Universal Flu Vaccine Recommendation May Be Coming: Top Vaccine Expert Suggests Guideline for Vaccination for Every Man, Woman and Child

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[One_World_Religion] Universal Flu Vaccine Recommendation May Be Coming: Top Vaccine Expert Suggests Guideline for Vaccination for Every Man, Woman and Child

 

 

FLU SHOT MANDATE LOOMS; FLU SHOT FAILS TO PROTECT

by Barbara Loe Fisher

In 2006, Mayo Clinic's Greg Poland, M.D., who has been a CDC vaccine policymaker and promotes worldwide use of multiple vaccines throughout life, called for mandatory vaccination of all health care workers with flu vaccine. http://www.sptimes.com/2 006/06/13/Tampabay/Expert_calls_for_heal.shtml. This year, the CDC issued a formal recommendation for all health care workers to do just that http://www.cidrap.u mn.edu/cidrap/content/influenza/general/news/jul0207a cip.html Dr. Poland has also been instrumental in defending the "safety" of the highly reactive anthrax vaccine the U.S. Department of Defense has required all soldiers to get. http://www.vaccines.mil/documents/l ibrary/MilitaryImztn2005fulc.pdf. Last week, he called for all 300 million Americans to get a flu shot every year. http://www.abcnews.go.com/Health/Flu/st ory?id=3781181Dr. Poland, like so many doctors in public health and pediatrics today, considers himself a "warrior" in the crusade to kill all infectious microbes that cause human disease. He says, "Vaccines are the singularly most important medical technology ever devised. We administer a series of vaccines over a lifetime to every single human being on earth." http://mayoresearch.mayo.edu /mayo/research/vaccine_research_group/ When ideology blinds a doctor, scientific truth is often the first casualty. A report out of Canada last week reveals that two of the three strains (Soloman Islands A, Wisconsin A, Malaysia B) selected by doctors at the World Health Organization and the CDC for North America "appear to be drifting and mutating, raising questions about how much protection this year's flu vaccine will offer." http://www.ctv.ca/servlet/ArticleNews/ story/CTVNews/20071024/flu_shot_071024/20071024 ?hub=TopStories The Public Health Agency of Canada reports that the Wisconsin strain has already mutated into a different form than is contained in the vaccine and the Malaysia strain is also showing signs of mutating. This is similar to what happened in the 2003-2004 flu season when there was a mismatch of circulating flu strains with the ones selected for the flu vaccine. http://www.nvic.org/History/Newsl etters/%203770Reaction.pdf So just how effective will the flu shot be at preventing death and illness from the flu this year, especially for children, the chronically ill and the elderly?Probably not any more effective than it has ever been, which is not very effective according to yet another study in the medical literature ( Lancet Infect Dis. 2007;7:658-666). The Lancet reported this month that the elderly over age 70, who have always been targeted for flu vaccination because they account for 90 percent of all flu related deaths, may not be protected at all from dying from complications of the flu. Flu vaccine use by the elderly and those with chronic diseases has increased from 15% to 65% in the US and other high-income countries since 1980 but there has been no decrease in influenza-related mortality among these groups. The few clinical trials that have included elderly people have indicated there is a decrease in antibody responses and clinical benefits of flu vaccination as people age beyond 70 years. http://www.medscape.com/viewarticle/56339 3?src=mp This new report reinforces an analysis of flu vaccine clinical trials published last year in the British Medical Journal by Cochrane Collaboration researchers http://www.bmj.com/cgi/content/full/333/7574/912 The 2006 Cochrane Collaboration analysis found that the majority of published influenza vaccine studies were methodologically flawed with selection biases, cofounders and heavy reliance on non-randomized studies. Authors pointed out that potential confusion between respiratory infections caused by flu viruses and those caused by non-flu viruses can result in a misdiagnosis and gross overestimation of the true impact of influenza on death and illness in a given flu season (CDC officials have never produced documented evidence for the 36,000 deaths they attribute to the flu every year). The 2006 study concluded that too few clinical trials have been conducted to prove flu vaccine safety and current evidence indicates that use of inactivated influenza vaccine has only a modest or no effect on preventing flu in children or the elderly. Co-author Tom Jefferson, an Italian epidemiologist said "There is a big gap between policies promoting annual influenza vaccinations for most children and adults and supporting scientific evidence." NVIC has taken the position that the CDC should stop recommending annual influenza vaccination for all young children when there is insufficient scientific justification for it. http://www.nvic.org/PressReleases/pr1031flu.htm Unfortunately, when the CDC makes a recommendation for universal use of vaccines, state mandates soon follow. Greg Poland's call for 300 million Americans to get an annual flu shot is a pretty good indicator the CDC will eventually follow suit and drug company lobbyists seeking higher profits will pressure state legislatures to institute flu vaccine mandates. Once every American has been softened up to accept an annual flu shot, more shots and mandates will follow.Only this time, the vaccine mandates will not just mean being barred from getting an education. Today, parental refusal to get a child vaccinated with all state mandated vaccines means the child can be barred from going to school or getting health insurance. Tomorrow vaccine mandates may mean being barred from getting a job or a driver's license unless you show proof you've saluted smartly and rolled up your sleeve for scores of new vaccines now being developed in more than 200 clinical trials worldwide. And that is a future that drug companies selling vaccines are convincing stockholders they can take all the way to the bank.http://www.abcnews.go.com/Health/Flu/st ory?id=3781181

