Tag: vaccine research

The Strategic Plan to Develop a Universal Influenza Vaccine

Even before you get to talk about problems with flu vaccine effectiveness,  it becomes clear that everyone wants a better flu vaccine.

One big problem with the current generation of flu vaccines?

You have to get them each and every year.

Developing a Better Flu Vaccine

So what would we all want in a new and better flu vaccine?

It would:

  • last longer, so you didn’t have to get a new vaccine every year
  • be more effective
  • cover more flu vaccine strains, so it wasn’t a “guess” about which flu strains to include in the flu vaccine each year and we didn’t have to worry about drifted flu vaccine strains or new and emerging strains for which there is no vaccine

A universal flu vaccine, which covers all possible flu strains, would be ideal.

So why haven’t we been working on developing a universal flu vaccine?

Well, we have.

It just isn’t that easy.

Many different research teams have been working on a universal flu vaccine for years and some have already had some success.

Does that mean we will see a universal flu vaccine soon?

Unfortunately, of the almost 40 organizations working on improved flu vaccines, including a universal flu vaccine, about 30 are still in preclinical or phase 1 trials. So the answer is no, we will not see a universal flu vaccine soon.

The Strategic Plan to Develop a Universal Influenza Vaccine

Maybe that will change now that more and more folks are pushing for a better flu vaccine and we see the effects of severe flu seasons without a good vaccine.

Of course, talk isn’t enough.

“A priority for the National Institute of Allergy and Infectious Diseases (NIAID) is development of an influenza vaccine providing durable protection against multiple influenza strains, including those that may cause a pandemic, i.e., a universal influenza vaccine. To invigorate research efforts, NIAID developed a strategic plan focused on knowledge gaps in three major research areas, as well as additional resources required to ensure progress towards a universal influenza vaccine. NIAID will use this plan as a foundation for future investments in influenza research and will support and coordinate a consortium of multidisciplinary scientists focused on accelerating progress towards this goal.”

Erbelding et al on A Universal Influenza Vaccine: The Strategic Plan for the National Institute of Allergy and Infectious Diseases

That’s why it is also encouraging that we have seen the:

  • The Flu Vaccine Act would help fund a universal flu vaccine.the Pathway to a Universal Influenza Vaccine workshop convened by the National Institute of Allergy and Infectious Diseases (NIAID) in 2017
  • the Strategic Plan for Developing a Universal Influenza Vaccine by the NIAID that was announced in 2018
  • U.S. Sen. Ed Markey (D-MA) introduced the Flu Vaccine Act, which would invest $1 billion towards development of a universal flu vaccine

Knowing that developing a universal flu vaccine is a priority of the NIAID and that so many organizations are already working towards this goal is very reassuring.

Hopefully we are a lot closer than some folks thing.

Until then, a seasonal flu vaccine is the best way to avoid the flu and serious flu complications.

What to Know About Developing a Universal Influenza Vaccine

Developing a better flu vaccine, including a universal flu vaccine, is an even bigger priority with the announcement of the Strategic Plan for Developing a Universal Influenza Vaccine.

More on Developing a Universal Influenza Vaccine

Hierarchy of Evidence and Vaccine Papers

Evidence is evidence, right?

Nope.

There is a hierarchy of evidence, from weakest to strongest, that help folks make decisions about science and medicine.

That’s why you can’t just search Google or PubMed, read abstracts, and say that you have done your research.

Hierarchy of Evidence

For any study, you have to review and judge the quality of the evidence it provides.

A meta-analysis with over 1.2 million kids found that vaccines were not associated with autism, while Wakefield's retracted case series included only 12 children.
A meta-analysis with over 1.2 million kids found that vaccines were not associated with autism, while Wakefield’s retracted case series included only 12 children.

Is it a case report (a glorified anecdote), case series, or animal study (lowest quality evidence)?

Or a systemic review or meta-analyses (highest quality evidence)?

“The first and earliest principle of evidence-based medicine indicated that a hierarchy of evidence exists. Not all evidence is the same. This principle became well known in the early 1990s as practising physicians learnt basic clinical epidemiology skills and started to appraise and apply evidence to their practice. Since evidence was described as a hierarchy, a compelling rationale for a pyramid was made.”

