Influenza Vaccine Has Been Studied in Pregnant Women

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Summer is very nearly over in the Northern hemisphere. Fall and winter creep ever closer. As the temperatures drop, we begin to think about pulling out our warmer clothes. We shake out our jackets. Those with oil heat make sure their tanks are filled. Others stock up on firewood. The really forward thinking might ensure that their shovels are in decent shape for any snow that may be coming their way.

We're also heading into flu season. Influenza rears its ugly head from fall, through winter, and into early spring. It's one of those diseases that people tend to underestimate and have a lot of misconceptions about. A lot of illnesses people think are the flu are actually different illnesses caused by bacteria, parasites, or different viruses. A lot of people think that it is a fairly benign disease, even though it kills thousands of people in the U.S. every year, and hundreds of thousands worldwide. Then there are the myths about the flu vaccine. Probably the most common mistaken belief is that the vaccine can give you the flu, even though it can't. The available vaccines use either inactivated virus or a severely weakened form of the virus, neither of which will give you the flu.

Suffice it to say, there is a lot of misinformation out there about the flu and the flu vaccine. But there is one population that is more seriously affected, both by the disease itself and by the myths: pregnant women.

Massachusetts Nurses Association Sues for Right to Endanger Patients

Yesterday, I wrote about how comedian Rob Schneider not only does not know anything about vaccines, but does not seem to understand the Constitution very well, either. Schneider was recently dropped by State Farm Insurance because of his vocal opposition to vaccinations. Understandably, a company that, in part, focuses on public health would not want to be associated with someone who argues against measures aimed at improving public health. The "Makin' Copies" guy has no business going anywhere near health related issues.

As a celebrity, Rob Schneider uses his fame to spread misinformation about vaccines, frightening people away from one of the most successful health measures ever devised. His notions regarding immunizations put others at risk. Public figures, particularly those with some measure of fame, ought to be careful when they speak out on matters of science and medicine. They might think that they are well-informed, but not infrequently, their rhetoric is based on lies and misunderstanding. Though they may seek to help others, they only serve to increase risk. Schneider is but one of the latest actors speaking out on issues for which he has absolutely no qualifications. But he's not the only one who ought to leave well enough alone when it comes to people's health.

MNA - Working to increase patient risk

The Massachusetts Nurses Association (MNA) apparently shares some of Schneider's misguided ideas of personal liberty at the expense of patients.

An Honest Flu Ad

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Last week, the National Vaccine (mis-)Information Center ran an ad in a New Hampshire newspaper designed to make people fear the flu vaccine. I wrote about why the NVIC ad is misleading, as did Moms Who Vax and Epidemiological. In short, the NVIC ad played to the myth that the flu vaccine makes you sick (it doesn't) and promoted the idea that the vaccine doesn't work (it does). It also played on fears of adverse reactions to the vaccine ("know the risks"), but did not so much as hint at the benefits.

At any rate, I though I'd put together a somewhat more honest ad. Here's my take on the NVIC ad. Please feel free to share this, unaltered, far and wide. I also have a higher resolution version of it that should be good to print. E-mail me (contact info's in the sidebar) if you would like a copy.

NVIC? Know the Omissions (Part 2)

Those of you who read this blog regularly know some of the common tactics that anti-vaccine activists use. They're fond of the Pharma Shill Gambit, in which they accuse those with whom they disagree as being paid by pharmaceutical companies. This allows them to blissfully dismiss anything their detractors have to say. If you're paid by pharma, after all, you're hopelessly biased and nothing you say can be taken as true or honest. Of course, it doesn't matter whether you actually get paid by pharma or not. Facts don't tend to matter much to those using the pharma shill gambit.

That brings us to another tactic: dishonest or misleading rhetoric. The less, shall we say, sophisticated anti-vaccine activists aren't all that subtle about it. They will brazenly state as truth claims that are easily shown to be wrong (e.g., the false claim that MMR has the preservative thimerosal in it, or that vaccines contain antifreeze; they don't). The more skilled among the anti-vaccine movement, however, use insinuation. They imply certain claims using language that, on the surface, is technically true or could be classified as opinion, but the unstated claim is at best misleading and at worst dangerously wrong.

