He has several excellent blogposts, providing numbers and context. It’s refreshing to read about how H1N1 is unfolding in another region of the world, another step removed from the rather loud voices in North America that keep insisting H1N1 is a US government conspiracy. One of my favourite posts of his is The Swine Flu Paradox. Anyone else surprised by the standard of medical reporting in different countries?

OK, let’s all admit this—public health officials, especially in Alberta where I live, have botched the distribution of the H1N1 vaccine from the get-go. Instead of starting with ONLY the folks science has shown to be at higher risk from H1N1, they said they’d vaccinate “anyone who showed up”…and then were shocked at the overwhelming numbers that did. Sure, polls showed only about half of folks asked planned to get the shot, but come on! Coundn’t they figure out that those planning to get it—more than a million and half people in AB with our population of more than 3 million—wanted the shot NOW, not later? Add in two deaths of children in Ontario in a matter of days, and you’ve now got levels of fear and panic I’ve never seen before in this country.

Anyways, I’ve had a look at who has been reading my blogposts on H1N1, and I’ve got readers from around the world, many in the US, but by far the majority are from Canada. So here’s my public service announcement:

IF you have decided to get vaccinated in Canada, and you DO NOT have an underlying health condition—especially if you are an adult and NOT pregnant--PLEASE WAIT. I know this is similar to what public health officials are saying, but let me give you some numbers, as always.

In Alberta, known underlying conditions are present in 76 per cent of hospitalized cases and 93 per cent of deaths. I just watched a live newscast from Quebec, where similar numbers were given: of the 27 deaths in that province, 24 had underlying health conditions (89%). Overall in Canada, 83.3% of females who have died have had underlying health conditions; the figure is 74.1% for males. Children under 15 have the highest hospitalization rate in Canada, at 12.1 per 100,000 (national crude hospitalization rate is 5.3 per 100,000). Of the 350 hospitalized women between 15 and 44, 93 (26.6%) were pregnant—or more than 1 in 4 hospitalized women were pregnant.

I hope that makes the wait for the shot a bit more bearable for some of you, though I know it won’t take all the fear away. In Alberta, we’ve had 5 H1N1 deaths in the past week. To put that number in perspective, Alberta has about 10% of the population of Canada. If the country as a whole had the kind of week we’ve just had here, there would have been about 50 deaths in Canada from H1N1 this past week. In reality, there has been 92 H1N1 deaths in Canada (thru October 24th) since this pandemic began last April. Yes, its been a rough week here and lineups for the vaccine are unbelievably long—as they are all around the country—but remember Albertans, 93% of deaths here had underlying conditions, or 13 of the 14 deaths. So let’s calm down and let the highest risk folks get their shots first, IF they want them, despite the incompetence of Alberta Health Services on this particular front.

As for who exactly is considered high risk, check with your provincial health authority.

And have a safe, happy, and healthy Halloween!

A recent study looks at what number of adverse events would be expected in a given population even without vaccines—per x million people, there will be a certain number who die, who have spontaneous abortions, etc. in the next few days or weeks.  We need to know these baseline numbers so that we can see if reactions post H1N1 vaccine go beyond what is statistically expected. I quite liked this bit, some much needed humour dealing with our current serious pandemic:

"By being ready with the expected numbers of chance cases, perhaps we can avoid over-reaction to sad, but coincidental, events. And why don't we ever see a headline 'Man wins lottery after flu jab'?"

Read the complete article here.

You’ve heard it in words; now here’s a graph from New Scientist. Swine flu, while causing less death overall, is not behaving like a “mild seasonal flu.”

Fergus on Flu from the BBC has a similar graph, showing the deaths from seasonal and H1N1 (swine flu) in the UK:

He says:

This graph shows that whereas 94% of deaths from seasonal flu are in the 65+ age group, with swine flu the fatalities are much more evenly spread.

Indeed, 60% of the deaths so far have been of people under the age of 45. 20% of those who have died had no underlying health conditions.

