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Had Your Flu Shots Yet?


Kimmo

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How did humans ever get to this point without ever taking a flu shot for thousands of years?

have you read "guns, germs and steel?" great book, if not. basic theory: germs have been one of the prime evolutionary tools shaping our societies since we started living in big'old herds :)

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I have a harder time understanding how people I put in the "intelligent-non-expert" category wind up refusing to vaccinate themselves or their children.

 

what sort of intelligence are we talking about? the ability to decipher a set of inter-related variables and their interactions and predict the optimal outcome? if we are to use this game theory model, there would be only one "intelligent" course of action for an american living an exclusively domestic life today: no vaccinations. when one computes the odds of contracting ANY of the illnesses we currently vaccinate for, then further computes the odds of having ANY serious side effects, and contrasts these with both the known and the possible side effects of vaccinations, the "intelligent" course of action is quite obvious. (this model assumes current disease prevalence in the US.)

 

any change in the variables above would potentially affect the optimal strategy of course.

 

ayn rand endorsed this approach, therefore you will too.

 

btw it was the pnas.org post that i found really interesting.

 

- I had more of the lucid, articulate, witty, able to understand complex material and formulate a logical argument sort of intelligence more in mind in your case than asperger's-type formal/computational/symbolic-logic/parameter optimization type intelligence but maybe you're good at that stuff too.

 

Speaking of which - what I feel like I'm seeing in your case, with regards to vaccination, is the same sort of relentless focus on particulars without either an ability or willingness to place them in the appropriate contexts. It feels like listening to a morbidly obese chain-smoking mechanical engineer living in a suburban neighborhood who has invested an enormous amount of time and energy researching street-crime and the particular threats that it poses to his life.

 

He's clearly got a fairly high level of intelligence since he'd never have made it through the weed-out courses, let alone his degree program if he weren't, the facts he's rattling off may be correct, and to some degree or another the risks are something that an informed person should be aware of, but the chasm between the real risks to his life arising from street-crime vs obesity and smoking are so vast and profoundly at odds with reality that it's difficult to comprehend how he can fixate on one and largely dismiss the significance of the other.

 

I can't help but think that in your case, the more you understand the basic biological phenomena in ways that say, practicing immunologists do the more likely you are to arrive at the same conclusions that they do regarding the safety, efficacy, and risks-vs-benefits of vaccination. Maybe not - but since you're a smart guy and seem to have a high level of interest/curiosity about this stuff it seemed like a suggestion worth making.

 

Speaking of which - if you liked the PNAS paper you'll probably enjoy at least one of these that I post below. The first touches on the role that viral recombinases seem to have played in the emergence of adaptive immunity, the second is on the role that viral integration into our pre-mammalian ancestor's genome played in the emergence of placental mammals, and the third is an overview of horizontal gene transfer mechanisms at work in plants/plant-evolution.

 

 

1.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823946/

2.

http://www.pnas.org/content/106/29/11827.full

3.

http://www.uky.edu/Ag/Agronomy/Chappell/Courses/Papers/Review%20-%20Bock%20-%20TIPS%202010%20%282%29.pdf

 

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not getting your kids a flu shot doesn't seem nearly as insane as not getting the hpv-vaccine

 

some context on the hpv vaccine:

 

The Human Papilloma Virus occurs as more than 100 subtypes, only four of which are associated with cervical cancer. When Merck created the first HPV vaccine, Gardasil, in 2006, the company engaged in an aggressive marketing and lobbying campaign to get governments to mandate vaccination of all girls ages 11 and older. Merck was in a hurry to establish Gardasil’s market dominance because it knew its competitor, GlaxoSmithKline, was not far behind with an HPV vaccine of its own.

 

Interestingly, this first high-pressure marketing campaign was launched before there was widespread experience with the vaccine to assess safety, and the attempt to ramrod HPV vaccination into the menu of government-mandated vaccines was met with substantial resistance.

 

she goes on to say:

 

Proponents of mandatory vaccination will point to studies showing HPV to be the most prevalent sexually transmitted disease with nearly 45% of women ages 20 to 24 being infected. However, this includes all of the various subtypes. When looking at the subtypes that are considered high risk for cervical cancer and covered by the HPV vaccine (subtypes 16 and 18), the prevalence rate drops to 2.3%.]

 

furthermore (bear with me):

 

Adding to the scandal of the promotion of these vaccines is the fact that at least 30% of all cases of cervical cancer are associated with HPV types that are not covered by vaccines. Therefore, getting the vaccine does not lessen the need to get regular pap smears.The Center for Disease Control (CDC) states that getting these regular pap smears alone will prevent most cases of cervical cancer because precancerous changes can be detected and successfully treated before they develop into actual cervical cancer.

