New Intranasal flu vaccine for Toddlers . Yes or no ?

[IAmADonkeyOnTheEdge]

Just had a letter asking us to bring our 3.5 yr Dd for a flu vaccine ( up the nose !). No idea how they will persuade to sniff it up and also not sure if we should go for it or not.... Anyone else having it?

but the kids would be protected from the flu themselves.

It's not really 'taking one for the herd' when the 'herd' will still outnumber the vaccinated quite considerably...

apart from people who are simply antivaccination, I'm surprised by the suggestion that it is immoral to try to reduce disease in the community.

Let's suppose there was a disease that women could get, and it was liable to be caused by contact with men, who can carry an infection which they pass on.

Would we want to immunise just the women, or would we want to immunise the men as well?

Having watched my son have swine flu when he was 3 and seeing how ill he was, I would definitely give him the vaccine.
As an asthmatic, and having had pneumonia from the flu before, I always have the vaccine myself. People who will risk having flu when they don't need to, clearly haven't ever had proper flu.

Piglet it's an autonomy thing as well as risk/reward. Some view vaccination as a serious violation of their rights even if no risk is involved.

They have their right to that viewpoint. But it makes me think of Bob The Angry Flower

ladybirds, some people have flu mildly. Look at how many asymptomatic/mild cases of swine flu there were - yes, some people had it badly(such as your son), but others did not. They still all had 'proper' swine flu.

ladybirds, some people have flu mildly.

that must be a great comfort to p[eople who get it severely

Lots of older people didn't suffer much from pig flu as it was similar to a strain that was around some 50 years ago. Younger people had no natural immunity.

My comment about some people having flu mildly was in response to "People who will risk having flu when they don't need to, clearly haven't ever had proper flu."

You can have 'proper' flu mildly.

Lots of younger people also had swine flu mildly despite not having come into contact with that previous strain.

But how do you know you will have flu "mildly" next time round?

You don't. I was simply responding to your post about people not having ever had 'proper' flu if they are turning down the vaccine.

I'm sorry but if it wasn't for herd immunity, terrible diseases such as polio, diphtheria, TB etc would still be harming/killing people.

So don't vaccinate and rely on the decency of others

DS's grandma gets the flu jab anyway, but if she wasn't able to for any reason that would be a very strong motivation for me. I don't want DS to be responsible for putting his gran in hospital (which is likely if she gets flu.)

Actually - can we still call it a jab if it isn't? What do you call it instead - a squirt? Getting your squirts done just doesn't have the same ring...

MsPickle, you talk about herd immunity regarding polio. That's fine, but in the year that India wiped out polio, nearly 50,000 Indian children were diagnosed with np-afp, that's polio by another name and guess whats driving the surge in np-afp............an untested polio vaccine pedaled by The Bill Gates foundation, now for a disease that affects less than 200 people worldwide, nearly 50,00 sounds like quite a lot of people to be affected by the drive to achieve herd immunity, that's not to mention the cost to the Indian government and what could have been achieved with that money.

I personally think the whole concept of herd immunity is tied up with huge moral, ethical and legal questions .

ForTheLoveofSocks, i don't agree with your statement, most of these diseases were well on their way out well before vaccination, due to better hygiene, living standards etc.

I'm not relying on the decency of others, I don't want to vaccinate, I don't expect others to either and can't be held responsible for what others do or do not do.

Re India and Polio - here's what all the fuss is about, the original paper: India and Polio paper: Polio programme: let us declare victory and move on

It's an interesting story. Looks like the vaccine may have been over-administrated in some regions?

Paper:

“In the states of Uttar Pradesh (UP) and Bihar, which have pulse polio rounds nearly every month, the non-polio AFP rate is 25- and 35-fold higher than the international norms. The relationship of the non-polio AFP rate is curvilinear with a more steep increase beyond six doses of OPV in one year.”

WHO Guidelines:

“The primary series of 3 OPV vaccinations should be administered according to the schedules of national immunization programmes, for example at 6 weeks, 10 weeks, and 14 weeks, or at 2 months, 4 months, and 6 months. In addition, a birth dose should be given as soon as possible after birth when the potential for poliovirus importation is very high or high and the transmission potential is high or moderate”

I'd like to see any more studies on this if anyone can find them (I can't).

Even the biggest fan of the establishment view on vaccines would agree that bad things are very possibly going to happen if you over-administrate vaccines. It's all very well chucking money at a problem but this can blow back at you if the money is paying to administer medicine with side-effects.

