Talk:Influenza vaccine/Archive 2

Archive 1

Archive 2

Archive 3

Material from Vaccine controversy

The following material was recently placed into Vaccine controversy but is very specific to influenza vaccine as opposed to vaccine controversy in general, so I'm moving it here as a possible addition to this article:

"Modern influenza vaccines have been criticized for a lack of effectiveness demonstrated in controlled studies. A 2006 Cochrane review of influenza vaccination in the elderly stated "The apparent high effectiveness of the vaccines in preventing death from all causes may reflect a baseline imbalance in health status and other systematic differences in the two groups of participants<ref>doi:10.1002/14651858.CD004876.pub2</ref>. A 2005 cohort study found that the entirety of the protective effect of the influenza vaccine in the elderly could be accounted for by selection bias.<ref>doi:10.1093/ije/dyi274</ref> A 2008 Cochrane review of healthy children found "Influenza vaccines are efficacious in children older than two but little evidence is available for children under two." <ref>doi:10.1002/14651858.CD004879.pub3</ref>. The CDC recommends every child over 6 months be given the influenza vaccine.<ref>Children, the Flu, and the Flu Vaccine http://www.cdc.gov/flu/protect/children.htm</ref> A 2007 Cochrane review on influenza vaccines in healthy adults found that while vaccines were effective against the influenza strains they are designed to vaccinate against, this ended up translating to only a modest impact on working days lost due to influenza-like infections. <ref>Demicheli, V.; Rivetti, C.; Di Pietrantonj, T.; Rivetti, A.; Demicheli, D. (April 2007). Rivetti, Daniela (ed.). "Vaccines for preventing influenza in healthy adults". Cochrane Database of Systematic Reviews (2): CD001269. doi:10.1002/14651858.CD001269.pub3. PMID 17443504.</ref>"

Eubulides (talk) 19:36, 22 October 2009 (UTC)

Added with some modifications of the wording. Originally this was in the vaccine controversy article, so it is slanted towards bringing out criticism- perhaps some of the other less negative conclusions should be pulled out of those reviews. I think the clinical trials and effectiveness section should be merged together. This addition has caused duplication, but there is no way around that- these sections are inherently duplicate because effectiveness is based off of clinical trials. If there is any division here, it might be better to divide information between efficacy and effectiveness. Gregwebs (talk) 22:01, 25 October 2009 (UTC)

Almost entirely original research

This section vaguely invokes, "various authorities." Literally.

"Various public health organizations, including the World Health Organization ...

And then proceeds to list a rather truncated, limited list of indications as though it were a comprehensive list:

... have recommended that yearly influenza vaccination be routinely offered to patients at risk of complications of influenza and those individuals who live with or care for high-risk individuals, including:

The list that follows is original research, replete with selective deletions of actual recommendations, and is far from comprehensive list of indications. The actual recommendations are quite a bit more extensive. The U.S. and U.K recommendations are summarized more credibly, with sources cited, at in an early section of this Wikipedia Article, "Purpose and benefits of annual flu vaccination" http://wiki.riteme.site/wiki/Influenza_vaccine#Purpose_and_benefits_of_annual_flu_vaccination

The misleading selective original research in this section should either be taken down as redundant, or else cleaned up to accurately reflect the actual " Vaccination recommendations" (per the section title) of the "various authorities" involved, each in turn and clearly sourced, without the systematic unrevealed omission of many of their actual recommendations. —Preceding unsigned comment added by 64.105.0.102 (talk) 21:20, 6 December 2009 (UTC)

Nosocomial infection rates reduced by vaccination of hospital staff

Engels, Goldman, Doyen, Duyse, Van Beers, Vergison

Reduction of the nosocomial influenza A burden in a paediatric hospital by immunisation of the healthcare workers

Abstract number: 1133_242 http://www.blackwellpublishing.com/eccmid15/abstract.asp?id=36255

See also:

Sabine Wicker, Dr. med.,1* Holger F. Rabenau, Prof. Dr. rer. med.,2 Volkhard A. J. Kempf, Prof. Dr. med.,3 and Christian Brandt, Dr.med.4

Vaccination Against Classical Influenza in Health-Care Workers Self-Protection and Patient Protection

Review Article Dtsch Arztebl Int. 2009 September; 106(36): 567–572. Published online 2009 September 4. doi: 10.3238/arztebl.2009.0567. PMC 2770210 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770210/ —Preceding unsigned comment added by Ocdcntx (talk • contribs) 01:21, 21 February 2010 (UTC)

Split out Annual reformulation of flu vaccine

Can we split out into a separate article the long section 'Annual reformulation of flu vaccine' and its many references ? Is there a better name ? Rod57 (talk) 13:35, 22 November 2010 (UTC)

vaccinated Expectant mothers passed protective antibodies to their babies

Study tracks H1N1 vaccine protection from moms to newborns Expectant mothers who are were immunized against the 2009 H1N1 virus passed protective antibodies to their babies that lasted at least 5 months, according to Italian researchers who reported their findings today in a letter to the Journal of the American Medical Association (JAMA).

http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/dec0110flunewsscan.html

http://jama.ama-assn.org/content/304/21/2360.extract

PMID 21119083 [PubMed - in process] —Preceding unsigned comment added by Ocdncntx (talk • contribs) 20:01, 5 December 2010 (UTC)

These sources sight no evidence and are too vague no support. 68.70.14.63 (talk) 16:31, 28 December 2010 (UTC)

egg alergy

why no mention of the alergy to eggs contributing to the mixe and why does this say nothin about getting a blood test before getting a vaccine? IN the main vaccine articele it mentions that those with egg alergies should net get the vaccine du to the use of egg protien. Why isnt it mentioned here? —Preceding unsigned comment added by 68.70.14.63 (talk) 13:30, 17 December 2010 (UTC)

adjuvant

Are mentioned in the article, but not explained. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19854 shows that many HEALTH CARE WORKERS see this as a risk. the high rates of narcolepsy in Finland are also not mentioned, which maybe related to this "dirty little secret". The article by not talking about the rôle and possible side effect of different adjuvants becomes speculative and full of original research. Weasel words and wooley thinking do not make it a good article. It seems long and rambling. —Preceding unsigned comment added by 88.113.96.60 (talk) 08:03, 1 May 2011 (UTC)

You seem to be confused about what WP:No original research means. It would be original research if this article did talk about the "rôle and possible side effect of different adjuvants" without appropriate sources. (And if it seems a bit "long and rambling now", wandering off into discussion about narcolepsy in Finland wouldn't exactly help that problem.) --GenericBob (talk) 14:03, 2 May 2011 (UTC)

Toddler ER visits lower in US after vaccination recommendation - NYT

In 2006 the United States began recommending influenza vaccinations for preschoolers but Canada did not follow suit until 2010. During the 2006-2010 interim, a study found emergency room visits significantly lower for 2- to 4-year-olds in Boston than in Montreal. Vaccination of preschoolers may have reduced their likelihood of transmission of flu to older siblings; and raised raised the chances that their parents would vaccinate older children as well, since emergency room visits by 5- to 18-year-olds were 18 percent lower in Boston than Montreal. — Preceding unsigned comment added by Ocdncntx (talk • contribs) 17:37, 24 September 2011 (UTC)

NPOV?

Is this NPOV? Parts of this article, in particular, "Injected flu vaccine was grown in fertilized chicken eggs as is the new FluMist nasal spray vaccine produced by MedImmune. FluMist causes a more durable immune response and is therefore more effective than injected vaccine was. It is the recommended type of flu vaccination for all healthy people ages 5 to 49 and contraindicated for those with allergy to egg proteins." read like a press release. -Unknown — Preceding unsigned comment added by 69.33.44.242 (talk • contribs) 22:12, 25 October 2005 (UTC)

