Vaccine issues: always interesting

Initially I found the article below (linked above too) good grist for vaccine skeptics, who have some good ammo already, i.e. reams of studies and data that contradict the rosy establishment view. Be that as it may, there doesn't seem to be much ammo here for the vaccine skeptic. Still interesting though, as we get a snapshot of a policy discussion unfolding in response to scientific data -- a feedback loop that has been cut in many cases by the you-know-who administration. In fact, the spokesepidemiologist from the CDC establishment comes off as the curmudgeon. Of course he's right to say a single study shouldn't change policy -- but then later, it is revealed that the study only confirms what everyone knows anyway -- so why not change the policy if that is so? It's a science vs. science SMACKDOWN!

Flu shots don't save lives of elderly, study says
Carla K. Johnson, Associated Press
February 15, 2005
CHICAGO -- A new study based on more than three decades of U.S. data suggests that giving flu shots to the elderly has not saved any lives.

Led by National Institutes of Health (NIH) researchers, the study challenges standard government dogma and is bound to confuse senior citizens. During last fall's flu vaccine shortage, thousands of older Americans, heeding the government's public health message, stood in long lines to get their shots.

"There is a sense that we're all going to die if we don't get the flu shot," said the study's lead author, Lone Simonsen, a senior epidemiologist at the National Institute of Allergy and Infectious Diseases in Bethesda, Md. "Maybe that's a little much."

The study should influence the nation's flu prevention strategy, Simonsen said, perhaps by expanding vaccination to schoolchildren, the biggest spreaders of the virus.

[snip] ... the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta plans no change in its advice on who should get flu shots, saying the NIH research isn't enough to shift gears.

"We think the best way to help the elderly is to vaccinate them," said CDC epidemiologist William Thompson. "These results don't contribute to changing vaccine policy."

[snip]

Although the study, published Monday in the Archives of Internal Medicine, looks at data from the whole U.S. elderly population over time, it doesn't directly compare vaccinated to unvaccinated elderly, Thompson said. Previous studies that made that comparison have found the vaccine decreased the rate of all winter deaths.

It's also unlikely that a single study would trigger a change in policy, said CDC spokesman Glen Nowak.

But the former head of the nation's vaccine strategy, Dr. Walter Orenstein, said Simonsen's work "should make us think twice about our current strategy and [about] potentially enhancing it." Orenstein is former director of the CDC's National Immunization Program and now leads a program for vaccine policy development at Emory University.

A shift to vaccinating schoolchildren, the age group most likely to spread the flu virus, is advocated by colleagues of Orenstein's at Emory in a separate report to be published today in the American Journal of Epidemiology.


-- Below is the bit about how everyone already knows vaccinating the elderly won't do as much good -- which the CDC seems clueless about, and resistant to the very idea of, even in the face of this latest study --


"It's been recognized quite a while the (flu) vaccines are not optimal in older and high-risk patients," said Baylor College of Medicine flu researcher Paul Glezen.

Last year, when the federal government issued recommendations that flu shots be set aside for high-risk groups, Glezen argued against rationing the vaccine. He said the best way to protect the community from an outbreak was to vaccinate children and as many adults as fast as possible.

"As people get older, they respond less well to the vaccine," he said Monday. "There's no certain age when this drops off, but this is related to chronic underlying illnesses (that weaken the immune system)."

A study co-authored by Glezen in the current issue of the scientific journal Vaccine supports the strategy of vaccinating children in order to protect others. In that study, close to 15,000 children within the Scott and White Health Plan HMO in Temple and Belton were recruited for free vaccinations over three years.

That community was compared to another Scott and White site (Waco, Bryan and College Station) where schoolchildren weren't actively recruited.

"What we found is, when schoolchildren are immunized, people over 35 have significantly lower illness rates," Glezen said. The study showed that vaccination of 20-25 percent of eligible children resulted in indirect protection of 8-18 percent of adults older than 35.


-- So really it's a story of some very interesting science vs. some very boring institutional resistance. Boring because it never ends...