Home > Expert Insights, Preventable Diseases, Science & Research, Seasonal Flu > Why Some Kids Need a Second Dose Of Flu Vaccine

Why Some Kids Need a Second Dose Of Flu Vaccine

Recently we received this question on our Vaccinate Your Family Facebook page:

“My child has already received his first dose of flu vaccine over a month ago, but lately I’ve been wondering if it’s really necessary for him to get his second dose?  Is he protected at all from one dose?  And will the second dose be any different?”

The following response has been provided by Dr. Lara Zibners*:

DrZibnersAh, microbiology. As much as I think “The Killer T Cells” would be an awesome name for a band, I’m not going to bore you with a lecture on B-cells and macrophages, cytokines, and lymphocytes. Mostly because, as much as I loved microbiology back in school, my memory of the intricate ways in which our immune systems perform a complex and perfectly coordinated dance to protect us from infection is a bit rusty.

I’m an ER pediatrician, remember? My focus is on caring for children who are already ill. Keeping them from getting sick is almost counter-productive from a career stance, if you know what I mean.  Darn me to be so passionate about healthy, happy children; about the miracle of vaccination. Sigh. Anyway, let me see if I can’t shake a few files loose, dust them off, and answer your question in a way that even I can understand. We’ll call this, “How the immune system works, Dr. Zibners’ style.” Ready?

Okay. A vaccine is really a kind of “fake infection” that stimulates the immune system so that it can defend the body against a real infection later by creating antibodies specific to that bacteria or virus. These antibodies then float around, bored out of their skulls, I imagine, since they have only one purpose in life. But if said antibody is lucky, one day he bumps into the very “antigen” he was created for, sticks to him like cat hair to a black sweater, and signals the body’s attack system to come and remove the invader. All clear so far? Okay, moving on.

When I was 10, I didn’t know a word of French. (Stick with me. This is going somewhere.) When I was 11, Madame Wheaton appeared in my classroom and began pointing around the room, yelling “L’ecole” this and “Au revoir” that. I thought it was cool. And I was the class nerd. So I did all my homework and studied my vocabulary words and developed a rather basic mastery of the language. At school I was definitely at the top of my class when Madame was in the room. But imagine if I’d gotten on a plane and flown to Paris. How far do you think a few months of middle school French would have gotten me? Exactly.

The way some vaccines work is kind of the same. More than one dose is needed to give the best possible protection against infection. (Or in my case, about 3 more years of French before I could order a croissant without hearing any snickering.) This is true of many vaccines. It’s just a fact. It has to do with “priming” the immune system to mount a response and creating memory cells.  It also hinges on a whole host of other factors such as the age of the person, the design of the vaccine, and the body’s response to that type of infection. But that’s all boring and well beyond what we need to know to answer the question, so let’s leave that for another day, eh?

In other words, a kid younger than age 9 may not have suffered a true bout of influenza. If he also has never had a flu vaccination, then his immunity against influenza is about as strong as my French verb conjugations were in the 4th grade. Which means when it comes to the influenza vaccine, the first immunization may not result in high enough levels of antibodies. So a second dose is necessary to bring the circulating safety net to a level that will adequately protect a child.

Those of us age 9 and older have probably already encountered influenza at some point in our lives.  Therefore, even if we have never had a flu vaccine, our bodies probably have enough circulating “memory” against influenza.  In which case, a single dose will give us enough protection against infection if we were to encounter  one of the anticipated strains of influenza that is expected during the current or upcoming season.

Which brings up another point.

Why do those of us who have had a flu vaccine last year need one this year?

Because every year the vaccine is adjusted to include the specific strains of infection that very smart scientists have decided are the greatest risk to us. This year we’re looking at A/California/7/2009 (H1N1); A/Victoria/361-2011; B/Wisconsin/1/2010. Notice that we’re protecting ourselves from three different strains of influenza, one of them the dreaded H1N1 of 2009.

And that brings up yet one more point. Not only should a child have more than one influenza vaccine in his lifetime, but he also needs to have had at least one dose of an H1N1-containing vaccine, which was first available as a separate shot in 2009, then combined with our annual influenza vaccine since 2010.

So, to summarize, here is how we determine the recommendations for the 2012-2013 influenza immunization schedule for children 6 months through 8 years:

  • Has the child ever received an influenza vaccine? No or don’t know = vaccinate with two doses given at least 4 weeks apart.
  • Has the child received 2 or more doses since July 1, 2010? No or don’t know = vaccinate with two doses given at least 4 weeks apart.
  • Is the kid 9 years or older? Or is he younger than 9 but has documentation showing at least 2 prior vaccinations, at least one of which contained H1N1? Yes = one dose.

