland; trips which my father never came on. I suspect that was why only she became ill. |
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carbon20
Moderator Joined: April 08 2006 Location: West Australia Status: Offline Points: 65816 |
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My father in law had TB and was in a sanaterium for months,his family,could only visit once a month and see him from outside the wire....
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Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.🖖
Marcus Aurelius |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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My conclusion is identical for the opposite reasons.................
My Mum was an anti-vaxer* As such she actually had TB and had to undergo months and months of treatment. Still she would not have vaccinated me, social services intervened in the end. Well, I escaped TB, but I have vivid memories of having chicken pox, post-flu-severe-bronchitis and, most especially, measles. I would not wish that on my greatest enemy. * Alongside other strange ideas like teaching me to smoke - I was 8. I finally gave up in my 30s just before my first pregnancy, or feeding me oranges for about 6 months - JUST ORANGES - nothing else. I could go on........ and on............. and on.............. and on............ |
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carbon20
Moderator Joined: April 08 2006 Location: West Australia Status: Offline Points: 65816 |
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its easy ,if you dont thinK getting vaccinated does not work,
then dont get vaccinated, and take the risk,
i had a flu at christmas 2016, 3 people at work also got it , it was the 3rd time in my life i had a "REAL FLU" not just a "bad cold", i dont want it again i was flat out for a week ,could not open a can of beans, took me 3+ weeks to recover, i had my first flu shot in 2017 ,because at 60yrs i dont want it again so get the shot even if it is on 20% effective............. when i was born vaccination was a very new thing , not flu ,( for measels, dipthiria etc.....) my MOM was first in line....... THANKS MOM!!!!! .......................... |
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Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.🖖
Marcus Aurelius |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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I hear you FluMom.
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How do you tell if a politician is lying?
His lips or pen are moving. |
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Look just do your best. My doc's nurse last week said she had the shot and just got back from 3 weeks from having the flu. I get the shot and I feel like I have done my best. If I get the flu well I still I believe I did my best.
You all argue about stuff that does not matter. Do what you want and others do the same. No one is right or wrong! |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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Have you got a link to any of this? It completely contradicts all of the stuff I have learned.
Finally:
I personally believe that vaccinating the patient is also proveably in their best interest, although that was not my original argument and I concede it to be more controversial, hence all the quotes from the CDC. |
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DeepThinker
V.I.P. Member Joined: September 26 2015 Location: So. California Status: Offline Points: 3245 |
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Many of the studies show higher mortality among the vaccinated. They explain it away as "selection bias". Those more likely to die are also more likely to get the vaccine... one doesn't cause the other. I remember seeing another showing childhood asthmatics did worse after receiving the jab... it was also explained away. Also famous Canadian study showed those that got the swine flu shot did worse than those who didn't. To show a benefit to the shot you have to resort to very convoluted complex statistical mathematics. I just hope you understand why a common man like myself might be skeptical.
"But it would be unethical to study it because we know it works" Don't you see circular reasoning in that argument? Particularly in light of the fact that most of the research out there isn't great. Look I don't currently take the shot but in the name of science I would volunteer for a double blind study.... Does this solve the ethical dilemma? First do no harm... to me that means NOT giving something unless you are certain it is in the patients best interest. |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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I did as you suggested. I often visit CDC information and education sites/publivations but this was my first flu vaccine search. You are right - it is fascinating. After a few minutes surfing, several interesting points were obvious, The first and most relevant is that randomised trials are not usually undertaken.
