Influenza still kills

I realize that everyone, is looking forward to my deconstruction of Mike Adams' quacktacular attempt at being a real scientist (well, some of you, anyway). I must confess, though. I was a bit disappointed. And, being like Dug the Dog (a comparison I so frequently make), my attention was easily distracted. I'm sure I'll get back to Mikey eventually, but he really did show such a lack of imagination in his "big announcement" that I'm actually having a hard time motivating myself to apply any "Insolence" to it. It just doesn't seem worthy of the effort it would take, at least not right now.

In the meantime, people are dying of the flu.

The flu vaccine is one of the two vaccines most easily demonized by the antivaccine movement. The first, of course, is Gardasil (or Cervarix), the vaccine against HPV. The reason why Gardasil is so easily demonized is because it protects against an infection whose end result of cancer is many years in the future. Alt-med fans frequently castigate "conventional medicine" for not emphasizing prevention enough, but HPV vaccines put the lie to that. HPV vaccines protect against an infection that is usually fairly harmless in and of itself but has the long term effect of vastly increasing the risk of at least one potentially deadly cancer, and likely several others. Also, HPV infections are commonly sexually transmitted, allowing the moralistic wing of the antivaccine movement and misguided religious people in essence to "slut shame" the vaccine by inferring that it will encourage promiscuity by removing one of the consequences. That is, of course, one of the stupidest arguments against the HPV in existence. (Seriously, does anyone think teens worry about maybe getting cancer 20 years down the road when their hormones are raging?)

The flu vaccine, of course, is the victim of the difficulty in targeting the vaccine to the strains of flu that circulate yearly, rendering the flu vaccine of variable effectiveness from year to year. When health officials guess right and target a year's flu vaccine correctly against the strains of flu that circulate that year, the vaccine is quite effective. When they don't guess right, not so much. Unfortunately, the design of a universal flu vaccine is very difficult and introducing one into the market is still likely still at least a few years off. There's also the widespread mistaken conflation of flu-like illnesses and colds with the actual flu. The actual flu is a bad actor. The last time I had it, which was, not so surprisingly, the last time I was too lazy to get the yearly flu vaccine, it knocked me on my ass for over a week. I truly thought I was in danger of dying: high fever, generalized malaise and musculoskeletal aches, a bad cough, and in general just feeling awful. That is the flu. It can cause so much inflammation in your lungs that you can get a secondary pneumonia or your lungs can fail. If all you have is a few sniffles and a cough ± a low grade fever, that is very likely not the flu, but people commonly think that it is. Based on this misconception, they downplay the seriousness of the flu, thinking they can deal with it if they get it. Most probably can, although they'll be laid up for several days. Some, however, cannot, even if they're young and healthy:

Alice Jones and her husband, Darrell, both in college and raising three children, got sick with the flu on a Thursday. By Monday, Alice, 29, an aspiring Dallas nurse, was dead.

Darrell Jones, a criminal justice student who served in the U.S. Army in Afghanistan for nearly a year, said he and his children are so devastated they can't stay in their house and are temporarily living with relatives.

"I made it through Afghanistan and thought we would move on with our lives," said Jones, who turned 27 the day his wife died. "I was thinking that was the most dangerous part of our marriage."

Neither Jones nor his wife had gotten flu shots this year. At the time of her death at University General Hospital on Jan. 6, doctors insisted that the three children, ages 10, 7 and 3, be checked out and vaccinated.

One of the boys tested positive for flu.

It happened fast, too. Three days after she started showing symptoms, Alice started to experience shortness of breath. The next morning, she went to a clinic to seek care and this is what happened:

Monday morning, Jones said he took his wife to their local medical clinic, and when they found that her blood pressure was low, the clinic called 911 and she was rushed to University General Hospital, where she began to experience seizures.

"They were going to do a CT scan and got her into the ICU," said Jones. "She started coding, and they couldn't get her stable. I made it out there on time before her last breath. … It was a big shock. I still can't really believe it."

Here was a woman who was young and healthy, and in a mere four days or so after getting sick she was dead. She had her whole life to look forward to, to quote the common cliche used whenever anyone young dies unexpectedly, and there are now three children without a mother and a husband without a wife. Antivaccinationists frequently try to discount people who die from the flu, either by claiming that it wasn't the flu that killed them or trying to argue that the flu only kills the very old and sick or the very young (as in babies). Of course, that latter observation is, at the very least, an excellent argument for vaccinating babies and children, but antivaccinationists do their best to spread fear, uncertainty, and doubt (FUD) about flu vaccines (all vaccines, actually) among the parents who have to consent to allow their babies and children to be vaccinated. In the case of Alice Jones, none of these arguments apply. In the fantasy world of antivaccinationists who downplay the seriousness of the flu as a disease Alice Jones should still be alive.

But she isn't.

Alice Jones is the human face of the toll influenza takes every year. I first noticed that it could be a bad flu season this year in my neck of the woods when this article appeared in a local newspaper shortly after New Years: 3 more die of H1N1 flu in Michigan, with a dozen others on life support:

Potentially deadly H1N1 — the influenza virus strain behind the 2009 pandemic — continues its resurgence in Michigan, with three more deaths reported by hospital officials.

About a dozen adults and children — patients who previously were healthy — have been on life support at the University of Michigan Health System’s hospitals because of the virus, according to the hospital system.

Three adults have died, according to a health system spokeswoman. An infant from central Michigan also has died from H1N1, according to the Michigan Department of Community Health.

“These deaths are among previously healthy individuals. This is not the group that the public usually thinks about as being susceptible to serious illness with influenza,” said Dr. Matt Davis, chief medical executive for the state health department and a U-M professor of pediatrics and communicable diseases and of internal medicine.

Some of these patients were referred to the University of Michigan Health System because their flu was so severe. Some had to be placed on extracorporeal membrane oxygenation (ECMO), in essence a heart lung bypass machine for "long term" use (days instead of the usual hours when it's used in the OR during cardiac surgery) to oxygenate the blood when the lungs shut down. U. of M. was a pioneer in this technique. This is consistent with a report I've heard from a certain infectious disease colleague of mine elsewhere in the country known for his strong opinions on the flu vaccine, who also has been consulted on patients with the flu who had to be placed on ECMO. It's also consistent with news reports from elsewhere in the country, such as Six more Bay Area flu deaths reported:

Six more deaths in relatively young Bay Area residents have been attributed to influenza, likely the subtype known as “swine flu,” public health officials reported Thursday.

So far, that makes eight flu-related deaths in the region as the annual flu season kicks into high gear.

In Marin County, a 63-year-old man with serious chronic conditions in addition to the flu died on Dec. 27, and a 48-year-old woman with no underlying conditions died Jan. 6, according to public health officials. In Santa Clara County, public health officials reported the death of a 61-year-old man, the second flu fatality there.

A 23-year-old resident died of flu in Sonoma County and a woman in her 40s died in San Mateo County. Thursday evening, San Francisco public health officials reported one death from the flu.

This story, as others have, reports that most, if not all, of the adults who have died of the flu thus far this flu season had not been vaccinated.

Perhaps the most famous flu vaccine "skeptic" (actually, pseudoskeptic/denialist) is Bill Maher, who has been known for spreading misinformation claiming that the flu vaccine can contribute to Alzheimer's disease, that it doesn't work, that it's full of toxins, and that getting vaccinated is the "worst thing you can do," all mixed with germ theory denialism (his denials notwithstanding) and an unjustified faith in the ability of "healthy living" to protect him from the flu. It's the vaccine that Maher criticizes the most, although, ironically, he's totally down with Gardasil. Maher's not alone, though. There are antivaccinationists, contrarians like Tom Jefferson (who has even appeared on Gary Null's radio show, and many others spreading FUD about the flu vaccine.

When you read the latest screed by the latest antivaccinationist telling you that you shouldn't get the flu vaccine, consider this. It is true that the flu vaccine could be better. It's true that it doesn't provide you anywhere near 100% protection against the flu (although in years when the vaccine matches the flu strains well it is quite good). It's even true that flu vaccines (for adults, anyway) may contain mercury in the form of the thimerosal preservative that is still in some flu vaccines. You should get it anyway. The risk is minuscule, and the flu can still kill. You might think, as Bill Maher does, that just because you're perfectly healthy you can prevent the flu with healthy living and, if you're unlucky and get it anyway, weather its effects with little difficulty.

We can't know whether Alice Jones thought that or not. She's dead now from the flu. But it wouldn't surprise me if she did.

Oh, and if you haven't already, get your damned flu vaccine, people. It's still not too late.

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I completely agree that most people think a bad cold is "the flu". I had it a few years ago and was on the verge of getting myself taken to hospital as I was coughing up blood, couldn't eat and was too weak to get out of bed unaided. I have mild asthma, so usually I get a flu shot for free on the NHS. Guess which year I missed it? Never again.

In terms of vaccines demonized by the anti-vaccine movement, don't forget the Hepatitis B, birth dose.

And thanks for the warning.

so do I need to make an appointment to come in for a flu shot?

At this time of year whilst Orac writes about Ms Jones' death, alt media trumpets natural solutions and the inefficacy or danger of the flu vaccine, such as:
( note the scarifying titles - PRN.fm/ garynull articles)-

-The deadly truth: Flu vaccine and Pregnancy ( sic)
-A New Flu Season of Pain, Profit and Politics
-Thimerisol: A Serious Reason to Avoid the Flu Vaccine

Articles like these get passed around woo-bent websites and facebook pages like a mind-numbing marijuana joint.
Adding heft to their psychoactive powers are quotes from Tom Jefferson of the Cochrane Collaboration who appeared on Null's show last January ( which was covered by Orac - see searchbox). So believers can opine, "Wow, even *scientists* think it's worthless!"

