Even in 2014, influenza kills

I don’t think it can be repeated too many times during flu season: People can die 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 arguing that it will encourage promiscuity by removing one of the consequences of sexual intercourse, one of the stupidest arguments against the HPV in existence. (Seriously, does anyone think teens and young adults, when their hormones are raging, worry about maybe the possibility of maybe getting cancer 20 years down the road when on the verge of a night of passion now? I don’t.)

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 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 posterior for over a week. I 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 from the inflammation caused by the infection. If all you have is a few sniffles and a cough plus or minus a low grade fever, you probably do not have 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 cliché 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 blogging infectious disease colleague of mine known for his strong opinions on the flu vaccine right here on this very blog, 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. You’d be wrong, even if you’re in seemingly perfect health.

We can’t know whether Alice Jones thought something like that or not. She’s dead now from the flu. But it wouldn’t surprise me if she did. I’m not saying that she was antivaccine. Again, we have no way of knowing that; most likely she was not. Far more probable is that she was more like most people who fail to get the flu vaccine. They tend to be just people who, perhaps under the sway of mistaken confidence that leads them to think that the flu isn’t so bad and that they can handle it if they catch it, place getting vaccinated low on their list of priorities, sometimes so low that some years they don’t bother to do it at all. It’s an easy omission to make, particularly if you’re a young mother with three children to take care of and are thus very busy doing other things. I’ve even made that mistake—once. Never again. I was fortunate enough that, although I was very sick, I didn’t need to be hospitalized, and I didn’t die. Far too many are not that fortunate. Like Alice Jones.

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

Posted in: Public Health, Vaccines

Leave a Comment (143) ↓

143 thoughts on “Even in 2014, influenza kills

  1. stanmrak says:

    “The risk (from mercury) is minuscule, and the flu can still kill.”

    Maybe the risk from the flu is just as miniscule as mercury poisoning from a vaccine – there really aren’t enough long-term studies to make such an assertion.

      1. Andrey Pavlov says:

        Stupendously irrelevant study. Stan, are you trying to say that the flu vaccine injected intramuscularly is similar to a case report of elemental mercury injected intravenously? Do you even remotely read what you post up here? Do you genuinely think you are comparing apples to apples here? Because you are comparing apples to Mars rovers.

      2. stanmrak says:

        citation please.

        1. Chris says:

          It had nothing to do with any vaccine, and not even the same kind of mercury. Both the dose and chemical structure were completely different?

          So what are your credentials? Did you even pass an a basic English class in high school?

          1. Andrey Pavlov says:

            He really is the epitome of Feynman’s cargo cult science. Either that or knowingly trying to obfuscate for personal/marketing gain.

            “Citation needed” I need a citation to comment that an intramuscularly injected organically conjugated mercury compound is fundamentally different than intravenously injected elemental mercury? Fine, here’s my reference: Zumdahl’s Chemistry. I believe I used the 5th edition back in the day, but you can start at the 8th edition Stan.

            Of course, Chris makes an excellent point so perhaps Guided Comprehension for English Learners might be more appropriate than a chemistry text.

            1. Sawyer says:

              *Shudder* I remember paying $120 for that textbook and a lab manual and thinking it was expensive at the time.

              1. Chris says:

                Personally I think taking an Adult Basic English class at his local community college would help Stan’s reading comprehension. It might go a long way to help him understand The Complete Idiot’s Guide to Chemistry.

                He might even learn the difference between elemental mercury and a molecule that contains a mercury atom. It might be to much to expect he would understand a mole, Avogadro Number, or how valence shells contribute to reactivity.

          2. WilliamLawrenceUtridge says:

            Stan’s in marketing, he realizes the importance of being FIRST! that way the fear portion of his message embeds in your subconscious so any rational response requires an uphill battle. Stan doesnt’ care what is accurate or truthful, he just cares about making people afraid.

    1. Chris says:

      Again, what are your credentials, Stan? Did you even take high school chemistry?

      1. WilliamLawrenceUtridge says:

        Marketing. Self-disclosed.

    2. Darwy says:

      IV injection of elemental mercury vs IM injection of an organomercury compound.

      The two situations are not comparable, nor do they have the same risks involved.

      Try again.

    3. janice says:

      A chemistry student did the math on mercury in flu vaccines and its equivalent to the same amount you got get from a meal of salmon. The math is available online and very detailed you just have to google it.

      1. Chris says:

        Sorry, Janice, if you make a claim you need to provide the supporting evidence. Especially since the University of Google is full of deck.

        For instance, the mercury containing molecule in salmon is not the same chemical as thimerosal.

        1. Sawyer says:

          I think Janice probably meant this statement as a point in favor of vaccines, not as anti-vaccine propaganda. Most people don’t think of salmon as a major cause of autism.

          1. Chris says:

            Hmmm, hard to say. She just could have pointed to the article she was commenting on, not to Google.

            1. WilliamLawrenceUtridge says:

              I read, then re-read the comment and agreed with Sawyer’s conclusion – that it was a well-intentioned effort to point out the error of worries about mercury in vaccines. Could use some refinement, hence…

      2. WilliamLawrenceUtridge says:

        Janice, did the chemistry student calcultae purely the amount, or did they factor in the difference between ethylmercury (found in some vaccines) and methylmercury (concentrated in apex predators and the reason salmon is considered a risky meal)?

        The two are different, ethylmercury is handled very differently by the body, is eliminated much more quickly, bioaccumulates significantly less, and is far less toxic.

  2. Jann Bellamy says:

    From this week’s news: University of Florida Health/Shands Hospital, in Gainesville, FL (which is not that big of a place), has admitted over 150 people with the flu virus since late October. 12 died, 5 of those were under 40 years old. Of the 12, 11 had not been vaccinated.

  3. Birdy says:

    For what it’s worth, in microbiology class yesterday, my prof (who also taught the sometimes-commenter here PEICurmudgeon some years ago. Small world) took a few minutes at the start of class to talk about a flu case in the news. When I put up my hand and commented about the circulating strain that has also been in the news, he gave me the mic for a few minutes to inform my classmates and urge them to go get their flu shots.

    I have chronic lung disease but have not always been terribly careful about getting my flu shot mostly because it was a bother to get it. After my son suffered pneumonia – repeatedly, he would get close to getting better then go downhill again – following the flu, we’ve been careful about getting it ever since, and I’ve been vocal about it with others.

  4. Sawyer says:

    My physic prediction for 2014 is that out of the ten most popular medical quacks (Adams, Oz, Mercola, Olmsted, etc.), at least two will cite Tom Jefferson’s work in the next week to dissuade people from getting vaccinated. I’ll go ahead and waive any claims to the JREF prize when I’m proven right.

    I’ve always been curious which spreads faster: influenza, or misguided conclusions about the Jefferson’s Cochrane review. They both seem to be highly infectious, show up in populations that are perfectly capable of protecting themselves against the infection, and cause symptoms of intense malaise and confusion. And both cause a high fever, at least for me. I suppose the flu itself is still technically more dangerous, but it’s a tough call.

    1. Sawyer says:

      Ugh, psychic prediction. Although now that I think about it is a physic prediction too!

  5. Chris says:

    I have resorted to bribery for my younger son. I have been reminding him for months to get the vaccine. He is a college student who lives in a house with eleven other young persons, and his job involves being around children, aka as infection vectors.

    Since he is a starving college student, I told him I’d give him cash if he’d get the vaccine.

  6. Sawyer says:

    Addendum: Thanks for the Saturday post. A dose of Crislip and Gorski in less than 24 hours has brightened my weekend.

    1. David Gorski says:

      Fear not. I’m still planning a Monday post. I just liked this one from my not-so-super-secret other blog that I thought it needed to be cross-posted, with some minor alterations.

  7. MTDoc says:

    I was a resident in a California County Hospital program during the 1965-1966 flu season. Having just come from six years in the USAF, I had received every vaccine known to man (Air Rescue Service required “world wide” immunization for all members,regardless of post). We had a hospital wing called the “chronic ward”, what we would call a nursing home today. We sustained a 60% mortality rate over a four week period. And on our active services, we soon learned that if you had COPD, you were not going to make it, no matter what we did. No ECMO in those days. But the other thing we observed was how sick many apparently healthy young people became. In keeping with the times, we at first thought these were secondary pneumonias, but they did not respond to antibiotics, and we concluded they must be primary viral pulmonary infections, which I think is acceptable theory today. I remember thinking at the time that we had been led to believe in Med School that the Spanish Flu epidemic of 1918 would have been different “if we had only had penicillin”. We have come a long way since then. But we’ve forgotten a lot , too.

