The CDC has two different terms. "Vaccine Efficacy" is measured using a double blind randomized placebo test. If the people who got the vaccine got the targeted disease 20 times less than the people who got the placebo, then the vaccine efficacy would be 95%. Getting the vaccine seems to make you 20 times less likely to get the disease than you would if you'd got a placebo.
"Vaccine Effectiveness" is what they usually talk to you about. Here's how they often measure vaccine effectiveness, especially I've noticed for flu vaccines. "Vaccine effectiveness was estimated as 100% x (1 - odds ratio [ratio of odds of being vaccinated among outpatients with influenza-positive test results to the odds of being vaccinated among outpatients with influenza-negative test results])" http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6401a4.htm
In other words, they take people presenting to the Doc for a respiratory illness and divide them up into 4 groups, first by whether they got the flu vax, and second by whether they have the flu or some other respiratory complaint. Let VF be the guys who were vaxed and have flu, VI be the guys who were vaxed and have some other respiratory infection, NF be guys who weren't vaxed and have flu, and NI be guys who weren't vaxed and have some other respiratory infection. Vaccine Effectiveness = 100% X (1-(VF/NF)(NI/VI))
Now the obvious problem with this is, you get a high Vaccine Effectiveness if a lot of people who get the flu vaccine get sick with other respiratory illnesses, independent of whether it helps with the flu. There are three problems with this.
(1) This formula seems likely to generate a substantial VE even if the vaccine were actually a placebo. It seems very plausible that people who are likely to go to the Doctor with a respiratory illness are more likely to get Vaxed for flu, either because they are more reliant on doctors, more hypochondriac, or genuinely sicklier. People who never get colds are unlikely to go for flu shots. On the other hand, when they actually get the flu, they'll come in. If many vaccinees are coming in with imagined or minor respiratory complaints and non-vaccinees are not, that would generate a good vaccine effectiveness for a placebo. etc.
(2) Even more importantly, a flu vaccine will get a high effectiveness rating if it causes recipients to get a lot of non-flu respiratory illnesses by damaging their immune system. If the only effect a flu vaccine had was to cause recipients to get 4 times as many non-flu respiratory illnesses as placebo recipients, then you would find a vaccine effectiveness of 75%. If a flu vaccine made you twice as likely to get the flu and 4 times as likely to get another respiratory illness, you would find a Vaccine Effectiveness of 50%.
(3) The second law of thermodynamics says its a lot easier to screw things up then to fix them. If vaccine makers are being rewarded for screwing up immune systems, you can bet they'll figure out how, especially if they are indemnified against any damage they cause. Even if they have the best of intentions. Getting a vaccine that protects against a specific flu strain you can't even predict easily, without in the process screwing up the immune system or the health of the recipient, that's an incredibly hard project. I don't believe anybody is even capable of it. Getting an injection that screws up the immune system so recipients get more respiratory illnesses? You could probably do that pretty quick by trial and error. When you blundered into it, you'd get rich and everybody would tell you you were a genius and saving mankind.
(4) If you think argument 3 isn't exactly a proof, note they report a solid VE each year, averaging .42. On what basis is it more likely this positive VE is due to preventing flu, then to assume it is coming from causing damage to the immune system? Mathematically the two terms play similar roles in the formula. The other evidence in this Topic indicates there is a strong case for damaging the immune system. So I submit that this high VE of .42 indicates damage at least as strongly as it indicates efficacy.
Early Estimates of Seasonal Influenza Vaccine Effectiveness United States
"Vaccine effectiveness was estimated as 100% x (1 - odds ratio [ratio of odds of being vaccinated among outpatients with influenza-positive test results to the odds of being vaccinated among outpatients with influenza-negative test results])" http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6401a4.htm
"These studies compare the odds of vaccination among outpatients with acute respiratory illness and laboratory-confirmed influenza infection to the odds of vaccination among outpatients with acute respiratory illness who test negative for influenza infection."
Increased risk of noninfluenza respiratory virus infections associated with receipt of inactivated influenza vaccine. Cowling BJ, Fang VJ, Nishiura H, Chan KH, Ng S, Ip DK, Chiu SS, Leung GM, Peiris JS.
Abstract: We randomized 115 children to trivalent inactivated influenza vaccine (TIV) or placebo. Over the following 9 months, TIV recipients had an increased risk of virologically-confirmed non-influenza infections (relative risk: 4.40; 95% confidence interval: 1.31-14.8). Being protected against influenza, TIV recipients may lack temporary non-specific immunity that protected against other respiratory viruses.
Note that since this landmark placebo controlled study, not only have I not seen it repeated with other flu vaccines, I also haven't seen the authorities question measures of vaccine effectiveness which would only conceivably make sense if the vaccine were already known not to be doing damage.