Other alt med and anti-vax sites discourage flu vaccines by saying it doesn't work; it's dangerous; it's a cash cow for greedy corporations/ doctors and that flu isn't really much to worry about anyway. Several sites have told the story of a nurse who lost her job because she refused to get vaccinated because she feared that it might end her current pregnancy: the hospital she worked at had no respect for her "freedom". Right.

They simultaneously frighten people about the vaccine and dismiss the seriousness of the flu.
Here's why I think otherwise:
-I worked for a non-profit and counselled people who had compromised immunity. No way I'd NOT be vaccinated.
- I visited several VERY elderly family members who had CVD amongst other conditions.
- I deal/ work with people on a daily basis and don't want to spread disease or contract others' flu.
- a few years ago, my healthy, young relative came down with H1N1 and was sick for more than a month which interfered with her work as an architecture student.

Thus if you don't worry about what happens to others ( that they'd catch your flu).
think only about yourself:
you could get very sick and die OR create great expense and bother for yourself OR merely waste time when you could be doing something useful.
PLUS you feel like h3ll.
I think I've only had the flu twiceand don't ever want it again.

-btw- Mikey continues to disappoint- I was expecting really outlandish, esoteric,scifi-like balderdash not boring,mediocre, pseudo-techie balderdash.
At any rate, he's now discussing Ecuadorian Cacao powder.

By Denice Walter (not verified) on 10 Jan 2014 #permalink

As a good minion, I received the flu vaccine for this season. Unfortunately, it caused me to have a sore arm on the side opposite the shot when I stumbled against a door's edge. This makes it eligible for a VAERS report by my neighbor's brother-in-law's third cousin twice removed who hears about it. Just one more damning statistic about those so-called "safe vaccines."

By the way, I asked for extra thimerosol, but the lady administering the shot just smiled at me and told me not to be greedy.

I would personally like to pillory the person who coined the name "stomach flu." I spend a LOT of time explaining to people that isn't the flu.
@sirhcton--I asked for extra thimerosol too--the nurse just groaned. Apparently she'd heard way too much about the evils of thimerosol.

Denice Walters wrote:

Several sites have told the story of a nurse who lost her job because she refused to get vaccinated because she feared that it might end her current pregnancy: the hospital she worked at had no respect for her “freedom”. Right.

I realize nutcases tend to be focused on, but RI is leaving me with the impression that wootiful thinking is worryingly common among nurses.

By Andreas Johansson (not verified) on 10 Jan 2014 #permalink

I realize nutcases tend to be focused on, but RI is leaving me with the impression that wootiful thinking is worryingly common among nurses.

Nothing contradictory about that. Like you, I hope the fraction of woo-prone nurses (and doctors, for that matter) is small, but even so, it's too high.

By Eric Lund (not verified) on 10 Jan 2014 #permalink

@ Andreas Johansson:

Unfortunately I've heard of quite a few via PRN, AoA, TMR etc. Null even has a woo-nurse/ enabler/ cohort, Luanne.

HOWEVER we shouldn't jump to conclusions and assume that they're anything more than outliers with vocalising tendencies. Just as there are alt med advocates amongst physicians. And probably, non-SB rogue physicists or chemists.

But there is a worrisome idea that nags me:
Steven Barrett ( @ Quackwatch) writes that sometimes people who work in medicine w/o the status of physician may seek out alt med as a way to feel important etc.

OT- I used to know how to say, "How are you?" in Swedish, but a means to transcribe it presently escapes me.

By Denice Walter (not verified) on 10 Jan 2014 #permalink

Andreas Johansen: I realize nutcases tend to be focused on, but RI is leaving me with the impression that wootiful thinking is worryingly common among nurses.

Oh, it is, even among the ones who support vaccines. My mom, a nurse, dragged me to biofeedback and acupuncture for my ADD, and has nearly a bookshelf full of spiritual gunk. One of the worst family arguments (between her, my sister and me) was over the Gerson protocols and juicing.
If she was younger, she'd probably be in the anti-vax bandwagon, but luckily, she remembers measles and polio.

By Politicalguineapig (not verified) on 10 Jan 2014 #permalink

OT- I used to know how to say, “How are you?” in Swedish, but a means to transcribe it presently escapes me.

It's "Hur mår du?"

(The letter in the middle is an 'a' with a ring above. Sounds like ... nothing in General American. Spanish 'o' is about right. The u's don't sound much like any English vowel either ...)

By Andreas Johansson (not verified) on 10 Jan 2014 #permalink

sueb:

so do I need to make an appointment to come in for a flu shot?

Depends on where you get it. A lot of pharmacists will happily administer flu shots on a walk-in basis. Regular clinics usually want you to make an appointment. My clinic wants appointments, but doesn't charge a consult fee for getting vaccinated; you just get charged for the vaccination itself, and the appointment takes maybe five minutes.

By Calli Arcale (not verified) on 10 Jan 2014 #permalink

I used to say "it's just the flu," but then I caught the actual flu one year instead of a slightly worse cold. Any time one finds oneself praying for sweet oblivion, and there's a quick poke in the arm that could have prevented it, the shot starts sounding really good.

This year's flu shot, for me, came in a multi-dose vial. Tasty Thimerosal! :) And I managed to drag BF in for one a couple weeks later, so it must not have damaged my ability to relate to people too much.

By ebrillblaiddes (not verified) on 10 Jan 2014 #permalink

@sueb, #3
[blockquote]so do I need to make an appointment to come in for a flu shot?[/blockquote]

I walk into the nearest Jewel/Osco pharmacy and am out in 5-10 minutes.

Sigh...blockquote fail.

In 1992 I started working with children and came down with the flu. Two weeks of fever, one week laid up in bed, coughing up blood, and unable to eat for most of it. Never been as sick (and I had the measles as a kid). Since then I've had a flu shot every year and where I work now offers it free to all staff and the children that we serve.

13 children diagnosed with infuenza A in my clinic so far this flu season. ALL had not received this year's flu vaccine. ONE was hospitalized.

Get your flu shot. NOW.

By Chris HIckie (not verified) on 10 Jan 2014 #permalink

@Orac

Don't forget oft-quoted non-epidemiologist Peter Doshi. He's got a bug up his butt about flu vaccine, too, based on misapplication of statistics and a gross misunderstanding of epidemiology.

@SoA #9:

Anyone else going to the Pharma Shill convention?

I've just been ordered to tell you that I can neither confirm nor deny that.

By Rich Woods (not verified) on 10 Jan 2014 #permalink

Anecdote here, but the hospital where I volunteer at has had a recent uptick in patients coming in with the flu or complications from it. In every single case, none of them had been vaccinated against it.

Luckily so far, there has been no fatalities, although a few cases seem very serious.

ebrillblaiddes:

I used to say “it’s just the flu,” but then I caught the actual flu one year instead of a slightly worse cold. Any time one finds oneself praying for sweet oblivion, and there’s a quick poke in the arm that could have prevented it, the shot starts sounding really good.

My dad likes to say that you can tell if a patient has the flu or just a cold. If they just have a cold, they're afraid they'll die. If they have the flu, they're afraid they won't. In some cases, this may be exaggeration, but I remember when my eldest came down with influenza. Yeah, she was vaccinated, but nothing's perfect. She was sick for two weeks. My *brother*, meanwhile, developed pneumonia and lost fifteen pounds that he still can't get back. Most people would be happy about that, but he's a naturally trim fellow; what he lost was muscle mass.

By Calli Arcale (not verified) on 10 Jan 2014 #permalink

While it may not be too late for the flu vaccine, the horse is out of the barn (and the cats have gone out of the bag) with respect to the flu overall. This is why we tell people to get vaccinated early. If you get the vaccine now, it will be a couple of weeks before it gives you immunity. So you very well might get the flu between now and then. This is often the case in people who get the flu vaccine on day zero, get sick on day six, and then say that they got the flu from the vaccine and not because the vaccine didn't kick in at the time they were exposed. I'm a strong advocate against using the vaccine as a "countermeasure" to outbreaks. It's a good preventative, though.

@Todd W. - I have it on good authority that Peter Doshi has run afoul of several infectious disease epidemiologists who teach at that place I'm going to. He continued to be "skeptical" about the vaccine even after it was explained to him in excruciating detail that the epidemiology of influenza and the effect on it by vaccinating was more complex than just pulling numbers. It was even explained to him mathematically why the reported numbers are underestimates of the true numbers. But you know how it is with facts and true believers.

I remember very clearly having to talk to the mother of a child who died from influenza. It was heartbreaking. However, after that, she became very vocal about getting children vaccinated on time, especially after she found out that the strain that infected her child was a perfect match to the vaccine. Even if the vaccine wouldn't have been effective, she understood that enough kids vaccinated meant that some immunity rather than no immunity could be had. It was bittersweet.

What I'm hearing now from my contacts in different health departments around the country is that under 50 year olds are the bulk of hospitalizations and visits to the doctor and that many of them do not have underlying medical conditions beyond a few excess pounds. (Don't we all?)

@ Andreas:

Thanks for that I actually know how to say the "du" part.
My late father knew bits and pieces of a few Scandinavian languages ( we're not that- but for some unknown reason they seem to love us- perhaps we're still white but exotic looking or something).

@ SofA:

That's hilarious.
Can I moderate a panel or do a presentation with Narad?