    1. Dr Robert Peers says:

      Right on, MTDoc! Who ARE these weakies with Apparently Healthy Person Syndrome [AHPS]? That’s what I am wondering. I read a big PubMed paper on the 1918-19 flu pandemic the other day–see FINCH C E AND LINGERING, on PubMed. If I recall correctly, he claims that most folks then suffered a surprisingly mild illness lasting a few days. Is that so? Whence cometh their magnificent immune power? In dramatic contrast, a proportion of young folks [what %?] died rapidly–so quickly, it was probably true primary viral pneumonia. Many oldies survived because of residual immunity from previous flu–about 1889? So what could explain AHPS? I have a suggestion–apart from having no previous flu exposure, we should consider ANXIETY DISORDER [known to the laity as “stress”]. Psychoneuroimmunofolks go on and on about poor anti-viral immunity in “stress”–which is really permanent anxiety. The stress hormone cortisol is said to impair lymphocyte proliferation. Hey, that could mean big trouble, since every immune scientist, from Nobel Prize winner Peter Doherty [here in Melbourne, Australia], to the Helmholtz Centre for Infectious Diseases, in Germany, says that ONLY A HIGH-SPEED IMMUNE RESPONSE will stop a virus actually KILLING us. Bacteria, I guess, breed much slower, so we have time to send a few pus cells around, before the situation gets critical. Stress/immunity guys like Sheldon Cohen and Ronald Glaser have shown that anxious folks are easily infected with inoculated nasal virus, while relaxed types may get no symptoms at all. Indeed, common cold virus stuck up volunteers’ noses fails to cause ANY symptoms in 25% of folks in general–so who are the weakies? Back in 1942, Yale’s Arthur Evans studied West Point officer cadets who all got hepatitis A-contaminated vaccinations: those most affected by clinical jaundice were more stressed and ambitious than calmer guys. What else does overactive cortisol do? Brisbane multiple sclerosis researcher Prof Michael Pender claims that Epstein Barr virus is a big player in autoimmune diseases, especially in “MS”. He finds that cases often have fewer cytotoxic CD8+ T lymphocytes, so can’t control EB–and this weakness also affects first degree relatives. He blames this on genes, but gave no citation on that. So I consulted The Oracle: PubMed–STRESS AND CYTOTOXIC CD8+ T LYMPHOCYTE, and struck gold. C C Norbury says hey, cortisol can weaken dendritic cell function, meaning poor processing and delayed display of viral antigens to passing CD8+ T-heroes, whose mission in life is to ruthlessly seek out and kill virus-infected cells. Cortisol may do other bad things, to create AHP Syndrome. Now anxiety has a cause–it has been traced to fatty maternal diet, by Elinor Sullivan [monkeys] and Staci Bilbo [mice]. Western nations eat a lot of fat, and anxiety affects 25% of Aussies, 30% of New Zealanders, and 32% of US adolescents [Kathleen Merikangas, NIH]. Fat inflames the placenta, which then lets maternal cortisol access the foetal brain, to programme life long anxiety epigenetically. Flu itself may cause offspring anxiety in mid-pregnancy, via the same placental inflammation, +/-inflammatory cytokines from Mum’s blood. Caleb Finch, in his LINGERING EFFECTS paper [above] says these 1919 kids were born smaller, and in adult life are prone to vascular disease, diabetes, and WORSE FLU!!! Is this some sort of sinister pseudo- or para-Lamarckianism!!?? So maybe anxiety does indeed dangerously slow down our critical early response to flu and other viruses? If the weakies are mostly anxious–a diagnosis easily missed–what can we do about that? I suggest lots of grains, beans, nuts and citrus–foods rich in the glucose isomer myo-inositol, which Israeli researchers have shown can reduce anxiety effectively, by inhibiting serotonin 2A receptors. My many inositol-treated anxious patients report calmness, unusual energy, and a new-found and striking resistance to coughs, colds and flus, that used to plague them previously. In addition, inositol has major anti-ageing properties, since it suppresses the pro-ageing IGF-1 growth pathway [M Falasca, 2005]. Downstream longevity genes activated by pathway suppression include genes for glutathione synthesis [which may enhance antiviral immunity], enhanced proteasomal function [needed for swift viral antigen processing] and a remarkable bunch of RNA-interference genes for rapid virus suppression, that are normally activated [it seems] ONLY IN THE GERMLINE. Gary Ruvkun at Harvard identified this “soma-to-germline transformation” effect in his long-lived IGF1 receptor mutation worms. This slight but strategic genetic effect of anti-ageing represents a mild rejuvenation of the mortal somatic cell–another result is high-precision DNA repair. WOW! Let’s all switch on some immortal germ line cytoprotective functions, by eating Boston Baked Beans, or drinking Florida citrus juice. This handy re-joov effect may be driven by FoxO1, one of two key longevity transcription factors: this one can induce the key stem-ness genes OCT4 and SOX2 [used in transcription factor cocktails to produce induced pluripotent stem cells], which may do the re-joov trick. Foxo1 also preserves stem cell function throughout life, meaning prolonged ability to produce T cells of all types–including cytotoxic virus-killers, Natural Killer cells etc.. And also a larger pool of T memory stem cells following infection or vaccination–a huge bonus for public health, that may restore immune memory in older folks who make no response to flu or pneumococcal vaccines.
      We’ve heard enough about fruit’n’veg–lets start pushing grains, nuts and legumes, to boost public immunity [and longevity]. And don’t forget the OJ.

  8. Andrey Pavlov says:

    My understanding of the 1918 flu pandemic (and flu mortality and morbidity in general) is that young healthy people are actually at increased risk from the flu. I’d love a comment from Dr. Crislip if I am wrong here, but my understanding is that it isn’t the virus itself that is so deadly but the immune response mounted against it that leads to overwhelming pulmonary edema from the inflammatory response in the lungs. That is why people end up on ECMO and the elderly are actually less likely to die; they don’t mount the same vigorous immune response healthy 29 year olds do.

    Yes, of course secondary bacterial pneumonia does happen and is a killer as well, but in the acute phase – such as this tragic story of Alice – it is the immune response to the virus itself. In 3 days it is highly unlikely she would have had a secondary bacterial infection and massive non-cardiogenic pulmonary edema (vasogenic from increased vascular permeability in the lungs from the immune response) could easily overwhelm her gas exchange capacity and create pulmonary hypertension and right sided cardiac failure.

    1. Mark Crislip says:

      It is more likely the elderly have residual antibody from being exposed to H1N1 when in circulated until sometime in the 1950’s:

      J Infect Dis. 2013 Oct 1;208(7):1051-61. doi: 10.1093/infdis/jit294. Epub 2013 Jun 28.
      Age-associated cross-reactive antibody-dependent cellular cytotoxicity toward 2009 pandemic influenza A virus subtype H1N1.

      and I like this:

      Vaccine. 2013 Dec 5;31(50):6030-3. doi: 10.1016/j.vaccine.2013.09.063. Epub 2013 Oct 3.
      Cochrane re-arranged: support for policies to vaccinate elderly people against influenza.

      1. David Gorski says:

        Wow. That last one (“Cochrane re-arranged”) is an eye opener…

        1. Sawyer says:

          I’m curious – how often is that “patient journey” approach used to sort and evaluate data for a particular treatment? It makes intuitive sense to me that this would be a much better way of figuring out what’s really going on, but I’m sure there are limitations. Is this method widely accepted by other researchers and doctors?

      2. Chris says:

        And there are some of us who as college students volunteered to get the Influenza A/NJ vaccine in 1976. :-)

        The next year or so my boyfriend (now hubby), came down with Russian flu that laid him up. I did not get it.

      3. Andrey Pavlov says:

        @Dr. Crislip:

        I apologize that I do not at the moment have more time to delve deeply and do my own reading, but I will tomorrow. This is what I was referring to in the idea that a more vigorous immune response contributes to influenza deaths and how that translates to younger people being more at risk than older people. The idea that older people may also have had additional protection from previous exposure makes sense as well, but I don’t see that the two ideas are mutually exclusive. There was a bench science article on the topic in Cell where they were trying to identify the specific mechanism by which a “cytokine storm” type response leads to mortality in influenza.

        I’ll track down more primary source data to read tomorrow on the topic and see if my limited understanding holds up.

        And yes, that last one about Cochrane is interesting. I’ve downloaded the full text and will read through it.

        Thanks for taking the time to respond Dr. Crislip.

  9. SC says:

    I am just now getting over H1N1. A few times I thought I might need to be hospitalized because I just couldn’t breathe. To put it in perspective, I am a healthy 30 year old who goes running and does advanced yoga several times a week. Didn’t matter. It knocked me fully on my ass for two weeks, as in, in-bed, wiped out, sick as a dog. It also left me with a lasting disgust for anti-vaccination advocates. This is the only year I forgot to get the flu shot because I was so busy with grad school and work and it took me out like a wrecking ball.

    1. WilliamLawrenceUtridge says:

      I judge you more for your choice of pop culture reference than your failure to vaccinate :)

  10. Glenda says:

    My family and I had flu shots back in October, but is there a separate H1N1 vaccine we should get? I didn’t realize H1N1 was circulating this flu season.

    1. Frederick says:

      there is always chance that it will be around, Here in Quebec there was couple of case reported.

      But i gonna had a Question to you question, I did get it, couple 2-3 years ago, does it need a “recall” ?

    2. Harriet Hall says:

      Not a separate vaccine. The 2013-2014 trivalent influenza vaccine is made from the following three viruses:
      an A/California/7/2009 (H1N1)pdm09-like virus;
      an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011;
      a B/Massachusetts/2/2012-like virus.