"What!" I cried: "That is nuts!" But, there was a good reason. The vast body of other types of research and the historical records of actual randomised trials long ago* make research of that type unethical. They know it prevents deaths, hospitaizations and a host of permanent damage so witholding the vaccine deliberately is not morally an option. Meta analysis is common though. This little essay is pretty informative, even more for the links it contains than for itself: https://www.cdc.gov/flu/about/qa/vaccineeffect.htm It shows where the CDC gets its information and lists a samples of its sources at https://www.cdc.gov/flu/about/qa/benefit-publications.html , https://www.cdc.gov/flu/about/qa/publications.htm and https://www.cdc.gov/flu/professionals/vaccination/effectiveness-studies.htm. There appear to be slightly more statistics available on the deaths of young children. https://www.reuters.com/article/us-usa-flu-cdc/u-s-cdc-director-urges-flu-vaccinations-as-pediatric-deaths-mount-idUSKBN1FB36O is not a study, but the results of several; put into action, as is this CDC leaflet which quotes the statistics https://www.cdc.gov/flu/pdf/freeresources/general/why-get-flu-vaccine.pdf. Sadly, it does not list its scientific sources. So this one I found is a bit more specific: https://www.cdc.gov/media/releases/2017/p0403-flu-vaccine.html . The reason for the difference in statiscs may have something to do with the age of the very imune systems under study. The young ones are fairly blank waiting to "be written on", while the old are both "Written all over" and failing overall, as this Oxford study found: https://academic.oup.com/aje/article/170/5/650/102527 . (They had the same morality issues, but found a way round them.) Although they concluded a drop in mortality came from vaccination of the subject, as the age of patient rose, the effectiveness dropped. Herd immunity still applied of course. The whole area of this type of research appears to be a minefield. Meta analysis of everything from death certificates to doctor's appointments clearly show the flu jab saves lives and many of them and a great deal of associated mysery too, but randomised trials and peer reviewed stuff are conspicuous by their absence, as are precise figures. Long term repeated vaccine use seems to be even more controversial - with different studies making diametrically opposed claims! To be honest on this last point, it appears that accumulated flu vaccinations increase overall immunity, but not by enough to take the figures outside the "margain for error" range. I am afraid, for now, we will have to settle for meta analysis. At least the figures behind that are colossal and so may be reasonably relied upon; even if they fail to satisfy the hunger for cosy, scientific randomised trialling. -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- *Long ago in flu research, not permian or triassic. I include one more essay here. Once again it is not a peer reviewed journal entry. I put it in simply because I liked it: https://www.nytimes.com/2018/01/15/upshot/flu-shot-deaths-herd-immunity.html |
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How do you tell if a politician is lying?
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DeepThinker
V.I.P. Member Joined: September 26 2015 Location: So. California Status: Offline Points: 3245 |
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I think you would find it fascinating to actually look at the research that the cdc does. It is strange complex statistical analysis that really doesn't show what I would like. I will repeat it again... we have virtually NO research to show that the flu vaccine reduces sick days/hospitalizations/mortality. |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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I thought those results were the basis of the % effecxtiveness published for each years vaccine.
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DeepThinker
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Very simple question... why can't I hear something like this "In 2015 those that received the flu vaccine had this rate of illness and those that didn't that?"
The research wouldn't be hard. |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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No no the difference is not trivial at all, but does not affect the effect on the eppidemiology. It is the epidemiology which affects the patient-carer relationship.
I also know the difference between the effects of the vaccine ,which do hang around and the vaccine itself which is gone in a few days. If the vaccine's effects did not hang around we would need to vaccinate every few days. You are right that in a normal season flu is not a particularly big risk - for the healthy, but that is not the case for the medically vulnerable. Hence the "moral duty" bit for healthcare workers. They have a choice whether or not to get the jab and take or not take the risk. But, the patient does not have a choice in whether or not they are sick and extra vulnerable to the flu. I believe the hypocratic oath starts with "First do no harm" and giving a patient flu when they came for aid is an obvious harm. Pneumonia is the big killer in many patient groups, but it most commonly follows the drop in effective immunity caused by a dose of the flu. Pneumonia causing bacteria are around us all the time; waiting for a first wave attack from another agent, like flu, to make a foothold in the body for them. Many death certificates mention pneumonia, but not the flu whick let it in. That was how my father died. Pneumonia also took my mum, but it was following surgery. Both were in care homes at the time. I do not know of California's drug reporting system. Here in Britain Paper copies of the pharmacopia have yellow reporting cards in the back for reporting adverse effects. When the majority of this went online, the online system included a virtual equivalent. This serves the long term effects study, at least in part. Most of the ingredients in the flu jab (other than the specific antigens) have undergone massive and extensive tests, although I can see a flaw in the system as the people doing the testing have vested interests. As for the antigens themselves, there is simply no time each year. Each flu season, an educated guestimate is made about which strains are most likely to circulate. Those guesses cover us against the most likely and the most nasty candidates, although not all. It is still somewhat of a lottery, you are right there, but the odds of catching (and for the purpose of this discussion spreading) the nastiest killers are dramatically shortened, resulting in fewer avoidable deaths. Primum non nocere. |
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How do you tell if a politician is lying?