He also has a graph showing the difference in hospitalizations between seasonal and swine (pandemic) flu:

He says:

I've included this data because it illustrates the difference between pandemic and seasonal flu. You can see that, whereas those over the age of 60 make up the peak group hospitalised by seasonal flu, it is children who are most affected by swine flu.

I have a link to one of my favourite articles by Fergus on Flu: The Swine Flu Paradox here. What’s the paradox? That this illness is mild in terms of overall death numbers, but causing strain on hospitals (ERs, ICUs) and doctors (for visits re: influenza-like illnesses, or ILI).

Came across an interesting idea while reading this article from the ECDC (European Centre for Disease Prevention and Control). Instead of measuring the severity of H1N1 in terms of number of deaths (which, by anyone’s count, it less than expected even for seasonal flu), let’s measure it in terms of the numbers of life-years lost:

…there has been some confusion between what is meant by ‘mild’: the disease being mild epidemiologically, as opposed to mild at the individual level.

Because the virus has mainly targeted younger people than seasonal flu, measuring the severity in terms of life-years lost, rather than the number of deaths, would give a more accurate picture of how severe the pandemic is in reality, suggests Ekdahl.

What do you think? Should we be counting deaths equally—a life is a life? Or is there something to the idea that the death of a young person is more tragic, somehow weighs upon us differently than the death of the elderly? Which strikes you as a worse illness: one that kills more folks overall, but the median age of death is quite elderly, say 83; or one that kills fewer folks overall but many more younger folks, including children, and the median age of death is say, 53?

In Sweden, there have been 4 deaths in individuals vaccinated for H1N1—a 74 year old woman with heart and lung disease, a 90 year old woman, a 50 year old man with a serious heart condition and a woman with an acute muscle disease. You can read more here. Keep in mind that we do not know at this stage what role, if any, the vaccinations played in their deaths—we know only that they died, and at some earlier time they had been vaccinated. But better you read the actual details than just the scary headline: “Four dead after swine flu vaccine in sweden!” This is concerning news to be sure, but it would be even more concerning if these deaths occurred in immunized young healthy folks, IMHO. And I’ll say for the record that I find this site—the Local: Sweden’s news In English—to be quite slanted in favour of the conspiracy theory side, if you do some clicking to other links. YMMV.

There’s also been a report out of Ireland of a 15-year-old boy with special needs being rushed to hospital after getting the shot. Details here. It turned out the boy has H1N1 (though whether this explained all his symptoms, or if he was also having a reaction to the H1N1 shot is unclear). As the vaccine in Ireland is made from dead virus, it is not possible for it to give him the disease—the only known cases of folks getting an illness from a vaccination is in the case of the live polio vaccine in the US (and these cases were extremely rare). The boy would have had H1N1 before getting the shot, just not yet be showing symptoms. (But again, I know some will question this). Again, this story is concerning, especially to those of us who are parents. I am glad to hear that he is recovering, especially in light of the 4 special needs children in Ireland dying of H1N1.

If anyone has stories (with references) to perfectly healthy young folks reacting negatively to an H1N1 shot, please share in the comments. As I’ve said all along, vaccines are not perfectly safe, there are no guarantees and there are always a few, rare negative reactions to any vaccine. I am curious if all 4 Swedish deaths will be shown to be connected to the vaccination; if so, this would suggest to me that as this group (the elderly) is less vulnerable to death from H1N1, perhaps they should not be vaccinated for it.  

