>"We have kind of hyped this vaccine so much for so long we are starting to believe our own hype. Really, what we should be doing is looking for better vaccines,"
The PR on the flu-vaccine/campaigns and the efficacy of the vaccine itself have long been misaligned. Good to hear scientists and public health-officials start to acknowledge this. We'll see how long it takes to trickle down to the general public.
"In Canada, the flu vaccine could be working even more poorly, with "little or no protection.""
...
"About 98 per cent of the viruses are mismatched that have been characterized in Canada, whereas in the U.S. its closer to about 68 per cent, or about two-thirds are mismatched. So it's not a good omen," said Dr. Danuta Skowronski of the British Columbia Centre for Disease Control.
"
Is that bad? The ease of getting a vaccine needs to be enough such that it's not a burden to do so. Once that's achieved, 23% effective is actually quite a good benefit, given that those 23% also fail to infect others and improve our overall herd immunity.
Its bad compared to how effective the vaccine normally is, its good compared to no vaccine at all.
The idea that its one vaccine in the first place that is being "hyped" is wrong, each year a new vaccine is created, and its done based on the strains of the flu that seem likely to be prominent. One of the reasons this year was worse than normal is that the strains that were prominent weren't what was predicted.
I don't think anyone would be against developing a better vaccine, though I do think lots of people would be opposed against trading off efforts to assure that each years vaccine made under the current process gets well promoted to the public and distributed to achieve that. Those aren't the only possible uses of resources in our society, and there is no reason that efforts to develop are better flu vaccination system need to be traded off against efforts to assure the reach of the current system.
>there is no reason that efforts to develop are better flu vaccination system need to be traded off against efforts to assure the reach of the current system
I'm not sure that this is true. From a purely market-driven perspective, pharma is able to successfully move this product each year, without risk of liability, and without additional R&D. As long as there is a PR machine around this current product that continues to "reach" and drive customers, then what's the incentive to engage in expensive R&D needed to develop the next round?
Since its a public health problem, I would expect that, were it adopted as a priority, that the incentive would be in the public funds allocated to grants for vaccine R&D, and (for existing Big Pharma firms) to avoid being left without a chair when the current gravy train ends (apologies for the mixed metaphors) when better vaccines are deployed.
Agreed. Once it becomes a priority with the subsequent funding/grants, I think that's when we'd see movement. Ironically, however, I wonder if the hype around the current program even slows adoption of new priorities.
Though, perhaps acknowledgments such as the type referenced by public health officials in this article portend the start of some movement.
>left without a chair when the current gravy train ends when better vaccines are deployed
I wonder if their thinking is that this problem is easily fixed through acquisition if/when the time comes, especially in an industry as M & A-driven as pharma. Meanwhile, gravy-train.
23% would not be bad if it increased your chances of avoiding the flu with near to zero risk. I've been a strong advocate of the flu vaccine, because why not putting all the odds, even if they're not 100%, on your side. But... Have you read the article? It lookalike getting vaccinated is actually not zero risk, on the contrary.
It is 23% this year, compared to 50-60% for most other years. It is bad and people are now dead who would still have been alive if it was a typical year.
Nobody is suggesting no vaccine would be an improvement so that isn't relevant. What is relevant is figuring out if we can do better, for example, instead of calculating risk in Feb for the upcoming winter, can we improve manufacturing so we can forecast in e.g. July, or better look at the data every month and change the formula mid-year if required (so people getting the vaccine in August and December might get a different formulation).
As I said, until someone suggests cancelling flu vaccines, the argument that it is "better than nothing" isn't relevant. Instead we should assume the vaccine is staying and compare it to itself.
"Nobody is suggesting no vaccine would be an improvement so that isn't relevant."
There are lots of people doing so. Probably very few here on Hacker News, but there are many in the real world. Many people who read the linked article will use that as an excuse to not get the flu vaccine next year.
