"How common is GBS, and how common is it among people who have been vaccinated against seasonal influenza?
GBS is rare. Medical events occur regardless of vaccination, and background rates are used to assess vaccine safety by comparing the expected rate of disease or death to the actual or observed rate in any given timeframe. The background rate for GBS in the U.S. is about 80 to 160 cases of GBS each week, regardless of vaccination."
I think you will have to keep searching for that red herring.
Now out tens of thousands vaccine articles no one can still provide one peer-reviewed article to support some research that shows some kind of evidence that is vastly different than what is published on CDC website.
I will post what I see fit based on the thread not based on how you think I should or should not respond.
Well, I say this much for you, you're certainly consistent. You went right ahead and quoted both LBRB (lol) and Snopes (lol), only one I missed was the poorly named (respectful? HA!) Orac. Does that mean I can expect to not get laughed at when I quote whale.to and Age of Autism?
Look, I get it, you're always going to pull out the woo handbook and stick to the admit nothing, deny everything and make counter-accusations edict. I also get it would pain you too much as a human being to admit that more needs to be done on ALL fronts because it doesn't mesh well with what is now an obvious and unyielding bias, one that actually conflicts with your purported very scientific way of being. Fine. But, as I asked before (and I was asking, not sure why you got all defensive about it), PLEASE address what I write as a person invested in this, not some talking head. It diminishes the dialogue and only serves to increase tensions, at least on my end. I take a lot of time to write what I do, it's not a copy and paste job for me, it's real life. With real implications.
So, Wakefield the researcher doesn't say anything about that connection in his scientific PAPER, but Wakefield the doc/ex-doc voices his personal views and that's a problem. Thompson the scientist colludes to hide a connection in a scientific STUDY, then almost a decade later Thompson the still-scientist shares his personal views on how it was all handled badly, revealing unethical behavior that hid statistically significant data and that's okay? L-O-L!!!
And as for that red herring; Thompson admitted the data was omitted. That's what matters most. No dissertation-length blog post by Matt Carey is going to change that. And as an aside, good ol' Matt should put that energy into having his chair on the IACC be more productive, because this is what we have Tom Insel saying: "We have no money. We have no ability to fund anybody to do anything. We are a bully pulpit and the best we can do is to try and inspire some of the funders around the room, the NIH, CDC, Autism Speaks, the Simons Foundation and others, Autism Science Foundation, to make appropriate investments in the issues that are in the Strategic Plan. But there is no real mandate to do that either." I'm sure Matt will insist it was a productive session though.
No, it is not significant because I can say from experience as a former immunization nurse that each patient is screened for contraindications & precautions prior to administering the flu shot. Example: if someone wanted the attenuated (live)vaccine, they would undoubtedly be asked whether they have an immune system problem, such as HIV, leukemia, systemic steroid or anti-cancer drug use, or radiation. Also "preservative-adjuvant combinations" are NOT contraindicated for immunocompromised individuals. Along those lines, did you know that babies receive more thimerosal from breast milk than the flu vaccine? Another fact: YOU ARE MORE LIKELY TO BE STRUCK BY LIGHTENING (1 in 700,000) IN A GIVEN YEAR THAN DEVELOP GBS (1 in 1,000,000) FROM THE FLU VACCINE.
Not trying to be snarky, but it's anecdotal report like this that's usually looked down upon when presented in debates such as this. That said, I value what you are saying here as a professional and I commend you on being so through, I'm sure you're aware there are those who aren't. However, my problem, as I stated earlier, is the lack of consistency and transparency with which immunization practice as a whole is conducted. In my (anecdotal) :) observations both as a HCP and a parent, too often the administering of a vaccination is done with a disregard for what it is; a medical procedure. I'm not saying that to be dramatic, but immunizations have, for the majority, reached the status of 'it's just a shot' level of trust, so much so that when people such as myself, who voice concern over this practice of healthcare (and receive vaccines, along with their kids), are taken to task as "anti-vax". Preposterous.
The CDC precautions are for moderate to severe illness, not only the illnesses/treatment regimens you listed. Moderate could include something as a bad day of seasonal allergies. But the prevailing attitude by many HCPs is 'it's just a flu shot'. That's the problem. I know what it says in black and white, but as I'm sure you're aware (again), what's done in practice can and does vary with regard to consistency.