Read the editorial “H1N1 is serious, but no need to panic” from the Toronto Star newspaper online today, and felt compelled to respond. My response was brief as I was limited to 1000 characters (I can see many of you thinking “thank goodness!” <g>). Find the editorial here, and here is my response (titled: “don’t panic, but let’s have some context” in the comments section online): 

According to FluWatch Canada's IMPACT network, there were 2 pediatric deaths from seasonal flu in Canada in 2006-7, 5 in 2005-6, 2 in 2004-5, and 4 in 2003-4. Another reasonable estimate of expected child flu deaths in Canada is 4-10 per season, working off the US CDC numbers (46-88 deaths); we have about 10% their population. In Ontario alone, there have been 6 H1N1 child deaths. So while H1N1 is "less deadly" than a typical seasonal flu OVERALL, its "deadliness" varies for different groups: less deadly to seniors, but more deadly to children. Lastly, while a teen with underlying health problems, or undergoing chemo, dying from seasonal flu would not have been ‘news-worthy’, I think the flu death a healthy 13-year-old, capable of playing hockey less than 48 hours earlier, would have made headlines at any time in the recent past in Canada.

I’ll get back to posting about family life and homeschool and all that soon, I promise! :-)

UPDATE NOV 4: I actually sent my questions in this area to Andre Picard, a Health reporter for the Globe and Mail, and here is what he had to say:

Q: There is a lot of talk of the risk of H1N1 to children. Can you tell me how many children have actually died? And were they all healthy? Also, how does that compare to a regular flu season?

A: As of Oct. 24, there have been 100 deaths from H1N1 in Canada, including six deaths in children 15 and under (that is seven per cent of the total). Only one of the children who died had an underlying health condition. By comparison, among adults, 63 per cent of the fatalities have occurred in people with an underlying condition.

In a ‘normal’ flu season, there are roughly 5,000 deaths, most of them seniors. Between three and five children die of seasonal influenza annually (less than 0.1 per cent), and they are usually babies with underdeveloped immune system. Deaths in the six months to 15 age category are very rare.

While every death of a child is tragic, it is also important to keep them in context. The greatest risk to children, by far, is unintentional injuries – motor vehicle crashes, falls, accidental poisoning – which result in almost 400 deaths a year. Another 170 children each year die of cancer. So one of the best ways to keep your child safe is to drive carefully when you head to the vaccination clinic.

Thanks so much for clarifying this, Mr. Picard!

UPDATE : NOV 2: I can’t find accurate data on current child deaths in Canada, and I am now suspicious of the claim that there have been 6 in Ontario alone. I suspect the numbers may be 6 in Canada as a whole (and, as anyone who lives outside Ontario would know, this wouldn’t be the first time the largely Toronto-based media in Canada has confused Canada and Ontario). I have asked a medical reporter to clarify the numbers of me; I will let you know if I hear back. If the true number is 6 for Canada, this is still above normals for Canada, and we are early in the season. But it’s nowhere near as concerning as 18!

There’s been a lot of press about how the number of child deaths from H1N1 in the United States has already surpassed that of any of the previous three years from seasonal flu, but getting data on Canada’s pediatric deaths has been much harder to find. Here’s what I was able to dig up from the annual reports for previous flu seasons listed on Canada’s Fluwatch page.

2006-2007  Two (2) pediatric deaths from seasonal flu, and 307 pediatric hospitalizations.

2005-2006 Five (5) pediatric deaths from seasonal flu, and 374 pediatric hospitalizations.

2004-2005 Two (2) pediatric deaths from seasonal flu, and 391 pediatric hospitalizations.

2003-2004 Four (4) pediatric deaths from seasonal flu, and 526 pediatric hospitalizations.

How does that compare to H1N1? To be honest I am not sure, and I can’t find the data. (Please send me links if you find this!) But I did find this, in several reports about the tragic and sudden death of a 13-year-old Toronto boy from H1N1:

There have been 28 deaths in Ontario since the outbreak of the swine flu, including six children since April, health officials said today.

Six child deaths among the 28 deaths in Ontario alone? There have been 83 confirmed H1N1 deaths in Canada according to FluWatch’s latest weekly report (data for week of October 11-17th), and at least 8 more have been announced since then (the 2 Ontario children, and 3 each in AB and BC). So that puts Ontario’s 28 deaths at about 1/3 of the total, which would mean that an estimate of about 18 pediatric deaths in Canada so far this flu season (again, I don’t know the actual number. Send me a link!) is not unreasonable. According to the data I gave above, there has been a total of 13 pediatric deaths from seasonal flu in Canada from 2003-2007 combined. Hmmm….

