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Mike Adams vs. the flu vaccine

Oh, geez. Mike Adams is at it again.

I know, I know, saying that Mike Adams has just laid down yet another hunk of napalm-grade–nay, hydrogen-bomb grade–burning stupid is akin to saying that the sun rises in the east and sets in the west, that water is wet, that we need oxygen to survive, or that the moon goes around the earth. It’s part of nature and a well-established fact. Even so, sometimes Adams surpasses even himself. Sometimes, when doing so, he even gives me an opportunity to discuss a scientific study and thus look as though I’m actually blogging about peer-reviewed research instead of having fun laying down some not-so-Respectful Insolence on a quack.

Actually, the beauty of the blogging niche I’ve created for myself is that, sometimes, I can do both in one post.

This time around, Mike Adams has gotten himself into a fine lather about a study published in The Lancet Infectious Diseases by investigators from the Center for Infectious Disease Research and Policy, the Department of International Health, and the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University; and the Epidemiology Research Center, Marshfield Clinic Research Foundation. Basically, it’s a systematic review and meta-analysis of influenza vaccines entitled, appropriately enough, Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. I’ll speak more about the study itself in a moment, but I can boil its conclusion down to three main findings:

  • Pooled efficacy of influenza vaccination over several years at preventing the flu was approximately 59%; efficacy of the H1N1 vaccine was 69%.
  • Flu vaccines are more effective in children (83%)
  • Efficacy of the flu vaccine against seasonal influenza is highly variable and is low in some years.

Mike Adams, however, is shocked–shocked, I say!–that “60% efficacy” doesn’t mean that flu was prevented in 60% of all subjects in the trials used for the meta-analysis. I kid you not. Look at the title of his post: Shock vaccine study reveals influenza vaccines only prevent the flu in 1.5 out of 100 adults (not 60% as you’ve been told).

Congratulations, Mike. You actually appear to understand the difference between absolute and relative efficacy, at least when it is to your advantage to do so. Too bad that’s about all you understand. Basically, Adams builds a Tokyo-sized straw man and then makes like Godzilla with his radioactive breath to burn it down:

What we found is that the “60% effectiveness” claim is utterly absurd and highly misleading. For starters, most people think that “60% effectiveness” means that for every 100 people injected with the flu shot, 60 of them won’t get the flu!

Thus, the “60% effectiveness” claim implies that getting a flu shot has about a 6 in 10 chance of preventing you from getting the flu.

This is utterly false.

In reality — and this is spelled out right in Figure 2 of the study itself, which is entitled, “Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis” — only about 2.7 in 100 adults get the flu in the first place!

No scientist claims that “60% effectiveness” means that for every 100 people injected, the flu will be prevented in 60 of them. That’s what Mike Adams thinks scientists are saying. While Adams might have a tiny point in that a lot of people probably don’t fully understand the difference between relative and absolute risk reduction (I’ve pointed out myself the difference in discussions of how effective chemotherapy after surgery for cancer is at reducing the risk of cancer recurrence), in the name of “educating” his readers about this difference, he tries to convince you that scientists are intentionally deceiving the public by not pointing out that 60% risk reduction does not mean that 60% of the population who receive flu vaccines will have the flu prevented.

Before I have more fun dismantling Adams’ spin, let’s take a look at the study itself. It’s a pretty straightforward meta-analysis that used rigorous inclusion criteria for the studies it ended up pooling. Basically, only studies that confirmed diagnosed cases of influenza with positive viral cultures or positive RT-PCR for the influenza virus and that also ruled out influenza through negative viral cultures or RT-PCR for the virus were included. The authors also looked at two kinds of studies, observational studies (effectiveness studies) and randomized clinical trials from 1967 to 2011 looking at either trivalent inactivated vaccine (TIV) and live attenuated influenza vaccine (LAIV). Among the latter, they only looked at studies that included a control arm where the subjects received either only placebo or a different vaccine for something other than influenza. (So much for a frequent anti-vaccine claim that there are no “randomized placebo-controlled studies” of vaccines! There were a total of 73 RCTs identified, of which 17 met the inclusion criteria.) Included studies also had to look at vaccine efficacy against all circulating strains of the flu during the year of the study. In other words, this is a pretty solid meta-analysis, as far as the rigor of the inclusion criteria for studies to be pooled.

So let’s look at the dreaded “Figure 2”:

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The studies and the relative risk ratios calculated from them are, as you can see, divided up into pediatric age groups and adults. You can also see that for children, all of the studies have relative risk values with error bars that do not overlap 1.0, while for the adults, the majority of the studies don’t overlap 1.0. When the studies are pooled, what the investigators found was that the pooled vaccine efficacy was 59%, with a median efficacy of 62%. Again, the efficacy of the H1N1 vaccine from a pooled analysis of five observational studies was 69%. All in all, this study indicates that flu vaccines are moderately effective. Personally, I consider the results not too shabby, given how often the predominant circulating flu strains change every year and how the CDC, WHO, and other health agencies in essence have to make an educated guess every year as to which flu strains to include in each year’s vaccine stock.

The authors conclude, quite reasonably and cautiously:

Seasonal influenza is an important public health and medical challenge. Pandemic influenza would cause a substantial burden of disease and seriously threaten the global economy. Based on a track record of substantial safety and moderate efficacy in many seasons, we believe the current influenza vaccines will continue to have a role in reduction of influenza morbidity until more effective interventions are available. However, evidence for consistent high-level protection is elusive for the present generation of vaccines, especially in individuals at risk of medical complications or those aged 65 years or older. The ongoing public health burden caused by seasonal influenza and the potential global effect of a severe pandemic suggests an urgent need for a new generation of more highly effective and cross-protective vaccines that can be manufactured rapidly….Active pursuit of this goal now will save lives every year and when the next influenza pandemic occurs. In the meantime, we should maintain public support for present vaccines that are the best intervention available for seasonal influenza.

In other words, our current generation of vaccines are far from perfect, but they do pretty well and, given how safe they are, currently represent the best defense we have against influenza. That’s why we should be trying to develop better vaccines and interventions; in the meantime, we should continue to use our current generation of flu vaccines.

Of course, reasonable is not what Adams is ever about, as you can see here:

Let’s start with the actual numbers from the study.

The “control group” of adults consisted of 13,095 non-vaccinated adults who were monitored to see if they caught influenza. Over 97% of them did not. Only 357 of them caught influenza, which means only 2.7% of these adults caught the flu in the first place.

The “treatment group” consisted of adults who were vaccinated with a trivalent inactivated influenza vaccine. Out of this group, according to the study, only 1.2% did not catch the flu.

The difference between these two groups is 1.5 people out of 100.

So even if you believe this study, and even if you believe all the pro-vaccine hype behind it, the truly “scientific” conclusion from this is rather astonishing:

Flu vaccines only prevent the flu in 1.5 out of every 100 adults injected with the vaccine!

Give that man a cookie! He can do simple arithmetic! Talk about thermonuclear burning stupid! Does Adams know that pretty much the same can be said of any preventative measure? The vast majority of people will not get the disease protected against by whatever modality, be it a vaccine, a drug, or–yes–a supplement or dietary intervention of the sort that Mike Adams promotes on his website. All preventative measures, be they vaccines, dietary or lifestyle interventions, or whatever, involve having a large number of people undergo them knowing that on an absolute basis few will actually benefit. That’s why risk-benefit ratios become so important. For the flu vaccine the risk is very, very low indeed, which is one reason why vaccination against this disease makes sense.

Another reason is the flip side of Adams’ “reasoning.” Adams uses absolute benefit numbers rather than relative risk reduction numbers in order to try to make the benefit of flu vaccination seem negligible. However, small absolute numbers, on a percentage basis, can easily represent large numbers of people when applied to populations. For example, there are estimated to be around 312 million people in the U.S. as of the 2010 census, of which approximately 235 million are adults aged 18 and over. If 2.7% of those adults get the flu every year, that’s roughly 6.3 million cases of flu every year. Preventing 60% of those cases translates to preventing 3.8 million cases of the flu every year. That’s nothing to sneeze at, if you’ll excuse my choice of phrasing. Of course, I know that nowhere near 100% of American adults are vaccinated against the flu every year, but even if only 50% were the number of cases prevented would still be huge.

Adams also claims:

The overall “60% effectiveness” being claimed from this study comes from adding additional data about vaccine efficacy for children, which returned higher numbers than adults (see below). There were other problems with the data for children, however, including one study that showed an increase in influenza rates in the second year after the flu shot.

Uh, no. The 2.7% risk of getting the flu in the control groups came from only adult studies, as did the estimate of 1.2% risk of getting the flu in vaccinated groups. The reduction in risk in adults in the pooled data was 59%. The data in children were analyzed separately. As for the other study, Adams is referring to this study. First off, a negative efficacy doesn’t necessarily mean that the vaccine increased the risk of flu. In fact, let’s look at what the study says:

The efficacy of the vaccine against culture-confirmed influenza was 66% (95% confidence interval [CI], 34%-82%) in 1999-2000 and −7% (95% CI, −247% to 67%) in 2000-2001; however, influenza attack rates differed between these 2 periods (in the placebo group, 15.9% and 3.3%, respectively).

-247$ to 67%? That’s a hell of a confidence interval! But what really matters is that it overlaps zero, which means that in that year, for whatever reason, in that population the flu vaccine didn’t reduce the risk of flu, not that it increased the risk. It’s also only one study.