One of the top level comments here questions if the vaccine is worthwhile, with a strong implication that a) it's not worthwhile for a disease which a healthy adult can recover from without it and b) nobody has been smart (or unbiased) enough to ask the question before.
It's not good but it's probably more beneficial than harmful. But the flu vaccine is one of the least compelling cases for vaccination - but also one of the most important ones for public perception.
Well, my comment was pointing more to the disparity between the PR around the vaccine vs. the reality of it. It's well-known that it's a hit-or-miss proposition each year and, here, we're seeing evidence of further holes borne of the annual effort itself. That is, there's now a downside to actually following the advice, beyond side effects and ineffective vaccines.
So, I'm speaking more to the juxtaposition of that reality against the "vaccine-is-everywhere-better-get-it-or-you-might-die" kind of PR in which public health officials and pharma engage every year.
You do know that vaccines makers have legal immunity, right?
One of the little quirks of the Patriot Act was to make it impossible to sue vaccine makers -- which is exactly why since 2001 you've seen a proliferation of every grocery store offering vaccines.
Presumably you are a start-up minded person. Imagine the legal challenges you would face in trying to come up with a business plan where you could inject biological material into people....think your lawyer would permit?
As for if 23% effeciancy is "worth it", well the protection you are getting must be offset by the negative effects caused by vaccines, if you doubt there are negative effects see Legal Immunity above.
What you're looking for is the 1986 National Childhood Vaccine Injury Act, not the PATRIOT Act for limiting tort liability for vaccine manufacturers. Which is pretty much a precondition for doing business developing vaccines to address emergency vaccines.
Presumably you are a start-up minded person. Would you do business if someone said "We need you to implement some very complex code, rush it into production on our timetable, and if there's a hiccup, your users will sue you into oblivion."
It's called "Believing the first thing you hear or read on the Internet, and automatically rejecting everything you hear or read on the subject after that." It just means that some loony anti-vaxxer got to him/her first.
There ought to be a formal name for the fallacy of assigning greater credibility to earlier information, but I'm not sure what it would be.
No, and I understand why it's necessary to make it difficult to sue vaccine makers. Vaccines are not 100% safe or effective. Nobody ever said they were. The battle against disease cannot be fought with weapons that are 100% safe or effective, because such weapons don't exist. Unfortunately it's true that a very small number of vaccine recipients are going to experience some very severe side effects. Life goes on for the rest of us.
Meanwhile, as long as we rely on private industry to supply the vaccines we need, we have to protect the manufacturers from obviously-frivolous lawsuits that nevertheless require decades of research and millions of dollars in pointless, unproductive studies to prove that they're frivolous. For some reason this field attracts kooks... or haven't you noticed?
The difference in what year and what act does cast doubt on the authority of your information. And it does limit your tort liability because, after a number of suits prior to the act, built on flimsy evidence, the vaccine manufacturing business in the U.S. became unpalatable.
Beyond that, other countries can and sometimes do do this. There's been discussions of limiting liability for Ebola vaccine manufacturers in the UK, because of the rush to market for them.
>after a number of suits prior to the act, built on flimsy evidence, the vaccine manufacturing business in the U.S. became unpalatable
Thats a funny way to say "big pharma bribed politicians".
Its amazing that the US was able to develop any technology, I mean imagine what state we would be in if you could sue car and plane manufacturers. Or if we could sue doctors?
You keep using Ford, when we do effectively limit the downside of domestic auto production via bailouts, or doctors, where tort liability is a major issue of discussion.
Yeah, as a pure anecdote, I got the vaccine and am just now getting over a brutal case of the flu. My doctor said he's been seeing tons of people in the same boat this year. Bummer.
It's fine to be skeptical, but far too many people turn it into blind contrarianism. Far too many people talk about the flu vaccine in terms of conspiracy theory, which is not productive for anyone.
>Far too many people talk about the flu vaccine in terms of conspiracy theory, which is not productive for anyone.