Top Vaccine Expert Suggests Guideline for Vaccination for Every Man, Woman and Child

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

"In Dr. Poland's war, there are no rules of engagement; anything goes. The enemy is what Dr. Poland calls "unwarranted death." These are deaths caused by infectious diseases that could have been prevented by vaccinations. It is an enemy that is as ruthless as it is resourceful. Says Dr Poland: "I was born into a Marine Corps family, and I spent my childhood growing up on military bases. As I went through medical school and residency, I knew right then and there that the warrior I was meant to be was the warrior taking on infectious diseases, to prevent them-because I just have a really hard time with death. Unwarranted death, the unexpected death." http://mayoresearch.mayo.edu/ mayo/research/vaccine_research_group/

Universal Flu Vaccine Recommendation May Be ComingTop Vaccine Expert Suggests Guideline for Vaccination for Every Man, Woman and Child

ABC NewsOctober 26, 2007by by Raja Jagadeesan, M.D.ABC News Medical UnitClick here for the URL:

The time may soon come when doctors recommend that every American man, woman and child be vaccinated every year for influenza an idea offered Wednesday by a leading expert in vaccines and preventive medicine. Dr. Gregory Poland, director of the Vaccine Research Group at the Mayo Clinic in Rochester, Minn., testified Wednesday at a meeting of the Advisory Committee on Immunization Practices (ACIP), the subcommittee at the Centers for Disease Control and Prevention that issues federal recommendations for the use of vaccines in the United States. In his testimony, Poland recommended that the United States should move to a so-called "universal recommendation" for vaccination against influenza, the virus that causes the flu. A universal recommendation would make official that Americans of all ages should receive an influenza vaccination every year. The testimony came at a time when the committee is considering a smaller step of recommending that all school-age children receive a yearly vaccine. "I think it's a good idea to expand [vaccination] to all school-age children," Poland said. "But a better idea is to say, 'let's not just go age group by age group; let's just recommend that everybody get it.'" Review of recent changes in the CDC recommendations shows that ACIP has been steadily increasing the indications for a flu vaccine for several years. Current estimates are that more than 70 percent of the U.S. population now meets one of the 15 published criteria for recommendation of a yearly flu vaccine. "We've changed the recommendation every year or two since '97," Poland said. "It's sort of a creeping incrementalism." Instead of marking out ever-increasing numbers of groups that should get the flu vaccine yearly, Poland espoused a universal recommendation that all Americans should be getting the shot, with particular emphasis on vulnerable groups. "Let's just make a universal recommendation that all Americans should get vaccinated. But then note that there are particular high-risk groups that should be particularly recommended to get the vaccine." How Do You Deliver 300 Million Vaccines? Such a move would not come without difficulty. Currently, less than 40 percent of America's 300 million people receive yearly flu shots and many of those for whom it is recommended do not receive their immunizations. Other vaccine experts pointed out that any effort to vaccinate all Americans would face many logistical hurdles. Concerns included the availability of enough flu vaccine for the entire American population and the lack of a public health infrastructure to deliver that many vaccines. "If a universal