 

and, thank god, finally:

 

What does this series of three shots costing $400 provide? It does not save women any money or time with regards to preventive care because they still need the same cervical cancer surveillance as those who are not vaccinated. And it does not change your ability to fight HPV subtypes not covered by the vaccine. All it does is prevent the need for treatment of precancerous lesions in that small percentage of women who contract subtypes 16 or 18 and do not clear the infection on their own.

 

she goes on to say that the vaccine is quite safe, and either path taken, in her eyes, is a reasonable one. pretty balanced and informative take, imo.

 

i suppose a concern might be that girls will think they are protected, therefore skipping out on regular pap smears? conjecture....

 

 

 

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- I had more of the lucid, articulate, witty, able to understand complex material and formulate a logical argument sort of intelligence more in mind in your case than asperger's-type formal/computational/symbolic-logic/parameter optimization type intelligence but maybe you're good at that stuff too.

 

what was the actual trouble you had with my asperger's analysis of the situation? i thought it to be quite robust in methodology and result.

 

 

Speaking of which - what I feel like I'm seeing in your case, with regards to vaccination, is the same sort of relentless focus on particulars without either an ability or willingness to place them in the appropriate contexts. It feels like listening to a morbidly obese chain-smoking mechanical engineer living in a suburban neighborhood who has invested an enormous amount of time and energy researching street-crime and the particular threats that it poses to his life.

 

my BF is around 10%, i quit smoking years ago, and i even stopped alcohol. now if i could somehow get over this interwebs thing....

 

but seriously, not really sure what you think the elephant in the room is that i'm avoiding?

 

Speaking of which - if you liked the PNAS paper you'll probably enjoy at least one of these that I post below. The first touches on the role that viral recombinases seem to have played in the emergence of adaptive immunity, the second is on the role that viral integration into our pre-mammalian ancestor's genome played in the emergence of placental mammals, and the third is an overview of horizontal gene transfer mechanisms at work in plants/plant-evolution.

 

 

1.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823946/

2.

http://www.pnas.org/content/106/29/11827.full

3.

http://www.uky.edu/Ag/Agronomy/Chappell/Courses/Papers/Review%20-%20Bock%20-%20TIPS%202010%20%282%29.pdf

 

thanks for links. looking forward to reading.

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I wonder how many of the people who don't get flu shots do get the anti-cervical cancer warts shot for their daughters.

 

Because cancer is the EXACT SAME THING as the flu.

 

U.S. Pneumonia- and Influenza-Related Mortality

 

During the 2011–12 influenza season, the percentage of deaths attributed to pneumonia and influenza (P&I) exceeded the epidemic threshold¶¶ for 1 week, during the week ending January 21, 2012 (week 3) and peaked at 7.9% (Figure 4). From the 2008–09 season through the 2010–11 season, the peak percentage of P&I deaths ranged from 7.9% to 9.1%, and the total number of consecutive weeks at or above the epidemic threshold ranged from 3 to 13 (CDC, unpublished data, 2012).

 

U.S. Influenza-Related Pediatric Mortality

 

For the 2011–12 influenza season, 26 laboratory-confirmed influenza-associated pediatric deaths were reported. These deaths were reported from 15 states: Arkansas (one case), Arizona (one), California (six), Florida (two), Hawaii (one), Missouri (one), North Carolina (two), New Jersey (one), Nevada (three), New York (one), Oklahoma (one), Texas (three), Virginia (one), Washington (one), and Wisconsin (one). Their mean and median ages were 7.3 and 6.5 years, respectively; three children were aged <6 months, six were aged 2–4 years, 12 were aged 5–11 years, and five were aged 12–17 years. Six of the 26 deaths reported were associated with influenza B viruses, five deaths were associated with influenza A (H3) viruses, seven were associated with pH1N1 viruses, seven were associated with an influenza A virus for which the subtype was not determined, and one was associated with an influenza virus with the type not determined.

 

For comparison, during the 2010–11 season, 122 pediatric deaths were reported. During the 2009 pandemic, 348 pediatric deaths were reported during April 15, 2009–October 2, 2010. Before the pandemic, 67 influenza-associated pediatric deaths were reported for the 2008–09 season.

 

Definition of cervical cancer: Cancer that forms in tissues of the cervix (the organ connecting the uterus and vagina). It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap tests (a procedure in which cells are scraped from the cervix and looked at under a microscope). Cervical cancer is almost always caused by human papillomavirus (HPV) infection.