Interesting that you mention the breast milk. Presumably it comes from the recommended flu shot in-utero? So maybe that needs to be looked at more since we hear the fans of genetic/epigenetic autism say it starts in the womb. Either way, I think we can both agree that the ingestion of something like thimerosal is markedly different than administration via IM solution, as the latter completely bypasses portal circulation (at least I think it does). Additionally, I believe nursing infants are incapable of demethylating mercury compounds, but I have to find where I read that to be sure. If true, that can lead to a cummulative load effect with regards to toxicity. Could? No, would.
While it's not wrong to question scientific research, it is also important to use reason for the sake of protecting your patients & the health of the community. The benefits of the flu vaccine far outweigh the risks, & our patients need to be privy to that information.
Completely agree. But for whatever reason, pointing out the potential side effects when it comes to vaccines is looked down upon. That, or we're subjected to ostracizing comments about vaccine safety studies and whatnot. As I always say, vaccines, by and large, have proven themselves to be safe and mostly effective. However, there is certainly quite a few avenues of research that need further investigation, including safety, vulnerable populations and efficacy.
Hmm I think the chances of me dying from the flu are much higher than dying from getting the vaccine, even though I'm sure there's things about the vaccine science probably doesn't know yet. Therefore, I always get my flu shot.
So you make an informed decision with the knowledge you have based on the information on hand, good. My problem is with the information on hand, or more specifically, how it is presented (or not) when talked about in media and health circles.
That wouldn't happen to be a vizsla as your avatar picture, would it?
Well, I say this much for you, you're certainly consistent. You went right ahead and quoted both LBRB (lol) and Snopes (lol), only one I missed was the poorly named (respectful? HA!) Orac. Does that mean I can expect to not get laughed at when I quote whale.to and Age of Autism?
Look, I get it, you're always going to pull out the woo handbook and stick to the admit nothing, deny everything and make counter-accusations edict. I also get it would pain you too much as a human being to admit that more needs to be done on ALL fronts because it doesn't mesh well with what is now an obvious and unyielding bias, one that actually conflicts with your purported very scientific way of being. Fine. But, as I asked before (and I was asking, not sure why you got all defensive about it), PLEASE address what I write as a person invested in this, not some talking head. It diminishes the dialogue and only serves to increase tensions, at least on my end. I take a lot of time to write what I do, it's not a copy and paste job for me, it's real life. With real implications.
So, Wakefield the researcher doesn't say anything about that connection in his scientific PAPER, but Wakefield the doc/ex-doc voices his personal views and that's a problem. Thompson the scientist colludes to hide a connection in a scientific STUDY, then almost a decade later Thompson the still-scientist shares his personal views on how it was all handled badly, revealing unethical behavior that hid statistically significant data and that's okay? L-O-L!!!
And as for that red herring; Thompson admitted the data was omitted. That's what matters most. No dissertation-length blog post by Matt Carey is going to change that. And as an aside, good ol' Matt should put that energy into having his chair on the IACC be more productive, because this is what we have Tom Insel saying: "We have no money. We have no ability to fund anybody to do anything. We are a bully pulpit and the best we can do is to try and inspire some of the funders around the room, the NIH, CDC, Autism Speaks, the Simons Foundation and others, Autism Science Foundation, to make appropriate investments in the issues that are in the Strategic Plan. But there is no real mandate to do that either." I'm sure Matt will insist it was a productive session though.
I am going keep saying the same thing you either provide some peer-reviewed scientific evidence to support your argument or you have nothing to debate.
The point with Wakefield, if you have followed his downfall after the MMR article is that he now claims that the MMR vaccines causes autism.
Thompson debacle is nothing. There has been nothing to show that his leaving that population subset out of his article would have had any kind of significant statistical difference. Trying to state one scientist made an mistake is equivalent to saying a nurse omitted a medication so all nurses must be omitted medications just to save the hospital money.
