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Getting the regular flu vaccine in 2008 made it more likely to get swine flu in 2009 in Canada.

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mhatrw Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 01:36 PM
Original message
Getting the regular flu vaccine in 2008 made it more likely to get swine flu in 2009 in Canada.
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000258

...

In contrast, estimates from the sentinel and three other observational studies, involving a total of 1,226 laboratory-confirmed pH1N1 (swine flu) cases and 1,505 controls, indicated that prior receipt of 2008–09 TIV (seasonal flu vaccine) was associated with increased risk of medically attended pH1N1 (swine flu) illness during the spring–summer 2009, with estimated risk or odds ratios ranging from 1.4 to 2.5. ...

Conclusions

Prior receipt of 2008–09 TIV ( seasonal flu vaccine)was associated with increased risk of medically attended pH1N1 (swine flu) illness during the spring–summer 2009 in Canada. ...
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postulater Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 01:38 PM
Response to Original message
1. Keep sticking us with stuff and eventually we can catch everything they want us to.
It creates jobs for the drug companies though.
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dixiegrrrrl Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 01:43 PM
Response to Reply #1
2. yep.
:thumbsup:
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 07:25 PM
Response to Reply #1
9. Not exactly.
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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Wed Feb-02-11 04:27 PM
Response to Original message
3. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
ZombieHorde Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 04:44 PM
Response to Reply #3
5. Why would they? nt
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ZombieHorde Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 04:43 PM
Response to Original message
4. "What Do These Findings Mean?"
(From the link in the OP)

"Because all the investigations in this study are “observational,” the people who had been vaccinated might share another unknown characteristic that is actually responsible for increasing their risk of developing pH1N1 illness (“confounding”). Furthermore, the results reported in this study might have arisen by chance, although the consistency of results across the studies makes this unlikely. Thus, the finding of an association between prior receipt of 2008–09 TIV and an increased risk of pH1N1 illness is not conclusive and needs to be investigated further, particularly since some other observational studies conducted in other countries have reported that seasonal vaccination had no influence or may have been associated with reduced chances of pH1N1 illness. If the findings in the current study are real, however, they raise important questions about the biological interactions between seasonal and pandemic influenza strains and vaccines, and about the best way to prevent and control both types of influenza in future."

-------------------------------

An interesting study, I have only looked at the first one at this point.
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mhatrw Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 04:54 PM
Response to Reply #4
6. Oh, so you are saying that case controlled studies should be taken
with a grain of salt?
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ZombieHorde Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 09:01 PM
Response to Reply #6
12. No, that is not what I am saying, but I can see why would think that from my reply.
Edited on Wed Feb-02-11 09:03 PM by ZombieHorde
The conclusion the researchers made was a little different than the conclusion in the subject line. Although the conclusions are a little different, I do think the conclusion in the subject line is very likely.

I think this study is really interesting and worthy of our attention. There may be a problem with this particular vaccine. Although most vaccines are safe for most people, there have been a few vaccines which seem problematic.

edit missing word
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 09:37 PM
Response to Reply #12
15. Can you explain what would be wrong with "this particular vaccine?"
Edited on Wed Feb-02-11 09:52 PM by HuckleB
And are you referring the annual flu vaccine or the H1N1 vaccine?

This study's authors actually acknowledge much more than in the quote in your post above:

"Several studies from Australia <22>, Mexico <23>,<24>, and the US <25>,<26> have instead reported null or protective effects of 2008–09 TIV against pH1N1 illness based on test-negative case-control <22>–<25>, case-cohort <25>, or ILI outbreak investigations <26>. One other test-negative case-control analysis from a US outbreak found a statistically significant increased risk, with an unadjusted OR of 2.9 (95% CI 1.8–4.69) for pH1N1 illness among military beneficiaries who received influenza vaccine within the previous 12 months <27>. Unlike in Canada, however, this association was driven primarily by receipt of live attenuated vaccine. Discrepant results across studies may reflect either differences in methods or real variation in the effect of specific vaccines, immunization programs, or population immunity. Most of the studies published to date, however, have not presented sufficient participant characteristics to properly assess methodological issues, sources of bias or confounding, or the validity of results. As previously highlighted, the importance of the public health and scientific implications requires that analyses of TIV effect on pH1N1 risk be more rigorous <28>,<29>. At a minimum, a detailed profile of cases and controls specifically included in vaccine effectiveness analyses should be displayed by vaccine status, age, and chronic conditions, as well as timeliness of specimen collection and other recognized influences. Where participant characteristics have been presented by investigators, conspicuous evidence of selection bias can be seen to explain opposite findings of TIV protection against pH1N1 <23>,<28>. In the detailed participant profiles we display for each of the four studies we report, evidence for this type of bias is not obvious, but that does not rule it out. We also cannot rule out the possibility that the increased risk of pH1N1 found in Canada was an effect specific to the Canadian vaccine: it is noteworthy that ORs were highest in Quebec, where a greater proportion of domestically produced vaccine is distributed than in the rest of Canada. However, even if our findings are considered a “Canadian problem,” if causal in nature they would still have wider implications for our understanding of influenza immunopathogenesis."

Thus, several studies came up with different conclusions. The authors of this study are honest enough to note that. They know the value of a single study is minimal. Oddly this is the study that the creator of the OP chose to post, as if no other studies had been done on the matter.

Further, in the author's exploration of possible causes for this possible effect, there is no supposition about the vaccine itself having a problem. Of course, supposition is just supposition, as the authors recognize.
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ZombieHorde Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 09:52 PM
Response to Reply #15
16. I did not see an explanation in the article, but I have not read the entire thing yet.
I have no idea what could be wrong with it, if it is actually problematic. I could speculate different human error scenarios, but what would be the point?

