Sunday, November 25, 2012

TriHealth (Cincinnati) fires 150 workers who did not get their flu shot

Happy Thanksgiving:  You're fired.   Donald Trump couldn't have done it with more aplomb.
"Health system TriHealth had a message for 150 employees Wednesday: We really mean it this time.  
The 150 workers who didn’t get the required flu shots by the Nov. 16 deadline received termination notices the day before Thanksgiving..."
On November 20, FDA approved a new flu vaccine, grown in mammalian cells.  It appears to work in adults below age 50, but the manufacturer was only able to show it was no worse than a different flu vaccine at generating antibodies in those over 50.  That is a poor correlate for effectiveness.  According to FDA:
"The use of Flucelvax in people older than 49 is supported by antibody responses in about 1,700 adults which showed it to be comparable to Agriflu, an egg-based seasonal influenza vaccine approved by FDA for use in people 18 years and older..."
UPDATE:  AHRP on Cochrane findings re flu vaccine efficacy.

Only 6 weeks ago the University of Minnesota published a long report on the Flu Vaccine Enterprise.  Among its key findings are the two below:
1.   "During some influenza seasons vaccination
offers substantially more protection for most
of the population than being unvaccinated;
however, influenza vaccine protection is markedly
lower than for most routinely recommended
vaccines and is suboptimal.  

We reviewed all studies that evaluated influenza
vaccine efficacy and effectiveness published from 1967
to 2012 and summarized those that used rigorous
methodology and had specific infection outcome end
points. For TIV, results demonstrated: (1) evidence of
moderate protection (pooled estimate of 59%) for
healthy adults 18 to 64 years of age, (2) inconsistent
evidence of protection in children age 2 to 17 years
and (3) a paucity of evidence for protection in adults 65
years of age and older
. For LAIV, (the live vaccine used mostly in children) results demonstrated:
(1) evidence of high protection (pooled estimate of
83%) for young children 6 months to 7 years of age,
(2) inconsistent evidence of protection in adults 60
years of age and older,
and (3) a lack of evidence for
protection in individuals between 8 and 59 years of
2.   Current policy goals for influenza vaccines focus
on increasing production capacity and have not
addressed key public health challenges related to
the effectiveness of current vaccines.
Current influenza vaccine public health policy
focuses on: (1) expanding current seasonal influenza
vaccination campaigns to vaccinate an increasing
proportion of the population each year using current
HA-head vaccines,
(2) ensuring that capacity is
available to rapidly produce HA-head vaccines at the
onset of an influenza pandemic, and (3) improving
vaccine access, particularly in developing countries.
While these are all laudable goals, they provide only
for incremental improvements. Public health policy
has not yet recognized the critical limitations of the
current HA-head vaccines or the limited impact of our
current strategies.
While officials are now recognizing
that better vaccines are needed, the current policy
focus and the lack of acknowledgment of the current
vaccines’ shortcomings have created an environment
lacking the political will to develop novel-antigen
game-changing vaccines.
Public health policy leaders
must overcome these barriers and make development
of game-changing vaccines a national priority.

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