Do antivirals and the flu-vaccine even work? • Hacker News Board

Re: Do antivirals and the flu-vaccine even work?

#11

Post by Locke1689 » Sun, Oct 25, 2009, 5:51 AM UTC

dazzawazza wrote: post #5

I've read some evidence that people who are more likely to die from flu are less likely to get vaccinated for flu thus the vaccinated population 'looks' healthier. Worst this means that flu vaccines are bogus (not likely, we're quite good at creating vaccines and they work in labs) and best it means they are a HUGE waste of time and money (a bit more likely but you can level that argument at most things we routinely…

Uh, what? At worst, that's indicative of nothing, not affirmation of the negative hypothesis.

Think of it this way: if you are healthy, you are more likely to get the flu vaccine and less likely to die of any reason. If you are unhealthy, you are less likely to get the flu vaccine and more likely to die of any reason. Notice that neither of these statements say the following, "Patients who receive the flu vaccine are [more/less] likely to die of the flu then they would have been." Instead, it simply makes the statement that you cannot treat statistics as affirmation of flu effectiveness.

Re: Do antivirals and the flu-vaccine even work?

#12

Post by systemtrigger » Sun, Oct 25, 2009, 6:05 AM UTC

According to the article, the researcher who "knows the flu-vaccine literature better than anyone else on the planet" calls the vast majority of studies "deeply flawed" and "rubbish." Only four studies were properly designed to pin down the effectiveness of flu vaccine, he says, and two of those showed that it might be effective in certain groups of patients, such as school-age children with no underlying health issues like asthma; the other two showed equivocal results or no benefit.

Re: Do antivirals and the flu-vaccine even work?

#13

Post by fauigerzigerk » Sun, Oct 25, 2009, 10:02 AM UTC

hanuman wrote: post #2

Oh, please. http://scienceblogs.com/effectmeasure/2009/10/journalists_si...

I'm surprised how controversial it is to demand placebo trials. The whole thing about ethics is ridiculous as the participants could be told about the uncertainties, about the majority and the minority views.

It shouldn't be hard to find enough educated people to volunteer in the interest of the billions potentially affected by the flu.

Re: Do antivirals and the flu-vaccine even work?

#14

Post by gojomo » Sun, Oct 25, 2009, 10:19 AM UTC

gloob wrote: post #10

dylanz wrote: post #8

I'll let you know. Neither I or my kids are vaccinated.

If you aren't vaccinated, then nothing that happens to you says anything about the effectiveness or the lack thereof of the vaccine.

Dylanz personal experience alone isn't helpful, true, but what happens to the unvaccinated as a group -- the control group compared to the vaccinated -- is absolutely significant to determining the vaccine's effectiveness.

Re: Do antivirals and the flu-vaccine even work?

#15

Post by ikitat » Sun, Oct 25, 2009, 3:51 PM UTC

fauigerzigerk wrote: post #13

hanuman wrote: post #2

Oh, please. http://scienceblogs.com/effectmeasure/2009/10/journalists_si...

I'm surprised how controversial it is to demand placebo trials. The whole thing about ethics is ridiculous as the participants could be told about the uncertainties, about the majority and the minority views. It shouldn't be hard to find enough educated people to volunteer in the interest of the billions potentially affected by the flu.

Ethics are not ridiculous. Randomized placebo controlled double-blinded studies have the potential to cause harm to humans.

A fantastic post on the issue can be found here http://www.sciencebasedmedicine.org/?p=467

Re: Do antivirals and the flu-vaccine even work?

#16

Post by fauigerzigerk » Sun, Oct 25, 2009, 5:03 PM UTC

ikitat wrote: post #15

fauigerzigerk wrote: post #13

Earlier quoted context omitted.

I'm surprised how controversial it is to demand placebo trials. The whole thing about ethics is ridiculous as the participants could be told about the uncertainties, about the majority and the minority views. It shouldn't be hard to find enough educated people to volunteer in the interest of the billions potentially affected by the flu.

Ethics are not ridiculous. Randomized placebo controlled double-blinded studies have the potential to cause harm to humans. A fantastic post on the issue can be found here http://www.sciencebasedmedicine.org/?p=467

Well, let's keep things in perspective. We're talking about the ethics of asking some 1000 volunteers _not_ to get a flu jab in one winter. ([edit] not about nazi death camps as the article you posted does)

And I think it is ridiculously un-ethical to vaccinate hundereds of millions of people with a vaccine that has never been tested properly (and I mean the seasonal flu, not the exceptional swine flu situation). These people go out and take risks that may cost them their lives because they have a false sense of safety.

Re: Do antivirals and the flu-vaccine even work?

#17

Post by ikitat » Sun, Oct 25, 2009, 5:21 PM UTC

fauigerzigerk wrote: post #16

ikitat wrote: post #15

Earlier quoted context omitted.