By Denice Walter (not verified) on 10 Jan 2014 #permalink

@ Todd W.:

Doshi also gets quoted a lot @ PRN and the afioementioned articles. He is much beloved by wooists.

By Denice Walter (not verified) on 10 Jan 2014 #permalink

AFOREMENTIONED

By Denice Walter (not verified) on 10 Jan 2014 #permalink

@Ren

What I’m hearing now from my contacts in different health departments around the country is that under 50 year olds are the bulk of hospitalizations and visits to the doctor and that many of them do not have underlying medical conditions beyond a few excess pounds. (Don’t we all?)

Echoes of 1918.

@Todd:

Echoes of 1918

Isn't it reasonably well accepted now that part of the 1918 pandemic was a 'cytokine storm', where the body's own immune system did a lot of the damage, and thus having a healthy immune system could actually be a liability? And that at least some of the more recent bugs, such as SARS and the H5N1 flu a few years ago, had similar characteristics?

All the more reason to have targeted immunity against the specific diseases through a reasonably safe injection rather than actually catching the disease and dealing with some of the nastier potential side effects.

By Jenora Feuer (not verified) on 10 Jan 2014 #permalink

@Jenora Feuer

Yep, that's exactly the point I was trying to make. The 1918 strain of influenza disproportionately affected the young and healthy, likely due to a cytokine storm. Part of the reason that H1N1 was so feared by those who study flu is because it shared a lot of similarities in structure with the 1918 strain. And like the 1918 influenza, H1N1 has predominantly affected younger individuals.

Deaths from H1N1 in my part of the US, not mentioned in Orac's compilation of news articles. Secondary pneumonia in this year's cases is severe.

By t_p_hamilton (not verified) on 10 Jan 2014 #permalink

I understand why they run the "it's not too late for the flu shot" ads -- it can still do some good after all, and the companies want to use up what they have, in some order. However, I wish they would run as many "get it now so it kicks in before flu season gets going" ads in August and September, since those would do more good while using up doses.

It would also be nice if we could talk people out of the habit of waiting to see if it's a bad flu year, since by the time you can tell...

By ebrillblaiddes (not verified) on 10 Jan 2014 #permalink

^Our local basketball team (the Golden State Warriors) actually had advertisements on local media last year pimping the flu shot. I was very pleased to see that, as professional sports aren't exactly bastions of SBM...
http://www.youtube.com/watch?v=rAhHA24L1s0

By Roadstergal (not verified) on 10 Jan 2014 #permalink

My work place offers free flu shots. I got mine in early november.

I never had the actual flu, thankfully.

Headline front page human interest story in The Register-Guard (Eugene, OR):

Headline reads:

Community Immunity - A Eugene mom who lost her son to the flu urges vaccinations.

It's a very sad situation, a 5-yr. old died a couple of weeks ago. The mother is doing what she can to speak out regarding the need for children (and adults) to be fully vaccinated. The R-G had a previous article re the illness and death. The paper then ran an editorial to remind folks to be vaccinated.

The vaccination rate here is appallingly low. Ignorance and superstition among people who you might think could know better.

Where I am in Western Australia about 8 years ago 3 children died within a week of each other due to flu related complications, I knew one of those children. The memory of that shattered mother still breaks my heart. Shortly after these horrific deaths, flu vaccines for children was rolled out here. Then a couple of years ago a young girl here (Saba Button) in WA was seriously injured by a flu vaccine. Many other children had serious fevers afterwards The particular vaccine was pulled consequently and since replaced with a safe one. But the harm done by that unfortunate incidence gave anti vaccinationists much ammo here.
My family (including my two kids on the autism spectrum) get the flu shots each year as of course I know how easily death can become a reality, but the fear of the vaccine here is still a battle being overcome.

By Sharon Morris (not verified) on 10 Jan 2014 #permalink

@ebrillbraiddes

I understand why they run the “it’s not too late for the flu shot” ads — it can still do some good after all

Once we're well into flu season, ads that try to get more people to get out and get vaccinated are sort of a double-edged sword. Yes, it can help reduce the risk of flu, but because of the ~2 week lag time between getting the shot and actually having immunity, there's a pretty big chance that the person will get exposed, infected and develop symptoms. It's then easy to say "the vaccine made me sick" or "the vaccine doesn't work", even though neither of those statements is true. It's a strong conviction.

I agree, that there needs to be more education and urging people to get vaccinated before the season actually gets going.

What is the definitive distinction between a cold and flu? Without identifying the particular virus involved, how can one determine whether one has cold or flu?

By Spectator (not verified) on 10 Jan 2014 #permalink

According to the Centers for Disease Control and Prevention

The flu and the common cold are both respiratory illnesses but they are caused by different viruses. Because these two types of illnesses have similar flu-like symptoms, it can be difficult to tell the difference between them based on symptoms alone. In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.
By Mephistopheles… (not verified) on 10 Jan 2014 #permalink

Sian--

I don't know where in the state you are, but I think my new GP (as of a couple of months ago) in downtown Bellevue is accepting new patients. The paperwork they had me fill out included asking how long it had been since the patient's last TDaP vaccine, and urging anyone for whom it was more than five years to get one. She was also happy to write a prescription for a shingles vaccine when I asked, now that I'm old enough.

I'm not sure our host would want me to put the information here, so email me if this is relevant.

In the Mid-Atlantic all of the pharmacies including those in supermarkets provide flu shots.

By Eli Rabett (not verified) on 10 Jan 2014 #permalink

Sharon - I remember that situation. I believe the anti-vacs tried to turn it into a "big Government" can't be trusted as well as it was argued the vaccine wasn't recalled quickly enough. The fact that we don't have a Vaccine Compensation Fund in Australia adds more heartache to families like the Buttons

I followed the link to the Alice Jones story and it's very sad and troubling. She got sick on Thursday and went to the ER on Saturday where they diagnosed her with the flu and sent her home with some medications. I'm guessing one of those medications was Tamiflu. She kept getting worse, though, and her husband took her to a clinic on Monday and she died later that day.

Do they know if she had a Tamiflu resistant strain of H1N1? Also, her husband says the doctors told him she had both a type A and type B flu. I wonder what her symptoms were like on Saturday for the hospital to feel like it was appropriate to send her home and yet she died Monday.

Even if you believe your own superior health makes you invincible to all contagious diseases (yet suspiciously susceptible to thermasol, go figure) do you want to be the person who kills a baby, grandmother, or ill loved one by passing your flu on to them?

For me there is one easy way to distinguish between flu and cold. Flu has always started rapidly - like when I was 16. One day I got up, felt OK, went to school. By the time lessons ended at about 2 pm I barely had enough strenght left to walk back home and crawl under the covers with fever about 39 centigrade. Colds roll out slowly - first it's just sore throat, then runny nose and then a bit of temperature. Of course it's andecdata but this distinction works very well for me.

I usually get a cold a few times a year but it resolves after 3-4 days. I've never had a flu since I started getting the shot every year, which was over 10 years ago. Before that I had a bad case of flu just before Christmas. I was so bad that my mother had to come and take me home (I was at university then) because I would be unable to get there on my own.

@Lina: I have seen that question answered with either a statement about culling of the weak, or, more commonly, denial of germ theory.

The latter is merely stupid but the first is truly repellent.

@Shay, agreed about repellent, it's astonishing, but mostly very sad.

@ Logo:

We're aware of Kelly Brogan: she's presented at PRN, TMR and is host of a monthly episode of FearlessParent Radio.
- in otrher words- deep into woo with apparently no intention of digging herself out of it.

By Denice Walter (not verified) on 11 Jan 2014 #permalink

OT but are vainglorious woo-meisters losing free venues for proselytising EVER truly OT @ RI, ask you?
AND it's Saturday and dreary outside.

from PRN.fm
It seems that the Null has been tossed from WPFW in Washington. He had been doing his commercials, I mean *shows* on the air "continuously for 31 years" ( altho' I suspect a gap is being glossed over- as it is with NYC's WBAI**).He claims it was becase he stood up for the listeners or suchlike.

FYI- these radio stations are part of an old liberal network called "Pacifica ": his tripe appears on several of them in leftish cities. The stations are supported by viewer contribution and the idiot-in-question raises money for them by shilling his 'premiums'- which are introductory products ( supplements/ films) in order to get listeners enraptured into his cult. He is not paid for his programming but I have heard it suggested that he is somehow re-imbursed beyond getting free airtime.( I can't offhand refer to the article which explained this) I doubt that he gives away products for free out of the 'goodness of his heart' - neither of which exist, just like is science.

He's been hinting that he'll ALWAYS be available on his own internet network, PRN, and via phone, i-tunes you-tube. So perhaps he's being cast out on his own devices.
Heh.

** possibly because of the efforts of hiv/aids realists

By Denice Walter (not verified) on 11 Jan 2014 #permalink

@Denice

You write: "We’re aware of Kelly Brogan"

Who is "we?"

So far, she seems to have gotten a free pass from the skeptical community (with one or two exceptions). I am not quite sure why this is. She has great credentials, has a current academic appointment, and is well-spoken and media-hungry. So she seems to be taken seriously by a lot of people who don't know better.

I hope professional woo-busters will apply a skeptical eye to her work the way they have Sayer Ji at greenmedinfo.

Vicki #45:

The paperwork they had me fill out included asking how long it had been since the patient’s last TDaP vaccine, and urging anyone for whom it was more than five years to get one.

