Gestapo Guidelines Elevated for Toxic Influenza Immunization in Children

Gestapo Guidelines Elevated for Toxic Influenza Immunization in Children
" ... children younger than 9 years receive 2 doses of influenza vaccine in
their second season of immunization if they only received 1 dose in the
previous season ..."

http://www.medscape.com/viewarticle/572661

Guidelines Updated for Influenza Immunization in Children CME
News Author: Laurie Barclay, MD
CME Author: Désirée Lie, MD, MSEd
Disclosures
Release Date: April 8, 2008; Valid for credit through April 8, 2009
Credits Available

Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)T for physicians;
Family Physicians - up to 0.25 AAFP Prescribed credit(s) for physicians



Authors and Disclosures
Laurie Barclay, MD
Disclosu Laurie Barclay, MD, has disclosed no relevant financial
relationships.

Désirée Lie, MD, MSEd
Disclosu Désirée Lie, MD, MSEd, has disclosed no relevant financial
relationships.

Brande Nicole Martin
Disclosu Brande Nicole Martin has disclosed no relevant financial
information.


April 8, 2008 * The American Academy of Pediatrics (AAP) has issued its
2007-2008 recommendations for influenza immunization in children. The
revised guidelines, developed by the 2007-2008 Committee on Infectious
Diseases, are published in the April issue of Pediatrics.

"The purpose of this statement is to update the current recommendations for
routine use of influenza vaccine in children, which were originally
published in a condensed format in April 2007," write Joseph A. Bocchini,
Jr, MD, and colleagues from the 2007-2008 Committee on Infectious Diseases.
"Highlights include (1) harmonization of the recommendation of the American
Academy of Pediatrics (AAP) and the Centers for Disease Control and
Prevention (CDC) that children younger than 9 years receive 2 doses of
influenza vaccine in their second season of immunization if they only
received 1 dose in the previous season; and (2) additional detail on the
recommended storage, dosage, and administration of live-attenuated influenza
vaccine (LAIV), including the recent licensure of LAIV for children as young
as 2 years."

The revised AAP guidelines recommend annual influenza immunization for all
children with high-risk conditions who are at least 6 months of age, all
healthy children ages 6 through 59 months, all household contacts and
out-of-home caregivers of children who have high-risk conditions and of
healthy children younger than 5 years, and all healthcare clinicians.

To help prevent influenza-associated complications, the committee mandates
increased efforts to identify and immunize all children at high risk and all
healthy children ages 6 through 59 months and to inform their parents when
annual immunizations are due. Previously unimmunized children between 6
months and 9 years of age should be given 2 doses of influenza vaccine,
administered 1 month apart, beginning as soon as local availability permits
during the influenza season.

Children in this cohort who received only 1 dose for the first time in the
previous season should be given 2 doses in the current season, but this
recommendation is only applicable to the influenza season that follows the
first year that a child younger than 9 years receives influenza vaccine.
Children who then also fail to receive 2 doses the next year should receive
only 1 dose per year from that point on.

Even after influenza activity has been documented in a community, influenza
vaccination should also continue to be offered throughout the influenza
season. The influenza vaccine may change from year to year based on global
surveillance of circulating virus strains. In the 2007-2008 vaccine, 1 of
the 3 strains differs from that in the previous year's vaccine.

Plans to immunize all children for whom influenza vaccine is recommended
require expanding outreach and infrastructure developed by all healthcare
clinicians, influenza campaign organizers, and public health agencies. When
vaccine supplies are delayed or limited, administration of influenza vaccine
must take priority.

Immunization against influenza is recommended throughout late winter and
early spring because the influenza season often continues into March.
Because of widespread resistance of influenza A virus strains to amantadine
or rimantadine, healthcare clinicians should not prescribe these antivirus
medications for influenza treatment or chemoprophylaxis during the 2007-2008
season and most likely beyond. However, influenza A and B strains remain
susceptible to oseltamivir and zanamivir, and these medications can still be
prescribed for treatment or chemoprophylaxis.