This passage is very poorly written. "vaccince was grown" "as is the new" "and is therefore" "injected vaccine was". Holy verb tense Batman! -Unknown — Preceding unsigned comment added by 24.235.64.232 (talk • contribs) 01:25, 22 January 2006 (UTC)

true and I agree. "As is the new" is bad grammer; its supposed to be "As the new is" ~~unknown~~ — Preceding unsigned comment added by 68.70.14.63 (talk • contribs) 12:43, 20 December 2010 (UTC)

Ordinary seasonal flu vaccination might provide some protection in an H5N1 pandemic

"Seasonal Flu Vaccination May Offer Partial Immunity to H5N1" reports Eric Toner, M.D. summarizing research studies revealing the protective effect of seasonal flu vaccinaton against H5N1. Dr. Toner reports for Clinitians' Biosecurity Network. Dr. Toner's report is available at: http://www.upmc-cbn.org/report_archive/2007/02_February_2007/cbnreport_02212007.html

At least two separate human studies to date indicate that annual flu shots may be protective against H5N1. In one, scientists from St. Jude's, summarize findings in animals and humans and conclude that

"Overall, these findings raise the possibility that seasonal influenza vaccination may provide some protection against pandemic H5N1l."

RESEARCH ARTICLE

Cross-Reactive Neuraminidase Antibodies Afford Partial Protection against H5N1 in Mice and Are Present in Unexposed Humans http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0040059&ct=1&SESSID=1386b277eb2b6128495454737b76f5d2

These studies suggest that it is prudent for individuals to seek vaccination for themselves and their families, and for governments to promote wide vaccination to create a herd immunity effect to slow contagion until more specific vaccines can be developed.

Seasonal flu vaccines (including FluMist) include an H1N1 strain with its N1 antigen, and "bird flu" H5N1 also has an N1 antigen. Italian scientists were curious whether the inclusion of an N1 antigen from each season's H1N1 might result in protection against the N1 antigen in an H5N1 strain. An experiment was done exposing the blood of vaccinated and unvaccinated humans to H5N1 (in a test tube) and the blood of vaccinated humans showed more immune response. "We also observed that seasonal vaccination is able to raise neutralizing immunity against influenza (H5N1) in a large number of donors." http://www.cdc.gov/eid/content/14/1/121.htm

An in vivo test found that mice immunized against the seasonal influenza developed substantial immunity against H5N1.http://www.newscientist.com/channel/health/bird-flu/mg19626273.700-drug-brings-hope-for-a-universal-flu-vaccine.html In this experiment, dead influenza A viruses from the H1N1 and H3N2 families in combination with Ampligen was administered nasally to mice. These are seasonal flu antigens, not pandemic H5N1 antigens. When the researchers then infected the mice with H5N1, the unvaccinated mice all died, but half or more of the nasally vaccinated mice lived. Immune response developed from nasal administration of ordinary seasonal flu antigens with Ampligen was protective against H5N1. By extension, one could hope that FluMist's inclusion of seasonal antigens taken from each season's H1N1 and H3N2 might result in immunity broad enough (and long-lasting enough) to provide FluMist-vaccinated persons with at least some protection against an H5N1 strain. This animal study supports breadth of immunity, particularly perhaps that elicited by an N1 antigen, as a third possible mechanism by which seasonal FluMist inoculation might provide at least some protection against an H5N1 "bird flu" pandemic when one emerged, and without the long delay inherent in current vaccination schemes. Such pre-existing immunity might protect the vaccinated individuals and their families, and a large percentage of vaccinated in the population might also slow the progression of a pandemic through the population while specific vaccines were being developed. — Preceding unsigned comment added by 67.101.69.35 (talk • contribs) 22:01, 9 January 2008 (UTC)

bias?

this page practically screams "get the flu shot". just thought I'd let you know. A little fact on the downside might me nice. --Toyboxmonster (talk) 14:30, 20 January 2008 (UTC)toyboxmonster

name a downside? right there are none compared to getting an actual flu, i doubt anyone here has ever gotten a confirmed case of Influenza (as it's quite rare)Markthemac (talk) 12:42, 8 December 2009 (UTC)

