It is a myth that influenza poses a greater risk to pregnant women than to the general population.

[mhatrw]

Yes, this myth is obviously CDC-sanctioned, but no scientific study that I have ever read legitimately supports this oft-repeated myth.

If you feel otherwise, please produce the text of the scientific study you feel proves otherwise. I would sincerely love to be convinced by some legitimate study that the CDC is not feeding pregnant women a pack of lies in order to goad them into taking thimerosal-spiked seasonal (and swine) flu vaccines that could easily harm their tiny unborn babies.

http://www.jpands.org/vol11no2/ayoub.pdf">Reference

[LeftishBrit]

1. I don't know about the seasonal flu...

but there is definite evidence that the swine flu is more dangerous to pregnant women than to others. It was reported in The Lancet that 13% of American deaths from swine flu have occurred in pregnant women. Presumably, pregnant women do not constitute 13% of the American population.

[mhatrw]

4. That was based on a total 6 pregnant women dying over a certain time period.

Over 1000 people have now died from swine flu, so that accounts for 0.6% of total deaths.

What are the more recent, more statistically significant statistics about pregnant women?

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961304-0/abstract

Between April 15 and June 16, 2009, six deaths in pregnant women were reported to the CDC.

What were the existing health problems of these 6 women? How can you base on recommendation on 6 total deaths and 11 total hospitalizations? Those are not statistics. Those are anecdotes.

Here is how the product inserts for all H1N1 vaccines read:

Pregnancy Category C: Animal reproduction studies have not been conducted with (the new swine flu vaccine) or (the seasonal flu vaccine it is based on). It is also not known whether these vaccines can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. (The new swine flu vaccine) should be given to a pregnant woman only if clearly needed.

I don't see how this advice can be overridden by a grand total of 6 deaths and 11 hospitalizations when influenza kills thousands of people with existing medical conditions every year.

[uppityperson]

17. 6 deaths are "not statistics" but are "anecdotes"? well, what IS a statistic then?

[mhatrw]

24. If influenza is actually a greater risk to pregnant woman than the general population, you should

be able to produce dozens of epidemiology studies showing this.

Where are these studies?

[uppityperson]

36. Fine statement, but you didn't answer my question. nt

[mhatrw]

50. Where are all the studies proving your contention? Please produce them.

[uppityperson]

51. 6 deaths are "not statistics" but are "anecdotes"? well, what IS a statistic then?

Those are questions, not contentions. I am hoping you can prove YOUR contention.

[mhatrw]

52. What were the other medical conditions of the 6 women who died?

At least 3 people in the United States have died and at least 22 have died, been hospitalized or experienced life threatening events directly after receiving swine flu vaccinations. Is this a valid statistic to you as well?

http://wonder.cdc.gov/vaers.html

[uppityperson]

54. No, I am asking YOU what YOU consider a statistic.

[mhatrw]

56. Let's see. More than 6 deaths over a two months or 11 hospitalizations over one month.

Here are some good statistics, IMHO:

[uppityperson]

58. You consider a bigass unsourced graph "statistics". Ah. So, are these statistics too?

[trotsky]

53. She can't, of course.

She throws out an unsupported claim, and hasn't even come close to supporting it on the entire thread. Her solitary scrap of "evidence" is one lone interpretation of an existing study that by itself clearly contradicts her. Her argumentation tactics consist of screaming louder and louder, just trying to bully everyone else into submission.

[uppityperson]

55. I am waiting to see if he/she can tell me what a "statistic" is rather than continuing to ask insinu

insinuating questions. Why is it so hard for some to simply answer a question?

[mhatrw]

57. LOL. I encourage everyone to read the entire thread. There is NO evidence that

influenza is a higher risk for pregnant women than it is for the general population. No evidence whatsoever has been presented that supports this claim.

It is the CDC who keeps pushing a wholly unsupported claim. Why?

[trotsky]

60. Newsflash: there's no one left to read this thread.

Your bullying, loudmouth tactics and total lack of ANY evidence to back up your claim have virtually assured that.

[mhatrw]

61. Except Big Pharma pushers

who never seem to tire and who always have some new, distracting, obfuscating rhetorical trick up their sleeves.

[trotsky]

62. And then there's your final desperate tactic.

Accuse those who disagree with you of being big pharma shills or just part of the GLOBAL CONSPIRACEEE TO KILL US ALLL!!!!1!OMG!

[mhatrw]

63. There are several people here engaged in a reasonable discussion,

seeking truth, willing to learn from each other and map out some middle ground and come to an agreement. You are not one of these people.

You throw anything you can against the wall to see if its sticks. You resort to multiple personal attacks, appeals to authority, red herrings, non sequiturs, gang tackling and every other rhetorical trick in the book to hide that fact that the CDC is promoting an unsupported myth that has indisputably resulted in many health practitioners scaring pregnant women into being injected with thimerosal.

Doctors and nurses understandably believe this myth because the CDC and the ACOG are promoting it, but if you examine the medical literature the CDC and ACOG provide to back their claims, it quickly becomes clear that there isn't any decent epidemiological evidence for this myth. Furthermore, the United States is one of the only countries in the world in which this particular health myth is being pushed. You have read the abstracts for the studies the CDC is using to promote this myth, so by now you must realize the truth about the paucity of this supposed evidence. And minimum, you must admit that the evidence in inconclusive. Yet still your only purpose is only to use whatever rhetorical tricks you can to suppress the truth and support this dangerous myth.