After his scorched earth policy using burning stupid, Adams then tries to play the “risk-benefit balancing game.” The problem, of course, is that he inflates risk beyond anything science will support and, when he can’t come up with accepted risks shown by science, makes up risks. For example:

It’s very likely that upon injecting 100 adults with vaccines containing chemical adjuvants (inflammatory chemicals used to make flu vaccines “work” better), you might get 7.5 cases of long-term neurological side effects such as dementia or Alzheimer’s. This is an estimate, by the way, used here to illustrate the statistics involved.

So for every 100 adults you injected with this flu vaccine, you prevent the flu in 1.5 of them, but you cause a neurological disorder in 7.5 of them! This means you are 500% more likely to be harmed by the flu vaccine than helped by it. (A theoretical example only. This study did not contain statistics on the harm of vaccines.)

Notice that here Adams doesn’t present any studies from the peer-reviewed literature. In fact, he even points out that his example is “a theoretical example only.” I wonder why. The answer is obvious: There are no studies suggesting that flu vaccines cause a neurological order in 7.5% of people who receive them. In fact, there’s no good evidence that flu vaccines cause significant neurological complications at all, except for equivocal evidence that in roughly one in a million it might cause Guillan-Barre syndrome. He basically pulled that figure out of his nether regions. He then throws in the scientifically discredited claim that vaccines cause autism to make the flu vaccine seem even riskier. In other words, if he can’t find a real risk from a vaccine, he makes one up, while proclaiming the vaccine-autism link as “provably quite real and yet has been politically and financially swept under the rug by the criminal vaccine industry (which relies on scientific lies to stay in business).”

Adams then concludes with seven “problems” with this study, all of which are typical anti-vaccine tropes, including the complaint that the control groups got vaccines as well:

In many of the studies used in this meta analysis, the “control” groups were given so-called “insert” vaccines which may have contained chemical adjuvants and other additives but not attenuated viruses. Why does this matter? Because the adjuvants can cause immune system disorders, thereby making the control group more susceptible to influenza infections and distorting the data in favor of vaccines. The “control” group, in other words, wasn’t really a proper control group in many studies.

Actually, the control groups were indeed proper control groups. In fact, let’s for the sake of argument assume that Adams’ lies are true and that adjuvants can cause immune system disorders making the control group more susceptible to disease. That would actually distort the data not in favor of vaccines because the same adjuvants are in the vaccine test group. In fact, the very reason placebos for vaccines often contain everything except the antigen used to provoke the immune response is to produce the best control group possible.

Adams’ other complaints include the usual litany, such as no comparison with completely unvaccinated controls (a complaint I’ve dealt with before); that there are no long term studies of the effects of vaccines (also not true); that flu vaccines were not tested against vitamin D (which is silly, given that a head-to-head comparison of vaccines against vitamin D was not the purpose of the study). The last three are even sillier. For example:

99.5% of eligible studies were excluded from this meta-analysis

Yes, but that’s because the inclusion criteria were very rigorous. They were also spelled out in the methods section. It is very typical of meta-analyses that the vast majority of studies will not meet the inclusion criteria, at least if the inclusion criteria are rigorous. Of course, Adams is free to do his own meta-analysis and include the studies that were excluded from this study. It will be crap, but he can do it if he wishes.

Even sillier:

I haven’t had time to follow the money ties for each individual study and author included in this meta analysis, but I’m willing to publicly and openly bet you large sums of money that at least some of these study authors have financial ties to the vaccine industry (drug makers). The corruption, financial influence and outright bribery is so pervasive in “scientific” circles today that you can hardly find a published author writing about vaccines who hasn’t been in some way financially influenced (or outright bought out) by the vaccine industry itself.

In other words, Adams doesn’t know. He just assumes. Perhaps he should have taken the time to “follow the money” before spouting off. Of course, even if some of the authors of some of the studies have ties to vaccine manufacturers that doesn’t invalidate the studies. One has to look at the methods. In any case, it is rather hilarious to see Adams rant that “The Lancet is, itself, a pro-vaccine propaganda mouthpiece funded by the vaccine industry!” Funny how one of the most famous anti-vaccine studies of all time (Andrew Wakefield’s case series from 1998) was published in The Lancet.

I can’t help but conclude with Adams going into full paranoid mode, letting his freak flag fly higher than ever:

The purpose of flu shots is to “soft kill” the global population. Vaccines are population control technologies, as openly admitted by Bill Gates (http://www.naturalnews.com/029911_v…) and they are so cleverly packaged under the fabricated “public health” message that even those who administer vaccines have no idea they are actually engaged in the reduction of human population through vaccine-induced infertility and genetic mutations.

Vaccines ultimately have but one purpose: To permanently alter the human gene pool and “weed out” those humans who are stupid enough to fall for vaccine propaganda.

And for that nefarious purpose, they probably are 60% effective after all.

If only there were a vaccine against the quackery, paranoia, conspiracy theories, and utter nonsense that is concentrated into the density of a black hole in the form of Mike Adams.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

109 replies on “Mike Adams vs. the flu vaccine”

The purpose of flu shots is to “soft kill” the global population.

Doesn’t seem to be working in our county — no one has died of the flu shot yet but we had three deaths in 2010 from H1N1.

I’m reminded of the Charles Addams cartoon showing the mad scientist leaning over a parapet with a blast-type weapon in his hands and saying, “Death ray, fiddlesticks! It doesn’t even slow them up.”

The purpose of flu shots is to “soft kill” the global population.

Doesn’t seem to be working in our county — no one has died of the flu shot yet but we had three deaths in 2010 from H1N1.

I’m reminded of the Charles Addams cartoon showing the mad scientist leaning over a parapet with a blast-type weapon in his hands and saying, “Death ray, fiddlesticks! It doesn’t even slow them up.”

“The purpose of flu shots is to “soft kill” the global population.”

Really? Then why are we quickly on the way to 7 billion people on this planet?? As a method of population control the “vaccine method” isn’t very effective! Perhaps he should check his OWN data! LOL

Oh my. I have recently started looking at some of the websites that claim to have “vaccine information” on them, but they really have the kind of mis-information and total misunderstanding of statistics that Mike Adams is displaying. I care for the pediatric population and am very interested in protecting them with vaccines. It is criminal the way that some bloggers out there have portrayed themselves as protectors of innocent people against the criminal activities and conspiracies of trustworthy agencies such as the CDC, FDA and the NIH; not to mention all the physicians out there who are trying their best to ensure their patients are protected against diseases that could kill them.
I guess I don’t really have a point here, just venting. But all this jobberwocky is really confusing the heck out of well-intended parents, who simply don’t know what to believe, and certainly might not have the educational background to be able to interpret primary scientific publications. Therefore they must rely upon something or someone they consider trustworthy. I have done pediatric critical care for decades, and I wish I had videotaped every death of a child I have witnessed from influenza complications, Hib, pertussis, tetanus, varicella, meningococcemia, post-measles encephalopathy. The list goes on. The real question is how to reach the masses with the kind of expose you have presented so well here.
Thanks for doing this.

I’m not sure, but to me Bill Gates words simply state that with better health care and more knowledge about birth control, people in thirth world countries are likely to give birth to less children.

But well, since I’ve seen the cancer-industry cartoons from Mike Adams website, cartoons which are just as funny as a concentration camp (they aren’t funny at all, but just very aggressive propaganda) mr. Adams belongs in my view to the most despicable persons on earth.

Orac, someone who doesn’t know you would be tempted to correct your example that the moon rotates around the sun, but as an astronomer I can say that the path of the moon is in fact always concave toward the sun, because the sun’s gravitational pull on the moon is greater than the earth’s.

So, you’re right! Except it’s “revolve” instead of “rotate”. Even I mix those up.

Got my flu shot the other day. I didn’t ask for extra tentacles — er, extra thimerisol. But the next time I say something stupid (probably within minutes) I’ll blame the flu shots for my obvious mental retardation. Hey, Michelle Bachmann said gardasil caused retardation in some lady’s daughter, which is good enough proof for anyone!

Adams is a crank, and either crazy or dishonest, but he does have a valid point hidden away in his paranoid rantings about the possibility of confusion between absolute and relative risk or benefit. Ben Goldacre has often talked about how the unwary can be confused by such statistics

I’m still waiting for the “vaccines are for population control” loons to explain why greedy Big Pharma would want to kill off a substantial part of the world’s population, thus sacrificing a large number of potential customers.

I mean sure, it’s blindingly obvious that health care workers, researchers, the Government etc. want a vaccine toxin-laden population afflicted with autoimmune diseases, autism, Alzheimer’s and so on (they love the idea of themselves and family members being so afflicted), but trying to kill people so the Pharma Overlords will have less income?

The brain reels.*

*it’s probably the aluminum.

I know, I know, saying that Mike Adams has just laid down yet another hunk of napalm-grade–nay, hydrogen-bomb grade–burning stupid is akin to saying that the sun rises in the east and sets in the west, that water is wet, that we need oxygen to survive, or that the moon rotates around the sun.

Is this a very clever joke that my numbed brain just isn’t getting? The Moon revolves around the Earth, of course, and rotates about its axis.

Of course, a far greater error is made by Adams:

It’s very likely that upon injecting 100 adults with vaccines containing chemical adjuvants (inflammatory chemicals used to make flu vaccines “work” better), you might get 7.5 cases of long-term neurological side effects such as dementia or Alzheimer’s. This is an estimate, by the way, used here to illustrate the statistics involved.

Adams uses the word “estimate” here incorrectly. The phrase he was actually looking for was “numbers I pulled out of my hinder”. Given that there is no evidence vaccines cause any of these conditions, it beggers the imagination that he could have figures for “illustrative” purposes which are not mere guesses. Of course, I don’t think he’s really guessing. That would imply an effort to speculate realistically. He’s come up with a number that supports his premise instead, which isn’t guessing, it’s inventing.

All right, Mr Adams. So most people don’t get the flu in the first place, therefore most people won’t end up being helped by the vaccine. Ignoring for now that you can’t tell whether you’re going to be one of the many lucky ones or not (how many people skip flu vaccines but buy lottery tickets, I wonder?), I wonder how you feel about these things:

* Seatbelts. The vast majority of automobile trips end without incident. Indeed, most people probably will never be in a car accident where seatbelts would have made a difference. (I never have.) Seatbelts were not widely used for the majority of the history of the automobile, and they are not commonly found on buses. Should we therefore conclude that they are a pointless intervention?

* Rape. Stranger rape is rare. Though most women (and probably more men than are currently recognized) will experience some form of sexual abuse in their lifetimes, and up to a quarter will be assaulted to some degree, few are assaulted by strangers. It’s nearly always someone they know. Does this make efforts to reduce rape meaningless? Should women inherently trust every male they encounter, knowing stranger rape is so rare that it’s not worth worrying about?

* Severe weather kills people every year; the Joplin tornado was especially bad. But most people will never see even a tornado-producing mesoscale convective system, much less the actual tornado, and much less be in any way impacted by it. Towns in this part of the country spend a lot of money on tornado sirens and emergency preparedness, and everybody is supposed to practice taking shelter once a year. Huge amounts of money are spent on our meteorological infrastructure, allowing advance warnings to go out. But since tornadoes are so rare (even here, statistically speaking, most people won’t see one much less be adversely affected by it), is it really worth worrying about?

Just because something happens to nobody you know doesn’t make it unimportant or not worth trying to prevent. It also doesn’t mean it won’t happen to you. If you honestly believe influenza is something that won’t happen to you, go ahead and skip the shot like Adams recommends. But remember that people think the same thing about car accidents, earthquakes, muggings, fires, lightning strikes, and workplace injuries and such.

For some reason, I am thinking of Stephen Colbert’s creation of a DoucheStrong bracelet for Alberto Contador. “Someday, they will find a cure for him being such a douche.” Although, even if a safe, effective treatment being a doucheweasel were ever developed, we know Mike wouldn’t take it.

But all this jobberwocky is really confusing the heck out of well-intended parents, who simply don’t know what to believe, and certainly might not have the educational background to be able to interpret primary scientific publications.

I hope that’s the case. So many of the ones that I’ve come across have been simply insufferable, using the ‘alternative ways of knowing’ and ‘things they don’t want you to know’ memes as a way to feel superior to people who, well, took a lot of time and effort to learn things.

I got my flu shot ten days ago and my TDaP on Saturday. Shouldn’t the tentacles be sprouting by now?

So, I’ve cut my chance the chance of getting the flu this year in half, and all it’s cost me is a slightly sore upper arm. That’s probably the best deal I’ll get all week.

Does Adams really think that anyone thinks that without vaccines, everyone will get the flu every winter?

OK Orac, I’ll see you that Adams and raise you two Nulls and an Olmstead**

Truth be told: woo-meisters hate vaccines for perfectly good reasons because these innovations represent the triumph of SBM in eradicating or diminishing the effects of serious and often deadly diseases that have plagued humans for millenia. If you peer into your own family history – even a hundred years ago, even in the western world- you might find that children died of “Spanish flu” or had polio, adults died of TB, men in the armed forces might have encountered and suffered malaria as well as other tropical illnesses. Anti-biotics- thoroughly despised- also represent a threat to “natural medicine”. As do ARVs. Because they work.

Because woo ( herbalism, homeopathy, supplements, nutrition, “Oriental” medicine, faith healing, etc) has no data illustrating improvements in any of these illnesses, it must rely upon muddying the waters by calling “Pharma Conspiracy!” at every turn in the road; recently they’ve needed to add, “Governmental Conspiracy!” and “Media Conspiracy!” as well.

Adams is so over-the-top, I can’t imagine people taking him seriously but he seems to have many fans ( 140,000 +) and I’m sure all of them aren’t reading him for sport, snark-fodder, and low-hanging-fruit gathering as we do.

** for your reading and listening … uh, “pleasure”- “The Flu Vaccine: the Hidden Dangers”; Null and Ashley: ProgressiveRadioNetwork; also @ same-see Archives/ Progressive Commentary Hour 10/24/11 re the vindication Of Andy W.

“Vaccines: Catalyst for the AIDS Epidemic”; Dan Olmstead @ AoA.

The CDC FluView site tracks reported confirmed cases, morbidity and mortality week by week during the seasonal flue season. The number Of Influenza-Associated Pediatric Deaths By Week of Death is charted for the seasonal flu season since 2008-2009:

2008-2009 Pediatric Deaths 133
2009-2010 Pediatric Deaths 282
2010-2011 Pediatric Deaths 116
2011-2012 Pediatric Deaths 0

(Source: FluView CDC 2011-2012 Influenza Season Week 14 Ending October 15, 2011)

What did Bill Gates actually state about vaccinations?

He stated, “If we do a good job with vaccines, health care, and reproductive services we could potentially lower the population by 15 percent”.

Mike Adams and the other psuedo-science hucksters on the internet have deliberately and maliciously completely misquoted Gates’ statement. They have emphatically accused Gates of genocide in areas of the world that have high infant mortality rates from vaccine-preventable diseases and with inefficient and sporadic health care to treat infants and to provide prenatal and antenatal care to women.

If babies were immunized against childhood diseases and women were assured that the children they gave birth to would survive into adulthood, then they would naturally decrease their birth rate. Of course, educating men and women and providing reproductive health care services, including availability of condoms, is an integral part of decreasing population rates and preventing the transmission of AIDS and other STDs.

The ability to sustain life in Sub-Saharan Africa and other underdeveloped areas of the world is based on bringing down the infant mortality rate, providing a safe water supply, providing reproductive services and condoms and prenatal/antenatal care and an ample safe food supply The horrendous toll due to easily preventable deaths in childhood and adulthood is a grim testament to not meeting those goals.

Adams states, “I haven’t had time to follow the money ties for each individual study and author included in this meta analysis, but I’m willing to publicly and openly bet you large sums of money that at least some of these study authors have financial ties to the vaccine industry (drug makers). The corruption, financial influence and outright bribery is so pervasive in “scientific” circles today that you can hardly find a published author writing about vaccines who hasn’t been in some way financially influenced (or outright bought out) by the vaccine industry itself.”

Well I DID check out each of the four authors of the study at the Universities where they have academic appointments. Each received their graduate Masters, Ph.D and Medical Degrees from prestigious Universities, each have impressive CVs with past experiences in conducted studies published in peer-reviewed journals based on their work for the CDC and their work in foreign countries. None of them have any affiliations with drug companies.

What an odious person this Adams is. He and his other cohort hucksters will stop at nothing to undermine the public health system in this country and worldwide.

I would’ve thought the same thing as Adams about what the 60% meant. As has been noted many times, technical words have specialized meanings. I have no problem with using such words when they fit the level of English needed for the topic. But how is the average reader supposed to know what “efficacy” is, as opposed to longer but more familiar ways of summarizing a study (assumptions, statistical mean and variance, confidence, etc.)?

The Lancet report may as well have said “cranks, eat your heart out”.

I am in bed with the most awful flu I’ve ever had. Im just one big, cranky, congested ache. Did I get a flu shot this year? No, I procrastinated. I shudder to think how I’d have fared through the worst of it last night had I relied upon natural remedies. Lord Draconis is gonna be pissed that Adams has his number though . . .

The question is, Pareidolius, do you think it’s worth the expense and risk of vaccinating millions of people in order to give a small number of them a slightly improved chance of not having to spend two days in bed with a headache and runny nose?

What a waste of time and money the flu shot is. Classic medical over-servicing.

“The question is, Pareidolius, do you think it’s worth the expense and risk of vaccinating millions of people in order to give a small number of them a slightly improved chance of not having to spend two days in bed with a headache and runny nose?”

The small expense (actually I get it for free) and miniscule risk are worth it to me to have a much smaller chance of being miserably ill for days, being one of the relatively few unfortunates who winds up in the hospital or dead, and helping protect more vulnerable people from catching my flu germs (I work in a hospital, but the same principle applies to anyone who might come in contact with the elderly, chronically ill and/or immunosuppressed, which is most of us).

Hope that answers your question.

As for Mike Adams, I don’t much care if he gets a flu shot or not. I just wish he’d gotten vaccinated for rabies before it was too late.

Wow Vince, I guess you’ve never attempted to calculate the economic costs of all of those people missing work (even a couple of days adds up across hundreds of thousands of people)…..

It’s very likely that […] you might get […] This is an estimate.

Start assertive, then pile on the weasel-words and qualifiers. Is this typical for Adams?

I’m willing to publicly and openly bet you large sums of money that at least some of these study authors have financial ties to the vaccine industry

No actual sum of money specified, after an initial claim to be offering a wager! Apparently it is typical!

Left a comment there asking him to be more specific about the size of his wager.

“”The question is, Pareidolius, do you think it’s worth the expense and risk of vaccinating millions of people in order to give a small number of them a slightly improved chance of not having to spend two days in bed with a headache and runny nose?”

Flu vaccine is an expense but how many people died from getting the flu shot? And, it is not like the common cold…it can have devastating effects (see my posting at #13 above) on infants and the elderly.

Would this be your method of population control Vince…to kill young babies and the elderly?

Mike lives in a funny little fantasy world, where people are secretly plotting to cull the world population but can’t resist leaking out the big secret during public meetings.

Two days with a runny nose? Try two weeks flat out in bed, wishing I could breathe. And as for missed work time, it runs into the billions of dollars, especially when a lot of places (like the hospital where I used to work) require an additional 24 hours with no fever before being allowed to come back to work (vulnerable population, and all that).

Flu is not a minor thing, health-wise or economically. Flu shots are a public good.

Lest there be any confusion @21: “Flu vaccine is an expense but how many people died from getting the flu shot? And, flu is not like the common cold…it can have devastating effects”.

lilady (#13):

2008-2009 Pediatric Deaths 133

2009-2010 Pediatric Deaths 282

2010-2011 Pediatric Deaths 116

2011-2012 Pediatric Deaths 0

I’m not disagreeing that influenza vaccination is a good idea – for everyone – but it is a little early in the 2011-2012 influenza season to be putting up data about paediatric deaths. Death reports typically lag a week or so behind case reports, so we won’t know the final butcher’s bill until next spring.

Since a lot of the children who have died from influenza are too young to be vaccinated, it is the vaccination of the young and healthy that protects them (as well as those too sick or debilitated to mount an effective immune response). Those who claim that influenza vaccination is “too expensive” (I’m lookin’ at you, Vince) should speak to the grieving parents about “expense”.

Prometheus

Actually, the control groups were indeed proper control groups. In fact, let’s for the sake of argument assume that Adams’ lies are true and that adjuvants can cause immune system disorders making the control group more susceptible to disease. That would actually distort the data not in favor of vaccines because the same adjuvants are in the vaccine test group. In fact, the very reason placebos for vaccines often contain everything except the antigen used to provoke the immune response is to produce the best control group possible.

That’s a flawed argument: in terms of efficacy of the vaccine, having a control group consisting of adjuvants minus active ingredient is proper. But in terms of investigation of side effects, such a control group masks them, making side effects due to the adjuvants invisible when compared to placebo. The proper way to investigate both efficacy and side effects would be a three-arm study: adjuvants+active ingredient, adjuvants, and placebo (e.g. saline).

@ Prometheus: Of course it is quite early in the flu season…I posted the numbers from the weekly CDC Seasonal Influenza Surveillance website. In the Western Hemisphere, the onslaught occurs toward the end of the year and we see huge numbers after kids return from their school holiday after the New Year.

Still haven’t heard from Vince about “population control” by not vaccinating against influenza…and other vaccines.

Adams’ other complaints include the usual litany, such as no comparison with completely unvaccinated controls (a complaint I’ve dealt with before); that there are no long term studies of the effects of vaccines (also not true);

But it was a meta-study about efficacy and effectiveness, so why would that matter? Or is Adams claiming that people who have never been vaccinated get the flu less often than people who’ve been vaccinated against the flu?

@Dangerous Bacon:

I’m still waiting for the “vaccines are for population control” loons to explain why greedy Big Pharma would want to kill off a substantial part of the world’s population, thus sacrificing a large number of potential customers.

From what I understand, according to this conspiracy theory Big Pharma is owned/controlled by people who either:

1) Have an ideological reason for wanting to kill of the majority of humanity (like thinking too large a population is bad for humanity, so they’ll kill of a large chunk of it for humanity’s own good)

2) Want to rule humanity, and somehow killing off a large chunk of humanity will help them with this goal.

Vaccines ultimately have but one purpose: To permanently alter the human gene pool and “weed out” those humans who are stupid enough to fall for vaccine propaganda.

Interesting theory. I would guess (and it’s just a guess) that the vaccination rate of people in the “medical establishment” is actually quite a bit higher than in the general population. Both because of institutional requirements to be vaccinated and a higher understanding of their benefits.

If he’s correct then people who are “in the know” about the true purpose of these vaccines would have vaccination rates of approximately zero. Isn’t this the plot of a few books? Oryx and Crake and Rainbow Six come to mind…

I would’ve thought the same thing as Adams about what the 60% meant. As has been noted many times, technical words have specialized meanings. I have no problem with using such words when they fit the level of English needed for the topic. But how is the average reader supposed to know what “efficacy” is, as opposed to longer but more familiar ways of summarizing a study (assumptions, statistical mean and variance, confidence, etc.)?

Not sure what your point is here? I can’t think of a simpler and better statistic than the quoted 60% to describe how effective the vaccine is. Because, in reality, 60% of people who were given the vaccine were immune to the disease. The fact that 97% of them didn’t actually catch it doesn’t change that fact. In the last days of smallpox, almost nobody caught it, and yet everybody who had the vaccine was (almost) totally protected. Does this mean the vaccine was useless? No, only that what it was fighting against was not common anymore. 60% is the accurate figure, and efficacy is the best way to describe the performance of the vaccine. If people are too stupid to understand what this means, perhaps they shouldn’t be making their own healthcare decisions based on reading such articles.. I don’t fully understand aerodynamics, turbofan engines and avionics, which is why I don’t make decisions about flying the plane I’m on, or even offer an opinion (apart from how I’d like my martini made).

@ Matthew Cline: I think the young and virile Adams may be looking to “bump off” the elderly…think of all the money we as a nation could save if could shorten their lifespan. Why, we might even be able to bring health care costs under control by “eliminating” non-productive people (the elderly, the medically frail and babies, as well) and cut the time that people are dependent on Medicare, Medicaid and Social Security benefits. The possibilities are endless…

Of course, if we then bring overall costs down for vaccine and other medicines in these populations, there would be room to reimburse for supplements, vitamins, Reiki, acupuncture and all the bogus treatments that Mikey promotes.

Adams, not known for his subtlety, succumbs to the Nirvana fallacy- so beloved of woos and other black-and-white thinkers: if it’s not perfect, i.e. 100% effective- it is worthless. So 60% being less than 100% = precisely 0.

This idea is often reflected in alt med’s calls for “guarantees” of total efficacy *without* side effects, in vaccines or pharmacological treatments: again, “all-or-nothing” as opposed to considered weighing of benefits to risks. Skills of this type are subsumed under formal operations, developed during adolescence along with other types of abstract thought including some of the pre-requisites for understanding research like knowledge of combinational possibilities, hypothetical thinking, holding a variable constant, etc. Not the strong suit for Mikey’s audience, I fear.

I got the flu vaccine because I don’t want to be the asshole that gives the flu to some preemie, some HIV+ person, some grandma on the bus, some kid who needs to take an exam that week.

That’s right. If you don’t get vaccinated and you don’t take steps to prevent spreading the flu once you do get it, you’re an asshole in my book. A world-class one. Maybe even a major league one as well.

Left a comment there asking him to be more specific about the size of his wager.

So far no response.
On the other hand, there is no response either to the three people who have pointed out the obvious error where Adams says that of the total control group, “only 1.2% did not catch the flu.” Either Adams does not read his comments, or he is even less interested than Orac in pedantic corrections to his proof-reading.

*raising hand*

Please put me in the non-asshole category, Reuben.

No tentacles at my injection site, either. Yet.

“Adams, not known for his subtlety, succumbs to the Nirvana fallacy- so beloved of woos and other black-and-white thinkers: if it’s not perfect, i.e. 100% effective- it is worthless. So 60% being less than 100% = precisely 0.

This idea is often reflected in alt med’s calls for “guarantees” of total efficacy *without* side effects, in vaccines or pharmacological treatments: again, “all-or-nothing” as opposed to considered weighing of benefits to risks.”

It’s especially puzzling, given the altie refrain about how we’re all different so it’s expected that alt med cures won’t be effective in clinical trials, what works for one person won’t work for another, and you’ve got to try all the different panaceas until you find one that works for you etc.

I sense a double standard.

@ Dangerous Bacon:

True but I’m sure he’d probably tell us that “consistency is the hobgoblin of little minds”: a common enough refrain from those who can’t sense that overarching conceptual identity despite superficial diversity usually does not signal a little mind.

Also he’s got stuff to sell.

I’m surprised he doesn’t complain that the studies don’t include controlled exposed and non-exposed groups as well.

Without that kind of control, it’s hard to determine the absolute protection of a vaccine, because you don’t how many of the people who didn’t get sick were or weren’t actually exposed to the influenza virus in question. You also don’t know how many of those exposed may have had naturally acquired protection from previously contracting that strain or a closely related strain of influenza.

So what you would really need for Adam’s end all to be all, last word on flu vaccine effectiveness (for any particular strain) is a very large number of people who have never been vaccinated or infected with any strain of influenza sealed into sterile environments and randomly assigned to groups where some are vaccinated and some are not while all are exposed to a specific strain of influenza virus.

Also one of the keys to effectiveness of a flu vaccine is strain matching, which is why the 2009 Pandemic H1N1 flu vaccine was a bit more effective, since we had a pretty good strain identification there. Every year, the WHO makes their best prediction of which three strains will be most prevalent in each hemisphere for their recommendations of what strains to vaccinate against. So even if a particular vaccine were somehow 100% effective in protecting against 3 particular strains of flu, you’d still have the risk of catching a difference strain. There’s no guarantee the WHO will predict the right strains or that there won’t be other strains circulating as well.

The question is, Pareidolius, do you think it’s worth the expense and risk of vaccinating millions of people in order to give a small number of them a slightly improved chance of not having to spend two days in bed with a headache and runny nose?

I don’t think Vince knows what the flu actually is. I’ve had it about 4 times in the last 30 years. It definitely stands out from all those common colds. btw, I just received my flu shot last week (no side effects, not even a sore injection site, and I barely felt the needle go in–in fact, if I hadn’t seen it go in I would have thought he just poked the skin).

Our evening news talked about this story. They did a pretty good job and even the person on the street they interviewed said something like, “I’ll get the shot–it still works–I like those odds”.

I’ll get the shot–it still works–I like those odds”

What do the safety studies on 60 years of flu shots say?

Cumulative, Chris. Cumulative. I’m also curious why some of you take such great pleasure in using my real name. Of course it doesn’t matter to me, but i see no such impulse to respond to this blog’s owner is a similar fashion. Finally, Chris, I saw this on your link:

The most common side effects from a
flu shot are a sore arm and maybe a low
fever or achiness. The nasal-spray flu
vaccine might cause congestion, runny
nose, sore throat, or cough.

(basically a mild case of the flu)

Which made me think all these sheep will be at risk for these side effects when the vaccine only reduces cases minimally. The flu shot’s an even worse bargain then I ever imagined. No wonder they have to be free and come with coupon books.

Dear Vince,
Let’s see, I’ve missed two days of work, made two important clients wait, possibly spread this foul thing to others, am still fairly miserable on day three, and will miss a gig this weekend I’ve been rehearsing for the last three weeks forcing my band mates to find a lasts minute replacement. So fuck you Vince, fuck you with a rotting, porcupine.

What do the safety studies on 60 years of flu shots say?

That they are safe. That they prevent outbreaks. That they lower pneumonia in the elderly. That they reduce the excess number of deaths from complications. That people with chronic lung disease should get them. That kids with asthma are really encouraged to get it. That pregnant women who get it are less likely to end up in the hospital with the flu. That there is no credible association will all the evil things you accuse it of being/doing out of your weird fear of the government. And that you’re a troll.

Guys, did I miss anything?

While I didn’t read the study referenced in this post, I can’t help but wonder what undocumented benefit the subjects of the study received from herd immunity.

Is it reasonable to hypothesize that, absent the confounding factor of immunized individuals in the community limiting the spread of the disease, the incidence rate of influenza in the control group would be significantly higher?

Mike Adams, The Health DANGER can pull whatever numbers he likes out of his keester; I suspect that the overall efficacy of the vaccination, herd immunity included, is at least somewhat greater than 60%. Am I off my rocker?

Yeah, I’m a total HTML noob… all those strikeouts were supposed to be bolds, Bob. But you get the point.

@ Offal: The efficacy of each year’s influenza virus also depends on antigenic drift and antigenic shift of circulating viruses that take place before and after the manufacturing process has begun for the current year’s seasonal influenza vaccine.

Why don’t you read my posting at # 14 above which tracks deaths of infants from influenza during recent flu seasons.

If you had any sort of education in the health care field, you would know that there are people with medical conditions such as pulmonary diseases and diabetes who are at particular risk for influenza. And, the elderly, who by their developmental stage (aging) have somewhat compromised immune systems…and the elderly who also have pulmonary diseases and diabetes are at extreme risk when they contract influenza. Did you also know that pregnant women are considered “immune-suppressed” and that people who have recently undergone or are undergoing cancer treatments are “immune-suppressed”?

“What do the safety studies on 60 years of flu shots say?”

What safety studies do you have in mind, Offal? Could you provide us with some PubMed citations of studies from peer-reviewed journals?

Perhaps I’m naive, but it seems to me there’s value in emphasizing the “do it for the sake of others” angle.

I’m scientifically literate and I know about disease vector paths. Yet my attitude toward flu shots was “I don’t get sick much anyway.” Then someone pointed out the item about herd immunity. I’ve gotten the shot every year since then. There are more of us around: people who can be convinced to get the shot not to protect ourselves but to protect others. This approach also produces the contrast whereby anti-vaxers are widely recognized as selfish arseholes who deserve to be shamed until they change their behavior.

Back a ways to a woo list that included “nutrition.” Please. Don’t. Someone comes into your clinic and tells you they’re eating organic veggies and they feel so much better: what do you tell them? “Nutrition is quackadoodle stuff, you’re having a placebo reaction,” or “Good for you, I like organic tomatoes, and we can all do to eat more vegetables.” If what you mean by “nutrition” is the nonsense about carrot juice enemas and obsessive tweaky-tweak over food combinations, sure, I’m with you there. But let’s avoid sweeping generalizations that throw the vegetables out with the dishwater.

The way to deal with this Mike Adams guy is to go undercover, wear a recording device, catch him making preposterously fraudulent claims for whatever dreck he’s peddling, and then turn him in to whatever law enforcement agency for medical fraud or whatever he can be busted for. Personally I wish the 1st Amendment could be interpreted more narrowly to exclude the promotion of pernicious lies (provable lies that cause demonstrable harm). But in lieu of that, just play dumb and let these bastards try to fleece you, and then spring the trap on them. Whatever it takes to put them out of action is justifiable in my book. Hell, play the “other woman” game on them too if that’s what it takes.

Dumb question department: any risk for any of the usual vaccines for a 24-year-old who’s been in remission from astrocytoma for 4 years? My inclination is that they’re safe, but I want to hear it from people with more initials after their names than I have after mine.

There is a study that I learned about from a researcher.

It seems that Japan had a law that required all school children to get a flu shot. The elderly flu rate was very low.

The law was removed. Elderly flu cases increased a lot. Old people sometimes die of flu.

Please protect me! Get your children immunized!

@ g724: At your young age (very young to me!), you should have had all the recommended childhood vaccines. If you missed out on some of them, by all means be certain to get “catch up” vaccines.

There is absolutely no reason for you to not get the yearly seasonal flu vaccine and the ten year Td booster. The newer Tdap vaccine is recommended as a booster for those under age 65 who expect to have close contact with infants under the age of 12 months of age. All the information about each childhood and adult vaccines are readily available on the VIS (Vaccine Information Sheet) website;

VIS-(name of the vaccine-preventable disease)

I don’t have too many initials after my name, but I am recently retired from a County department of health-division of communicable disease control.

Best wishes to you for permanent remission of your astrocytoma.

lilady-BSc-Nursing, RN

@g724

“Perhaps I’m naive, but it seems to me there’s value in emphasizing the “do it for the sake of others” angle. ”

Perhaps a bit. There’s a significant radical libertarian aspect to a lot of anti-vaccinationists.

Those convinced vaccines are not safe see this as health socialism, they see it as them sacrificing some of their health for some (in their opinion, imagined)social good. They are convinced that vaccines don’t benefit them personally in any way, evidence be damned.

“Every man for himself. I’m fine and screw the common good. Let other people look out for themselves, I’m not giving up anything for anyone else, Don’t tell me what I have to put in my body, If it costs me a penny, let them die, etc”

@ O A Wehmanen: I located the entire article that your referred to, and you are correct with the incidence of morbidity and mortality in the elderly, associated with vaccinating youngsters in Japan:

The Japanese Experience With Vaccinating Schoolchildren Against Influenza

NEJM March 22, 2001

I’m also curious why some of you take such great pleasure in using my real name.

Is it that we take pleasure in using your real name, or that we prefer that to using an offensive nom de plume? When you decided to take the pseudonym “Sid Offit,” did you “take great pleasure” in the thought that you’d be associating the name “Offit” with anti-vaccine screeds? I think you should perhaps have realized that if you were going to choose a pseudonym as a tactic, that some people might decline to use your pseudonym in order not to go along with your tactic.

Left a comment there asking him to be more specific about the size of his wager.

Sadly, my comment — asking what size of wager he had in mind, $100 say, or $1000, or what — seems to have disappeared.
I would hate to think that Adams’ proclaimed willingness “to publicly and openly bet you large sums of money” was purely a rhetorical styling, for then who would know which others of his statements were also not meant to be taken literally?

“I’m also curious why some of you take such great pleasure in using my real name.”

I’m innocent of that charge, Offal.

@ Herr Doktor Bimler: Mikey’s offer to bet was rhetorical and his other statements are bullshit.

Re. Lilady @ #15: Actually I’m “older than 40” and the person who is in year 4 of remission from astrocytoma is the son of a close friend of mine. But “in cyberspace no-one knows you’re a dog,” or whether your beard is gray. In any case thanks for your kind words.

#52, Karl: Those attitudes are typical of antisocial personality disorder, the leading psychiatric pandemic in our society today. And parents worry about their kids developing autism?!

#56, Herr Doktor Bimler:

You or someone else could post yet another comment challenging that quack to a bet, and then take date/time-stamped screenshots of a) his dare and b) your posting as it appears and then c) later after it has been disappeared again.

THEN put up a web site titled something along the lines of “MikeAdamsQuackery.com” and post the before & after screenshots, and call him out on his bovine excrement.

I’d suggest you do it quickly or he might retract his dare, and then you have to use “wayback machine” or a similar site to see if the earlier version is cached.

Something else that someone ought to try: posting on his site something to the effect that hand-washing after using the bathroom “destroys natural immunity” and urging people to do various things that are obviously unsanitary. This kind of stuff will turn off some of the people who read it, creating a bad association with the guy’s site. And if by chance he happens to reply favorably to such things, you can spring the trap on that too.

Yes, nonviolent guerrilla tactics (technically “gray ops”) are justified against someone who is a manifest hazard to public health. Better of course to get him thrown in jail for selling quack medicine, but hey, “whatever works.”

@g724

Here in New Zealand, previous malignancy means a person gets free vaccinations instead of being charged for them. My own teenage offspring is also in remission from astrocytoma and gets free flu vaccination every year on the first day it’s available!

I have a few initials after my name and frequently see patients in remission. My advice to them is exactly the same as I give to patients without malignancies: “Keep up to date with your vaccinations.”

I would really encourage the son of your friend to keep up to date with his vaccinations.

Jamie: we’re on the way to 7 billion people on the planet because Gates vaccine campaign hasn’t simply killed people, it has just maimed the shit out of them and left them with soft-sign neurological damage, they are different things, you understand.

Shatner, what color is the sky on your planet?

Or you could just post actual evidence for your claim that “Gates vaccine campaign hasn’t simply killed people, it has just maimed the shit out of them and left them with soft-sign neurological damage.”

You made the claim, you need to prove it with real evidence. Just post the journal, title, date and author of the papers that show there has been neurological damage from the vaccine campaign. Something of this kind of quality:

Neurologic Disorders after Measles-Mumps-Rubella Vaccination.
Makela A et al.
Pediatrics 2002; 110:957-63

Association Between Thimerosal-Containing Vaccine and Autism
Hviid A, Stellfeld M, Wohlfahrt J, Melbye M
Journal of the American Medical Association, October 1, 2003, Vol. 290(13):1763-6

Thimerosal and the Occurrence of Autism: Negative Ecological Evidence from Danish Population-Based Data
Madsen KM, Lauritsen MB, Pedersen CB, et al
Pediatrics, Sept. 2003, Vol. 112(3 Pt 1):604-606

Autism and Thimerosal-Containing Vaccines. Lack of Consistent Evidence for an Association
Stehr-Green P, Tull P, Stellfeld M, Mortenson PB, Simpson D
American Journal of Preventive Medicine, August 2003, Vol. 25(2):101-6

Impact of specific medical interventions on reducing the prevalence of mental retardation.
Brosco JP, Mattingly M, Sanders LM.
Arch Pediatr Adolesc Med. 2006 Mar;160(3):302-9. Review.

Encephalopathy after whole-cell pertussis or measles vaccination: lack of evidence for a causal association in a retrospective case-control study.
Ray P, Hayward J, Michelson D, Lewis E, Schwalbe J, Black S, Shinefield H, Marcy M, Huff K, Ward J, Mullooly J, Chen R, Davis R; Vaccine Safety Datalink Group.
Pediatr Infect Dis J. 2006 Sep;25(9):768-73.

Pediatrics. 2010 Jun;125(6):1134-41. Epub 2010 May 24.
On-time vaccine receipt in the first year does not adversely affect neuropsychological outcomes.
Smith MJ, Woods CR.

“Does that actually represent a new entry in Th1Th2’s vocabulamentarium?” I dunno, maybe. We should look it up in the Thinglish dictionary.

Maybe it is the result of a Haldol injection…Thingy may have been quite “agitated” recently.

Vaccination is a woo? Tell that to the people who got polio, because their parents refused to vaccinate them, because it was against Gods will.

Vaccination is a woo? Tell that to the people who got polio, because their parents refused to vaccinate them, because it was against Gods will. of Cutter.

I don’t think they are eternally grateful, do you?

Yes, Th1Th2 still thinks the Cutter incident alone is proof that all polio vaccines are equally dangerous. Just as the Trabant alone proves all cars are made of cotton.

And, Dr. Jay, what are your thoughts?

I listened to that episode, and I still think that getting the annual flu shot is a good idea. Do you not think that protecting older folks by increasing herd immunity by younger folks is not a good idea?

Or do you think old people should just die because they are just old? And why do you prefer folks to get influenza than the vaccine?

Do you enjoy the pain folks get from the actual disease? Because that is just a sick attitude.

And, Dr. Jay, what are your thoughts?

I listened to that episode, and I still think that getting the annual flu shot is a good idea. Do you not think that protecting older folks by increasing herd immunity by younger folks is not a good idea?

Or do you think old people should just die because they are just old? And why do you prefer folks to get influenza than the vaccine?

Do you enjoy the pain folks get from the actual disease? Because that is just a sick attitude.

@ Dr. Jay Gordon: This senior citizen is still awake here on the East Coast and wondering why you didn’t post on Orac’s blog “Whither the anti-vax movement”. I posted a lot of your tweets about flu vaccine, including the ones where you discouraged parents of a 2-year-old whose pulmonologist wanted to give the youngster the seasonal flu vaccine. You also encouraged a pregnant woman to not take her obstetrician’s advice to be vaccinated against influenza.

We had a lively discussion on that particular blog about your “tweets” and your absence was duly noted.

Dr. Jay, you can’t be that old to have forgotten Immunology 101 and the people who are considered to be at great risk (kids who need pulmonologists, pregnant women, diabetics, the elderly, those undergoing cancer treatments) for complications, if they contract influenza. Have you also forgotten that antigenic drift and antigenic shift of circulating strains of the virus, plus the extended manufacturing process, may cause the seasonal flu vaccine to not be effective in certain years? (hint) Remember the H1N1 swine flu that appeared summer 2009 and the heroic effort of the vaccine manufacturers to develop an effective vaccine for young people who had never had exposure to this type of virus.

I always got the seasonal flu vaccine in my younger years, even though I never had influenza disease. (Last and only episode was when I was a teenager in the mid 1950s-Hong Kong Flu?). It was a real pain…I’m quite sensitive to IM injections…but I did it to protect the patients I saw in my clinical practice. As health care providers, we should think about the vulnerable people who are entrusted to our care.

You must know Dr. Jay, that the CDC is aware that the efficaciousness of seasonal flu vaccine in the elderly (age65+) is not as good as in younger patients. That is why a high potency vaccine is now available.

Jay, you really ought to take advantage of the CME childhood vaccine credits offered by the AAP…you need to keep up with cutting edge research about childhood vaccines.

Also Jay, Brooklyn is not a small town and the Haredi Jewish Orthodox community is experiencing an outbreak of measles AND mumps due to low vaccination rates.

No Thingy, those people in Staphorst got polio, because their parents thoght it was against Gods will, to have their children vaccinated.

I am 59, I’ve got COPD, sleep apnoea, and numerous diseases. I also have a supressed imune system and I don’t mix with large groups because I always get ill if there is anything like a virus going about. I picked up something like the Nova Virus in hospital and thought I was going to die.

I used to get the Flu Jab as a matter of course. My GP who is very good, tells me the Flu Jabs are now counted and I am not eligible. So what has changed? The government must be rationing the flu antidote and if I get the flu it could kill me as I am extremely weak. Another Govt policy that doesn’t make sense.

Stwart Jenssen
Pharmaspider.com

@ Mr. Jenssen: I am assuming that you reside in the U.K. and I haven’t heard that the NHS has made changes to their policy regarding eligibility for flu vaccine.

The NHS has various websites. Some state that respiratory diseases “such as asthma” qualifies a person for the flu “jab”.

There is a NHS website that expands the definition of respiratory diseases to include COPD:

NHS Choices Flu vaccination-Who should have it

“People with medical conditions

The flu vaccine is offered free to anyone who is over six months of age and has one of the following medical conditions:

* chronic (long-term) respiratory disease, such as severe asthma, COPD or bronchitis
* chronic heart disease, such as heart failure
* chronic kidney disease
* chronic liver disease, such as hepatitis
* chronic neurological disease, such as a stroke, TIA or post-polio syndrome
* diabetes
* a weakened immune system due to conditions such as HIV, or treatments that suppress the immune system such as chemotherapy

If you live with someone who has a weakened immune system, you may also be able to have a flu vaccine. Speak to your GP about this.”

Beneath this article, there are 16 comments, including comments from health care workers who care for patients with these qualifying conditions, who were denied free influenza “jabs”.

If you look at my comments at # 74 above, you will understand why health care workers in the United States are urged by the CDC and their employers to get the seasonal influenza vaccine.

Karl @52:

If libertarians can’t tell generosity from socialism, that tells me everything I need to know about their brand of libertarianism.

But it never seems to occur to some people that I might choose to do things that will benefit others more than myself, or even at my own expense. (And then they claim that private charity will somehow replace welfare.)

“And, Dr. Jay, what are your thoughts?”

I’m not sure “thoughts” is a good term for whatever was running through Jay Gordon’s head when he posted that NPR link and then dashed away.

Actual thought would have run along the lines of “Hmm, the elderly are an especially vulnerable population when it comes to seasonal influenza, yet the current vaccine is of limited efficacy when given to seniors. Maybe I should rethink my opposition to giving influenza vaccine to pregnant moms and young kids (populations where the vaccine has substantial effectiveness), in order to limit the spread of influenza and protect our vulnerable seniors from infection.”

It appears however that Jay just decided to drop another turd pearl of antivax “wisdom” and run away before having to engage in thoughtful responses.

Sad, but typical.

Here is what Dr. Shaffner (chair of Vanderbilt University Med. Center’s Dept. of Preventive Medicine) had to say about the influenza vaccine in Jay’s linked article:

“…we all promote the immunization of people age six months and older in the United States because, as he says, even in most years, there is, at least, moderate benefit in most age groups. Influenza vaccine will if not eliminating the disease completely, modify the illness so that you do prevent some cases of pneumonia, hospitalization and death.

I like to paraphrase Voltaire: While we wait perfection, that can be the greatest enemy of the current good. And we have a good vaccine; we don’t have a great vaccine. We need to use the good vaccine.”

Re: Cutter – that was more than 50 years ago. Yes terrible. No, not typical. No, not currently relevant.

@ Stwart Jenssen: I think I may have messed up (again) a reply to your comment. I assume that you reside in the U.K. and in previous years you were eligible for the NHS seasonal flu vaccine, based on your respiratory disease.

I’ve checked some NHS websites and located a site that states those with COPD are eligible:

Flu Vaccination-Who should have it NHS

There are some comments on that site as well from health care workers who care for “eligible” people. It seems that many of these health care workers have had their requests denied by the NHS.

If you peruse my comment at #74 above, you can get a sense of the real need for clinicians who care for vulnerable people to get the vaccine. It is the reason why the CDC, hospitals and clinics urge their employees to get the vaccine and it is provided to employees free of charge.

@ Dangerous Bacon: Yes, Dr. Gordon did stop by momentarily and then did his usual disappearing act. I’m glad that Chris and I had the opportunity to post right after his “short visit”.

I don’t think Dr. Gordon is capable of understanding the principles of herd immunity to protect vulnerable people in our society. He doesn’t even “get it” that his endless tweets directed at people who are not his patients undermine what their own physicians have recommended. His “turds” are another example of his colossal hubris.

I’m actually not that statistically-minded. Can someone please explain, in a really simple way, what that 60% effectiveness rate actually means? Thanks.

In really simple terms, it means you’re less than half as likely to get the flu if you’re vaccinated than if you’re not.

Thanks, that was adequately simple – so that’s as opposed to the Adams strawman of preventing the ‘Flu in 60% of those vaccinated, right?

Got my flu shot during a CBC draw before starting my latest round of chemo. No big deal. Then again, I do still have cancer… coincidence? I think not!

Weren’t all those H1N1 flu deaths really MRSA deaths from dirty hospital wards? I believe so. If you’re a healthy individual the flu is exeptionally minor. Why are preventative measures against illness so low on the priorities of conventional healthcare professionals. Never had a vaccine in my life and my quality of health is exceptionally high. Ditto my children. Isn’t that delicious exemption clause a miraculous intervention. I know I can hear the multitude of fluorosis ridden teeth grinding on scienceblogs. The hilarious sight of brainless zombies lining up for their aborted foetus ridden shots is a sight to behold. Imagine a world with smug people like me who never get ill. 😉

You can believe what you like, AJP, but I prefer facts where available. No, all of the H1N1 flu deaths were not caused by MRSA infections, but you could easily see this for yourself if you were interested in looking up the actual stats instead of inventing ones more to your liking.

Here’s a question love. Why do vaccine producers pay out for damages caused by vaccines when according to this site vaccines never cause debilitating disease?? It’s a strange one. Surely these parents (caring for little Johnny, permanently damaged right after taking the shots) would be laughed out of court. You know literally. I bet you’d laugh at them.

Also why is it that the government (tax payers) are paying out damages and not big pharma? Rhetorical question of course. We all know they are exempt from all claims. Revolving door CDC/ Big pharma…big pharma/CDC wooga booga 😉

The H1N1 flu deaths were mostly caused by primary viral pneumonia or acute respiratory distress syndrome. Secondary bacterial pneumonia was usually from pneumococcus (a vaccine-preventable infection BTW). MRSA was not a factor, as far as I can see.

Since your “belief” about H1N1 and MRSA is a load of BS, why should we believe anything else you say?

P.S Here’s a great one in the annals of vaccine quackery. You’re all going to love this one. The ‘kansas city pandemic of 1921’ A citizen watchdog group called the ‘Advertiser’s protective bureau’ successfully prosecuted the Missouri chapter of the AMA for unduly spreading fear of a smallpox pandemic when none existed. They’d declared a smallpox epidemic quite falsely in the fall of ’21. The Jackson medical society effectively vaccinated the entire population free of charge, declaring it essential for every man, woman and child. They got over a million victims (I guess in the 20’s their were more excuses for the average Joe to trust the quacks than today).

You all know what happened of course, not because you know the case but because of the history of mass vaccinations. The hospitals were inundated with vaccine induced small pox. Tens of thousands of cases, hundreds crippled, many dead. The media trumpeted the event claiming the whole city would have succumbed were it not for the illustrious quacks. Trouble is for all you vaccinators there was that troubling court case and the victory for the watchdog group. Naturally the whole event never made national news though.

Nowt changes does it, ‘cept it gets worse of course. Enjoy 😉

I find it hilarious that you simultaneously complain about “conventional healthcare professionals” having preventive measures low on their list AND complain about the single most effective preventive measure ever devised.

And we do not claim that vaccines “never” have debilitating side effects. Sometimes they do, though far more rarely than the diseases they prevent. But many of the commonly claimed side effects are simply false.

You should also check into who funds the vaccine court awards. (Hint: it’s an excise tax on vaccine doses sold; i.e. “big pharma” is paying for it, not taxpayers in general.)

It’s also funny to note that virtually every single statement you’ve made is factually false:

Weren’t all those H1N1 flu deaths really MRSA deaths from dirty hospital wards? I believe so.

You may believe it, but you have no evidence and the illnesses are not similar.

If you’re a healthy individual the flu is exeptionally minor.

Yeah, a week of unmitigated misery is such a great thing I’d love to do it every month!

Why are preventative measures against illness so low on the priorities of conventional healthcare professionals.

Yeah, no “conventional healthcare professional” has ever recommended vaccination, sensible diet, exercise, smoking cessation, etc.

Never had a vaccine in my life and my quality of health is exceptionally high. Ditto my children. Isn’t that delicious exemption clause a miraculous intervention.

The many children killed by measles and crippled by polio demonstrate how idiotic this attitude is. The only reason you can get away with not vaccinating yourself is vaccination of everybody else…

The hilarious sight of brainless zombies lining up for their aborted foetus ridden shots is a sight to behold.

No tissue from aborted fetuses is present in vaccines. By parroting this repeatedly-debunked lie you demonstrate yourself to have not the faintest clue what you’re talking about.

Imagine a world with smug people like me who never get ill. 😉

Couldn’t happen. If everybody were like you, vaccine-preventable diseases would be ubiquitous again and you’d probably be dead.

Why do vaccine producers pay out for damages caused by vaccines when according to this site vaccines never cause debilitating disease??

No such claim is made, as above.

Also why is it that the government (tax payers) are paying out damages and not big pharma? Rhetorical question of course. We all know they are exempt from all claims.

“Big Pharma” IS paying the damages, again as above.

Gonna need a citation for that KC thing. As far as I can tell you’ve copied it straight from whale.to and thereby made yourself a laughingstock given that said site is populated pretty exclusively by made-up garbage with no foundation in reality.

Too easy.

thesuperbug known as methicillin-resistant Staphylococcus aureus (MRSA), spiked the risk for flu-related deaths 8-fold in children who were otherwise believed to be totally healthy before they became ill.

8 fold! That’s 800% isn’t it. Mike Adams would love that stat. I’ll have to send him it.

“There’s more risk for MRSA to become invasive in the presence of flu or other viruses,” study leader Adrienne Randolph, MD, MsC, of the Division of Critical Care Medicine at Children’s Hospital Boston. Said in a statement to the media. “These deaths in co-infected children are a warning sign.” He added this is especially alarming given the rising rates of MRSA infections being carried widely among children.

“It is not common in the U.S. to lose a previously healthy child to pneumonia,” Randolph said. “Unfortunately, these children had necrotizing pneumonia eating away at their tissue and killing off whole areas of the lung. They looked like immunocompromised patients in the way MRSA went through their body. It’s not that flu alone can’t kill – it can -but in most cases children with flu alone survived.”

Damn isn’t MRSA caused by all those quacky quack quack antibiotics handed out like candy. If only Bechamp had beaten old Louis ‘bacterium’ Pastuer to death with a mallet we may have a health service worth the name. It’s the soil old boy, the soil 😉

Just to announce my last comment under AJP has seemingly been denied entry. Don’t think there was anything offensive in there, oh apart from the truth of course and we all know we can’t have that. I’m surpised it took several posts before the censorship began. By my reckoning that means I just won the argument. Oh here’s part of the post. Enjoy and keep on taking the medication. Pill poppers are voluntarily putting themselves forward for the Bill Gates eugenics experiment afterall (wasn’t his dad head of planned parenthood) lol.

The superbug known as methicillin-resistant Staphylococcus aureus (MRSA), spiked the risk for flu-related deaths 8-fold in children who were otherwise believed to be totally healthy before they became ill.

