Posted by: sayamika, the killer bunny | 2009 September 24

Evidence? What evidence?

There are two types of chiropractor:

1. The good “mechanic.” This chiropractor knows a lot about back anatomy and back pain, and is able to use chiropractic techniques to bring relief to people who have things like degenerative disc disease, bad posture, old injuries, etc.

This type of chiropractor does not see children.

2. The “woo-meister.” This type pretends he can cure diseases by fiddling with your neck. He “treats” children, and tells them to stop their asthma puffers. He says, if your back is aligned, you don’t need to get vaccinated. He clearly has no understanding of disease processes.

Guess which type posted this:

I don’t believe flu shots work. Here’s why:

* If they work…why do some people who get the shot still get the flu?
* If they’re only 50% effective, why get the dang shot, anyway?
* I don’t know what’s in that vile
* Where’s the proof that they REALLY work?
* EVEN if the flu shot worked, the little flu virus adapts quicker than the appropriate vaccine can be developed.
* Did you know that many MDs that recommend the flu shot DON’T get them.
* Anecdotally, the last flu shot I got was forced on me by Uncle Sam before I left the Air Force 33 years ago. I’ve had the flu ONCE.
* Isn’t it funny how flu season ALWAYS comes AFTER the flu shots are given out?

Let’s start with the beginning:

* If they work…why do some people who get the shot still get the flu?

In my community, our priority is to vaccinate those at highest risk of harm once they get flu, and after that those at highest risk of getting flu.

Those at highest risk of harm are the obvious ones: the elderly, particularly the ones in nursing homes. Also, people who have suppressed immune systems, such as transplant recipients, people with rheumatoid arthritis or multiple sclerosis whose medications are immune modulators, and pregnant women, whose state of pregnancy is a natural immunosuppressor.

Consider the elderly. The reason elderly people are high risk is because their immune systems, like the rest of their bodies, are slowing down. They do not mount as fast an immune response. Much of the failure rate of the vaccine is in this group. They fail for the exact reason they were high risk in the first place: the immune system of such people sometimes even with a vaccine, just isn’t up to much.

Therefore, if you are the sole caregiver for your elderly shut-in mother, if you get your flu shot, you’d pretect her more than if you simply sent her for one and didn’t get your own. You’re presumably younger and healthier, and the shot works better if you have a better baseline.

All that said, it still prevents flu in a high proportion of elderly people. It is still safe and cost-effective. I would not stop vaccinating residents of nursing homes.

* If they’re only 50% effective, why get the dang shot, anyway?

Oh great reasoning there. If there are 50% fewer cases of influenza in an area, that’s half the number of people showing up to emergency. That’s halving your chances of a week of aching, fever, vomiting, wishing you could just die already.

And that 50%, that’s on a year with a poor match to strains. Usually it’s closer to 70-75%. I’ll take that, thanks.

* I don’t know what’s in that vile

That vile? That vile what?

Oh, wait, I got it, the VIAL, with the vaccine in it.

You could oh maybe read the LABEL.

This took me about 10 seconds to find:

VAXIGRIP® [Inactivated Influenza Vaccine Trivalent Types A and B (Split Virion)] for
intramuscular use, is a sterile suspension containing 3 strains of influenza virus cultivated on
embryonated eggs, concentrated, purified by zonal centrifugation in a sucrose gradient, split by
Triton® X-100, inactivated by formaldehyde and then diluted in phosphate buffered saline
solution. The type and amount of viral antigens contained in VAXIGRIP® conform to the current
requirements of the World Health Organization (WHO). (1) The strains for the 2009-2010 season
are: A/Brisbane/59/2007 (H1N1)-like strain [A/Brisbane/59/2007 (IVR-148)],
A/Brisbane/10/2007 (H3N2)-like strain [A/Uruguay/716/2007 (NYMC X-175C)] and
B/Brisbane/60/2008-like strain (B/Brisbane/60/2008).

Triton X-100 sounds SCARY, but it’s essentially detergent, to keep the ingredients in solution. Formaldehyde also sounds scary, but in the amounts you’ll find, well, your liver makes more when you have a glass of wine. WAY more. Neomycin is an antibiotic used to preserve the vaccine, and again, the dose is ridiculously small. You could shoot up with the whole box and still not cure your stye.