Well, it's productive if there's really a "conspiracy", right? Short of "blind contrarianism", there is certainly reason enough to be skeptical. At a minimum, public health officials have been putting forth an annual vaccine campaign PR effort that seems significantly overstated with regard to the true efficacy of flu vaccines, and this hasn't been bad for big pharma.
Now, we can say they were doing it for the right reasons, but we can't ignore the credibility gap they are creating.
More generally, I am not sure why we have a notion that anything that counters the mainstream version of events is automatically to be dubbed conspiracy theory in the dismissive sense. It's actually even weirder to encounter so much of that sort of attitude on a site called HackerNews, where there have been routine calls to keyboard arms over domestic surveillance and the like.
But, I've also noticed here an adherence to scientific dogma that borders on the religious at times. It creates blind spots and a certain overstated assuredness. Overall, it's hard to put into words, but it is very real.
Contrarianism and conspiracy theories are about how you think, not about what conclusions you reach. Sometimes they reach the correct conclusions by coincidence, but that doesn't make them good. Conspiracy theories aren't validated by the existence of conspiracies, any more than astrology is validated by your horoscope coming true on any given day.
Conspiracy theories are about faulty reasoning. In particular, they involve highly inconsistent evaluation of evidence, and rely heavily on post-hoc rationalization.
You say that "anything that counters the mainstream version of events is automatically to be dubbed conspiracy theory in the dismissive sense." That's simply not true. What's happening is that the only people who happen to be countering the mainstream version of events are doing so with conspiracy theories.
Show me some good arguments that counter the mainstream version of events and we can talk. Nobody has done so thus far.
When I talk about conspiracy theories, it's not because people are saying the flu vaccine is ineffective. It's because people are talking about crazy stuff like how vaccines have been pushed hard in the past decade because of a non-existent provision of the PATRIOT act.
Straining for an analogy? Am I the only one who hated this quote from the article?:
"The idea basically is that your immune system
is occupied elsewhere. It would be like getting
the swirling ball of death on your Mac where your
operating system is doing something else rather
than opening the file."
>the flu averages out to about 10k deaths each year
There's actually a lot of controversy around these numbers, with the CDC itself acknowledging that it's challenging to truly know for a number of reasons [1].
Here's a pretty remarkable quote from that page:
>"most people who die from seasonal flu-related complications are not tested for flu, or they seek medical care later in their illness when seasonal influenza can no longer be detected from respiratory samples"
So, it's really tough to know. As a result, some allege that the estimates are inflated as part of the campaign to ensure vaccination.
How many of those were terminally ill or otherwise unlikely to survive the year without the flu? Fungal infections (something you practically never hear about) kill more people than influenza, but mostly the immune compromised.
Yes, because even though you may not be at risk of dying, you may still contribute to spreading the virus. So you get the vaccine to be a good citizen to those at greater risk than yourself.
Pertussis is similar. Adults are highly unlikely to die from whooping cough, but it kills millions of kids every year. So as an adult, you should get the tdap booster at least every ten years.
For almost everyone these are painless shots with no side-effects, typically covered by insurance, and at least in the US, often available at the pharmacy, no appointment neeeded.
The impact of getting the flu is NOT having a few days of feeling crummy.
The impact is spreading the flu to potentially a huge number of people. Some of those people may ultimately die from the flu that you gave them, and that's a big deal.
That depends on what costs more: the sickness, or the vaccine (adjusted for effectiveness).
At $25/shot it seems unlikely that the vaccine costs more. The fact that my HMO gives it away for free suggests that they think it's a net financial gain to vaccinate, and they don't even see the costs from lost productivity.
You assume nobody asked the question. Perhaps it has been asked and answered "yes."
The PR on the flu-vaccine/campaigns and the efficacy of the vaccine itself have long been misaligned. Good to hear scientists and public health-officials start to acknowledge this. We'll see how long it takes to trickle down to the general public.