These recommendations apply whether a child has received the inactivated injection (approved for those 6 months and older) or the live-attenuated nasal spray (for kids over age 2 who are otherwise healthy and have no contraindications to the nasal spray).

Hopefully this has helped clarify the second dose requirement.  I know it’s inconvenient and miserable, dragging your child off for yet another dose of the flu vaccine. But a kid under age 9, who has only had one dose of flu vaccine, has sub-optimal, or even no real protection against influenza.  And we don’t want that, do we?

Oh? What’s that? How’s my French these days? Right. Um. So I sort of let it slide a bit after high school.  A while later I needed to learn German to communicate with my in-laws so if you ask me to how to say, “Bless you,” in French, I’ll probably slip up and say “Gesundheit.” But, on a recent trip to Paris I found that I could understand a few French words. As the week went by, my memory became clearer, the nouns and verbs first appeared as ghosts but then they took shape as real words passing through my lips.  But wait! That’s a conversation about booster shots. We’ll save that discussion for tetanus sometime soon, okay?

For more information on influenza vaccine recommendations, including who should and should not be vaccinated, head to these sites:

http://www2.aap.org/immunization/illnesses/flu/influenza.html

http://www.cdc.gov/flu/protect/whoshouldvax.htm

http://www.cdc.gov/flu/protect/children.htm

**************************************************************************************************************************************************************************************

* Dr. Lara Zibners graduated cum laude from the Ohio State University School of Medicine. She completed both a residency in pediatrics and a fellowship in pediatric emergency medicine at Nationwide Children’s Hospital in Columbus, Ohio, and is currently board certified in both general pediatrics and pediatric emergency medicine. As the author of the award-winning “If Your Kid Eats This Book, Everything Will Still Be Okay,” and the hilarious blog we love at www.drzibners.com, she has been an avid and very public supporter of vaccination. When not speaking, writing or doctoring, Dr. Zibners does her best to mother two toddlers and a middle-aged husband, all of whom are fully vaccinated.
  1. Addi
    December 5, 2012 at 4:15 pm

    Why do you think it is better for a child to take the risk of a vaccine and only get temporary immunity to a virus, at best? Many of us think it’s better to take the risk of a usually mild disease and get genuine, longer-lasting antibodies to the disease in question.

    Like

  2. Chris
    December 5, 2012 at 4:42 pm

    Addi, kids have died from influenza. Please post the title, journal and date of the PubMed indexed article that there is a greater risk from the thimerosal-free influenza vaccine (there are at least four of them) and getting influenza.

    Like

  3. Lawrence
    December 5, 2012 at 5:58 pm

    @addi (CIA Parker sock puppet) – since there are multiple strains and the flu does tend to mutate frequently, your statement above is demonstratably false.

    Like

  4. March 25, 2014 at 7:58 pm

    @Chris…..who would have funded this research? Those with something to gain financially are funding research. No one can gain anything by not providing a product. It sounds like you are aware of the risks of thimerosal….are you also aware of instances of physicians being deceptive about whether the vaccine has thimerosal?
    Further, kids have died from influenza that were vaccinated. The rates of “protection” are published…..not all that impressive. And that info is coming from those that are supporting the importance of vaccination.

    Like

  5. Chris
    March 25, 2014 at 8:37 pm

    Mr. Pratt, why did it take you over eighteen months to come up with that series of questions?

    Actually, why don’t you just answer the question I asked. Give us that PubMed study, and then we will find out who funded the study. Let’s look at this study, and its paragraph on funding:

    This work was supported by a contract from the CDC to America’s Health Insurance Plans and via America’s Health Insurance Plans subcontracts to Abt Associates Inc; Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School; Southern California Kaiser Permanente, and Center for Vaccine Research, University of California Los Angeles; and Division of Research, Kaiser Permanente Northern California.

    It looks like those entities are trying to save money by preventing illnesses so that they don’t have to pay for hospital care, ventilator costs and pharmaceuticals (like antibiotics for secondary infections).

    So what gives more money to pharmaceuticals: preventing diseases or treating them?

    “are you also aware of instances of physicians being deceptive about whether the vaccine has thimerosal?”

    Citation needed. Especially in states like California and Washington where it is legislated that children only be given thimerosal free vaccines.

    “Further, kids have died from influenza that were vaccinated.”

