Six Reason to Question Vaccinations

[Eos of the Eons]

Like I said, they just have to ask an MD. Unfortunately alties have lied and slandered them so much that many parents aren't trusting them. If people weren't allowed to slander others to push their wares, then parents would just have to ask MDs or an RN for information. It's as easy as going to a baby appointment or booking immunizations and asking when they go in.

Enough of your claims that information is not easy to gain and accessible to parents.

Chiros lie about vaccines, homeopaths lie about vaccines, every quack out there lies about them to push their wares. Ain't freedom of speech sweet?

It's sick that you defend them, continuously all day long.

 

[Ivor the Engineer]

Here's my simple solution: bring back smallpox and let polio climb again to epidemic proportions. That'll shut-up all the anti-vax nutters.

-Dr. Imago

Nah, anti-vaxers will just claim the diseases have been genetically engineered to be resistant to echinacea and muesli.

 

[Big Les]

You two seem to be questioning the flu jab on the same specious correlation-related basis that the MMR - autism link was claimed. Do you also oppose the MMR? Or have I misunderstood?

 

[Ivor the Engineer]

You two seem to be questioning the flu jab on the same specious correlation-related basis that the MMR - autism link was claimed. Do you also oppose the MMR? Or have I misunderstood?

You have definitely misunderstood. The effectiveness of the flu jab is highly questionable, as the studies in my last post in the flu shots thread indicate.

I don't 'oppose' any vaccinations, I think some of them are being used on-mass when targeted use would be more appropriate.

I think (like Beth) there is a case to be made for some vaccinations to be mandatory for kids who attend daycare/schools, but the number of these should be a lot less than it currently is in the US, and limited to diseases that are real public health concerns.

And finally, I think public health departments coming out with nonsense like Measles causing 1 death per 330 cases is counter-productive, even if these types of scare tactics work to increase vaccine uptake in the short term.

 

[Big Les]

OK, fair enough. I really can't call this either way for myself at this point, so I'll duck back out again and re-read the thread.

 

[Beth]

Like I said, they just have to ask an MD. Unfortunately alties have lied and slandered them so much that many parents aren't trusting them. If people weren't allowed to slander others to push their wares, then parents would just have to ask MDs or an RN for information. It's as easy as going to a baby appointment or booking immunizations and asking when they go in.

Enough of your claims that information is not accessible to parents.

Huh???? I'm not saying that the information is not accessible. I'm saying the problem is that many people don't trust the medical authorities.

Chiros lie about vaccines, homeopaths lie about vaccines, every quack out there lies about them to push their wares. Ain't freedom of speech sweet?
It's sick that you defend them, continuously all day long.

Freedom of speech is very precious to me. I'm also willing to defend pornographers right to freedom of speech too. Do you want to discuss how loathsome they are as well?

But I'm not actually defending those people in this case. I'm saying that a big problem is the medical establishment producing biased policy recommendations on vaccines. I don't trust their recommendations. I can't blame other people for not trusting them either. If people aren't able to research the issue for themselves, which takes a lot of time and a considerable amount of effort and background knowledge, then they must decide based on who they trust. That's why the integrity of the system that produces those recommendations is so important. When that is lost and people no longer trust the establishment, they turn to alternative sources.

I think that fixing the problem involves reducing or eliminating the bias towards vaccinations in the committee membership and policy recommendations, not forcing people to vaccinate their children even when they don't trust the medical establishment about their safety and efficacy and prefer not to do so. You don't gain people's trust by forcing a particular course of action on them. That only makes the problem worse.

ETA: As Ivan said, it's counterproduct to put out stuff like "Measles causing 1 death per 330 cases". Yet another reason for people not to trust the information coming from the medical establishment.

 

[Deetee]

You have definitely misunderstood. The effectiveness of the flu jab is highly questionable, as the studies in my last post in the flu shots thread indicate.