Murad et al. on the New Evidence Pyramid

What about case control studies, cohort studies, and randomized controlled trials?

They lie somewhere in between on the hierarchy of evidence scale or pyramid.

And there are other factors to consider when judging the reliability of a study.

“Ultimately, the interpretation of the medical literature requires not only the understanding of the strengths and limitations of different study designs but also an appreciation for the circumstances in which the traditional hierarchy does not apply and integration of complementary information derived from various study designs is needed.”

Ho et al. on Evaluating the Evidence

For example, you might also have to take into account the sample size of the study.

A study can be underpowered if it doesn’t have enough subjects. Unfortunately, even an underpowered study will give you results. They likely won’t be statistically significant results, but folks don’t always realize that.

Even a meta-analysis, usually considered to be at the top of the hierarchy of evidence pyramid, can have problems that make their results less useful, such as not using appropriate inclusion criteria when selecting studies and leaving out important studies.

All in all, there are many factors to look at when reading a medical paper and considering if the results are valid and should influence what you do and how you think. This is especially true when looking at low quality vaccine papers, many of which the anti-vaccine movement uses to scare people, even though they are often poorly designed, and several of which have been retracted.

What to Know About the Hierarchy of Evidence

Learning about the hierarchy of evidence can help you better evaluate medical studies and vaccine papers and understand that there is more to doing your research about vaccines than searching PubMed and reading abstracts.

More on the Hierarchy of Evidence

 

How to Claim a Vaccine Exemption

Don’t want to get your kids vaccinated?

You might be surprised to know that no one is out there trying to force you into vaccinating them.

Want to enroll your kids in daycare, preschool, school, or college?

Then they will need to be vaccinated.

How to Claim a Vaccine Exemption

Of course, depending on where you live, you could get a vaccine exemption and leave your kids unvaccinated and unprotected.

Does your child qualify for a medical exemption? All states allow kids to claim medical exemptions to getting vaccinated. True medical exemptions are rare though, as you can see from the rates in states that actually require screening and approval of medical vaccine exemptions.

Are you a Christian Scientist? In 47 states, laws allow religious exemptions to vaccinations. Ironically, these exemptions are often abused, as you don’t actually need to belong to a religion that is against vaccines to claim a religious exemption to vaccinations.

“When you are challenged by the viewpoint of a denomination, pastor, publication, or atheist authority: You do not worship any pastor, church, religious publication, or denomination. Your pastor’s personal view on vaccines is irrelevant to your stance because pastors do not learn about the biblical implications of vaccinating during seminary and your pastor isn’t God. (Though if you have a pastor willing to go to bat for you, use him.)”

Megan on How To Get a Vaccine Religious Exemption Like a Boss

It is not even a secret that parents abuse the religious vaccine exemption, claiming them even when they don’t have a sincere religious belief against getting vaccinated.

And in 20 states, it is even easier to claim a vaccine exemption. These are the states that allow philosophical or personal belief vaccine exemptions, in which you can typically just say that you are against vaccinating and protecting your kids “for reasons of conscience.”

Vaccine exemptions are too easy to get in some states, but even with an exemption, your child will still be excluded if there is an outbreak.
Vaccine exemptions are too easy to get in some states, but even with an exemption, your child will still be excluded if there is an outbreak.

What reasons? You don’t usually have to go into much detail…

Why Parents Abuse Vaccine Exemptions

It is not hard to understand why some parents abuse vaccine exemptions.

They abuse vaccine exemptions because they can.

In many states, it is easy to abuse vaccine exemptions because medical exemptions aren’t verified and approved and it is often easier and more convenient to get an exemption than to get vaccinated. Believe it or not, some doctors will even sell you a medical exemption for your child. Also, parents are made to feel so scared by anti-vaccine propaganda that they think that they need to get an exemption.

“Permitting personal belief exemptions and easily granting exemptions are associated with higher and increasing nonmedical US exemption rates. State policies granting personal belief exemptions and states that easily grant exemptions are associated with increased pertussis incidence.”