So now that you’ve got some context, how do you feel about comments such as these made by health professionals today after the well-publicized deaths of two Ontario children in recent days?

Dr. Bonnie Henry, director of public health emergency management at the B.C. Center for Disease Control, cautioned against reading too much into the deaths of two young people this week.

"The average age of hospitalization we're seeing is young children under 15," she said.

"Most of them get better, and their illnesses don't progress. But because there are so many people susceptible to this virus, it's inevitable that we're going to see people without any underlying risk factors get very sick and die from it, unfortunately."

Dr. Gerald Evans, president of the Association of Medical Microbiology and Infectious Disease Canada, said it's important to put the deaths of the two teens into context, because teens die during regular flu season, as well.

"It gets over-amplified because there is so much in the press right now about pandemic flu," he said.

"What we do know is that, whenever there are initial reports of healthy people, particularly healthy young people dying . . . that this is going to drive people to suddenly rethink their position on whether they should be vaccinated or not."

While I agree that the overall pediatric numbers are small, saying not to read too much into 2 deaths of children in a matter of days when this equals the total of pediatric deaths in Canada from flu for both the 2006-07 and 2004-05 seasons seems somehow misleading to me. Yes, swine flu has been milder than seasonal flu in terms of total deaths (so far), but it is clearly affecting certain groups, such as children, in numbers vastly disproportionate to previous seasonal flus.

As always, the decision to vaccinate or not is up to you—flu vaccine is not without risks, and it is also not 100% effective. But at least now you’ve got a context to make sense of some numbers for your Canadian kids, yes?  

Googling for “squalene” or “vaccine adjuvants” will get you in touch with the numerous anti-vaccination arguments in a hurry, so I’m not going to link any particular site here. I was reading this piece out of the UK, which linked to the WHO’s position on squalene after the comment that more than 20 million people in Europe have had flu vaccine with squalene since 1997. This is the other side of the argument. Read both and you decide what you feel about the risks of adjuvants, and particularly squalene, in the H1N1 virus. Note: Canadian H1N1 vaccines contain adjuvants; US vaccines do not.

I didn’t either. Here’s a well-referenced and interesting article on the benefits and risks of the H1N1 shot, from a UK perspective. It includes a discussion of the 1976 flu season, Guillain-Barre, and this rather startling stat: during the first wave of swine flu this summer, 1 out of every 20,000 children aged 4 or under in the US ended up in hospital. For more, check out The New Scientist.

The province of Quebec has created a useful self-care guide on H1N1 / swine flu. I particularly like the “decision chart” (when to seek medical attention) at the end, and the chart comparing cold and flu symptoms.  It can be found by clinking on the pdf link here. I meant to include it in my previous post; sorry about that.

Given that I have a 4-year-old with asthma, I’ve been doing a lot of reading and researching on this year’s H1N1 outbreak. I’ve written various things to various folks in private emails, and I thought I’d post them here as they may be of benefit to those looking for answers in a media environment characterized by fear-mongering on both sides of the debate. Or patronization (“Vaccines are safe!” end of discussion). Or conspiracy (“Never trust government / corporations / media / scientists!”) For those wanting to try to weigh risks and benefits in a scientific / mathematical way, read on. For those who’s minds cannot be changed no matter what new evidence may come to light, on either side, power to you—but know that your view is not based on science. Science is always open to new evidence and changed conclusions because of it.

I’ve gathered information from three primary sources. In the US, the CDC. In Canada, FluWatch, from the Public Health Agency of Canada. And from Australia, who has now been through their usual winter flu season, the government’s Influenza Surveillance page. At the time of writing, the most recent data comes from the week ending October 9/10th. I have relied on wikipedia for information about Guillain-Barre syndrome and the 1976 flu season.