The first principle of medicine should be to do no harm. Why do you promote breaking that principle?

Perhaps you feel that perpetuating this myth is a good thing because you think it is beneficial to scare doctors into recommending and pregnant women into getting two flu vaccinations (H1N1 and seasonal), even if these vaccinations contain thimerosal. Since you don't recognize any risks of thimerosal, even to the tiniest developing fetus, perhaps you feel that the benefits of flu vaccination far outweigh their risks even when there is no special influenza risk to a given sub-population. Is that how you feel?

[trotsky]

64. You have no information on your side.

Only misinformation and outright lies.

You can't even state my position accurately, instead choosing to use a strawman.

You are a caricature of a position. I'm convinced that you must be some kind of big pharma plant to discredit the alt-med movement with your disjointed, fanatical ramblings. That is truly the only explanation that makes sense. Good luck with your insane crusade. Thankfully you've displayed such unbelievable insanity that I can rest assured no one will take you seriously.

[mhatrw]

66. So you accuse me of being a liar, a big pharma plant, and a fanatical rambler

with an insane crusade who suffers from unbelievable insanity in a single post.

If I have no information on my side, why do you feel the need to resort to these personal attacks?

[trotsky]

68. Aha, so you DO see what you're doing!

Congrats! Now work on getting that information to back up something - ANYTHING - that you say. Since you've now deplored your very own tactics, I can hopefully assume you won't engage in any of them anymore and will finally bring some kind of facts to the table instead of wild, ranting conspiracy theories and bogus information.

[mhatrw]

70. LOL

[Chemisse]

2. Pregnant women should be getting the adjuvant-free vaccine - nt

[mhatrw]

5. You mean thimerosal-free. None of these vaccines have adjuvants in them as far as I know.

But it seems that pregnant women must specially request the thimerosal-free H1N1 vaccine (as well as seasonal flu vaccines), otherwise they will get the multivial thimerosal-spiked versions just like everybody else.

[Chemisse]

10. Eep! my mistake

My daughter is pregnant and the nurse at her OB was trying to get her to take the one with the thimerosol in it, saying, amazingly, if it wasn't safe it wouldn't be out there.

Thankfully she said no. Apparently the other vaccine was due in in a couple of weeks.

[mhatrw]

23. The exact same thing just happened to my brother's pregnant wife! n/t

[trotsky]

3. Spreading such foul untruths, threatening to harm pregnant women and their unborn children...

is one of the lowest lows I've seen on DU. Congratulations.

Risks to the pregnant woman:
* Pneumonia, a common complication from the flu, is more deadly in pregnant women: http://www.ncbi.nlm.nih.gov/pubmed/16215363?dopt=Abstract
* Pregnancy hormones alter a woman's immune system to be more favorable to the fetus, resulting in increased susceptibility to pathogens: http://www.ncbi.nlm.nih.gov/pubmed/17283611?dopt=Abstract
* In one group of reproductive-aged women in the 1957 pandemic, half of those who died were pregnant: http://journals.lww.com/obgynsurvey/Citation/1960/04000/Deaths_From_Asian_Influenza_Associated_With.13.aspx
* Pregnant women are significantly more likely to be hospitalized with complications from the flu: http://www.ncbi.nlm.nih.gov/pubmed/9850132?dopt=Abstract

Risks to the fetus:
* In mice, influenza in the mother has been shown to result in physical changes in the brain (http://www.ncbi.nlm.nih.gov/pubmed/12064515?dopt=Abstract) and behavioral changes (http://www.ncbi.nlm.nih.gov/pubmed/12514227?dopt=Abstract). A similar study in humans cannot ethically be performed.
* High rates of spontaneous abortion and pre-term birth were observed during the deadly 1918 flu: Harris JW. Influenza occurring in pregnant women. JAMA. 1919;72:978–80.; Nuzum JW, Pilot I, Stangl FH, Bonar BE. Pandemic influenza and pneumonia in a large civilian hospital. JAMA. 1918;71:1562–5.
* During the 1957 epidemic, increased neural system defects, general birth defects, and spontaneous abortion were observed. (http://www.ncbi.nlm.nih.gov/pubmed/14021958?dopt=Abstract http://www.ncbi.nlm.nih.gov/pubmed/14442130?dopt=Abstract http://www.ncbi.nlm.nih.gov/pubmed/5394374?dopt=Abstract)
* Some studies have even suggested a link between either seasonal OR pandemic influenza and increased risk of childhood leukemia (http://www.ncbi.nlm.nih.gov/pubmed/17035343?dopt=Abstract), schizophrenia (http://www.ncbi.nlm.nih.gov/pubmed/15658144?dopt=Abstract), and even Parkinson's disease (http://www.ncbi.nlm.nih.gov/pubmed/11554013?dopt=Abstract).
* Flu symptoms in a pregnant woman can specifically cause a wide range of deformities and developmental problems (http://www.ncbi.nlm.nih.gov/pubmed/16933304?dopt=Abstract), and in particular deformities of the neural tube (http://www.ncbi.nlm.nih.gov/pubmed/15703536?dopt=Abstract).