Not trying to be snarky, but it's anecdotal report like this that's usually looked down upon when presented in debates such as this. That said, I value what you are saying here as a professional and I commend you on being so through, I'm sure you're aware there are those who aren't. However, my problem, as I stated early, is the lack of consistency and transparency with which immunization practice as a whole is conducted. In my (anecdotal) observations both as a HCP and a parent, too often the administering of a vaccination is done with a disregard for what it is; a medical procedure. I'm not saying that to be dramatic, but immunizations have, for the majority, reached the status of 'it's just a shot' level of trust, so much so that when people such as myself, who voice concern over this practice of healthcare (and receive vaccines, along with their kids), are taken to task as "anti-vax". Preposterous.
The CDC precautions are for moderate to severe illness, not only the illnesses/treatment regimens you listed. Moderate could include something as a bad day of seasonal allergies. But the prevailing attitude by many HCPs is 'it's just a flu shot'. That's the problem. I know what it says in black and white, but as I'm sure you're aware (again), what's done in practice can and does vary with regard to consistency.
Interesting that you mention the breast milk. Presumably it comes from the recommended flu shot in-utero? So maybe that needs to be looked at more since we hear the fans of genetic/epigenetic autism say it starts in the womb. Either way, I think we can both agree that the ingestion of something like thimerosal is markedly different than administration via IM solution, as the latter completely bypasses portal circulation. Additionally, I believe nursing infants are incapable of demethylating mercury compounds, but I have to find where I read that to be sure. If true, that can lead to a cummulative load effect with regards to toxicity. Could? No, would.
Completely agree. But for whatever reason, pointing out the potential side effects when it comes to vaccines is looked down upon. That, or we're subjected to ostracizing comments about vaccine safety studies and whatnot. As I always say, vaccines, by and large, have proven themselves to be safe and mostly effective. However, there is certainly quite a few avenues of research that need further investigation, including safety, vulnerable populations and efficacy.
1. Please, state how having a public database that is open to all researchers is showing a lack of transparency. Also, can you name one other medication that has been as vigorously studied as vaccines?
What further study on vaccines would you suggest should be done that has not already been published? Anyone can state something needs more research, but to show lack of ignorance someone needs state exactly what those research questions should be based on at least a brief review of the literature.
The first thing I learned in my MSN and both of my doctorate programs concerning research is what does the literature state?
I am going keep saying the same thing you either provide some peer-reviewed scientific evidence to support your argument or you have nothing to debate.
My argument is that the program as a whole needs more transparency and should be looked at to identify vulnerable populations. You obviously disagree as you've stated that the research says they are safe. You also know what's been looked at as well as what hasn't been looked at. For whatever reason, you want me to somehow produce peer-review studies to either prove a negative outcome or that show what HASN'T been studied. AFAIK, none of that exists. If that's the case, how can your position be correct?
The point with Wakefield, if you have followed his downfall after the MMR article is that he now claims that the MMR vaccines causes autism.
That's not the point, you just want it to be so. Again, what people like you claim he said in the paper (which he never did) was what initially what caused all the trouble. Now that he shares his personal views, it's a problem. Like I said, it was a canard.
Thompson debacle is nothing. There has been nothing to show that his leaving that population subset out of his article would have had any kind of significant statistical difference. Trying to state one scientist made an mistake is equivalent to saying a nurse omitted a medication so all nurses must be omitted medications just to save the hospital money.
Thanks for confirming to me that you have no problem with unethical behavior so long as it lines up with your ideology. And this wasn't "one scientist", it was all the authors, including the lead (Destefano), and possibly the director of the CDC at the time (Gerberding). The data set was found to be more than statistically significant. Your analogy would make more sense if the other nurses were omitting medications because they saw one omitting them and accepted it as practice, but even then it's a stretch.
Really? Cherry-picking quotes? The guy admitted he lied, albeit in legalese. Why not quote that, because that's the talking point. Even more laughable, that IOM study references the Destefano et al study we are debating that Thompson was a co-author on, to say nothing of the somewhat conflicted Verstraeten-Destefano (there's that name again!) study. Nothing to see here, move along now. Got it.
You can keep grasping at straws, but until you can provide some peer-reviewed scientific evidence you have no argument.
Then why continue to respond? Obviously as far as you're concerned I'm just spewing daft nonsense. Yet you continually have trouble refuting what I'm saying.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
She's beautiful!!! Why is she so famous?
