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posted by chromas on Wednesday August 29 2018, @04:47PM   Printer-friendly
from the butt-heads-on-trade-agreements dept.

The Chinese government appears to be withholding samples of the bird flu virus H7N9, requested by U.S. researchers:

The samples are critical for studying the virus and developing life-saving treatments and vaccines in preparation for potential outbreaks or pandemics. Usually, countries share viral samples "in a timely manner" without any fanfare under an agreement established by the World Health Organization to address such potential flu threats. That usually means a matter of months.

But according to The New York Times, China has failed to share the samples for more than a year, despite persistent requests from government officials and researchers, including those at the Centers for Disease Control and Prevention. Moreover, scientists and experts worry that, as the US and China continue to butt heads on trade agreements, the issue of sharing biological samples and other medical-related materials could worsen.

We can make our own flu, and send them live samples.

Also at The New York Times.


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  • (Score: 2, Informative) by Anonymous Coward on Wednesday August 29 2018, @06:22PM (31 children)

    by Anonymous Coward on Wednesday August 29 2018, @06:22PM (#727928)

    Your paper from 1994:

    The efficacy of inactivated vaccine in preventing culture-positive influenza was 76% (95% confidence interval [CI], 58%–87%) for HINI disease

    https://academic.oup.com/jid/article-abstract/169/1/68/896278 [oup.com]

    More recent data:

    This report uses data from 4,562 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness Network (U.S. Flu VE Network) during November 2, 2017–February 3, 2018. During this period, overall adjusted vaccine effectiveness (VE) against influenza A and influenza B virus infection associated with medically attended ARI was 36% (95% confidence interval [CI] = 27%–44%).

    https://www.cdc.gov/mmwr/volumes/67/wr/mm6706a2.htm [cdc.gov]

    vaccine efficacy shows how effective the vaccine could be given ideal circumstances and 100% vaccine uptake; vaccine effectiveness measures how well a vaccine performs when it is used in routine circumstances in the community.

    https://en.wikipedia.org/wiki/Vaccine_efficacy [wikipedia.org]

    Healthy adults who receive inactivated parenteral influenza vaccine rather than no vaccine probably experience less influenza, from just over 2% to just under 1% (moderate-certainty evidence). They also probably experience less ILI following vaccination, but the degree of benefit when expressed in absolute terms varied across different settings. Variation in protection against ILI may be due in part to inconsistent symptom classification. Certainty of evidence for the small reductions in hospitalisations and time off work is low. Protection against influenza and ILI in mothers and newborns was smaller than the effects seen in other populations considered in this review.Vaccines increase the risk of a number of adverse events, including a small increase in fever, but rates of nausea and vomiting are uncertain. The protective effect of vaccination in pregnant women and newborns is also very modest. We did not find any evidence of an association between influenza vaccination and serious adverse events in the comparative studies considered in this review. Fifteen included RCTs were industry funded (29%).

    https://www.ncbi.nlm.nih.gov/pubmed/29388196 [nih.gov]

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  • (Score: 4, Interesting) by ikanreed on Wednesday August 29 2018, @06:30PM (29 children)

    by ikanreed (3164) Subscriber Badge on Wednesday August 29 2018, @06:30PM (#727930) Journal

    Did you read past the first percentage you saw in your paper?

    Preventing the particular strain they selected for in creation was 67%. Acute respiratory incidents are more commonly associated with other strains like Bird Flu. Moreover, I don't know what you aim to prove to me by pointing at a paper that says higher vaccination rates would save thousands of lives in 2018 in their conclusion. That seems to definetly undercut your "does nothing" line.

    Your second paper, you seem to be purposefully conflating absolute and relative risk to make 1-2% sound like small numbers.

    • (Score: 2, Interesting) by Anonymous Coward on Wednesday August 29 2018, @06:40PM (28 children)

      by Anonymous Coward on Wednesday August 29 2018, @06:40PM (#727934)

      Preventing the particular strain they selected for in creation was 67%.

      Its all in the 70% range but doesnt really matter since vaccine efficacy is not the correct number to apply to a member of the public getting vaccinated. That is vaccine effectiveness.

      Acute respiratory incidents are more commonly associated with other strains like Bird Flu.

