Flu Vaccine Not Working Too Well - Only 23% Effective

haidut

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I don't even know if they do a full risk assessment of flu vaccines. That will means calculating the risk of getting flu by not getting the vaccine and comparing it to the SUM of risks of getting flu after getting the vaccine and getting sick (not flu) from side effects related to the vaccine.
Btw, AFIAK the flu vaccine has never been studied in a double blind placebo controlled trial.

http://news.yahoo.com/flu-vaccine-not-w ... 44538.html

"...This year's flu vaccine is doing a pretty crummy job. It's only 23 percent effective, which is one of the worst performances in the last decade, according to a government study released Thursday. The poor showing is primarily because the vaccine doesn't include the bug that is making most people sick, health officials say. In the last decade, flu vaccines at their best were 50 to 60 percent effective. "This is an uncommon year," said Dr. Alicia Fry, a flu vaccine expert at the Atlanta-based Centers for Disease Control and Prevention, who was involved in the study. The findings are not surprising, though. In early December, CDC officials warned the vaccine probably wouldn't work very well because it isn't well matched to a strain that's been spreading widely."
 

jaa

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Re: Flu vaccin not working too well - only 23% effective

Seems fine / acceptable to me. They used the best techniques they have and had an off year. It's still way better than not putting it out (0% effective) in terms of reducing human suffering when 3,000 - 49,000 people die from flu and flu associated deaths each year in USA alone.

The CDC uses confusing language when talking about how the vaccine is studied. They say mostly observational studies because withholding the vaccine from people could cost lives, but they do mention blind (I assume double blind) placebo studies as well.

http://www.cdc.gov/flu/about/qa/vaccineeffect.htm
 
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haidut

haidut

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Re: Flu vaccin not working too well - only 23% effective

jaa said:
Seems fine / acceptable to me. They used the best techniques they have and had an off year. It's still way better than not putting it out (0% effective) in terms of reducing human suffering when 3,000 - 49,000 people die from flu and flu associated deaths each year in USA alone.

The CDC uses confusing language when talking about how the vaccine is studied. They say mostly observational studies because withholding the vaccine from people could cost lives, but they do mention blind (I assume double blind) placebo studies as well.

http://www.cdc.gov/flu/about/qa/vaccineeffect.htm

There are no placebo trials that I now of. This website talks about it and even CDC admits there is no placebo trial, but comparison to another vaccine.
http://www.skepticalob.com/2009/10/late ... ccine.html

The ethical argument does not fly. Many other vaccines have been through placebo trials, and of all vaccines arguably the flu vaccine is the least unethical to undergo a placebo trial. Much more dangerous conditions such as tetanus, chickenpox, and polio had placebo trials so to say that the flu (which many people end up getting many many times in their life) is not suitable for it is just fraudulent on CDC part.
Note that I am not against vaccines. For certain ones like tetanus, chickenpox, and mumps in boys the benefits vastly outweigh the risks and they have all been through a placebo trial.
The flu vaccine is just laughable. The only criteria of success set by the FDA for a flu vaccine is the so-called immugenicity potential. Btw, not only is this a far less rigorous criteria than a placebo group but we don't even know if immunogenicity for the flu viruses is actually good or bad. For instance, high antibodies to viruses like HIV and hepatitis are actually an indication of a very poor prognosis. I am not sure anything like that has been analyzed for the flu, but I believe there is a study on PubMed showing much lower survival for people infected with the swine flu and showing high immugenicity.
So, the truth is much more nuanced than what CDC would have us believe and in some cases like the flu vaccine it is just blatant manipulation of public opinion in favor of the drug companies. Other vaccines are much better handled and maybe that's b/c the fallout from an ineffective vaccine for say Ebola would be much worse than for the flu vaccine (if someone somehow proved that it is no better than placebo).
Lastly, do a search on the forum for Tamiflu. I posted a study on it actually being worse than placebo. I know it is not a vaccine but if the flagship flu product performs so bad I have little faith that the vaccines will be any better.
Just my 2c.
 
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Re: Flu vaccin not working too well - only 23% effective

jaa said:
Seems fine / acceptable to me. They used the best techniques they have and had an off year. It's still way better than not putting it out (0% effective) in terms of reducing human suffering when 3,000 - 49,000 people die from flu and flu associated deaths each year in USA alone.

The CDC uses confusing language when talking about how the vaccine is studied. They say mostly observational studies because withholding the vaccine from people could cost lives, but they do mention blind (I assume double blind) placebo studies as well.

http://www.cdc.gov/flu/about/qa/vaccineeffect.htm

But doesn't withholding any drug from people for ten years have the potential to cost lives?
 

jaa

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Re: Flu vaccin not working too well - only 23% effective

haidut said:
jaa said:
Seems fine / acceptable to me. They used the best techniques they have and had an off year. It's still way better than not putting it out (0% effective) in terms of reducing human suffering when 3,000 - 49,000 people die from flu and flu associated deaths each year in USA alone.

