
Do antivirals and the flu-vaccine even work? - gnosis
http://www.theatlantic.com/doc/print/200911/brownlee-h1n1
======
hanuman
Oh, please.

[http://scienceblogs.com/effectmeasure/2009/10/journalists_si...](http://scienceblogs.com/effectmeasure/2009/10/journalists_sink_in_the_atlant.php)

~~~
joe_the_user
The tone of this article is _far_ more shrill than the Atlantic article. Dr.
Thomas Jefferson is demanding evidence for assertions - that's "methodolotry"?
He's betraying the original ideas of evidence-based medicine by demanding that
medicine be based on evidence? For shame.

 _In this case his evidence base isn't even relevant, because we aren't
dealing with seasonal flu but pandemic flu._

Ah, but the epidemiology to back this statement has mostly come from very
dubious and biased statistics - specifically, the way that, in Mexico where
epidemic originated, the only people they found with the disease were those on
the edge of death because of the tendency there to only go to the doctor when
you are on the edge of death. Despite the pandemic declaration, we haven't
seen death rates above the normal rates of flu season yet (though a slightly
different group is dying..). We might see high death rates but ... perhaps ...
we should look at evidence before making grand declarations that this like
nothing seen before.

Note, the original article is a not screaming endorsement of Jefferson's view,
just a summary of debate:

 _The most vocal—and undoubtedly most vexing—critic of the gospel of flu
vaccine is the Cochrane Collaboration’s Jefferson, who’s also an
epidemiologist trained at the famed London School of Tropical Hygiene, and
who, in Lisa Jackson’s view, makes other skeptics seem “moderate by
comparison.” Among his fellow flu researchers, Jefferson’s outspokenness has
made him something of a pariah._

~~~
Retric
No, he is demanding a specific type of evidence and automatically discounts
cohort based research.

Anyway, to prevent another 1918 flu pandemic and 50+ million deaths you need
to see if your treatment protects vs cytokine storm
<http://en.wikipedia.org/wiki/Cytokine_storm> not the standard symptoms.
(<http://en.wikipedia.org/wiki/1918_flu_pandemic>) H1N1 is far from this
deadly but doing nothing is playing with fire.

PS: You can't compare the results of two studies without looking at their
methodology 60% fewer deaths in group A, vs 50% _after some adjustments_.

------
systemtrigger
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.

------
alexfarran
Yes

------
dazzawazza
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 do for health).

However since I am _not_ a virologist or epidemiologist I tend to follow what
my doctor says.

~~~
Locke1689
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.

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

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

~~~
gojomo
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.

