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Thank you Juan, Is there any benefit for herd immunity for older or vulnerable populations? For health professionals, I thought the concern was the transmission as a carrier to vulnerable populations? Best, Amy From: "[log in to unmask]" <[log in to unmask]> on behalf of Juan Gérvas <[log in to unmask]> Reply-To: Juan Gérvas <[log in to unmask]> Date: Sunday, December 4, 2016 at 10:38 AM To: "[log in to unmask]" <[log in to unmask]> Subject: Re: USA: What is the impact of the influenza vaccine? -please, Amy, go to the subject "Acceptable? BMJ & Ann Intern Med. misleading use of words - influenza vaccine study" where we have discussed in this list the topic of the impact on deaths of the influenza vaccine, in RCT -by the way, influenza vaccine coverage is more than 50%; it is 63.4% in people aged ≥65 years http://www.cdc.gov/flu/fluvaxview/coverage-1516estimates.htm -about population sick days [Cochrane Review] Vaccination shows no appreciable effect on working days lost or hospitalisation. http://www.cochrane.org/CD001269/ARI_vaccines-to-prevent-influenza-in-healthy-adults -but, in general, death by influenza is always in papers about influenza vaccine, even in the media when the CDC recommend it every year -see the first words of the CDC paper i have sent previously about "influenza vaccine coverage" http://www.cdc.gov/flu/fluvaxview/coverage-1415estimates.htm : Influenza (flu) can cause serious illness and death... -introducing fear where they have no scientific knowledge, and where the data show no impact http://jamanetwork.com/journals/jama/article-abstract/2585966 http://www.medicalbag.com/medicine/us-mortality-rates-from-infectious-diseases-holding-steady/article/575032/ -un saludo juan gérvas @JuanGrvas 2016-12-04 16:12 GMT+01:00 healingjia Price <[log in to unmask]<mailto:[log in to unmask]>>: Dear all, People are also living longer due to better supportive care. It would be interesting to see if the ages at which they succumb to pneumonia are constant and to compare vaccinated v unvaccinated populations, of course these are often low resource so there would have to be adjustments for that. It would also be intriguing to look at population sick days. Best Amy From: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>> on behalf of Tom Jefferson <[log in to unmask]<mailto:[log in to unmask]>> Reply-To: Tom Jefferson <[log in to unmask]<mailto:[log in to unmask]>> Date: Sunday, December 4, 2016 at 6:25 AM To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>> Subject: Re: USA: What is the impact of the influenza vaccine? Yes, it's the same trend that Peter Doshi picked up in 2008 in his eminal paper on AJPH. Steady - no visible effect of any of the CDC policies. But it's ecology. Best wishes, Tom. Dr Tom Jefferson Honorary Research Fellow Centre for Evidence Based Medicine Oxford OX2 6GG On 4 December 2016 at 12:21, Juan Gérvas <[log in to unmask]<mailto:[log in to unmask]>> wrote: -what is the use of the influenza vaccine (even mandatory for health professionals!) in the USA where almost half of the population get the vaccine (around 150 millions each year)? (http://www.cdc.gov/flu/fluvaxview/coverage-1415estimates.htm ) US Mortality Rates from Infectious Diseases Holding Steady. Pneumonia and influenza were the most common causes, accounting for 38.3% of infectious disease deaths during that time period. The mortality rate from pneumonia and the flu held steady between 1980 and 2014, at 17.1 per 100,000. http://jamanetwork.com/journals/jama/article-abstract/2585966 http://www.medicalbag.com/medicine/us-mortality-rates-from-infectious-diseases-holding-steady/article/575032/ -un saludo juan gérvas @JuanGrvas MD, PhD, retired rural GP, visiting professor National School of Public Health (Dep of International Health, Madrid-Spain), visiting professor (1991-2003) Johns Hopkins School of Public Health (Dep of Health Policy and Management, Baltimore-USA)