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H1N1 Pandemic Update

In a special episode of the Skeptics’ Guide to the Universe podcast, I host a discussion with David Gorski, Mark Crislip, and Joe Albietz about the flu, the H1N1 “swine” flu pandemic, and the controversies surrounding the flu vaccine.

You can download or stream the episode here. You can also subscribe to the podcast via iTunes or other popular aggregators.

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42 thoughts on “H1N1 Pandemic Update

  1. pmoran says:

    I despise video as an extremely inefficient form of science communication, but this contains excellent up-to-the minute material that is not readily available elsewhere. What about a concise, referenced text summary somewhere?

    I am sure I will be wanting to refer to it in response to anti-vax claims, but I don’t want to have to watch a lengthy video every time I need to refresh an aging memory concerning any point.

  2. DevoutCatalyst says:

    Great to have Gorski on SGU again!

  3. Chris says:

    Wait, there was video? I only saw the mp3 audio file! I listened to it on my mp3 player while I was doing mundane chores.

    I found it fun and informative, and a digest of many of the posts posted here on SBM.

  4. Chris says:

    I was really trying to create a snarky joke about the swimming deaths and the Parks and Recreation conspiracy to keep high school and college kids gainfully employed. But I could not.

    My middle child is a public pool lifeguard. It is a really good job and pays quite well for a high school kid, and now a freshman in college ($16 per hour!). He mostly teaches swimming, but he has had to actually do in-water rescues twice (once for a kid over extending his endurance due to parental pressure, and another when a kid jumped off the high dive before going through the required swim test for the deep end), and call 911 when an older swimmer had a cardiac event in the pool.

    I bet if we looked at the statistics, most of the drowning and near drowning incidents were in unsupervised areas and in open water (I have been dumped into a freezing cold lake, even though I am a good swimmer, plus a former lifeguard, the shock of the cold water would have been a serious issue if I had not had a life vest!). Lifeguards help prevent most drownings. First many of them are swim teachers, and they try to keep the unskilled swimmers out of deep water… plus they are there when trouble occurs.

    Vaccines are like lifeguards. They teach your body what to look for and how to handle a foreign antigen… and then they go into action if that antigen enters the body.

    Stupid analogy, I know… but I had to after this podcast and bit about the dangers of swimming.

    (Okay, it was noted baseball was even more dangerous… but the favorite thing I heard from my middle child (now lifeguard college student) when he was in third grade was “I don’t think I want to play baseball anymore.” Yay! The poor child could never hit the ball. But at least he could swim — the next summer he won a breaststroke competition.)

  5. edaps says:

    What about what Dr. Anthony Morris says, a distinguished virologist and former Chief Vaccine Office at the U.S. Federal Drug Administration (FDA), states that “There is no evidence that any influenza vaccine thus far developed is effective in preventing or mitigating any attack of influenza” and that “The producers of these vaccines know they are worthless, but they go on selling them anyway.”

  6. JTNAKN says:

    Can anyone help me explain this?

    http://vaers.hhs.gov/resources/2009H1N1Summary_Nov9.pdf

    Trying not to freak… but the 6 deaths are hard to ignore.

  7. JJ from Cowtown says:

    @edaps

    http://www.sciencebasedmedicine.org/?p=2040

    The authors here have made many attempts to convey the evidence for efficacy and measurable benefit for the influenza vaccine. The efficacy is hard to measure because the people that are at the most risk from seasonal flu (the elderly) are also the least likely to have a flu shot produce a proper antibody response.

    However, by immunizing groups that are not necessarily at risk you can provide benefit to the group. The best example can be seen at:

    http://www.ncbi.nlm.nih.gov/pubmed/18959473?dopt=Abstract

    (yes, this study is in the blog post above)

    Benefit seems clear when you try to convey immunity to as much of the population as possible.

  8. Zetetic says:

    JTNAKN:

    Six deaths divided by 33.7 million doses given = A statistically significant rate??? And… Is causality definitely connected to the immunization?