    Citation needed. Something similar to this but for this year: CDC Reports About 90 Percent of Children Who Died From Flu This Season Not Vaccinated. No vaccine is perfect, but as you can see for many it was better than nothing (like what happened to 90% of the pediatric deaths). Also the more that are vaccinated the better chance that the kids who had vaccine failure will not get influenza due to community immunity.

    Like

  6. Chris
    March 26, 2014 at 2:01 am

    Oh, rats, I screwed up the calendar math… it is “only” fifteen months. But that is still a long time to bring up those silly questions.

    So, Robert Pratt, Doctor of Chiropractic… what is your sure fire way to prevent kids from getting influenza? Provide the PubMed indexed study from a reputable qualified researcher to support your answer.

    Like

  7. Lawrence
    March 26, 2014 at 9:56 am

    Since the flu virus rapidly mutates, the Anti-vax militia doesn’t even have the argument that natural infections give long-term immunity either…….

    Like

  8. Rachel Morris
    March 26, 2014 at 11:00 am

    But having permanent immunity to one flu strain gives you partial immunity when that flu strain is recycled into a new mutation, making that infection milder. And, Chris, what is your surefire way to keep kids from dying from the flu vaccine?

    Like

  9. Lawrence
    March 26, 2014 at 11:34 am

    @Rachel – except people don’t die of the flu vaccine. Even the Cochrane Review was very specific in stating that the flu vaccine was among the safest vaccines available.

    Like

  10. March 26, 2014 at 12:07 pm

    @Chris….My apologies about my timing. Yesterday I was wondering why it is necessary to have multiple doses of the same vaccine, and why some people may now need a booster, when I came upon this site. I was unaware that one can only comment about something they read within a certain time frame to be taken seriously.

    I would assume when you say that someone should answer your question, that you are actually referring to your request regarding studies about the relative risks of vaccines and the flu.In answer to that I would suggest an article I googled about a 7 year old that died 4 days following a flu vaccine. She lived in Vermont. Should not be hard to find. It suggests that the dismissal by medical authorities of the vaccine being a cause would be a reason for these things not being in the literature. It is commonly referred to as under reporting.Given your apparent knowledge of medical literature I am sure you are aware of this phenomenon.

    I actually accept the concept that vaccines have an immune regulatory effect. It appears to me to be somewhat variable and not as impressive as the government and pharma ads would have us believe. I agree with those that suggest the hosts health is a significant component in the germ theory of disease. My observation is that those that are not good methylators (I think that is the term) are likely the individuals that have difficulty with the adjuvants of the vaccines.

    Big Pharma makes money “preventing”, researching and “treating” disease. I will not answer your question regarding which is a bigger money maker, because they are able to do all three….without any lack of more money coming their way. Just put more vaccines on the schedule and they have a constant revenue stream. Small pox vaccine during the Gulf War incident would be something I would suggest you read about.

    There is no “study” about physicians being deceptive regarding the ingredients in vaccines. However, there are reports from individuals. Some of these experiences are recorded at the NVIC.org website. I have personally observed very unorthodox practices that have claimed the life of an infant. In order to “catch up” on the vaccine schedule, more vaccines were administered at one visit than is suggested. The youth died from the reactions.

    Vaccinated people in Colorado have died from diseases they were vaccinated against. This includes the flu. I am confident that with a little search of news in Colorado you can find this.

    There is no “sure fire way” to prevent anything. However, there are many things we can do to lower our risk. Avoiding a hospital is one of them. (more virulent infectious diseases there apparently) Good hygiene is another. Quality dietary practices is another. Avoiding toxins in our environment is another. Being vaccinated may be another. Each of these have their strengths and limitations.

    I apologize about my lack of research studies presented. Part of that is due to my limited skills on the computer. The other part is my awareness that research is quite flawed. I use the common sense principle….the more natural the better, the less processed the better. Thus, when research suggested that butter and eggs were bad for us 25 years ago…..I totally disregarded the “experts” advice.

    We can agree to disagree and still treat each other with respect

    Like

  11. Narad
    March 26, 2014 at 12:30 pm

    Rachel Morris :
    But having permanent immunity to one flu strain gives you partial immunity when that flu strain is recycled into a new mutation, making that infection milder.

    Except when it does exactly the opposite.

    Like

  12. Narad
    March 26, 2014 at 12:43 pm

    Robert Pratt :
    My observation is that those that are not good methylators (I think that is the term) are likely the individuals that have difficulty with the adjuvants of the vaccines.

    And this would work how? The excretion of aluminum is rather well understood.