We have a vizsla, bought her to be a therapy dog to our daughter:
They are such good dogs. Once they calm down ...LOL
Brief off topic...I have posted her pictures as my avatar for a long time. She has "grown up" her. I post pictures of her doing funny things, dressed up and change it frequently. She loves the camera
1. Please, state how having a public database that is open to all researchers is showing a lack of transparency. Also, can you name one other medication that has been as vigorously studied as vaccines?
What further study on vaccines would you suggest should be done that has not already been published? Anyone can state something needs more research, but to show lack of ignorance someone needs state exactly what those research questions should be based on at least a brief review of the literature.
The first thing I learned in my MSN and both of my doctorate programs concerning research is what does the literature state?
1) Please, show me how I can easily find both the precautions/contraindications for flu vaccines in the link provided in the OP's post? Maybe easily is the wrong word. Basically, what I mean is those are things that should be in the OP's link to begin with. That, imo, is a lack of transparency.
2) Well, you go right ahead believing that then, I'll reserve myself from stating what I am beginning to believe about you. There are also plenty of articles on PubMed on autism and vaccine injuries, but it doesn't prove much, now does it? I already have made suggestions about what should be studied; vulnerable populations, vaccinated versus unvaccinated cohorts, Hep B vaccine, schedule as a whole, etc. All the argument ever comes back to is MMR>thimerosal>autism. Like anything else, there's a lot more to it.
And in supporting a thesis I would expect that makes complete, utter, logical sense.
1) Please, show me how I can easily find both the precautions/contraindications for flu vaccines in the link provided in the OP's post? Maybe easily is the wrong word. Basically, what I mean is those are things that should be in the OP's link to begin with. That, imo, is a lack of transparency.
OK, here ya go, from the cdc as well. Took me like 5 seconds to find from the url in my original post. It's long and pretty transparent....
Influenza Vaccination: A Summary for Clinicians
Who Should Get Vaccinated?
All persons 6 months and older should be vaccinated annually.
Persons at Risk for Medical Complications Attributable to Severe Influenza
Vaccination to prevent influenza is particularly important for persons who are at increased risk for severe complications from influenza, or at higher risk for influenza-related outpatient, ED, or hospital visits. When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to the following persons (no hierarchy is implied by order of listing):
all children aged 6 through 59 months;
all persons aged 50 years and older;
adults and children who have chronic pulmonary (including asthma) or cardiovascular (except isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus);
persons who have immunosuppression (including immunosuppression caused by medications or by HIV infection);
women who are or will be pregnant during the influenza season;
children and adolescents (aged 6 months through 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye's syndrome after influenza virus infection;
residents of nursing homes and other long-term care facilities;
American Indians/Alaska Natives; and
persons who are morbidly obese (body mass index of 40 or greater).
Persons Who Live With or Care for Persons at High Risk for Influenza-Related Complications
All persons aged 6 months and older should be vaccinated annually. Continued emphasis should be placed on vaccination of persons who live with or care for persons at higher risk for influenza-related complications. When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to persons at higher risk for influenza-related complications listed above, as well as these persons:
health-care personnel;
household contacts (including children) and caregivers of children aged 59 months and older (i.e., aged younger than 5 years) and adults aged 50 years and older, with particular emphasis on vaccinating contacts of children aged younger than 6 months; and
household contacts (including children) and caregivers of persons with medical conditions that put them at high risk for severe complications from influenza.
There are special considerations regarding vaccination of persons with history of egg allergy.
What are the influenza vaccine options this season?
There are several flu vaccine options for the 2014-2015 flu season.
Traditional flu vaccines made to protect against three different flu viruses (called trivalent†vaccines) are available. In addition, flu vaccines made to protect against four different flu viruses (called quadrivalent†vaccines) also are available.
Trivalent flu vaccine protects against two influenza A viruses (an H1N1 and an H3N2) and an influenza B virus. The following trivalent flu vaccines are available:
Standard-dose trivalent shots (IIV3) that are manufactured using virus grown in eggs. Different flu shots are approved for people of different ages, but there are flu shots that are approved for use in people as young as 6 months of age and up.