      Ok, who cares? Every strain is different.

      Moreover, I don't know what you aim to prove to me by pointing at a paper that says higher vaccination rates would save thousands of lives in 2018 in their conclusion.

      The part I quoted contained the part I wished you to notice. It was that vaccine effectiveness more recently is reported to be closer to 35% than the 70% vaccine efficacy reported in your source. I don't really care what spin they put on the results. If they wanted they could have said that higher vaccination rates will lead to billions of dollars lost due to people who get unnecessarily ill from the flu vaccine and have to miss work/etc.

      Your second paper, you seem to be purposefully conflating absolute and relative risk to make 1-2% sound like small numbers.

      I didnt conflate anything, I quoted the entire conclusion of the most recent cochrane review on flu vaccines... Sorry you dont like the results.

      • (Score: 4, Interesting) by Taibhsear on Wednesday August 29 2018, @06:55PM (4 children)

        by Taibhsear (1464) on Wednesday August 29 2018, @06:55PM (#727941)

        vaccine effectiveness more recently is reported to be closer to 35% than the 70% vaccine efficacy reported in your source.

        Not sure if you know or not but that's comparing two different vaccines. They don't have the same target strains. They are based on estimates of what strains appear to be the biggest upcoming threats for that year/season and then put into production. Last years vaccine just ended up being not as accurate with their chosen targets. It doesn't mean all flu vaccines are therefore pointless. You still end up having immunity/resistance to the strains from last years vaccine. It just wasn't effective vs the strains that ended up being the most successful last year. The virus mutates constantly. It's actually pretty fascinating how it does so. I'd recommend people read up on it if interested.

        • (Score: 2, Interesting) by Anonymous Coward on Wednesday August 29 2018, @07:09PM (3 children)

          by Anonymous Coward on Wednesday August 29 2018, @07:09PM (#727951)

          Yes, even within strains you need a new vaccine every year. I'm making no attempt to distinguish between different strains or vaccines in my comments.

          • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @10:58AM (2 children)

            by Anonymous Coward on Thursday August 30 2018, @10:58AM (#728224)

            "new vaccine every year"

            An optimized vaccine for the same recombinants (e.g. the current strain derived from the 2009 H1N1) with minor mutations - not new recombinants that aren't circulating like H7N9. The previous year's vaccine was limited in effectiveness due to a mutation producing a glycosylation site that isn't represented well in egg-adapted vaccine production systems.

            • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @12:33PM (1 child)

              by Anonymous Coward on Thursday August 30 2018, @12:33PM (#728242)

              The previous year's vaccine was limited in effectiveness due to a mutation producing a glycosylation site

              Was this predicted beforehand, or did they notice the vaccine didnt work and then go look for an excuse?

              • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @01:52PM

                by Anonymous Coward on Thursday August 30 2018, @01:52PM (#728253)

                IIRC they noticed during production/QC before the season began when they were doing HA neutralizing assays. The antibodies worked, but not as well as normal or compared to non-egg, in vitro produced vaccine that produce fully glycosylated surface proteins. It's worth noting that this was for one of the A strains (the vaccine includes 3-4 A strains and influenza B).

      • (Score: 2) by ikanreed on Wednesday August 29 2018, @09:05PM (16 children)

        by ikanreed (3164) Subscriber Badge on Wednesday August 29 2018, @09:05PM (#728007) Journal

        I didnt conflate anything

        You did, and now you're lying about it.

        • (Score: 1, Interesting) by Anonymous Coward on Wednesday August 29 2018, @09:19PM (15 children)

          by Anonymous Coward on Wednesday August 29 2018, @09:19PM (#728017)

          Do you understand what a cochrane review is and why I would want to include it?

          I had already earlier directly addressed your (wrong) application of old vaccine efficacy numbers with a different paper that provided more recent (correctly applied) vaccine effectiveness values. The cochrane review, however, is usually the most extensive meta-analysis available for any treatment. They conclude the evidence is somewhat shaky for even a small net benefit of flu vaccines at the societal level. You don't like that (which is fine, I dont claim the cochrane reviews are the word of god) but apparently cant offer any valid critique.