    Like

  13. March 26, 2014 at 12:48 pm

    @Chris….I thought you might find this interesting. Something considered very safe, apparehttp://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm381650.htmntly isn’t as safe as we were led to believe.

    Like

  14. Lawrence
    March 26, 2014 at 12:50 pm

    @Robert – perhaps you’d like to clarify? Your link got eaten, it seems by formatting.

    Like

  15. Lawrence
    March 26, 2014 at 12:51 pm
  16. March 26, 2014 at 12:53 pm

    @Narad… for one, Dr. Amy Yasko has studied this. Apparently we are not all exactly alike. Some people have an ability to detox better than others. Some are suggesting that this is due to a minor genetic difference or defect. They are called snips. Somewhat like a genetic predisposition to cancer or heart disease. I hope that this helps your understanding of poor methylators. A conference of Functional Medicine practitioners would be where you could find more detailed information. It is quite a fascinating group to listen to. Making some permanent changes in lives through their understanding of how the body works.

    Like

  17. Lawrence
    March 26, 2014 at 12:58 pm

    @Robert – Dr. Yasko is not someone whom I would ask for advice….

    http://www.quackwatch.org/04ConsumerEducation/Nonrecorg/clayton.html

    Like

  18. Lawrence
    March 26, 2014 at 12:59 pm

    @Robert – and what does that link have to do with vaccines?

    Like

  19. March 26, 2014 at 12:59 pm

    @Lawrence. I went to your site…the FDA. Not sure what your point was, please clarify. Thanks

    Like

  20. March 26, 2014 at 1:06 pm

    @Lawrence. It had nothing to do with vaccines. Just pointing out that “the authorities” have not always lead us in the right path from the start. With a little more digging you could find out how many people have died from taking this safe medicine. You are aware that medication is a leading cause of death in the US I would presume.

    Further, I am fully aware that people that think outside the medical box are considered quacks. So, when following these types of quacky things I changed someones liver enzymes back to normal in a 6 month period of time and they were told to get off their diabetes medication by their physician because they were not necessary…..that was quacky.

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  21. Lawrence
    March 26, 2014 at 1:13 pm

    @Robert – vaccines & vaccine safety are tracked by multiple regulatory agencies (both here and abroad) using various methods – starting with the initial clinical trials & of course, post-release surveillance programs. There are literally thousands of research papers that detail the decades of safety information about vaccines…..

    As to leading causes of death – I beg to differ:

    http://www.cdc.gov/nchs/fastats/lcod.htm

    Like

  22. Chris
    March 26, 2014 at 1:18 pm

    Mr. Pratt, I see no reason to believe any of your claims since you are posting anecdotes without supporting data. Next time come back with some actual verifiable evidence, not news stories you have googled (that particular story was found to be false, plus it was one anecdote). Here is one you should read:
    Pediatrics. 2014 Mar 3. [Epub ahead of print]
    Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009..

    “There is no “study” about physicians being deceptive regarding the ingredients in vaccines.”

    There is plenty of evidence that NVIC, and their friends are deceptive about ingredients, risks and other things. This has actually been studied. For instance, take this study:
    Hum Exp Toxicol. 2011 Sep;30(9):1420-8.
    Infant mortality rates regressed against number of vaccine doses routinely given: is there a biochemical or synergistic toxicity?

    Not only was it done badly and also deceptively by a pair of totally unqualified persons, they failed to declare their conflict of interest:

    Declaration of Conflict of Interest

    No declaration of Conflict of Interest was made at the time of submission. The Authors would like to make the following declaration at this time:

    Neil Z Miller is associated with the ‘Think Twice Global Vaccine Institute’. Gary S Goldman has not been associated with the ‘World Association for Vaccine Education’ (WAVE) for more than four years but was, at the time of publication of the article, still listed as a Director for it on the WAVE website.

    Funding

    The National Vaccine Information Center (NVIC) donated $2,500 and Michael Belkin made a personal donation of $500 in memory of his daughter Lyla towards the SAGE Choice Open Access fee for this article.

    Also, for fun, you should read what the Vaccine Court Special Masters had to say by Dr. Mark Geier (who has since lost his license to practice medicine). Here is one of the rulings.

    Like

  23. March 26, 2014 at 1:18 pm

    http://www.webmd.com/news/19991130/medical-mistakes-are-leading-cause-of-death-disability perhaps I was wrong. Maybe things have improved since this article.

    Like

  24. March 26, 2014 at 1:25 pm

    Thank you for the information. I was seeking to find out why additional doses are necessary. Found out my information and should have left it at that.