Your wild, unsupported crusade against vaccination will put people at risk. I sincerely hope that no one takes you seriously - but fortunately given your behavior on these threads, I'm pretty sure that would never happen.

[mhatrw]

6. You are the one pushing lies.

Here is the abstract of your first article:

OBJECTIVE: Historically, pneumonia during pregnancy has been associated with increased morbidity and mortality compared with nonpregnant women. The goal of this article is to review current literature describing pneumonia in pregnancy. This review will identify maternal risk factors, potential complications, and prenatal outcomes associated with pneumonia and describe the contemporary management of the varied causes of pneumonia in pregnancy. RESULTS: Coexisting maternal disease, including asthma and anemia, increase the risk of contracting pneumonia in pregnancy. Neonatal effects of pneumonia in pregnancy include low birth weight and increased risk of preterm birth, and serious maternal complications include respiratory failure. Community-acquired pneumonia is the most common form of pneumonia in pregnancy, with Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae accounting for most identified bacterial organisms. Beta-lactam and macrolide antibiotics are considered safe in pregnancy and are effective for most community-acquired pneumonia in pregnancy. Viral respiratory infections, including varicella, influenza, and severe acute respiratory syndrome, can be associated with maternal pneumonia. Current antiviral and respiratory therapies can reduce maternal morbidity and mortality from viral pneumonia. Influenza vaccination can reduce the prevalence of respiratory hospitalizations among pregnant women during influenza season. Pneumocystis pneumonia continues to carry significant maternal risk to an immunocompromised population. Prevention and treatment of Pneumocystis pneumonia with trimethoprim/sulfamethoxazole is effective in reducing this risk. CONCLUSIONS: Prompt diagnosis and treatment with contemporary antimicrobial therapy and intensive care unit management of respiratory compromise has reduced the maternal morbidity and mortality due to pneumonia in pregnancy. Prevention with vaccination in at-risk populations may reduce the prevalence and severity of pneumonia in pregnant women.

Note that there is no mention of influenza being a higher risk to pregnant women than to the general population in this abstract, only vague guesses that vaccination could reduce the number of influenza cases in women. Just linking studies that show that influenza can hurt pregnant women and their fetuses is not enough. Of course, influenza can hurt anyone.

What I am looking for is studies that show that influenza outcomes are generally worse for pregnant women than for the general population. I would love to be convinced of this by any decent, rigorously designed, epidemiological study. If what you contend is true, there should be dozens of such studies available. Please supply the abtracts, not just the links, of any studies you know of that present such epidemiological evidence.

[trotsky]

7. I will simply note that you were unable to counter ANY of the data presented.

All you can do is hem and haw and obfuscate and distract.

[mhatrw]

20. You produced a grand total of ONE epidemiology study that so much as addressed the issue at hand.

As for that study:

http://www.jpands.org/vol11no2/ayoub.pdf

Neuzil et al. reported that pregnant Medicaid-eligible women in a Tennessee registry had higher hospitalization rates during the influenza season than nonpregnant and postpartum women, particularly during the third trimester of pregnancy. Hospitalization was infrequent, ranging from 3.1 per 10,000 women-months in the first trimester to 10.5 per 10,000 in the third trimester. The study failed to discover a greater incidence of specific adverse events, including death, during pregnancies complicated by influenza. The following factors significantly limit the study's impact:
*The Medicaid population is known to have more comorbidity and receive less adequate outpatient care. Patients are more likely to seek emergency room services at a more advanced stage of illness and thus to be admitted to the hospital more frequently.
*The hospitalization rate was overestimated by the inclusion of admissions for delivery.
*Influenza was not confirmed by laboratory testing and not differentiated from other infections.
*Reasons for admission were never quantified, and included a broad range of ICD-8 and ICD-9 codes.
*Aside from the event of a hospital admission, per se, no difference in morbidity or mortality was reported.

[trotsky]

25. You were unable to counter any of the data presented.

ALL of which proves you and your OP wrong. Sorry you can't accept that.

[mhatrw]

29. You and the CDC both need to learn that saying something over and over doesn't make it true.

[trotsky]

34. But it does prove you wrong. n/t

[mhatrw]

38. Do you really think your audience here is that stupid?

You have nothing but bombast backing your your claims.

[trotsky]

39. You appear to be talking to yourself.

I'm sorry, but no one else is paying attention to you. No one has come to your defense in your outlandish and false claims. The more you post, the more ridiculous you look, and the more you destroy your own pathetic position. Thanks for the laughs!

[Chemisse]

11. I don't see how there could be such studies about

This is all happening so fast. They are just counting up the numbers as it all happens. Pregnant women seem to be disproportionally present among the severely affected.

I'm sure the perfectly controlled studies will come in time, but for now people need to react twith common sense to real time observations.

[mhatrw]

21. Link the studies that show pregnant women are disproportionally present among the severely affected.

Thanks!

[Chemisse]

26. You can find it as easily as I can

You're the one who wants to see the proof; you can do the footwork.