      1. Glenda says:

        Great; thanks for your reply.

  11. Frederick says:

    Couple of years back i did get the Flu vaccine and did get the H1N1 in, 2011? ( i don’t remember when i was a big thing) on of my friend did get the h1n1 and my nephew ( who was a little over 1 years old, he got through it without too much problem luckily. So i did get the h1n1 vax not only for me but to protect people, i was happy to see long lines of people. My wife work in public health so she had to get to be coherent with her work.
    But for the regular flu, like i said, did got it 7-9 years ago, but never repeated, probably too lazy or thinking it was useless for me etc. I was not as informed has I’m now. And at my old workplace (a paper mill, i worked there 11 and half years until last august) offered it free ( in Quebec it is free for vulnerable peoples but not for the others), but never got it. I did get sick couple of time, Last years ( and 4 years ago, i remembered i was sick like hell) i had a bad flu. But most of the time i have only a cold, that maybe why i was thinking i was useless.

    Anyway all this to say that I Promise to SBM to get my Flu shot every year from now on, ( My wife got the FLU right now, not a cold, with are aware of symptoms enough, But it is not to bad, a bit of fever and muscle pain, but today she was better) If not for me for other people, the mother of one of our friend she have a weak immune system ( I don’t know the proper word in English so please corrected me ) After fighting some kind of leukemia and having bone marrow transplant. ( She had a experimental treatment with the chemo that seem to have work good). So Yeah I gonna do that in the future! ( i also have all my “travel” vaccine i guest anti-vaccine people don’t travel very far)

    1. WilliamLawrenceUtridge says:

      Every year I get the ‘flu vaccine for my grandmother. Me, I get sick, I stay home for a couple days while still getting paid. Her, she gets sick after I visit her, she’s dead. And I like my grandmother.

      Don’t get the ‘flu for you, get it for other people.*

      *But get it for you too, because sometimes it preferrentially kills the young and healthy.

  12. Carl Fink says:

    I’m currently experiencing a very annoying vaccine reaction (lichen planula subsequent to hepatitis B vaccine) and you are still completely right, Dr. Gorski.

    1. Frederick says:

      I never had bad reaction to Vaccine except pain where i had the shot, but every time i get a shot, i get really dizzy, need to be lying down, every damn time. nearly pass out once lol. i have to wait 5-10 min until the dizziness goes away. Blood pressure drop something like that.

      1. Alia says:

        It looks like a stress reaction, some people react like this to needles or sight of blood. As for me, I had a very unpleasant reaction to Hep B (that was one year I thought I got the flu despite the shot – but high fever and general maialse lasted just one day and it was two days after the Hep B shot), following a flu shot I only get a bit of painful swelling at the site, which is nothing really.
        My mother, on the other hand, had the flu shot only once in her life and following it she had a very high fever, complete with delirium. So we all vaccinate for her, including my father, who is 80 and entitled to free vaccine.

      2. nancy brownlee says:

        Do you faint or get very dizzy at other times? Vasovagal syncope- good to know your triggers, and to LIE DOWN when (or before) you get dizzy. Immediately, since cracking your skull while falling is the biggest danger.

        1. Frederick says:

          I’m not prone to get dizzy on other occasion, I think the nervous reaction might be it. Funny i Broke my wrist in 2012 snowboarding, it was PAINFUL, my god, but no dizziness. But vaccine, yeah. I do always lie down, I know it’s gonna happen.
          Last vaccine i had was H1N1, there was a small bed for the ‘in case of’ i lie down straight on it, the nurse was laughing “Ah ok seem like you know what is going to happen” I guess i never liked that. I have the same reactions with i got blood test. Seem like i don’t like needles.

          1. jdl83 says:

            I’m a fellow VVS (Vasovagal Syncope) sufferer. Mine is also triggered by needles/blades. It’s not the “pain.” It’s merely the knowledge of having something sticking into my skin. As soon as the object is removed, I’m completely fine. I lose consciousness nearly every time I have to give blood.

            Some things you can try next time:

            1. Drink a sports drink, and consume some salt, about 30 minutes before being exposed to your trigger. This thickens the blood which can help keep your blood pressure from dropping too far.

            2. Tense up you muscles in legs and core. I use to try to “just relax” before giving blood, but this is the wrong thing to do. You want your blood pressure higher, not lower.


      3. Stacy says:


        I have a pharmacist colleague that has the same reaction so imagine my excitement when I was asked to do his flu shot the first year I received my license to do immunizations! Haha!

        My trick? I sing. Yeah, it’s super awkward because I’m a terrible singer but as silence set in over the counselling room where I do my flu shots and the color drained from his face I thought “eh, what the heck?” and started singing “Soft Kitty”. He immediately burst out laughing, I quickly gave him his shot and he’s never felt better after an immunization. Pharmacists LOVE mechanism of actions so here’s mine: laughing increased the blood pressure in his head (slightly) which kept him from getting dizzy…or he was just distracted…whatevs.

        Best part? We did the flu shot as a promotional ad for our local paper and the journalist that was taking pictures burst out laughing too. Worst part? The picture in the journal was of me clearly in mid-song and my boss having a giggle fit – real professional.

        SBM/SBP bloggers and the people who leave comments: keep up the great work. Great way to start my day with coffee and some EBM.

        1. Andrey Pavlov says:

          Worst part? The picture in the journal was of me clearly in mid-song and my boss having a giggle fit – real professional.

          I am a firm believer that we should try and have fun and be silly like children as often as we can, whenever we can, and as late into life as we can*.

          *There are obvious times when this is highly inappropriate, but any time I can make my patients smile, let alone laugh, I consider that a win.

          1. Harriet Hall says:

            I love the laughter idea. It reminds me of a nurse I once knew who would slap a child on the buttocks and while the child was registering the slap, she would sneak the injection into the same area without the child realizing he’d gotten a shot.

            1. Andrey Pavlov says:

              My dentist has a neat little “trick.” Just as he is inserting the novacaine needle into your gum, he grabs your lip and shakes it quickly and vigorously just a few times. I’ve never had an issue with needles, but with him I’ve never even been able to feel the needle going in, even though I’ve actively tried ever since I figured out why the heck he was shaking my lip!

  13. Young CC Prof says:

    My son, age 1 week, thanks you for this message. (Really, vicious flu season, vicious RSV season, still a peak year for pertussis, it’s enough to give a mother nightmares.)

    1. brewandferment says:

      congratulations on the arrival of your new baby. Enjoy this time!

  14. It is also important to note that recent studies have shown that of the kids who die with the flu, many don’t have a high-risk medical condition (just over 40%) and die before they are even admitted to the hospital. Also, the vast majority of kids who die from flu didn’t have a flu vaccine.

    Pediatrics – Study of Flu Related Deaths in Children Shows Even Healthy Children at Risk

    CDC Reports About 90 Percent of Children Who Died From Flu This Season Not Vaccinated

    1. Frederick says:

      That’s a shame, of course that all probably lies paid by big pharma ( who prefer to get paid for vaccine that prevent sickness than let people being sick.. yeah that logical! ). Seriously I hope those number will convince at least the people who are not in the believers field ( those are already broken )

  15. dawn fischer says:

    I’m curious if there are cases of people getting the flu this year that DID get vaccinated.

    1. Charity says:

      This year, just like every year, I received a flu vaccine and my husband did not. The weekend before last, we both caught the flu. His started first with a little cough, and soon he had a high fever, incapacitating aches and fatigue, and awful, awful chest congestion. I soon started coughing too, and I could feel my chest starting to fill with gunk.

      The difference is that by a day and a half later, while he was in bed shivering with fever and choking on mucus, I was feeling completely healthy. The minor cough and congestion never did develop into anything more; I never even had a fever. It’s a good thing I felt well, though, so that I could nurse him through HIS illness! I was concerned a few times that he’d have to be hospitalized if his breathing worsened any further.

      He’s finally getting better and should be back at work soon, while I never missed a day. The beautiful part of it all is that this experience was finally enough to convince him that he should start getting his yearly shot! The man who used to react to the idea with “I don’t need that voodoo!” has finally been persuaded to see reason. :)

    2. MadisonMD says:

      I’m curious if there are cases of people getting the flu this year that DID get vaccinated.

      Your question is irrelevant. How would this matter if vaccination reduces incidence and deaths from influenza?

      If one person got lung cancer without smoking, you would conclude it is safe to smoke?

      If a person died in a car crash while wearing a seatbelt, you would conclude it is safe not to wear it?

      1. Chris says:

        “Your question is irrelevant. How would this matter if vaccination reduces incidence and deaths from influenza? ”

        It is part of the Nirvana Fallacy. A common argument against vaccines is that they are not worth the “risk” if they do not provide 100% immunity. Which in the real world is impossible.

      2. dawn says:

        My question was relevant to me!
        On 12/28/13 I was on holiday in Brazil where I picked up a ‘cold,’ returned on New Years to visit my elderly mom in Los Angeles. By the time I returned to home to Sacramento two days later I had a fever and what I believe to be the flu. I worried that I exposed my mom. She is vaccinated. I am not On 1/14/14 I am still ill with fever and symptoms of flu, she is seemingly well.
        Thank you for your response.

