vaccines
revere | November 5, 2009For somebody so out to lunch on so many issues there is something undeniably likable about Ron Paul. As congressthings, he and Dennis Kucinich (there's an odd couple) had the clearest and best positions on the Iraq debacle. And as a principled libertarian (there seem to be some big chinks in Paul's libertarian armor -- like reproductive choice -- but his passion is undeniable), there is something admirable about him. It almost makes you forget his principles are self-centered, wrong-headed and inhumane. Little gnome-like figures aren't supposed to be that unfeeling toward others. Anti-science…
revere | November 3, 2009A reader asked an offline question that is general enough to post about (NB: I try to respond to as many questions as I can, but I'm traveling and can't keep up, so in most cases I won't be able to respond. I also don't hand out personal medical advice over the internet, something I consider bad practice). CDC says on the basis of clinical trials with the unadjuvanted vaccine used in the US that two shots, 21 days apart, are needed for children under 10. WHO, on the other hand, is telling its member nations that one will suffice. Why the confusion?
We may be comparing apples and oranges. Many…
revere | October 27, 2009On Saturday we posted our take on The Atlantic magazine article by Shannon Brownlee and Jeanne Lenzer. It's a major story in the November issue, a banner across the top of the cover page reading: Swine flu: Does the vaccine really work? We tried to ignore it. People kept asking us to comment on it, but we didn't want to get entangled in vaccine controversies. As Orac warned me, it's a game of Whac-A-Mole. But we got fed up and posted our global response, not a point by point refutation, since that wasn't what the issue was. Our main point was that it was a straw man argument built around the…
ddobbs | October 26, 2009In a disturbing post at ScienceInsider, Jon Cohen and Martin Enserink explain why the swine flu vaccine is running so late. Or at least they try to explain why it's so late. For while all the suppliers are running into problems, we're not allowed to know what they are.
The delays are substantial and critical. They leave us naked as the flu spreads through the country. The flu has now killed 1000 people, over 100 of them children. Even as this happens, the delivery dates keep moving back and the delivery amounts keep shrinking. As recently as a month ago, the CDC was telling us that we'd…
revere | October 26, 2009CDC is again warning parents not to send your children to a swine flu party. The idea is to provide them with immunity, like used to be done with chickenpox parties. It's pretty hard to believe this is a live issue and CDC admits it doesn't have evidence that any have actually occurred. When it came up in the spring, during the first wave of H1N1, we and all other flu experts said it was a very bad idea, but at least one could understand the reasoning then. Since there was no vaccine and the worry was that swine flu might come back in the fall in altered and worse form during flu season, it…
terrasig | October 25, 2009
One of the most engaging and clearly-written pieces of science journalism over the last year or so was published in Wired magazine last week. Amy Wallace's, "An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All," is part interview with rotavirus vaccine developer, pediatric infectious disease physician, Dr Paul Offit, and description of the anti-vaccination movement in the United States.
Wallace's work is the centerpiece of a collection of smaller articles providing science-based information about vaccination that also refutes common anti-vaccination myths including "…
revere | October 24, 2009I keep getting asked about the Atlantic Magazine article, Does the Vaccine Matter? by Shannon Brownlee and Jeanne Lenzer, two reporters whose particular bias is that we as a nation are "over treated." As a generalization that's probably true, and finding examples isn't hard. Unfortunately by taking as their main example flu vaccine during a pandemic, they have not only picked the wrong example but created more confusion at a time when there's already too much.
Here's the gist:
Vaccination is central to the government’s plan for preventing deaths from swine flu. The CDC has recommended that…
tsmith | October 21, 2009I realize that, despite the scientific evidence to the contrary, there is still a lot of fear and misunderstanding about vaccine safety. Two recent articles discuss this "epidemic of fear" and why it affects us all, the first here at Wired magazine, and the second here at the Gotham Skeptic. I especially like the second, which has some excellent points:
My pediatric practice is situated at the nexus of three Manhattan neighborhoods (the West Village, Chelsea, and the Meat Packing District) that seem to comprise just the right balance of wealth, edginess, and socio-cultural awareness that…
revere | October 17, 2009The vaccine problem as seen from a different angle:
The Daily Show With Jon Stewart
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Ron Paul Interview
revere | October 16, 2009Via Crof's blog (invaluable, as always) I learned of the decision of Massachusetts state health officials to vaccinate state prisoners before the rest of the population:
Prison officials warn that inmates could quickly spread the flu if not inoculated -- particularly those in high-risk groups such as AIDS patients.
Middlesex Sheriff James DiPaola told the Boston Herald that prisons were the perfect flu "breeding ground."