          Anyway, this is the second time I've had an interaction with you like this.... I suspect you are one of those trumptards posting under a false flag to make the "other side" look drunk or stupid or ignorant or whatever.

          • (Score: 2) by ikanreed on Wednesday August 29 2018, @09:49PM (8 children)

            by ikanreed (3164) Subscriber Badge on Wednesday August 29 2018, @09:49PM (#728031) Journal

            Okay, I get it. You're angry because you're wrong.

            The words "Cocherane review" do nothing to answer for conflating absolute and relative risk to misrepresent numbers. You're dumb, your antivax views are dumb, and this argument is way too dumb to be having.

            • (Score: 1, Interesting) by Anonymous Coward on Wednesday August 29 2018, @10:16PM

              by Anonymous Coward on Wednesday August 29 2018, @10:16PM (#728036)

              conflating absolute and relative risk to misrepresent numbers.

              Which was done where? Just because I included the two types of values in the same post? I don't think that is too confusing for most readers on this site.

            • (Score: 1, Interesting) by Anonymous Coward on Wednesday August 29 2018, @10:19PM (6 children)

              by Anonymous Coward on Wednesday August 29 2018, @10:19PM (#728038)

              And in fact its you who conflated vaccine efficacy with vaccine effectiveness. Not that I dont think that set of terms isnt designed to confuse people...

              • (Score: 2) by RandomFactor on Wednesday August 29 2018, @10:37PM (5 children)

                by RandomFactor (3682) Subscriber Badge on Wednesday August 29 2018, @10:37PM (#728042) Journal

                I get the vaccine about every other year.
                 
                I don't generally get the flu regardless (or it is so mild it doesn't matter), but I've notably never gotten it when i had the vaccine that year.

                (In before someone with the exact opposite anecdote)
                 
                Now I -would- make a comment about insurance companies being businesses that don't pay for ineffective treatments, but then i would have to shred my own argument, so I'll just leave it there.

                --
                В «Правде» нет известий, в «Известиях» нет правды
                • (Score: 1, Insightful) by Anonymous Coward on Wednesday August 29 2018, @11:14PM (4 children)

                  by Anonymous Coward on Wednesday August 29 2018, @11:14PM (#728059)

                  I think insurance companies just figured out vaccinated people are less likely to visit the doctor for minor flu like symptoms if they consider themselves "protected", so its cheaper to pay for these vaccines whether placebo or not.

                  I wouldnt go to the doctor if I did have the flu, ie these visits being avoided are mostly unnecessary anyway.

                  • (Score: 2) by Runaway1956 on Thursday August 30 2018, @02:33AM (3 children)

                    by Runaway1956 (2926) Subscriber Badge on Thursday August 30 2018, @02:33AM (#728116) Journal

                    I wouldnt go to the doctor if I did have the flu,

                    I'm with you, about 85%. I don't go to the doctor with every sniffle, headache, or bout of diarhea, or vomiting. But, you should be aware that flu can, and does kill people. Different strains, different people, different years - everything changes.

                    How about a statement more like, "I'm not running to the doctor at the first sign of illness, but if the flu gets severe, I may seek medical care." Fever and dehydration, if left uncontrolled for any length of time, will kill you. The other symptoms are less serious, and only make you miserable - not worth wasting a trip to the doctor.

                    Then again - to some extent, that fever and dehydration can be dealt with in most cases. Soak in bathtub of cool water to lower fever, and drink lots of electrolytes. Pedialyte, sports drinks, even just plain salt water helps.

                    There is some point at which you need a doctor's care, but most Americans think that point is "I don't feel well."

                    • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @02:46AM (2 children)

                      by Anonymous Coward on Thursday August 30 2018, @02:46AM (#728128)

                      It sounds like you already know what to do in that situation, what is the doctor adding? Do we need an uber-IV drip?

                      • (Score: 2) by Runaway1956 on Thursday August 30 2018, @02:54AM (1 child)

                        by Runaway1956 (2926) Subscriber Badge on Thursday August 30 2018, @02:54AM (#728135) Journal

                        You may need an IV, if things get bad. Or, you may submit, and die. The only point here is, flu does kill. You may or may not be a statistic, if you're overly stubborn about going to the doctor.

