What’s the deal there? Does the CDC figure that more of it gets to the public if it’s available in drug stores rather than in various doctors’ offices? (They might be right– I’m just curious.)

Thanks for quoting me and then EXcluding the correction of my post so that it actually made sense.

(Of those who died from the H1N1 virus) HOW MANY WERE VACCINATED?

That was my complete sentence, if the truth has any meaning to you.

It’s amazing how such a simple question has created such a frenetic, nervous response.

You claimed I was demonizing the H1N1 vaccine by asking for evidence of its effectiveness. I never knew that asking for evidence could be seen as demonizing, especially on a site with “science” in its name.

And to claim there isn’t enough data is remarkable. If 2 die from H1N1, you look at their vaccine records. If 10 die, you look at their vaccine records. If 100 die, you look at their vaccine records, etc, etc. We’re only talking about deaths from H1N1, nothing else.

The more that die, the more accurate your ratio. This is just numbers.

Chris states: “most of the deaths occurred before the vaccine was available” is totally irrelevant because you simply limit the scope of your analysis to AFTER the introduction of the vaccine, or any time period you want for that matter that will give you the best data.

Someone else claimed there was a privacy issue on corpses (another astounding concept), but in any case, the numbers and ratios would not have to show names.

The solid hard evidence that confirms the effectiveness of the vaccine is this: of those who died from the H1N1 virus, We’re not evaluating trends, we’re not making a “good guess”, we’re not having to deal with the natural fluctuations of a disease as it moves through a population, nor the fact that a good percentage of people didn’t get the vaccine. It’s pure numbers.

Furthermore this evidence is very easy to attain, since medical experts would have vaccinations records of all those how died. Easy info at our fingertips, except for one thing……I can’t find it.

Since only 20% of the entire population has been vaccinated, and most of the deaths occurred before the vaccine was available, the answer is that it is too early.

Look at the data here: http://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm

Read this paragraph:

CDC estimated that between about 7,070 and 13,930 2009 H1N1-related deaths occurred between April and November 14, 2009. The mid-level in this range was about 9,820 2009 H1N1-related deaths.

Assume that no one who got the flu had been vaccinated, and remember this is a key concept: because there was no vaccine.

Now note that the vaccine had barely been available, but to only select groups. As of yet (I repeat) only 20% of the USA has been vaccinated. So it is a fair guess that the additional 1300 deaths (using the mid-level estimate) were not vaccinated.

So the answer to why you cannot find the information you want (for some unknown reason) is because of insufficient data.

Since the H1N1 vaccine is a monovalent, and it is designed for a specific virus (no guessing required like the regular bivalent flu vaccine) there are estimates that it is at least 90% effective (remember not everyone will respond to a vaccine, no matter how good it is, due to genetic variability). For more information on influenza, including a Virology 101 course checkout http://www.virology.ws/.

She did not seem to understand that there were more months between April 2009 (when the count of deaths started) to November 2009 (when the vaccine was available), than between November 2009 and January 2010. So she did not like my answer that the deaths before November were of people who were not vaccinated (and for those who are slow: it is because there was no vaccine), and then estimate the rest. At the present (late Jan. 2010) the CDC has reported that 20% of the USA population has been vaccinated:
http://www.reuters.com/article/idUSN1521475420100115

She also claimed some great stuff with Cuba and vaccine, claiming the literature was only available in Spanish. Unfortunately she did not count on Dr. Harriet Hall being fluent in Spanish. Apparently Cuba is not immune to flu:
http://www.laht.com/article.asp?ArticleId=349456&CategoryId=14510

Huh? I had to do a doubletake. December 29 and the WHO director still hasn’t been vaccinated for H1N1? What does she mean by “soon”? Doesn’t she heed her own warning about viral mutation? Surely the WHO director would have been given top priority, had she chosen to become vaccinated. Doesn’t she care about her responsibility to the world as WHO director, and her responsibility to prevent spread of H1N1 to her co-workers, family and friends? Is she some sort of vaccine “free-rider” relying on herd immunity?

http://news.bbc.co.uk/2/hi/health/8434273.stm

I am curious though that it seem like a ton of HCP are not getting the vaccine. My husband did, but a lot of his collegues are refusing it, and advocating it only for children or immunocompromised people.

I definitely will not be submitting a report to VAERS, though, as the cause of my chest pain was quickly determined to be esophageal spasm — my acid reflux disease (which I’ve battled for many years, and which runs strongly in my family) has apparently kicked itself up a notch. That, and I probably shouldn’t have had all that yummy, delicious rommegrot. I’ll be getting an endoscopy next month, as it’s suspected that I’ve developed another stricture. Yay.

Still, if I were an anti-vaxxer, I’m sure I would’ve believed there was some kind of a connection, despite the fact that I’ve had gradually increasing episodes of epigastric pain over the last month, leading up to this particularly severe episode.

That depends on the reproductive number (R0) of the infection you are dealing with. This indicates the number of people a case is likely to infect. For measles it is around 15, but for flu it seems to be between 1.5 and 2. An infection with a very low R0 will not spread widely, meaning that you need fewer people in the herd to be “immune” before it grinds to a complete halt.

To estimate how many of the population need to be immune (vaccinated or recovered from infection) in order to negate the risk of epidemic spread, you can use the R0 in the following calculation:

Proportion of population required to be immune = 1-1/R0.

For measles this is 1-1/15, which is 0.933 (or 93%, which is why the aim is to achieve this amount of vaccine uptake to get herd immunity). For flu it is between 1-1/1.5 and 1-1/2, or between 33% and 50%.

So it is possible that with only 1/3 to 1/2 of the herd being immune through vaccination or having had flu, that onward transmission would fizzle out. There are many other factors that could influence this however, and things are not always that simple (but it is still clear that you will not need 90% vaccine uptake to eliminate flu transmission)

I do not have info on the availability, but generally it is distributed through CDC to Tribes that offer vax in their clinics, and through the states through some that don’t (some Tribes are so small that their clinics and mostly referral only)

However, there is something called GPRA, and it is a publically available data set, where you can look up vax coverage rates. Although interpret with caution, especially with vax, as low vax rates may be in indication of tracking issues and not coverage (i.e. a parent may go tot he health department for 1 or more vax, and that info does not get back into the system).
As for being consider high risk, i think in practice they generally are, what with the high rate of diabetes and other chronic illness.

Thank you for yet another great post on this topic. Good info to have available. It is wonderful that there is a source for this information, like SBM, since the media tends to ignore or misstate the issues.

I would like to add a third topic: the inability to get the vaccine. I for one am still waiting. Doesn’t herd immunity require something on the order of 90% immunization?