Omer et al on Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence.

But just because you can claim an easy exemption in a state without strong vaccine exemption laws doesn’t mean that you should.

While there are no benefits to delaying or skipping vaccines, there are plenty of risks. And the risks aren’t just to your unvaccinated child. We continue to see and hear about kids who are too young to be vaccinated or who couldn’t be vaccinated getting caught up in outbreaks caused by others who simply chose to not get vaccinated.

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

Not surprisingly, websites and organizations that give advice on getting kids easy vaccine exemptions never mention these risks. They also overstate the risks of vaccines and don’t mention the benefits of getting vaccinated.

Vaccines are safe and necessary. Unless your child has a true medical contraindication to getting one or more vaccines, do a little more research before getting a non-medical exemption.

What to Know About Claiming a Vaccine Exemption

While it is typically not hard to claim a vaccine exemption for your child, since vaccines are safe and necessary, be sure you understand the risks of delaying or skipping any vaccines if your child doesn’t need a true medical exemption.

More on Claiming a Vaccine Exemption

 

Using Pubmed to Do Research About Vaccines

A lot of the vaccine research that folks do is on PubMed.

Using PubMed to Do Research About Vaccines

And that’s not necessarily a bad thing.

“PubMed comprises more than 27 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.”

All of the studies that say that vaccines are safe, that vaccines work, and that vaccines are necessary are in PubMed.

So are the studies that show that vaccines are not associated with autism, SIDS, and other so-called vaccine induced diseases, like ASIA.

Unfortunately, there are also poorly done studies in PubMed that do purport that vaccines are associated with autism and that ASIA is a real thing.

Can You Use PubMed to Do Research About Vaccines?

Kelly Brogan didn't make history in getting a case report published in a low impact journal who's editorial board includes a Reiki Master, chiropractors, and naturopaths.
Kelly Brogan didn’t make history in getting a case report published in a low impact journal who’s editorial board includes a Reiki Master, chiropractors, and naturopaths.

Just like anyone can put up a website or Facebook page and say whatever they want, almost anyone can get a study or article published in a journal and get it indexed in PubMed.

While PubMed is an index with over 27 million citations, it doesn’t do anything to evaluate those citations to see if they include studies with design flaws, conflicts of interest, or are simply fraudulent.

That means that you need to know that a study does not get a badge of legitimacy for simply being in PubMed!

And it does not automatically mean that the evidence and conclusions from the article are of high quality just because it is listed in PubMed.

So use PubMed to find articles to help you do research about vaccines, but then read the article from beginning to end, not just the abstract, and make sure it is an article you can trust:

  • Was it published in a legitimate journal, like Vaccine or Pediatrics, and some of these high-impact journals? (good)
  • Was it published in a predatory journals?  (bad)
  • Does it involve simply looking at VAERS data?  (usually bad)
  • Is it written by folks with a conflict of interest that makes the article biased?  (bad)
  • Has it already been refuted by other people because it wasn’t designed properly or had other major flaws?  (bad)
  • Is it written by people who have expertise on the topic they are writing about? (good)
  • Has it been retracted?  (very bad)
  • Is it a case report (a glorified anecdote), case series, or animal study (lowest quality evidence) or a systemic review or meta analyses (highest quality evidence)?
  • Is it a case control study, cohort study, and randomized controlled trial, which lie somewhere in between case reports and reviews on the hierarchy of evidence scale?

Are you ready to get educated about vaccines?

That’s great, but PubMed shouldn’t be your first stop, or your only stop.

As you do your research or get bombarded with a list of links or abstracts from PubMed, remember that there is a hierarchy of evidence to consider before deciding if a paper or study is really evidence of anything. And finding a case report, study on rats, or an invitro study won’t win you an argument about vaccines when there are randomized control trials and systemic reviews on the other side.

What to Know About Using PubMed to Do Research About Vaccines

PubMed is a giant index of journal articles, but simply being in PubMed doesn’t mean that an article or study is reliable or of high quality, whether it is about vaccines, a vaccine-preventable disease, or any other medical topic.

More on Using PubMed to Do Research About Vaccines