Here’s an article I thought was one of the more even-handed discussions of H1N1 and the vaccine, Andre Picard’s Reader Questions on H1N1 Answered from Canada’s Globe and Mail newspaper.

Here’s an article arguing against the vaccine, that was sent to me by a friend. I found this article raised a number of valid issues of concern, and was far better than most on the anti-vaccination side, as she/he gave numerous references: Seven Inconvenient Truths about the 2009 H1N1 Pandemic. It’ll probably be easiest to open this article in another window to follow along with my comments about it, which are as follows:

1 - Yes, correct. ‘Pandemic’ refers to how contagious something is, and how far/easily it has spread, not to how deadly or severe the illness is. And yes, many folks misunderstand the word.

2 - She/he is using old data (August), but is basically correct that H1N1 has overall been less deadly than a typical seasonal flu in the US. However, the deadliness of this illness varies dramatically by age group, underlying condition, etc. From my read of the evidence, this flu has been far less deadly overall because those who flu normally kills are not coming down with it, perhaps due to natural immunity built up during previous H1N1 epidemics (such as in '57). Among children though, H1N1 has killed as many (I believe as of today slightly more) than any of the three previous flu seasons. (86 confirmed H1N1 deaths as of last Friday, compared with 46-88 pediatric deaths in the US in the previous 3 seasons.) Note too that 43 of these deaths have come about in the past 6 weeks (Sept and first half of October), and we are by no means thru what is typically the peak flu season as yet. BTW, Australia, which is now thru its typical flu season, reported a death rate of 8.8 per million (185 deaths, pop. 21 million). If the US has a similar death rate, it should have 2675 deaths--far less than in a typical flu season, but certain groups will have far higher death rates than in a typical year.

3 - I know the US stopped counting H1N1 cases after lab results were showing that 97% of all suspected flu turned out to be H1N1 rather than seasonal. My understanding was that deaths and hospitalizations are still being sent for confirmation re: H1N1; in fact, one child's death suspected of being H1N1 turned out not to be, which is why the US went from 76 child deaths two weeks ago, had 11 more last week, and only totalled to 86. I also wonder if this is any different than with seasonal flu, where what ends up killing the elderly is secondary infections like pneumonia and not the flu itself, but it is recorded as death by flu.

4 - (which is actually labelled 3 again). This I think is a very serious issue, as there does not seem to be a lot of studies looking at the effectiveness of vaccines, especially for flu. But I have a qualm with the data presented. For children over two, she/he says:
"The same meta analysis found influenza vaccines effective 33% of the time in children over the age of two. (16) Followed to it's logical conclusion, this means the flu vaccines are ineffective 67% of the time in children over the age of two."
I went and found the referenced study online, and this is what I found:
"Fifty-one studies with 294,159 observations were included. Sixteen RCTs and 18 cohort studies were included in the analysis of vaccine efficacy and effectiveness. From RCTs, live vaccines showed an efficacy of 82% (95% confidence interval (CI) 71% to 89%) and an effectiveness of 33% (95% CI 28% to 38%) in children older than two compared with placebo or no intervention. Inactivated vaccines had a lower efficacy of 59% (95% CI 41% to 71%) than live vaccines but similar effectiveness: 36% (95% CI 24% to 46%)."

Clearly we need more research here, but we also need to understand the difference between efficacy and effectiveness: from her logic, the vaccines are "ineffective" 67% of the time, but the study being referenced says they "have an efficacy rate of 59-82%". From what I could gather doing more investigation, efficacy is the rate by which incidence (not severity) of a disease decreases between vaccinated and unvaccinated populations, under ideal conditions and carefully controlled clinical trials. "Effectiveness" is whether or not the vaccine benefited those getting it in the real world, not under idealized clinical conditions (looking at data and rate of disease after the fact). Of course, there are many reasons why real world conditions show worse results, like vaccines being administered incorrectly (wrong dosage, wrong timing/spacing of vaccines), folks already being ill with disease at time of vaccination, folks consuming other substances that limits the vaccines effectiveness (like perhaps Tylenol, a recent study suggests), etc. But she/he does highlight some serious issues here--we need more study of the very young, and we need more investigation into why there is such a discrepancy between efficacy and effectiveness rates.

