meganursula | (no subject)

I think this article is well worth reading.

http://www.wired.com/magazine/2009/10/ff_waronscience/

For the record, i think there is room for people to evaluate their vaccination approach. Something i like about this article is that is discusses many of the details in the debate which i think are too often poorly understood or just plain ignored by people.

There are a number of things i would quote from it, but perhaps the most salient for today is “The choice not to get a vaccine is not a choice to take no risk,” he says. “It’s just a choice to take a different risk, and we need to be better about saying, ‘Here’s what that different risk looks like.’

While people are wondering about flu vaccines, and novel H1N1 vaccines, i think we should keep this in mind. I do fall prey to the tendency to want to avoid the vaccines - both of them - because it is an unknown, and because i am currently healthy under the status quo. Why take a risky action when i can avoid it? The answer, of course, is that inaction is also a decision that carries some risk*, and all the current evidence suggests that for me, and my family, at this time, inaction is far more dangerous than the actual action. But, while my head can accept that, my gut still gives me trouble.

My out, of course, is that H1N1, the vaccine that i, particularly, should have this fall, but which is also more frightening because i haven't had it before, isn't available. So i have to hope that no one with exposed symptoms of swine flu rides the bus with my pregnant self, but i'm saved from a decision so far.

* complete aside - this, of course, applies to other areas in my life. Like my job.

Flat | Top-Level Comments Only

It's worth pointing out that the "15% of third-trimester pregnant women who get H1N1 die!" scare statistic is based on only a single death, at least as of the last time I checked. There just aren't many cases in that category, and one woman had several complicating factors (including asthma, a severe one) and died.

My wife's been doing a fair bit of research on this. If you go to the CDC web site and look up "pregnant" and "H1N1" as of May 2009 (yes, slightly out of date), there have been 20 total cases estimated (15 confirmed), three hospitalizations, and one death with severe pre-H1N1 complications.

There have also been a couple of articles recently, including one in Atlantic Monthly, that actually call into question the effectiveness of flu vaccines generally, though that's more for seasonal flu and less for H1N1 -- that vaccine barely exists, so it's not really studied.

I'm not going to say "so therefore you shouldn't get the vaccine!". Rather, I'm going to say, "common wisdom says to get the vaccine, and research isn't ready to support either side of this issue yet, so consider whether a new and untested vaccine for a disease of unknown danger is a good bet -- and consider it without much actual information :-("

On the other hand, constant hand-washing, staying home if you're sick and avoiding potentially infected individuals are all very well proven methods, and very good ideas.

Death is pretty depressing for everyone around you. But hospitalization, and even just being laid-up for a week, also aren't a lot of fun. Compare that with a vaccine that has been used by millions annually for years now without major issue (albeit a different strain, but they change strains annually), and you get...

oh right, a massive shortage.

1) My local hospital has been recording numerous complications from swine flu in pregnant women. I don't care about whatever scare statistic you quoted - i have not been told that statistic. What i do care about is that women are being hospitalized at relatively high rates to control fever, prevent premature birth, and treat complications ranging from respiratory distress to mental confusion and hallucinations. These experiences have increased in the past month - statistics from May aren't going to cut it.
2) I have asthma
3) Vaccinating myself can help prevent infection for me, my two very young children, and my close friend who is undergoing chemo.
4) Suggesting that the vaccine is untested is as misleading as suggesting that we'll all die without it. This vaccine is similar enough to that normal annual flu vaccine that we can draw some conclusions about its safety and efficacy.
5) Sure, i believe in good hygiene, except that i live in a community where people are prone to choosing not to vaccinate and rely on herd immunity - meaning herd immunity is lower. (Or, if you prefer that i am less inflammatory, i ride the bus to my job at a university. Both Buses and Universities are prone to having sick people wandering around.)

In short, i actually do a fair amount of reading on this stuff, and i ask a number of questions. I recognize that we have no sure answer, but, everything i've read leads me to believe that the CDC's recommendations for vaccinations really are the most conservative bet for retaining long term health - both for myself and for my family.

Fair enough. Those are good reasons.

On number 4, there are also some pretty big question marks on the efficacy of the seasonal flu vaccines, though more for preventing hospitalizations and deaths than for preventing spread. One really nice thing about the H1N1 vaccine is that it *is* tailored to a specific strain of flu, which is a lot of where the seasonal ones fall down hard.