There is also a consistent case in both human and animal studies reporting that flu vaccines damage CD 8+ T cells and harm immunity to other diseases than the one vaccinated. Vaccinated animals died from diseases the placebo animals fought off.
Annual vaccination against influenza virus hampers development of virus-specific CD8+ T cell immunity in children.
Bodewes R1, Fraaij PL, Geelhoed-Mieras MM, van Baalen CA, Tiddens HA, van Rossum AM, van der Klis FR, Fouchier RA, Osterhaus AD, Rimmelzwaan GF.
Abstract: Infection with seasonal influenza A viruses induces immunity to potentially pandemic influenza A viruses of other subtypes (heterosubtypic immunity). We recently demonstrated that vaccination against seasonal influenza prevented the induction of heterosubtypic immunity against influenza A/H5N1 virus induced by infection with seasonal influenza in animal models, which correlated with the absence of virus-specific CD8(+) T cell responses. Annual vaccination of all healthy children against influenza has been recommended, but the impact of vaccination on the development of the virus-specific CD8(+) T cell immunity in children is currently unknown. Here we compared the virus-specific CD8(+) T cell immunity in children vaccinated annually with that in unvaccinated children. In the present study, we compared influenza A virus-specific cellular and humoral responses of unvaccinated healthy control children with those of children with cystic fibrosis (CF) who were vaccinated annually. Similar virus-specific CD4(+) T cell and antibody responses were observed, while an age-dependent increase of the virus-specific CD8(+) T cell response that was absent in vaccinated CF children was observed in unvaccinated healthy control children. Our results indicate that annual influenza vaccination is effective against seasonal influenza but hampers the development of virus-specific CD8(+) T cell responses. The consequences of these findings are discussed in the light of the development of protective immunity to seasonal and future pandemic influenza viruses.
Abstract: It was recently shown that the use of an experimental subunit vaccine protected mice against infection with a human A/H3N2 influenza virus, but consequently affected the induction of heterosubtypic immunity to a highly pathogenic A/H5N1 influenza virus, which was otherwise induced by the A/H3N2 infection. As whole inactivated virus (WIV) vaccines are widely used to protect against seasonal influenza and also contain inner viral proteins such as the nucleoprotein (NP), the potential of a WIV vaccine to induce protective immunity against infection was tested with a homologous A/H3N2 (A/Hong Kong/2/68) and a heterosubtypic A/H5N1 influenza virus (A/Indonesia/5/05). As expected, the vaccine afforded protection against infection with the A/H3N2 virus only. In addition, it was demonstrated that the use of WIV vaccine for protection against A/H3N2 infection affected the induction of heterosubtypic immunity that was otherwise afforded by A/H3N2 influenza virus infection. The reduction in protective immunity correlated with changes in the immunodominance patterns of the CD8(+) T-cell responses directed to the epitopes located in the acid polymerase subunit of the viral RNA polymerase (PA(224-233)) and the NP (NP(366-374)). In unvaccinated mice that experienced infection with the A/H3N2 influenza virus, the magnitude of the CD8(+) T-cell response to both peptides was similar on secondary infection with A/H5N1 influenza virus. In contrast, prior vaccination with WIV affected the immunodominance pattern and skewed the response after infection with influenza virus A/Indonesia/5/05 towards a dominant NP(366-374)-specific response. These findings may have implications for vaccination strategies aimed at the induction of protective immunity to seasonal and/or pandemic influenza.
Vaccination against human influenza A/H3N2 virus prevents the induction of heterosubtypic immunity against lethal infection with avian influenza A/H5N1 virus.
Bodewes R, Kreijtz JH, Baas C, Geelhoed-Mieras MM, de Mutsert G, van Amerongen G, van den Brand JM, Fouchier RA, Osterhaus AD, Rimmelzwaan GF.
Abstract: Annual vaccination against seasonal influenza viruses is recommended for certain individuals that have a high risk for complications resulting from infection with these viruses. Recently it was recommended in a number of countries including the USA to vaccinate all healthy children between 6 and 59 months of age as well. However, vaccination of immunologically naïve subjects against seasonal influenza may prevent the induction of heterosubtypic immunity against potentially pandemic strains of an alternative subtype, otherwise induced by infection with the seasonal strains. Here we show in a mouse model that the induction of protective heterosubtypic immunity by infection with a human A/H3N2 influenza virus is prevented by effective vaccination against the A/H3N2 strain. Consequently, vaccinated mice were no longer protected against a lethal infection with an avian A/H5N1 influenza virus. As a result H3N2-vaccinated mice continued to loose body weight after A/H5N1 infection, had 100-fold higher lung virus titers on day 7 post infection and more severe histopathological changes than mice that were not protected by vaccination against A/H3N2 influenza. The lack of protection correlated with reduced virus-specific CD8+ T cell responses after A/H5N1 virus challenge infection. These findings may have implications for the general recommendation to vaccinate all healthy children against seasonal influenza in the light of the current pandemic threat caused by highly pathogenic avian A/H5N1 influenza viruses.
