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Medical Theater: Vaccines and Ebola

Me and my wife, in a very small number of years from now. YOU KIDS GET OFF MY LAWN!

Me and my wife, in a very small number of years from now. YOU KIDS GET OFF MY LAWN!

And all the men and women merely players;

They have their exits and their entrances,

And one man in his time plays many parts,

His acts being seven ages. At first, the infant,

Mewling and puking in the nurse’s arms.

Then the whining schoolboy, with his satchel

And shining morning face, creeping like snail

Unwillingly to school. And then the lover,

Sighing like furnace, with a woeful ballad

Made to his mistress’ eyebrow. Then a soldier,

Full of strange oaths and bearded like the pard,

Jealous in honor, sudden and quick in quarrel,

Seeking the bubble reputation

Even in the cannon’s mouth. And then the justice,

In fair round belly with good capon lined,

With eyes severe and beard of formal cut,

Full of wise saws and modern instances;

And so he plays his part. The sixth age shifts

Into the lean and slippered pantaloon,

With spectacles on nose and pouch on side;

His youthful hose, well saved, a world too wide

For his shrunk shank, and his big manly voice,

Turning again toward childish treble, pipes

And whistles in his sound. Last scene of all,

That ends this strange eventful history,

Is second childishness and mere oblivion,

Sans teeth, sans eyes, sans taste, sans everything.

As You Like It, Act II, Scene VII

This summer my wife and I have been transitioning somewhere between stage 5 and 6. My eldest left Tuesday for law school in Boston and my youngest leaves for college next week in LA. So we will soon be empty nesters. As part of the change we have been making a point of going out, to dinners, bars, concerts and theater. (more…)

Posted in: Science and Medicine, Science and the Media, Vaccines

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An Alternative “Truth” About Flu Shots

Vaccines, and flu shots in particular, have been covered ad nauseum on this blog; but the anti-vaccine propaganda never stops, so forgive me for bringing it up again. A correspondent inquired about a podcast by Steve Wright on Revolution Health Radio entitled “The Truth About Flu Shots (and What to do Instead).” You can either listen or read the transcript. It’s just too funny to pass up. That is, it would be funny if it weren’t endangering our public health by spreading misinformation.   (more…)

Posted in: Herbs & Supplements, Vaccines

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High Dose Flu Vaccine for the Elderly

One weird trick to avoid the 'flu.

One weird trick to avoid the ‘flu.

Dr. Novella  has recently written about this year’s seasonal flu vaccine and Dr. Crislip has reviewed the evidence for flu vaccine efficacy.

There’s one little wrinkle that they didn’t address — one that I’m more attuned to because I’m older than they are.  I got my Medicare card last summer, so I am now officially one of the elderly. A recent review by Goodwin et al. showed that the antibody response to flu vaccines is significantly lower in the elderly.  They called for a more immunogenic vaccine formulation for that age group. My age group.

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Posted in: Vaccines

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Some Flu Vaccine Updates

It is always flu season somewhere in the world. As Australia’s flu season comes to a close, we are getting ready for ours in the Northern Hemisphere. This is a good time to start thinking about getting the flu vaccine, and as always there is a lot of flu vaccine news to sort through.

Mark Crislip has already reviewed the evidence for the efficacy of the seasonal flu vaccine. Like most questions in medicine, the evidence is deceptively complex, and Mark does an excellent job of sorting through it, so I won’t repeat it here.

This year the H1N1 pandemic flu virus will be incorporated into the seasonal flu vaccine, so there will not be two separate vaccines as there was last year. H1N1 remains the dominant strain of seasonal flu, and as predicted the pandemic has simply been incorporated into the seasonal flu pattern.

Here are some updates on flu vaccine news – first the good news:

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Posted in: Science and Medicine, Vaccines

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H1N1 Pandemic Update

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

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

Posted in: Announcements

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H1N1 Update

One weird trick to avoid the 'flu.