That's one thing about Scudamo you can always count
on him to Godwin -- and now he doesn't even fiddle around
on the way there.

--
| The most important exclamation in science isn't "Eureka!" |
| The most important exclamation is "What the BLEEP?" |
+---------- D. C. Sessions ----------+

"JOHN" wrote in message
...
Gestapo Guidelines Elevated for Toxic Influenza Immunization in Children
" ... children younger than 9 years receive 2 doses of influenza vaccine
in their second season of immunization if they only received 1 dose in the
previous season ..."

http://www.medscape.com/viewarticle/572661

Guidelines Updated for Influenza Immunization in Children CME
News Author: Laurie Barclay, MD
CME Author: Désirée Lie, MD, MSEd
Disclosures
Release Date: April 8, 2008; Valid for credit through April 8, 2009
Credits Available

Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)T for physicians;
Family Physicians - up to 0.25 AAFP Prescribed credit(s) for physicians



Authors and Disclosures
Laurie Barclay, MD
Disclosu Laurie Barclay, MD, has disclosed no relevant financial
relationships.

Désirée Lie, MD, MSEd
Disclosu Désirée Lie, MD, MSEd, has disclosed no relevant financial
relationships.

Brande Nicole Martin
Disclosu Brande Nicole Martin has disclosed no relevant financial
information.


April 8, 2008 * The American Academy of Pediatrics (AAP) has issued its
2007-2008 recommendations for influenza immunization in children. The
revised guidelines, developed by the 2007-2008 Committee on Infectious
Diseases, are published in the April issue of Pediatrics.

"The purpose of this statement is to update the current recommendations
for routine use of influenza vaccine in children, which were originally
published in a condensed format in April 2007," write Joseph A. Bocchini,
Jr, MD, and colleagues from the 2007-2008 Committee on Infectious
Diseases. "Highlights include (1) harmonization of the recommendation of
the American Academy of Pediatrics (AAP) and the Centers for Disease
Control and Prevention (CDC) that children younger than 9 years receive 2
doses of influenza vaccine in their second season of immunization if they
only received 1 dose in the previous season; and (2) additional detail on
the recommended storage, dosage, and administration of live-attenuated
influenza vaccine (LAIV), including the recent licensure of LAIV for
children as young as 2 years."

The revised AAP guidelines recommend annual influenza immunization for all
children with high-risk conditions who are at least 6 months of age, all
healthy children ages 6 through 59 months, all household contacts and
out-of-home caregivers of children who have high-risk conditions and of
healthy children younger than 5 years, and all healthcare clinicians.

To help prevent influenza-associated complications, the committee mandates
increased efforts to identify and immunize all children at high risk and
all healthy children ages 6 through 59 months and to inform their parents
when annual immunizations are due. Previously unimmunized children between
6 months and 9 years of age should be given 2 doses of influenza vaccine,
administered 1 month apart, beginning as soon as local availability
permits during the influenza season.

Children in this cohort who received only 1 dose for the first time in the
previous season should be given 2 doses in the current season, but this
recommendation is only applicable to the influenza season that follows the
first year that a child younger than 9 years receives influenza vaccine.
Children who then also fail to receive 2 doses the next year should
receive only 1 dose per year from that point on.

Even after influenza activity has been documented in a community,
influenza vaccination should also continue to be offered throughout the
influenza season. The influenza vaccine may change from year to year based
on global surveillance of circulating virus strains. In the 2007-2008
vaccine, 1 of the 3 strains differs from that in the previous year's
vaccine.

Plans to immunize all children for whom influenza vaccine is recommended
require expanding outreach and infrastructure developed by all healthcare
clinicians, influenza campaign organizers, and public health agencies.
When vaccine supplies are delayed or limited, administration of influenza
vaccine must take priority.