                        • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @03:02AM

                          by Anonymous Coward on Thursday August 30 2018, @03:02AM (#728139)

                          Right so the worst case scenario all they can do is give you an IV. You can just go to a rave and get that for free, so I doubt a doctor visit is really necessary.

          • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @11:38AM (5 children)

            by Anonymous Coward on Thursday August 30 2018, @11:38AM (#728226)

            Pointing at a single year's numbers and implying that they invalidate the historical trend is pretty misleading.

            "They conclude the evidence is somewhat shaky for even a small net benefit of flu vaccines at the societal level."
            Where did they say that?
            It wasn't in the quoted section and I didn't find anythng about it when I scanned the review. Are you extrapolating from the low certainty of the four "time off work" studies?

            • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @12:38PM (4 children)

              by Anonymous Coward on Thursday August 30 2018, @12:38PM (#728243)

              Its not a single years numbers... the cochrane review covers decades of studies.

              You'll have to understand that I was paraphrasing rather than directly quoting. "Moderate certainty" == "somewhat shaky" and "2% to 1%" == "small net benefit":

              Conclusions favourable to the use of influenza vaccines
              were associated with a higher risk of bias. The authors of
              studies in this review made claims and drew conclusions that were
              unsupported by the data they presented...Any interpretation of the body of evidence
              in this review should be made with these findings in mind.
              [...]
              Healthy adults who receive inactivated parenteral influenza vaccine
              rather than no vaccine probably have a 1%lower risk of experiencing
              influenza over a single influenza season (2.3%versus 1%,
              moderate-certainty evidence)

              https://soylentnews.org/comments.pl?sid=27349 [soylentnews.org]

              • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @02:42PM (3 children)

                by Anonymous Coward on Thursday August 30 2018, @02:42PM (#728275)

                "Its not a single years numbers"
                You cited the MMWR reported number for the most recent season (36% effectiveness) as evidence that influenza vaccines don't work.

                It seems that saying "somewhat shaky" is overstating the uncertainty a bit.

                GRADE Working Group grades of evidence
                High quality: We are very confident that the true effect lies close to that of the estimate of the effect.
                Moderate quality: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
                Low quality: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
                Very low quality: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

                ""2% to 1%" == "small net benefit"
                2.3% to 1% risk is reducing the risk by more than half (~57%) and is probably close/within the 95%CI (using the 1994 paper as a reference class).

                Saying "they conclude ... [your interpretation]" is putting words in their mouth and raises suspicions of motivated reasoning. Also, going from (I'm paraphrasing): "[influenza vaccines don't work]" to "[they didn't work well last year]" then "[they don't work well and the evidence is bad]" and "[small net benefit to society]" looks like you're moving the goal posts.

                • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @08:16PM (2 children)

                  by Anonymous Coward on Thursday August 30 2018, @08:16PM (#728385)

                  "Its not a single years numbers"
                  You cited the MMWR reported number for the most recent season (36% effectiveness) as evidence that influenza vaccines don't work.

                  No, I cited that number to demonstrate the difference between vaccine effectiveness and vaccine efficacy. This is already explained in the thread.

                  But whatever, I originally provided just the quotes and the sources. When I first didnt interpret for people some other poster said I was trying to conflate absolute and relative risk for some reason. No matter what there's just a bunch of pseudo-skeptic whining and nitpicking about some misinterpretation of what I wrote.

                  • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @09:40PM (1 child)

                    by Anonymous Coward on Thursday August 30 2018, @09:40PM (#728438)

                    Your original post, with bolding for emphasis:

                    The flu vaccines dont work anyway... all this means is whoever is making those will be able to scam less people indirectly through their insurance.

                    And its strange that China is apparently just doing this without any public comment, and has been for awhile (which invalidates the "trade war" narrative). They are probably covering up some shady activities. Are they worried the US is going to find a bunch of myc/his/flag/etc tags in there?

                    "pseudo-skeptic whining and nitpicking about some misinterpretation"
                    Your original post was full of strong claims and baseless speculation, so you don't really have the high ground. Misinterpreting a strong vague statement "flu vaccines dont work" is fair, but it seems you meant "[they don't work very well and don't have a strong benefit at the societal level]"

                    I didn't bother earlier with how you implied that China bioengineered the current H7N9, are covering it up, and that they were careless enough to leave obvious evidence, but I'll be a "pseudo-skeptic" and ask now for any evidence you have to support that claim or clear-up my misinterpretation.