        1. WilliamLawrenceUtridge says:

          Yes, people who are vaccinated can get influenza. However, most people will respond to the vaccine and, if not immune, then at least experience a milder form of infection (assuming the vaccine they get is well-matched to the strain of influenza they are exposed to). Influenza is a complicated infection, Dr. Crislip discusses the flu vaccine efficacy here, and you can search for more information by plugging “influenza” into the search box at the top-right part of the page.

    3. WilliamLawrenceUtridge says:

      Absolutely there are, for myriad reasons. The vaccine is not 100% effective. The vaccine does not cover every strain. The vaccine is sometimes given too late. These reasons are covered in these and other posts.

      All of this means that it is important to maximize the number of people who get the vaccines. Increases herd immunity, reduces morbidity and mortality, reduces the burden on the limited resources that exist in hospitals, such as ventilators; and of course, generally reduces the overall amount of misery in the world because fewer people get sick with a rather unpleasant infection.

      1. Jay says:

        What about the risk of Narcolepsy or something else not yet discovered? I don’t want the flu, regardless of whether it is live or dead!

        1. Chris says:

          Of course you don’t want to get flu! Did you read the title of this article?

          Oh, and the narcolepsy stuff is from two years ago in just a couple of countries in a vaccine never used in the U SA.

        2. Sawyer says:

          This is sort of like claiming that you don’t want to encounter a bear in the forest, whether it’s live or dead. Your estimation of the danger involved in each of these scenarios is a wee bit off.

        3. WilliamLawrenceUtridge says:

          Jay, if you don’t want the flu, live or dead, I suggest you live in a hermetically sealed bubble, with air filters and sterilizers for any food or water brought inside, and never, ever have contact with another human being, ever. Perhaps volunteer for that mission to Mars?

          There’s basically no way to ensure you never get the ‘flu, live or dead. However, encountering it while dead, in the form of a killed vaccine, will help* ensure that when you do encounter a live version, it will not make you sick, or blunt the symptoms you do experience.

          *The vaccine is not perfect, far less so than many other vaccines, for a variety of reasons. I suggest John Barry’s The Great Influenza for a good overview of the topic.

  16. tjohnson_nb says:

    whooping cough mortality

    What do you suppose were the reasons for the decline in mortality shown in this graph? Why aren’t we investigating this as an alternative to vaccination?

    1. Andrey Pavlov says:


      Not sure what you mean exactly – it is reasonably well known that sanitation and better living conditions decrease the spread of infectious disease. Why would we be researching that as an alternative to vaccination? They together decrease the incidence of disease for the better health of everyone.

    2. Chris says:

      Influenza is not pertussis. The biggest thing between the two: one is a virus and the other is not.

      The reduction for deaths from pertussis is due to inventions of ways to keep people alive with better hospital care. What do you think was invented between 1838 and the 1950s that would help? Perhaps it was electricity? How about laundering hospital linens? Do you think hand washing was used more in the 1950s? What about ventilators?

      But that is only mortality, people who get pertussis still suffer from three months of rib breaking coughs, and babies require a great deal of very expensive hospital care to survive. Also, antibiotics don’t really help much with pertussis once the cough starts. Antibiotics do absolutely nothing for influenza.

      Why do you think it is better to provide very expensive hospital care instead of preventing the disease in the first place? What if the hospital runs out ventilators, which Dr. Crislip has mentioned almost happening:

      A month ago all the ICU beds were full, most of the ventilators were in use and we were wondering how we were going to triage the next batch of patients who needed advanced life support and we had none to offer. Then, right as we reached maximum capacity and had no more wiggle room, the rates plummeted. We skated right up to the edge of the precipice, looked down, and did not have to jump.

      And he described even more detail:

      Oregon has had 1200 hospitalizations and 68 deaths. We had about 8 deaths from H1N1 in my hospital system. We would have had twice that number, but one of our hospitals is a trauma center and offers ECMO (Extra Corporeal Membrane Oxygenation) and we managed to save a number of people who would have died if they had been in a lesser hospital.

      Do you think that equipment is inexpensive? What about the nursing care? Do you think keeping people alive is cheaper than preventing the disease? Really?

    3. Harriet Hall says:

      The decrease in “mortality” can be attributed to improved medical care and hygiene. To see the effect of vaccines, you need to look at the decrease in “incidence” that followed the introduction of the vaccine That chart also shows how the incidence is rising again since more people are rejecting or delaying vaccines. The vaccine is not 100% effective, and immunity wanes over time; but the solution is to find a better vaccine and/or give booster shots, not to look for “alternatives.” There is no alternative to vaccination except total isolation from other people.

      1. Chris says:

        I think that chart clearly shows that the reason more people live now than in 1838 is the invention of electricity and very expensive ventilation equipment.

        I also think that taking some of the data from the CDC Pink Book Appendix G and just comparing six years half a century apart is interesting:

        This is for pertussis:
        2000____7867____ 12___1950__120718__1118
        2001____7580____ 17___1951___68687___951
        2002____9771____ 18___1952___45030___402
        2003___11647____ 11___1953___37129___270
        2004___25827____ 27___1954___60886___373
        2005___25616____ 39___1955___62786___467
        2006___15632____ 16___1956___31732___266

        Unfortunately, babies are still dying from pertussis. Which is still not influenza.

    4. WilliamLawrenceUtridge says:

      Because it’s “mortality”. People stopped dying of pertussis because supportive and supplementary health care allows people, particularly infants, to survive disease through things like supplementary oxygen and non-infective tracheotomies. If you graphed “incidence”, it would be essentially gyrations about an average until the vaccine hit. Kids still got the miserable, suffocating, rib-breaking bouts of pertussis, they just ended up undergoing lengthy, expensive, painful hospital stays instead of just dying.

      Now, if you graphed mortality and hospital-based complications, you’d see a nice cross-over; since kids stopped dying of pertussis, they started living long enough to get secondary infections and complications. Ditto if you graphed “infected but survived”.

      Also, why would you ever investigate an “alternative” to vaccinating? Why wouldn’t you seek out a “supplement” to vaccination?

      Last question, how many dead babies are acceptable in your mind, to offset the possible detrimental effects of pertussis vaccination? Make no mistake – pertussis is a nasty bug and not a great vaccine, with some unpleasant, even life-long side effects. It’s just that we have to choose between those broken ribs and side effects on one side – and dead babies on the other.

      Please let me know what your acceptable ratio of fever, redness, soreness, irritability, fatigue, seizures and comas to dead babies you feel is acceptable.

    5. dreamthief says:

      You’re confused, I think. You can only be referring to the long slow decline in mortality preceding the point on the graph labeled “Pertussis Vaccine Widespread Use In The 1950s.” Please correct me if I’m mistaken, but unless I’m reading them wrong, I can interpret your questions in no other way.

      You’ve missed a couple of key factors. First, consider when the decline began on the timeline. It began with the disappearance of notable spikes or outbreaks of pertussis. Then the smaller peaks started to get lower near the end of the 1800s, a time when great advances were being made all over including the medical field.
      Then, in 1905 (or 06?) the very first pertussis vaccine was developed.

      Now, note the words “Widespread Use” that we see on the graph. Leading up to this point the Pertussis Vaccine was slowing being refined and introduced to the population, thus the slow decline in the mortality rate. As the vaccine was improved and used more often the mortality rate dropped even more, until the vaccine gained “widespread” acceptance and usage, and the the mortality rate plummeted to the low point on the chart – in the 1950s.

      There was no natural or alternative to vaccinations as you seem to have mistakenly concluded. Better levels of cleanliness, medical care and an understanding of what was happening at a cellular level (which led to the development of a vaccine) are what started the slow decline on the graph. But without the vaccine, the decline would have inevitably stayed at a heartbreakingly high rate with an outbreak spiking much higher with unpredictable frequency.

    6. Sawyer says:

      I’m beginning to think “morbidity”, “mortality”, and “incidence” are words that now need to be required vocabulary in middle school. Even the most wacky cranks in physics are generally forced to use words like “energy” and “force” in the correct manner because everyone is familiar with their meaning. Anti-vaxxers have no such restrictions to spouting gobbledy gook, and are happy to exploit a language barrier to promote nonsense.

      Surprisingly, these words were never taught to me in my high school health class. Or consumer education. Or biology. Or math. Maybe I had one too many football coaches as teachers?

      1. Chris says:

        I’d be happy if they figured out how different it was to live in the 1950s compared to the mid-1800s. Oh, there was a vaccine for pertussis in the 1950s.

        1. nancy brownlee says:

          “Oh, there was a vaccine for pertussis in the 1950s.”

          There sure was. I had it. I caught it anyway, and so did every other first-wave boomer in my little tract house neighborhood; dozens of us. Mild cases, we were told… cough til you vomit, cough til your eyeballs are bright red from broken blood vessels, cough til you almost pass out because you can’t catch your breath, cough til you have a nosebleed, cough so much you have a horrible headache for two weeks straight.