An intradermal trivalent shot, which is injected into the skin instead of the muscle and uses a much smaller needle than the regular flu shot. It is approved for people 18 through 64 years of age.
A high-dose trivalent shot, approved for people 65 and older.
A trivalent shot containing virus grown in cell culture, which is approved for people 18 and older.
A recombinant trivalent shot that is egg-free, approved for people 18 through 49 years of age.
The quadrivalent flu vaccine protects against two influenza A viruses and two influenza B viruses. The following quadrivalent flu vaccines are available:
A quadrivalent flu shot.
A quadrivalent nasal spray vaccine, approved for people 2 through 49 years of age (recommended preferentially for healthy* children 2 years through 8 years old when immediately available and there are no contraindications or precautions).
(*Healthy†in this instance refers to children 2 years through 8 years old who do not have an underlying medical condition that predisposes them to influenza complications.)
Package inserts should be consulted for recommended age groups and possible contraindications for each vaccine in addition to information regarding additional components of various vaccine formulations.
In addition, the Advisory Committee on Immunization Practices (ACIP), Influenza Vaccine Recommendations, 2014-15 should be consulted.
Are any of the available flu vaccines recommended over others?
CDC has not expressed a preference for which flu vaccine people should get this season except for one: Starting in 2014-2015, CDC recommends use of the nasal spray vaccine in healthy children 2 through 8 years of age when it is immediately available and if the child has no contraindications or precautions to that vaccine. If the nasal spray vaccine is not immediately available and the flu shot is, vaccination should not be delayed and a flu shot should be given. For more information about the new CDC recommendation, see Nasal Spray Flu Vaccine in Children 2 through 8 Years Old or the 2014-2015 MMWR Influenza Vaccine Recommendations.
While there will be more than one vaccine option for many people to choose from, including high-dose vaccine, intradermal vaccine and the regular flu shot, the only preferential recommendation is for the nasal spray vaccine in children 2 through 8 years of age. The most important thing is for all people 6 months and older to get a flu vaccine every year.
When should vaccination occur?
Flu vaccination should begin soon after vaccine becomes available, ideally by October. However, as long as flu viruses are circulating, vaccination should continue to be offered throughout the flu season, even in January or later. While seasonal influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later. Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against influenza virus infection, it is best that people get vaccinated so they are protected before influenza begins spreading in their community.
All children aged 6 months--8 years who are recommended for 2 doses should receive their first dose as soon as possible after vaccine becomes available; these children should receive the second dose at least 4 weeks later. This practice increases the opportunity for both doses to be administered before or shortly after the onset of influenza activity.
To avoid missed opportunities for vaccination, doctors and other health care professionals should offer vaccination during routine health care visits or during hospitalizations if flu vaccine is available.
See Vaccine Dose Considerations for Children 6 Months through 8 Years of Age for more information.
Vaccination for Children
Children under 6 months old are the pediatric group at highest risk of influenza complications, but they are too young to get an influenza vaccine. The best way to protect young children is to make sure members of their household and their caregivers are vaccinated.
Influenza vaccination is recommended for all children 6 months of age and older.
Some children 6 months through 8 years of age require 2 doses of influenza vaccine. Children in this age group who are getting vaccinated for the first time will need two doses. Some children who have received influenza vaccine previously will also need two doses. The 2014-2015 ACIP recommendations has an algorithm to help guide clinician decision-making regarding vaccination of children 6 months- 8 years of age.
The 2009 H1N1 virus continues to circulate. It wasn't added to the seasonal vaccine until the 2010-2011 flu season. This means that children who did not get the 2009 H1N1 vaccine in 2009-2010, or a seasonal flu vaccine in 2010-2011 or later, will not be fully protected from the 2009 H1N1 virus until they receive 2 doses of the 2014-2015 flu vaccine.
2 Dose Vaccination Instructions
The first dose should be given as soon as vaccine becomes available, and the second dose should be given 28 more days after the first dose. The first dose primes†the immune system; the second dose provides immune protection. Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine. Two doses are necessary to protect these children. If your patient needs the two doses, begin the process early, so that children are protected before influenza starts circulating in your community. Make sure to remind the parent to follow up to get the child a second dose if they need one. It usually takes about two weeks after the second dose for protection to begin.