Ethics are not ridiculous. Randomized placebo controlled double-blinded studies have the potential to cause harm to humans. A fantastic post on the issue can be found here http://www.sciencebasedmedicine.org/?p=467

Well, let's keep things in perspective. We're talking about the ethics of asking some 1000 volunteers _not_ to get a flu jab in one winter. ([edit] not about nazi death camps as the article you posted does) And I think it is ridiculously un-ethical to vaccinate hundereds of millions of people with a vaccine that has never been tested properly (and I mean the seasonal flu, not the exceptional swine flu situation). The…

Did you read the article? The ethical issue is the fact that you are _not_ preventing a vaccine preventable disease.

What information do you have that the flu vaccine is not tested properly?

edit to your edit: You clearly didn't read the post I linked to above if you think it's about nazi death camps above the ethical considerations of randomized, placebo controlled, double blinded studies.

Re: Do antivirals and the flu-vaccine even work?

#18

Post by fauigerzigerk » Sun, Oct 25, 2009, 5:32 PM UTC

ikitat wrote: post #17

fauigerzigerk wrote: post #16

Earlier quoted context omitted.

Well, let's keep things in perspective. We're talking about the ethics of asking some 1000 volunteers _not_ to get a flu jab in one winter. ([edit] not about nazi death camps as the article you posted does) And I think it is ridiculously un-ethical to vaccinate hundereds of millions of people with a vaccine that has never been tested properly (and I mean the seasonal flu, not the exceptional swine flu situation). The…

Did you read the article? The ethical issue is the fact that you are _not_ preventing a vaccine preventable disease. What information do you have that the flu vaccine is not tested properly? edit to your edit: You clearly didn't read the post I linked to above if you think it's about nazi death camps above the ethical considerations of randomized, placebo controlled, double blinded studies.

Look, I don't doubt that there are difficult ethical situations. But the flu situation is not one of them. The danger of not getting a flu jab just isn't severe enough to throw Dr. Mengele into the debate.

And to answer your question, I gather that seasonal flu vaccines have never been tested using a controlled, randomized, double-blind study. If that is not the case, then what are we talking about?

And I fail to see how it can be an ethical problem not to use a vaccine of which we don't know whether it prevents anything or not.

Re: Do antivirals and the flu-vaccine even work?

#19

Post by ikitat » Sun, Oct 25, 2009, 5:55 PM UTC

fauigerzigerk wrote: post #18

ikitat wrote: post #17

Earlier quoted context omitted.

Did you read the article? The ethical issue is the fact that you are _not_ preventing a vaccine preventable disease. What information do you have that the flu vaccine is not tested properly? edit to your edit: You clearly didn't read the post I linked to above if you think it's about nazi death camps above the ethical considerations of randomized, placebo controlled, double blinded studies.

Look, I don't doubt that there are difficult ethical situations. But the flu situation is not one of them. The danger of not getting a flu jab just isn't severe enough to throw Dr. Mengele into the debate. And to answer your question, I gather that seasonal flu vaccines have never been tested using a controlled, randomized, double-blind study. If that is not the case, then what are we talking about? And I fail to see…

Perhaps an analogy would help:

Most car accidents don't kill people.

Seat belts have been proven as an effective defense against injury and death in automobile accidents.

It would be unethical to perform a study in which you ask humans to undergo a car accident without a seatbelt.

Anyway, that's how I understand it. I guess you could read up on the Tuskegee syphilis experiment, Belemont Report, Declaration of Helsinki and Nuremburg Code to learn more.

Re: Do antivirals and the flu-vaccine even work?

#20

Post by fauigerzigerk » Sun, Oct 25, 2009, 6:47 PM UTC

ikitat wrote: post #19

fauigerzigerk wrote: post #18

Earlier quoted context omitted.

Look, I don't doubt that there are difficult ethical situations. But the flu situation is not one of them. The danger of not getting a flu jab just isn't severe enough to throw Dr. Mengele into the debate. And to answer your question, I gather that seasonal flu vaccines have never been tested using a controlled, randomized, double-blind study. If that is not the case, then what are we talking about? And I fail to see…

Perhaps an analogy would help: Most car accidents don't kill people. Seat belts have been proven as an effective defense against injury and death in automobile accidents. It would be unethical to perform a study in which you ask humans to undergo a car accident without a seatbelt. Anyway, that's how I understand it. I guess you could read up on the Tuskegee syphilis experiment, Belemont Report, Declaration of Helsink…

Making people not use something that is proven to prevent death and injury is unethical.

Making people not use something that is _not_ proven to prevent death and injury is _not_ unethical.

None of your examples for unethical procedures have any similarity with that second situation. The syphilis sufferers were not treated with penicillin even though it was proven to be effective. The nazis used prisoners, not well informed volunteers.

And your car accident analogy involves making people have accidents that they would not otherwise have, not using preventive measures proven to work. We're not talking about infecting people with the flu, are we?