Flu Vaccine For Everyone: When the Science Contradicts the Science - Page 9

Skeptic Ginger · 2nd March 2013, 04:54 PM

Originally Posted by Dymanic

Hmm. Well there's this (which I will admit up front to not having read in detail):

"Mar 1, 2013 (CIDRAP News) – Experts are puzzled by a new study in which influenza vaccination seemed to provide little or no protection against flu in the 2010-11 season—and in which the only participants who seemed to benefit from the vaccine were those who hadn't been vaccinated the season before."

http://www.cidrap.umn.edu/cidrap/con...13vestudy.html

Troubling. The first thing that pops into my head is "original antigenic sin" -- a notion I seem to recall having argued with some vigor against; at least against the idea of it being a very common occurrance. (I've never known Kelly to be the sort of person to gloat, but it looks as though she may have earned that right in this case, whether she choses to use it or not.)

Seems like the more I learn about flu, the less I know for sure.

If by "original antigenic sin" you mean the thing which occurs with Dengue virus, it's fairly well known and specific to certain kinds of virus-antibody interactions.

antibody-dependent enhancement

It's been proposed in influenza, but I wouldn't go jumping on the anti-flu vaccine bandwagon just yet. Influenza virus antibody is no-doubt prevalent in the entire human population over the age of 5. You'd need to show that somehow the vaccine antibody was more harmful than naturally acquired antibody.

Antibody-Dependent Enhancement (ADE) of infection and its possible role in the pathogenesis of influenza

Quote:

ADE occurs when non-neutralised virus-antibody complexes find alternative receptors and routes entry into the cell via the Fc-receptor pathway. ADE has been demonstrated predominantly in macrophages or Fc-receptor bearing cells although other types of cells have also been occasionally implicated (1,2). Thus, viruses may find routes of entry to cells lacking the usual virus receptor. Alternatively, the innate immune signals triggered by virus infection via the FcR pathway may be different to those triggered by entry via the physiological virus receptor. Both these consequences may have implications for virus tropism and pathogenesis. Recently there have been reports of increased infection rates by pandemic influenza H1N1 virus following receipt of seasonal flu vaccination (3,4). ADE has been proposed as one mechanism. Here we illustrate the possible role played by humoral immunity in providing Influenza A viruses an opportunity to better infect immune cells.

Natural infection and the attenuated vaccine induced antibodies that enhanced uptake of homologous virus and H1N1 virus isolated several years later It's like saying no one should get varicella vaccine because they might be deferring varicella and then getting it at a riskier age. That's great it you weren't one of the kids that had severe varicella in childhood.

What it all means for this season's flu vaccine remains to be seen.

Dymanic · 3rd March 2013, 02:59 AM

Originally Posted by Skeptic Ginger

If by "original antigenic sin" you mean the thing which occurs with Dengue virus...

At present, I'm actually more interested in that thing that occurs (or, as you say, has been proposed to occur) with influenza. "The experts are puzzled", and I don't have anything that can trump that. All I said was that it was the first thing that popped into my mind.

Quote:

I wouldn't go jumping on the anti-flu vaccine bandwagon just yet.

I would regard that bizarre non-sequitur as rather surprising if it were coming from anyone but you.

Quote:

You'd need to show that somehow the vaccine antibody was more harmful than naturally acquired antibody.

Would I?

In the first place, you will not find a single post I've ever made in the decade I've been posting here in which I have even come close to suggesting that vaccine antibody is "harmful". Your attempts to paint me with that brush are just the usual SG crap, which is why I've come to view it as largely a waste of time to even try to discuss this sort of thing with you. In the second place, if you understood the concept of original antigenic sin (or even read and understood the paragraph you just posted), you'd know that the source of the antigen is irrelevant; nothing says it could not occur in a person who has never received a single vaccine.

kellyb · 3rd March 2013, 03:21 AM

Almost everything I know about original antigenic sin comes from pertussis.

Like:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1082800/

Estellea · 3rd March 2013, 05:41 AM

Originally Posted by Skeptic Ginger

If by "original antigenic sin" you mean the thing which occurs with Dengue virus, it's fairly well known and specific to certain kinds of virus-antibody interactions.

antibody-dependent enhancement

It's been proposed in influenza, but I wouldn't go jumping on the anti-flu vaccine bandwagon just yet. Influenza virus antibody is no-doubt prevalent in the entire human population over the age of 5. You'd need to show that somehow the vaccine antibody was more harmful than naturally acquired antibody.