You are forgetting exactly what was said in the flu thread.
The studies quoted were skeptigirl's. This is what they said:
http://www.ncbi.nlm.nih.gov/sites/en...RVAbstractPlus

The pooled effectiveness of vaccine against deaths due to respiratory disease was 12% (95% CI, 8%-16%). /snip/
CONCLUSIONS: Influenza vaccination reduces the number of hospitalizations and deaths due to respiratory disease, after correction for confounding in individuals >64 years of age who had a high risk or a low risk for influenza. For elderly people, untargeted influenza vaccination is of confirmed benefit against serious outcomes.

and:
http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

Vaccination was associated with a 27% reduction in the risk of hospitalization for pneumonia or influenza (adjusted odds ratio, 0.73; 95% confidence interval [CI], 0.68 to 0.77) and a 48% reduction in the risk of death (adjusted odds ratio, 0.52; 95% CI, 0.50 to 0.55). /snip/
CONCLUSIONS: During 10 seasons, influenza vaccination was associated with significant reductions in the risk of hospitalization for pneumonia or influenza and in the risk of death among community-dwelling elderly persons.

The vaccine's effects are clearly modest, at least by the high standards that we are used to in regard to other vaccine preventable diseases, but how on earth do you jump to the conclusion that "the effectiveness of the flu jab is highly questionable"? You also forget that respiratory disease in the elderly is due to many different infections, so a reduction in overall mortality may indicate pretty good efficacy against influenza itself.

I admit, you did respond in the other thread by saying

So both studies confirm exactly what I said in my previous post, which was that the flu shot varies in effectiveness from poor to good and doesn't stop many people being admitted to hospital or dying.

But this is a chasm away from a declaration that the vaccines are of highly questionable efficacy.

Pray tell, would you agree with the following analagous statement?

Seatbelts do not stop people dying or being injured in car crashes. (studies have shown that they only reduce the risk of death by between 12% to 48%).
Therefore I conclude their effectiveness is highly questionable.

 

[Ivor the Engineer]

Deetee: What about the last study I posted in the flu thread?

http://www.ncbi.nlm.nih.gov/sites/e...med.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus

BACKGROUND: Numerous observational studies have reported that seniors who receive influenza vaccine are at substantially lower risk of death and hospitalization during the influenza season than unvaccinated seniors. These estimates could be influenced by differences in underlying health status between the vaccinated and unvaccinated groups. Since a protective effect of vaccination should be specific to influenza season, evaluation of non-influenza periods could indicate the possible contribution of bias to the estimates observed during influenza season. METHODS: We evaluated a cohort of 72,527 persons 65 years of age and older followed during an 8 year period and assessed the risk of death from any cause, or hospitalization for pneumonia or influenza, in relation to influenza vaccination, in periods before, during, and after influenza seasons. Secondary models adjusted for covariates defined primarily by diagnosis codes assigned to medical encounters. RESULTS: The relative risk of death for vaccinated persons compared with unvaccinated persons was 0.39 [95% confidence interval (95% CI), 0.33-0.47] before influenza season, 0.56 (0.52-0.61) during influenza season, and 0.74 (0.67-0.80) after influenza season. The relative risk of pneumonia hospitalization was 0.72 (0.59-0.89) before, 0.82 (0.75-0.89) during, and 0.95 (0.85-1.07) after influenza season. Adjustment for diagnosis code variables resulted in estimates that were further from the null, in all time periods. CONCLUSIONS: The reductions in risk before influenza season indicate preferential receipt of vaccine by relatively healthy seniors. Adjustment for diagnosis code variables did not control for this bias. In this study, the magnitude of the bias demonstrated by the associations before the influenza season was sufficient to account entirely for the associations observed during influenza season.

 

[Deetee]

Yes, this study questions whether the numerous studies which observe a reduction in morbidity and mortality may be subject to bias. The paper itself states things a little bit differently to how the abstract sound-bite puts things:

The results of our study suggest that the observation of a greater reduction in risk during influenza season compared with a later period could be due to a decrease in the magnitude of the differences between vaccinated and unvaccinated persons over time, and so is not necessarily evidence of a true vaccine effect during influenza season. Therefore, evaluation of a before influenza period is needed in order to appropriately interpret the relative risk estimates observed in the influenza and post-influenza periods.

It then goes on to talk about one very such study (which showed a decrease in mortality with vaccine) but they questioned some aspects of this.