The National Vaccine Information Center (a more Orwellian-named organization would be hard to find) falls into that latter category, for the most part. Take, for instance, their latest ad, placed in a local New Hampshire newspaper:

Rep. Jeremy Thiesfeldt: Making It Easier to Get Sick at Hospitals

I know I've been remiss in writing new posts lately. "Real" life has intruded and kept my time limited and my mind a bit preoccupied. But I'm back, and what better way to come back from a lag than to follow up on a previous post?

At the end of May, I wrote about how Wisconsin Representative Jeremy Thiesfeldt was working on legislation that would ban employers (and not just health care employers) from requiring influenza immunizations as a requirement for employment (or, as noted, even internship or being a volunteer). The bill has been submitted and has a designation, now: Assembly Bill 247. AB247 was introduced on June 17, 2013, read and referred to the Committee on Health.

The text of AB247 has not changed since I last discussed this.

Wisconsin Rep. Jeremy Thiesfeldt Befriends the Flu

One of the greatest refuges of those opposed to sound science and science-based policy is the legislature. After all, if you have no scientific basis to your position, change the laws to support your arguments instead. That's what opponents of vaccines generally like to do. They launch PR campaigns and wine and dine Congresscritters to try to get their way, rather than conducting actual quality scientific research and publishing the results. They really don't like it when public laws that aim to protect the public health are based on science and work quite hard to get those laws quashed.

The latest effort to undermine public health comes from Wisconsin Representative Jeremy Thiesfeldt. Rep. Thiesfeldt is in the process of drafting and proposing a law that would ban public health employers from requiring their employees to receive the seasonal flu vaccine as a condition of employment. The fledgling bill comes after Rep. Thiesfeldt apparently received complaints from health care workers complained that they were forced to be immunized against the flu or lose their jobs. The accompanying memo is couched in "health freedom" style language and pits individual rights against employers' (and the public's) rights.

In the Midst of an Outbreak: Better to Immunize or Not?

The flu season is well and fully upon us. In the U.S., the season generally begins in October and runs through May, with a peak sometime in February. There are a number of factors that may play a role in this cyclic nature of influenza, ranging from people being indoors more in the winter, thereby creating greater opportunity for the virus to spread, to less UV radiation that would otherwise kill the virus. Whatever the reason, the cycle is rather predictable.

This season, the flu has hit hard and early:

Source: CDC Influenza Weekly Report, January 14, 2013

The red line is the current season. Unlike most seasons, we're taking a track similar to the 2003-2004 season, with an early peak. This has led a number of regions to declare a public health emergency, meaning that states can release more resources to fight the spread of disease, such as allowing expansion of immunization clinics.

With increased rates, is this sort of declaration helpful? With influenza already in full swing, will expanding immunization help, or is it a bit of a double-edged sword?

I Have to Wear a Mask? Unfair!

I recently discovered something that disturbed me a bit, but which I did not find altogether surprising. In December, the Massachusetts Nursing Association (MNA) issued a position statement opposing mandatory masking of health care workers as a means of preventing the spread of influenza. The statement comes as many hospitals in the state are beginning to require that those health care workers who do not get vaccinated against the flu must wear surgical masks to help prevent the transmission of the virus. In some hospitals, refusal to either get vaccinated or wear a mask while at work can result in disciplinary action. This does not seem all that unreasonable, to me, and I've touched on the use of masks before (for example here and here). It is another tool in the fight to make our health care facilities that much safer for patients, so to see an organization representing hundreds of thousands of health care personnel opposing measures that would help achieve that goal simply boggles my mind.

Reading the statement makes me think that the opposition stems mainly from those who do not want to get vaccinated and find that the masks are uncomfortable. Images of petulant teens whinging about the unfairness of it all spring to mind ("Spinach or broccoli for my vegetable? Why can't I just skip the veggies for dinner! It's not fair!"). Of course, the MNA doesn't outright take this approach; it's just the impression I got. And I won't even get into how these policies generally apply to more than just nurses (e.g., all other health care workers, and may even extend to non-employees, such as volunteer greeters and so on).

No, they try to claim that science supports their opposition.

Wanted: Influenza

Image from the Public Health Image Library. Logo design by Maggie McFee. More VPD Wanted Poster details here. If you are interested in a print version (16"x20" poster or 4"x5" card), please email me for more information. I can also provide it in electronic format for printing on regular 8.5"x11" paper.