Is it OK to get that one that often, then? Because I heard that there was something about the aP component to where you shouldn't get that more often than every 15 years, so I was planning on alternating it with the TD, but I wouldn't mind at all not doing it that way if what I heard can be debunked.

By ebrillblaiddes (not verified) on 11 Jan 2014 #permalink

@ Logo:

WE are legion.

A few of us have put up information or links to her woo @ RI. So our peerless leader, his colleagues, shills, minions and other readers know.

By Denice Walter (not verified) on 11 Jan 2014 #permalink

The comments on the first article Orac links to are encouragingly rational, but a similar article from the same news site could definitely use some rational commentary. I've posted a couple of comments but they're completely swamped by the usual paranoia and off-the-cuff conspiracy theories.

@ Logo:

We are OBVIOUSLY pleased by your participation which will not -btw- necessitate wearing a Guy Fawkes mask, camping outside of corporate headquarters or marching in hastily organised parades ((shudder)).

We're much too elitist for that.

By Denice Walter (not verified) on 11 Jan 2014 #permalink

I have tried to get my younger son to get the flu vaccine for months. He is a college student who lives in a house with eleven other twenty something students and recent grads. Even worse his job requires him to be around the infection vectors affectionately known as children.

Yesterday I texted him with a bribe of cash if he gets the influenza vaccine. He works for the city's parks department, so he has health insurance that should pay for it.

@Sharon - I am so glad you shared your story here. I saw a post on Facebook that announced that Australia had banned flu shots for being so unsafe and then including the deadly toxins gambit and the causes all diseases thing... and I was sure that the Australia ban was misleading and of course, with all the woo sites, my googling kept bringing up articles about banned flu shots and not if it had been replaced. I hope you don't mind that I shared your comments in my further efforts to debunk the post that was shared.

"it will encourage promiscuity by removing one of the consequences, one of the stupidest arguments against the HPV in existence."
Come on Orac, you know that it's not about *prevention*, It's about *punishment*. The argument only sounds stupid because they can't actually say that out loud.

FYI- these radio stations are part of an old liberal network called “Pacifica “

I have the Dick Alpert box set "Love Serve Remember," which includes three sides of calls that he took on WBAI, on vinyl. Pacifica just ain't what it used to be. There are some recording's of Ayn Rand's commentaries for them at archive.org.

Because I heard that there was something about the aP component to where you shouldn’t get that more often than every 15 years

My understanding was that the current recommendation is for only one Tdap for ages 19–64. I'm unclear as to just why this is.

The (has not gotten the flu shot) spousal unit & I had lunch today with his sister, who recently suffered through a bout with the flu (had not gotten the flu shot) and given it to her daughter (medically compromised and can not get the flu shot). Sister in law is now swearing that she will get the flu shot religiously every year.

Let's hope some of that rubs off on him.

Ah. Looks to be a cost issue. Moreover, the recommendation is for Tdap with each pregnancy.

^ (Or perhaps 2004, judging from the Cohen letter in the first link.)

I asked for Tdap at my last physical when I couldn't remember my most recent tetanus booster - have lots of grandbabies being born lately and the last thing I need to do is give them whooping cough holding them.

Yet another bad day for antivaxers looms:

"The World Health Organization plans to announce on Monday that India has officially eliminated polio, one of the biggest public-health achievements of recent times, and one that could set the stage for stamping out the ancient scourge globally."

"Public-health officials have been counting the days to the three-year anniversary of India's last recorded case, which allows the WHO to certify it as polio free."

"Many long doubted that India could pull it off, given the country's size, poor sanitation and the enormous challenge of vaccinating millions of children, often in far-flung places and in the face of societal and religious resistance."

"India was by far the hardest place in the world to get rid of polio," said Bill Gates, chairman of Microsoft Corp. MSFT +1.44% and co-chair of the Bill and Melinda Gates Foundation, a major financial donor in the global polio campaign. "It's quite phenomenal they did it."

http://online.wsj.com/news/articles/SB100014240527023038481045793124538…

By Dangerous Bacon (not verified) on 11 Jan 2014 #permalink

WOOT!

By Julian Frost (not verified) on 11 Jan 2014 #permalink

Narad #68:

Ah. Looks to be a cost issue. Moreover, the recommendation is for Tdap with each pregnancy.
So if I don't mind paying a few bucks extra there's no reason I shouldn't do my best to avoid the hundred day cough as often as I would be getting a tetanus shot anyway? And if I happen to spawn when I haven't had a shot in a couple years there's no reason not to roll up my sleeve? Cool, there's one more thing to put in my Customized Personal Vaccine Schedule :)

By ebrillblaiddes (not verified) on 11 Jan 2014 #permalink

I closed that blockquote, d@mm!t...

By ebrillblaiddes (not verified) on 11 Jan 2014 #permalink

@49 and @51, I honestly don't vaccinate because if it's solely myself at risk, I am willing to take the chance. I am suspicious of putting any medication into my body unless I can help it. But I also never seriously gave great thought regarding flu and vaccination. Without being too brutal, would someone please provide arguments? Sincere question. I'm willing to be persuaded. If there is a compelling greater good argument, I am willing to put my personal preference aside. At the same time, if it's just a general "it's a good idea" then … I'm still willing to put my personal preference aside, just have to do more research.

Thanks.

@Vicki #45:

Thanks, but Bellevue is pretty far out of my way. I made the appointment with whoever was free and this physician had an opening. I've had other appointments with other physicians with that group and they've all been really great.

@ebrillblaiddes #77:

I talked to the medical assistant beforehand about the Tdap schedule because there's a question about how often a booster should be given. The current recommendation and what that physician group recommends is once every 10 years, but since the switch to the acellular pertussis component, there's a question decreasing the gap to 5 years. Given that I'm going to make a case to update mine after five because my roommates are trying to have a baby and I will not be spreading pertussis.

By Sian Williams (not verified) on 11 Jan 2014 #permalink

My mother-in-law is a nurse. As such, she and her coworkers are highly pressured to receive a yearly flu vaccine. One of her coworkers, a healthy 38 year old father of 3, suffered Guillain-Barre a few days after receiving the shot in November. By Thanksgiving, he lay in Hershey Medical Center ICU and his family was told he may or may not ever walk again. By Christmas he was experiencing organ failure. He is most likely going to die. The psychiatric hospital he works for at first denied that his reaction had anything to do with the flu shot, but has now admitted that it was indeed a result of the shot and his case has been submitted to VAERS. You think his 3 young children want money or their father? Sounds like damned if you do, damned if you don't.

By Designer121584 (not verified) on 11 Jan 2014 #permalink

@ Narad:

Yep, Henwood is the guy I meant. Thanks for that.
Those posts and comments illustrate that often the foundations of woo-empires rest upon slime, muck and detritus.
And these people talk about corporate greed and corruption!

By Denice Walter (not verified) on 11 Jan 2014 #permalink

There are a number of things associated with Guillain-Barre syndrome. It appears that currently administered flu vaccines are not one of them:

"But now a 12-year retrospective study, published in the July 15 issue of Clinical Infectious Diseases, has found no link between the syndrome and the flu vaccine or other vaccines."

"Using data from a large California health care system — covering more than 30 million person-years — researchers identified 415 confirmed cases of Guillain-Barré syndrome, which can cause severe weakness and other serious problems. Of these, only 25 had received any vaccine in the six weeks before the onset of the illness. Most had received flu vaccines, but there were also pneumococcal, tetanus, diphtheria, pertussis, typhoid, hepatitis A and hepatitis B vaccinations in the group."

"The researchers acknowledge that the rare occurrence of Guillain-Barré limits the statistical power of the study, but they found no significant connection between getting a vaccine and developing Guillain-Barré syndrome."

“We do believe that there was a connection with flu vaccine years ago when they made the vaccine under special circumstances,” said the lead author, Dr. Roger Baxter, co-director of the Kaiser Permanente Vaccine Study Center in Oakland, Calif. “But we haven’t seen it since, and we’re confident we won’t. We think infections are much more likely than vaccines to cause Guillain-Barré.”

http://well.blogs.nytimes.com/2013/06/27/study-finds-no-vaccine-link-to…
http://formularyjournal.modernmedicine.com/formulary-journal/news/risk-…

By Dangerous Bacon (not verified) on 11 Jan 2014 #permalink

We got ours in early November, in anticipation of the Thanksgiving "sharing" season.

For dealing with family, friends, co-workers, fellow students etc., who might be lax about their vax: "I'll take you out to dinner if I can get you a flu shot on the way." This really works. After doing it for a couple of years, many of them will keep getting their shots on their own.

Here in California you can get the shot on a walk-in basis, from Walgreen's, CVS, any Safeway supermarket with a pharmacy, and probably any other local pharmacy. They all have signs out front saying "Flu shots here!" and so on.

I caught H1N1 in 2009 before the vaccine was released here, as it was definitely on my "to get" list. (The vaccine came out about four days after I started showing symptoms.) If I'm never that sick again, it'll be too soon. The first 30 hours or so, I spent with a really high fever, and what I call the "total-body migraine." It felt like even my hair hurt. I knew I was in really big trouble when my abdomen started throbbing and I palpated it, to find all the lymph nodes were swollen up to practically the size of golf balls. I spent the next 30 hours or so vomiting up everything I'd eaten since childhood, and then some. About midnight on the 3rd/4th day, I started to cough a little bit. By 4AM, I couldn't breathe and was in full-blown bronchitis, which needed Ventolin.

H1N1 is killing people in western Canada right now, which is thankfully very far from where I live, but I can't help being grateful that I'm now immune.