    7. Chris says:

      One big problem I have with that graph, along with it covering a huge time span, was the sloppiness of how the arrow pointing to some general area of the early 1950s as the date the pertussis vaccine was introduces. According to the CDC Pink Book Pertussis Chapter a vaccine was developed in the 1930s and was in general clinical use by the mid-1940s in the USA!

      As a math geek, that graph deserves more than sarcasm, something you like to accuse the site of. It deserves a full dressing down for its abject dishonestly and complete idiocy. Is seems to imply the only bad outcome from pertussis is mortality, and ignores the progress in medical are for over a century. Plus the American authors cherry picked by choosing the data from the UK, which according o Impact of anti-vaccine movements on pertussis control: the untold story introduced the vaccine in 1950s. It is by the way, a much smaller country than the USA.

      Read that article, where it compares countries with varying vaccine policies. I especially like the difference between Norway and Sweden.

    8. Chris says:

      My apologies to the moderators, but those goofy “morality” graphs drive me nuts.

      First, here is how Dr. Crislip treats the site the graph came from when it had a slightly different name, which I found just by putting the name of Suzzanne Humpfries in the search box on this page:

      And here is Dr. Gorski on the basic dishonesty of those mortality graphs:

      And another reminder: pertussis is not influenza.

      1. Chris says:

        Stupid ironic typo: goofy “mortality” graphs

        Though I question the “morality” of anyone who creates those deceptive graphs.

  17. windriven says:

    “What do you suppose were the reasons for the decline in mortality shown in this graph? ”

    Mortality rates bounced around 50 per 100k until the late 19th century when the germ theory of disease was becoming widely accepted. With that acceptance came public health measures. You will note from the graph that infant deaths didn’t stop until vaccination was widely embraced.

    Are you arguing that a few infant deaths are OK so long as we prevent … I’m sorry, what is it that you’re hoping to prevent through curtailing vaccination for pertussis?

    “Why aren’t we investigating this as an alternative to vaccination?”

    This question suggests the silver bullet fantasy. Good public health practice isn’t a single tactic or intervention. Further, in a perfect world we would ultimately eliminate the threat of many infectious diseases through universal vaccination by completely drying up the reservoirs* – as has been done with smallpox and as we are approaching with polio.

    *I will leave it to others with deeper understanding of pertussis to explain whether or not there are non-human pertussis reservoirs – I don’t know.

  18. Liz says:

    I’m taking my kids in today to get the flu mist. A little late but we’re on the West Coast where the flu tends to hit later. Is the mist as effective as the injection?

  19. NovaSquadron says:

    Is anyone aware of the vaccine efficacy when not injected into muscle? My friendly CVS pharmacist injected my shot too high and gave me tendonitis (yay!), and I am debating getting another shot. Sorry this is kind of unrelated I am having a difficult time finding legit info on the interwebz aside from an IOM powerpoint indicating “possible” reduced efficacy.

  20. Mary Schwenkler says:

    People can be so foolish. They think the flu is a joke. Not this year!

  21. James Rouzier says:

    I am worried about the influenza because I have narcolepsy and since there seems to a link between the two.

    I am concern whether I should or should not get vaccinated for influenza regularly.

    Would it strengthen the autoimmune the response or help calm it down?

    I do not see any studies out that answers this does anyone know of any studies?

    1. Sawyer says:

      First question: do you live in the US?

      Unless the GSK shot is the only one available to you I don’t think there’s much to worry about. If the GSK shot is the only thing available, then you’ll have to do some more digging. Does something that causes (rarely) narcolepsy automatically aggravate the symptoms of someone that already has it?

      Disclaimer: Do not rely on me for medical advice. My Google University tenure only goes so far.

      1. James Rouzier says:

        Sawyer thanks for your reply.

        I am US expat living in Canada.
        I did receive that vaccine in 2010 during my first work permit in Canada.
        I was diagnosed in 2012.
        My symptoms of narcolepsy were present before I got vaccinated.
        Since during that time I was under a lot of stress I cannot say it made it worse.
        I am just curious if there are any studies that someone knows about.

        1. Jay says:

          Maybe the narcolepsy was caused by the vaccine?

          1. Chris says:

            Which influenza flu? Can you be specific since there are over half a dozen approved for use in the USA? And provide us some actual verifiable scientific documentation to support your statements.

            1. WilliamLawrenceUtridge says:

              There actually is a link:


          2. Sawyer says:

            Even if James got the Pandemrix shot (already not very likely living in Canada), the odds of developing narcolepsy naturally or from some unknown environmental factor still vastly outweigh the odds of getting it from the vaccine. I haven’t combed through narcolepsy stats in detail but you’re welcome to present evidence to the contrary.

            1. Sawyer says:

              Whoops, I didn’t completely read James’s post. His symptoms showed up before the vaccine. Do vaccines time travel Jay?

          3. James says:

            Very unlikely I was a sleepy person my entire life.

          4. Laurel says:


            David Gorski is an ex heroin addict. It amazes me that anyone would listen to him.

            Sheesh, the Flu doesn’t kill people, it is the secondary infections that do. Even the Huffington Post points this out:

            “According to the National Vital Statistics System in the U.S., for example, annual flu deaths in 2010 amounted to just 500 per year — fewer than deaths from ulcers (2,977), hernias (1,832) and pregnancy and childbirth (825), and a far cry from the big killers such as heart disease (597,689) and cancers (574,743). The story is similar in Canada, where unlikely killers likewise dwarf Statistics Canada’s count of flu deaths.”

            Getting vaccinated only enriches the drug companies while it screws up your own natural immunity.

            You are MUCH better off ignoring the shrill cries of those who expect YOU to accept a non emergency medicine that is neither healthy nor helpful.

            Keep drinking your own kool-aid. It will cull more useless thinkers. Time will show that crap shots are the worst thing ever invented by man.


            1. Chris says:

              “David Gorski is an ex heroin addict. It amazes me that anyone would listen to him.”

              Citation needed. Seriously, where would you come up with kind of stuff?

              And I think even if it was true, how does it make any difference when anti-vaxers idolize Robert F. Kennedy, Jr? Who only got into the Riverkeepers program as part of community service due to a drug conviction.

              And here is reply to the Huff-Po piece (URL munged because a quirk here does not let me post links):
              thepoxesblog DOT wordpress DOT com/2014/01/28/spitting-on-the-graves-of-children-lost-to-influenza/

        2. WilliamLawrenceUtridge says:

          James, my understanding is that the vaccine has been shown to cause a small number of cases of narcolepsy, primarily in Northern Europe. If you already have narcolepsy, then you should be “safe”.

          But the article I link to just below should have more information.

    2. mousethatroared says:

      James Rouzier – I am not a doctor. I don’t know anything about narcolepsy. In fact I was surprised to hear you refer to it as an auto-immune disease.

      My understanding is, with connective tissue auto-immune diseases, such as Rhuematoid Arthritis and Lupus, that the killed vaccine is much less likely to provoke a flare than actually getting the flu. The few flares provoked by the vaccine tend to be milder and shorter than those provoked by the flu. So getting the vaccine is preferable to

      Do you see a specialist for your Narcolepsy? Have you asked them about this?

      1. James says:

        Thank everyone for their replies.

        I was diagnosed in the US then I started working in Canada so I never really seen a specialist since everything is “under control”.

        But next time I see my family doctor I will inquire about seeing a specialist since I do not think my doctor knows a lot narcolepsy.

  22. Jenny says:

    Yes lots of new research findings on the connection between narcolepsy and H1N1. Narcolepsy also requires a genetic variant that is present in about 20% of the human population. Problem is that health care providers know nothing about narcolepsy. I have narcolepsy with cataplexy. Yes it is now known to be autoimmune. This leaves us narcoleptic wondering do we get a flu shot? Are we already immune? Do I get my kids a flu shot?! I would rather have narcolepsy than be dead from flu but narcolepsy is a devastating brain disorder and a horrible way to live. Do I inject my kids? Uuggghh

    1. WilliamLawrenceUtridge says:

      I’m not expert, but may I suggest you contact the authors of this literature review? I doubt you’ll find a specialist on this blog or in the comments, I doubt you’ll be able to contact one in your city, but I’ve had had surprising success contacting researchers for pdf reprints and discussions of specific topics directly, via e-mail. And chances are the two authors of the article are, if not the experts in the connection between vaccination and narcolepsy, at least highly knowledgeable about the topic. Enough to say whether an American faces the same risks as a northern European, whether it’s a specific vaccine, or perhaps the adjuvant (if the latter, then you don’t have to worry about nonadjuvanted vaccines, of which there are many to choose from).

      Sadly, because of imperfect knowledge and the horrors of specifics, you are unlikely to ever know if an action you took either prevented, or potentiated the development of narcolepsy in your children. The best you can ever probably manage is the rather weak statement “I did the best I could at the time”. Unsatisfying, and if your kids ever do develop narcolepsy – you’ll probably always wonder.

      Sorry :(

      1. Sawyer says:

        The CDC link hints very strongly that Pandemrix adjuvants are the primary culprit, but for some they don’t come right out and say “adjuvants cause narcolepsy”. I’d put money on the non-adjuvant versions being just fine, but then again I don’t have kids to worry about.