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DeepThinker
V.I.P. Member Joined: September 26 2015 Location: So. California Status: Offline Points: 3245 |
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What kind of work do you do? I work in 177 bed long term care/post acute/rehab facility. This flu season hasn't been that hard on our patients/residents, it seems the staff was more affected. I keep hearing "but I got the shot why am I sick?". It seemed this year those that got the shot tended to get more sick than those that didn't. Last year was worse for respiratory illnesses for us. We had at least 4 or 5 waves of illness that started in November and lasted till may some got sick every time. '15-16 was MUCH MUCH worse. I remember the week before Christmas we were placing 2-3 people a night on oxygen on just my hall of 24. Probably 75 or 80 percent of the residents where affected many very severely. It was also the last time I was sick enough to miss work. I find it odd that I got sick almost 2 weeks after first caring for sick people, so either the incubation period for flu can very greatly or I was able to actually avoid being exposed for quite a while working all around it. We keep hearing about the great number of people over 65 that die of the flu.... I think most are just pneumonia and not flu related. Sad to say but those that the flu does take... most are ready to go. We all have to die from something. So many people come and go through our facility ever day... at least 100 outside vendors and likely just as many visitors. Even if you could get 100% vaccine compliance among the staff I doubt it would make a big difference. Also it was strange this year was the first time we ever had a diagnosed flu patient. We had to be in-serviced and made a big deal about it, while at the time most of the staff and most of the patients had probably already been exposed. But because it it is diagnosed you have to take it seriously. |
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DeepThinker
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You act as though that is a trivial difference. This is entire crux of my argument. We vaccinate for an accidental quality of the virus and not its fundamental quality. If there was a universal flu vaccine I would seriously consider it. However I have very serious doubts if it is even possible. We keep hearing that it is only a few years away. I have been hearing that my entire adult life. IMO if it was possible for our immune system to gain immunity from all flu viruses I think it would have already happened through evolution.
So do you think that the vaccine and effects of the vaccine are also gone from your system "in a week or two" like the virus is? If the vaccine did prevent some flu infections but also caused long term effects would it be worth it for a virus that will be gone soon anyways? Virtually every medical procedure/medicine/equipment has to be tested over a very long period of time before use, why not the same for flu vaccines? While I know you can't do all this testing before releasing the vaccine you can still do it after the vaccine was given. I feel as though my objections are being addressed as if they come from a place of ignorance, when in fact the more I study the more questions I have, not the other way around. I also don't like being tossed in with all the other "antivax nuts" when I am objecting to a very specific vaccine not all of them. In every case it is a risk vs reward equation. IMO normal seasonal flu is not a huge risk. When actually looked at and counted only a few thousand people a year die in this country, and the vaccines effectiveness is questionable at best. While on the other hand the risks of the flu vaccine,particularly long term risks are mostly unknown. I am not disputing or disagreeing with science, I am just asking for more of it to be done. Why does this all feel like "the emperor has no clothes". |
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jacksdad
Executive Admin Joined: September 08 2007 Location: San Diego Status: Offline Points: 47251 |
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An AFT thread stay completely on topic? I would say that I eagerly await the day, but in truth I like the way we cover more ground than a topic title might suggest. It's what often separates us from the more heavily moderated sites.
Hachi - we have to either get the shot or wear a mask for the duration of the flu season, and we require our patients to do the same. |
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"Buy it cheap. Stack it deep"
"Any community that fails to prepare, with the expectation that the federal government will come to the rescue, will be tragically wrong." Michael Leavitt, HHS Secretary. |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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I'm sorry, Deep thinker; I did not realise the connection was not obvious. I might understand it, but I will never make a teacher. The first class would lynch me for being too cryptic.
Epidemiologically, the flu is just another disease. It follows the same biological rules. The only difference between flu and most of the rest, is that flu is a master of disguise. The "working parts" of the flu virus stay pretty much the same, but it has a "coat" of haemagglutinin molecular protrusions which cover its surface. That "coat" is the bit our immune system learns to recognise. The flu keeps evolving a new coat. A bit like an enemy agent changing his coat and hat in the train station so our spies lose track of him. Each time a new strain of flu emerges from the evolutionary remix, we have to re-learn the colour of his coat* As vaccination is designed to teach our immune sysytems to recognise this coat, the vaccine has to change each year. Like the Radio broadcast: "Attention all personnel: Agent X is wearing a tweed hat and blue fedora now." This is expected to change in a short few years as several scientific teams are working on ways of recognising the "spy" by his "shoes". For now, we still have to run to keep up. REFRENCES *http://www.virology.ws/2009/04/30/structure-of-influenza-virus/ and PDF https://ecdc.europa.eu/sites/portal/files/media/en/press/Press Releases/071012_PR_SI_Prof_Fact_Sheet.pdf |
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How do you tell if a politician is lying?
