Friday night on Real Time with Bill Maher, Maher interviewed Dr. Bill Frist, a former U.S. Senator and physician about the necessity of swine flu vaccinations. Maher said he didn't think pregnant women needed to get the vaccine. He is WRONG. Lives could be lost over this unscientific "opinion" of Bill Maher, who after all has no particular research or clinical training to back up his arguments.
(cross posted at http://www.huffingtonpost.com/... )
First, let's try to separate fact from fiction.
1. Swine flu or H1N1 is a real strain of influenza and it has killed and sickened many people around the world.
2. Ordinary flu kills thousandsof people every year.
3. The cases of H1N1 (swine flu) in the U.S. are on the rise and certain parts of the population are at more risk than others.
4. TheCenters for Disease Control have recommended vaccination for certain parts of this population -- younger people, people with immune deficiency, children, and pregnant women.
In addition to the CDC, other sites like WebMD, which have no particular profit to be made from vaccinations, warn that pregnant women are significantly more likely to have complications or death from swine flu, for a variety of reasons.
5. It is true that many reasonable people can and should question the effectiveness of vaccines in general. How effective was the regular flu vaccine during the 2007-08 season?
The effectiveness of the vaccine depends in part on the match between the viruses in the vaccine and influenza viruses that are circulating in the community. If these are closely matched, vaccine effectiveness (VE) is higher. If they are not closely matched, vaccine effectiveness can be reduced. During well-matched years, clinical trials have shown VE between 70% and 90% for inactivated influenza vaccines in the prevention of serologically confirmed influenza infection among healthy adults.
Interim results from a study carried out this season with the Marshfield Clinic in Wisconsin found overall vaccine effectiveness (VE) of 44% for the 2007-08 flu shot. This included VE of 58% effectiveness against the predominant influenza A (H3N2) viruses, but no effectiveness against influenza B viruses. No influenza A (H1N1) viruses were seen in the study population, so VE against these viruses could not be assessed. A higher VE against H3N2 viruses than against influenza B viruses was likely because the circulating H3N2 strains and H3N2 strain in the vaccine were closely related while the circulating B viruses were antigenically and genetically much different from the influenza B virus in the vaccine and there was little to no cross-reactivity.
CDC has other systems for estimating vaccine effectiveness. These systems cover multiple sites across the country, which provides vaccine effectiveness data on different populations in areas where different influenza strains may predominate. However, vaccine effectiveness estimates using these systems are not yet available.
6. Because of questions about the effectiveness of flu vaccines, there is a lot of fear-mongering about the dangers of vaccines, particularly swine flu vaccine. But if you look at where this information comes from, a lot of it comes from less than credible sources. People who warn against vaccinations often do so with very little evidence that can be corroborated.
This is where Bill Maher is absolutely wrong and actually dangerous. He is suggesting that pregnant women should not be concerned, but he gave NO evidence to support his assertions other than his assertion. Dr. Frist, who has not always been right on a lot of things, did attempt to argue with Maher, based on evidence from researchers but Maher didn't listen to him. (Some will note Frist's strange and unscientific reaction to the Terry Schiavo episode, but that doesn't necessarily invalidate his reaction in this case.)
This flu season there will be illness and death. There always is. But if you are in a high risk group, not to be vaccinated seems like a serious risk to take. And whatever you decide, don't base it on Bill Maher. Base it on whatever good information you can get from sources you can trust. Hopefully those sources will be from physicians, clinicians and people who understand data and evidence. Not entertainers.