[mhatrw]

30. I did the footwork. The claim is based on exactly two studies.

One was flawed and showed no difference in flu related morbidity or mortality outcomes.

http://www.jpands.org/vol11no2/ayoub.pdf

Neuzil et al. reported that pregnant Medicaid-eligible women in a Tennessee registry had higher hospitalization rates during the influenza season than nonpregnant and postpartum women, particularly during the third trimester of pregnancy. Hospitalization was infrequent, ranging from 3.1 per 10,000 women-months in the first trimester to 10.5 per 10,000 in the third trimester. The study failed to discover a greater incidence of specific adverse events, including death, during pregnancies complicated by influenza. The following factors significantly limit the study's impact:
*The Medicaid population is known to have more comorbidity and receive less adequate outpatient care. Patients are more likely to seek emergency room services at a more advanced stage of illness and thus to be admitted to the hospital more frequently.
*The hospitalization rate was overestimated by the inclusion of admissions for delivery.
*Influenza was not confirmed by laboratory testing and not differentiated from other infections.
*Reasons for admission were never quantified, and included a broad range of ICD-8 and ICD-9 codes.
*Aside from the event of a hospital admission, per se, no difference in morbidity or mortality was reported.

The other drew its conclusions based on a grand total of 6 US H1N1-related deaths over a 63 day period and 11 US H1N1-related hospitalizations of pregnant women over a 34 day period:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961304-0/abstract

That's not statistical evidence. It's anecdotal evidence.

[Chemisse]

46. This information suggests pregnant women are at higher risk

From http://www.thelancet.com/journals/lancet/article/PIIS01...
Interpretation
Pregnant women might be at increased risk for complications from pandemic H1N1 virus infection. These data lend support to the present recommendation to promptly treat pregnant women with H1N1 influenza virus infection with anti-influenza drugs.

I am sure this pandemic will be studied for years to come, and the research that you desire will come in time. But right now we have only these numbers that are very suggestive. Rather than put their thumbs up their asses and say, 'gee I dunno, we haven't had time to do utterly perfect studies yet", the CDC is giving us the best info they can, in real time - not 3 years from now.

I, for one, am grateful to get it. And I have urged my pregnant daughter to get the thimerosol-free vaccine. If it turns out to have been a fluke, and pregnant women are not at any extra risk, no harm has been done.

[mhatrw]

48. A grand total of 11 pregnant women were hospitalized during the height of the initial H1N1 flu scare

The only thing this is suggestive of is admirable precautionary actions on the part of these pregnant women and their physicians.

At this point over 1000 people have died of swine flu in the US. The CDC could commission a new, far more comprehensive epidemiological study of these deaths at any time. Instead, all we have is the initial study of the first month of the disease. We are currently basing our entire health policy that pregnant women should be immunized first for H1N1 on a grand total 11 hospitalizations.

I think it is great that you urged your pregnant daughter to get the thimerosal-free vaccine. But many health practitioners have been urging pregnant women to get the thimerosal-spiked vaccine based on the CDC's unsupported recommendations.

[Chemisse]

59. That is very true.

They tried to get her to take the one with the thimerosol. Luckily, she refused and is waiting for the thimerosol -free one to come in a couple of weeks.

The woman in line ahead of her argued for a bit, then just gave in and had the shot anyway.

[mhatrw]

69. All I am trying to do is to give some perspective to this issue.

There simply isn't much evidence that influenza is a special risk for pregnant women.

There are very few countries other than the United States that recommend a seasonal influenza vaccine for pregnant women unless these women have other special influenza risk factors.

Pregnant women should not be frightened into injecting themselves and their fetuses with two doses of thimerosal (one for the H1N1 virus and one for the seasonal flu virus) because of a grand total of two epidemiological studies (one that examined just 32 days of data and documented just 11 hospitalizations), neither of which clearly demonstrated that influenza is a special risk for pregnant women in terms of patient outcomes.

Demanding the thimerosal-free vaccine, as you recommended to your daughter, is the smart call here.

[Fire_Medic_Dave]

14. So you chose to completely overlook the 4th study. Typical.

[mhatrw]

19. Wrong . I already addressed this study, the only epidemiology study I know of about this, in my OP.

http://www.jpands.org/vol11no2/ayoub.pdf

Neuzil et al. reported that pregnant Medicaid-eligible women in a Tennessee registry had higher hospitalization rates during the influenza season than nonpregnant and postpartum women, particularly during the third trimester of pregnancy. Hospitalization was infrequent, ranging from 3.1 per 10,000 women-months in the first trimester to 10.5 per 10,000 in the third trimester. The study failed to discover a greater incidence of specific adverse events, including death, during pregnancies complicated by influenza. The following factors significantly limit the study's impact:
*The Medicaid population is known to have more comorbidity and receive less adequate outpatient care. Patients are more likely to seek emergency room services at a more advanced stage of illness and thus to be admitted to the hospital more frequently.
*The hospitalization rate was overestimated by the inclusion of admissions for delivery.
*Influenza was not confirmed by laboratory testing and not differentiated from other infections.
*Reasons for admission were never quantified, and included a broad range of ICD-8 and ICD-9 codes.
*Aside from the event of a hospital admission, per se, no difference in morbidity or mortality was reported.