Immunization against influenza is recommended throughout late winter and
early spring because the influenza season often continues into March.
Because of widespread resistance of influenza A virus strains to
amantadine or rimantadine, healthcare clinicians should not prescribe
these antivirus medications for influenza treatment or chemoprophylaxis
during the 2007-2008 season and most likely beyond. However, influenza A
and B strains remain susceptible to oseltamivir and zanamivir, and these
medications can still be prescribed for treatment or chemoprophylaxis.


http://www.cbc.ca/health/story/2006/...flu-shots.html

http://www.medicalconsumers.org/page...orkforKidsorth...

http://www.medicalconsumers.org/page...Effective.html

http://www.doctorbob.com/vd--flu-shot-season.html

"JOHN" wrote in message
...
Gestapo Guidelines Elevated for Toxic Influenza Immunization in Children
" ... children younger than 9 years receive 2 doses of influenza vaccine
in their second season of immunization if they only received 1 dose in the
previous season ..."

http://www.medscape.com/viewarticle/572661

Guidelines Updated for Influenza Immunization in Children CME
News Author: Laurie Barclay, MD
CME Author: Désirée Lie, MD, MSEd
Disclosures
Release Date: April 8, 2008; Valid for credit through April 8, 2009
Credits Available

Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)T for physicians;
Family Physicians - up to 0.25 AAFP Prescribed credit(s) for physicians



Authors and Disclosures
Laurie Barclay, MD
Disclosu Laurie Barclay, MD, has disclosed no relevant financial
relationships.

Désirée Lie, MD, MSEd
Disclosu Désirée Lie, MD, MSEd, has disclosed no relevant financial
relationships.

Brande Nicole Martin
Disclosu Brande Nicole Martin has disclosed no relevant financial
information.


April 8, 2008 * The American Academy of Pediatrics (AAP) has issued its
2007-2008 recommendations for influenza immunization in children. The
revised guidelines, developed by the 2007-2008 Committee on Infectious
Diseases, are published in the April issue of Pediatrics.

"The purpose of this statement is to update the current recommendations
for routine use of influenza vaccine in children, which were originally
published in a condensed format in April 2007," write Joseph A. Bocchini,
Jr, MD, and colleagues from the 2007-2008 Committee on Infectious
Diseases. "Highlights include (1) harmonization of the recommendation of
the American Academy of Pediatrics (AAP) and the Centers for Disease
Control and Prevention (CDC) that children younger than 9 years receive 2
doses of influenza vaccine in their second season of immunization if they
only received 1 dose in the previous season; and (2) additional detail on
the recommended storage, dosage, and administration of live-attenuated
influenza vaccine (LAIV), including the recent licensure of LAIV for
children as young as 2 years."

The revised AAP guidelines recommend annual influenza immunization for all
children with high-risk conditions who are at least 6 months of age, all
healthy children ages 6 through 59 months, all household contacts and
out-of-home caregivers of children who have high-risk conditions and of
healthy children younger than 5 years, and all healthcare clinicians.

To help prevent influenza-associated complications, the committee mandates
increased efforts to identify and immunize all children at high risk and
all healthy children ages 6 through 59 months and to inform their parents
when annual immunizations are due. Previously unimmunized children between
6 months and 9 years of age should be given 2 doses of influenza vaccine,
administered 1 month apart, beginning as soon as local availability
permits during the influenza season.

Children in this cohort who received only 1 dose for the first time in the
previous season should be given 2 doses in the current season, but this
recommendation is only applicable to the influenza season that follows the
first year that a child younger than 9 years receives influenza vaccine.
Children who then also fail to receive 2 doses the next year should
receive only 1 dose per year from that point on.

Even after influenza activity has been documented in a community,
influenza vaccination should also continue to be offered throughout the
influenza season. The influenza vaccine may change from year to year based
on global surveillance of circulating virus strains. In the 2007-2008
vaccine, 1 of the 3 strains differs from that in the previous year's
vaccine.