Antibody-Dependent Enhancement (ADE) of infection and its possible role in the pathogenesis of influenza

Natural infection and the attenuated vaccine induced antibodies that enhanced uptake of homologous virus and H1N1 virus isolated several years later It's like saying no one should get varicella vaccine because they might be deferring varicella and then getting it at a riskier age. That's great it you weren't one of the kids that had severe varicella in childhood.

What it all means for this season's flu vaccine remains to be seen.

It's a shame that you don't grasp what your own citations say and aren't curious about what Dymanic posted. Instead you just find ways to dig your heels in. Given your earlier question of why, if the flu vaccine is effective in healthy adults, shouldn't a reduction in hospitalisations and mortality be detected, I would think that at least a dim bulb would come on with this recent CIDRAP report.

Este

Perpetual Student · 3rd March 2013, 09:09 PM

Originally Posted by Estellea

It's a shame that you don't grasp what your own citations say and aren't curious about what Dymanic posted. Instead you just find ways to dig your heels in. Given your earlier question of why, if the flu vaccine is effective in healthy adults, shouldn't a reduction in hospitalisations and mortality be detected, I would think that at least a dim bulb would come on with this recent CIDRAP report.

Este

It's a shame that your own "bulb" has a broken filament, apparently preventing you from simply discussing the science and abandoning irrelevant personal comments.
Enough!

Skeptiquette · 3rd March 2013, 10:38 PM

Hi SkepticGinger,
Could you clear up a couple things from your opening post for me?

First, you write:

Quote:

From my perspective, when you have two discrepant data sources (lots of published research and several relevant Cochrane Reviews) it's wise to look for the reason for the discrepancy.

It doesn’t make sense that these are two data sources. Isn’t a Cochrane review a meta-analysis of the “lots of published research” and therefore this is just one data source?

I think the discrepancy is between the conclusion of the Cochrane reviewers and the conclusion of some other entity that has reviewed the relevant data. Is this correct?

Quote:

It's not wise to assume the Reviews are superior because RCTs are the gold standard for medical research

I don’t follow this either, maybe you could briefly overview how a Cochrane review is performed, do they only look at RCT’s? It’s not wise to assume the conclusions of the reviews are superior to what? The conclusions that some other entity has arrived at?

If you are trying to get to the bottom of why conclusions of reviews are discrepant and why one may be superior over the other then you have to start by looking at the methodology of the review. Has this been done in the thread already?

Then it comes down to: 1) was the methodology sound? If yes, then (2) were the conclusions in line with the evidence?

What is the methodology of the Cochrane review that you are criticizing?

And What specific criticisms do you have with the way the review was performed?

Quote:

or that the benefit only shows up because drug companies fund the studies (a lot of the studies are done in collaboration with universities and HMOs like Kaiser and Group Health, they aren't all direct drug company research).

Do the Cochrane reviewers discount a study if the results are positive and the study is funded by a pharmaceutical company?

Quote:

And it's not wise to ignore the potential for confirmation bias either.

Who would have more potential for confirmation bias? The review team using a strict methodology or the individual entity that has reviewed the relevant data over the years?

Estellea · 4th March 2013, 04:31 AM

Originally Posted by Perpetual Student

It's a shame that your own "bulb" has a broken filament, apparently preventing you from simply discussing the science and abandoning irrelevant personal comments.
Enough!

Given that SG refuses to read the Cochrane Reviews which she has stated are incorrect, doesn't read/understand her own citations, ignores relevant questions and "the science" presented, attempts to distract and paint others as CT'ers, and pretends she's an authority on all matters she choses, I'd say your tone-trolling is rather misdirected.