Thanks for playing!

[Fire_Medic_Dave]

32. Then you are just willfully blind or mistaken.

http://www.ncbi.nlm.nih.gov/pubmed/9850132?dopt=Abstract

[mhatrw]

41. Wrong. You are the one who must be willfully blind or mistaken.

http://www.jpands.org/vol11no2/ayoub.pdf

Neuzil et al. reported that pregnant Medicaid-eligible women in a Tennessee registry had higher hospitalization rates during the influenza season than nonpregnant and postpartum women, particularly during the third trimester of pregnancy. Hospitalization was infrequent, ranging from 3.1 per 10,000 women-months in the first trimester to 10.5 per 10,000 in the third trimester. The study failed to discover a greater incidence of specific adverse events, including death, during pregnancies complicated by influenza. The following factors significantly limit the study's impact:
*The Medicaid population is known to have more comorbidity and receive less adequate outpatient care. Patients are more likely to seek emergency room services at a more advanced stage of illness and thus to be admitted to the hospital more frequently.
*The hospitalization rate was overestimated by the inclusion of admissions for delivery.
*Influenza was not confirmed by laboratory testing and not differentiated from other infections.
*Reasons for admission were never quantified, and included a broad range of ICD-8 and ICD-9 codes.
*Aside from the event of a hospital admission, per se, no difference in morbidity or mortality was reported.

Here is the summary of your vaunted "evidence": Medicaid pregnant women who get sick, especially those in their third trimester, check into the hospital more than non-pregant women do. Well, duh.

[HuckleB]

12. +1 Thank you, Trotsky.

[Warpy]

8. Pregnant women in their third trimester are especially at risk

and it's been suggested it's because they can't inflate their lungs adequately to clear the secretions that are building up in their lungs.

Some stats were reported in July at http://www.cnn.com/2009/HEALTH/07/28/swine.flu.pregnant/index.html

If you really want to investigate what's being published in reputable medical journals, I suggest you get a membership at http://www.medscape.com

Until then, please stop spreading the kind of lies that KILL PEOPLE.

It's not only irresponsible, it's reprehensible.

[mhatrw]

15. Produce the epidemiology studies.

There is a grand total of one. It is a deeply flawed study, and pregnant women had the same influenza outcomes as non-pregnant women.

[Warpy]

16. I just told you where to find them

Do your own damn homework.

And stop trying to kill people with LIES.

[mhatrw]

22. THERE AREN'T ANY!

That is the whole point of the OP. If you feel differently, produce the epidemiology studies.

[trotsky]

27. And as I've said to you many, many times...

the kind of "study" you require would make a Nazi blush. We cannot experiment on humans the way that you desire.

[mhatrw]

28. Do you know what epidemiology is?

It doesn't require any experimentation at all. It is the analysis of historical medical data.

http://en.wikipedia.org/wiki/Epidemiology

[trotsky]

33. And you've been presented with such data.

It is you who doesn't know what epidemiology is.

[mhatrw]

37. I have been presented with exactly two epidemiology studies both with which I was already familiar.

One was flawed and showed no difference in flu related morbidity or mortality outcomes.

http://www.jpands.org/vol11no2/ayoub.pdf

Neuzil et al. reported that pregnant Medicaid-eligible women in a Tennessee registry had higher hospitalization rates during the influenza season than nonpregnant and postpartum women, particularly during the third trimester of pregnancy. Hospitalization was infrequent, ranging from 3.1 per 10,000 women-months in the first trimester to 10.5 per 10,000 in the third trimester. The study failed to discover a greater incidence of specific adverse events, including death, during pregnancies complicated by influenza. The following factors significantly limit the study's impact:
*The Medicaid population is known to have more comorbidity and receive less adequate outpatient care. Patients are more likely to seek emergency room services at a more advanced stage of illness and thus to be admitted to the hospital more frequently.
*The hospitalization rate was overestimated by the inclusion of admissions for delivery.
*Influenza was not confirmed by laboratory testing and not differentiated from other infections.
*Reasons for admission were never quantified, and included a broad range of ICD-8 and ICD-9 codes.
*Aside from the event of a hospital admission, per se, no difference in morbidity or mortality was reported.

The other drew its conclusions (that pregnant women MAY be at more risk to the H1N1 virus) based on a grand total of 6 US H1N1-related deaths over a 63 day period and 11 US H1N1-related hospitalizations of pregnant women over a 34 day period:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961304-0/abstract

That's not statistical evidence. It's anecdotal evidence.

If you know of any other epidemiological studies promoting the CDC's myth that influenza is a greater risk to pregnant women than it is to the general population, you have not supplied them. Please supply them here if you know of any.

[trotsky]

40. And your spin on those particular studies is completely wrong.

I'm sorry that reality doesn't match up with what you want to believe.