    Obviously if you think I am lying, there is no reason for us to have a conversation. Perhaps I was insulting in something I said. It was not intentional. My apologies. I suppose I could show you the lab reports….but, those can be photoshopped or something…

    Again, I thank you for taking the time to respond to inquiry.

    Like

  25. Lawrence
    March 26, 2014 at 1:25 pm

    @Robert – “medical mistakes” don’t even make the top 15

    The 15 leading causes of death in 2010 were:

    1. Diseases of heart (heart disease)
    2. Malignant neoplasms (cancer)
    3. Chronic lower respiratory diseases
    4. Cerebrovascular diseases (stroke)
    5. Accidents (unintentional injuries)
    6. Alzheimer’s disease
    7. Diabetes mellitus (diabetes)
    8. Nephritis, nephrotic syndrome and nephrosis (kidney disease)
    9. Influenza and pneumonia
    10. Intentional self-harm (suicide)
    11. Septicemia
    12. Chronic liver disease and cirrhosis
    13. Essential hypertension and hypertensive renal dis­ease (hypertension)
    14. Parkinson’s disease
    15. Pneumonitis due to solids and liquids

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  26. Chris
    March 26, 2014 at 1:27 pm

    That has nothing to do with vaccines. It is a news release Though the following is a blog post, it does link to several studies you should be aware of: Whack em hard/Whack em once and Stroke.

    Try to stay on topic by answering the questions you were asked, with verifiable scientific evidence, not news releases:

    Provide the PubMed indexed study by reputable qualified researchers that any influenza vaccine used in the USA is more dangerous than influenza.

    Like

  27. Chris
    March 26, 2014 at 1:30 pm

    “Thank you for the information. I was seeking to find out why additional doses are necessary. Found out my information and should have left it at that.”

    It is explained here:
    http://www.cdc.gov/flu/

    And you may not be purposely lying, but there is no reason to believe what you write because you are using sources of information that are known to be deceptive, and you cannot seem to distinguish between data and anecdotes. Essentially you are unqualified..

    Like

  28. Lawrence
    March 26, 2014 at 1:37 pm

    At the end of the day, the flu is dangerous – taking the chance with a wild illness over a very safe and effective vaccine (though the effectiveness could always be better), doesn’t make a lick of sense to me.

    Like

  29. Narad
    March 26, 2014 at 2:17 pm

    Robert Pratt :
    @Narad… for one, Dr. Amy Yasko has studied this. Apparently we are not all exactly alike. Some people have an ability to detox better than others. Some are suggesting that this is due to a minor genetic difference or defect. They are called snips. Somewhat like a genetic predisposition to cancer or heart disease. I hope that this helps your understanding of poor methylators.

    I wasn’t asking for any such “help.” I want you to explain what methylation has to do with aluminum excretion. Note the last word: aluminum is not “detoxified.”

    A conference of Functional Medicine practitioners would be where you could find more detailed information. It is quite a fascinating group to listen to. Making some permanent changes in lives through their understanding of how the body works.

    Interesting that you should say this, given that chiropractors are deeply insinuated into this mishmash of unsupported modalities.

    Like

  30. lilady
    March 26, 2014 at 6:25 pm

    Mr. Pratt, you’ve been posting some provocative comments here about influenza vaccine safety and effectiveness. All of your sources seem to be quack doctors and unqualified researchers who produce poorly designed and poorly executed studies, that you pluck off anti-vaccine websites.

    Upthread (#10 comment) you made this statement:

    “I would assume when you say that someone should answer your question, that you are actually referring to your request regarding studies about the relative risks of vaccines and the flu.In answer to that I would suggest an article I googled about a 7 year old that died 4 days following a flu vaccine. She lived in Vermont. Should not be hard to find. It suggests that the dismissal by medical authorities of the vaccine being a cause would be a reason for these things not being in the literature. It is commonly referred to as under reporting.Given your apparent knowledge of medical literature I am sure you are aware of this phenomenon.”

    When that seven year girl died four days after receiving the seasonal influenza vaccine shot, all those anti-vaccine websites publicized her death…yet failed to alert their readership, that the cause of death was myocarditis (which is usually caused by a “live virus”…and never caused by the killed influenza viruses contained in seasonal influenza vaccine shots).

    http://www.wcax.com/story/16619953/vt-health-commissioner-on-childs-toxicology-report

    Like

  31. March 26, 2014 at 6:59 pm

    Thank you for continued interest. According to your source the cause of death was undetermined. Further, the doctor performing the autopsy refused to rule out the vaccine as a role player in this incident. It looks like the anti-vaccine crowd was wrong in posting this as an absolute. I would suggest that your comments are similarly presuming things.