Michigan Legislature Aims to Restrict Public Health

Now that Memorial Day has passed in the United States and I've had some time to get over last week's emotion-draining post, it seems like a good time to take a look at what lies ahead. What developments are in the works? Where is public health headed? We can expect the pertussis outbreaks in the U.S. to continue to spread, very likely including more pertussis deaths. We will likely see cases of measles imported from Europe. And we'll see public health officials work hard to prevent and contain outbreaks of disease.

Legislators, on the other hand, may need a bit of prodding.

In Michigan, it appears that the legislature is taking steps to make it harder for health care facilities to protect the health of their patients. A group of 11 republicans and 1 democrat have introduced legislation that aims to dictate to hospitals and other health facilities and agencies what they can and cannot do with regard to ensuring their staff are not a potential source of influenza infection.

Pertussis Toxin, Aiding and Abetting Influenza

Pertussis, or whooping cough, is bad. In infants, it can kill or lead to neurological impairment or other permanent injuries. In adults, the 100-day cough can range from a persistent annoyance to bone-wracking agony. As bacteria go, it's a pretty nasty one. Less than two years ago, an outbreak in California resulted in the deaths of 10 babies. In the mid- to late-1970s, vaccination rates plummeted in many countries after reports of neurological damage following immunization, leaving the immunocompromised at much greater risk. The reports were ultimately mistaken. We are currently seeing another downward trend in vaccine uptake rates, as well as reminders that immunity wanes with time. Outbreaks continue to spread across the United States and other nations as teens and adults fail to get timely boosters and parents opt out of immunizing their children.

Avoiding the agony and loss of time, not to mention possible heartache, that accompanies whooping cough would seem to be a good idea regardless of any other factors. But a new study published in PLoS One hints at another reason to immunize.

A Little Bit of Poison in a Sweet, Inviting Wrapper

If you follow me on Twitter (and if you don't, why aren't you?), you have likely already heard about a PSA put out by the National Vaccine Information Center (NVIC) and Mercola.com, two slick anti-vaccine organizations. The PSA is being run on Delta Airlines flight. You can read more about it at Skepchick and Respectful Insolence. The Skepchick article includes steps you can take to combat the propaganda, including a link to a petition to get Delta to stop showing it on their flights.

The video is available on YouTube (Update: It looks like NVIC removed the video at that link, but it is still up here and here [Update: looks like it has been removed from Facebook, now, too]), but cannot be embedded. Comments have also been turned off, perhaps to avoid inconvenient critiques from science-minded individuals. On the surface, it appears to be pretty good advice, so why all the fuss?

Because the PSA includes some iffy information and, more importantly, directs people to the NVIC web site, which is rife with misinformation and distortions of fact.

On the Impact of a Flu Vaccine and Health Care Workers

The latest issue of the CDC's Morbidity and Mortality Weekly Report contains a notice to readers, advising them of revisions that were made to the estimated impact of the 2009 H1N1 Influenza vaccine. Before I get into the specifics of the notice, I just want to point out how cool it is that organizations like the CDC that are based in science will readily correct themselves, even before anyone outside the organization points out an error. This is something that I don't think I've ever seen from an anti-vaccine organization, even when glaring errors are highlighted for them.

So, what does the CDC say?

Mary Tocco, Is She Mistaken or Misrepresenting?

Something that has been noted here and elsewhere over the years is that anti-vaccine activists generally play rather loose and free with facts. They have this tendency to misrepresent reality in a way that suggests support for their opinions, and sometimes they even downright fabricate "facts" that have no basis in the real world. Take the long-debunked claim that vaccines contain anti-freeze. (They don't.) Because their goal is to stir up fears about vaccines, they latch onto scary-sounding chemical names and equate them with all manner of ills. Where nuance is called for, they resort to hyperbole. Their goal is fear, not truth.

Mary Tocco is no exception. I came across an article she wrote August 2 entitled "Seasonal Flu Vaccines, Are They Safe or Necessary?". Other than the poor word choice (I think they are generally safe and necessary in order to protect the greatest portion of the population; are they really only safe or only necessary?), I'll give you one guess as to what she thinks. In true anti-vaccine activist form, she jumps straight into getting things wrong in the very first paragraph: