A reader of the post “Severe cases of pandemic influenza” asked whether I could comment on an article in The Atlantic which questions the efficacy of the influenza vaccine in the elderly population. I passed the request on to Revere at Effect Measure who wrote an excellent and thoughtful response, “Journalists sink in The Atlantic article on vaccines“. It’s required reading.
If you’re not familiar with Effect Measure, I recommend that you add it to your daily science reading. It’s an outstanding source of information on the science of public health. You’ll also find that the discussion there is lively and opinionated.
I wonder if you could comment on the study by the Univ. of Michigan, published in the NEJM on September 24, 2009, showing that the 2007-08 flu shot in adults was 50% more effective than the LAIV Flumist nasal spray vaccine for that year. Complicates the decision for my 23yr old as to whether she should take the nasal spray now, since it's all her doctor has, or wait until late November when the shot should be available. Yes, it's a gamble as usual, but it's frustrating to have to wait until then for what could be the better option. When the nasal spray is ineffective in adults, is it 100% ineffective, or does it just give less immunity, possibly making the flu symptoms less severe. If that's the case, getting the nasal spray now might be a good idea for young adults, rather than waiting until late November.
By the way, I do realize that the study in the NEJM that I mentioned in my previous comment related to a seasonal flu vaccine, and that there is hope that the 2009 H1N1 swine flu vaccine will behave differently, hopefully providing more immunity. Does seem to be a lot of uncertainty here.
Oops……I am slipping at my multi-tasking here. Sorry.
I omitted from my very first comment that I was asking about this NEJM study as it relates to getting the H1N1 2009 swine flu nasal spray versus the shot.
This flu epidemic as it has been refer to has hit the poorest states with no means of support to vacinate the states such as Louisiana. Futhermore with the mecury level being in question its doing more harm than good. I think that we need to reevaluate the importance of futher testing on the products before pharm aceutical companies make money and put the lives of anyone in jeopardy..
I think the lower protection rate observed in the NEJM study, done in 2007-08, was that replication of the vaccine was reduced by pre-existing immunity. In other words, the strain in the vaccine is similar to one that previously circulated and hence there is some population immunity. I don't believe that will be a problem this year because the 2009 H1N1 virus is antigenically different from anything we have seen since 1950. If you were born before that year, your anti-influenza antibodies might reduce the efficacy of the vaccine, but for everyone else the protection should be as good as that conferred by the inactivated vaccine.
I think the lower protection rate observed in the NEJM study, done in 2007-08, was that replication of the vaccine was reduced by pre-existing immunity. In other words, the strain in the vaccine is similar to one that previously circulated and hence there is some population immunity. I don't believe that will be a problem this year because the 2009 H1N1 virus is antigenically different from anything we have seen since 1950. If you were born before that year, your anti-influenza antibodies might reduce the efficacy of the vaccine, but for everyone else the protection should be as good as that conferred by the inactivated vaccine.
Nasal Dilators to avoid collapse of the nostrils and allow more air into the nose. For details go to http://www.breatherightnasalstrips.com/Â