Children seen at the Mayo Clinic for flu 1996-2006 were 3 times as likely to be hospitalized if they had had a flu shot as not.
Prior receipt of 2008–09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring–summer 2009 in Canada. Estimates from the sentinel and three other observational studies, involving a total of 1,226 laboratory-confirmed pH1N1 cases and 1,505 controls, indicated that prior receipt of 2008–09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring–summer 2009, with estimated risk or odds ratios ranging from 1.4 to 2.5. Risk of pH1N1 hospitalization was not further increased among vaccinated people when comparing hospitalized to community cases.
Effectiveness of trivalent inactivated influenza vaccine in influenza-related hospitalization in children: a case-control study. Joshi AY, Iyer VN, Hartz MF, Patel AM, Li JT.
Abstract: Influenza is known to be associated with asthma exacerbation but the effectiveness of the trivalent inactivated flu vaccine (TIV) in children, especially children with asthma, in preventing hospitalization is unknown. We assessed the effectiveness of the TIV in all children and especially children with asthma to prevent hospitalization with influenza. We conducted a nested case control study of all pediatric subjects (6 months to 18 years old) who were evaluated at the Mayo Clinic, Rochester, MN, who had laboratory-confirmed influenza during each flu season from 1999 to 2006 to evaluate the efficacy of TIV in preventing hospitalization. A case-control analysis was performed with the cases and the controls being the subjects who did and did not required hospitalization with the influenza illness, respectively. There were 261 subjects with laboratory-confirmed influenza from 1996 to 2006. There was an overall trend toward higher rates of hospitalization in subjects who got the TIV when compared with the ones who did not get the TIV (odds ratio [OR], 3.67; CI, 1.6, 8.4). Using the Cochran-Mantel-Haenszel test for asthma status stratification, there was a significant association between hospitalization in asthmatic subjects and TIV (p = 0.001). TIV did not provide any protection against hospitalization in pediatric subjects, especially children with asthma. On the contrary, we found a threefold increased risk of hospitalization in subjects who did get the TIV vaccine. This may be a reflection not only of vaccine effectiveness but also the population of children who are more likely to get the vaccine.
Association between the 2008–09 Seasonal Influenza Vaccine and Pandemic H1N1 Illness during Spring–Summer 2009: Four Observational Studies from Canada Danuta M. Skowronski , Gaston De Serres, Natasha S. Crowcroft, Naveed Z. Janjua, Nicole Boulianne, Travis S. Hottes, Laura C. Rosella, James A. Dickinson, Rodica Gilca, Pam Sethi, Najwa Ouhoummane, Donald J. Willison, Isabelle Rouleau, Martin Petric, Kevin Fonseca, Steven J. Drews, Anuradha Rebbapragada, Hugues Charest, Marie-Ève Hamelin, Guy Boivin, Jennifer L. Gardy, Yan Li, Trijntje L. Kwindt, David M. Patrick, Robert C. Brunham, for the Canadian SAVOIR Team
Conclusions: Prior receipt of 2008–09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring–summer 2009 in Canada. The occurrence of bias (selection, information) or confounding cannot be ruled out. Further experimental and epidemiological assessment is warranted. Possible biological mechanisms and immunoepidemiologic implications are considered.
The only Placebo Controlled Study that I've yet found which followed health of child patients for a sustained period, rather than just whether they got the vaccinated disease, reported recipients of a Flu Vaccine got 4 Times as Many Respiratory Infections as Placebo Recipients. The fact that it found such stark effects suggests they may be much more widely present in other vaccines, and that there may be rampant confirmation bias in the vaccine safety literature. Placebo controlled studies are the gold standard, the studies proponents of safety are relying on are all subject to confounders, and this result suggests they may well all be confounded. The fact that the experiment hasn't been repeated even for other flu vaccines is outrageous and demonstrates the system is either broken or rigged.
"We evaluated the impact of previous flu vaccinations on IFN-γ production and A/H1N1/California/7/2009-specific Ab levels measured by SRH at study entry (Table 1). The analysis showed significantly lower levels of IFN-γ production in response to A/H1N1/Brisbane/59/2007, A/H1N1/Solomon Islands/3/2006 and B/Florida/4/2006 in blood from study participants who had previously received seasonal flu vaccination (during the period 2006 to spring 2009) and who did not receive the pdm flu vaccine, than in those without any seasonal flu (or pdm) vaccination during the same period (p ≤ 0.04). "
This just goes to a link of a large number of papers purporting to be on vaccine effectiveness.