  9. JTNAKN says:

    I know you are right. But it’s so hard when I give something to my kids. I wonder, though, if the govt would ever admit if a death is indeed linked to a vaccine?

  10. Chris says:

    JTNAKN, the data in VAERS is raw self-selected data. Many times when the reports are investigated the cause of injury/death was unrelated to vaccines. Some wags have successfully reported that they were turned either into The Hulk or Wonder Woman to VAERS. Take VAERS data with a very large grain of skeptical salt.

    edaps, pulling one comment from much of the actual data is called “cherry picking.” You would be better off reading Dr. Crislip’s recent critique of the Atlantic article (it is on the list to the right). Your comment also indicates that you have not listened to the podcast.

  11. SF Mom and Scientist says:

    JTNAKN – if you took 33.7 million people and gave them all a placebo, you would certainly get some deaths in there, just because of the large number of people. People do die of a variety of reasons every day. Since this vaccine is being followed so closely, and VAERS is an open database, it makes sense to report them here in order to look for a pattern. (As the link states, there does not seem to be a pattern at this point.)

  12. edaps says:

    JJ and Chris…

    For the 1992-1993 season, the prediction was off by 84 percent. For the 1994-1995 season, it was off 43 percent for the primary strain and off 87 percent and 76 percent for two other strains. The Laboratory Center for Disease Control’s study comparing vaccine strains with the strains appearing during the 1997-1998 season found the match was off by 84 percent.

    yeah real effective….

  13. Chris says:

    I see you have not listened to the podcast. This is about the novel H1N1 virus, notabout the strains in the 1990s. What is the match between that virus and its vaccine?

    Dr. Crislip explains it very nicely in the podcast.

  14. JJ from Cowtown says:

    @ edaps

    1. Who are you quoting?

    2. What does it have to do with the demonstrable benefit shown in the Ontario study?

  15. edaps says:

    Zetetic

    “Six deaths divided by 33.7 million doses given = A statistically significant rate??? ”

    This made me laugh…lets play your statistically significant game

    measles death 1966 (two years prior to vaccine)=80

    population=48,272,100

    80 deaths divided by 48,272,100 = A statistically significant rate for mass vacinations???

  16. edaps says:

    Zetetic

    Oh and by the way there were 25 VAERS reported MMR deaths in 2007. so we are potentially ( i say potentially here because i am still on the fence in regards to vaccines ) risking millions of people to save 55 people? I am not sure the trade off is worth it.

  17. Composer99 says:

    @edaps:

    A measles vaccine was licensed for use in the US in 1963.

    http://www.texaschildrens.org/carecenters/vaccine/Vaccines_MMR.aspx

    That would probably explain the rather low number of measles deaths in 1966.

  18. Chris says:

    Look at the title of the blog posting. Look at the title of the podcast. Why do you think they both contain the alphanumeric combination “H1N1″?

    Repeat: VAERS is self-selected raw data. While it is useful to catch issues on the large scale, it is not useful as a way to evaluate vaccine safety on its own. Often when the cases are examined the vaccine connection is tenuous, and very often does not exist. Anyone can report any effect, and even be in a different country, like this gentleman in the UK who reported his daughter turned into Wonder Woman after a vaccine:
    http://leftbrainrightbrain.co.uk/?p=342

    Really, you should listen to the podcast. Do you need instructions on how to listen to a podcast? Go to the website and press the button that says “Listen to our Podcast Player.” Alternatively you can do a right click on your mouse pad on the words “Download Podcast”… you will see a drop down menu, click “Save Link as” or “Save Target” (depends on your browser). That will save an mp3 file on your hard drive. Then use whatever music player on your computer to play the podcast.

    Do try to figure out how to listen to the podcast. You might learn something, and may actually cease posting comments that show incredible ignorance (look up the phrase “herd immunity”).

  19. pmoran says:

    A silly mistake of mine ot refer to the podcast as a video, But recent posts suggests there would be advantages from having the main points available in a text version, as I suggested.