    Thanks again for your interest in providing information that is helpful in trying to sort out the truth. Again, my apologies for stating things that were interpreted as inflammatory in nature.

    Like

  32. March 26, 2014 at 7:07 pm

    Please explain the table 2 regarding the 2012-2013 season effective rate of seasonal flu. I am not sure what the CI means. I would appreciate your help. TABLE 2. Number and percentage receiving 2012–13 seasonal trivalent influenza vaccine among 2,697 outpatients with acute respiratory illness and cough, by influenza test result status, age group, and vaccine effectiveness* against all influenza A and B and against virus types A (H3N2) and B — U.S. Influenza Vaccine Effectiveness Network,† United States, December 3, 2012–January 19, 2013

    Influenza type/Age group

    Influenza-positive

    Influenza-negative

    Vaccine effectiveness

    Unadjusted

    Adjusted

    No. vaccinated/Total

    (%)

    No. vaccinated/Total

    (%)

    (%)

    (95% CI)

    (%)

    (95% CI)

    Influenza A and B

    Overall

    367/1,115

    (33)

    793/1,582

    (50)

    (51)

    (43–58)

    (56)

    (47–63)

    Age group (yrs)

    6 mos–17

    118/463

    (26)

    275/565

    (49)

    (64)

    (53–72)

    (64)

    (51–73)

    18–49

    100/353

    (28)

    256/604

    (42)

    (46)

    (29–60)

    (52)

    (38–79)

    50–64

    63/174

    (36)

    143/248

    (58)

    (58)

    (38–72)

    (63)

    (43–76)

    ≥65

    86/125

    (69)

    119/165

    (72)

    (15)

    (-42 to 49)

    (27)

    (-31 to 59)

    Influenza A (H3N2) only

    Overall

    211/544

    (39)

    793/1,582

    (50)

    (37)

    (23–48)

    (47)

    (35–58)

    Age group (yrs)

    6 mos–17

    52/179

    (29)

    275/565

    (49)

    (57)

    (38–70)

    (58)

    (38–71)

    18–49

    53/183

    (29)

    256/604

    (42)

    (45)

    (21–61)

    (46)

    (20–63)

    50–64

    41/96

    (43)

    143/248

    (58)

    (45)

    (12–66)

    (50)

    (15–71)

    ≥65

    65/86

    (76)

    119/165

    (72)

    (-20)

    (-118 to 34)

    (9)

    (-84 to 55)

    Influenza B only

    Overall

    90/364

    (25)

    793/1,582

    (47)

    (67)

    (58–77)

    (67)

    (51–78)

    Age group (yrs)

    6 mos–17

    59/230

    (26)

    275/565

    (49)

    (64)

    (49–74)

    (64)

    (46–75)

    18–49

    17/79

    (22)

    256/604

    (42)

    (63)

    (35–79)

    (68)

    (40–83)

    50–64

    8/40

    (20)

    143/248

    (58)

    (82)

    (59–92)

    (75)

    (39–90)

    ≥65

    6/15

    (40)

    119/165

    (72)

    (74)

    (24–91)

    (67)

    (-10 to 90)

    Abbreviation: CI = confidence interval.

    * Vaccine effectiveness was estimated as 100% x (1 – odds ratio [ratio of odds of being vaccinated among outpatients with influenza-positive test results to the odds of being vaccinated among outpatients with influenza-negative test results]); odds ratios were estimated using logistic regression.

    † The five network sites and the dates enrollment began were as follows: Group Health Cooperative (Seattle, Washington) (December 26, 2012); the Marshfield Clinic Research Foundation (Marshfield, Wisconsin) (December 17, 2012); the University of Michigan School of Public Health, partnered with the University of Michigan Health System (Ann Arbor, Michigan) (December 17, 2012) and the Henry Ford Health System (Detroit, Michigan) (January 2, 2013); the Univ

    ha ha…ok that didn’t post so well.

    Like

  33. lilady
    March 26, 2014 at 8:35 pm

    Don’t delude yourself…I have no interest in you and your pseudoscientific necromancing posts.

    That case of a myocarditis death was already addressed on this blog. According to the medical examiner….

    The report says the manner of death could not be determined but it does list contributing conditions, including myocarditis. That’s an inflammation of the heart usually caused by a virus.

    Kaylynne had just gotten a flu shot four days before her death and the family suspects she died due to complications from that vaccination.

    The influenza vaccine was present in her body, but not in Kaylynne’s heart. That’s why the health department could not directly attribute the death to her flu shot.