One weird trick to avoid the ‘flu.

I know we have been focusing on the vaccine issue extensively, but this is crunch time and the anti-vaccine forces are relentless. We are now facing a regular seasonal flu spiked with the H1N1 pandemic. Our best weapon against morbidity and mortality caused by the flu is information, and yet the public is being barraged with misinformation designed to encourage poor choices and thereby result in maximal morbidity and mortality.

I confess I was never impressed with FDR’s famous quip, “All we have to fear is fear itself,” – I think there is plenty else to fear. But his sentiment is very appropriate to the current situation – fear mongering around the seasonal flu and H1N1 vaccines is what we have most to fear.

And of course, as is almost always the case, accurate information is complex and requires a nuanced understanding. This creates uncertainty, which is easy to exploit to manufacture unreasonable fear.

The anti-vaccine fear mongers are playing every card in the deck. They are arguing (falsely) that H1N1 is not severe enough to warrant getting the vaccine, that the vaccine does not work anyway, and that there are unacceptable or unknown risks to the vaccine. In the most extreme cases, bizarre conspiracy theories are brought to bear, but I will not discuss these here as anyone compelled by such fantasies is likely beyond the reach of any information I could provide.

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Posted in: Public Health, Vaccines

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Flu Vaccine Efficacy

One weird trick to avoid the 'flu.

One weird trick to avoid the ‘flu.

I guess I will be spending the rest the flu season writing about the nonsense that is promulgated about the flu vaccine and the disease. One of the more common laments about the flu vaccine is that it doesn’t work: I got the flu vaccine and still got the flu. Well maybe. Maybe not.  It takes a few weeks to get protection, so the flu could have developed before the antibody response to the vaccine.  The vaccine does not protect to the numerous other viral infections that circulate each winter, so perhaps you had an adenovirus but thought it was the flu. Then there is the evidence.  Some readers of the blog are worried that the literature does not support the use of the vaccine.

My research for good studies on the efficasy [sic] of seasonal flu vaccines so far has left me wondering if I’ve somehow missed the good research. Tom Jefferson of the Cochrane Institute says that Most studies are of poor methodological quality and the impact of confounders is high. I agree.  Please would you refer me to some of the best studies on the efficasy [sic] of seasonal flu vaccines.  After a critical appraisal of the best studies you know of I’d like to submit the same for publication in the interest of science.

Why some readers think I am a research librarian, I do not know. It is not an uncommon request. As an aside, I have a full time job and a family to raise.  Don’t be asking me to do your grunt work. It’s called Pubmed. Use it.

But the topic for this post concerns the efficacy of the flu vaccine. I am limiting myself to the use of the vaccine in adults.
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Posted in: Science and Medicine, Vaccines

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Swine Flu Vaccine Fearmongering

One weird trick to avoid the 'flu.

One weird trick to avoid the ‘flu.

Fear is a curious thing. It often bears no relation to the actual risk of what we fear. When swine flu first broke out in Mexico, people were understandably afraid. Travel was restricted, schools were closed, and so many people stayed home that the streets of Mexico City were empty. As the disease spread around the world, Egypt developed a paranoid fear of pigs and committed national pigicide. They ordered the slaughter of all 300,000 of their country’s innocent little porkers, ignoring the fact that the flu is spread person-to-person, not pig-to-person. Now that the disease has officially been labeled a pandemic, fears have switched from the real threat of the disease to an imagined danger from the vaccine.

Some people just plain hate the idea of vaccines – to the point that they are willing to spread old falsehoods, make up new lies, distort the results of studies, misrepresent statistics, and endanger our public health. There are websites like “Operation Fax to Stop the Vax” and even anti-swine-flu-vaccine rap videos. Press releases, e-mail campaigns, talk shows, and blogs are being used to stir up irrational fears. These people are irresponsible fearmongers. They are wrong, and they are dangerous.
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Posted in: Vaccines

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