The CDC should rethink its H1N1 vaccination strategy, study says

The Centers for Disease Control and Prevention has recommended that when the H1N1 flu vaccine is ready, the first people to get it should be children and young adults between age 6 months and 24 years. That strategy is expected to result in 59 million swine flu cases, 139,000 deaths and cost $67 billion.

But there is a better way, according to researchers from Yale and Clemson universities.

If vaccine doses were first distributed to children between age 5 and 19 and to adults age 30 to 39, there would be 15 million fewer infections and 31,000 fewer deaths, write mathematician Jan Medlock and epidemiologist Alison Galvani in Friday's edition of the journal Science. Their strategy would also save $14 billion, they calculate.

In their mathematical model, Medlock and Galvani assume H1N1 will be deadlier than the 1957 flu pandemic but tamer than the 1918 pandemic. They also assumed that each person infected with H1N1 will spread the virus to 1.4 additional people (if they are unvaccinated), as has been previously estimated.

To gauge how H1N1 will spread, they examined patterns in 97,904 personal interactions recorded by 7,290 people in a single day. That data led them to conclude that the strongest mixing occurs among people of similar ages, followed by mixing between school-age children and people in their parents’ age group. And children are known to be “responsible for a disproportionate amount of influenza transmission,” they write in their study.

All of that led Medlock and Galvani to conclude that the most important groups to immunize are 5- to 19-year-olds and their parents, typically between the ages of 30 and 39. This “optimal” vaccination strategy would require 62 million to 63 million doses of vaccine.

U.S. health officials have said 45 million doses will be ready by Oct. 15, with an additional 20 million doses coming online each week after that. It is not yet clear whether people will need one or two doses to get full protection.

The CDC will study the paper, but spokesman Tom Skinner told Nature News that he didn’t expect the public health agency to rethink its strategy.

“Our immunization recommendations really are not based on one single model,” he told Nature. “Models are based on many assumptions. They can be a helpful tool for identifying possibilities, but it’s really not possible to know how any specific model might play out.”

-- Karen Kaplan

Photo: Marisa Grunder got an H1N1 flu shot last week as part of a clinical trial, but at age 27, she is not considered a member of one of the high-risk age groups, according to a new study in Science. Photo credit: David Greedy/Getty Images

Comments

[Ben]

While I agree that the people most likely to transmit H1N1 are small children and their parents, I do not agree that they should be the first to get immunized.
Nurses, Doctors, Firefighters, Cops and all other Emergency personnel should be given any type of immunization before others. If not, who will be around to even give you the shot? Just my two cents

[bogus]

Most vaccinations are not necessary and the swine flu has been blown totally out of proportion. Don't get this vaccine.

http://www.foodconsumer.org/newsite/Non-food/Miscellaneous/200820090724_is_forced_experimental_vaccination_on_the_way.html

[Mark]

I think the congress and washington should get the shots first, since there has been no human testing.

[jayperk]

The proposed strategy makes sense. Early vaccinations of the most likely carriers ( school children and their parents) would be most effective in stopping a pandemic before it starts.

[Laure]

Mark, did you even read the article? Human clinical trials are going on right now. I love how people against vaccines can say basically anything, whether or not it is true, and think people will believe.

And to bogus - "Most vaccinations are not necessary." Unbelievable.

[Joanne]

That is what the authorities thought in 1918. By the time they realized that they were wrong, it was too late. People had to try to stay away from one another, and ride it out. Those who will be safe, are those who got the flu this time around, and those who get the shot. I hope it doesn't come back around this Fall, but if it does, we have to be ready or face the same fate as those who died from the Spanish Flu. In any case, there will be other flu strains in the vaccination too. There is never just one in the shot.

[Walking Queen]

It always irks me that people are so easy to jump towards getting a vaccine, but they don't want to take the time to exercise and eat healthy, which would probably prevent the flu just as much as that shot.

[Mike OHara]

I bet authors Jan and Alison are in the 30-39 age group.

[Observer57]

Adding another filter: anyone who has already had H1N1 should not be innoculated as they now have natural immunity. If H1N1 mutates so much that their hard-won resistance turns out to be worthless, the vaccine will also be useless.