I caught this year's variation, I'm pretty sure, as I procrastinated about getting the shot, but I think I must've had partial immunity from somewhere, as I was only feverish, fatigued, and achy for about a week. I think I'm going to pass on the vax this year, as I'm pretty sure I've already had it, and supplies are low. Next year for sure, though, as flu sucks.

By Interrobang (not verified) on 11 Jan 2014 #permalink

If there is a compelling greater good argument, I am willing to put my personal preference aside.

The reduction in the susceptible population necessary to prevent large outbreaks is, crudely, 1 – 1/R₀. So, for influenza A(H1N1), for which R₀ is around 1.5, that's 33% effective coverage required. Ballpark the effectiveness at 59%. That means that uptake needs to increase to 56%. Right now, the real gap is in adults 18–49. Nonetheless, we're still talking "only" every other person.

Reasons to get a flu shot: (for villainx if sincere or any lurkers with same question)

In the state where I live, a nine-day-old baby (i.e. too young for its parents to have chosen to get it vaccinated), reportedly otherwise healthy, who died of the flu or flu complications (the data I found doesn't say which), a few weeks ago. The flu virus it had was one that this year's flu shot provided protection against. http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2014/

I don't know if I would have gotten the flu in the absence of a flu shot. If I did, I don't know how many people I would have spread it to, how many they would have spread it to, etc., so I can't tell you what the "greater good" value of my flu shot was. That's the kind of thing we can't know exactly without having a spare universe in order to let it play out both ways (talk about matched controls). I do know, however, that I was NOT part of the chain of transmission that led to infecting and killing that baby or any other. For my own piece of mind, since I'm not a sociopath, that's worth something; and a poke in the arm and a little soreness in the few days afterward is a small price to pay.

By ebrillblaiddes (not verified) on 11 Jan 2014 #permalink

#78 villainx

Probably the best reason to get the flu shot is that you can be contagious before you are symptomatic, and can give the flu to other people before you know you have it.

That includes giving it to vulnerable people, such as old people, babies and those who are immunosuppressed, such as people undergoing chemotherapy. Those people can be killed by the flu.

It's just not worth the risk not to vaccinate, knowing that you could inadvertently kill someone--and that the death would have been preventable.

Interesting about the TDaP booster shots. When I got my flu shot, I asked the doctor about any other vaccines that I should have at my age and she only talked about Hep B (which I already had). She said I need nothing else - even though it was a private practice and I would pay for the shot anyway. So I guess I need to find another doctor, then.

Simple rule of thumb for those who think they have the "flu".
Someone puts a $10 note pinned to your bedroom door.
If you can get out of bed and go grab it, you haven't got flu.

Besides the risk of getting others sick, 'greater good' of saving money. $35 (depends?/) out of pocket cost for flu shot vs how much for a hospital stay? Or even how much medication would you have to take in a weeks+ time of being sick, even OTC meds are expensive. Missed work? etc etc etc. And I tried to read up on any Guillaine-Barre syndrome, I think that if a young man with such a story existed, the anti-vaxxers would be all over it, and I can't find anything.

By Scared Momma (not verified) on 12 Jan 2014 #permalink

Villainx, see my post @67. My SIL had no idea (until she was told by her doctor) that she could be contagious for several days before actually manifesting symptoms. Her daughter did not die, was not hospitalized, but was a very sick young woman and gave her family a week of heartache and worry that might have been avoided.

The thing about my niece is that there's no way to tell she's medically compromised. She doesn't wear a sign around her neck...she looks healthy as a horse (and she used to be, she went through college on a soccer scholarship).

So how do you, as a (presumably) decent human being, protect people like my niece from the flu?

Alia, where do you live? Some county health departments in the US do adult immunizations.

Some of my permanent teeth came in damaged, most likely by a fever associated with the flu from when I was young. Even if you get through the flu just fine, it can still have long lasting consequences.

Some U.S. insurance plans now cover a variety of immunizations, including flu, with no out-of-pocket cost. (With that and a 10% off one order coupon from the grocery store pharmacy, I actually made money by getting a flu shot this year.)

Is Washington the only place where a lot of the pharmacies have large signs out front advertising whopping cough vaccines as well as flu vaccines? (They specifically say "whooping cough," though I assume it would be the usual trivalent vaccine that covers tetanus and diphtheria as well.)

@ villianx:

See my comment # 4.
The first half is about how anti-vaccinationists disparage the usage of flu vaccines and the last part is about why I personally get the vaccine.

People who proselytise against vaccines usually have a product/ worldview to sell to you and/ or an axe to grind because they blame illnesses or conditions such as autism - which family members might suffer- on vaccines- which is nonsense.

Personanly, I want to protect clients and family members from the flu AND don't want to waste time being sick myself.

As a child / young adult, I was probably more vaccinated than most people my age because of lost records, schools/universities in various locales and travel. I never had GBS, ASDs ( I'm quite the reverse on tests) or any other syndromes anti-vaxxers carp about ceaselessly.( see the Canary Party website for a list)
I HAVE had measles and flu.

By Denice Walter (not verified) on 12 Jan 2014 #permalink

Simple rule of thumb for those who think they have the “flu”.
Someone puts a $10 note pinned to your bedroom door.
If you can get out of bed and go grab it, you haven’t got flu.

Mind I use that quote on facebook?

Alain

@Vicki: Pharmacies here have those signs, too. I think it's either national or based on whether there's been an outbreak nearby.

By ebrillblaiddes (not verified) on 12 Jan 2014 #permalink

One of the only perks of getting old -- free vaccinations!

(I'm a fainter, too. When I got the first Hep B shot, clunk! After that the tech had me lay on the exam table.)

Several sites have told the story of a nurse who lost her job because she refused to get vaccinated because she feared that it might end her current pregnancy: the hospital she worked at had no respect for her “freedom”. Right.

Whilst it is arguable that she is certainly "free" to refuse the shot and doing so is her right, working in a hospital and taking care of patients who depend on her for their safety is her privilege.

By AnObservingParty (not verified) on 12 Jan 2014 #permalink

@ sueb #3

so do I need to make an appointment to come in for a flu shot?

As others have said, pharmacies. But if you live in the US, go to Target. Get a flu shot and you get a 5% off your purchase that day coupon. Score.

By AnObservingParty (not verified) on 12 Jan 2014 #permalink

Is Washington the only place where a lot of the pharmacies have large signs out front advertising whopping cough vaccines as well as flu vaccines? (They specifically say “whooping cough,” though I assume it would be the usual trivalent vaccine that covers tetanus and diphtheria as well.)

The Walgreens down the street advertises flu, Tdap, and shingles on their illuminated sign. I imagine just saying "Tdap" simplifies fitting it onto the board, which was one character too short for "December Employee."

AnObservingParty: "But if you live in the US, go to Target."

Just remember to pay with cash!

Leann Stroebel: "Here is the latest I’ve seen being used as an excuse for not getting the flu shot"

Because it is over a year old, and we are not ferrets.

Because it is over a year old, and we are not ferrets.

The VAERD story isn't over, but pulling out Skowronski doesn't help, given that A/H1N1 is part of the seasonal vaccine this time around.

Had this misfortune to get into a discussion about flu vaccines with a woo-y colleague today, who insisted that you'll be healthier in the long run if you get the flu and get laid low for a week than if you inject "poison". No evidence offered, just the naturalistic fallacy (flu is natural, vaccine is not, therefore the former has to be preferable).

The discussion grew into a more general one about the merits of "naturalness": my contention that people live longer in industrialized societies than in "natural" ones was shot down by the argument that I was arguing from what's known - we should, apparently, base our conclusions on what's not known, because that's somehow more humble. I asked if we then should base our behaviour on the opinions of unicorns, since those are unknown, but got no answer (not even to the effect I misunderstood or misconstrued).

Perhaps needless to say, I have little hope arguing with this guy will lead anywhere, but I can't stand to stand silent when he spouts off either.

By Andreas Johansson (not verified) on 13 Jan 2014 #permalink

Has he ever taken the tour at an old cemetery? Natural was the only option back then, after all...

By ebrillblaiddes (not verified) on 13 Jan 2014 #permalink

Has he ever taken the tour at an old cemetery? Natural was the only option back then, after all…

That's exactly the sort of argument that's, apparently, invalid because it's based on knowledge rather than ignorance. He literally told me I shouldn't argue from the known but from the unknown.

By Andreas Johansson (not verified) on 13 Jan 2014 #permalink

@Andreas
As my mom used to say "you can't fix stupid", and then she would add, "Unless Stupid is the name of your dog".

@Andreas

For some reason, my boss won't let me have a t-shirt printed that says "XX County Health Department; Battling Ignorance since 1946 (It's Taking Longer Than We Thought)"

@Shay #92 - I'm in Europe and over here I won't be able to get a vaccine without a prescription from a doctor. Even if I want to pay the whole price for it. So now I need to find a doctor who will see my point (and I work at school with 70+ teachers and 600+ students, so I see the need).

Narad @106: I see that AoA has given Bill Welsh the keys to the giant dog whistle.

Well that is a whole kettle of worms or can of red herrings or something. Mycoplasma and CFS and Lyme, oh my!
It takes me back to the early 90s when Shyh-Ching Lo reckoned he had found a new strain of M. fermentans incognitus and was finding it involved in every disease he checked, using new PCR techniques.
That was before Lo became one of the main instigators of the whole XMRV / CFS farrago, when he moved on to finding XMRV involved in every disease he checked, using new PCR techniques.