    – even on Quackwatch, although some have been induced to become reflexly suspicious of anything said there.

  20. micheleinmichigan says:

    pmoran “But recent posts suggests there would be advantages from having the main points available in a text version, as I suggested.”

    I agree, it may be worthwhile if someone can find the time or means to transcribe. Two reasons.

    1) Some of us readers just won’t listen. (my pod cast access is annoyingly slow. I can’t stand it.)

    2) The deaf and HOH community. CC or transcript might be appreciated in that population

  21. edaps says:

    Composer…

    WOW even better there were 39 measles deaths in 1962.

    explain that.

  22. JJ from Cowtown says:

    @edaps

    Death is not the only result worth measuring.

    Have you made the comparison of a pre-vaccine measles year and ALL associated incidents against a year with good vaccine uptake?

    Have you made the comparison of the risk of infection with the risk of vaccine harm?

    Show your work.

  23. Grglstr says:

    Great show Steve, David, Mark & Joe. I’m pointing all my friends toward it — wonderful overview.

    Could anyone point me toward information on Vitamin D and the flu? I have a few friends that are upping their dosage of vitamin D under the suggestion that people don’t generate enough vitamin D during winter months due to a lack of sun exposure and, as the thinking goes, this is why the flu is such a winter problem. (Of course, one would think that Mexicans would get plenty of sun in the spring).

    The NIH factsheet on Vitamin D doesn’t mention influenza, but does mention that Vitamin D does have a role in the immune system (below). Is this for real or is someone trying to sell supplements?

    http://dietary-supplements.info.nih.gov/factsheets/vitamind.asp

  24. Harriet Hall says:

    Grglstr,

    There is no evidence on Vitamin D and the flu. There is some evidence that vitamin D can reduce the risk of colds – but probably only in those who were vitamin D deficient. If you are not getting enough sun or enough vitamin D in your diet, you should take a supplement – not to prevent the flu but for a variety of other health reasons. There is a blood test to find out if you are deficient.

  25. Grglstr says:

    Thanks Harriet, I suspected as much. However, you can get a ton of links to people claiming just that if you Google “vitamin d flu,” so I can see how it is taking hold.

  26. Chris says:

    edaps:

    WOW even better there were 39 measles deaths in 1962

    Where are you getting your information? It seems quite flawed.

    There is a list of measles cases and deaths here:
    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/appdx-full-g.pdf

    Sorry, it is an image file, but I can type the numbers for measles for you:
    1961 there were 423,919 cases, and 434 deaths
    1962 there were 481,530 cases, and 408 deaths (you seem to be off by more than a factor of ten).
    1963 there were 385,156 cases, and 364 deaths, which was when the first vaccine was licensed. It takes a while for the vaccine to be effective. So…
    1964 there were 458,083 cases, and 421 deaths
    1965 there were 261,905 cases, and 276 deaths (hey it seems to be working… now let us flash forward a couple of years).
    1967 there were 62,705 cases, and 81 deaths…. much better, but got even better in the 1970s after the MMR was licensed.

    But then something happened between 1989 and 1991. What happened?

    Now show that you have listened to the podcast: Tell us what the state of Connecticut wants doctors like Dr. Novella to report?

  27. Composer99 says:

    I was going to look up some numbers as I thought edaps’ claim for 1962 measles deaths was incorrect, but I see Chris has beat me to it. Thanks, Chris!

  28. Chris says:

    Grglstr:

    Thanks Harriet, I suspected as much. However, you can get a ton of links to people claiming just that if you Google “vitamin d flu,” so I can see how it is taking hold.

    Dr. Crislip addressed some of the Vitamin D and influenza claims on the “More Flu Woo for You” posting:
    http://www.sciencebasedmedicine.org/?p=1455

  29. edaps says:

    Sorry, the stats i am looking at are for the UK, forgot to specify

  30. Chris says:

    edaps, why should we know you were using UK numbers when you keep harping on the American VAERS system? Plus, you seem to be cherry picking. From:
    http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1195733835814

    The numbers are:
    1961 there were 763,531 cases, and 152 deaths
    1962 there were 184,895 cases and 39 deaths
    and in 1963 there were 601,255 cases and 127 deaths.