Este

2nd March 2013, 04:54 PM	#321
Skeptic Ginger formerly skeptigirl Join Date: Feb 2005 Location: Shifting through paradigms Posts: 40,646	Originally Posted by Dymanic Hmm. Well there's this (which I will admit up front to not having read in detail): "Mar 1, 2013 (CIDRAP News) – Experts are puzzled by a new study in which influenza vaccination seemed to provide little or no protection against flu in the 2010-11 season—and in which the only participants who seemed to benefit from the vaccine were those who hadn't been vaccinated the season before." http://www.cidrap.umn.edu/cidrap/con...13vestudy.html Troubling. The first thing that pops into my head is "original antigenic sin" -- a notion I seem to recall having argued with some vigor against; at least against the idea of it being a very common occurrance. (I've never known Kelly to be the sort of person to gloat, but it looks as though she may have earned that right in this case, whether she choses to use it or not.) Seems like the more I learn about flu, the less I know for sure. If by "original antigenic sin" you mean the thing which occurs with Dengue virus, it's fairly well known and specific to certain kinds of virus-antibody interactions. antibody-dependent enhancement It's been proposed in influenza, but I wouldn't go jumping on the anti-flu vaccine bandwagon just yet. Influenza virus antibody is no-doubt prevalent in the entire human population over the age of 5. You'd need to show that somehow the vaccine antibody was more harmful than naturally acquired antibody. Antibody-Dependent Enhancement (ADE) of infection and its possible role in the pathogenesis of influenza Quote: ADE occurs when non-neutralised virus-antibody complexes find alternative receptors and routes entry into the cell via the Fc-receptor pathway. ADE has been demonstrated predominantly in macrophages or Fc-receptor bearing cells although other types of cells have also been occasionally implicated (1,2). Thus, viruses may find routes of entry to cells lacking the usual virus receptor. Alternatively, the innate immune signals triggered by virus infection via the FcR pathway may be different to those triggered by entry via the physiological virus receptor. Both these consequences may have implications for virus tropism and pathogenesis. Recently there have been reports of increased infection rates by pandemic influenza H1N1 virus following receipt of seasonal flu vaccination (3,4). ADE has been proposed as one mechanism. Here we illustrate the possible role played by humoral immunity in providing Influenza A viruses an opportunity to better infect immune cells. Natural infection and the attenuated vaccine induced antibodies that enhanced uptake of homologous virus and H1N1 virus isolated several years later It's like saying no one should get varicella vaccine because they might be deferring varicella and then getting it at a riskier age. That's great it you weren't one of the kids that had severe varicella in childhood. What it all means for this season's flu vaccine remains to be seen.
	__________________ (*Tired of continuing to hear the "Democrat Party" repeatedly I've decided to adopt the name, ~~Pubbie Party, Repubs~~ "Republics" and Republic Party in response.)

3rd March 2013, 02:59 AM	#322
Dymanic Illuminator Join Date: Sep 2002 Posts: 4,739	Originally Posted by Skeptic Ginger If by "original antigenic sin" you mean the thing which occurs with Dengue virus... At present, I'm actually more interested in that thing that occurs (or, as you say, has been proposed to occur) with influenza. "The experts are puzzled", and I don't have anything that can trump that. All I said was that it was the first thing that popped into my mind. Quote: I wouldn't go jumping on the anti-flu vaccine bandwagon just yet. I would regard that bizarre non-sequitur as rather surprising if it were coming from anyone but you. Quote: You'd need to show that somehow the vaccine antibody was more harmful than naturally acquired antibody. Would I? In the first place, you will not find a single post I've ever made in the decade I've been posting here in which I have even come close to suggesting that vaccine antibody is "harmful". Your attempts to paint me with that brush are just the usual SG crap, which is why I've come to view it as largely a waste of time to even try to discuss this sort of thing with you. In the second place, if you understood the concept of original antigenic sin (or even read and understood the paragraph you just posted), you'd know that the source of the antigen is irrelevant; nothing says it could not occur in a person who has never received a single vaccine.
Dymanic Illuminator Join Date: Sep 2002 Posts: 4,739

3rd March 2013, 03:21 AM	#323
kellyb Illuminator Join Date: Jan 2006 Location: Tennessee. Ain't you jealous? Posts: 4,417	Almost everything I know about original antigenic sin comes from pertussis. Like: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1082800/
	__________________ The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts ~ Bertrand Russell