By herr doktor bimler (not verified) on 13 Jan 2014 #permalink

Andreas Johansson #109:

He literally told me I shouldn’t argue from the known but from the unknown.

Huh. I think you're not gonna be able to save that one, unless something different slowly trickles into his head as happened to at least one of the regulars here (I don't remember which), but I still can see wanting to address what he's saying, in some way, because of bystanders. For that purpose I think I would go with "you're just making stuff* up now, aren't you?" applied as needed.

*or other words depending on if it's appropriate in your setting

By ebrillblaiddes (not verified) on 13 Jan 2014 #permalink

@Julian Frost #72:

The only thing new in that stupid article was the author's name, Lawrence Solomon. He claims to be an "environmentalist" who has written "best-selling" books. He is in reality a global-warming denialist who did write a book "The Denialists", about the Brave Scientists Who Defied the Global Warming Hoax. I can find nothing about his education in any of his biographical information. Given the way he puffs up his meager credentials, I think it's safe to assume that he has no scientific education beyond High School.
This anti-vax stuff appears to be a new incarnation of his old "Maverick Scientist" schtick. Boring.

At least he's getting some good smackdowns from commentators at the Puff Ho.

@TBruce #115

Do we have a sighting of the rare and elusive Left Wing AGW Denialist?

By Militant Agnostic (not verified) on 13 Jan 2014 #permalink

@Militant Agnostic:
Let's see...he's anti-nuclear power, but very pro-fossil fuel. From what I can tell, he's anti-atheist. He writes a column for the National Post, which is the national right-wing newspaper, which frequently used to have articles promoting ID creationism. I don't know much of his work, because I avoid the NatPo if I can possibly help it.
It's a bit hard to tell, since some of his views are ideosyncratic, but overall, he appears to be essentially right-wing, for a Canadian.

@TBruce

I would concur with right wing since Atomic Energy Canada is a Crown Corporation and and a couple of Unions owned a large minority share in Bruce Power the last time I looked. I think it is safe to assume that all his positions are based on ideology rather than evidence. One of the bloggers in the Skeptic North collective occasionally blogs at the NP website - anything he does on AGW is met with solid denialism in the comments. I don't know if he ever has anything in the dead tree edition. Both our dogs were house trained before we got them, so I wouldn't take the print edition of the NP even it was free.

By Militant Agnostic (not verified) on 13 Jan 2014 #permalink

I don't know but I'm not convinced about efficacy/benefit of flu vaccine. Have no problems with Gardasil/Cervarix though. Flu vaccine is like a lottery, it has to match the strain that is prevalent and if you live in a city like Singapore that has very high proportion of transient population from all over the world, I just don't see any benefit of flu vaccine. At any given moment there could be multiple strains, one from America, one from East Asia, etc.

HPV vaccines I do accept though, my daughter just had her first shot (she is 10). I read it is now recommended for boys too so likely will get for my sons too.

I see others have already latched onto Solomon. I know him from his global warming denial idiocy (I read some of the chapters of his Denialists book in the bookstore and it repeated long-debunked canards and cherry picked quotes so ripe that a creationist would be proud). As noted above, his views are indeed based on ideology and not on evidence.

I didn't know he was venturing into the vaccine area. Given his past history of ignoring corrections, evidence, and the experts it isn't surprising he's messing up this one too.

By Dan J. Andrews (not verified) on 13 Jan 2014 #permalink

@Andreas Johansson:

He literally told me I shouldn’t argue from the known but from the unknown.

Times like this, I wish I could post rage comic faces in the comments. I would have posted the "My head is full of ****" Jackie Chan face.
@TBruce #115: thanks. Good to know that he's getting pushback.
@Teeger #119:

I don’t know but I’m not convinced about efficacy/benefit of flu vaccine.

I'm guessing you never had a proper (and major) bout of flu. I have. Oh, and the health insurers' actuaries have looked at the risk/benefit equation. They found that every dollar/rand/pound/euro spent on vaccination pays for itself several times over. That excludes people taking time off work and the feeling of utter misery a bout of flu gives.

By Julian Frost (not verified) on 13 Jan 2014 #permalink

Julian, *everybody* has had the flu at some time or multiple times. And virtually *everybody* has survived it unscathed.
A vaccine that provides an indifferent level of immunity for such a very limited amount of time (and therefore needs to be repeated annually), in order to immunise against something that has infinitesimally low rates of morbidity let alone mortality is a vaccine that doesn't really stack up on the effort:risk-averted equation.

On the other hand, a vaccine that eliminates polio from India is obviously a good thing.

Wake me up the day they come up with a flu vaccine that will eliminate the flu.

In the meantime, all it is is yet another example of medical over-servicing, its proponents buttressing their dubious claims with tragic anecdotes about dead 29-year-olds..

Sceptic, virtually every claim you have made is wrong.

And virtually *everybody* has survived it unscathed.

Most people survive car crashes. Doesn't mean we shouldn't try to reduce it further.

A vaccine that provides an indifferent level of immunity

Indifferent? No. 80% at least.

for such a very limited amount of time (and therefore needs to be repeated annually)

The reason it needs to be repeated annually is because each year the strain changes, not because it works for a limited amount of time (it works for years).

in order to immunise against something that has infinitesimally low rates of morbidity let alone mortality

Morbidity is fairly high. As for mortality, 1918 epidemic ring a bell?

a vaccine that doesn’t really stack up on the effort:risk-averted equation

The medical insurance providers disagree with you. I get flu shots for free every year. If the effort:risk-averted equation was as bad as that, they wouldn't.
TL, DR: You have made claims I have heard and refuted before. You are wrong.

By Julian Frost (not verified) on 14 Jan 2014 #permalink

@Sceptic, many people say they have "the flu" when they have a bad cold or other respiratory infection. Colds have very low morbidity and mortality, but that doesn't mean that the flu itself does. Did you not read above about the rising death toll from this year's flu? The flu most certainly does not have "infinitesimally low rates of morbidity".

Anecdote: I have had the flu. I developed secondary pneumonia and missed two months of work. (I was lucky to have an understanding boss.) Since then I have gotten a flu shot every single year, and glad to do it.

For the non-believers...

I had the flu in 1996. I was 24, a runner, played tennis or hockey at least 2-3 times a week. BMI of 19. The healthiest and fittest I will ever be.

3 PM: Start feeling a little off during a meeting.
5 PM: Take a cab home, because the dizziness is overwhelming and I'm not sure I can remain standing for two stops on the subway.
5:30: Lie down on couch.
7PM: Awake. A man has come into my apartment and has beaten me around the body with a large hammer. Stagger to bathroom. Take temp - over 103F.
7:15: Vomiting begins.
7:30: Nosebleed. Coughing commences.
7:45: So hot. Remove all clothing, lie on floor in own waste. Contemplate crawling to the phone in living room. Give up.
8 PM: More vomiting. More coughing.
8:30: Succeed in crawling 10 feet to phone. Call father, a physician. Crawl back to bathroom so as not to vomit and bleed on new area rug.
9:15: Father arrives. Realize I'm still naked. Don't care. Don't care about anything.
9:20: Wrapped in duvet and carried to elevator like a child by father.
9:45: ER.

Eleven days in hospital. Thirteen days of missed work. Twelve pounds lost off of a frame that didn't need to lose one. Unable to walk two blocks to subway without resting at least twice for the next month. Unable to run, play tennis, or play hockey, for the rest of winter.

Flu shot ever since.

@Sceptic:

To steal a phrase from the Firesign Theater: Everything you know is wrong.

I have been spared getting influenza as an adult (at least a diagnostic case). Does that mean "the flu" is nothing to get worked up about, or that I keep my immune system "boosted" adequately? No, it just means I've been lucky so far. It's also possible that I've had a subclinical infection and passed it on to others. I don't know. I get the flu shot every year in case my luck fails me (and it will). I suggest you do the same.

I don’t know but I’m not convinced about efficacy/benefit of flu vaccine. ... Flu vaccine is like a lottery, it has to match the strain that is prevalent and if you live in a city like Singapore that has very high proportion of transient population from all over the world, I just don’t see any benefit of flu vaccine. At any given moment there could be multiple strains, one from America, one from East Asia, etc.

Your reasoning is logical, but it's founded in some assumptions that are wrong.

For instance, one assumption is that because flu strains are not perfectly predictable, they are instead perfectly unpredictable - a "lottery" where there's no way to make educated guesses about what's going to come up. But that's not true: between the fact that researchers engage in constant surveillance of circulating flu strains (and the surveillance is worldwide, since they're well aware of how fast flu can travel) and the fact that flu viruses go in surprisingly predictable long-term cycles, researchers can make very accurate flu strain predictions. There may be misses, certainly, but it's not a "lottery" where misses are the norm.

Another mistaken assumption is that nothing other than a perfect match provides any benefit (again, like a lottery.) In reality, an imperfect match can still assist the immune system in preparing for a strain and fighting it off. The better the match, of course, the better the immune response, but an imperfect match is better than no protection.

By Antaeus Feldspar (not verified) on 14 Jan 2014 #permalink

When I had what I assume was flu ( no testing/ no doctor) I knew- without a doubt- that I could NOT drive my car to get OTC meds 1/2 a mile away. I did not think that I could walk down the staircase either.

While I didn't have as serious a condition as Delphine did, for 5 or 6 days I did literally nothing- no work, no exercise, didn't go anywhere, didn't even wash my hair- I don't think that I ate anything at all for about 3 of those days.

I did feed the cat because I didn't want him to die because of my neglect. Also to stop his infernal yowling after a day or two without any food.