    Measles incidence is cyclic, you chose a low part of the cycle. And a reminder that it takes few years before the vaccine takes effect, so measles in the UK did drop in the 1970s, and finally plummeted after the MMR was introduced in 1988. I would cut and paste the numbers, but since I provided a link (unlike you) I do not think that is necessary.

    Though a reminder: measles has nothing to do with H1N1. So what does say his kids do at the swimming pool? If you have listened to the podcast you would know the answer.

  31. Grglstr says:

    Thanks Chris, I missed that post.

  32. hellshousewife says:

    Great podcast, one problem:

    Those of us outside the US would have loved to hear a discussion on the decision is to withhold the vaccine from infants and children (until further notice). In Australia, for example, the H1N1 vaccine is not approved for children under the age of 10. In some countries, under the age of 18. Is this in any way evidence-based?

  33. RandyG says:

    Just wanted to let you know that I very much enjoyed the podcast, and I hope that you consider producing more in the near future, perhaps even on a regular basis. While I love SGU and listen to it every week, I consider it more entertaining than educational. SBM, however, conveys medically relevant, authoritative information that more effectively helps the less informed get beyond the silly and often dangerous voodoo that is CAM. The well-written and thoughtful posts on SBM are great, but for the lay audience (of which I’m an engaged member), a regular podcast is more easily digested, at least as portable (I can listen to it anywhere, even while driving), and because of its conversational nature, a bit more entertaining. You guys are naturals.

    Unfortunately, skeptics and SBM advocates often do most of their preaching to the long-since converted. This podcast is a welcome break from that trend, and I appreciate the time you all have taken from your busy lives to offer it up free of charge for everyone. A real public service. Thanks much!

  34. changeottawadotorg says:

    http://www.bolenreport.com/feature_articles/feature_article086.htm

    My fave part:

    So, who and what is a “David Gorski MD?”

    It is pretty clear here that we are dealing with a serious mental aberration. What kind of person sets themselves up, and actually believes, that they are an infallible Oracle, and then presents themselves in public as one?

    What I found did not surprise me.

    In short, David Gorski MD is a loser. He got himself a good education and set off on what he thought, at the time, was a good career path. But, like many focused people, he didn’t make the effort to compare the situation he was currently in with the reality of the surrounding world.

    He became a Breast Cancer Surgeon – and as we all know, that’s kind of like being a major DDT Manufacturer just before the EPA wakes up.

    Every day Gorski gets out of bed and heads to work where he claims, on his website, that he “is a surgical oncologist specializing in breast cancer and an Associate Professor of Surgery at the Wayne State University School of Medicine based at the Barbara Ann Karmanos Cancer Institute.”

    Sounds impressive? It isn’t. There is absolutely no recognized medical specialty known as “surgical oncologist.” It is a made up term. One to soften, I think, the reality that there is a whole male dominated mini-industry promoting the horror of hacking off women’s beasts as a health measure.

    The whole idea of breast cancer surgery is being challenged right now by studies conducted by the US government – as well it should be. The “Gold Standard” of breast cancer surgery is called the Halstead Procedure, which, in reality, draws a surgical line four inches above the naval, and a second line just below the collar bone. Everything between the lines is chopped off – down to the ribs, including all those 29 lymph nodes. “Mom” comes home from the hospital looking a lot different. Then, since all those lymph nodes are gone her arms are going to swell up to the size of her waist.

    But the family needn’t worry. They won’t have to look at “Mom” in her new ugliness for long, for the surgery itself released all those tumorous cancer cells that her body’s immune system had encapsulated, into her blood stream spreading the cancer EVERYWHERE. So “Mom” will be heading back to the hospital where the same white-coated-stethoscope-around-the-neck doctor will now recommend $400,000 of chemotherapy (and could you stop by the hospital business office while you are here, and sign over the title to your home as guarantee of your co-pay please?).