Children who require two doses of flu vaccine do not need to receive the same flu vaccine both times; live or inactivated vaccine can be used for either dose. (Within approved indications and recommendations, no preferential recommendation is made for any type or brand of licensed influenza vaccine over another.)
Nasal Spray Vaccine for Children Age 2 through 8 Years
Starting in 2014-2015, CDC recommends use of the nasal spray vaccine (LAIV) for healthy* children 2 through 8 years of age, when it is immediately available and if the child has no contraindications or precautions to that vaccine. Recent studies suggest that the nasal spray flu vaccine may work better than the flu shot in younger children. However, if the nasal spray vaccine is not immediately available and the flu shot is, children 2 years through 8 years old should get the flu shot. Don't delay vaccination to find the nasal spray flu vaccine. For more information about the new CDC recommendation, see Nasal Spray Flu Vaccine in Children 2 through 8 Years Old or the 2014-2015 MMWR Influenza Vaccine Recommendations.
(*Healthy†in this instance refers to children 2 years through 8 years old who do not have an underlying medical condition that predisposes them to influenza complications.)
Vaccination for Adults
Everyone 6 months of age and older are recommended to get the flu vaccine, which includes even the healthiest adults. Vaccination is especially important for people at higher risk of serious influenza complications or people who live with or care for people at higher risk for serious complications.
Persons working in health care settings also should be vaccinated annually against influenza. Vaccination of health care professionals has been associated with reduced work absenteeism and with fewer deaths among nursing home patients.
People Who Should Not Be Vaccinated
People who have had a severe reaction to an influenza vaccination, and children younger than 6 months of age should not be vaccinated.
People who are moderately or severely ill with or without fever should usually wait until they recover before getting flu vaccine.
See Contraindications and Precautions (Table 2, 2013-2014 ACIP Influenza Vaccine Recommendations) for more information.
Vaccination of People with a History of Egg Allergy
This season, vaccine options are available for the following:
Persons with a history of egg allergy who have experienced only hives after exposure to egg
Persons with a history of severe reaction to egg
Persons with no known history of exposure to egg, but who are suspected of being egg-allergic
All vaccines should be administered in settings in which personnel and equipment for rapid recognition and treatment of anaphylaxis are available.
A previous severe allergic reaction to influenza vaccine, regardless of the component suspected to be responsible for the reaction, is a contraindication to future receipt of the vaccine.
See Influenza Vaccination of Persons with a History of Egg Allergy for complete information and an algorithm to guide decision-making.
Influenza Vaccines and Use of Influenza Antiviral Medications
Administration of inactivated influenza vaccine to persons receiving influenza antiviral drugs for treatment or chemoprophylaxis is acceptable.
Live-attenuated influenza vaccine should not be administered until 48 hours after cessation of influenza antiviral therapy.
If influenza antiviral medications are administered within 2 weeks after receipt of live-attenuated influenza vaccine, the vaccine dose should be repeated 48 or more hours after the last dose of antiviral medication.
Concurrent Administration of Influenza Vaccine With Other Vaccines
Inactivated vaccines do not interfere with the immune response to other inactivated vaccines or to live vaccines.
Inactivated or live vaccines can be administered simultaneously with live-attenuated influenza vaccine.
However, after administration of a live vaccine, at least 4 weeks should pass before another live vaccine is administered.
More Information
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) â€" United States, 2014â€"15 Influenza Season, MMWR 2014, August 15, 2014 / 63(32);691-697
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices â€" United States, 2013-14, MMWR 2013, September 20, 2013 / 62(RR07);1-43
Seasonal Influenza Vaccination Resources for Health Professionals
Flu Activity and Surveillance
For Your Patients
Vaccine Information Statement: Inactivated Influenza Vaccine
OK, here ya go, from the cdc as well. Took me like 5 seconds to find from the url in my original post. It's long and pretty transparent....
Influenza Vaccination: A Summary for Clinicians
Who Should Get Vaccinated?
Allpersons 6 months and older should be vaccinated annually.