[Chuck]

Laure,

Please conduct some cursory research on vaccines before you bleat your ignorant statements. Here's an idea on how to conduct some basic research into vaccines:

1) Go to the CDC's website and read page 33 of this link: http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf

2) Then while reading the above link, let your brain take note of the fact that only 1,800 people died of the flu in 2005 and not the 30,000 statistic that is regurgitated by incompetent journalists and doctors.

3) Once your brain recognizes the discrepancy between 1,800 and 30,000. Ask yourself this question: "What else don't I know?"

4) You could perhaps then check the CDC's stats for the preceding 20 years as a start (which also show flu death numbers far below the oft-quoted 30,000).

5) After realizing that you in fact no nothing about the Flu or the Flu Vaccine. You could then research the ingredients of the Flu Vaccine. For a humorous poke in your brainwashed eye, nobody beats the Canadians (see Eye on: Flu Shot): http://www.airfarce.com/seasons/season13/051202.html

6) Further research would then involve delving into Polio, Mumps, Chicken Pox, etc. and actually analyzing the available statistical information that clearly links the decline of disease to nutrition and sanitation (not vaccines).

7) Please, better yourself intellectually. Learning may not have intrinsic value in your worldview - but the rest of humanity will sigh in relief for not having to listen to your diatribes.

Thank you,
Chuck

[John McCarthy]

Why are we NOT being told the ingredients of the vaccine? We are told the ingredients on a bag of Cheetos! Why has the WHO approved Squaline and live Monkey Virus for the HiNi vaccine? Why wont the Surgeon General tell us the ingredients of the Swine Flu Vaccine?

[Laure]

Chuck,

http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm

For all causes of death to add up to 100%, and not more, only one cause is attributed to every death. If someone had pneumonia that started as influenza and then died, it would be classified as "pneumonia", even if that particular case of pneumonia would not have happened without influenza occurring first.

Also, while the Air Farce skit was amusing, I wouldn't personally cite it as scientific evidence.

For a good response to some of the misinformation being spread about the swine flu vaccine, see the following.

http://www.sciencebasedmedicine.org/?p=851

I feel like I could put your point #7 here, directed toward you. Learning is not just about believing what you see on the surface.

[Laure]

One more thing - the idea that vaccines did not contribute to diseases going away is one of the biggest pieces of misinformation out there. Recent measles outbreaks have occurred where there have been low vaccination rates, and where hygiene has not been an issue. Polio would be eradicated if it were not for pockets of low vaccination in the world. In areas where there is poor hygiene but high vaccination rates, these diseases are not an issue.

[And]

25 Deaths in Britain, Confidential Documents Obtained by the Press:
http://www.dailymail.co.uk/news/article-1206807/Swine-flu-jab-link-killer-nerve-disease-Leaked-letter-reveals-concern-neurologists-25-deaths-America.html#ixzz0OnWpYsPO

[Chris W.]

"Polio would be eradicated if it were not for pockets of low vaccination in the world. In areas where there is poor hygiene but high vaccination rates, these diseases are not an issue."

Laure, PLEASE tell me you're joking! Because if you're serious, your ignorance is truly stupefying.

http://www.cbsnews.com/stories/2009/08/14/health/main5242168.shtml
[Mutant Polio Virus Spreads in Nigeria:
124 Children Afflicted This Year By Paralyzing Disease, Believed To Be Caused By Same Vaccine Used To Fight It]

[Laure]

Chuck W - if you actually read the article you cite, you will see that the main reason there is such a large issue with polio in Nigeria is because vaccination was suspended there due to irrational fears. This is one of the places I meant when I refer to pockets of low-vaccination, so I guess you helped me prove my point.

For example, here are a couple of quotes from your article,

"But in rare instances, as the (vaccine's) virus passes through unimmunized children, it can mutate into a strain dangerous enough to ignite new outbreaks, particularly if immunization rates in the rest of the population are low."

"Until a better vaccine is ready, WHO and U.S. CDC officials say the oral vaccine is the best available tool to eradicate polio and that when inoculation rates are nearly 100 percent it works fine. "

The biggest issue of this virus becoming an epidemic is it passing through kids who are not vaccinated. So again, thank you for helping me prove my point. This would not have been as large of an issue in a region where vaccination rates were high.

Also, it is well known that the oral polio vaccine is more risky than the shot that industrialized countries get as the shot does not contain a live virus. I don't like it, and wish every country could have access to the shot.