[mhatrw]

42. It's not my spin. It's the "spin" of a published, peer reviewed medical journal article.

http://www.jpands.org/vol11no2/ayoub.pdf

Neuzil et al. reported that pregnant Medicaid-eligible women in a Tennessee registry had higher hospitalization rates during the influenza season than nonpregnant and postpartum women, particularly during the third trimester of pregnancy. Hospitalization was infrequent, ranging from 3.1 per 10,000 women-months in the first trimester to 10.5 per 10,000 in the third trimester. The study failed to discover a greater incidence of specific adverse events, including death, during pregnancies complicated by influenza. The following factors significantly limit the study's impact:
*The Medicaid population is known to have more comorbidity and receive less adequate outpatient care. Patients are more likely to seek emergency room services at a more advanced stage of illness and thus to be admitted to the hospital more frequently.
*The hospitalization rate was overestimated by the inclusion of admissions for delivery.
*Influenza was not confirmed by laboratory testing and not differentiated from other infections.
*Reasons for admission were never quantified, and included a broad range of ICD-8 and ICD-9 codes.
*Aside from the event of a hospital admission, per se, no difference in morbidity or mortality was reported.

Here is the summary of your vaunted "evidence": Medicaid pregnant women who get sick, especially those in their third trimester, check into the hospital more than non-pregant women do. Well, duh.

[trotsky]

44. There are volumes of evidence against you.

All you have is one interpretation of a study (that was ALSO in a published, peer-reviewed medical journal). Your position is in shambles, your arguments in shreds. You cannot dispute anything but simply repeat yourself louder and louder hoping to out-scream the facts.

But you can't.

[mhatrw]

47. LOL. If there are "volumes" of evidence against me, why isn't seasonal flu vaccination

recommended for all pregnant women in all other countries besides the United States?

And where are these supposed "volumes" of evidence?

[trotsky]

71. Ooh, you were shot down twice already on this claim.

#1 by yourself, after you found out that Mexico and Finland do too.

#2 by another poster, who demonstrated to you that Canada does as well.

You acknowledged your peddling of FALSE information.

[mhatrw]

72. That was NOT about pregnant women. It was about children.

Try to keep up.

[trotsky]

73. Oh, changing the subject?

Clearly you have no other option, when you get shot down OVER and OVER and OVER again.

By the way, the dose makes the poison: TRUE or FALSE?

[mhatrw]

74. The dose makes the poison

http://www.actionbioscience.org/environment/trautmann.html">or does it?

[trotsky]

75. Your new favorite article does not say what you think it says.

So, does the dose make the poision? True or false?

When are you going to answer and stop acting like a kindergarten on the playground?

[mhatrw]

76. My new favorite article is my answer to your incessant, disruptive questioning.

[EvolveOrConvolve]

9. Are you familiar with Occam's Razor?

If not: http://en.wikipedia.org/wiki/Occam%27s_Razor

Which is more likely:

1) That the CDC is purposefully "goad{ing} women into taking thimerosal-spiked seasonal (and swine) flu vaccines..." - your words, not mine. And, those words seem to make the assumption that there is some sort of evil intent/conspiracy behind that "goading", a conspiracy that goes deep into the bowels of the government, the pharmaceutical industry, and across the breadth of the medical community.

or

2) That the CDC, and organization that has a large amount of data at their disposal, is basing their recommendation on science and empirical evidence?

Which is more likely to be true? If we use Occam's Razor as even a basic guide, the choice seems obvious which theory should be followed to its logical conclusion and which is a bunch of tin-foil ass-hattery.

[HuckleB]

13. +1

[mhatrw]

18. Are you familiar with epidemiology?

If so, then please produce the epidemiology studies that show influenza is a greater risk to pregnant women than it is to the general population.

[EvolveOrConvolve]

31. You didn't answer my question - did you even read the post?

Let's try this - maybe your reading comprehension will miraculously improve from that post to this one. :shrug:

The March of Dimes (another member of the conspiracy?): http://www.marchofdimes.com/pnhec/188_10596.asp

"Complications of flu, such as bacterial pneumonia and dehydration, can be serious and even fatal. Pregnancy can increase the risk of these and other complications. Pregnant women are more likely to be hospitalized from complications of the flu than non-pregnant women of the same age. Pregnancy can change a pregnant women's immune system and affect her heart and lungs. These changes can increase the risk for complications from the flu."

WebMD (another member of the conspiracy?": Worried about getting flu during pregnancy? While catching the flu during pregnancy rarely causes birth defects, pregnancy can increase your risk for flu complications such as pneumonia. The best way to have a healthy pregnancy is to try to prevent the flu altogether.

"Worried about getting flu during pregnancy? While catching the flu during pregnancy rarely causes birth defects, pregnancy can increase your risk for flu complications such as pneumonia. The best way to have a healthy pregnancy is to try to prevent the flu altogether."

---

Just in case the links above weren't satisfactory to you, because they aren't backed up with links to sources, the Palo Alto Medical Foundation generously provides a large list of references that should be able to convince even you: http://www.pamf.org/flu/preg.html (this group must be the leader of your conspiracy because of all the icky facts that have!)

(1) Neuzil, K.M., Reed, G.W., Mitchel, E.F., Simonsen, L., Griffin , M.R. 1998. "Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women." American Journal of Epidemiology, 148:1094-102.

(2) Hartert, T., Neuzil, K., Shintani, A., Mitchel, E., Snowden, M., Wood, L., Dittus, R., Griffin , M. 2003. "Maternal morbidity and perinatal outcomes among pregnant women with respiratory hospitalizations during influenza season." American Journal of Obstetric Gynecology, 189:1705-12.

