This was a really crappy season. The system for developing flu viruses is the best we’ve got, but it’s imperfect. This year, we had significant mismatch between the vaccine and the circulating strains.
According to the CDC, this season peaked in mid-February, and was “moderately severe”—and the worst season in four years.
Improving our system of flu prevention will take lots of work, including epidemiology, basic science, and front-line medicine.
A lousy flu season not only causes suffering and death, but also fuels denialits, who sit at their keyboards drooling at the prospect of pointing out vaccine failures. Most arguments center around the tu quoque fallacy: “maybe my vaccine lunacy is useless, but look, you made a big boo-boo this year.” The problem with this reasoning is that in the final analysis, vaccines always do far more good than harm.
Some critics (OK, one obsessive-compulsive commenter) bring up outbreaks of vaccine-related polio in Nigeria and India. This is an example of imcomplete knowledge. The response to a vaccine-related polio outbreak is the same as a natural outbreak—mass vaccination.
As I’ve told you before, there are two types of polio vaccine: IPV and OPV. Both have certain advantages and disadvantages. The OPV (oral polio vaccine) is a live virus, but usually does not cause disease. The disadvantage is that rarely it can cause human disease. The advantage is that if you give it to several children in a rural village, it will be passed to the rest of the village via contaminated drinking water—the same way that wild-type poliovirus is spread. Kids take the vaccine and poop out the virus. Poor sewerage takes the vaccine to the water supply, and the villagers drink it. Mass vaccination then occurs passively. In the U.S., this has been phased out. One of the reasons for this is the large number of immunosuppressed people in this country—those undergoing chemotherapy, etc. They are the ones most at risk for having problems with the live oral vaccine.
The other polio vaccine is the IPV, which is an inactivated virus that is injected. This confers immunity, and avoids the problems of the live vaccine. What it doesn’t do is passively immunize others like the OPV.
The usual effective response to an outbreak of vaccine-preventable disease is to create a wide area of vaccination around the center of the outbreak. This has been very effective. The correct response is not to throw your hands in the air and say, “I guess vaccines don’t work, let’s give up.”
One of the basic problems with the anti-vaccine crowd is that they offer no real solutions. Vaccines have been found in study after study to prevent death and debility from many different illnesses. Since denialists don’t have the data on their side, they like to simply point at the problems with current vaccines, without offering solutions.
If they really wanted to help, denialists could get an education and join the fight. Help us find ways of improving our methods of developing and delivering flu vaccines.
But quit yer whining.
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