Estimated new cases and deaths from cervical (uterine cervix) cancer in the United States in 2012:

 

 

New cases: 12,170

Deaths: 4,220

 

From cancer.gov

 

So, which vaccine will save more lives? Bayesian statistics. Do the math, report back.

 

 

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furthermore (bear with me):

 

Adding to the scandal of the promotion of these vaccines is the fact that at least 30% of all cases of cervical cancer are associated with HPV types that are not covered by vaccines.

 

Wait, talk about the glass half empty - 70% of all cases of cervical cancer are associated with the subtypes covered by the vaccines - 70%. Do you still have to get pap smears? Sure. Will some women still get HPV-related cervical cancer? Sure. But you're going to sneer at 70% and say vaccinating and not vaccinating are equally reasonable approaches? What kind of world does she live in? I don't anyone would wouldn't reduce their exposure to that degree in a heartbeat.

 

Unimaginable.

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what was the actual trouble you had with my asperger's analysis of the situation? i thought it to be quite robust in methodology and result.

 

but seriously, not really sure what you think the elephant in the room is that i'm avoiding?

 

Basically just the weighing of the relative magnitudes of the risks and the benefits on both the individual and collective levels.

 

I know you picked this up - but just to belabor the point a bit more, the "obese-chain-smoking-engineer-in-suburbia" who's more worried about dying from street-crime than getting cancer or having a heart attack was just quick analogy to illustrate what's puzzling to me about your perspective. All of the facts and evidence demonstrate that he's way (like millions of times) more likely to suffer from the obvious, common, and easily controlled risks from obesity and smoking, but for some reason he ignores those and has a vastly higher level of concern and anxiety about exotic threats that have a vanishingly small chance of ever affecting him.

 

 

Change smoking and obesity to "transmissible diseases that you can fully or partially protect yourself and the vulnerable people in the population from via vaccination" and street crime to "exceptionally rare and overwhelmingly non-lethal adverse reactions to vaccines" and we get to me not understanding your thinking or conclusions on this issue.

 

Maybe that's too great a bridge to cross? If that's the case, that's fine - but whatever the limitations of this format - it's given me an opportunity to have an exchange that (in my experience) it's very difficult to have in person with folks who seem to share many of your conclusions, if not all of your particular reasons for arriving at them.

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sure, i got your point, but we disagree on the particulars that make up your metaphor (we disagree on vaccine risk assessments and how they are arrived at).

 

and, as stated before, i think the individual risk currently is near zero from the vaccinatable illnesses (that vaccines have no doubt helped eradicate), but it is the potential collective risk that undervaccination might lead to that causes me concern.

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Basically just the weighing of the relative magnitudes of the risks and the benefits on both the individual and collective levels.

 

Exactly. In medicine and public health there are always folks who end up with the short straw and if you dwell on the fate of those individuals' tragic circumstance you'll end up in paralytic state which will prevent you doing what is necessary for society as a whole - i.e. don't run the theory of the game from the measure of individual outcomes, rather run it from the measure of the outcome of the whole.

 

I know as humans tend to view ourselves as apart and above nature, but with regard to actions in the face of infections we as a society are no different than school of fish, flock of birds, or herd of gazelle confronted by a predator - there will generally always be a sacrificial cost of individuals to save the whole. It's a cruel world in that respect - but that's living - and our frontline responses to infectious disease will always come at an unavoidable cost of some lives being adversely affected to one degree or another.

 

And if enough folks focus on the effects on a small number of users, and respond by not supporting what's necessary to protect the whole, they may change lessen their odds with regard to the risk of adverse effects, but they greatly increase they're individual odds of being the target of the primary risk and also decrease the defense of the whole. It's a fear-driven, irrational perspective.

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sure, i got your point, but we disagree on the particulars that make up your metaphor (we disagree on vaccine risk assessments and how they are arrived at).

 

and, as stated before, i think the individual risk currently is near zero from the vaccinatable illnesses (that vaccines have no doubt helped eradicate), but it is the potential collective risk that undervaccination might lead to that causes me concern.

 

Okay. Sounds like the best we can do is wave across the chasm. If you read the IOM report - I'd be curious to know which particulars/specifics you don't accept/disagree with.

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and, as stated before, i think the individual risk currently is near zero from the vaccinatable illnesses (that vaccines have no doubt helped eradicate), but it is the potential collective risk that undervaccination might lead to that causes me concern.

 

The individual risk is "near zero" only because of the societal vaccine coverage - and that's exactly what makes the anti-science / anti-vaccine point of view and focus on individual risks of adverse reaction so irrational.

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