Vaccines and Data

[selenite0]

The Atlantic has an interesting article on the issues surrounding influenza vaccinations. Makes a pretty good case that the flu shots don't have much effectiveness in keeping people from dying. There's a rebuttal out, of course.

The scariest part for me is the poor quality of the data on flu deaths. Diagnoses are based on symptoms, not tests of the virus, so we don't actually know how many people have been getting sick or dying from influenza. No one's doing well designed experiments to test the effectiveness of the vaccine and one of the big arguments (herd immunity) would be damned hard to test in any case.

I suspect we're not going to have a real grasp of the effectiveness of medical treatments until we give up on the privacy of medical records. If we get to the point where everyone's records are searchable, and detailed to the point where you can tell if a swab test was H1N1 positive or the doc just wrote a prescription to make the patient go away, there's going to be a lot of patterns discovered that'll make irrelevant all the watch-36-patients-for-six-months microstudies that policies get based on now.

Comments

[estokien.livejournal.com]

Well it may be anecdotal, but having an otherwise healthy 29 year old former colleague die from H1N1 related complications recently and hearing that it has a similar mortality rate between the healthy and the traditionally vulnerable populations makes me feel that this particular vaccine is not one to opt out on. And, of course, part of the reason for the regular vaccines is to prevent healthy people from getting the virus and spreading it to the vulnerable population.

I do agree that some kind of medical research exception to privacy of patient records could be very useful so long as it could be kept focused.

[selenite.livejournal.com]

I don't think providing medical researchers special access would do much good. The breakthroughs will come when amateurs and specialists in unrelated fields can apply their tools to easily accessible data.

My two cents

[carbonelle.livejournal.com]

My money is on the second article (rebuttal) as more generally useful, particularly as it provides links to more scholarly, less, ah, journalistic coverage of the pitfalls of current influenza vaccine research (seriously, the links are well worth following)

One of the worst fallouts in the vaccine-causes-autism scare is the unwillingess of either side to play rationally (generally speaking: I'm fortunate to have a sensible pediatrician, myself) Limiting vaccines to children under 2.5 years of age (when autism appears) in families with a history of Aspergers spectrum disorder would be an obvious way to manage fears while deligitmizing the luddite/scientific illiterates. Can you believe that there are grown women arguing that adults shouldn't get a flu vaccine because it could cause autism? Oy!

I get the flu shot because I'm a healthy workaholic who serves the public--the odds I'd get infected, or more likely infect someone else because I didn't distinguish between "just a cold" and "golly, I'm really sick" is darn likely. There's a whole cohort of healthy individuals who can, by being resistant, help prevent the spread of disease. We who can, should.

Re: My two cents

[selenite.livejournal.com]

I followed several of the links from the rebuttal and was a bit alarmed by the agreement on how bad the data quality is. They freely admit they don't have good science backing up the policies they recommend . . . and yet are offended when someone else has doubts. It reminds me of theologians discussing the lack of Roman documentation or archeological evidence without their faith in the Resurrection being affected. Appropriate for religion . . . worrisome for medicine.

As for which kids should get fewer vaccines I'd think a family history of autoimmune disorders should be a bigger warning flag than autism spectrum ones. But I have yet to find a doctor willing to deviate from the prescribed shot schedule. Skip entirely, yes, but not slow it down or just do the most crucial ones.

Re: My two cents

[carbonelle.livejournal.com]

Some of it's just common sense: keeping the people who are going to be most likely to spread diseases to the high risk people they work with ("young" service people like me, esp. health care workers) who are both the best recipients (easily stimulated immune system) and most likely to ignore having a contagious disease until they've already spread it, innoculated? Of course.

But yes, it's pretty disturbing how unscientific scientists can--not to mention irrational--be the minute they leave their labs. It's as if being so smart, educated and knowlegeable in one area innoculates them from a useful humilty viz their powers in every other subject.

Next time I see my pediatrician I'll have to ask her why she was so willing to adapt the Mighty Mite's vaccine schedule to my needs (I have both a history of autoimmune disorders and Autism spectrum: I did not want to take chances with my baby!) We delayed, skipped--we'll be fully up to speed by the time the kid is 10 and in the meantime, she's got the most critical covered. I wish more doctors would evince her compassion and common sense.