Persons at Risk for Medical Complications Attributable to Severe Influenza
Vaccination to prevent influenza is particularly important for persons who are at increased risk for severe complications from influenza, or at higher risk for influenza-related outpatient, ED, or hospital visits. When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to the following persons (no hierarchy is implied by order of listing):
all children aged 6 through 59 months;
all persons aged 50 years and older;
adults and children who have chronic pulmonary (including asthma) or cardiovascular (except isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus);
persons who have immunosuppression (including immunosuppression caused by medications or by HIV infection);
women who are or will be pregnant during the influenza season;
children and adolescents (aged 6 months through 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye's syndrome after influenza virus infection;
residents of nursing homes and other long-term care facilities;
American Indians/Alaska Natives; and
persons who are morbidly obese (body mass index of 40 or greater).
Persons Who Live With or Care for Persons at High Risk for Influenza-Related Complications
All persons aged 6 months and older should be vaccinated annually. Continued emphasis should be placed on vaccination of persons who live with or care for persons at higher risk for influenza-related complications. When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to persons at higher risk for influenza-related complications listed above, as well as these persons:
health-care personnel;
household contacts (including children) and caregivers of children aged 59 months and older (i.e., aged younger than 5 years) and adults aged 50 years and older, with particular emphasis on vaccinating contacts of children aged younger than 6 months; and
household contacts (including children) and caregivers of persons with medical conditions that put them at high risk for severe complications from influenza.
There are special considerations regarding vaccination of persons with history of egg allergy.
What are the influenza vaccine options this season?
There are several flu vaccine options for the 2014-2015 flu season.
Traditional flu vaccines made to protect against three different flu viruses (called trivalent†vaccines) are available. In addition, flu vaccines made to protect against four different flu viruses (called quadrivalent†vaccines) also are available.
Trivalent flu vaccine protects against two influenza A viruses (an H1N1 and an H3N2) and an influenza B virus. The following trivalent flu vaccines are available:
Standard-dose trivalent shots (IIV3) that are manufactured using virus grown in eggs. Different flu shots are approved for people of different ages, but there are flu shots that are approved for use in people as young as 6 months of age and up.
An intradermal trivalent shot, which is injected into the skin instead of the muscle and uses a much smaller needle than the regular flu shot. It is approved for people 18 through 64 years of age.
A high-dose trivalent shot, approved for people 65 and older.
A trivalent shot containing virus grown in cell culture, which is approved for people 18 and older.
A recombinant trivalent shot that is egg-free, approved for people 18 through 49 years of age.
The quadrivalent flu vaccine protects against two influenza A viruses and two influenza B viruses. The following quadrivalent flu vaccines are available:
A quadrivalent flu shot.
A quadrivalent nasal spray vaccine, approved for people 2 through 49 years of age (recommended preferentially for healthy* children 2 years through 8 years old when immediately available and there are no contraindications or precautions).
(*Healthy†in this instance refers to children 2 years through 8 years old who do not have an underlying medical condition that predisposes them to influenza complications.)
Package inserts should be consulted for recommended age groups and possible contraindications for each vaccine in addition to information regarding additional components of various vaccine formulations.
In addition, the Advisory Committee on Immunization Practices (ACIP), Influenza Vaccine Recommendations, 2014-15 should be consulted.
Are any of the available flu vaccines recommended over others?
CDC has not expressed a preference for which flu vaccine people should get this season except for one: Starting in 2014-2015, CDC recommends use of the nasal spray vaccine in healthy children 2 through 8 years of age when it is immediately available and if the child has no contraindications or precautions to that vaccine. If the nasal spray vaccine is not immediately available and the flu shot is, vaccination should not be delayed and a flu shot should be given. For more information about the new CDC recommendation, see Nasal Spray Flu Vaccine in Children 2 through 8 Years Old or the 2014-2015 MMWR Influenza Vaccine Recommendations.
While there will be more than one vaccine option for many people to choose from, including high-dose vaccine, intradermal vaccine and the regular flu shot, the only preferential recommendation is for the nasal spray vaccine in children 2 through 8 years of age. The most important thing is for all people 6 months and older to get a flu vaccine every year.
When should vaccination occur?