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DeepThinker
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Technophobe I don't understand why you keep bringing up stories involving other diseases. With most all you need is a single shot or a short series of immunizations and you are done for life. We have good evidence they work and a fair amount of safety data. With flu you are asking me to be vaccinated EVERY year and we have none of the research data we need to make an informed decision.
This is the research that I want to see. Follow three groups of people for 5-10 years. One group will be people that never receive the flu shot, one group infrequently receives and a group that always receives. Simply compare their respiratory illness rates, and look at any other health related patterns that might emerge. Hell I would be ecstatic if they even did this for ONE season. Why would this type of research be considered controversial? |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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Toddler dies of diphtheria after parents refused to vaccinate her against disease
Saturday, 17 Mar 2018 “The only reason we are seeing diphtheria
cases is not because vaccine has failed, but because parents do not want
their children to take the vaccine,” he said. Source and full story: https://www.thestar.com.my/news/nation/2018/03/17/fear-and-superstition-prove-deadly-toddler-dies-of-diphtheria-after-parents-refused-to-vaccinate-her/ |
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Penham
Chief Moderator Moderator Joined: February 09 2006 Location: United States Status: Offline Points: 14913 |
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I am one of those that are very happy they require health care workers to get the flu vaccine. I have asthma and if there is ANY chance of it reducing the opportunity of a health care worker spreading whatever it is they are exposed to while treating patient after patient after patient that has "who knows what" then I am all for it.
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carbon20
Moderator Joined: April 08 2006 Location: West Australia Status: Offline Points: 65816 |
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Sorry, Aussie plain language......
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Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.🖖
Marcus Aurelius |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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I am not sure I would put it quite so strongly, Carbon, but we are definitely on the same page. How about misinformed?
Upon which subject, I posted this just now http://www.avianflutalk.com/topic37116_post269301.html#269301 and may I draw attention tp the following part of the article: " Soriano said five people, aged between 4 and 23, had died. None of the fatalities, however, was a recipient of the controversial vaccine Dengvaxia, which was used in the national government dengue immunization program starting 2016." |
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How do you tell if a politician is lying?
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carbon20
Moderator Joined: April 08 2006 Location: West Australia Status: Offline Points: 65816 |
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children here are not allowed to go to school if they not been Vaccinated,
antivaxers are DUMB.............................. |
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Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.🖖
Marcus Aurelius |
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Technophobe
Assistant Admin Joined: January 16 2014 Location: Scotland Status: Offline Points: 88450 |
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No. Longitudinal studies are controversial and most often applied to sociological science or psychology. They are probably not the best method in this case, at least not for effectiveness. What would be the point? The flu is gone in a week or two.
As regards safety, that is aother matter. I suspect a longitudinal study would have some merit here. I have nothing to go on except the pharmaceutical companies' own studies - and they have a vested interest. However, should really nasty stuff emerge over time, it would eventually come to light, wether they wanted it to or not, via the drug reaction reporting system, which takes the place of/functions as a longitudinal study. The only exception to that would be if the really nasty stuff was incredibly rare. Then it might not be linked to its actual cause. In that case, it is still a far better set of odds and my conclusion remains the same. I believe there was a fatality from the flu jab this year; yet THOUSANDS die of the flu every year, even when the circulating strain is a mild one. It is possible that the measles jab has improved. I have not necessarily spotted all medicine's updates. It was 80% when the studies I quoted were done; that is where the statistical science springs from and therefore remains the relevant figure to this discussion and the epidemiological conclusions/models. |
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DeepThinker
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As far as I understand the measles shot can be up to 97% effective but because it is so contagious ou can still have outbreaks. If it was only 80% it wouldn't even be that useful. The best that the flu vaccine is 40-50%.