The CDC uses confusing language when talking about how the vaccine is studied. They say mostly observational studies because withholding the vaccine from people could cost lives, but they do mention blind (I assume double blind) placebo studies as well.

http://www.cdc.gov/flu/about/qa/vaccineeffect.htm

There are no placebo trials that I now of. This website talks about it and even CDC admits there is no placebo trial, but comparison to another vaccine.
http://www.skepticalob.com/2009/10/late ... ccine.html

The ethical argument does not fly. Many other vaccines have been through placebo trials, and of all vaccines arguably the flu vaccine is the least unethical to undergo a placebo trial. Much more dangerous conditions such as tetanus, chickenpox, and polio had placebo trials so to say that the flu (which many people end up getting many many times in their life) is not suitable for it is just fraudulent on CDC part.
Note that I am not against vaccines. For certain ones like tetanus, chickenpox, and mumps in boys the benefits vastly outweigh the risks and they have all been through a placebo trial.
The flu vaccine is just laughable. The only criteria of success set by the FDA for a flu vaccine is the so-called immugenicity potential. Btw, not only is this a far less rigorous criteria than a placebo group but we don't even know if immunogenicity for the flu viruses is actually good or bad. For instance, high antibodies to viruses like HIV and hepatitis are actually an indication of a very poor prognosis. I am not sure anything like that has been analyzed for the flu, but I believe there is a study on PubMed showing much lower survival for people infected with the swine flu and showing high immugenicity.
So, the truth is much more nuanced than what CDC would have us believe and in some cases like the flu vaccine it is just blatant manipulation of public opinion in favor of the drug companies. Other vaccines are much better handled and maybe that's b/c the fallout from an ineffective vaccine for say Ebola would be much worse than for the flu vaccine (if someone somehow proved that it is no better than placebo).
Lastly, do a search on the forum for Tamiflu. I posted a study on it actually being worse than placebo. I know it is not a vaccine but if the flagship flu product performs so bad I have little faith that the vaccines will be any better.
Just my 2c.

All good points. I have only examined this issue superficially and assumed the low rate of effectiveness was about the best they can do given the circumstances, which now appears to be a false belief.

But doesn't withholding any drug from people for ten years have the potential to cost lives?

I don't understand what you are referring to. Are you talking about a potential flu vaccine they could invent if they performed more rigorous testing?
 
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Every drug on the market is usually tested for ten years before becoming available.
 

Sea

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"We included 50 reports. Forty (59 sub-studies) were clinical trials of over 70,000 people. Eight were comparative non-RCTs and assessed serious harms. Two were reports of harms which could not be introduced in the data analysis. In the relatively uncommon circumstance of vaccine matching the viral circulating strain and high circulation, 4% of unvaccinated people versus 1% of vaccinated people developed influenza symptoms (risk difference (RD) 3%, 95% confidence interval (CI) 2% to 5%). The corresponding figures for poor vaccine matching were 2% and 1% (RD 1, 95% CI 0% to 3%). These differences were not likely to be due to chance. Vaccination had a modest effect on time off work and had no effect on hospital admissions or complication rates. Inactivated vaccines caused local harms and an estimated 1.6 additional cases of Guillain-Barré Syndrome per million vaccinations. The harms evidence base is limited." (http://www.ncbi.nlm.nih.gov/pubmed/20614424)

So when there is a perfect match 4 out of 100 unvaccinated people get the flu while 1 out of 100 vaccinated people get it. When their is a poor match, 2 out of 100 unvaccinated people get the flu, while 1 out of 100 vaccinated people get the flu. Oh, and you have a real chance of getting side effects far more severe than the actual flu.

But wait,

"WARNING: This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies." (http://www.ncbi.nlm.nih.gov/pubmed/20614424)

I wonder what the data would like if the studies were actually objective.
 
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I like a study with a WARNING. Why did they take it out in the update?
 

tara

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haidut said:
Btw, AFIAK the flu vaccine has never been studied in a double blind placebo controlled trial.
I imagine it would be hard to do a meaningful double-blind placebo controlled trial for the common flu vaccines, given that they change every year to address the predicted most prevalent 3 strains.

How useful the vaccines are to individuals probably depends on their relative vulnerability to flu, as well as the severity of the flu strains that the vaccines are matched to, as well as how good the match is. This changes every year.
 
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