    “There’s no record of a person dying of a flu shot in Vermont. Well, it’s listed undetermined, so how many are there?” mom Nicole Matten said.

    “Myocarditis is a rare disease– probably a handful of cases each year in this country. And it’s an inflammation of the heart, but unfortunately we can’t tell you what caused that” said Dr. Harry Chen, the Vermont Health Commissioner.

    Reporter Gina Bullard: Do you think the flu shot played any role in this?

    Dr. Harry Chen: In my opinion I don’t think it had anything to do with it, but I don’t have the evidence to be absolutely certain to say no.”

    Did you happen to read or did you understand that the the killed influenza vaccine was found present in her body (presumably at the site of injection and in body fluids, but not found in the child’s heart tissue). “Contributing conditions” which led to the child’s death were not provided, due to HIPPA regulations and the parent did not provide the “contributing conditions” to reporters.

    Nice try, but fail.

    Like

  34. March 26, 2014 at 9:19 pm

    wow…ruffled feathers again, so sorry.

    You are supposing that the only ingredient that could have aggravated her immune system was the virus of the vaccine. I did not make the assumption that it was. According to webMD there are various causes of myocarditis, although you are likely correct in stating that the most likely scenario is the virus since it was found in the heart tissue. Thank you for also pointing out that perhaps there was a “contributing condition” that was a major factor, that is not being revealed.

    My question about the effectiveness of vaccines is perplexing to me. According to the site I posted it appeared that about 25% of those that got the flu that year were vaccinated. I didn’t understand what the CI meant. If you can clarify without any demeaning comments I would appreciate it.

    Like

  35. Chris
    March 26, 2014 at 11:10 pm

    “My question about the effectiveness of vaccines is perplexing to me.”

    Take a basic statistics course. I am sure that there is one offered at local community college. Then you could try asking a real epidemiologist, there are several that blog.

    Like

  36. Narad
    March 27, 2014 at 1:57 am

    Robert Pratt :
    Please explain the table 2 regarding the 2012-2013 season effective rate of seasonal flu. I am not sure what the CI means. I would appreciate your help….
    ha ha…ok that didn’t post so well.

    No, it did not. You are pointing at this, presumably to draw attention to 56% overall effectiveness in the 2012–2013 flu season. The 95% confidence interval can be taken naively to mean that there’s a very good chance that the true value lies in the range.

    A generous real-world estimate (i.e., including people who are vaccinated) of one’s odds, if unvaccinated, of contracting the flu is 5%. The amount of time it takes to have a 50–50 chance of succumbing after one bout is log(50%)/log(100% – 5%) = 13.5 years. [Apologies to those who have already seen this; the reason is the the same as rolling dice: Snake-eyes, 1/12 = 8.3%. Snake-eyes twice, 1/144 = 0.7%. Hence, log(50%)/log(100% – 0.7%) = 98.7 rolls to have even odds of hitting it again.]

    OK, so the 50% numerator means the 50–50, right? And the (100% – 5%) denotes the chance of not getting the flu. For simplicity, let’s say that the influenza vaccine is only 50% effective over time. So, the risk is halved. This means log(50%)/log(100% – 2.5%) = 27.4 years

    Basically, if you can cut the risk in half, you can double the length of time during which one has better-than-even odds of not catching the flu. This is what an “ineffective” vaccine buys you.

    Like

  37. March 27, 2014 at 6:22 am

    @Narad. Thanks. I may have to take Chris’ advice and retake stats to fully appreciate how you came to the conclusion, however….you are saying that getting a flu shot that year cut your likelihood of getting the flu in half. Further, the confidence index means that we have a 95% likely hood of this estimate being accurate.

    So, are there any theories as to why this is not effective in all the participants? I am aware of the estimating of virus mutation and how that plays somewhat of a role. Do we know of any factors that make a vaccinated person still vulnerable to the flu? I think the terminology is, why did the vaccine not “take”?

    Again, thank you for taking my questions and concerns and explaining.

    Regarding your earlier question about eliminating aluminum. I am very interested in your knowledge of this elimination process. Please provide a link so I can learn more about this. Perhaps, I was misled in thinking that elimination rates could be improved by diet and supplements. I have been trying to answer the question as to why some people appear to not deal as well with toxins in the environment than others.

    Like

  38. Lawrence
    March 27, 2014 at 6:41 am

    @Robert – when someone says “toxins” it is immediately suspect, since the definition of what is “toxic” can be very broad. Heck, even H20 is toxic in high enough quantities (not to mention drowning, etc). Aluminum is everywhere – you absorb more aluminum from the environment in a single day than is contained in every vaccine that you would ever receive (given that it is one of, if not the most plentiful element on the planet).