IF that were the case why does the article mention that there are alergic reactions then; And the fact that some can seriously harm you? ~unknown~~ — Preceding unsigned comment added by 68.70.14.63 (talk • contribs) 13:10, 17 December 2010 (UTC)

If you go to the page for "Guillain–Barré syndrome" you will see that there is a heading named "Cause" which is subheaded by "Influenza" and also "Influenza Vaacine". It only makes sense that this article on the Influenza vaacine should have more information on the link that exists between Influenza and Guillain–Barré syndrome. Not having that information clearly in a heading is a glaring lack of information about the vaacine. — Preceding unsigned comment added by 173.174.74.194 (talk) 16:23, 13 October 2011 (UTC)

Does wikipedia have a cut-off for adverse events? The estimated risk based on recent surveillance of the pandemic vaccine is an association of vaccination with ~0.74 excess cases of GBS per million doses. I'm not sure whether this is high enough to deserve mention, as it is roughly 1 in 1,350,000, which would certainly be extremely rare, and might fall below an establiished cutoff for reporting. --Synaptophysin (talk) 13:19, 20 June 2012 (UTC)

I would agree that this article doesn't list the disadvantages such as that there is mercury and chick embryonic fluid in the flu shot, combined with the new Harvard study that says that people that have received the flu are more likely to catch the "flu".

L O N G Article

The article is (apart from the vast references that make editing a nightmare) extremely long. It covers quite varied topics - what is the vaccine, what benefits, who should take it (general matters); then specific details like which variety will come to my place this coming winter - perhaps split into main and subsidiary article? Chiswick Chap (talk) 09:28, 27 October 2011 (UTC)

Animal influenza vaccines and the annual reformulations might be moved into separate articles, with short summaries here. Rest seems germane.  ;;If kept here, the annual reformulations sections should be combined. Each year's variants do not merit a separate heading in the article's table of contents.

I agree that at least the annual reformulations need to be forked to a separate article, and I'm doing it now. Mikael Häggström (talk) 23:04, 13 June 2012 (UTC)

I fixed up the historical reformulations page in tabular format, and it condenses the material a great deal. Perhaps in this form it could be merged back into the main article? --Synaptophysin (talk) 12:52, 22 June 2012 (UTC)

Fluzone - Merge discussion

I cannot see why Fluzone would require a separate article from the regular flu vaccines, as it seems to be mostly the same as the previous vaccines.W n C? 19:25, 9 February 2011 (UTC)

• Fluzone is a product. It would get undue and unfair advertising if it were the only vaccine discussed in the general flu vaccine article. All or no products should be mentioned. Perhaps each product should have it's own page and be referenced here. Ocdncntx (talk) 02:28, 17 October 2011 (UTC)

• Agreed. There is no need for Fluzone to have a separate page. --Synaptophysin (talk) 17:02, 3 October 2012 (UTC)
• No merge, enough information for a stand alone article. --Richard Arthur Norton (1958- ) (talk) 14:18, 23 October 2012 (UTC)

Automatic archiving added

I've added an automatic archiver. Let me know if anyone disapproves. Gabbe (talk) 12:12, 29 December 2011 (UTC)

Needs re-organization.

Discussion of effectiveness appears at several places, and should be consolidated. The article's various treatments seems at points to be self-contradictory. — Preceding unsigned comment added by 99.190.133.143 (talk) 02:20, 24 March 2012 (UTC)

I agree that it needs some work, particularly around the different types of influenza; the majority of the article is in fact on seasonal (tri- and qudrivalent vaccines) but also has information on H5N1 and H9N2, and a comment made in the past few days pointing out that there is no H17 vaccine. Perhaps a clear section for seasonal vaccines should be made, with the non-seasonal (pandemic H1N1, and the H5N1 and H9N2, for example) vaccines in a separate section (or perhaps in another article?), perhaps with a table of the types of influenza virus and whether there are vaccines approved or in development for them. --Synaptophysin (talk) 18:54, 13 June 2012 (UTC)