3rd March 2013, 09:09 PM	#325
Perpetual Student Illuminator Join Date: Jul 2008 Location: USA Posts: 3,707	Originally Posted by Estellea It's a shame that you don't grasp what your own citations say and aren't curious about what Dymanic posted. Instead you just find ways to dig your heels in. Given your earlier question of why, if the flu vaccine is effective in healthy adults, shouldn't a reduction in hospitalisations and mortality be detected, I would think that at least a dim bulb would come on with this recent CIDRAP report. Este It's a shame that your own "bulb" has a broken filament, apparently preventing you from simply discussing the science and abandoning irrelevant personal comments. Enough!
	__________________ _{It doesn't matter how beautiful your theory is, it doesn't matter how smart you are. If it doesn't agree with experiment, it's wrong. - Richard P. Feynman} ξ

3rd March 2013, 10:38 PM	#326
Skeptiquette Scholar Join Date: Feb 2009 Posts: 98	Hi SkepticGinger, Could you clear up a couple things from your opening post for me? First, you write: Quote: From my perspective, when you have two discrepant data sources (lots of published research and several relevant Cochrane Reviews) it's wise to look for the reason for the discrepancy. It doesn’t make sense that these are two data sources. Isn’t a Cochrane review a meta-analysis of the “lots of published research” and therefore this is just one data source? I think the discrepancy is between the conclusion of the Cochrane reviewers and the conclusion of some other entity that has reviewed the relevant data. Is this correct? Quote: It's not wise to assume the Reviews are superior because RCTs are the gold standard for medical research I don’t follow this either, maybe you could briefly overview how a Cochrane review is performed, do they only look at RCT’s? It’s not wise to assume the conclusions of the reviews are superior to what? The conclusions that some other entity has arrived at? If you are trying to get to the bottom of why conclusions of reviews are discrepant and why one may be superior over the other then you have to start by looking at the methodology of the review. Has this been done in the thread already? Then it comes down to: 1) was the methodology sound? If yes, then (2) were the conclusions in line with the evidence? What is the methodology of the Cochrane review that you are criticizing? And What specific criticisms do you have with the way the review was performed? Quote: or that the benefit only shows up because drug companies fund the studies (a lot of the studies are done in collaboration with universities and HMOs like Kaiser and Group Health, they aren't all direct drug company research). Do the Cochrane reviewers discount a study if the results are positive and the study is funded by a pharmaceutical company? Quote: And it's not wise to ignore the potential for confirmation bias either. Who would have more potential for confirmation bias? The review team using a strict methodology or the individual entity that has reviewed the relevant data over the years?
Skeptiquette Scholar Join Date: Feb 2009 Posts: 98

3rd March 2013, 05:41 AM	#324
Estellea Graduate Poster Join Date: Mar 2009 Posts: 1,120	Originally Posted by Skeptic Ginger If by "original antigenic sin" you mean the thing which occurs with Dengue virus, it's fairly well known and specific to certain kinds of virus-antibody interactions. antibody-dependent enhancement It's been proposed in influenza, but I wouldn't go jumping on the anti-flu vaccine bandwagon just yet. Influenza virus antibody is no-doubt prevalent in the entire human population over the age of 5. You'd need to show that somehow the vaccine antibody was more harmful than naturally acquired antibody. Antibody-Dependent Enhancement (ADE) of infection and its possible role in the pathogenesis of influenza Natural infection and the attenuated vaccine induced antibodies that enhanced uptake of homologous virus and H1N1 virus isolated several years later It's like saying no one should get varicella vaccine because they might be deferring varicella and then getting it at a riskier age. That's great it you weren't one of the kids that had severe varicella in childhood. What it all means for this season's flu vaccine remains to be seen. It's a shame that you don't grasp what your own citations say and aren't curious about what Dymanic posted. Instead you just find ways to dig your heels in. Given your earlier question of why, if the flu vaccine is effective in healthy adults, shouldn't a reduction in hospitalisations and mortality be detected, I would think that at least a dim bulb would come on with this recent CIDRAP report. Este

4th March 2013, 04:31 AM	#327
Estellea Graduate Poster Join Date: Mar 2009 Posts: 1,120	Originally Posted by Perpetual Student It's a shame that your own "bulb" has a broken filament, apparently preventing you from simply discussing the science and abandoning irrelevant personal comments. Enough! Given that SG refuses to read the Cochrane Reviews which she has stated are incorrect, doesn't read/understand her own citations, ignores relevant questions and "the science" presented, attempts to distract and paint others as CT'ers, and pretends she's an authority on all matters she choses, I'd say your tone-trolling is rather misdirected. Este