The "key message" was

The reductions in risk before influenza season suggest the presence of bias due to preferential receipt of vaccine by relatively healthy seniors on the estimates of influenza vaccine effectiveness observed during influenza season.

I see valid points raised by this paper, but are you suggesting that this one study is sufficient to undermine all previously reported benefits of flu vaccine? (after all the authors seem to think more evidence is needed on this point)

The acompanying editorial to this paper, while agreeing there is true bias, actually arrives at a conclusion you will not agree with - namely that it may be a better strategy to immunise everyone with live attenuated vaccine but give the elderly inactivated vaccine.

So I will rephrase my question to you:
Would you agree with the following analagous statement?

Seatbelts do not stop people dying or being injured in car crashes, since studies have shown that they only reduce the risk of death by between 12% to 48%. (It may be the case that better drivers are the ones who use seatbelts, but more information is necessary to determine this).
Nevertheless I still conclude their effectiveness is highly questionable.

 

[Ivor the Engineer]

Yes, this study questions whether the numerous studies which observe a reduction in morbidity and mortality may be subject to bias. The paper itself states things a little bit differently to how the abstract sound-bite puts things:
It then goes on to talk about one very such study (which showed a decrease in mortality with vaccine) but they questioned some aspects of this.

The "key message" was

I see valid points raised by this paper, but are you suggesting that this one study is sufficient to undermine all previously reported benefits of flu vaccine? (after all the authors seem to think more evidence is needed on this point)

The acompanying editorial to this paper, while agreeing there is true bias, actually arrives at a conclusion you will not agree with - namely that it may be a better strategy to immunise everyone with live attenuated vaccine but give the elderly inactivated vaccine.

So I will rephrase my question to you:
Would you agree with the following analogous statement?

Seatbelts do not stop people dying or being injured in car crashes, since studies have shown that they only reduce the risk of death by between 12% to 48%. (It may be the case that better drivers are the ones who use seatbelts, but more information is necessary to determine this).
Nevertheless I still conclude their effectiveness is highly questionable.

From my brief look at the effectiveness of seltbelts, they appear to reduce the risk of death in a car crash by 42% +/-4%. Obviously someone realised that seatbelts were a far from perfect solution, and thought up the idea of the airbag.

So in answer to your question, no, I don't think the two statements are analogous.

 

[Belz...]

From my brief look at the effectiveness of seltbelts, they appear to reduce the risk of death in a car crash by 42% +/-4%. Obviously someone realised that seatbelts were a far from perfect solution, and thought up the idea of the airbag.

Airbags kills a few people, too, however.

Small people shouldn't be allowed to drive

 

[Eos of the Eons]

Imaginary biases about vaccine committees aren't the issue. As outlined, the data bias comes in when evaluating more healthy individuals vs whose lives vaccines actually save.

Keep on overblowing like all the rest of the antivaccinators, keep on overblowing. Your unethical bias towards making mountains out of molehills keeps on showing.

You have no noble cause, and your misrepresenation of the issue will only end in tragedy for those sucked in by the misrepresenations.

Keep blowing hot air all you want to though, but most of us can see through it.

 

[T.A.M.]

From my brief look at the effectiveness of seltbelts, they appear to reduce the risk of death in a car crash by 42% +/-4%. Obviously someone realised that seatbelts were a far from perfect solution, and thought up the idea of the airbag.

So in answer to your question, no, I don't think the two statements are analogous.

What about other endpoints besides mortality? How do seatbelts effect the rates of fractures, and head injuries in car accidents?

TAM

 

[Beth]

Imaginary biases about vaccine committees aren't the issue.

Whether or not you agree with my concerns, they are not imaginary. The proper paperwork gets filed. I'm sure the history of the committee in that regard is available via public records of some sort or another. It took me quite a while to dig it up when I checked it out for myself back in the nineties, but it might all be on-line these days. I believe skeptigirl posted a link earlier in this thread to the official explanation of why it's necessary to have the vaccine committee members with ties to vaccine manufacturers and thus the waivers to the conflict of interest regulations are justified.

As outlined, the data bias comes in when evaluating more healthy individuals vs whose lives vaccines actually save.