I've tried to fix things a bit - my comments are in the edit summaries. I think a lot more rewriting is still necessary (and in the other sections as well), but I'm done for now. A few things:

• I'm not really sure that the discussion of efficacy and effectiveness is necessary for the reader to understand the section.
• The (after my edits) 2nd, 4th, and 5th paragraphs still have significant overlap in informational content. In fact, the 4th paragraph describes a source already discussed in the 2nd.
• The likely effectiveness of vaccines in a pandemic situation could have a lot more information.
• There's still no mention of the different types of flu vaccines (other than the passing reference to FluZone). Arc de Ciel (talk) 07:24, 17 September 2012 (UTC)

Duration of effect

I've seen some sources say that the vaccine wears off and so it's best to get in late October or early November so as to maintain immunity during the peak. Other sources say that there is no scientific evidence that this is worthwhile, and that antibodies last 8-12 months. Everyone also seems to think that once you have immunity to a disease, you should have it for life unless it mutates. It would be helpful if the article sorted out these various claims. -- Beland (talk) 23:50, 26 September 2012 (UTC)

Citation of rense.com amounts to advertising for rense.com, which is an unabashed commercial site that ignores safety of vaccines to attack by innuendo of risk.

A glance at http://rense.com suggests it is a blog or blog-like sales site, an unabashedly commercial, self-promotional site which seems at first glance to lean toward also being a conspiracy site.

To put it mildly, there is no reason to expect special expertise or any expertise on the part of someone who posts or re-posts on rense.com.

On the subject of vaccines, although studies show vaccines are safer than lack of vaccination, Rense omits this information and turns to innuendo to fan fears by listing vaccine ingredients to imply that there is a net risk to vaccines, contrary to studies.

http://rense.com/general59/vvac.htm

This listing of the ingredients of two injectable vaccines is currently set out in the vaccine manufacturing section.

Should rense.com , and its anti-science study-free attack be apparently endorsed by being cited as authority in Wikipedia, which tends on other issues to require not just peer-reviewed studies, but reviews of such studies?

Also, listing the ingredients of just two vaccines gives those two undeserved fame or infamy, compared to their competition in the marketplace.

--Ocdnctx (talk) 17:09, 1 October 2012 (UTC)

Definitely doesn't look like a reliable source. I've deleted the relevant bits accordingly. --GenericBob (talk) 23:37, 2 October 2012 (UTC)

More info on controversies to clarify the issue.

Please note: There is a full separate article on vaccine controversies and a full article on Thiomersal controversy. Concerns about the manner in which the flu shot article directs to or integrates them have been raised elsewhere on this page. Squish7 (talk) 00:25, 7 April 2013 (UTC)

It would be nice if this article did not read like a mindless propaganda for getting the flu-vaccine, with no clear section delineating controversies. Anything negative is so buried in the article, such that the article seems only to sing the praises of the vaccines. Even if the controversies can't be "scientifically proven", neither can the flu shots be scientifically proven effective. They may possibly benefit some people in some circumstances, and possibly harm people in others. That is not a scientifically generated body of evidence proving that they are effective, and therefore can not be used as justification for stifling and hindering the other side of the story. It would be of benefit as a reader seeking information, to see a section (or perhaps a link to a new page), which can delineate the various forms of controversy that have popped up, and one by one list a general consensus of the status of any controversies, citing sources as they are found or become available, and indicating the possible merit or lack thereof of such sources. It makes me quite irritated that some see fit here to take all the power and control of the content and decide unilaterally when to delete things and give flimsy circular arguments as justification for doing so. I question the motives of such people, and wonder who they work for, and what bribes or kickbacks they are getting, so to vehemently squash opposing views. I myself have nothing to gain monetarily by people taking, or not taking vaccine shots. I have no anti-vaccine propaganda to spread, nor any alternative-quack remedies to sell. There are just so many unanswered questions and a glaring lack of information on this page, that I can only choose the safest action is to use the immune system I was born with, and be mindful of transmission vectors (damp weather, close quarters, populated areas, hand washing, coughing/sneezing, etc). To me, it seems that basic common sense is probably a hell of a lot more effective than anything when it comes to the avoid the cold or flu virus. Unfortunately, common sense can not be so easily quantified or reproduced in laboratory conditions, and therefore can not be counted as scientific evidence, ever. A generalized failure of people with the neurotic over-dependence on and gross misunderstanding of the scientific method is not justification to stop asking questions and seek facts. 108.49.84.173 (talk) 16:08, 16 November 2011 (UTC)

