Tuesday, November 1, 2016

She didn’t think a flu shot was necessary — until her daughter died/ WaPo

Last week's Washington Post had a very sad, haunting story about the death of a twelve year old girl from flu-related causes.  Her mother had tried for ten years to have her, and finally succeeded using in vitro fertilization.  Then her daughter developed flu, organ failure and died, in rapid succession, last January.

It was probably no coincidence the story was published in October, the prime month for advertisements for flu shots.  While the take home message was to get your children vaccinated, the odds that a vaccine would have prevented this death are less than even. 

My comment:

This story omitted important information. 
According to CDC, the flu shot has been, on average, 37% effective over the past 12 years. However, also according to CDC, the FluMist nasal vaccine used in children was pulled this year, because it *did not work* over the past 3 flu seasons. 

According to the Cochrane Collaboration, there are no data on flu vaccine efficacy in infants and toddlers. Therefore I would not encourage parents of very young children to vaccinate them for flu, as the vaccine might be considered experimental in this age group. 

Last year there were 85 pediatric deaths from flu. There are 80 million flu vaccine-eligible children in the US. If you vaccinated 80,000,000, you might prevent an estimated 31 pediatric deaths (37% x 85)---but you would cause many cases of Guillain-Barre paralysis and other side effects. So the net cost/benefit of vaccinating children is uncertain, and could well be negative. 

Finally, nearly all people who die from flu-related causes die from a complication of flu, like pneumonia. In Piper Lowery's case, her mother took her to the hospital "several times" in the 4 days from illness onset to death. Why was she sent home several times? Her doctors should have known better. 

4 comments:

SatyaPranava said...

A comment and a question as we engage in this thought process:

First, do we even know how many of the 85 had been vaccinated against

Second, with respect to (and in support of) your term "might," how do we know that the a successfully vaccinated child would prevent a single death? It could be argued just as easily that maybe the number of cases would drop, as a whole; but instead, it would have only prevented the 37% whose immune systems were on the cusp of being able to contain the disease from becoming a bigger problem, not simply of all those vaccinated. It would stand to reason that in such a case, maybe a small number, say 17((or 5) might not die (or 23 more might), but would still be pretty close. And this is not necessarily because of among the vaccination or not, but how destroyed one's immune system is.

Again, to repeat, i would imagine that most of the gains (and none of the deaths) would be among the 37% of those who contracted, but were the least ill.

Please feel free to answer or comment at your convenience.

Meryl Nass, M.D. said...

I deliberately used the CDC's efficacy statistics to drive an average of 37 percent. I don't vouch for this number.

There are no reliable data to tell us The frequency severity and scope of adverse reaction to influenza vaccines.

SatyaPranava said...

Of course the CDC's numbers are not reliable. Moreover, Wehn working in the hospitals and other clinics, I've read many of the vaccines inserts and one of the major things that's missed in this sad debate (as the term debate almost justifies that there is a legitimate 2nd side) is that these companies are not even testing their products against influenza; rather the more broad category of influenza-like-illnesses (ILIs).

But even more importantly, it's been very well established in the literature over the past 30+ years that bacterial infections make up on average more than 85%-90% of ILIs (hence all viruses makeup no more than 15% of ILIs and the major influenzas a smaller percentage of that number).

Yet, the inserts will claim that they're effective at preventing up to 60+% and 70+% (and some say as little as 9%, which is probably more accurate IF it's even that effective).

Thus it comes down to how many scientists and doctors really believe how likely (or possible) for a 4-antigen, viral influenza vaccine to be 70% effective against a class of 85%+ bacterial infections (15% viruses, and say maybe 10% influenzas, including many more than the 4 antigens selected). If they do believe such efficacy, they have some statistical, microbiological, physiological, and immunological explaining to do.

And if (somehow, against the teachings of all these fields of study) it's true, that sure is a powerful vaccine; maybe it can prevent car-accidents, suicides, and maybe even childhood bathtub drownings too! Let's go for herd-immunity for those too!

Meryl Nass, M.D. said...

If you vaccinated 80 million children with FluMist vaccine it is likely we would not have prevented any deaths. However, you probably would have caused several dozen cases of Guillen Barre syndrome and most likely other side effects as well.