  23. Donna says:

    In this article only mercury was addressed. Why not the numerous other additives in flu vaccines, such as carcinogens and neurotoxins? It seems that in every argument pro flu vaccine no mention is ever made of any additive besides mercury, and there are many. Also none of the pro flu vaccine people are ever willing to acknowledge the devastating side effects, and sometimes death, caused by this vaccine, most likely due to one or more of these additives. More people may be willing to consider getting the vaccine if these issues were openly and honestly discussed. Without all the facts how can anyone truly make an informed decision regarding the flu vaccine?

    1. weing says:

      “Also none of the pro flu vaccine people are ever willing to acknowledge the devastating side effects, and sometimes death, caused by this vaccine, most likely due to one or more of these additives.”

      You’re right. I heard one guy would turn into the incredible Hulk after the vaccine. What did you hear?

    2. Sawyer says:

      Also none of the pro flu vaccine people are ever willing to acknowledge the devastating side effects

      Name one of them.

      Every single person and institution that promotes flu vaccines bends over backwards to provide stats on the rare side effects that can occur. The CDC, NIH, WHO, etc. give this information to people for free even though they know that it hinders vaccination campaigns. Hell, we just told someone yesterday that they needed to do some further research before vaccinating their children.

      This is the textbook definition of honesty and openness.

    3. Sawyer says:

      *Clarification, I’m asking you to name a single person that dishonestly promotes vaccinations.

      Although if you want to name a side effect and exaggerate the odds by a factor of 1000 go right ahead.

    4. WilliamLawrenceUtridge says:

      Hi Donna,

      There’s a couple reasons:

      – even if the internet does theoretically allow nigh-unlimited text, readers have a finite attention span, so no post can cover every possible lunatic screed paranoid ravings about every single ingredient in every single vaccine

      – your comment is referred to as “goalpost moving”; since thimerosal has been found essentially harmless at the doses found in vaccines, people who think vaccines are evil have to find something else to blame instead; they don’t care whether vaccines really cause autism, they just don’t want to have to change their mind

      – the constituents in vaccines are all safety-tested, with well-known toxicological profiles and pharmacokinetics; we know how the body processes and excretes them

      – some of the crap the nutters worry about are produced by the body itself – witness two, formaldehyde and dihydrogen monoxide

      – the amounts of all adjuvants found in vaccines are trivial, the idea that their effects are lethal at tiny doses, but don’t show up anywhere but vaccines, is a little absurd – don’t you think? I mean, if mercury (or aluminum, or whatever the flavour of the week) is such a potent neurotoxin, why don’t we see its effects anywhere but vaccination?

      Also, if one wants to discuss issues openly and honestly, it requires discussion. What you, and most of your ilk, want is not discussion – you want your rants to be taken seriously and to exist in a vacuum, unchallenged and with no reference to the existing knowledge base and scientific literature. See, real experts actually do study vaccines and adjuvants. They are studied for toxicology and effectiveness. They are studied singly and in combination. But most people who froth about the dangers of vaccines either don’t know about this, or know but are perfectly comfortable lying about it.

      People would take you and your concerns more seriously if you showed any evidence of understanding the issue you are agitating about.

  24. OSL01 says:

    The risks of dying from the flu for most people is so low that these risks by far outweigh the risks from receiving the flu vaccine(s), which are never discussed in the public domain.

    An elaboration on this point can be found here:

    What’s more, it appears that the flu vaccine is the most dangerous vaccine in the U. S. based on settled cases for Injuries:

    Between Aug and Nov 2013 (only 3 months), there were 139 claims settled, with 70 of them being compensated by the Department of Justice (Vaccine Court) – that’s just over 50% of the claims filed for vaccine damages were compensated during this period.

    The greatest percentage of damages compensated were for the influenza vaccine, and most of those were for Guillain-Barré Syndrome (GBS) caused by the vaccines.

    Some people even die from receiving flu shots as early as during the vaccine trials: Package insert for Fluzone flu vaccine marketed to seniors reveals 23 seniors died during drug trial. (pp 6-7)

    1. By what basis can they conclude that “No deaths were considered to be caused by vaccination”??

    2. If, as it is implied, the majority of these 23 deaths were caused by pre-existing conditions, why were there no deaths in the first 28 days? Shouldn’t the deaths, if not attributable to the vaccine but pre-existing conditions, be equally spread out through all time periods?

    3. How does the medical history for these 23 seniors compare to the medical history of those who did not die? Were there any significant differences? The range of symptoms given in the package insert can very well cover almost all seniors during the flu season. And what about those who died that were not among the “majority” who had these pre-existing conditions? A majority could simply be 12 out of the 23.

    Besides death, which is just one “serious adverse event,” there were 226 other “serious” adverse events, for a total of 249 serious adverse events, out of only 3,833 participants.

    If this does not constitute a dangerous drug that should probably not even be on the market, then I don’t know what does. And yet, it is sold to unsuspecting seniors and others like candy at these drug stores.

    1. Sawyer says:

      You have crammed so much misinformation and half-truths into your post that none of us here have any hope of responding to all of it. Would you like to reiterate your strongest point so we can explain to you why it’s wrong, or should we just pick one at random?

      Alternatively you could put a bit of effort into reviewing previous posts on vaccines on this forum. Learning science is actually really fun.

    2. WilliamLawrenceUtridge says:

      Hi OSL01,

      Note that influenza itself causes GBS, at higher rates (much higher) than the vaccine.

      Note that influenza is fairly unpredictable – though often merely unpleasant (unless you happen to be a senior citizen, a pregnant woman, a child or anyone with compromised immune or lung function) it can turn unexpectedly lethal. Terrifyingly so. Note the Spanish Influenza epidemic for instance, with an estimated total number killed in the hundreds of millions.

      Regards the PDF you link to – it appears that death rates for seniors were being compared for normal and high-dose Fluzone, and those death rates were essentially identical. This suggests that death rates do not change with higher doses of the vaccine, which in turn suggests no toxicological challenge at increasing doses, which in turn suggests that the vaccine isn’t dangerous. Otherwise we would expect higher death rates at higher exposures. As far as why there were 23 deaths, did you note the follow-up period was for six months? Six months is a long time, there’s a multitude of things that could have killed them in six months – they were elderly after all. Why are you so convinced that it was the flu vaccine? I mean, aside from the fact that you don’t really care about the evidence, your conviction about the lethality of the flu vaccine is an unchanging entity and no evidence will ever make you change your mind. Also note that the vaccine would have been given well-before the influenza (and winter) season, and death rates spike in the winter.

      Anyway, your comments mostly show that you don’t really appreciate how one associates deaths and adverse events to a vaccine. Consider educating yourself a little more.

      1. Sawyer says:

        with an estimated total number killed in the hundreds of millions.

        I’ve always heard 80 million as the most likely estimate. Where are you getting these stats WLU?!?! OMG, YOU’RE PART OF THE VACCINE CONSPIRACY!!!!!


        1. WilliamLawrenceUtridge says:

          The number I’m reporting was a bare literal truth, I remember the highest estimate being two hundred million and my recall was based on John Barry’s excellent The Great Influenza. Google books corrects me, the upper esitmate is 100 million. The range is 50-100M.

          Always cite sources!

  25. OSL01 says:

    I started the above post with the main point: The potential benefits of vaccines / flu vaccines are nullified by the risks associated with these drugs, the latter of which, on top of it, are systematically covered up.

    There you are – for the slow learners among you.

    Some evidence:

    Article: The Vaccine Coverup – 30 Years of Secret Official Transcripts Show UK Government Experts Cover Up Vaccine Hazards To Sell More Vaccines And Harm Your Kids.

    Quote by Dr David Freed on this subject at the 2011 ‘The Health Hazards of Disease Prevention’ – Proceedings (British Society for Ecological Medicine):

    “It seems to me that the ethical background to vaccination – giving potentially harmful medications to healthy individuals in the hope of keeping them that way – has never been clearly addressed… Who gave us the right (a) to invade the bodies of healthy people who never asked us to, and (b) to do it not only without explanation of the possible risks, but in some countries even applying coercive pressures, denying the existence of the risks, and suppressing relevant information?”

    More evidence – a paper by Lucija Tomljenovic:

    The vaccination policy and the Code of Practice of the Joint Committee on Vaccination and Immunisation (JCVI): are they at odds?


    “Here I present the documentation which appears to show that the JCVI made continuous efforts to withhold critical data on severe adverse reactions and contraindications to vaccinations to both parents and health practitioners in order to reach overall vaccination rates which they deemed were necessary for “herd immunity”, a concept which with regards to vaccination, and contrary to prevalent beliefs, does not rest on solid scientific evidence as will be explained.

    As a result of such vaccination policy promoted by the JCVI and the DH, many children have been vaccinated without their parents being disclosed the critical information about demonstrated risks of serious adverse reactions, one that the JCVI appeared to have been fully aware of.

    It would also appear that, by withholding this information, the JCVI/DH neglected the right of individuals to make an informed consent concerning vaccination.

    By doing so, the JCVI/DH may have violated not only International Guidelines for Medical Ethics (i.e., Helsinki Declaration and the International Code of Medical Ethics) [2] but also, their own Code of Practice.