Plans to immunize all children for whom influenza vaccine is recommended
require expanding outreach and infrastructure developed by all healthcare
clinicians, influenza campaign organizers, and public health agencies.
When vaccine supplies are delayed or limited, administration of influenza
vaccine must take priority.

Immunization against influenza is recommended throughout late winter and
early spring because the influenza season often continues into March.
Because of widespread resistance of influenza A virus strains to
amantadine or rimantadine, healthcare clinicians should not prescribe
these antivirus medications for influenza treatment or chemoprophylaxis
during the 2007-2008 season and most likely beyond. However, influenza A
and B strains remain susceptible to oseltamivir and zanamivir, and these
medications can still be prescribed for treatment or chemoprophylaxis.


Thank you, John. Keep up the good work.

Here are two more reposts:

Expert says flu vaccination programs a pointless waste of money


According to a vaccine expert the millions spent on flu vaccination programs
each year are a waste of time and money.
Dr. Tom Jefferson the coordinator of the vaccines field at the Cochrane
Collaboration in Italy, which independently reviews healthcare provision,
says the effectiveness of vaccines is compromised by the fact that influenza
viruses mutated and varied from year to year.

Dr. Jefferson also says little clinical evidence exists that the vaccines
had any effect on length of hospital stay, time taken off work or the
likelihood of death in adults, regardless of whether people were otherwise
healthy or already had conditions such as asthma and cystic fibrosis.

He says vaccines given to children under the age of two have the same effect
as a placebo.

He believes his findings will make taxpayers on both sides of the Atlantic
question whether the effort and expense are justified.

Jefferson arrived at this conclusion after reviewing all the studies done on
the effects of inactivated vaccines (vaccines with dead viruses) and found
that flu shot campaigns have either no effect, or a very negligible effect,
on the number of hospitalizations, work/school time lost, complications from
flu, or death from flu.

Jefferson says a massive gap exists between the benefits listed in policy
documents and what the data actually indicates when it is rigorously
assembled and evaluated.

There is he says a huge gap between vaccination campaign policy and evidence
of its effectiveness.

According to Jefferson the reasons are unclear and may be complex but he
suggests there is possibly potential confusion between influenza and
influenza-like illness, and some surveillance systems report cases of
influenza-like illness as influenza without further explanation.

This he says leads to a 'gross overestimation of the impact of influenza,
unrealistic expectations of the performance of vaccines and spurious
certainty of our ability to predict viral circulation and impact'.

Jefferson say there is an urgent need for a re-evaluation of such campaigns.

Other experts beg to differ and remain convinced that flu vaccines are the
best way to protect against influenza, which is why countries around the
world used them to protect vulnerable communities.

The injection is recommended for high-risk groups including the over-65s,
people with respiratory conditions, such as asthma, and those with chronic
conditions including diabetes.

According to the CDC, approximately 200,000 Americans are hospitalized with
flu each year and about 36,000 people die.

The findings are published in The British Medical Journal (BMJ), October 28.



http://www.news-medical.net/?id=20804

Thanks to Roman Bystrianyk [our honest,polite and informative guide on MHA.]

http://groups.google.com/group/misc....9e984666e30ac3

For your consideration. Enjoy your day.

Roman


Roman Bystrianyk, "Flu vaccines for all nursing home patients?", Health
Sentinel, August 29, 2005,


The Centers for Medicare and Medicaid Services (CMS) has put forth a
proposal to provide flu and pneumococcal vaccines to all nursing home
residents that are under the Medicare and Medicaid programs. Unless
refused by the patient or patient's family or for medical reasons,
nursing homes would be required to ensure that each resident received
the immunizations as a condition of participation in the two programs.


According to the CMS website, "About two million Americans, most age
65 years or older, live in long-term care facilities. People aged 65
years and older account for more than 90 percent of influenza-related
deaths in the United States and elderly nursing home residents are
particularly vulnerable to influenza-related complications. In
addition, the elderly are more likely than younger individuals to die
from pneumonia."


