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Damn that flu bug!
- Thread starter maureen
- Start date
robert ames
robert ames
originally posted by Sharon Bowman:
originally posted by robert ames:
statistics like this infer that...
Oh, you didn't....
sorry, quite sloppy of me. present evidence to the contrary, i do know better.
You might also look to earlier efforts to force vaccination and ask, how effective were they? What's the relationship between the most powerful requirements and the actual outcomes in terms of coverage rates and relations between ordinary people and healthcare providers? Those rates have tended to be higher in places like Germany, which allowed people to opt out, albeit with some considerable effort, than England, which refused exemptions. There are hard questions about the final stages of smallpox eradication, where terribly coercive practices were used -- compromising public health officials' later efforts. All the evidence I have seen suggests that a more pragmatic, tolerant approach will yield more effective results, for everyone, in the end.
originally posted by VLM:
I am just amazed that people don't see this as a civic duty.
And it's in their own self-interest to boot.
My line of thinking isn't controversial in my field.
I agree with this part. People who want to live with other people should be willing to make some sacrifices.
originally posted by Jeff Grossman:
I go to my doc for the shot; I'm not persuaded that discount pharmacies take care of the serum or the needles very well. (But that is just suspicion... anybody know?)
You could always get the intradermal at the pharmacy, no? It's a single dose. And for Brad: it uses a smaller needle.
originally posted by Cliff:
Jumping in...You might also look to earlier efforts to force vaccination and ask, how effective were they? What's the relationship between the most powerful requirements and the actual outcomes in terms of coverage rates and relations between ordinary people and healthcare providers? Those rates have tended to be higher in places like Germany, which allowed people to opt out, albeit with some considerable effort, than England, which refused exemptions. There are hard questions about the final stages of smallpox eradication, where terribly coercive practices were used -- compromising public health officials' later efforts. All the evidence I have seen suggests that a more pragmatic, tolerant approach will yield more effective results, for everyone, in the end.
For sure look at the behavioral modeling data before you set up your system.
A difficult opt out is probably best. Hell, even a simple opt out changes peoples savings rates...
The state surely has a right to make taking such vaccines mandatory, but in the case of flu shots it has not.
Can you expand on this apparently self-contradictory statement, Other Prof? Does the State (my German forebears demand the capitalization) have the right to mandate vaccination in the name of public health, or doesn't it? Is there some essential difference between influenza and smallpox that prevents the same approach being taken for the former that was used for the latter?
Mark Lipton
There is some flu-specific history here as well. It is only recently that there has been enough flu vaccine to go around. You haven't seen ads for competing vaccines, for instance, because everyone sold whatever they could make, at less-than-fabulous margins. The vaccine was targeted to the most vulnerable (age extremes), despite considerable epidemiologic thought that it would be more effective to vaccinate granny's family than granny herself.
There is still not enough to reach the whole population in the US, so some folks will wind up without it even if everyone wanted some. The vaccines are made either in a Rube Goldberg egg system, or in an inefficient and equally expensive cell culture process.
There is still not enough to reach the whole population in the US, so some folks will wind up without it even if everyone wanted some. The vaccines are made either in a Rube Goldberg egg system, or in an inefficient and equally expensive cell culture process.
Ian Fitzsimmons
Ian Fitzsimmons
originally posted by Jonathan Loesberg:
I'm not missing the point, I'm disputing the fact that it justifies your intolerance. If you started a movement to make flu shots obligatory, with only a little more evidence than I (I stress I) am aware of about the general costs of not getting them, and a lot more argument about the social costs of legislating such an obligation, I might support you. I would, even then, distance myself from your style of controversy.
I agree with you at gut level, Jonathan, but positive use of personal epithet is just how Nathan rolls, and this statistic
originally posted by Dan McQ:
Usually between 30-35K annually in the US.
lends the contention some weight in this case. But for better or worse, in democratic society, there's a lot of trial and error and slippage in public policy formulation.
Jonathan Loesberg
Jonathan Loesberg
originally posted by MLipton:
The state surely has a right to make taking such vaccines mandatory, but in the case of flu shots it has not.
Can you expand on this apparently self-contradictory statement, Other Prof? Does the State (my German forebears demand the capitalization) have the right to mandate vaccination in the name of public health, or doesn't it? Is there some essential difference between influenza and smallpox that prevents the same approach being taken for the former that was used for the latter?
