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Old 01-02-2015, 07:22 AM
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Mary Pat Campbell
Join Date: Nov 2003
Location: NY
Studying for duolingo and coursera
Favorite beer: Murphy's Irish Stout
Posts: 89,063
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Now that flu season again is closing in on all of us, it’s time to trot out the annual debate about flu vaccines.

On one side are pro-vaccine stalwarts like those in public health (and yours truly), who look at the needle and syringe and see lives saved and hospitalizations averted. On the inevitable other side stand those against vaccination, people looking for plot, conspiracy, and intrigue in all the wrong places: the anti-vaccine brigade. Somehow, the discussion each year begins from scratch, Groundhog Day-style, with identical claims, counterclaims, and mud-slinging from all quarters.

This year, it must be admitted, the discussion is a bit more dicey—the Centers for Disease Control and Prevention announced a few weeks ago that this season’s vaccine is not such a good match, meaning that the vaccine may prevent fewer cases of influenza. On average, the vaccine has an efficacy of about 60 percent. This number is arrived at by comparing proven influenza rates in groups that vaccinated and those that didn’t—a fair-enough and simple-enough way to examine an extremely complex epidemiologic problem.

This year, the vaccine protection rate may be even lower because, even in the red-hot super-cool molecular science world of the 21st century, we still generate flu vaccine like it’s 1963. Here’s the staid approach: In winter each year, certified flu experts meet in a room and decide which of the dozens of strains circulating worldwide are likeliest to cause the most harm when the next winter’s flu season hits, eight to 10 months hence. They look at all sorts of data and then like weathermen forced by the ticking clock to make a judgment despite imperfect information, they vote three or four strains into the vaccine.

It is this fear of giving the anti-vaxxers a leg up that has stifled any sort of honest discussion about the very real limits of the flu vaccine. Because let’s face it, by modern standards, where measles vaccine and hepatitis B vaccine are 99 percent effective in every study, a report card coming in at 60 percent efficacy is pretty lame.

Though this too is debatable given that 25,000 to 40,000 people a year die of influenza—the vast majority of them unvaccinated. A simple halving of the number with today’s mediocre vaccine would represent a major public-health triumph. By way of comparison, about 14,000 people in the U.S. died of AIDS in 2011—a vaccine to cut that number in half likely would result in a Nobel Prize.

In other words, the anti-vax crowd, basing their debate well outside the corridors of standard science, has somehow pushed the entire public-health discussion of how best to control infectious diseases to a place outside the rational and evidenced-based. And that’s where a flimsy but emotionally effective argument can do real harm by causing an outbreak not of influenza but of deliberate and profound misunderstanding.

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