According to the proposal listed in the August 15, 2005 Federal
Register, "In the elderly population residing in nursing homes, the
vaccine can be 50-60 percent effective in preventing hospitalization or
pneumonia and 80 percent effective in preventing death, even though the
effectiveness in preventing influenza illness often ranges from 30
percent to 40 percent."


However, the proposal notes that a February 14, 2005 study published in
the Archives of Internal Medicine found that, "vaccination of the
elderly population against influenza may be less effective in
preventing death among the elderly than previously estimated." In
fact, this study examined the influenza related deaths in the entire US
elderly population. The authors expected that since influenza
vaccination had greatly increased over the last 25 years that there
would be a reduction in mortality by about 35% to 40%. What they found
instead was no reduction in death despite increased vaccination and
concluding, "these estimates, which provide the best available
national estimates of the fraction of all winter deaths that are
specifically attributable to influenza, show that the observational
studies must overstate the mortality benefits of the vaccine."


Why did this study differ so greatly from the generally stated benefit?


According to the study, "an immunologic study that found antibody
responses following influenza vaccination decline sharply after age 65
years and a clinical trial involving subjects 60 years or older that
the efficacy of the influenza vaccine in preventing illness was lower
in people older than 70 years." They also conclude, "Some or all of
the reduction in all-cause mortality in other observational studies was
not attributable to vaccination but rather to underlying differences
between vaccinated and unvaccinated cohorts." This means that the
authors believe that the studies that found a benefit were flawed in
how they chose the people that participated in the study.


Taking the raw mortality data from a number of sources and plotting
them versus vaccination rates I arrived at similarly interesting
results
(http://www.healthsentinel.com/graphs..._print_lis...).
In 1979 the mortality rate was approximately 21 per 100,000. By 2002,
the rate had increased to 37 per 100,000. During the same time period
influenza vaccination rates had gone from 20% of the population to
approximately 65% of the population. Contrary to general assertions the
mortality rate increased during the time vaccination rates had
increased. However, through an email exchange with the lead author of
that February 14, 2005 study, Dr. Simonsen, she noted that after
adjusting for an increasingly aging population and for changes in
circulating influenza strains that the increase became a flat trend.
That is to say there was no change at all despite a 50% increase in
influenza vaccinations.


A report by the CDC on the effectiveness of the 2003-2004 influenza
vaccine (http://www.cdc.gov/nchs/data/nvsr/nvsr52/nvsr52_03.pdf) showed
only a 14% and 3% effectiveness. Still worse, the person-time analysis
showed that vaccinated persons had a 12.28% chance of becoming ill
(ILI), whereas non-vaccinated persons had a 11.5% (or 10.6% analysis
#2) chance of becoming ill, indicating you were more likely to become
ill if you were vaccinated against influenza.


In the July/August, 2004 issue of the ACP Journal Club the authors
examined the question of whether the pneumococcal vaccination was
effective in preventing disease or death in adults. Fifteen randomized
controlled trials were examined. This included 75,197 patients with a
follow-up ranging from 18 months to 4 years. The analysis showed that,
"11 trials that evaluated all-cause mortality showed no benefit of
vaccination. Results for pneumococcal pneumonia and pneumonia mortality
were heterogeneous, with more recent trials showing no effect." The
conclusion was, "Pneumococcal vaccination is not effective in
preventing disease or death in adults."


We know from looking at the historical trends that there was a 90%
decrease in mortality rates for flu/pneumonia from 1900 to around 1979
(http://www.healthsentinel.com/graphs..._print_lis...).
This decline was in conjunction with decrease in mortality from all
infectious diseases. Examples - the measles mortality rate in
England/Wales was at a peak of 70.49 per 100,000 in 1839 and declined
to .11 per 100,000 by 1968, which is a 99.8% decrease. Similarly, the
mortality rate for whooping cough was at a peak of 75.10 per 100,000 in
1866 and declined to 0.9 per 100,000 by 1950, which is a 98.8%
decrease. In addition to declines in all infectious diseases we know
that deaths from scurvy also decline through the 1900s indicating that
there was an increase in nutritional intake of vitamin C.