(3) Jamieson, D.J., Honein, M.A., Rasmussen, S.A., et al. 2009. “H1N1 2009 influenza virus infection during pregnancy in the USA.” Lancet , 374:451-458.

(4) Centers for Disease Control and Prevention. "Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP)." MMWR 2008; 57 (No. RR-7): 1-60.

(5) ACOG Committee on Obstetric Practice. 2004. Influenza vaccination and treatment during pregnancy. ACOG Committee Opinion No. 305, November 2004. Obstetric Gynecology, 104 (5 Pt 1):1125-6.

(6) Black, S., Shinefield, H., France, E., Fireman, B., Platt, S., Shay, D. 2004. Vaccine Safety Datalink Workgroup. "Effectiveness of influenza vaccine during pregnancy in preventing hospitalizations and outpatient visits for respiratory illness in pregnant women and their infants." American Journal of Perinatology, 21:333-9.

(7) Zaman K, Roy E, Arifeen S, Rahman M, Raqib R, Wilson E, et al. "Effectiveness of maternal influenza immunization in mothers and infants." N Engl J Med < 10.1056/NEJMoa0708630 >. 2008 Sept . Available from the New England Journal of Medicine.

(8) Heinonen, O.P., Shapiro, S., Monson, R.R., Hartz , S.C. , Rosenberg , L., Slone, D. 1973. "Immunization during pregnancy against poliomyelitis and influenza in relation to childhood malignancy." International Journal of Epidemiology, 2:229-35.

(9) Deinard, A.S., Ogburn, P. 1981. A/NJ/8/76 influenza vaccination program: effects on maternal health and pregnancy outcome. American Journal of Obstetric Gynecology, 140:240-5.

(10) Munoz, F., Greisinger, A., Wehmanen, O., Mouzoon, M., Hoyle, J., Smith, F., Glezen, W. 2005. Safety of influenza vaccination during pregnancy. American Journal of Obstetric Gynecology, 192:1098-106.

[trotsky]

35. Nicely done.

She'll either ignore your post, or deny you gave her what she wants. It's data that contradicts her beliefs, so it doesn't exist.

[mhatrw]

43. Do you know the difference between medical research and "expert" advice?

Yes, the CDC says that influenza is a special risk for pregnant women. Because the CDC says this, so does the March of Dimes, WebMD and the Palo Alto Medical Foundation.

But what does the medical research say? Can you comprehend the difference? Do you have the capacity to analyze the epidemiology studies that are linked for yourself?

(1) Neuzil, K.M., Reed, G.W., Mitchel, E.F., Simonsen, L., Griffin , M.R. 1998. "Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women." American Journal of Epidemiology, 148:1094-102.

http://www.jpands.org/vol11no2/ayoub.pdf

Neuzil et al. reported that pregnant Medicaid-eligible women in a Tennessee registry had higher hospitalization rates during the influenza season than nonpregnant and postpartum women, particularly during the third trimester of pregnancy. Hospitalization was infrequent, ranging from 3.1 per 10,000 women-months in the first trimester to 10.5 per 10,000 in the third trimester. The study failed to discover a greater incidence of specific adverse events, including death, during pregnancies complicated by influenza. The following factors significantly limit the study's impact:
*The Medicaid population is known to have more comorbidity and receive less adequate outpatient care. Patients are more likely to seek emergency room services at a more advanced stage of illness and thus to be admitted to the hospital more frequently.
*The hospitalization rate was overestimated by the inclusion of admissions for delivery.
*Influenza was not confirmed by laboratory testing and not differentiated from other infections.
*Reasons for admission were never quantified, and included a broad range of ICD-8 and ICD-9 codes.
*Aside from the event of a hospital admission, per se, no difference in morbidity or mortality was reported.

Here is the summary of your vaunted "evidence": Medicaid pregnant women who get sick, especially those in their third trimester, check into the hospital more than non-pregant women do. Well, duh.

(2) Hartert, T., Neuzil, K., Shintani, A., Mitchel, E., Snowden, M., Wood, L., Dittus, R., Griffin , M. 2003. "Maternal morbidity and perinatal outcomes among pregnant women with respiratory hospitalizations during influenza season." American Journal of Obstetric Gynecology, 189:1705-12.

The abstract of this study makes no claims about any special risks of influenza to pregnant women.

(3) Jamieson, D.J., Honein, M.A., Rasmussen, S.A., et al. 2009. “H1N1 2009 influenza virus infection during pregnancy in the USA.” Lancet , 374:451-458.

This study drew its conclusions (that pregnant women MAY be at more risk to the H1N1 virus) based on a grand total of 6 US H1N1-related deaths over a 63 day period and 11 US H1N1-related hospitalizations of pregnant women over a 34 day period:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961304-0/abstract

This is not statistical evidence. This is anecdotal evidence.

(4) Centers for Disease Control and Prevention. "Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP)." MMWR 2008; 57 (No. RR-7): 1-60.

This is a document of recommendation, not a medical study.