What are you talking about here? Lots of various statistics have been discussed in this thread. I'm not clear which ones you are referring to here.

Keep on overblowing like all the rest of the antivaccinators, keep on overblowing. Your unethical bias towards making mountains out of molehills keeps on showing.

I've been critized before for being lengthy and obtuse. Sorry. I'm not anti-vaccination. I'm critical of the current U.S. system for setting vacciantion policy. I think there are serious problems with it and I don't trust the recommendations of the committee as necessarily being in the best interest of me or my children. Sort of like I can be critical of the Bush administration without being anti-American.

You have no noble cause, and your misrepresenation of the issue will only end in tragedy for those sucked in by the misrepresenations.

Noble cause? Tragedy? I'm just stating my opinion on an Internet forum and it isn't even anti-vaccination. So who exactly is being overblown in this conversation?

Keep blowing hot air all you want to though, but most of us can see through it.

The ones that aren't blowing too much smoke of their own anyway.

 

[robinson]

I'm just stating my opinion on an Internet forum and it isn't even anti-vaccination. So who exactly is being overblown in this conversation?

Maybe those, who know deep in their heart, that all is not well.

 

[Ivor the Engineer]

What about other endpoints besides mortality? How do seatbelts effect the rates of fractures, and head injuries in car accidents?

TAM

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=2319551

Injuries among samples of car accident cases attending the Accident & Emergency (A & E) department of a District General Hospital (DGH) in the year before and after the introduction of seat belt legislation were classified applying the Abbreviated Injury Scale using information recorded in the patient case notes. Those who died or did not attend an A & E department were not included in the sampling frame. The number of those who escaped injury increased by 40% and those with mild and moderate injuries decreased by 35% after seatbelt legislation. There was a significant reduction in soft tissue injuries to the head. Only whiplash injuries to the neck showed a significant increase.

http://www.ncbi.nlm.nih.gov/sites/e...med.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus

The severity of injuries sustained by 2577 car occupants in road traffic accidents in the catchment area of one district accident service during February 1982 to January 1984 inclusive was assessed using the injury severity score system. In the first 12 months the mean injury severity score for front seat occupants injured in a road traffic accident was 4.94 and in the second 12 month period, after the implementation of the seat belt law, the mean injury severity score of all injured front seat occupants was 2.80. These figures indicated a reduction in injury severity of front seat occupants of 53.4% on the previous 12 month figures. The severity of injury sustained by unbelted front seat occupants and back seat passengers showed no significant change over the two years. The number of front seat occupants killed or sustaining serious injuries (injury severity score greater than 12) showed a reduction of 54% in the 12 months beginning February 1983. Front seat occupants requiring admission for injuries sustained showed a decline of 42% in the 12 months after the introduction of the seat belt law, and deaths among front seat occupants fell by 27% compared with the previous 12 months. After the implementation of seat belt legislation those front seat occupants killed or sustaining serious injuries included a significantly higher proportion of victims who were not wearing their seat belts or showed positive evidence of alcohol intake at the time of the accident. This series suggests that the incidence of serious injury or deaths among front seat occupants of cars has decreased substantially since the seat belt law became effective on 31 January 1983.

http://www.ncbi.nlm.nih.gov/sites/e...med.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus

OBJECTIVE: To study effectiveness of seat belts for protecting school age children in road vehicle crashes. DESIGN: Crash examinations by trained investigators. SETTING: Ten Canadian university based crash investigation centres. SUBJECTS: 470 children aged 4-14 years, with 168 selected for detailed analysis, and 1301 adults. MAIN OUTCOME MEASURES: Use of seat belts by vehicle occupants; severity of injury adjusted for age and crash severity. RESULTS: Overall, 40% (189/470) of children were unbelted. Of the 335 children in cars driven by belted adults, 73 (22%) were unbelted. The odds of sustaining fatal or moderately severe injury (injury severity score > or =4) for children in the front passenger seat was more than nine times higher for unbelted children than for belted ones (odds ratio 9.8 (95% confidence interval 2.4 to 39.4)) and for those in the rear left seat was more than two times higher for unbelted than for belted children (2.6 (1.1 to 5.9)). The protection afforded by seat belts compared favourably with the results for adults in the same seat positions (odds ratios for unbelted v belted adults of 2.4 and 2.7 for front and rear seat passengers respectively). CONCLUSIONS: Seat belts helped to protect school age children from injury in road vehicle crashes. However, 40% of children were unbelted. Despite standard seat belts being designed for adults, school age children were at least as well protected as adults.