Re what that has to do with ethics around herd protection - one may think (as that paper's authors do) that polio eradication is infeasible or at least not a sensible goal to pursue because there are better ways to spend the money. That's not the same thing as saying that trying to get herd protection effects is in any way a bad thing in itself.

I'd agree there are non-trivial ethical etc questions raised by herd protection concerns. The herd doesn't, or shouldn't, get to decide what everyone else does.

Apart from anything else regarding polio, can't polio be made in the lab, so it can never be truly eradicated, anyone can bring polio back at any time.

India and the rest of the world have been sold an impossible dream regarding polio eradication. Herd immunity is being tauted as a solution to a problem but that solution can never be truly achieved.

People have made both poliovirus and Spanish influenza virus completely from scratch.

I believe the current state is that any virus (Ebola etc) can be reconstructed from its genome at a cost of 1 USD per 20,000 base pairs.

Eg very cheap, and getting cheaper.

The test-tube synthesis of a chemical called poliovirus: The simple synthesis of a virus has far-reaching societal implications (EMBO Rep. 2006 July; 7(Spec No): S3–S9.)

"Herd immunity" means different things to different people. It's such an ambiguous term that I prefer to talk in terms of the value of specific herd protection effects in specific situations.

In any case it's clear that we can't talk about any virus being guaranteed to never appear again (once its genome has been sequenced).

Yes arkestra, you are right about herd immunity meaning different things to different people, I also think the moral issues mean different things to different people and people will have different sets of morals and also see the risks and benefits in different ways.

Yeah, agree Frontdoorstep, it's not just a difference over definitions - although clear definitions help sort out where the real differences are.

It seems you give autonomy a higher weighting as a good relative to some other goods than some others on the thread, probably including me. It's not like I don't think autonomy is important. Eg we got people today floating the idea that benefits should get cut for people not taking up MMR for their kids, which (even) I think is a total fail from an autonomy perspective. Does anyone seriously think that makes sense?

Think we probably differ on risk/reward too. I'm interested in finding out about vaccine missteps etc but ultimately I am pretty mainstream in my views there. Interested in papers on India etc but have only found the one so far.

Yeah, I've heard the idea too of withholding benefits from people who don't vaccinate, I guess it would be child benefit, since that is the only one that many people get. Tbh, I don't think that idea would be able to take off now that child benefit is restricted above £50,000. I guess you might be tempted to vaccinate to get money, but if you weren't getting money because your income was too high then the money issue won't come into it.

Yes the India situation is interesting, thanks for the link, I'm afraid my technical skills aren't good enough to post a link.

You raised a good point earlier about the children and old people being one and the same and one day someone else will protect my child when they are old but I'm afraid that isn't enough to persuade me to vaccinate.

LaVolcan also raised a good point about why old people refuse the vaccine.

LaVolcan also raised a good point about why old people refuse the vaccine.

I don't know how good her point is as I haven't seen evidence that it is true or any statistics to show how common refusals are for people of different ages. Have you?

I think the best we have in uptake numbers is here Flu vaccine uptake GP stats for 2012-13. See end for graphs/trends etc.

I'm not aware of research into reasons why people refuse vaccines in general though. Whether in general or by age or whatever. There must be something out there? Otherwise all any of us has is individual responses... meaning LaVolcan's point is as valid as anything I can come up with.

I don't have a toddler but my first question would be how effective is the vaccine? There are many different strains of flu, the vaccine cant possibly cover them all?
And having given intra nasal vaccines to animals IME the majority of it is sneezed/dribbled out.
My parents get the flu vaccine and my dad had an awful flu bug last year.
I think gp's should be giving parents more information about the vaccine rather than just 'we have a new vaccine, come get your child vaccinated'.

LaVolcan also raised a good point.............

I don't know how good her point is

I said that my father used to refuse it on the grounds that he was losing his faculties and most of his friends had died and he felt that his life was less and less worth living.

That was the opinion of one old man (who was 90 when he died), but he is not the only old person who I have heard expressing similar opinions. In short, their answer to an offer of the flu vaccine is "why bother?"

My kids have been offered it at school, I've said no. My basis is that they are fit and healthy, don't get colds and this vaccine changes every year so will need redone next year. I'm not prepared to make the decision of them getting different drugs every year when IMO they don't need them and I am unsure of long term effects.

i see

When I read a lot of the said herd i.e. the adults, don't want to know about it I did not think that "A LOT" meant one man you knew closely plus some comments by some others.