"And are you referring the annual flu vaccine or the H1N1 vaccine?"

Seems like they were researching one specific flu vaccine.
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 09:56 PM
Response to Reply #16
17. You are correct on the last point. I need coffee.
Edited on Wed Feb-02-11 10:06 PM by HuckleB
I had just edited my post, btw, which addresses the study author's suppositions, as well as a more complete reference paragraph of the many studies that came up with different conclusions on this matter. I'm not sure why this selected study was pushed as an OP, when it's very clear that the science on this matter is nothing but muddled. Thus, I am quite confused about the reasoning for this particular OP being presented as it is.
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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Wed Feb-02-11 06:02 PM
Response to Reply #4
8. Deleted message
Sub-thread removed by moderator. Click here to review the message board rules.
 
mhatrw Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-03-11 11:25 AM
Response to Reply #4
19. In other words, the authors took as much as they could into account.
Edited on Thu Feb-03-11 11:29 AM by mhatrw
Limitations should always be addressed, and they were. They are part of any study. That's why I always give links to the whole study whenever possible (and to the entire abstract if the articles are not available for free).

If you want to see the limitations of the study (and there are always limitations to EVERY study), I suggest that you click the link. Nobody should believe anything in science without reading the methodology and results for themselves, at least whenever possible.
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-03-11 11:26 AM
Response to Reply #19
20. Yes, they did.
Unfortunately, the OP clearly tried to hide that.
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mhatrw Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-03-11 11:33 AM
Response to Reply #20
22. LOL. One minute after my post, the tireless AI arrives.
:rofl:
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-03-11 11:36 AM
Response to Reply #22
23. And the usual red herring response is offered up.
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mhatrw Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-03-11 01:09 PM
Response to Reply #23
24. And three minutes later the Spamish Inquistion strikes again! n/t
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-03-11 01:22 PM
Response to Reply #24
25. And the nonsense ad hominem hits the board.
Edited on Thu Feb-03-11 01:27 PM by HuckleB
:boring:

And, yes, the irony of your attack is quite hilarious.

:rofl:
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 05:59 PM
Response to Original message
7. This is not the conclusion of all studies on this matter.
Seasonal Influenza Vaccine and Protection against Pandemic (H1N1) 2009-Associated Illness among US Military Personnel
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873284/
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mhatrw Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 08:09 PM
Response to Reply #7
10. Interesting that you ignored THESE paragraphs from YOUR linked study.
Edited on Wed Feb-02-11 08:10 PM by mhatrw
There are several limitations with this study. First, tobacco exposure (e.g., smoking), an important co-factor in increasing the risk for influenza infection/disease, was not addressed in this study. There is animal, laboratory-based <44> and human epidemiologic-based evidence <45> which strongly suggests smoking as an important factor in predisposing to influenza infection and/or pneumonia. It is possible that lower rates of tobacco use among older military populations contrasted with higher use among younger military personnel outside of basic training (where tobacco use is more controlled) may have been an important confounder not adjusted for in this study. ...

Third, it is possible that misclassification of cases into the control group may have occurred. Since laboratory testing requirements for pH1N1 confirmation have changed over the time period of this study (starting with universal testing to only testing severe cases), and since physicians may not have requested confirmatory testing for all suspected cases, the possibility exists that a control subject may have been infected with pH1N1 but did not get recorded as a laboratory-confirmed case. In order to decrease this risk of misclassification we excluded from our potential control pool anyone who had a wide range of respiratory-associated symptoms or diagnoses during their qualifying medical encounter. However, if this misclassification did occur we expect it would be non-differential in nature and, again, bias our results toward the null.

Fourth, both cases and controls were highly vaccinated; 80% and 89%, respectively. Thus, it is possible that the minority of the service members who did not receive the 2008–09 seasonal vaccine may have differed in the risk for influenza if they suffered from predisposing, co-morbid conditions which may have increased their risk of infection and/or illness as previously described <46>. However, similar to findings from observational studies among the elderly, we actually found that vaccinated subjects were more likely to have history of an underlying medical condition compared to unvaccinated subjects <47>–<49>. This could have potentially biased our study results towards the null (e.g. less VE), however, when added to the model we found this had no effect on the VE estimates due to the high correlation with age and prior receipt of an influenza vaccine.

Lastly, there are a number of studies that clearly illustrate the inherent bias in assessing influenza vaccine effectiveness when conducting observational, cross-sectional studies such as ours <50>, <51>. Inherent biases in case ascertainment and access to care may have taken place, however, we feel these potential biases were minimized due to our study population. The active component military population receives universal health care coverage at military treatment facilities regardless of the nature of their underlying conditions or presenting medical symptoms (e.g., equal access to care for respiratory and non-respiratory complaints) and thus, would not have influenced our results in a significant manner.
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mhatrw Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 08:11 PM
Response to Reply #10
11. Very odd indeed.
It's not like that poster has a demonstrated history of using selective quoting to try and misrepresent something.
:shrug:
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 09:04 PM
Response to Reply #11
13. Where have I ever done that?
Prove your assertion.
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-03-11 07:48 AM
Response to Reply #13
18. She can't address the criticisms brought against her,
so she lashes out with unsupported accusations instead. S.O.P.
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-03-11 11:30 AM
Response to Reply #18
21. That does seem to be the case.
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-02-11 09:06 PM
Response to Reply #10
14. In other words, the authors took as much as they could into account.
Edited on Wed Feb-02-11 09:13 PM by HuckleB
Limitations should always be addressed, and they were. I gave a link to a whole study, while you offered quotes clearly selected to support your preconceived notions, and to fool anyone who doesn't bother to look further, from your study. Heck, you even wrote your own title for the OP, and thus, of the study. Your consistent routines are, well, consistent. They are not helping you push your preconceived notions, however.
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