    But, thank God, all this is on the way out. City Cemeteries won’t be doing a boom business in “Mom we love you…” signage so much, now that the government, and hence insurance companies, have cut out those “annual mammograms” designed to scare young women into letting some ghoul stick needles into her breasts for so-called tests.

    More, needle biopsies themselves are death waiting in the wings. The action of some ham-handed, poke-a-lot, drooling(?) older male “surgical oncologist” jabbing, and jabbing, and jabbing, and jabbing, and jabbing, a biopsy needle into a soft tissue breast trying to find an actual tumor is a cancer spreading procedure. Why? Once the needle finds the tumor it pierces the shell the body’s immune system has built up around the cancer cells. Withdrawing the needle, while squeezing the breast makes the cancer cells squirt into the breast tissue along the needle hole. More jabbing spreads the cancer cells around, and the capillaries in the breast pick up the cells and transport them throughout the body to lodge and replicate elsewhere – Isn’t that special?

  35. pmoran says:

    Re biopsies spreading cancer —

    “Yet following routine biopsy and surgical treatment only 6.7% of patients with breast cancers up to 3 cm (1.2 inches) in diameter develop axillary lymph node metastases within five years [1]. If bad prognosis cancers i.e. those with a high score on four parameters combined (larger tumor size, high tumour grade, laminin receptor positive, and HER2 over-expression) are excluded, the rate of development of lymph node metastases is only 2%. We know from other studies that many, possibly all, of these metastases would be present before any medical attention, but undetectable clinically.

    The same applied to blood stream spread. Only 11% per cent of such patients went on to develop distant metastases within five years, and only 5% when those with a bad prognostic score were excluded. It is known that more aggressive breast cancers can give rise to occult (undetectable) blood-borne metastases at a very early stage, so that many or most of these metastases will be pre-existing. The biology of the cancer again appears to be the main determinant of outcomes.

    (These are medium-term results and will overestimate the final cure rate of breast cancer in these patients).”

    Reference at http://www.cancertreatmentwatch.org/general/biopsies.shtml

    The fact is that absolute mortality rates from breast cancer have decreased substantially over the recent years of intensive mammography use *despite* the routine use of needle biopsy and various forms of surgery. Mastectomy is needed less often in these earlier cancers.

    There is also a theoretical risk of implanting cancer along a needle track, but that is excised and/or irradiated.

  36. pmoran says:

    (The other comments are beneath contempt and not worthy of response. )

  37. David Gorski says:

    I seem to recall that you’ve had some experience with Mr. Bolen yourself, haven’t you?

  38. pmoran says:

    “I seem to recall that you’ve had some experience with Mr. Bolen yourself, haven’t you?”

    Yes, but back then Tim was threatening everyone who criticised Hulda Clark. He pretended he was gathering a list of us for court action.

  39. David Gorski says:

    These days, Mr. Bolen appears to be up to the old tricks he turned against anyone who criticized Hulda Clark, except now he’s turning them against anyone who criticizes Suzanne Somers or Dr. Nicholas Gonzalez, which is, as far as I can tell, apparently how his attention turned to me. (It may also have something to do with previous posts elsewhere about the Desiree Jennings case, given that Mr. Bolen cites Dr. Rashid Buttar as a friend.) My two posts elsewhere about Hulda Clark’s death probably also didn’t help. I have no idea if Mr. Bolen has any concrete connection to either Ms. Somers or her organization or to Dr. Gonzalez. My guess is that Ms. Somers’ publicists and lawyers are almost certainly too savvy to let her become associated with Mr. Bolen because the potential for embarrassment for a figure as public as she due to Mr. Bolen’s antics far outweighs anything he could do for her, which is pretty much nothing her own people couldn’t do and do a lot better. I don’t know whether Dr. Gonzalez would associate with him.

    It is rather amazing though, how fast Mr. Bolen has moved on after the sad death of Hulda Clark from cancer in September.

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