Insane people are doing big things these days.
RFK Jr. cancels flu vaccine meetings
- Thread starter FAUlty Gator
- Start date
"Cancelling a critically important Food and Drug Administration meeting that is vital to the development of effective vaccines for the next flu season is irresponsible, ignores science and shows a lack of concern for the protection of the public from this potentially severe disease." (Dr. Tina Tan)
Considering how effective flu vaccines have been historically, I have a solution.
Write down each of the possible flu strains on a separate ball, put them in a box then let a monkey pull the appropriate number out.
You want a 3-strain blend this year then let the monkey pull 3 balls. Problem solved.
Considering how effective flu vaccines have been historically, I have a solution.
Write down each of the possible flu strains on a separate ball, put them in a box then let a monkey pull the appropriate number out.
You want a 3-strain blend this year then let the monkey pull 3 balls. Problem solved.
This is effectively how the decision has been made in years past. They guess. More efficient to let everyone cast their vote using a surveymonkey!
Flu vaccine is over-hyped and quite ineffective. 🤷♂️
PRESENTEEISM
Presenteeism is defined as working while ill. This is a problem across many industries, but it has particular impact in healthcare because infected workers may transmit infection to patients who have multiple comorbidities, are immunosuppressed, and/ or are at risk of severe complications. Two recent studies demonstrate the high prevalence of presenteeism. In a national study of approximately 2000 healthcare workers, 41% of those experiencing ILI reported working while ill [4]. Presenteeism was 63% for physicians and 47% for nurses. Another study conducted in a major tertiary care medical center, which surveyed healthcare workers caring for hospitalized internal medicine and transplant patients, found that presenteeism was 92% in those with ILI [5]. Despite high rates of presenteeism, hospital infection prevention programs put little emphasis on keeping ill employees from work, instead basing their influenza prevention efforts primarily on attempting to achieve high rates of compliance with vaccination.
One driver of presenteeism is paid time off. This is an increasingly common human resource practice in which a bank of
combined leave time is used for personal days, sick days, and vacation. For some employees, a perverse incentive exists to work while ill to avoid using time off so that vacation time can be maximized [6]. More importantly, particularly for physicians, are strong professionalism forces (ie, feelings of obligations to patients and colleagues) that compel attendance when ill. In a survey of physicians and advanced practice clinicians at a large academic children’s hospital, 83% reported working while ill in the past year, despite 95% reporting that this put patients at risk [7]. Over 90% of respondents worked while ill because they did not want to let their colleagues or their patients down.
INFLUENZA VACCINE
The influenza vaccine has been approved and available since the mid-1940s. Approximately 60% of adults in the United States receive the vaccine yearly [8]. It is very safe. The only significant adverse effects are allergic reactions, primarily in persons allergic to eggs, and a possible association with Guillain-Barré Syndrome, occurring at a rate of 1–2 additional cases per million vaccinations [9].
The influenza vaccine is modestly effective. The mean effectiveness over the most recent 14 consecutive influenza seasons beginning in 2004–2005 was 41% (range, 10%–60%; Figure 1) [10]. This stands in sharp contrast to effectiveness rates for other commonly used vaccines in clinical practice, many of which exceed 90%. A large meta-analysis of influenza vaccine effectiveness evaluated placebo (or no intervention) controlled randomized trials and quasi-randomized trials in healthy adults (ages 16 to 65 years old). This analysis included 52 studies with 80 000 subjects. The relative risk reduction for influenza infection associated with influenza vaccine was 59%. However, the absolute risk reduction was only 1.4% (2.3% infected among unvaccinated persons versus 0.9% infected among vaccinated). Moreover, this study also found no significant effect of vaccination on working days lost or hospitalization [11]. In the healthcare setting, the direct effect of vaccination is reduction of influenza rates in healthcare workers. The indirect effect is the reduction of influenza rates in patients due to vaccinating healthcare workers. Two meta-analyses evaluating the impact of influenza vaccination of healthcare workers on outcomes in patients have been published. Both studies evaluated the same 4 cluster randomized trials that were performed in long-term care facilities. Of note, these same 4 studies were used by SHEA to recommend mandating influenza vaccination of healthcare workers. Ahmed et al [12] found a significant reduction in all-cause mortality (−44 per 1000 patients) in facilities where healthcare workers were offered influenza vaccination. The quality of evidence was graded as moderate. There was also a significant reduction in ILI among patients (−68 per 1000 patients) using evidence that was graded as low. There was no significant difference in all-cause hospitalization or laboratory-confirmed influenza [12]. The meta-analysis by Thomas et al [13] showed no significant difference in influenza, lower respiratory tract infection, or hospitalization for respiratory illness. Influenza-related mortality and all-cause mortality were not assessed because the data were not pooled due to incon- sistencies in the size and direction of the risk differences [13]. Thus, there is no evidence to date that vaccinating healthcare workers will indirectly reduce influenza infection in patients in long-term care settings. (academic.oup.com)
