Sunday, March 30, 2014

Why exemptions?

The link below is to a parent's response to a physician's editorial encouraging the elimination of exemptions to vaccination - it has apparently gone "viral" (um, even more terrifying is the thought of government "vaccinating" us against free speech with net "neutrality", among other forms of censorship ... );

Her blog is a great summation of why vaccination is such a heated topic, and why I agree that exemptions are necessary and should remain available and easy to obtain. Actually, I think we should not need exemptions, but that vaccination should rather be "opt in" so to speak - in other words, available, and if you want them, get them. If you don't want them you should not be bullied or manipulated into obtaining them (ie: as a condition of employment, or of education, or to receive federal benefits that to which you are otherwise entitled, etc ... );

The only nit I have to pick is that I would extend this to adults as well, since they are targeted for vaccination too - all the more so. It's incredibly lucrative, and virtually risk free (well, except for the person receiving the vaccine!)


Sunday, March 16, 2014

Who's next?

This writer has long wondered if mandating annual flu vaccine for HCW's was just a start. This article from the CDC may be dropping hints of what group may be the next target (real estate and hospitality industries).

The article (dated 3.14.2014) looks back to the 2009 - 2010 flu season and estimates rates of illness and flu vaccine coverage by taking telephone samples and "adjusting" numbers - how any of this could be verified for accuracy is anyone's guess. The response rates were low, just over 1/3 of those called (~6,000/month - and even these targets were approximate) took part in the survey, further calling into question the veracity of the results.

Influenza like illness was defined as " having been sick with fever and cough or sore throat in the past month" ... which could be influenza/ILI/or just about anything else. 

Contradictions abound in the following paragraph, quoted from the article:
Among all adults, employed persons had a similar prevalence of ILI in the month before the interview (5.5%) compared with those not in the labor force (6.0%); these groups also had similar pH1N1 vaccination coverage (23.7% versus 26.5%) (Table 3). In contrast, ILI prevalence was higher (9.4%) and pH1N1 vaccination coverage was lower (16.7%) among unemployed adults in the labor force.
 "Unemployed adults in the labor force" must be the same group that counts as part of the official unemployment statistic, whereas if you are unemployed but no longer looking you do not count as being unemployed (officially) - clearly a factor in differentiating risk of flu. Those "not in the labor force" are defined as "homemakers, students, retirees, and adults unable to work", a rather broad, and diverse, group by any standards, which could also affect accuracy of the "estimates". How many students work in addition to going to school? How many women who at home would like to once again, be informed, that they are not really working! Adults "unable to work" = disabled, a group that might well be at increased risk for a variety of illnesses, including flu/ILI!

The authors do at least acknowledge these weaknesses in the editorial section of the write up, but this could hardly be considered data upon which to base policy decisions of any kind.

When it comes to vaccinations, let people make up their own minds.


Sunday, March 09, 2014

Unintended consequences ...

One of the reasons public health officials and health care providers are so concerned about influenza is its link to secondary infections (generally pneumonia) that may be at least as deadly, if not more so, than a primary infection with influenza (especially for those who are already compromised with other chronic or acute health conditions).

LAIVs are Live Attenuated Influenza Vaccines, given intra-nasally, generally to a pediatric population (and contra-indicated for pregnant women). The link below (#1) is to a study showing that use of LAIVs can result in increased colonization of the respiratory tract with streptococcus pneumonia and staphylococcus aureus - two bacteria that can be human pathogens. This is similar to what happens in naturally acquired influenza.

Not only are those who receive this vaccine shedding live flu virus to those around them after receiving it, but they may also be shedding/spreading other pathogens as well (even if they do not get ill).

But this begs several questions -
1) MRSA (methcillin resistant staph aureus) is an increasing problem - it used to be limited to         a nosocomial infection (acquired when in-patient), but it is now community acquired as well         as nosocomially acquired. Could the use of this vaccine have played a role in that change?

2) How many people are becoming sick with pneumonia without an initial influenza and could
    the phenomena described in this study be playing a role with this as well? In other words,
    could this intervention be causing more illness than it prevents?

Remember - this vaccine is used primarily in a pediatric population who are still being taught to cover their mouth when they cough or sneeze ... and for that matter, how many adults do this?

Consider this report from 2012:
  1778 • CID 2012:54 (15 June) - Increased Risk of NonInfluenza Respiratory Virus Infections
   Associated with Receipt of Inactivated Flu Vaccine;
Could the Inactivated (injected) flu vaccine be having a similar effect, or does it cause a disregulation of the immune system that causes us to be more vulnerable to becoming ill
subsequent to vaccination? If so, why is it hyped and pushed so much? If it causes this kind
of disregulation of the immune system might there be other immune problems caused by
this intervention about which we do not yet know?

Interestingly enough, this issue also contains reports regarding pertussis outbreaks among highly/fully vaccinated populations ... but that's for another blog post. Scape-goating the unvaccinated is far too easy, and simply un-justified.

In the past, I didn't believe people when they said "I always get sick after I get the flu vaccine."
Now I do.

The phenomena of poly-pharmacy is well known - this can happen when multiple physicians or health care providers are writing prescriptions for various reasons/conditions, or it can happen as drug A causes a side effect for which drug B is prescribed, which may cause still more side effects leading to further prescriptions, etc ... );

I suspect we have already arrived at poly-vaccination but that the phenomenon is not recognized, or if acknowledged, is ignored because so many have agendas around vaccination (financial or otherwise) that motivates them to remain silent.

Vaccination should be voluntary, not compulsory. Period. People should be free to determine for themselves what risk/benefit ratio they are willing to live with.