And thimerosal. It’s ethyl mercury. Not methyl mercury. About as different as ethanol (in beer and wine) and methanol (methylated spirit). Ethyl mercury does not bioaccumulate, the kidneys flush it out. It’s safe, safe, safe. That’s all I’m going to say about it, for fear of attracting the autism spambot brigade, who have apparently gotten to and rewritten the thimerosal wikipedia article. *sigh*

* Where’s the proof that they REALLY work?

Oh, here. And here. And don’t forget here. And here. I could keep going, but I’ve made my point.

* EVEN if the flu shot worked, the little flu virus adapts quicker than the appropriate vaccine can be developed.

Er, no, not in general. This year is a little different.

* Did you know that many MDs that recommend the flu shot DON’T get them.

That’s partly true, and I don’t know why. It may be a case of the shoemaker’s children never being shod. I get mine to protect a vulnerable family member of mine, and to protect my nursing home and COPD patients. I’m young and healthy, and probably would be otherwise fine.

It’s not a great argument, but it does go to show that MDs are human and fallible. Not exactly earthshaking, that.

* Anecdotally, the last flu shot I got was forced on me by Uncle Sam before I left the Air Force 33 years ago. I’ve had the flu ONCE.

Um. So?

I’ve NEVER had flu. I get my shot every year. My anecdote wins! Lol!

* Isn’t it funny how flu season ALWAYS comes AFTER the flu shots are given out?

Facepalm: because expressing how stupid that was in words just doesn't work.

Facepalm: because expressing how stupid that was in words just doesn't work.

So, yeah, if that’s all you’ve got, Mr. Chiropractor, I guess it shows you’re too lazy to look a few things up.

Eight reasons to get a flu shot:

8. Because even if you’re a bed-bound 98 year-old, it’ll still halve your chances of getting flu. If you’re healthier than that, it’s even better.
7. You’ve had flu before, and once was enough, thanks.
6. You know exactly what’s in that vial.
5. You can’t afford a week off work, then another week when your kids get it.
4. Vomiting and sneezing at the same time is unattractive. Also, messy.
3. Because you have a family member you want to protect by not bringing them flu.
2. It’s free! (in Canada)
1. All the cool people are doing it.

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Responses

  1. So I wake up this morning to the radio, and the top story on the news report is summarized as follows: “getting the flu shot can double your chance of getting swine flu”.

    Now, I’m just a layperson and all, but something sounds fishy in the state of Denmark (mixing metaphors, yay!) Do you know anything about this?

    • Irresponsible reporting. Preliminary results, neither peer-reviewed nor validated. As in, may or may not mean anything, but the story is likely to stop people getting vaccinated.

      I mean, it’s possible, but it doesn’t fit with what we know about influenza immunity. Cross-reactivity for various strains in general confers partial immunity. The other case where something like this happened, it explained two forms of the same illness (dengue fever vs breakbone fever) wherein partial immunity due to either previous infection by a related but not identical strain or by vaccination led to breakbone fever when infection by a different strain occurred. So, we don’t vaccinate travellers to dengue for that reason.

      Flu is well-studied and there has never been anything like that with the cross-reacting strains, so I’m guessing the result here is some sort of error. The only way to know is wait for the final paper. If not, I’d go with the seasonal shot and take my chances with the milder swine flu.

      UPDATE: WHO is looking at the Canadian data. Similar studies have been done in many other countries and only Canada has got a wonky result. http://www.cbc.ca/health/story/2009/09/24/h1n1-vaccine-who.html

  2. […] Evidence? What evidence? Posted in Red Rabitt's Life by Skepdude on September 24, 2009 READ THE REST OF THIS ENTRY AT RED RABITT’S LIFE […]

  3. “I’ve NEVER had flu. I get my shot every year. My anecdote wins! Lol!” – Precious! LOL! I surely featured this entry in my blog.

  4. Facepalm is right. Gah.

  5. So, what happened to the Swine Flu?


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