Is it only my experience, or does it seem to be the following:
1. Those patients and parents who most vehemently refuse influenza vaccines are the same ones who complain the loudest about their symptoms and their childrens’ symptoms when they actually come down with the flu. And I wish I had a dollar every time I hear someone say they don’t get vaccinated because “I get sick from the flu shots.” Since the virii in the shots are dead, getting sick from the flu shot is highly unlikely. But hey, enjoy your fever, headache, cough, and muscle aches for the next week or so.
2. Entirely too many people think that the “flu” is vomiting and diarrhea. It isn’t. The “stomach flu” is a misnomer. Symptoms of influenza are fever, cough, runny nose, sore throat, headaches, muscle aches, and fatigue.
And while I’m on an influenza rant, remember the 26 million treatment courses of Tamiflu that the US government stockpiled? Yeah. That’s all past its expiration date now. At about $100 per treatment course, that’s $2.6 billion that the government can now flush down the crapper. I’m sure that there was bulk pricing for the government’s stockpile, but even half that amount of money is a lot to be throwing away.
I wanted to make a separate post so that I could post a graph that I scanned from a 2008 AMA article (click on the graph for a larger version if you can’t read the numbers).
The graph below shows the incidence of disease before and after introduction of vaccines. In every instance, the incidence of disease post-vaccine decreased by between 80% and 99.9%. The incidence of death from several diseases decreased to zero.
I realize that correlation does not equate to causation. I also admit the potential for the factual fallacy of post hoc ergo propter hoc. There is even the possibility that the data could be a government plot to classify pertussis infections by some other name to falsely increase vaccine effectiveness and to enrich the pharmaceutical companies that produce the vaccines.
When vaccination occurs, incidence of every disease goes down. When larger numbers of citizens in California fail to get immunized (or possibly receive booster shots), incidence of preventable disease goes up. I think that the data make a pretty compelling argument that vaccines work and that vaccines save lives.
I continue to think that those parents whose unvaccinated children die from a preventable disease should suffer some legal consequence.
I’ve heard a lot of reasons why people don’t want to get influenza vaccinations.
“I always get the flu after I get the shot” – injections are killed viruses containing only surface antigens and subvirons, so flu shots can’t cause infection. The intranasal sprays are weakened (“attenuated”) viruses which do have the potential to cause mild symptoms. Maaaybe you can say you got the flu from the spray – not from the shot.
“Jenny McCarthy says that I’ll get autism from them” – don’t get me started. She also recommends doing routine “poop analysis” to check for “yeast, bacteria, or infections.”
“The swine flu is a conspiracy by the government (see comment section) to increase pharmaceutical profits” – um … right … let me introduce you to Ms. McCarthy over here.
“I never get the flu” – with up to 20% of the US population getting influenza each year, odds are against you.
“I’m healthy. My body can handle the flu.”
I heard someone use the last excuse recently and had to remind that person about a unique feature of the novel H1N1 virus (aka the “swine flu”). A disproportionate number of patients who died from H1N1 were young and relatively healthy. According to this Reuters article, 90 percent of the seriously ill victims in Mexico were less than 50 years old and most of those patients were previously healthy. In addition, 87% of those who died were aged 5 to 59 — compared to a usual average of 32% for seasonal flu. All of the patients who died had “multiple organ failure.” Here is another article from the Washington Post about increased H1N1 influenza deaths in young healthy victims.
Why are young healthy patients the ones dying from H1N1?
One theory is that the patients’ own immune systems are killing them. In younger children, the immune system hasn’t fully developed. In older patients, the immune system loses some of its effectiveness. The theory is that immune systems in young healthy people are “too good” and go out of control. Scientists call the theory “cytokine storm.”
I”ll attempt a simple explanation of a cytokine storm, but realize that the process is more complicated than what I am trying to explain. When a virus infects the body, the body produces extra immune cells to combat the infection. Some immune cells attempt to kill the virus, others analyze the virus and produce antibodies. Some immune cells produce inflammatory chemicals called cytokines that serve several functions. Included in the function of cytokines is an inflammatory response – an increase in inflammation throughout the body. Normally, the body holds the inflammatory response in check – similar to the way that the thermostat in your home regulates the temperature. When the temperature in your house hits a certain set-point, the furnace shuts off. In a cytokine storm, the immune response is so intense that the feedback systems become overwhelmed. Cytokine production continues out of control and a generalized inflammatory response occurs in the body. Similar responses occur in anaphylactic shock and sepsis. Think of the difference between controlling a few bees buzzing around a picnic looking for food and a swarm of bees defending a hive.
More information about cytokine storm can be found here and here.
One study noted that gemfibrozil (Lopid) – a cholesterol medication – doubled survival rates in mice that had severe influenza infections. Apparently gemfibrozil has an inhibitory effect on inflammatory cytokine production.
Not saying that every young healthy adult who gets swine flu is an automatic ICU admission. Death rates for H1N1 are low, but are still about 3 times the rate of that for seasonal influenza. Just noting how strange it is that a healthy immune system may cause an increased risk of death from H1N1 virus.