Flu vaccination should begin soon after vaccine becomes available, ideally by October. However, as long as flu viruses are circulating, vaccination should continue to be offered throughout the flu season, even in January or later. While seasonal influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later. Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against influenza virus infection, it is best that people get vaccinated so they are protected before influenza begins spreading in their community.
All children aged 6 months--8 years who are recommended for 2 doses should receive their first dose as soon as possible after vaccine becomes available; these children should receive the second dose at least 4 weeks later. This practice increases the opportunity for both doses to be administered before or shortly after the onset of influenza activity.
To avoid missed opportunities for vaccination, doctors and other health care professionals should offer vaccination during routine health care visits or during hospitalizations if flu vaccine is available.
See Vaccine Dose Considerations for Children 6 Months through 8 Years of Age for more information.
My bold. Thanks for taking the time to post all of that, but in the interest in saving some space I stopped bolding about halfway through. Anyway, I take it you remember nursing school and what you were taught about 'all' in any question? Because it's sure as hell been beaten into my skull.
Basically, that's kind of what I'm getting at here. The vaccine program is, understandably, about doing the most good for the greatest amount of people. Unfortunately, a one-size-fits-all approach leaves a rather large window open when it comes to adverse events/side effects. Why the first do no harm mantra is cast aside and vaccines assume some moral high ground in the interest of the greater good is where I have a problem. Some people don't share that problem, insisting the vaccines are abundantly safe. Again, I disagree and there appears to be an increasing reason to feel that way. And once again, some people think that's unwarranted.
Here's a link to what I've been referring back to in this thread:
That wasn't particularly hard to find, but it wasn't exactly screaming "hey, look at me before you get a flu shot" either, which to me is a lack of transparency. It's forcing the end-user to do research when it comes to receiving or providing healthcare. While the latter should be requisite amongst HCP, the public shouldn't. And as I also stated earlier, HCPs aren't always as up to date or forthright about vaccinations, leaning on the "just a shot" mantra. That's problematic. But I don't have peer-reviewed papers to back that up. So it must not ever happen. Right?
Interesting to note the caveat after every formulation with regards to "moderate to severe illness, with or without fever" for precautions, along with a history of GBS. Such a precaution advisement would seem to fly in the face of their recommendation for ALL persons who have immunosuppression to receive the vaccination, unless I'm missing something there.
Nurseworks, ASN, RN
77 Posts
That wouldn't happen to be a vizsla as your avatar picture, would it?
Well, I say this much for you, you're certainly consistent. You went right ahead and quoted both LBRB (lol) and Snopes (lol), only one I missed was the poorly named (respectful? HA!) Orac. Does that mean I can expect to not get laughed at when I quote whale.to and Age of Autism?
Look, I get it, you're always going to pull out the woo handbook and stick to the admit nothing, deny everything and make counter-accusations edict. I also get it would pain you too much as a human being to admit that more needs to be done on ALL fronts because it doesn't mesh well with what is now an obvious and unyielding bias, one that actually conflicts with your purported very scientific way of being. Fine. But, as I asked before (and I was asking, not sure why you got all defensive about it), PLEASE address what I write as a person invested in this, not some talking head. It diminishes the dialogue and only serves to increase tensions, at least on my end. I take a lot of time to write what I do, it's not a copy and paste job for me, it's real life. With real implications.
So, Wakefield the researcher doesn't say anything about that connection in his scientific PAPER, but Wakefield the doc/ex-doc voices his personal views and that's a problem. Thompson the scientist colludes to hide a connection in a scientific STUDY, then almost a decade later Thompson the still-scientist shares his personal views on how it was all handled badly, revealing unethical behavior that hid statistically significant data and that's okay? L-O-L!!!
And as for that red herring; Thompson admitted the data was omitted. That's what matters most. No dissertation-length blog post by Matt Carey is going to change that. And as an aside, good ol' Matt should put that energy into having his chair on the IACC be more productive, because this is what we have Tom Insel saying: "We have no money. We have no ability to fund anybody to do anything. We are a bully pulpit and the best we can do is to try and inspire some of the funders around the room, the NIH, CDC, Autism Speaks, the Simons Foundation and others, Autism Science Foundation, to make appropriate investments in the issues that are in the Strategic Plan. But there is no real mandate to do that either." I'm sure Matt will insist it was a productive session though.