I hope avoiding transmission vectors works for you. Such "common sense" is also supported by studies showing diligent use of hand-hygiene and masks cuts influenza transmission in half. However, as this article is about vaccines, and rightly notes that there are also quite a few studies showing that vaccines in general are protective, and that influenza vaccines in particular help protect the recipient from influenza, and indirectly help protect those around the recipient since what a vaccine recipient doesn't catch they don't so much spread. Protection of others is especially important if you are around vulnerable persons whose immune system doesn't protect them well, e.g., newborns, HIV patients, the elderly, etc. Though there is a scientific consensus on the effectiveness of vaccines, it sounds like this article failed to convey that to you. How could it be more clearly stated or supported? — Preceding unsigned comment added by 99.190.133.143 (talk) 11:39, 24 March 2012 (UTC)

Perhaps you can point to these controversies? The fact that a minority of uninformed citizens is upset isn't really relevant, the information presented is pretty much the consensus of experts. Groups like CDC’s Advisory Committee on Immunization Practices and PHAC's National Advisory Committee on Immunization have weighed in on the importance of vaccination, and the science has shown that the vaccines induce protection, both in animal models and in clinical trial. If you have a credible source with some plausible controversy, I am sure it would be welcomed. If there are unanswered questions and glaring lacks of information, why not ask them (questions) and point them out (omisssions), and we'll try to patch it up? And you are incorrect in your second line - if controversies can't be supported with evidence they are not worth mentioning, and you CAN demonstrate effectiveness scientifically. Showing effectiveness is a requirement to being approved as a drug. --Synaptophysin (talk) 18:12, 17 May 2012 (UTC)

this is not the place for conspiracy theories. Remember , the definition of a conspiracy is that it has no evidence to backup the claim. 98.198.72.100 (talk) 04:29, 13 January 2013 (UTC)

I want to know why you think a committee with financial motivation to report a certain way (CDC's advisory committee) qualifies as anything near a reliable source. By Wikipedia policy and general common sense standards, that's a conflict of interest. That's just one keystone tell of the type of invalid logic you're using to claim this lofty absolute scientific consensus. Squish7 (talk) 23:33, 28 March 2013 (UTC)

If controversies are needed, see the following reviews: Jefferson T, Di Pietrantonj C, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E. Vaccines for preventing influenza in healthy adults. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD001269. DOI: 10.1002/14651858.CD001269.pub4

Jefferson T, Di Pietrantonj C, Al-Ansary LA, Ferroni E, Thorning S, Thomas RE. Vaccines for preventing influenza in the elderly. Cochrane Database of Systematic Reviews 2010, Issue 2. Art. No.: CD004876. DOI: 10.1002/14651858.CD004876.pub3

Thomas RE, Jefferson T, Lasserson TJ. Influenza vaccination for healthcare workers who work with the elderly. Cochrane Database of Systematic Reviews 2010, Issue 2. Art. No.: CD005187. DOI: 10.1002/14651858.CD005187.pub3

None are particularly favorable to influenza vaccination, see my comment on the Cochrane review — Preceding unsigned comment added by 167.171.195.39 (talk) 19:21, 12 October 2012 (UTC)