DiPaola dealt with riots in a Cambridge jail when rumors of swine flu spread there. (AP)
State legislators are already complaining that there are other, more vulnerable…
revere | October 15, 2009I've been asked a number of times why I am bothering to get both flu vaccines this year (the seasonal flu trivalent vaccine and the swine flu vaccine when it is my turn). I am in the older age group (last in line for swine flu vaccine) and it is my group that is hit the least hard from the swine flu virus. But there are a lot of us and we're still being hit. I don't know if I will be one of the unlucky few in my age group who draws the short straw or not, and I'd rather get vaccinated with an acceptably safe vaccine than take a chance in winding up having a machine breathe for me or not…
revere | October 11, 2009If you are hesitating to be vaccinated for swine flu this year, perhaps this post will help you make up your mind. If it does, I hope it pushes you to get vaccinated, but whatever persuasion we attempt here will only be from a recital of what we know of the epidemiology of this pandemic. Because it is the different epidemiology that is the main feature, not the clinical characteristics or the virulence of the virus. So far this looks pretty much like a standard influenza A virus -- except for the epidemiology. Since I'm an epidemiologist, you might expect me to think this is important, and I…
revere | October 8, 2009A Catholic hospital system in Arkansas seems to have come up with an innovative solution to encouraging health care workers be vaccinated while allowing them the autonomy to make their own decision. When we last brought up this question one of our commenters said he'd like to see a button on health care workers that said, "I'm not vaccinated." St. Vincent hospital system seems to have figured out a way to do this while still protecting both the worker and the patient. The idea is surprisingly simple:
Given the choice between face masks or the seasonal flu vaccine, nearly all 3,200 employees…
revere | October 7, 2009This is the internet. Like the newspaper, you shouldn't automatically believe everything you read on it, and when it comes to some of the more outlandish stuff, most people don't. But there are a lot of sites that appear quite legitimate, and maybe for some of the material on them they are fine, but sometimes mixed in is some real dangerous stuff. One genre we know is influential and a major source of information is what is sometimes called a "Mommy Blog," blogs or websites that cater to the insatiable hunger for reliable information of newly pregnant women or new moms. We wouldn't have…
revere | October 6, 2009Vaccines is a topic I don't like writing about so much for many reasons. Vaccination programs are important to public health but we (all the Reveres, including this one) have always interested either in basic science or programs that are applied to the whole population at once, such as clean water, air or food or safe products in the marketplace. But vaccines keep coming up so we talk about them. Since this blog has spent a lot of time on flu, most of it has related to influenza vaccine, but not always. This is a "not always" post, and it is partially about the latest news that US Army and…
ddobbs | October 5, 2009Never know what'll top the charts. Top post was a post I put up in January, "Pfizer takes $2.3 billion offl-label marketing fine." That post reported the news (via FiercePharma) that Pfizer had tucked away in its financial disclosure forms a $2.3 billion charge to end the federal investigation into allegations of off-label promotions of its Cox-2 painkillers, including Bextra. (Lot of money ... but it didn't quite wipe out the company's 2008 net income.) The company had set aside the money as part of a deal it was negotiating Justiice. Finalizing the deal, however, took until September. At…
revere | October 5, 2009In an earlier post I said I opposed mandatory vaccination for adults (but not for children), the one exception being for health care workers because they come in contact with people at high risk. My view then was that if you work in a health care institution and won't get vaccinated against flu, then you shouldn't come to work. Now I am re-evaluating my position as a result of some cogent and pragmatic comments from lawyer-bioethicist George Annas, professor of health law, bioethics and human rights at Boston University School of Public Health, and author of "The Rights of Patients." I know…
ddobbs | October 1, 2009
Last week the Times ran a story by Andrew Pollack, Benefit and Doubt in Vaccine Additive, that covered some of the ground I trod in my Slate story, "To Boost or Not to Boost: The United States' swine flu vaccines will leave millions worldwide unprotected. Pollack also had the room to explore something I lacked room for -- the fascinating history of adjuvants, and the strange mystery of how they work.
Like so many things that work in medicine, adjuvants were discovered more or less by accident -- and were in fact a "dirty little secret" in a fairly literal sense. As the Wikipedia entry…
revere | September 28, 2009A good story by the AP's Lauran Neergaard yesterday highlighted the need for better public health surveillance and the efforts being made to improve it so as to keep track of possible rare side effects from the swine flu vaccine. This is an issue we've talked about a lot here, most recently in the context of not being able to fully test any vaccine for rare adverse outcomes prior to deployment. There's more involved than that, but first here's Neergaard's lede:
The U.S. government is starting an unprecedented system to track possible side effects as mass swine flu vaccinations begin next…
revere | September 27, 2009We don't do vaccines so much here, so I missed it last Sunday (Sept. 20) when it was posted over at JustTheVax, but there's an excellent summary of this year's swine flu vaccine offerings by Science Mom. It's hard to keep track of all this stuff so this is really valuable, and I know many readers here are interested. Thanks to Science Mom.