Doesn't it bother you that the flu vaccine has NEVER been shown to be effective with a longitudinal study? It does me. |
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Technophobe
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I took the coursera course listed in my post. (Two+ years ago, but I am still boasting about my 100% score!) A detailed epidemiological study of several diseases was included in one week's course module. Among these was a study of measles
Opinions on the Ro of measles vary but the average figure is about 16 (By comparison, flu has an Ro of 1-3 depending on strain.) Measles vaccine has an effectiveness of around 80%. Those measles figures, along with anti-vaccine campaigns, make it a wonderful study (scientifically wonderful only, it still kills occasionally and often maims.) With vaccination the Ro effectively drops to around 3 (flu's worst figure) and as the number of infected in a community either die or recover (neither of whom can spread the disease anymore) The effective Ro drops slowly below the magic Ro1 number and the outbreak ends. (Any disease with an Ro below 1 is self-limiting.) This model is universally applicable and has been repeatedly tested and proven in the field. I have lost count of the number of studies there are which apply the calculations - there are computer programmes which use it and even a couple of games. True, flu is not completely understood*, also true that the vaccine varies in effectiveness, but neither of those facts alter the epidemiological effects to any great degree. Vaccination is scientifically proven. People merely confuse a few unique results (6 sigma and above if you study probability, or mathematical modelling) with the statistical certanties. It is also true that vaccination has its down side. Mercury preservatives (rarer now thankfully) alergic reactions (which are a variation on what the vaccine is designed to do) and the mild symptoms (which make some ill-educated twits think they have been given the flu) all put people off. Although the very worst of these are colossally milder than the mildest case of the disease itself. Frankly, members of the public are entitled to any opinion they wish. It would be universally good if vaccine uptake rates rose, but free will is precious too. However, when it comes to health care workers, they should know better. They should have a basic understanding of the science at least and their patients are often utterly dependant upon them. This is a moral obligation. If they do not care about the health, suffering or very lives of their patients they should get anoter job. * That applies to everything in the universe. Chemically, epidemiologically and biologically we have the nasty s*d's full profile. |
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How do you tell if a politician is lying?
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hachiban08
Senior Moderator Joined: December 06 2007 Location: California, USA Status: Offline Points: 15627 |
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Kaiser Permanente in Orange County, California doesn't force the flu shot on health care workers from my understanding, but if you choose to not get it, you are required to wear a mask for the whole flu season, per my physical therapist.
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Be prepared! It may be time....^_^v
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DeepThinker
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Yes I understand basic epidemiology at least to the degree you would expect from a well informed curious lay person. My question seemed so simple and basic and the answer seems so straightforward that it seems absurd that I would even ask it. However flu is a superbug with strange qualities that we really don't understand.
The flu Vaccine's efficacy has never been proven through a longitudinal study. If you doubt me find ONE study that shows the vaccine reduces sick days, reduces hospitalizations, or mortality. For the sake of argument lets say the vaccine does work to some degree. Even if you could prove that you wouldn't know for sure if it would reduce healthcare acquired infections. If I am truly sick with the flu I am staying home. I am probably not even capable of work. But if I got the vaccine and now I have a sub clinical flu infection I might feel a little under the weather but I am going into work. So if the vaccine does cause more sub clinical cases, it might make hospital acquired infections worse. Superspreaders.... do you have any evidence that flu vaccines effect the occurrence rate of superspreaders within a population? I find the whole subject of superspreaders to be fascinating and would love to read info on the flu. Except as in the cases of novel flu viruses I really don't think healthcareworkers are the nexus. Flu is primarily a community disease. If in an imaginary world you closed down all the hospitals, many diseases would just go away. They only thrive in the hospitals. However I doubt you would see any meaningful change in flu rates in a community. Forcing healthcareworkers to get flu shots is a very controversial subject. It seems as though officials would want to do the kind of research that I asked for just to back u p their policy decisions. It is hard to argue with science.... I want to see it. |
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Technophobe
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VERY basic eppidemiology. Healthcare workers are nexuses (nexii? I have no idea what the plural of nexus is). To contain or limit the spread of anything, they are the first step. Unvaccinated, they make most superspreaders look tame. Worse, those they spread to have a higher death rate from the damn bug.
Refrences: Just a few - I lost count of how many there are. https:///www.ncbi.nlm.nih.gov/pmc/articles/PMC5383605/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945728/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775324/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021207/ 'And most importantly: https://www.coursera.org/learn/epidemics where I learnt the basics. (Thanks again Rickster) |
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How do you tell if a politician is lying?
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DeepThinker
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Just currious... do we have any actual scientific evidence that vaccinating healthcare workers reduces flu illness in those they care for. It is very difficult to prove that vaccinating reduces illness just in those vaccinated. I would love to see a study.(not holding my breath because I know it won't happen)
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Technophobe
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I am delighted to see common sense/good science being demonstrated in Australia. For those who object on "personal freedom" grounds, the alternative is permanent mask wearing whilst on duty. (Quite appart from the freedom of the very seriously sick not to have their lives put at risk!)
Source and full article: https://www.smh.com.au/national/nsw/flu-shots-nsw-medical-high-risk-wards-20180313-p4z447.html |
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How do you tell if a politician is lying?
His lips or pen are moving. |
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