    The transcripts of the JCVI meetings also show that some of the Committee members had extensive ties to pharmaceutical companies and that the JCVI frequently co-operated with vaccine manufacturers on strategies aimed at boosting vaccine uptake. “

    1. Chris says:

      “I started the above post with the main point: The potential benefits of vaccines / flu vaccines are nullified by the risks associated with these drugs, the latter of which, on top of it, are systematically covered up”

      So you bring us biased opinion pieces from those with an agenda? Why should we believe you or care about your opinion?

      If the risks are so high, then produce the PubMed indexed studies from qualified reputable researchers that the influenza vaccine causes more harm than influenza. This year about twenty kids have died and last year there were 171 pediatric deaths.

      And for your information Tomljenovic is not a reputable researcher. And neither is Christina England (a journalist, not a researcher) nor Richard Halvorsen (who has a private clinic offering “separate vaccine”, except not for mumps since they had to stop illegally importing the Urabe mumps single vaccine because it was not approved).

      If you try to persuade us with random opinion pieces or things authored by those who get funding from anti-vaccine groups like the Dwosin Family Foundation, then you are the slow learner. Give us real verifiable science, nothing else.

    2. WilliamLawrenceUtridge says:

      Vaccines aren’t drugs. Drugs modify the existing metabolic processes of the body. Vaccines prime the immune system by presenting a low-dose of dead or attenuated viral/bacterial particle to speed recognition of the same infective agent in the future.

      Also note that “ties to the drug companies” is the laziest excuse people ever use to discount real evidence. Please try harder.

    3. Sawyer says:

      Oh boy, the Tomljenovic paper. I’m sincerely sorry if this is the main source of information that set you on the anti-vaccine path. It sounds somewhat convincing to people with minimal background in science or little experience working with large government institutions, but people with real knowledge about public health and medical statistics can tear this paper apart.

      Lucija Tomljenovic, like many anti-vaxxers, appears to lack not only the scientific expertise but just plain doesn’t understand how to communicate with other human beings. If the paper you citing is the one I’m thinking of, she frequently points out JCVI talking about “anomalies”, “inconsistencies”, or “disagreements” in epidemiological data. She takes these words completely out of context, and automatically assumes they are some sort of secret code words for “cover up” and “fraud”. What these words actually mean is pretty simple: real world data is messy. You always find anomalies and inconsistencies. It’s the job of professional scientists to figure out whether these differences are real and need to be communicated to the public, or are just part of the noise.

      The data on vaccine side effects may very well be off by 5%, 25%, or 50% (although that uncertainty cuts both ways, and I’d hazard a guess that some of the real side effect rates are even lower than what is reported). However, the rates are not going to be off by 5000%. That’s the gap that would have to be bridged for me to even consider not getting a flu vaccine. And we haven’t even touched on the secondary benefits of vaccines.

      Once again I find myself offering the same advice we’ve given before: go take a course or buy a textbook on epidemiology. You won’t become an expert , but it will help you gain an appreciation for how things work outside of anti-vaxxer fantasy world.

      1. Chris says:

        I glanced at her twitter feed. My one word impression: gullible.

  26. ballerinaRN says:

    I thoroughly enjoyed reading all the educated responses to the uneducated anti vaxxers. I’m faced with them frequently and I work In a large Hospital! This leads me to print out copies of Dr. Crislip’s Budget Of Dumb Asses and leave them around at the Hospital. Sadly I see HCW wearing masks as required. (Although more than half the time they have them pulled down around their chins making them ineffective!)

    1. Wrong article, sorry.

  27. Can anyone explain this than?

    The following is straight from the CDC. “In the U.S., the Food and Drug Administration (FDA) regulates and licenses all vaccines to ensure safety and effectiveness. No federal vaccination laws exist, but all 50 states require certain vaccinations for children entering public schools. Depending on the state, children must be vaccinated against some or all of the following diseases: mumps, measles, rubella, diphtheria, pertussis, tetanus, and polio.” No laws exist, yet one law does, that receiving these vaccinations is mandatory.

    Here is an excerpt about alluminum in vaccinations. “Thimerosal, which contains the organic compound ethyl mercury, is a known neurotoxin and used to be a major ingredient in childhood vaccines. There are over 15,000 articles in the medical literature describing the adverse health effects on the human body with exposure to varying amounts and forms of mercury.” Pharmaceutical and the medical profession continue to recklessly add ingredients without any real regulations to abide to. Aluminum is only one of many harmful ingredients that are added to vaccinations. They are left to their own devices and only until millions die will they have to answer to this. By then it is already to late.

    When they are finally called out on their harmful practices, this is the protocol. “If the proposed Rule Change is put into effect, a vaccine manufacturer could request a change in the content or amount of vaccine ingredients by simply writing a “brief statement describing the basis for the request and supporting data” as part of the original license application or for a pending or approved application. There is no information about how much scientific evidence the drug companies will have to submit to prove the new ingredients are safe; or whether the FDA’s Vaccine Advisory Committee will be able to review that evidence; or whether the American public will have a chance to comment before vaccine ingredients are changed.” In order to change an ingredient they only need to write a brief statement and dont need any scientific evidence.

    The only evidence on vaccinations is that they are dangerous. So why are we forced to take them? Why are we kept in the dark about them? Because of money. Its the only driving force for these companies and why they can look the other way on the publics safety. Its why politicans will campain on their support and it is not in the interest of the greater good, but the interest of who has power.

    1. weing says:

      “Here is an excerpt about alluminum in vaccinations. “Thimerosal, which contains the organic compound ethyl mercury, is a known neurotoxin and used to be a major ingredient in childhood vaccines. There are over 15,000 articles in the medical literature describing the adverse health effects on the human body with exposure to varying amounts and forms of mercury.” ”

      You really do lack reading comprehension. You are also copying and pasting some anti-vax wacko’s imaginings as evidence. But I guess you can’t figure that out either. Nevermind.

    2. windriven says:

      “No laws exist, yet one law does, that receiving these vaccinations is mandatory.”

      Echoing weing’s questions about your reading comprehension skills, there is no FEDERAL law requiring vaccinations but each of the 50 states has a law requiring various vaccinations. Federal laws are passed by your US representative and senators. State laws are passed by your state representative and senator. The FDA, which was created by federal law, regulates the manufacture of vaccines. It does not require you to receive them.

      “The only evidence on vaccinations is that they are dangerous.”

      Blistering horse hockey. The vaccines in use in the US are broadly safe and effective. There are quite rare adverse drug reactions that do affect a small fraction of the population. Smallpox on the other hand is dangerous. Polio too is quite dangerous. Mumps, measles, rubella, influenza, human papilloma virus – these are quite dangerous.

    3. WilliamLawrenceUtridge says:

      Damon, there is a considerable amount of aluminum in the food, soil and water that you consume on a daily basis, and no evidence that it is particularly dangerous. Claiming aluminum is harmful because it seems scary to you, doesn’t actually make it harmful. The trace amount that is found in vaccines is easily washed out by the much larger amount you swallow along with your daily bread.

      The only evidence on vaccinations is that they are dangerous

      Smallpox. That’s pretty good evidence that vaccines are great at driving lethal diseases into extinction. Do you know how much money could be made by drug companies in treating the acute infections that are prevented through vaccination? Huge amounts. But in my mind – babies not dying of pertussis, polio, chicken pox, measles and rotavirus is in the greater good. I dunno, maybe you like dead babies or something, but I’m against it.

      Final point – you claim “millions” die because of vaccines. On what basis do make this claim? Don’t you think we would notice millions of people dying from vaccination? Do you know what we have noticed? Millions dying from diseases that are preventable through vaccination.

      Again, fewer dead babies > paranoid ravings about a mineral found in the human diet for millions of years.

    4. Chris says:

      Mr. Noonan: “The only evidence on vaccinations is that they are dangerous.”

      Citation needed. Please provide the PubMed indexed study by a reputable qualified researcher that the influenza vaccine causes as much harm as the influenza. This year the pediatric death toll is at least twenty, last year over a hundred children died from flu. Show us that the vaccine causes at least that much harm.

      “So why are we forced to take them?”

      Please provide the citation of the regulation that forces you to be vaccinated. Even in Mississippi and West Virginia you don’t have to vaccinated if you homeschool.

      “Why are we kept in the dark about them? Because of money.”

      Do tell us why preventing diseases, with subsequent hospitalizations, is more costly than letting people get sick. Please provide the economic analysis similar to the following as evidence:

      Arch Pediatr Adolesc Med. 2005;159:1136-1144.
      Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001

      J Infect Dis. 2004 May 1;189 Suppl 1:S131-45.
      An economic analysis of the current universal 2-dose measles-mumps-rubella vaccination program in the United States.

      Since one in five who get measles ends up with pneumonia, with about one in ten requiring expensive hospital care, I am very interested in how that is more cost effective than providing two MMR doses per child. Then there is the problem of measles causing about one in a thousand cases of encephalitis. So really, provide some actual verifiable scientific and economic documentation for your claims.

      1. Sawyer says:

        “The only evidence on vaccinations is that they are dangerous”

        ONLY?!? Jesus, even if I thought doctors were purposely murdering children I wouldn’t have the audacity to make that statement.