This wiki article explains why children should use booster seats when being restrained by a seatbelt designed for adult-sized occupants.

 

[Professor Yaffle]

But all these seatbelt campaign adverts you saw on TV (clunk click, on every trip) kept showing you pictures of crashes and never told you the actual probability that you would be involved in an accident. They were just playing on people's fears to increase the number of people wearing seatbelts. And they are coercing people by making it illegal to not wear a seatbelt. People should be allowed to make their own decisions on seatbelts.

 

[Ivor the Engineer]

But all these seatbelt campaign adverts you saw on TV (clunk click, on every trip) kept showing you pictures of crashes and never told you the actual probability that you would be involved in an accident. They were just playing on people's fears to increase the number of people wearing seatbelts. And they are coercing people by making it illegal to not wear a seatbelt. People should be allowed to make their own decisions on seatbelts.

I agree. The science should be presented in an unbiased and understandable way. Coercion should be a last resort. What reasons do people give for not wearing seatbelts?

http://www.nhtsa.dot.gov/people/injury/research/SafetySurvey/Chapter2.html

The vast majority of the non-use described on the previous page came from persons who indicated at least some use of seat belts. However, Figure 25 also included a small number of persons who said that they never wore their seat belt while driving. Reasons for non-use among adamant non-users may differ from that of part time users. Figure 26 suggests that is the case. Although the Figure is based on very small numbers (100 cases), it shows that discomfort (65%) and "Other" reasons (38%) were far more predominant among those who never wore seat belts.

Here's some info. on the scale of the problem:

http://www.statistics.gov.uk/cci/nugget.asp?id=1208

The total number of deaths in road accidents fell slightly by 1 per cent to 3,201 in 2005 from 3,221 in 2004. However, the number of fatalities has remained fairly constant over the last ten years.

Just over half (52 per cent) of people killed in road accidents in 2005 were car users. Pedal cyclists and two-wheeled motor vehicle users represented 5 and 18 per cent of those killed respectively. Occupants of buses, coaches, goods and other vehicles accounted for the remaining 4 per cent of road deaths.

The total number of road casualties of all severities fell by 3 per cent between 2004 and 2005 to approximately 271,000 in Great Britain. This compares with an annual average of approximately 320,000 for the years 1994-98 and 324,000 in 1984.

 

[Rolfe]

<small derail>
The psychology of that can be interesting. When the seat belt law came into force I was against it, simply because I was against compulsion. However, I noticed an interesting thing, once it was law. I was belting up without any second thoughts. Why?

I realised that before it was compulsory, if I was a driver, some little thing in the back of my mind was whispering, hey, do you think you're likely to have an accident? Is that why you're fastening the seat belt? And of course I didn't like this feeing that I might be heading for an accident. If I was a passenger, I subliminally felt that fastening the seat belt was an implicit criticism of the driver's ability - hey, do you think this person is likely to have an accident?

Once the reason for fastening the belt was simply that "it's the law", all that went. No subliminal bad feelings, just do it.

I had no idea that was how I was thinking until after the law came into force.
</derail>

Rolfe.

 

[T.A.M.]

From the point of view of someone who has worked in Emerg I will say this.

Seatbelts are a benign, well tolerated (come on, discomfort while wearing them...give me a break), and there is no financial incentive for the companies to put them cars except safety. While I have no doubt, the reduction in Injury and mortality, OVERALL is perhaps not as marked as everyone would expect, I would imagine in some subgroups of the study population it was probably more than others.

In the end, of course it should have been presented more fairly and balanced, but you are counting on everyone having your degree of sensibility and intellect...

As well, there are lots of other things that we do because they have been legislated, regardless of whether we want to or not. Part of what govt and what not do, is decide on things for the people...not every act or law has to have a referendum.

TAM