Mark Lipton
The final sentence meant it has not in fact made it mandatory, even though it has a right, not that it both has a right and hasn't. Sorry about that. Just to make it worse, while I think the state may have the right, that wouldn't necessarily make it good policy to invoke it either, but that's still another issue.
originally posted by Jonathan Loesberg:
originally posted by MLipton:
The state surely has a right to make taking such vaccines mandatory, but in the case of flu shots it has not.
Can you expand on this apparently self-contradictory statement, Other Prof? Does the State (my German forebears demand the capitalization) have the right to mandate vaccination in the name of public health, or doesn't it? Is there some essential difference between influenza and smallpox that prevents the same approach being taken for the former that was used for the latter?
Mark Lipton
The final sentence meant it has not in fact made it mandatory, even though it has a right, not that it both has a right and hasn't. Sorry about that. Just to make it worse, while I think the state may have the right, that wouldn't necessarily make it good policy to invoke it either, but that's still another issue.
Aha! Gotcha. This was a Clintonesque, meaning of "has" moment.
Mark Lipton
Steve Edmunds
Steve Edmunds
is, innit?
Jay Winton
Jay Winton
Keep in mind the vaccine takes 2 weeks to be totally effective.
originally posted by MLipton:
originally posted by Jonathan Loesberg:
originally posted by MLipton:
The state surely has a right to make taking such vaccines mandatory, but in the case of flu shots it has not.
Can you expand on this apparently self-contradictory statement, Other Prof? Does the State (my German forebears demand the capitalization) have the right to mandate vaccination in the name of public health, or doesn't it? Is there some essential difference between influenza and smallpox that prevents the same approach being taken for the former that was used for the latter?
Mark Lipton
The final sentence meant it has not in fact made it mandatory, even though it has a right, not that it both has a right and hasn't. Sorry about that. Just to make it worse, while I think the state may have the right, that wouldn't necessarily make it good policy to invoke it either, but that's still another issue.
Aha! Gotcha. This was a Clintonesque, meaning of "has" moment.
Mark Lipton
It reeked of semiotics to me...
Tom Glasgow
Thomas W Glasgow
Cole Kendall
Cole Kendall
originally posted by SFJoe:
Folks, the US doesn't provide health care to a boatload of its citizens. Mandatory vaccination may not be the place to start.
Anyhow, peeps desiring boatloads o' info on flu can find it here.
I have to say as an empiricist when I read stuff like:
The results of 31 studies show that the trivalent inactivated influenza vaccine is overall 59% effective in individuals 18-65 years of age. That means of every 100 individuals immunized, 41 will be susceptible to influenza. This number is far too low it should be above 90%.
and
These findings will provide a rationale for those do not feel it is necessary to be immunized against influenza. But the study authors do not condone abandoning the inactivated influenza vaccine:
We should maintain public support for present vaccines that are the best intervention available for seasonal influenza.
In other words, it’s better than nothing, surely not a ringing endorsement. I suspect that the results of this study will lead to a decline in influenza immunization rates in the US.
from there
I am not quite so taken with the Monkey rhetoric above (note: after a flu episode of a dozen years ago I get the vaccine every year and have not been in the 41%).
originally posted by Cole Kendall:
In other words, it’s better than nothing...
Yup. Also, if you sprinkle immunized people through the herd, transmission peters out more often, and fewer people are reached even if the vaccine is a bit lame.
Lots of people working on better vaccines, though, and flu is a big target. Some promising ones just a few seasons away. Stay tuned.
originally posted by Cliff:
You could always get the intradermal at the pharmacy, no? It's a single dose. And for Brad: it uses a smaller needle.
Anecdotally, the intradermal flu vaccine is far more efficient at producing extremely sore arms the day after than is the traditional flu vaccine.
I think you can make a far better case for mandating flu vaccine in health care workers than for the general population (though of course I favor everyone getting it): if you are a HCW it is counterintuitive that you would not protect your patients from the flu by putting yourself at risk of becoming the vector.
So true.originally posted by Dan McQ:
I think you can make a far better case for mandating flu vaccine in health care workers than for the general population (though of course I favor everyone getting it): if you are a HCW it is counterintuitive that you would not protect your patients from the flu by putting yourself at risk of becoming the vector.