        Is there a secret negotiation school or debate training you guys go through to join the anti-vaccine brigade? Besides the blatant lack of knowledge of modern medicine, you all seem to believe that you can start with a ludicrous statement like this one and then slowly negotiate your way back to some sort of middle ground. And it never works. Go look through all the previous vaccine threads and find me a single person that falls for this.

        I would suggest that anti-vaxxers are taking cues from politicians on how to employ this debate tactic, but that’s giving politicians a bad name.

  28. Laurel says:

    David Gorski is an ex heroin addict. It amazes me that anyone would listen to him.

    Sheesh, the Flu doesn’t kill people, it is the secondary infections that do. Even the Huffington Post points this out:

    “According to the National Vital Statistics System in the U.S., for example, annual flu deaths in 2010 amounted to just 500 per year — fewer than deaths from ulcers (2,977), hernias (1,832) and pregnancy and childbirth (825), and a far cry from the big killers such as heart disease (597,689) and cancers (574,743). The story is similar in Canada, where unlikely killers likewise dwarf Statistics Canada’s count of flu deaths.”

    Getting vaccinated only enriches the drug companies while it screws up your own natural immunity.

    You are MUCH better off ignoring the shrill cries of those who expect YOU to accept a non emergency medicine that is neither healthy nor helpful.

    Keep drinking your own kool-aid. It will cull more useless thinkers. Time will show that crap shots are the worst thing ever invented by man.

    1. Scottynuke says:

      Wow, Laurel’s so proud of that lovely bit of irrelevant libel that it just had to be posted twice! *facepalm*

      And BTW, the quote from HuffPoo (which, shocker of shockers, is NOT a peer-reviewed medical journal) says nothing about secondary infections.

      I’ll offer the hypothesis that Laurel will cull him or herself long before Dr. Gorski or any of the other SBM contributors.

    2. Andrey Pavlov says:


      I mean, some legit and typical anti-vax crazy in there, but the ex-heroin addict seems over the top. I dunno. One reason I love being in medicine – people never cease to surprise me.

      1. Chris says:

        I think the heroin accusation is just priceless. It is one that was lobbed at Seth Mnookin by anti-vaxers:
        blogs DOT plos DOT org/thepanicvirus/2011/04/22/heroin-and-ad-hominem-attacks/

        The hypocrisy of that accusation is that one of the anti-vax heroes is Robert F. Kennedy, Jr. Who has been tried and convicted for heroin use.

        1. Sawyer says:

          I came across the same information this morning. Both Seth and Dr. Gorki’s spats with Age of Autism are infuriating to read, but nonetheless very enlightening.

          One of the things that amazes me about the trolls here is not just their massive ignorance about medicine, but their pathetic level of internet literacy. They really don’t understand that other people have this thing called “google” and will use it to vet their claims. In the last hour Mnookin’s book has moved to the top of my reading list and I’ve added the blog Chris provided to my bookmarks. All thanks to Laurel’s post.

          1. Chris says:

            Well I tried to Google “david gorski heroin”, but it kept substituting the word “drug” for heroin. That was not helpful.

            Yes, Seth Mnookin’s book is a good read.

            I add that the AoA crowd often mix up their stories. One thing that they like to rag on is that the vaccine that Dr. Offit worked on was pulled from the market. Except that is not true, since he was a co-creator of RotaTeq, not RotaShield.

            And there are lots more from not knowing the USA had an MMR vaccine almost two decades before the UK, that Japan did not see a drop in SIDS when they stopped vaccinating babies for pertussis (they did see pertussis deaths go up!), and on and on.

    3. Chris says:

      It seems that a quirk on this site will not let me post even one link. So I will have to mung it. Sorry.

      A reply to that Huff-Po piece:
      thepoxesblog DOT wordpress DOT com/2014/01/28/spitting-on-the-graves-of-children-lost-to-influenza/

    4. Sawyer says:

      It has to be pretty embarrassing for you guys when we have to correct you on your very own talking points. Seth Mnookin is the person you’re supposed to be launching vicious diatribes about drug use at, not David Gorski. Heck, I’d encourage everyone here to look up Seth’s writings on struggling with addiction (although they are completely tangential to the topic of vaccines).

      Have JB Handley and Jake Crosby’s writing on this topic has poisoned your mind so much you can’t even tell human beings apart anymore?

    5. mousethatroared says:

      Ex heroin addict? I think you might be confusing David Gorski with House.

      Here’s the problem with ad hominem attacks. I have read David Gorski’s article for awhile. His conclusions are well thought out and logical. He is excellent about linking to sources that back up the information he presents and I have never seen a source that didn’t say what he claimed in his article (I’ve checked regularly). In short, his argument stand on their own.

      So even if you could present evidence for your silly accusation, it wouldn’t effect the validity of his argument.

      Come on where’s your self-respect? You’re not even making an effort to appear credible. I mean, I hope you’re not making an effort, because if that’s your best effort, you don’t have much.

  29. Bob says:

    Well there’s plenty of editorializing in this article. But you didn’t take even a moment to explain why these people died. Just some vague references to lung failure. How about some logical, scientific explanations for why some die, and others don’t? I’m 40 years old. I’ve never had the flu shot. Bill Mahar is somewhat right, when he says if you simply avoid picking your nose during flu season, you can avoid the flu. That’s also scientific fact. Don’t touch your face. And if you do, only do so after you sanitize your hands. 40 years, never had the flu. Now how did I swing that? And have never had the flu shot either. Tonight? Diagnosed with influenza A. Why? Last Saturday I went out drinking, and repeatedly Touched my face with my dirty ass hands. And yes. I got unlucky. How did I manage to go 40 years without the flu? Good hygiene. Not worth the risk of the vaccine. If the trade-off is a potentially health damaging vaccine, versus simply washing your hands and not picking your nose? It’s a no-brainer. By the way, now that I know what the flu is like? I *really* want to know why people die from it. I’ve had colds worse than this. I had a 102.3 fever last night. This is a walk in the park compared to when I had Mono. So don’t leave out the most important parts of your article. There’s obviously some major information being left out. Nobody would die from what I’ve got right now. Maybe there’s a genetic defect at play. Maybe only certain populations have it. I’m interested in the science.

    1. MadisonMD says:

      Bill Mahar is somewhat right, when he says if you simply avoid picking your nose during flu season, you can avoid the flu. That’s also scientific fact.

      The CDC is a better source of scientific facts, Bob. Here’s what the CDC says:

      People with flu can spread it to others up to about 6 feet away. Most experts think that flu viruses are spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose.

      So if a person with suspected influenza shows up in the emergency room of any hospital, droplet precautions are taken. Here’s a description (also

      So yes, handwashing is an important precaution, but will not suffice if someone with influenza coughs or even talks near you–airborne droplets are produced and can get to you.

      I *really* want to know why people die from it. I’ve had colds worse than this.

      It depends on the strain of the influenza, our body’s reaction to it (perhaps there is a genetic component), and whether a bacterial pneumonia takes hold. Yet even accounting for these factors, severity of illness and dying is not wholly deterministic and predictable. To make an analogy: You could get in a car accident, live through it, and state that you’ve had worse soccer injuries than what you got in the accident. Yet, you might have been inches from going through the guardrail, flipping over, and getting crushed to death. How is it possible to *really* know why you didn’t die?

      Keep in mind that most of the time, only a fraction of those who get influenza actually die of it– so your experience is not extraordinary. Yet, sometimes it can get out of hand. In 1918, influenza infected 500 million people in the world and killed 20-40 million– about 3% of the world population.

      Finally, I can’t but help observe that you were lucky that influenza was but a minor inconvenience to you. Yet, you likely passed it on. If so, you might have indirectly contributed to a serious illness or death in someone else. Had you been vaccinated, this could have been avoided.

  30. james singer says:

    I had a flu shot at Target in October of 2013. A few months later I had a pneumonia vaccine shot. The past three days, I have a flu that’s been the all time worst I have ever suffered from. My doctor put me on clarithromycin and Tamiflu (incredibly expensive at $70 after insurance.) Maybe the Target shot did not match the specific flu virus I contracted. I’ll never know. I can also say that none of the resistance builders that Doctor Oz touts such as elderberry extract have done nothing for me.

  31. Andrés says:

    There has been several flu posts without mentioning vitamin D as Dr. Crislip uses to do (my bolds):

    Preventing influenza, and other infections, is both simple and difficult. Ameliorate risks by not smoking or being overweight. Wash hands. Don’t inhale around coughers or on airplanes. Be replete in vitamin D. And be vaccinated.

    It seems highly plausible that vitamin D status can influence both seasonal flu infection and mortality:

    The lowest pneumonia and influenza mortality rates were seen in the areas with the highest solar UVB irradiance and lowest latitudes (these being good indicators for high levels of vitamin D), while the highest rates were in the areas with the lowest UVB irradiance and highest latitudes (indicators of low vitamin D levels).

    As I have already said it is plausible that vitamin D helps in increasing vaccination response.

    I am at a loss why (as far as I can see) information about vitamin D status of the flu victims is not collected by the CDC.

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