flu vaccine is recommended, it would need a plan," said Ira M. Longini Jr., a professor in biostatistics and biomathematics at the University of Washington School of Public Health. "Right now, if you look at vaccine supply, we can't make 300 million dose of vaccine and get them to the right people. Even if we could make enough dose, we would need to put in place a program to reach everyone." A move to vaccinate everyone could also face significant financial hurdles. "Who is going to pay for all of this?" asked Dr. William Schaffner, chair of the department of preventive medicine at Vanderbilt University. "For example, we know that there are 40 million people who don't have medical insurance. Who is going to get the vaccine to those people?" According to Poland, though, vaccine supplies have been increasing steadily since the widely publicized vaccine shortages from several years ago. "This year, manufacturers are going to make 130 million doses in America. Last year & we threw away about 12 million doses," he said. "Every year this decade, we've leaned on the manufacturers to make more vaccine, and we've thrown away doses in the millions.Until this year, there were concerns that we'd even have enough vaccines to cover our indicated patients," said Schaffner. "However, that concern is receding. We are having more manufacturers coming into the U.S. market. This year we'll have 130 million doses or even more. This year, we are faced with the idea of, 'can we even use it all?'" Preparing America for Pandemics and BioterrorismAccording to Poland, however, there could be a very important hidden benefit to addressing these issues now: Americans would learn how to be prepared in case of a bioterrorist attack or a pandemic infectious disease. "Once you've made a recommendation and then implement the recommendations, you go a long way towards figuring out the ways to operationalize the ways to administer these things to all Americans," Poland said. "You can't make that happen in the middle of an emergency." Schaffner agreed that the development of such public health infrastructure could be a critically important step for the future. "If we undertook to vaccinate a very substantial proportion of the U.S. population each year, you'd have to organize everything from vaccine development to production to delivery," he said. "It'd be like a training session or a fire drill that we'd conduct each year. "So if we had to do it in any kind of emergent situation for example, anthrax, smallpox vaccine, delivering cipro [antibiotics] we'd have a trained provider network and a trained public," he said. "Just as most of us know where to go to vote, we'd be trained on where to go to get vaccinated or get your antibiotics or whatever the public health intervention would be.It may be something that could lay the groundwork for something looming down the line in the form of an avian flu pandemic," said Dr. Peter Hotez, chair of the Department of Microbiology, Immunology and Tropical Medicine at The George Washington University. "By getting this infrastructure into place by vaccinating the whole population against [seasonal] flu, you lay the groundwork to combat deadly avian influenza. "In effect, you would be killing two birds with one stone." But according to Poland, this type of recommendation would likely need some advance warning to allow for the infrastructure to be built. "I suggest we make the recommendation in advance," Poland said. "For example, something like 'starting next year, we'll be recommending all Americans get a flu vaccine.'" Carla Williams and Dan Childs contributed to this report.

This year's flu shot missing new strains of virus

CTV.ca October 24, 2007Click here for the URL:

Canadians heading out to get their annual flu shot may want to know that the strains of the influenza aiming for North America appear to be drifting and mutating, raising questions about how much protection this year's flu vaccine will offer. The process of creating the annual flu shot is a complicated one and actually begins almost a year ahead of time. The World Health Organization monitors flu activity around the world, looking for predominant strains. As flu viruses reproduce, they often trigger slight changes in their genetic code, which scientists call antigenic drift. The WHO researchers take particular note of what's happening in the southern hemisphere to see what strains are emerging there, since they go through their winter flu season long before we do. The WHO then selects the strains that they think are most likely to predominate in the northern hemisphere. They generally select three -- two subtypes of influenza A viruses and one influenza B virus-- to go into the vaccines to be used the following fall and winter. Each year, authorities change one or two of the three strains in the vaccine, which is why it is important to get a new flu shot every year to ensure protection against the most recent strains. This year's supply of shots is already being sent out to clinics and doctor's offices across Canada. But experts say it's beginning to appear that this year's vaccine may have two relative mismatches -- two viruses have been changing and may no longer match the viruses contained in this year's vaccine. And because it takes at least six months to manufacture the vaccines, it's far too late to change them. This year, scientists picked these three strains: Influenza A - Solomon Islands/3/2006 (H1N1)-like Influenza A - Wisconsin/67/2005 (H3N2)-like Influenza B - Malaysia/2506/2004-like antigenThe Wisconsin strain, says the Public Health Agency of Canada, has already mutated into a different form than the one used for the vaccine, and the Malaysia strain shows signs of changing too. "There is an inherent vulnerability in trying to develop a vaccine now for what might happen six months from now when flu season starts," says infectious disease specialist Dr. Neil Rau. "And with a strain mutating or gradually mutating, sometimes the guess is good, sometimes the guess is sub-optimal and sometimes it's bad.The process of making the vaccination is something of an educated guess based on what happened in the southern hemisphere during the preceding season." No one knows how severe this year's flu season will be but Rau says it's theoretically possible the mismatch could result in more flu illnesses and hospitalizations. "The worst case scenario with a bad match situation would be lot of disease in the elderly, manifesting in nursing home and cruise ships outbreaks, and with children you might see a lot of absenteeism and therefore a lot of parents off work as a result trying to care for them," he says. Flu bug 'drift' speeding upBut other experts say these viral drifts are not unusual and happen on a regular basis because of the dynamic nature of the flu virus. They also note that in the past five years, the flu bugs have been drifting faster, though no one is sure why. "We have noticed that there have been, certainly in one of the influenza A subtypes more recently, more frequent or rapid change in the virus, more rapid evolution," says Danuta Skowronski of the epidemiology services branch of the B.C. Centre for Disease Control. "Having said that, though, that more rapid evolution has not been associated with more severe or intense outbreaks, so how meaningful that is ultimately is uncertain.It certainly makes it more difficult in terms of keeping pace with the changes in the vaccine to match those changes in the virus," she says. "But in terms of overall illness impact in the community, we have not seen that that has increased." No drug or vaccine is ever 100 per cent effective and this year's vaccine won't be a perfect match either. But scientists point out that the antibodies the vaccine helps produce will offer some immunity over whatever strains do arrive. "In recent seasons, even where there has been a vaccine mismatch, the vaccine can afford 40-50 per cent protection," says Dr. Theresa Tam of the Public Health Agency of Canada. And some protection is better than none, especially for the elderly, she says, for whom the flu can actually be fatal. "Even if it doesn't protect you from actually getting it, it can reduce the severity of the illness and complications," she notes. That's why public health experts say, despite the complex science of tracking drifting strains, the flu vaccine is still the best protection against a tricky disease.Influenza and pneumonia killed 4,725 Canadians in 2002, the last year for which detailed statistics are available, according to Statistics Canada. Health Canada estimates that 700 to 2,500 deaths a year may be attributable to influenza. The National Advisory Committee on Immunization recommends that everyone over the age of six months be vaccinated against the flu.With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip

Annual Flu Shots May Be of Little Benefit to the Elderly

Medscape TodaySeptember 26, 2007by Laurie Barclay, MDClick here for the URL:

The elderly may receive little to no benefit from annual influenza vaccinations, according to a review of current evidence study reported in the October issue of Lancet Infectious Diseases. "Influenza vaccination policy in most high-income countries attempts to reduce the mortality burden of influenza by targeting people aged at least 65 years for vaccination," write Lone Simonsen, from George Washington University in Washington, DC, and colleagues. "However, the effectiveness of this strategy is under debate. Although placebo-controlled randomised trials show influenza vaccine is effective in younger adults, few trials have included elderly people, and especially those aged at least 70 years."Nearly every year, winter influenza epidemics in the United States affect approximately 5% to 20% of the population, causing about 300,000 hospitalizations and 36,000 deaths. People aged 65 years and older account for up to 90% of all influenza-related deaths.In most high-income countries, one of the strategies of vaccination policy against influenza is to target people 65 years of age and older in hopes of decreasing the mortality burden of influenza. However, the apparent benefits of this strategy may have been exaggerated by frailty selection bias, in which healthier elderly are vaccinated more often than frail elderly, as well as by the use of all-cause mortality and other nonspecific trial endpoints.When these factors are considered, the authors suggest that the remaining evidence base is at present insufficient to determine the magnitude of the mortality benefit, if any, that influenza vaccination offers the elderly.Few trials demonstrating the efficacy of influenza vaccination have included elderly people, but those that have done so have indicated that clinical benefits and antibody responses decrease as age increases for individuals older than 70 years.In 1960, US policy began targeting influenza vaccination at individuals at high risk for poor outcomes by virtue of chronic comorbid conditions and/or advanced age. Other high-income countries have followed suit, and the World Health Organization has endorsed these policies. From 1980 to the present, vaccination coverage increased from 15% to 65%, but recent excess mortality studies have not documented a corresponding decrease in influenza- related mortality. "Paradoxically, whereas those studies attribute about 5% of all winter deaths to influenza, many cohort studies report a 50% reduction in the total risk of death in winter - a benefit ten times greater than the estimated influenza mortality burden," the authors write. "New studies, however, have shown substantial unadjusted selection bias in previous cohort studies."This review includes a suggested analytical approach to identify this type of residual bias, which should help elucidate what mortality benefits can and cannot reasonably be expected from influenza vaccination. The authors recommend use of more specific endpoints in future trials. For example, vaccine effectiveness should be measured against laboratory- confirmed influenza virus. This highly specific outcome would yield more reliable estimates of vaccine efficacy, thereby justifying higher costs and labor involved in its measurement. In addition, use of actual virus surveillance data, and not the arbitrary 4-month period used at present, would help identify each seasonal epidemic period. Although performing randomized controlled trials may seem ethically problematic, the authors suggest that such evidence is sorely needed.Recognizing that the aged immune system may not efficiently respond to influenza vaccination should facilitate development of other options for influenza control, such as more immunogenic vaccines or larger doses of vaccine to be used in the elderly, a combination of live and killed vaccine formulations, more aggressive use of antivirals for treatment and prophylaxis, and indirect protection via increased vaccination of transmitter populations. Ongoing evaluation would need to determine the effectiveness of such approaches."While awaiting an improved evidence base for influenza vaccine mortality benefits in elderly people, we suggest that this group should continue to be vaccinated against influenza," the authors conclude. "Influenza causes many deaths each year, and even a partly effective vaccine would be better than no vaccine at all. But the evidence base concerning influenza vaccine benefits in elderly people does need to be strengthened."The authors report no relevant financial relationships. Dr. Taylor worked on this paper under a contract between National Institute of Allergy and Infectious Diseases and LTS Corporation in Bethesda, Maryland.In an accompanying Comment, Tom Jefferson and Carlo Di Pietrantonj, from Cochrane Vaccines Field in Alessandria, Italy, discuss future options to resolve the present uncertainty regarding the efficacy of influenza vaccination in the elderly."Simonsen and colleagues suggest that refocusing on the likely complications of immune senescence would require vigorous pursuit of other options," Dr. Jefferson and Dr. Di Pietrantonj write. "They also confront the ultimate taboo that drew so much scorn in the evidence overview: doing randomised trials in elderly people to settle the issue conclusively. That suggestion, which seems to fly in the face of current policies, is in our opinion the only ethical and scientific way to have a definitive answer to the question of whether or not current influenza vaccines protect elderly people."Dr. Jefferson has received consultancy fees from Sanofi Synthelabo and Roche. Dr. Di Pietrantonj reports no relevant financial relationships.Lancet Infect Dis. 2007;7:658-666.