Now what lessons can we learn from the past? Can we apply these
principals to the present day?


We know that there is severe malnutrition in nursing homes. According
to the American Journal of Nursing, March 2005, "The Nutrition
Screening Initiative [NSI], a multidisciplinary coalition headed by the
America Dietetic Association and the American Academy of Family
Physicians, estimates that 40% to 60% of hospitalized older adults are
malnourished or at risk of malnutrition; it also estimates that 40% to
85% of nursing home residents suffer from malnutrition and that 20% to
60% of home care patients are so afflicted." Having so many nursing
home patients malnourished one would expect that many would have
diminished immune systems.


According to the Morbidity and Mortality Weekly Report, approximately 2
million patients in the United States acquire infections while
hospitalized for other conditions. These infections account for 88,000
deaths and cost approximately $4.6 billion. According to Infection
Control and Hospital Epidemiology, September 2004, the authors conclude
that, "Hand washing is a simple and economical intervention that can
lower the incidence of nosocomial infection. Compliance with hand
hygiene can be sustained with an ongoing multidisciplinary campaign
involving monitoring compliance and providing feedback to HCWs [Health
Care Workers]." We can assume that hygiene in nursing homes could be
greatly improved with an impact on transmission of diseases of all
types.


According to the Archives of Internal Medicine, June 13, 2005, "more
than 1 of every 4 (27.6%)" nursing home residents receiving Medicare
receives antipsychotic medications. The average amount of time per year
that a person was on antipsychotics was just over half a year at 6.4
months. The study also found that "over half (58.2%)" of these
residents received antipsychotic medications that exceeded the maximum
recommended dose of the medication, received duplicate therapy, or had
inappropriate indications for the medication in the first place
according to guidelines. We also know that these medications increase
death by 1.6 to 1.7 times (BMJ, April 23, 2005).


Also, according to July 27, 1998 The American Journal of Medicine,
"Conservative calculations estimate that approximately 107,000
patients are hospitalized annually for nonsteroidal anti-inflammatory
drug (NSAID)-related gastrointestinal (GI) complications and at least
16,500 NSAID-related deaths occur each year among arthritis patients
alone. The figures of all NSAID users would be overwhelming, yet the
scope of this problem is generally under-appreciated." A large number
of the elderly are on these types of medications to treat arthritis.


In Archives of Internal Medicine, April 2005, the authors of a study
found that compared with the control groups the risk ratio for death
was reduced by 23% for omega-3 (or n-3) fatty acids. In American
Journal of Health-System Pharmacists, August 1, 2004, "Eight early,
small, randomized trials involving nearly 1,000 patients suggested that
magnesium supplementation reduced mortality by as much as 50%". In
the American Journal of Clinical Nutrition, December 2004, the authors
of that study found that the people, who took the larger supplemental
doses of vitamin C, at a median of 750 mg/d, had a 24% lower risk for a
major CHD [Coronary Heart Disease] event. According to an article in
Forbes, August 17, 2004, "vitamin E group had a 20 percent lower risk
of catching a cold than those in the placebo group."


Taking these puzzle pieces and putting them together we could construct
a new model for nursing home reform that would involve improved
nutrition, strict use of medication (such as antipsychotics and
NSAIDs), improved hygiene, targeted nutrients (as proved from the
scientific literature) to make a major difference in improving not only
the death rate, but also the quality of life. These are only some
components in a larger mosaic of possibilities that when brought
together as a comprehensive protocol would make a tremendous difference
- something much more than a pair of vaccines with dubious results.


Is it fair to force nursing homes to comply with the proposed CMS
vaccination strategy or do we need to look at the bigger picture of
health and well being in the residents of nursing homes?