By Denice Walter (not verified) on 14 Jan 2014 #permalink

I did feed the cat because I didn’t want him to die because of my neglect.

...and that's pretty much how owning pets saved my life during a *bad* depressive episode. I *had* to get out of bed to feed the cats and decided that they'd starve to death if I killed myself.

And people wonder why I spoil my cats. ;)

Julian, *everybody* has had the flu at some time or multiple times. And virtually *everybody* has survived it unscathed.

Citation needed, methinks.

I don't believe I've ever had the flu, unless that's what caused the mystery case of meningitis I had at age 4. (The causative agent was never determined, because the hospital managed to misplace the spinal tap specimens. They were severely overwhelmed by a major flu epidemic at the time.)

And I've gotta second what Julian said about how most people survive car crashes, but it's still worth trying to reduce the number.

By Calli Arcale (not verified) on 14 Jan 2014 #permalink

@Julian
I've never had the flu. I never even want to *think* I didn't do everything in my power to protect myself from getting the flu. I am lucky in that I can take a flu shot; I'm unlucky that I have asthma and that if I get the flu, I will have a really good (bad?) chance of dying. I exercise, I eat right, and yet, if I get the flu there's a good chance I'll die of it. If I get it from YOU, I hope you can live with the knowledge that you killed me.
There are many many others like me. It's not all about you.

Julian, the above rant was aimed at Sceptic, not you.

And virtually *everybody* has survived it unscathed

Check the pediatric death count from last year's flu season and come back and say that.

"Wake me up the day they come up with a flu vaccine that will eliminate the flu."

There will never be such a thing. The influenza virus is different than polio. It has a wide variety of natural (and unnatural) hosts. Its genome is not as stable and, thus, its antigens shift and drift in composition. Even the "universal" influenza vaccine will not address these problems very well.

It's one thing to try and come off as intelligent; it's another to think we're stupid.

"And virtually *everybody* has survived it unscathed"

Said by probably someone who doesn't have to track influenza-associated deaths for a living.

There is a minor bug going around in L.A. that has affected half of everybody I know -- perhaps that is an exaggeration, but it seems that way. The local emergency rooms have been getting their fill, and they assure us that this is not a serious disease. In other words, we already have a minor epidemic making thousands and thousands of people really miserable, and it is not even the influenza. I'm not sure I actually had the real influenza back in grad school, but I remember having a 103 temperature, aching all over, and being in bed for a full week, followed by a recovery that took at least another week. At the time, the doctor told me I had the flu, but they didn't have the sophisticated molecular testing that we can do now. Something like that is worth avoiding, and if an 80 percent likelihood of avoiding it is what I can get, then that's what I will take.

As for the variability of strains from year to year, I look at it like this (real epidemiologists correct me if this is wrong). Over the course of several years, I get immunized against lots of different strains at the rate of 3 strains per year. I suspect that last year's shot gives me some fairly long term immunity against one set of strains, and the previous year's shot covers some other strains. I believe that H1N1 has been in the shot for several years, so I get boosted against that one. Anyway, I would suspect that getting the flu shot every year eventually adds up to at least some immunity against a whole variety of flu strains, which is what we would like to have.

Nope. The vaccine immunity wanes pretty fast, compared to other vaccines. Also, contrary to anti-vaccine nutbaggery, there are no adjuvants in flu vaccines, further reducing the likelihood of a good immune response. (Not in the US, anyway. Adjuvants have been used successfully and safely in Europe and Canada.)

To @Shay at #111 I need one of those shirts! Somehow I don't think my bosses will approve. To weigh in on the flu vaccine, as an epidemiologist who sees the flu surveillance data and death numbers only an idiot thinks the flu doesn't kill anyone. I also agree with whomever said they would like to strangle whoever coined the term 'stomach flu' as that makes my job way more difficult. That being said, the research (and I would cite if I could find my articles) seems to be coming down on the side that universal child vaccination could drastically drop the rate of flu morbidity and mortality in everyone but particularly the elderly. Saw a presentation on Japan's data when they mandated flu vaccine yearly for school age children. If you graph the mortality it takes a massive dive the year implemented and every year thereafter. Then Japan apparently decided to not make it a mandate and lo and behold, mortality rose right back up to pre-mandate levels. Children are excellent vectors. The main reason my little man is up to date completely on all vaccines.

I'm sorry, I'm willing to grant Skeptic one point - while not minimizing the pain, inconvenience, and risk of complications and long term injury (including but not limited to death), the survival rate of influenza in a normal year's epidemic is relative high when compared with, say, ebola, rabies, or pertussis.

But then, I've never felt the mortality rate was the only way to determine whether it was wise to be immunized against a disease or not.

By Mephistopheles… (not verified) on 14 Jan 2014 #permalink

"Nope. The vaccine immunity wanes pretty fast, compared to other vaccines. Also, contrary to anti-vaccine nutbaggery, there are no adjuvants in flu vaccines, further reducing the likelihood of a good immune response. (Not in the US, anyway. Adjuvants have been used successfully and safely in Europe and Canada.)"

Pandemrix was so immunogenic, thanks to ASO3, it had a snoozy effect.

Vaccine adjuvants: putting innate immunity to
work. Immunity 2010; 33:492-503.

How about some more recent studies on the associated narcolepsy? 2010 is so 2010.

@Ren

You mean like that study finding that a protein on the virus bears striking similarities to proteins in the human body, thereby leading to the immune system getting mixed up and thereby being a likely culprit to cause narcolepsy? I.e., vaccine slightly increased risk and infection significantly increased risk for those who are susceptible?

@Todd

Yeah, the one Dr. Crislip talked about on his "puscast".

“And virtually *everybody* has survived it unscathed”

Said by probably someone who doesn’t have to track influenza-associated deaths for a living.

Guaranteed. "Virtually everybody" leaves out the, what, 157 kids that died of flu last year?

And Skeptic, no, most people have not had the flu. In fact, part of the problem faced by public health agencies is a public misunderstanding of what "flu" actually is. "Stomach flu" is not influenza. A bad cold--"influenza-like illness"--is not influenza (usually). If you can stand in the pharmacy and announce that you need DayQuil because you have "the flu" you probably don't have influenza. Actual influenza is a special kind of terrible that many people have never had the displeasure of experiencing, but them thinking they have leads to misconceptions that "the flu isn't that bad."

By AnObservingParty (not verified) on 15 Jan 2014 #permalink

The real honest-to-gosh flu struck my office in early 2013 and of the four coworkers who got it, not one of them was out for less than a fortnight. One of the poor devils missed almost a month of work.

Not uncoincidentally, the office sponsored a free shot clinic before this current "season" rolled around.

I need to start using "fortnight" again. I want to bring it back.

By AnObservingParty (not verified) on 15 Jan 2014 #permalink

AOP -- Only if you can say it in a suitably Patrick Stewart voice and accent.

Well, I'm still somewhat British and my voice gets pretty deep when my allergies act up... ;)

It's a lovely word, isn't it? But I've been running into increasing amounts of bafflement when I've used it during the past few years, so I save it for the erudite folks, like the gang here. ;)

Oh, I know, Johanna. I'm not British but when my allergies are really bad I acquire this down-around-the-ankles throaty alto that makes me sound like Lauren Bacall.

At least, that's what I tell myself.

It is a lovely word. Whenever I see it typed I hear Benedict Cumberbatch saying it. He's much more 2014 than Patrick Stewart.

By AnObservingParty (not verified) on 15 Jan 2014 #permalink

Kiiri:

I also agree with whomever said they would like to strangle whoever coined the term ‘stomach flu’ as that makes my job way more difficult.

Well, given that the word "flu" traditionally meant more than influenza, that might not be entirely fair. The word predates the germ theory by a long shot; traditionally, many illnesses that we now know are distinct entities were ascribed to a malevolent influence. *The* Influence. You were said to have The Influence if you were sick with some vague problem that wasn't a pox or bubonic or something like that with more visible signs. Over time, as more and more illnesses became identified, The Influence was blamed for fewer illnesses, and eventually the germ theory came along and people (generally) stopped ascribing disease to a mysterious evil force. But the word Influence had gotten itself pretty well fixed in the language, and even shortened to Fluence and then Flu. A specific pattern of disease was eventually dubbed "influenza" to make it look a bit more respectably scientific, but the older, broader use of the word persisted, and so we have flus that aren't influenza.

Yeah, it makes your job harder. Unfortunately it's hard to fight natural language, which does peculiar things sometimes.

By Calli Arcale (not verified) on 15 Jan 2014 #permalink

And Skeptic, no, most people have not had the flu. In fact, part of the problem faced by public health agencies is a public misunderstanding of what “flu” actually is.

I've contracted it three times, at about 20-year intervals since childhood (IIRC, this is slightly longer than the usual interval), with last season's being the one to convince me to actively pester my PCP for it if they weren't going to go out of their way to do it themselves.

At least, that’s what I tell myself.

Trust me, it works in practice.

@Calli Arcale - agreed, you can't fight the endless morphology of the English language. I just wish the first question I had to ask at the start of an outbreak investigation which was reported as 'flu' wasn't "Was it coughing, fever flu, or vomiting, diarrhea flu?" 99% it is vomiting/diarrhea flu most often my friend and yours norovirus. I keep trying to convince people that the shortened 'noro' is a sexy name for 'stomach flu'. It's not quite catching on yet but give me time.

In my case, the flu was coughing, fever, AND vomiting flu. Vomiting is not unusual with influenza, but vomiting unaccompanied by coughing and fever is typically indicative of a gastro bug and not influenza. And yes, the words "stomach flu" need to die in a fire.