                    • (Score: 0) by Anonymous Coward on Saturday September 01 2018, @11:01PM

                      by Anonymous Coward on Saturday September 01 2018, @11:01PM (#729349)

                      Obviously that was speculation it got released on accident from some chinese lab before they could "clean" it.

      • (Score: 3, Insightful) by axsdenied on Thursday August 30 2018, @01:30AM (5 children)

        by axsdenied (384) on Thursday August 30 2018, @01:30AM (#728093)

        Now you are contradicting yourself. Let me quote two statements from you:

        The flu vaccines dont work anyway...

        and

        It was that vaccine effectiveness more recently is reported to be closer to 35% than the 70%...

        • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @02:39AM (3 children)

          by Anonymous Coward on Thursday August 30 2018, @02:39AM (#728121)

          Yes, that was one paper that I skimmed... I also went on to site the 2018 cochrane review which concludes these studies seem to have issues:

          Conclusions favourable to the use of influenza vaccines
          were associated with a higher risk of bias. The authors of
          studies in this review made claims and drew conclusions that were
          unsupported by the data they presented.

          • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @02:49AM

            by Anonymous Coward on Thursday August 30 2018, @02:49AM (#728130)

            site -> cite

          • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @11:45AM (1 child)

            by Anonymous Coward on Thursday August 30 2018, @11:45AM (#728227)

            So the fact that they assessed bias and attempted to correct for it means that the review is wrong?

            • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @12:41PM

              by Anonymous Coward on Thursday August 30 2018, @12:41PM (#728245)

              No? Sorry, I have no idea what you are talking about.

        • (Score: 0) by Anonymous Coward on Thursday August 30 2018, @02:44AM

          by Anonymous Coward on Thursday August 30 2018, @02:44AM (#728125)

          I don't take any of these claims I am citing to be fact if that is how you are thinking... but, at best, what these vaccines have to offer me sounds very limited. So Im not going to run off to pay big pharma for it (or get someone else to pay for me).

  • (Score: 3, Informative) by Anonymous Coward on Wednesday August 29 2018, @07:06PM

    by Anonymous Coward on Wednesday August 29 2018, @07:06PM (#727948)

    More from the 2018 cochrane review:

    Conclusions favourable to the use of influenza vaccines
    were associated with a higher risk of bias. The authors of
    studies in this review made claims and drew conclusions that were
    unsupported by the data they presented. In addition, industryfunded
    studies are more likely to have favourable conclusions, to
    be published in significantly higher-impact factor journals, and to
    have higher citation rates than non-industry-funded studies. This
    difference is not explained by either their size or methodological
    quality (Jefferson 2009b). Any interpretation of the body of evidence
    in this review should be made with these findings in mind.

    [...]

    Implications for practice
    Healthy adults who receive inactivated parenteral influenza vaccine
    rather than no vaccine probably have a 1%lower risk of experiencing
    influenza over a single influenza season (2.3%versus 1%,
    moderate-certainty evidence) and probably have a 3.4%lower risk
    of experiencing influenza-like illness (ILI) (21.5% versus 18.1%,
    moderate-certainty evidence). The numbers needed to vaccinate
    (NNVs) for influenza and ILI were 71 and 29, respectively, reflecting
    high rates of ILI in the control groups for many of the trials.
    The NNV of 29 conceals variation in the absolute reduction in
    ILI for low- and high-risk groups, and the degree of benefit may
    vary at least in part due to inconsistent symptomclassification. Extrapolatiing
    these effects to settings other than those of the studies
    is challenging due to uncertain methods for confirming influenza
    and variation in the absolute reductions in ILI following vaccination.
    We found low-certainty evidence that hospitalisation rates and
    time off work may be comparable between vaccinated and unvaccinated
    adults, although the confidence interval around the effect
    for hospital admission is wide and there was substantial variation
    in the direction of effect on time off work. Vaccines increase the
    risk of a number of adverse events, including a small increase in
    fever, but the effect on nausea or vomiting is less clear.