In the first place, this node http://truthsift.com/search_view?statement=Vaccine-Effectiveness-used-to-measure-flu-vaccines-gives-a-higher-score-to-a-flu-vaccine-if-it-damages-the-immune-system-of-the-recipient.&id=386&nid=2823
points out that by "effectiveness" papers frequently use a measure that includes collateral damage. On the face of it none of these papers discuss collateral damage, but I haven't examined them closely. If you want to assert some of them do, please make the case.
They never actually specify how the controls were selected, or what the odds ratios are they are computing. If you think this is a valid reference, please write equations for the odds ratios and explain by what what criteria the controls were selected? Were they presenting as sick or randomly chosen from a data base?
However, this is a study of vaccine effectiveness, which is generally computed using odds ratios that assume the vaccines do not cause susceptibility to other conditions as a side effect. Thus they do not measure whether vaccines cause susceptibility to other conditions as a side effect.
Refutations (7) - CON To Topic
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Given that the evidence indicates the vaccine often damages immune systems of recipients, and given that it requires as large number of administrations of the vaccine to prevent a case of flu, it seems to follow that the flu vaccine likely has a higher cost to patients than benefit.
Influenza vaccines have a very modest effect in reducing influenza symptoms and working days lost in the general population, including pregnant women. No evidence of association between influenza vaccination and serious adverse events was found in the comparative studies considered in the review. This review includes 90 studies, 24 of which (26.7%) were funded totally or partially by industry. Out of the 48 RCTs, 17 were industry-funded (35.4%).
The preventive effect of parenteral inactivated influenza vaccine on healthy adults is small: at least 40 people would need vaccination to avoid one ILI case (95% confidence interval (CI) 26 to 128) and 71 people would need vaccination to prevent one case of influenza (95% CI 64 to 80). Vaccination shows no appreciable effect on working days lost or hospitalisation.
The protection against ILI that is given by the administration of inactivated influenza vaccine to pregnant women is uncertain or at least very limited; the effect on their newborns is not statistically significant.
The effectiveness of live aerosol vaccines on healthy adults is similar to inactivated vaccines: 46 people (95% CI 29 to 115) would need immunisation to avoid one ILI case.
The administration of seasonal inactivated influenza vaccine is not associated with the onset of multiple sclerosis, optic neuritis (inflammation of the optic nerve of the eye) or immune thrombocytopaenic purpura (a disease that affects blood platelets). The administration of pandemic monovalent H1N1 inactivated vaccine is not associated with Guillain-Barré syndrome (a disease that affects the nerves of the limbs and body).
Evidence suggests that the administration of both seasonal and 2009 pandemic vaccines during pregnancy has no significant effect on abortion or neonatal death.
Quality of the evidence
The real impact of biases could not be determined for about 70% of the included studies (e.g. insufficient reporting details, very different scores among the items evaluated). About 20% of the included studies (mainly cohorts) had a high risk of bias. Just under 10% had good methodological quality.
The Cochrane's survey seemed to find vaccinated not getting sick a little less than unvaccinated, thus arguing against extensive collateral damage in healthy adults. However, only 10% of their data had good methodological quality, so impossible to conclude anything with high confidence. Also, I'm not certain how to compare their effectiveness measures to CDC's, but to the extent they are reporting a lower efficacy, that would mathematically indicate that some of the CDC effectiveness measure was due to damage. Also, their results are only for ILI, and don't include any data on any other infections.
SUMMARY The effectiveness of influenza vaccine in reducing hospital admissions for pneumonia, influenza, bronchitis, or emphysema was assessed by a case-control study of people aged 16 years and older who were admitted to 10 Leicestershire hospitals between 1 December 1989 and 31 January 1990. Hospital and general practitioners’ records for 156 admissions (the cases) and 289 controls matched for age and sex were reviewed. Information was collected on demography, the usual place of residence (institutional or non-institutional), the existence of chronic illness, and vaccination during the 5 years before admission. The odds ratio for hospital admission among vaccinees was 0±67 (95% CI 0±39–1±12) giving an estimate of vaccine effectiveness in this setting of 33% (95% CI 0–61). However, multivariate logistic regression, adjusting for the effects of institutional care and chronic illness, revealed that influenza vaccination reduced hospital admissions by 63% (95% CI 17–84%). There was a strong trend towards improved vaccine effectiveness when used in institutional settings. Influenza vaccine is effective in reducing hospital admissions for influenza, pneumonia, bronchitis and emphysema, and effectiveness is comparable to that observed for influenza and pneumonia admissions in North America.