Still want to skip that flu shot?
Oh yeah, and cover your mouth when you sneeze. While looking for a picture for this post, I found a video showing how many goobers are sprayed from the mouth during one sneeze. Blecch.
Many vaccines have a low profit margin. In addition, most vaccines have only one or two manufacturers. If you were a vaccine manufacturer and knew that you could potentially spend tens or hundreds of millions of dollars defending and paying out on one class action lawsuit about a vaccine you produced, would you continue to make the vaccines?
By immunizing manufacturers from liability for producing vaccines, the public policy argument is that the public benefits vaccines produce far outweigh the potential public detriment to the point that the government wants to encourage manufacturers to make vaccines.
Several of the attorneys that frequent this blog have stated that legal immunity for physicians is the equivalent of a “license to kill” but they are also quick to defend legal immunity for judges in performance of their duties.
So based on the above, I have two questions related to this immunity topic:
The federal government has immunized manufacturers from liability for making a swine flu vaccine. Will this ruling influence your decision to get the vaccine when it becomes available?
No, I'm getting the vaccine no matter what (81%, 250 Votes)
Yes, I probably won't get the vaccine because manufacturers can't be held liable (11%, 33 Votes)
I don't believe in vaccinations and wouldn't get the vaccine anyway (8%, 26 Votes)
Total Voters: 309
Using the public policy argument regarding vaccine production, would you support immunizing emergency physicians from liability if doing so would increase the availablity of emergency medical care?
Yes. We need more doctors providing emergency care (74%, 221 Votes)
No way. They're playing with people's lives and should be held liable if there's a mistake (26%, 76 Votes)
[I'm sure that everyone will be tired of hearing about the swine flu by next week, but I'll leave this post stuck to the top of the blog for a little while and will add links to the bottom so that those who are looking for more information can easily access it.]
Who ever thought that this phrase might be applicable to everyday life?
With the current swine flu having genetic components from N. American swine influenza A, European/Asian swine influenza A, N. American avian influenza, and N. American human influenza, it just goes to show you …
I’m not going to add any more pithy statements, but did want to give everyone a few resources to look at for more information about the swine flu.
First, EP Monthly just posted an excellent article about swine flu here. There are also several pertinent questions in the comments section of the article that are worth reading. One commenter notes that there is no Tamiflu left in the pharmacies in his city. The article will be updated when more information becomes available, so check back if you have questions or even consider posting a question in the comments section yourself.
UPDATE APRIL 29, 2009
Swine flu described as “uncontainable” – USA Today
First US fatality from swine flu is 23 month old Texas child – AP #1, AP #2
Vaccines for swine flu likely not available until November – NY Times.com, LA Times Do masks help prevent swine flu? ABC Houston
Mexican government shuts all nonessential functions to fight flu – MSNBC
UPDATE MAY 1, 2009 Hospitals swamped amid flu fear – LA Times [quote from article: "The pressure has been to close excess beds and get lean," said Columbia's Redlener. "Lean is not your friend in a pandemic."]
Lack of funding affects hospital’s ability to respond to prolonged flu outbreak – San Jose Mercury News
Press release from American College of Emergency Physicians regarding swine flu – ACEP.org
Caring for influenza at home – CDC.gov
US sends Tamiflu to Mexico, purchases 13 million more courses of treatment from manufacturers – Reuters
More Tamiflu use = higher likelihood Tamiflu resistance – Bloomberg.com
I’m not going to reiterate all the facts that are available in most news articles, but from what I’ve read, it appears that swine flu will be the real deal. Sixty eight people are dead and more than 1000 are sick from the disease in Mexico. Swine flu has already made it to the US.
Which brings me to the reason for the post — a challenge/query to the antivaccinistsas.
Time to put up or shut up.
Going to get your influenza vaccines? Going to wear masks? Going to take Tamiflu and Relenza?
Are you just going to rely on the “natural immunity” of you and your families to get you through the influenza pandemic or are you going to be hypocrites and get in line for your vaccinations? Perhaps carve out some reason why it’s OK to get vaccinated for this type of influenza but nothing else?
There were five kids diagnosed with the disease last year and one 7 month old died from the disease – the first death from the disease in Minnesota since 1991.
The article noted how Hemophilus influenza is “a disease that had been nearly wiped out across the United States after a vaccine that is given to babies in the first months of life was introduced in the early 1990s.”
This CNN article also notes that “Before vaccines became widely used, about 20,000 HiB cases were reported each year in the country. After children began receiving the vaccinations in the early 1990s, CDC officials said, there was a 99 percent drop in cases.”
Yup, you guessed it.
Three of the five kids, including the 7-month-old who died, “had not been immunized because their parents did not want them vaccinated.” One of the other kids hadn’t received all doses of the vaccination, and the last child had an immune deficiency – making it less likely that the immunization would work.
Should parents who fail to take steps to prevent a largely preventable illness be held accountable if their children suffer a bad outcome?
As an aside, does anyone know the specifics of the “religious exemption” that some parents use to avoid vaccinating their children? Isn’t that kind of like stating that my religion prevents me from paying taxes?