5 - One the one hand, I agree, but see little way around this when a disease is spreading quickly. On the other, I find the fact that pretty much ALL first world nations are rolling out H1N1 mass immunization campaigns, even those who have differences from the US when it comes to routine childhood immunizations and schedules, to be of some comfort. I cannot find any other country using the live FluMist version, BTW, other than the US, and that alone is enough to make me suspicious of it (that version will not be available in Canada anyways).

6 - Yes, vaccine risk may be worse than disease risks, and that is why you need to have hard data (scarce!) to compare risks to benefits. Guillain-Barre is a serious illness, to be sure, but we need to know how deadly or otherwise life-altering it is for those who get immunized. The data I have found suggest rates of G-B varying from 2 per 100,000 immunizations thru 1 per 1 million. It's also important to note that of those diagnosed with G-B, the vast majority make a full recovery after treatment; about 5-10% continue to have severe disability, and 2-4% die. If I'm doing my math right, we get (at most) 4% of 2 in 100,000 shots leading to death by G-B, which means 2 in 2,500,000, or 0.8 per million. On the low side, the rate would be 2% of 1 in 1 million dying of G-B, which means 2 in 50 million, or 0.04 per million. Right now, Canada's death rate from H1N1 is 2.4 per million, and again, Australia's was 8.8 over the flu season. Of course, there are other possible side effects to shots, and these need to be factored in. I am open to the idea that various other illnesses are linked (e.g. autism), but have yet to find solid scientific proof (replicable, peer-reviewed).
It's also interesting to note that the 1976 H1N1 flu did not behave like the current outbreak. The majority of those who had flu that year had seasonal flu, not H1N1, and deaths from flu affected the typical groups (elderly, etc.). Very sad as the H1N1 vaccinations were damaging with G-B, and probably unnecessary given this information.

7 - I honestly don't know enough about "herd immunity" arguments, and have never been persuaded by them anyways. I think each individual needs to protect themselves as best they can given their particular health issues, age, etc.

So to sum up looking at her final 6 points:
1 - I agree in some ways.
2 - Overall true, but the severity is much higher for some groups compared to seasonal flu.
3 - Not sure about risk of contracting (I'd say it's higher than average given that it is a novel strain). And while her risks of death may be less than with seasonal flu, they are not for all--e.g., my 4-year-old asthmatic child
4 - The evidence here is conflicting, and we need to understand the difference between efficacy in ideal setting and effectiveness in the real world. I am not sure if any of these studies address the severity of illness--e.g., a vaccine that did not prevent people from getting flu, but did reduce hospitalization and death rates from it, would that be considered effective?
5 - Don't know enough to comment.
6 - Agreed, but these need to be weighed against known risks from H1N1 (or whatever vaccine in question). We also need to ask if the outcomes for those with H1N1 are only two: death, or full recovery. Do any folks have lifelong complications / disability from it?

And as for her conclusion? I agree there are many other proactive things one can do to lessen the chance of getting H1N1, and increase the chance of full and easy recovery if you do--and we're doing them. But "make sure" I (or my asthmatic child) suffers only a mild case? Sadly, I doubt it.

Here’s another link I came across from a friend, Dr. Jay Gordon’s Swine Flu, Other Viruses and High Anxiety, and my thoughts on it:

He is correct that for the vast majority of folks this is no different--the illness is minor, and they will not feel any worse than regular seasonal flu. He is also correct that the reason we have such a high infection rate is because it is a new strain, and in new strain years infection rates skyrocket as virtually no one has built any immunity to similar strains (this is one reason the elderly may not be being infected as much this year; it is hypothesized the '57 flu was similar enough that older folks built immunity to this years' strain then.)
However,

1 - many studies are showing that rates of death for those with no underlying health conditions to be far higher than his 20-25% (though he quotes only children, and there I am not sure. The studies I can find relate to adults, a common one mentioning that 45% had no underlying health issues.) This result—45% without underlying health issues—has been presented in two very different ways in the media, and both headlines are technically correct:
"Almost half of all H1N1 victims had no underlying health problems" and
"The majority of H1N1 victims had underlying health problems"   Reader beware!