"Vomiting is not unusual with influenza"

No, it's not unusual. In fact, a lot of H1N1 cases in infants and children manifested abdominal pain and discomfort as well, including vomiting.

"but vomiting unaccompanied by coughing and fever is typically indicative of a gastro bug and not influenza."

Booyah!

No, it’s not unusual. In fact, a lot of H1N1 cases in infants and children manifested abdominal pain and discomfort as well, including vomiting.

When I had it, no vomiting, but the nausea was unbelievable. However, fever and intractable cough were the defining characteristics.

I don't care if people keep using "stomach flu"...so long as they are clear it is not influenza and the vaccine has nothing to do with it.

Narad, I think it was 20, but it wasn't steady I thought? Like, even distribution would be 20 years, but the distrubution throughout the population wasn't equal? I will continue to be dubious when someone announces to me they have "flu" or think they had "flu" and were out of work for two days, and the fever never got above 99.9.

By AnObservingParty (not verified) on 16 Jan 2014 #permalink

I think it was 20, but it wasn’t steady I thought? Like, even distribution would be 20 years, but the distrubution throughout the population wasn’t equal?

I can't readily turn up the source of the figure, but I have a mean of 16 or 17 years lodged in my head.

Correct @squirrelelite. Norovirus. The friend to outbreak epidemiologists everywhere.

On the subject of influenza woo, I found this recipe for Thieves Oil to prevent the flu.
http://www.primallyinspired.com/prevent-flu-naturally/

They suggest mixing it with coconut oil and rubbing it on your chest or your feet. How that prevents inhaling an airborne virus escapes me.

Also, would smelling like cloves, eucalyptus, rosemary and cinnamon really be a good idea for a thief???

By squirrelelite (not verified) on 18 Jan 2014 #permalink

We've just had our second flu fatality here. Male, mid-30's, no underlying health conditions.

And I sat at a local venue this morning handing out flu flyers and biting my tongue every time some ninny told me that flu shots made them sick.

When I received my flu shot (you guys have had a positive effect on me - I have mostly avoided flu shots over the years because I never get it - never have, even when other family members I would be taking care of got it, which is strange because I should get it sooner or later) my doctor said that if I wanted to avoid the jab I could rinse my nasal passages with saline several times a day to help reduce my risk of getting it. The theory is that if the virus can't stay in there, it can't affect you. He said studies have demonstrated a marked risk of flu in people who chose to use nasal irrigation to reduce their risk. Kind of a cumbersome way of avoiding it, and I know it is unlikely I would have stuck to that protocol. The over-reaching reason, though, was because my friend Chen has stage IV cancer and I want to be able to safely visit him and his family without being a vector.

This blog has made a difference - I didn't realize (though it made sense immediately and felt like a serious "oh duh" moment - I know chicken pox is contagious before onset of symptoms) that you could spread flu before symptoms started. Since the onset of symptoms is so dramatic, I had always assumed that if you isolated when you developed them you would be unlikely to make the population at large sick.

This blog makes a difference, and the information shared in the comments does, too. As you all know, I'm not a lover of woo, especially the stuff that immediately sounds like it has no rational basis to begin with. That being said, I am only self-educated, and am very aware there are gaps in my understanding of my body and how it works.

Thank you for your comments here. Wanted to encourage you in the fight against misinformation and fear-mongering.

Kudos,
Mrs Woo

*marked risk of flu reduction (reduction in cases of flu would have been even better) OOPS!

@squirrelelite: the idea of cinnamon in the Thieves Oil was that it was thought to promote invisibility (and no, I don't know why...just have read that was the theory)

I find the story propounded for Young Living's Thieves Oil to be rather amusing:

Thieves oil originated from around the 15th century, when the bubonic plague was running rampid through Europe and Asia. Four thieves from Europe, who were notoriously robbing the infectious dead bodies of all their possessions. They, miraculously, never contracted the highly infectious plague and this led to deep inquiry in court after they were caught and charged.

When was eucalyptus first recorded, again?

And today....
'Scientist exposes flu shot lies and doom-and-gloom propaganda'
@ NaturalNews- compleat with 15minute explanatory video/audio that details media disinformation

And guess who the 'scientist' is.

By Denice Walter (not verified) on 19 Jan 2014 #permalink

"Running ampid"? I assume that this is the adjectival form of the Latin noun "rampor".

the highly infectious plague
"This specific oil that they had created, concocted from aromatic herbs and oils, was HIGHLY EFFECTIVE in killing all of the airborne bacteria".

Bubonic plague is spread by airborne bacteria? OK. Some people are just happier with medieval miasmata.

By herr doktor bimler (not verified) on 19 Jan 2014 #permalink

Over twenty five years ago I took a course on herbal medicine taught by a naturopath. I remember hearing the story about "thieves' wine." Which was wine with garlic in it.

When the story was related that those who buried the bubonic plague victims survived because they drank it, I blurted out that no self respecting flea would go near them because of the garlic. I was making a joke about the smell of garlic.

Though now I see there are lots of Google hits about garlic being used to repel fleas from dogs. Um, sorry about that. I was seriously only joking.

Over twenty five years ago I took a course on herbal medicine taught by a naturopath. I remember hearing the story about “thieves’ wine.”

Conveniently, one can also purchase "Thieves Vinegar."

Steal This Vinegar!

By herr doktor bimler (not verified) on 19 Jan 2014 #permalink

@ #171

I believe there was an airborne(I think it was more like being unlucky enough to breathe in infectious matter from an already infected person. blood, spittle, puss...etc) version of the plague. Bubonic was the lymphatic system, pneumonic was the respiratory system, and septicemic was a blood infection. It was all the same bacteria it was just where you got the infection. Pneumonic was more person to person transmission, not necessarily from the fleas. I could be mistaken though, I'm sure someone here knows more than me.

By shadow1458 (not verified) on 19 Jan 2014 #permalink

Perhaps someone can explain this specimen of Grifter Arithmetic:

Studies conducted at Weber State University in 1997 showed it to have a 99.96% success rate against airborne bacteria. The bacteria cultures were sprayed in an enclosed area, and Thieves oil blend was diffused for a given amount of time.
After only 10 minutes of exposure, there was a reduction of
82% in Micrococcus luteus
96% in Pseudomonas aeruginosa
44% in Staphylococcus aureus

The anodyne "studies" turn out to have been conducted by D.G. Young, the proprietor of Thieves Oil, and published in the trade journal.

Also from the company:

But D. Gary Young, founder of Young Living, is probably most responsible for the story reaching the legendary status it enjoys today. While at his clinic in Mexico, Young was introduced to the therapeutic possibilities of premium essential oils.[18] He learned that they are hundreds of times more concentrated than the herbs and tinctures he had worked with while studying under pioneers like Norman Walker, Bernard Jenson and, yes, Dr. Christopher.

IOW, once the proprietor realised that "herbs and tinctures" were available in concentrated form, he happily conceded that everything he had previously sold to customers from his Mexican clinic had been worthless flimflam.

By herr doktor bimler (not verified) on 19 Jan 2014 #permalink

I believe there was an airborne... version of the plague.

Oh yes, there is pneumonic plague. But the "Hippy Homemaker" grifters were careful to specify Bubonic plague as "running rampid".

By herr doktor bimler (not verified) on 19 Jan 2014 #permalink

@MI Dawn,
Thanks for the info.
According to wikipedia, eucalyptus was introduced to Europe after the Cook expedition in 1770.
Fifteenth century thieves would have found it hard to come by.
At least it's a good disinfectant, if quite flammable.

By squirrelelite (not verified) on 19 Jan 2014 #permalink

Looking at the comments about thieves' oil, I see oil of cloves is an ingredient. That is known to kill the bacillus that causes plague.

By Julian Frost (not verified) on 20 Jan 2014 #permalink

Thanks for pointing out that health officials are guessing what strain will develop, and that vaccination is no guarantee you won't catch the current flu being spread around the school/workplace.

So poor Alice Jones may have died even with the injection.

It takes several months from conception to market before a vaccine can make it to the pharmacy, so it's not like the annual flu vaccine is for the current strain of flu that you're being threatened by.

Well, it *can* be the current strain of flu you're being threatened by. In fact, it often is. It's just there's no guarantee. It's a bit like forecasting the weather more than a couple of weeks out. There's uncertainty, but it's not like it's totally useless.

By Calli Arcale (not verified) on 29 Jan 2014 #permalink

so it’s not like the annual flu vaccine is for the current strain of flu that you’re being threatened by

There's a reason that strain "number" is subordinate to antigenic specificity.

Dustin, if you want guarantees - on anything - I'm afraid you've come to the wrong universe.

Suppose you're in the dark, and you know someone out there is going to take a punch at you, but you can't see them. You can hear noises, so you have a rough idea of where they might be; you can put up your guard to try and block the punch, but you're guessing at where that punch is coming from.

How dumb would it be for you to shrug and say "Oh, well, I guess I'll just stand here and not do ANYTHING to try to block or avoid that punch, because I can't predict PERFECTLY where it's going to be?" That's pretty much how dumb it is to say "Well, our predictions on which flu strains will be most prevalent this year are based on surveillance data collected from over 100 countries, and those predictions are usually 50%-70% accurate, but since we can't GUARANTEE that those predictions will be accurate, let's just throw up our hands and not attempt to defend ourselves at all."

By Antaeus Feldspar (not verified) on 29 Jan 2014 #permalink