“There’s more risk for MRSA to become invasive in the presence of flu or other viruses,” study leader Adrienne Randolph, MD, MsC, of the Division of Critical Care Medicine at Children’s Hospital Boston. Said in a statement to the media. “These deaths in co-infected children are a warning sign.” He added this is especially alarming given the rising rates of MRSA infections being carried widely among children.

“It is not common in the U.S. to lose a previously healthy child to pneumonia,” Randolph said. “Unfortunately, these children had necrotizing pneumonia eating away at their tissue and killing off whole areas of the lung. They looked like immunocompromised patients in the way MRSA went through their body. It’s not that flu alone can’t kill – it can -but in most cases children with flu alone survived.”

Damn if only Bechamp had driven a mallet into Louis ‘Bacterium’ Pasteur’s skull this could all have been avoided. It’s the soil dear, the soil 😉

Imagine a world with smug people like me who never get ill. 😉

If they were all like you, then I would look forward to the sweet release of death.

Just to announce that my last reply has been denied. How interesting. Certainly np offensive language used, just opinions you deem so scandalous as not to be allowed for public consumption. By my reckoning that means I just won the argument. Enjoy and keep taking the medication. Pill poppers are voluntarily putting themselves forward for the bill gates eugenics experiment afterall wasn’t daddy head of planned parenthood lol.

The superbug less spiked the risk for flu related deaths 8 fold in children who were otherwise believed to be totally healthy before they became ill.

“there’s more risk for news to become invasive on the presence of flu or other viruses” study leader adrienne randolph, md, mac of the division or critical care medicine at children’s hosital, Boston. “these deaths in co infected children are a warning sign…they looked like imunocompromised patients in the way news went through their bodies. It’s not that flu alone can’t kill but in most cases children will flu alone survived.”

Danny if only Bechamp had driven a mallet into Louis ‘bacterium’ Pastrie’s skull this could all have been avoided. It’s the soil dear, the soil .

I too call shennanigans on the KC thing, as I see no citations in journals and the only Google links mentioning the incident all lead to whale.to. The NY Times online archive shows nothing for that year (though it does show a reported outbreak and resulting quarantine of the city in Feb 25, 1889) and none of the Kansas City newspapers with online archives mention a thing about it.

So [citation needed], and yet another link to whale.to (or a blog repeating same) doesn’t count.

— Steve

I was going to call Poe on AJP, even with the winky smiley. Further evidence (including premature trumpeting of censorship) obviously points to an exceedingly unimaginative troll.

I’m not even sure if #96 is English – as the syntax is confusing, words are either misspelled or used incorrectly (or just plain old word substitutions) or even grammatically close to being correct.

Yes, incoherent troll has become completely incoherent.

He actually managed to say something reasonable this time around – that overuse of antibiotics contributes to problems like MRSA. Still not the faintest shred of a hint of evidence that H1N1 deaths were actually MRSA deaths, though. Just random unattributed statements.

Wait a sec. Do I even see germ theory denialism there? I think I do! Just need something like Holocaust denial, birther claims, or troofing to hit the crank trifecta.

Morphtroll has it wrong about MRSA and the flu. Big surprise. The necrotizing MRSA is not the variety seen in hospital-acquired infections. It is a staph that is acquired in the community, and acts very much like the usual MSSA. Pneumonia from MSSA is also necrotizing, and a very serious illness. “Community-acquired” MRSA is sensitive to antibiotics other than methacillin.
The article morphtroll quotes from actually supports the case for H1N1 vaccination in childhood. Prevent influenza with the vaccine, prevent MRSA pneumonia.

“He actually managed to say something reasonable this time around – that overuse of antibiotics contributes to problems like MRSA. Still not the faintest shred of a hint of evidence that H1N1 deaths were actually MRSA deaths, though. Just random unattributed statements.”

No he didn’t say anything reasonable “this time”…troll’s exact words in his posting about MRSA and H1N1 are “lifted” directly off Alex Jones Infowars website.

ken, the H1N1 flu shot was so two years ago. And Chris Shaw is not a vaccine researcher.

For goodness sake AJP do a bit of fact-checking before you regurgitate this stuff – just how gullible are you? They are lying to you. There is masses of this rubbish all over the place, and too many people just swallow it whole like you have. By the way, some comments get sent to moderation automatically for reasons none of us can fathom – this one will because it has two links in it. It’s not censorship.

On the Kansas City smallpox thing, there was an outbreak of smallpox in Kansas City in 1921, which was exaggerated in the press costing retailers there millions of dollars. There were 60 deaths and 290 cases reported in total. The only references to the ‘Advertiser’s Protective Bureau’ I can find are from crank sites that all repeat the same story, with none giving a source for it.

I did find a short article about smallpox written in 1921, which seems to confirm that there were just as many complacent and idiotic people around then as there are now. I found this interesting:

We should teach:
1st. That vaccination with re-vaccination until the susceptibility to vaccine is exhausted gives absolute immunity from smallpox.
2nd. That practically every person is susceptible to vaccinia and vaccination should be repeated until it “takes.”
3rd. That vaccinia is a systemic disease and that one point of inoculation is as good as more unless there is a period of time between the inoculations.
4th. That no large scratches or scarifications should be made for introducing vaccine. An abrasion one-sixteenth of an inch square is large enough or a scratch one-sixteenth of an inch is long enough. Avoid drawing blood.
5. Treat a vaccination with the same care that is demanded in all surgical procedures.
If these rules or other equally good rules are followed the occasional blood poisoning and painful sore arm would be avoided and anti-vaccinationists would be robbed of the only real argument they have against vaccination.
The neglect of vaccination alone is responsible for the presence of smallpox.

I think the tale of the wicked doctors inventing a smallpox epidemic just to line their pockets is a myth, whether it was invented in 1921 or more recently I don’t know. It wouldn’t have been the first time that an epidemic was predicted for good reasons, and then when it arrived some people blamed vaccination for it, whereas in truth if more people had been vaccinated the epidemic would not have happened and if less vaccination had been carried out the epidemic would have been much worse.

When does science become a religion? When scientists that challenge sacred cows have their research grants scrapped. Lol This blog is infested with shill sheeple of the very worst kind. At what stage do any of you comprehend the magnitude of the delusion we face on a daily basis whether that may be the drugs war (monumental scam where the feds physically arm mexican drug gangs), the cancer war where a maverick doctor with substantially better results than conventional treatments (Dr Burzinski) is threatened with 120 years in jail for offering an alternative, to the HIV causes AIDS scam. 186 billion dollars in research money wasted on a scam that has died a death, unlike the hundreds of millions we were told were doomed. Where poor Africans with no clean water are used as guinea pigs and are given AZT drugs that actually cause the symptoms they purportedly cure. ‘Slim’ is caused by unclean water and poor sanitation people! To the vaccine scam where infectious disease was decimated by 99% through clean water and sanitation yet the industry claims they defeated measles, mumps and rubella despite the fact throughtout history the vaccinated areas always had increased incidences! AND…polio and other diseases were simply renamed to give the impression the condition had been eradicated! To the ludicrous and now proven a baseless lie anthropomorhpic global warming to the disgusting genocidal Monsanto GM crop debacle where there is no increase in yield and farmers adjacent to GM crop farms are sued and put out of business for cross contamination and rats fertility is proven destroyed through its consumption. To the discredited fluoride water treatments, where even the bent medical establishment are struggling to keep a lid on to the 50% mercury amalgam filling fiasco that will be seen in the same light as tobacco was in years to come. How did the American and British dental associations cover up the damaging effects of putting mercury in childrens mouths. How did they put profit above all else. All the sacred cows demolished yet because of the totally bought and paid for compliant media we are still in this sorry sorry state of affairs.

You will lose this war you sycophantic wretches. Even now with all the financial resources you have at your disposal the awakening is gathering steam. It’s only a matter of time don’t you know. 😉

@ Ken: Dr. Shaw is not a vaccine researcher and he has some odd theories about aluminum used as adjuvants in vaccines…including his “theory” about aluminum-adjuvants-causing Gulf War Syndrome:

The H1N1 adjuvanted with aluminum vaccine was in short supply during November, 2009 when Dr. Shaw was “quoted” for that link you supplied.

The BMJ published a study about the effectiveness of H1N1 vaccine in “vulnerable” populations (infants, children and adults ages 50 years and less) who were immunized with the available vaccine through November, 2009. The conclusions of the study:

“Conclusions

We report estimates of vaccine effectiveness suggesting very high protection conferred by a single dose of the monovalent AS03 adjuvanted pandemic vaccine most used in Canada during autumn 2009, with reference in particular to children and young adults. Although limited by a small number of vaccine failures, we interpret these findings to be consistent with indicators of immunogenicity showing very high vaccine induced antibody response and with virological characterisation suggesting an excellent match of vaccine to circulating virus. Our findings are relevant to the evaluation of pandemic vaccination efforts not only in Canada but also in other countries where adjuvanted vaccines were used. Our results may help to inform the further development of influenza vaccine options.”

(Source-BMJ Published 3, February, 20ll) Effectiveness of AS03 adjuvanted pandemic H1N1 vaccine: case control based on sentinel surveillance system in Canada, Autumn, 2009

I wonder why Dr. Shaw has not “updated” his opinion about aluminum adjuvanted H1N1 vaccine efficacy and safety, now that 2 years have elapsed?

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