(5) ACOG Committee on Obstetric Practice. 2004. Influenza vaccination and treatment during pregnancy. ACOG Committee Opinion No. 305, November 2004. Obstetric Gynecology, 104 (5 Pt 1):1125-6.

This is a document of recommendation, not a medical study.

(6) Black, S., Shinefield, H., France, E., Fireman, B., Platt, S., Shay, D. 2004. Vaccine Safety Datalink Workgroup. "Effectiveness of influenza vaccine during pregnancy in preventing hospitalizations and outpatient visits for respiratory illness in pregnant women and their infants." American Journal of Perinatology, 21:333-9.

This study presents no evidence concerning any special risks of influenza to pregnant women.

(7) Zaman K, Roy E, Arifeen S, Rahman M, Raqib R, Wilson E, et al. "Effectiveness of maternal influenza immunization in mothers and infants." N Engl J Med < 10.1056/NEJMoa0708630 >. 2008 Sept . Available from the New England Journal of Medicine.

This study presents no evidence concerning any special risks of influenza to pregnant women.

(8) Heinonen, O.P., Shapiro, S., Monson, R.R., Hartz , S.C. , Rosenberg , L., Slone, D. 1973. "Immunization during pregnancy against poliomyelitis and influenza in relation to childhood malignancy." International Journal of Epidemiology, 2:229-35.

This study presents no evidence concerning any special risks of influenza to pregnant women.

(9) Deinard, A.S., Ogburn, P. 1981. A/NJ/8/76 influenza vaccination program: effects on maternal health and pregnancy outcome. American Journal of Obstetric Gynecology, 140:240-5.

This study presents no evidence concerning any special risks of influenza to pregnant women.

(10) Munoz, F., Greisinger, A., Wehmanen, O., Mouzoon, M., Hoyle, J., Smith, F., Glezen, W. 2005. Safety of influenza vaccination during pregnancy. American Journal of Obstetric Gynecology, 192:1098-106.

This study presents no evidence concerning any special risks of influenza to pregnant women.

[EvolveOrConvolve]

45. You seem to pick and choose the evidence you want to believe

The evidence, if looked at from a global perspective shows that pregnant woman have special risks and requirements as regarding influenza.

You, instead of looking at the all the evidence and taking it as it should, as a body of work with a strong lean towards their being higher risks in pregnant women, attack each item individually by nitpicking one small point. You then dismiss each item individually because you have a strong confirmation bias and only look at sources that back up your own view. Your methods are either intellectual laziness or intellectual dishonesty. I have a feeling that, unfortunately, you are both.

FWIW: linking to a "doctor" who still thinks that vaccines causes autism shows how intellectually lazy and/or dishonest you are.

[mhatrw]

49. Really? Then produce this "global" evidence.

Let's see the "global" epidemiological studies that show influenza is a higher risk to pregnant women than it is to the general population. If what you say is the proven medical fact you contend it to be, you should be able to produce dozens of "global" studies demonstrating this special risk.

So let's see them.

[EvolveOrConvolve]

65. Again?

Didn't you read my previous post?

[mhatrw]

67. I read it. There were no global studies listed. There were only the

same two flawed US-based studies -- neither of which demonstrates influenza is a greater risk to pregnant women than it is to the general population -- that I have critiqued now about a dozen times on this thread.

Would you like to read those critiques again?

(1) Neuzil, K.M., Reed, G.W., Mitchel, E.F., Simonsen, L., Griffin , M.R. 1998. "Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women." American Journal of Epidemiology, 148:1094-102.

http://www.jpands.org/vol11no2/ayoub.pdf

Neuzil et al. reported that pregnant Medicaid-eligible women in a Tennessee registry had higher hospitalization rates during the influenza season than nonpregnant and postpartum women, particularly during the third trimester of pregnancy. Hospitalization was infrequent, ranging from 3.1 per 10,000 women-months in the first trimester to 10.5 per 10,000 in the third trimester. The study failed to discover a greater incidence of specific adverse events, including death, during pregnancies complicated by influenza. The following factors significantly limit the study's impa/t:
*The Medicaid population is known to have more comorbidity and receive less adequate outpatient care. Patients are more likely to seek emergency room services at a more advanced stage of illness and thus to be admitted to the hospital more frequently.
*The hospitalization rate was overestimated by the inclusion of admissions for delivery.
*Influenza was not confirmed by laboratory testing and not differentiated from other infections.
*Reasons for admission were never quantified, and included a broad range of ICD-8 and ICD-9 codes.
*Aside from the event of a hospital admission, per se, no difference in morbidity or mortality was reported.

Here is the summary of your vaunted "evidence": Medicaid pregnant women who get sick, especially those in their third trimester, check into the hospital more than non-pregant women do. Well, duh.

(3) Jamieson, D.J., Honein, M.A., Rasmussen, S.A., et al. 2009. “H1N1 2009 influenza virus infection during pregnancy in the USA.” Lancet , 374:451-458.

This study drew its conclusions (that pregnant women MAY be at more risk to the H1N1 virus) based on a grand total of 6 US H1N1-related deaths over a 63 day period and 11 US H1N1-related hospitalizations of pregnant women over a 34 day period:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961304-0/abstract

This is not statistical evidence. This is anecdotal evidence.