    There is also a significant difference between elemental aluminum and aluminum salts – much as there is a huge difference between sodium & table salt.

    Understanding the Science is key – if you don’t know the difference between elements and compounds, then you are unlikely to understand the rest.

    Like

  39. Chris
    March 27, 2014 at 10:43 am

    Perhaps, Mr. Pratt should also retake freshman chemistry and biology. Plus, the influenza vaccines in the USA often do not contain adjuvants.

    Like

  40. Chris
    March 27, 2014 at 12:58 pm

    Of course, Mr. Pratt could have just read the above article by Dr. Zibners instead of just coming in here and telling to look for funding of studies.

    Which is good advice, because the folks who would be trying to prove that influenza vaccines are more dangerous than the diseases would be folks like SafeMinds, NVIC, Think Twice, Generation Rescue, and the Dwoskin Family Foundation.

    It is just that the article I posted was mostly funded by the health insurance industry, which strives to keep medical costs down. This is perhaps why their policy on childhood vaccination has changed dramatically over the past twenty five years ago. They refused to pay for my oldest son’s four year old vaccines that he needed for school, but that changed for the next kid who was two years younger. Now the health insurance company sends out warnings for vaccines, and even paid for the influenza vaccines we received at our local pharmacy.

    It seems the numbers came in on the 1990 measles epidemic which proved that prevention is better than treatment:
    Pediatric hospital admissions for measles. Lessons from the 1990 epidemic.

    Along with the other economic studies over the past fifteen years:

    Arch Pediatr Adolesc Med. 2005;159:1136-1144.
    Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001

    J Infect Dis. 2004 May 1;189 Suppl 1:S131-45.
    An economic analysis of the current universal 2-dose measles-mumps-rubella vaccination program in the United States.

    Pediatrics. 2014 Mar 3. [Epub ahead of print]
    Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009.

    Like

  41. Narad
    March 27, 2014 at 9:17 pm

    Robert Pratt :
    @Narad. Thanks. I may have to take Chris’ advice and retake stats to fully appreciate how you came to the conclusion

    So anyway, I spent about 45 minutes this afternoon working on a reply. I got through confidence intervals and a more explicit explanation of the calculation, with superscripts and a brief refresher on logarithms and everything. I was halfway into primary vaccine failure and seroconversion when the browser crashed.

    I have since installed the Lazarus plugin (doesn’t work with certain WebKit builds, BTW), but I’m not going to able to reconstruct it all just now. I’ll note, though, that the 95% in the CI is not the 95% in the calculation of the odds of not getting the flu; it’s just a coincidence that the number appears in both places.

    Like

  42. March 28, 2014 at 2:13 pm

    @Lawrence. Thanks. I was reading that there is no known value of aluminum for the human body. This, despite the fact that is a most abundant mineral as you so aptly noted, That seems odd, given evolutionary dynamics. I am aware that compounds act differently than the elements themselves. Are you suggesting that the aluminum salts are not a problem for human exposure? Is it aluminum from cans, pans and other exposure that is toxic to us, or am I completely wrong thinking that aluminum is toxic in any significant way

    @Narad….no worries, but, thank you very much for your hard work in explaining this to me. I look forward to your reply. So sorry about the computer problems.

    @Chris…cool. which ones do not contain adjuvants. why and why not? that is fascinating to me to learn this.

    Like

  43. Chris
    March 28, 2014 at 3:40 pm

    There was debate on the adjuvants, especially during the H1N1 outbreak. It was just decided to not use them. I suggest you check the FDA, CDC and ACIP sites for that information. Plus there is a vast array of literature on PubMed about adjuvants, just ignore the ones funded by the Dwoskin Family Foundation. Also there is this podcast where they are discussed:
    http://www.twiv.tv/2009/06/07/twiv-35-much-achoo-about-nothing/

    The same virologist who runs that podcast also has a couple of courses online that you might find useful like:
    http://www.virology.ws/influenza-101/

    Like

  44. Aimee
    February 6, 2017 at 11:27 pm

    What do I do when I’ve asked my doctor and other pediatricians about this second dose for our young children that I keep reading about, and they keep telling me one shot is enough? (my 4 kids have never had the shot, they range from 1 year old to 5 year old). Are doctors just not aware of this issue? Should I insist on the second one being done? Thank you!

    Like

  1. December 6, 2012 at 5:19 am

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