[Chris W.]

Larry - I guessed you missed a couple of these choice quotes:

"So when WHO officials discovered a polio outbreak in Nigeria was sparked by the polio vaccine itself, they assumed it would be easier to stop than a natural 'wild' virus.

They were wrong. "

"Some experts now say that once viruses from vaccines start circulating they can become just as dangerous as wild viruses."

" 'Eradication is a gamble,' said Scott Barrett, an economist at Columbia University who has studied polio policies. 'It's all or nothing ... and there is a very real risk this whole thing may fall apart.' "

As for the claim regarding herd immunity, much of that is based upon epidemiological mythology. After all, in a study published in May it was revealed that, "In the entire Kaiser Permanente of Colorado pediatric population, 11% of all pertussis cases were attributed to parental vaccine refusal." Which means that, aside from the fact that the whooping cough vaccine DOES work much better than blind refusal, 89% of all those children who contracted the virus ***were already vaccinated***.

One more from the paper below: "Herd immunity does not seem to completely protect unvaccinated children from pertussis."

And both of those statements were pulled from a paper written by the staunchest of vaccination advocates. Read it and weep:

http://pediatrics.aappublications.org/cgi/content/abstract/123/6/1446
[Parental Refusal of Pertussis Vaccination Is Associated With an Increased Risk of Pertussis Infection in Children]

Do you know what the REAL cure for polio is? CLEAN WATER. Take the oral-fecal route out of the equation, which is almost solely responsible for polio's propagation, and it has nowhere to go.

Similarly, for almost all other related infectious diseases such as cholera, diphtheria, tuberculosis, measles and even leprosy, the cure is good hygiene, clean water and suitable nutrition- especially with respect to the consumption of protein. Vaccination should always be seen as a last resort. Not the first resort. Or every resort, more like it, judging from how things are being done now.

[Rosa]

As this points out, the vaccine may not be readily available by the time we need it: http://www.newsy.com/videos/h1n1_vaccine_needed_but_not_ready
But if we give it out to high risk groups the threat will be minimized. Unlike other illnesses 20-30 year olds are at the highest risk,rather than kids and the elderly.

[Onni]

I agree with Chuck! I just got a brochure from the CDC for my kids school and it doesn't mention any warnings regarding getting the h1n1 vaccine. Oh really it is 100% safe? No side effects, no chance of illness or death? Talk about propaganda! Is this the USA or Communist Russia? And to the person who said they are testing it on people right now where are the reports about that? Make sure if you have this vaccine given to your kid and your kid becomes paralized or worse, dies you are prepared to accept that. You will not be able to sue anyone, thanks to our governement.

[SP]

My place of work is making it mandatory for us health care workers to get the h1n1 vaccine, any suggestions to how I go about NOT getting it, with out loosing my job

[ddd]

According to the CDC, Laboratory confirmed Swine flu deaths in US is roughly 1ooo as of OCT 24 09.
Worldwide the Laboratory confirmed deaths is roughly 6000. It is a good bet that most of these people had underlying health conditions which contributed to their deaths. In addition we also have good cause to question these numbers based on the fact that the CDC currently claims that 30,000 people die of the Flu each year , a number that has been proven to be inaccurate and grossly over exaggerated.
The number of healthy people who died from Swine flu is likely far lower than the numbers promoted by the CDC but even if we believe and accept these numbers, any thinking person (of which there are very few left)understanding there are roughly 7,000,000,000 (billion) people in the world, can easily do basic math and reach the only sensibility conclusion, There is no pandemic. There never was. This is a manufactured fictional pandemic designed to scare the population into enriching the medical/pharmaceutical industry via the selling of drugs and vaccines.

The Swine flu will not hurt you, the Vaccine WILL!

Flu

[ddd]

Can any of you do basic math? Run the numbers, It's ridiculous that we are even talking about Swine flu as a viable threat. Vaccines? Good lord, please don't put those horrific death and disease causing chemicals in your children s bodies.

People have lost the ability to think clearly. There are 7 BILLION people in the world. The flu season is over for many people. 6000 deaths (if you believe the CDC, which you should not) worldwide is sad for those people and families effected but it's so small of a number as to be statistically meaningless.