PRESENTEEISM
Presenteeism is defined as working while ill. This is a problem across many industries, but it has particular impact in healthcare because infected workers may transmit infection to patients who have multiple comorbidities, are immunosuppressed, and/ or are at risk of severe complications. Two recent studies demonstrate the high prevalence of presenteeism. In a national study of approximately 2000 healthcare workers, 41% of those experiencing ILI reported working while ill [4]. Presenteeism was 63% for physicians and 47% for nurses. Another study conducted in a major tertiary care medical center, which surveyed healthcare workers caring for hospitalized internal medicine and transplant patients, found that presenteeism was 92% in those with ILI [5]. Despite high rates of presenteeism, hospital infection prevention programs put little emphasis on keeping ill employees from work, instead basing their influenza prevention efforts primarily on attempting to achieve high rates of compliance with vaccination.
One driver of presenteeism is paid time off. This is an increasingly common human resource practice in which a bank of
combined leave time is used for personal days, sick days, and vacation. For some employees, a perverse incentive exists to work while ill to avoid using time off so that vacation time can be maximized [6]. More importantly, particularly for physicians, are strong professionalism forces (ie, feelings of obligations to patients and colleagues) that compel attendance when ill. In a survey of physicians and advanced practice clinicians at a large academic children’s hospital, 83% reported working while ill in the past year, despite 95% reporting that this put patients at risk [7]. Over 90% of respondents worked while ill because they did not want to let their colleagues or their patients down.
INFLUENZA VACCINE
The influenza vaccine has been approved and available since the mid-1940s. Approximately 60% of adults in the United States receive the vaccine yearly [8]. It is very safe. The only significant adverse effects are allergic reactions, primarily in persons allergic to eggs, and a possible association with Guillain-Barré Syndrome, occurring at a rate of 1–2 additional cases per million vaccinations [9].
The influenza vaccine is modestly effective. The mean effectiveness over the most recent 14 consecutive influenza seasons beginning in 2004–2005 was 41% (range, 10%–60%; Figure 1) [10]. This stands in sharp contrast to effectiveness rates for other commonly used vaccines in clinical practice, many of which exceed 90%. A large meta-analysis of influenza vaccine effectiveness evaluated placebo (or no intervention) controlled randomized trials and quasi-randomized trials in healthy adults (ages 16 to 65 years old). This analysis included 52 studies with 80 000 subjects. The relative risk reduction for influenza infection associated with influenza vaccine was 59%. However, the absolute risk reduction was only 1.4% (2.3% infected among unvaccinated persons versus 0.9% infected among vaccinated). Moreover, this study also found no significant effect of vaccination on working days lost or hospitalization [11]. In the healthcare setting, the direct effect of vaccination is reduction of influenza rates in healthcare workers. The indirect effect is the reduction of influenza rates in patients due to vaccinating healthcare workers. Two meta-analyses evaluating the impact of influenza vaccination of healthcare workers on outcomes in patients have been published. Both studies evaluated the same 4 cluster randomized trials that were performed in long-term care facilities. Of note, these same 4 studies were used by SHEA to recommend mandating influenza vaccination of healthcare workers. Ahmed et al [12] found a significant reduction in all-cause mortality (−44 per 1000 patients) in facilities where healthcare workers were offered influenza vaccination. The quality of evidence was graded as moderate. There was also a significant reduction in ILI among patients (−68 per 1000 patients) using evidence that was graded as low. There was no significant difference in all-cause hospitalization or laboratory-confirmed influenza [12]. The meta-analysis by Thomas et al [13] showed no significant difference in influenza, lower respiratory tract infection, or hospitalization for respiratory illness. Influenza-related mortality and all-cause mortality were not assessed because the data were not pooled due to incon- sistencies in the size and direction of the risk differences [13]. Thus, there is no evidence to date that vaccinating healthcare workers will indirectly reduce influenza infection in patients in long-term care settings. (academic.oup.com)
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