2 - Child deaths from H1N1 in the US are already at levels seen in a bad regular flu season (86, whereas in the past 3 years child flu deaths have ranged from 46-88). 43 of these have come in September and the first half of October alone; in other words, in the past 6-ish weeks, the pediatric death rate is equal to that of an entire regular (low) flu season. Peak flu season usually occurs in the Xmas-January time frame.

3 - In various studies, pregnant women comprise 6 percent of those who have died from  H1N1. Pregnant women comprise 1 percent of the general population. In Australia, pregnant women aged 20-39 comprised a whopping 32% of all hospitalizations for H1N1.

4 - His mathematical illiteracy drives me crazy. Here's a quote: "Some of us will get high fevers and have to miss school and work for a few days and 99.9999% of us will remain completely unaffected after the flu season except that those who contract Swine Flu this year will be protected if it gets meaner and more virulent in coming years as expected."

Ok, bear with me, those of you who are math-phobic. Let's remove the decimals and start as though he said 99% of us remain unaffected. That would mean 1 in 100 of us are affected. Ok so far? Let's continue this line of reasoning.

99% of us unaffected means 1 in 100 are affected by H1N1
99.9% means 1 in 1000 are affected
99.99% means 1 in 10,000
99.999% means 1 in 100,000
and, his original quote:
99.9999% means 1 in 1,000,000 of us are affected. In plain English, only 1 in 1 million of us are or will be affected by H1N1.

Now, let's just look at the most recent stats from Canada.

"The national hospitalization rate was 4.6 per 100,000 population with the highest rates in children under 15 years of age (10.9 per 100,000). The national mortality rate was 0.24 per 100,000 population; those 45 years and older had the highest mortality rate (0.35 per 100,000). ICU admission rate and ventilation rate were also elevated in children under five years of age (1.6 and 1.1 per 100,000, respectively)."

Right off the bat, a hospitalization rate of 4.6 per 100,000 means 46 people per 1 million hospitalized, and I don't know about you, but I'd count being hospitalized as being "affected" by the flu. That becomes 109 out of 1 million for the under-15 crowd. And the national mortality (DEATH!) rate is .24 per 100,000, which is 2.4 deaths per million...again, something you'd have to call being "affected by swine flu". (Sorry for the sarcasm, and I mean no disrespect to anyone who has lost friends or family to this disease.) Australia’s death rate was 8.8 per million, and hospitalization rate 227 per million. It was 679 per million for males under age 5---or 679 times Dr. Gordon’s 99.9999% estimate of who would be affected.

So, while he is correct that more than 99% of folks will sail thru this season just fine, his innumeracy re: 99.9999% of us makes me question his reasoning, and hence judgment, on the whole issue. And yes, you read that right, more than 99% of the population will have no problems with this illness. Do keep that in mind when making your vaccinate or not decisions. And he does point out a legitimate issue as to future strains of swine flu, and whether those who have not built anti-bodies naturally will be worse affected in future. But I really don't think it is asking too much of him (or anyone else) to get the numbers right.  

Ok, I’m done. Hope that was helpful to someone out there. I had one friend ask me to do a mathematical analysis and come up with a clear answer of whether to vaccinate or not. Unfortunately, this is not possible to do, as first, certain data is unknown, and second, how much you weight various information depends on your personal values, not numbers. I wish everyone out there health, and peace in coming to a decision on this issue that you are comfortable with.

I welcome respectful comments. Feel free to disagree, ask questions, etc. But anyone being nasty will have their comments simply deleted, in the interest of maintaining a place where discussion is welcome.