I came to this article with the intention of reading about the controversies and conspiracies, but to my surprise there is no Controversy section, and the existence of conspiracy theories isn't even acknowledged. I agree that this article should clearly address the controversies, not because I think the public should be aware of them, but because the article seems biased without them. Some quick Googling led me to this: http://www.nytimes.com/2009/08/02/opinion/02allen.html though I'm sure you could do better. As for the conspiracy theories, this article could at least acknowledge that they are widespread and have a significant negative impact. I'm sure there are good sources for that; with luck they may even have survey results. Here's a start: https://www.google.com/#q=flu+vaccine+conspiracy&tbm=nws&tbs=ar:1 SheepEffect (talk) 02:34, 17 October 2012 (UTC)

I too came to this article looking to read about the controversy. The fact that exploration of this topic here has effectively been suppressed does not increase my confidence in conventional medicine; it merely decreases my confidence in Wikipedia. Miconian (talk) 20:20, 28 January 2013 (UTC)

Cochrane review

I am worried about the tone of the article, although there are many benefits from the influenza vaccination, I cannot say there are no controversies, nor side effects. The Cochrane review, is widely accepted as a unbiased and careful, and it does not share the glowing review this article gives to influenza vaccination.

on vaccination for healthcare workers: We conclude that there is no evidence that only vaccinating healthcare workers prevents laboratory-proven influenza, pneumonia, and death from pneumonia in elderly residents in long-term care facilities. Other interventions such as hand washing, masks, early detection of influenza with nasal swabs, anti-virals, quarantine, restricting visitors and asking healthcare workers with an influenza-like illness not to attend work might protect individuals over 60 in long-term care facilities and high quality randomised controlled trials testing combinations of these interventions are needed

on vaccination of health adults: "Authors of this review assessed all trials that compared vaccinated people with unvaccinated people. The combined results of these trials showed that under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid one set of influenza symptoms. In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms. Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations. Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited."

Why not add such views in this article? — Preceding unsigned comment added by 167.171.195.39 (talk) 18:32, 11 October 2012 (UTC)

Cochrane reviews

Here are the eleven Cochrane reviews relating to influenza vaccines:

• Cates CJ, Jefferson TO, Rowe BH (2008). "Vaccines for preventing influenza in people with asthma". Cochrane Database Syst Rev (2): CD000364. doi:10.1002/14651858.CD000364.pub3. PMID 18425863.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Jefferson T, Di Pietrantonj C, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E (2010). "Vaccines for preventing influenza in healthy adults". Cochrane Database Syst Rev (7): CD001269. doi:10.1002/14651858.CD001269.pub4. PMID 20614424.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Dharmaraj P, Smyth RL (2009). "Vaccines for preventing influenza in people with cystic fibrosis". Cochrane Database Syst Rev (4): CD001753. doi:10.1002/14651858.CD001753.pub2. PMID 19821281.
• Poole PJ, Chacko E, Wood-Baker RW, Cates CJ (2006). "Influenza vaccine for patients with chronic obstructive pulmonary disease". Cochrane Database Syst Rev (1): CD002733. doi:10.1002/14651858.CD002733.pub2. PMID 16437444.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Jefferson T, Di Pietrantonj C, Al-Ansary LA, Ferroni E, Thorning S, Thomas RE (2010). "Vaccines for preventing influenza in the elderly". Cochrane Database Syst Rev (2): CD004876. doi:10.1002/14651858.CD004876.pub3. PMID 20166072.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Jefferson T, Rivetti A, Di Pietrantonj C, Demicheli V, Ferroni E (2012). "Vaccines for preventing influenza in healthy children". Cochrane Database Syst Rev. 8: CD004879. doi:10.1002/14651858.CD004879.pub4. PMID 22895945.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Keller T, Weeda VB, van Dongen CJ, Levi M (2008). "Influenza vaccines for preventing coronary heart disease". Cochrane Database Syst Rev (3): CD005050. doi:10.1002/14651858.CD005050.pub2. PMID 18646119.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Thomas RE, Jefferson T, Lasserson TJ (2010). "Influenza vaccination for healthcare workers who work with the elderly". Cochrane Database Syst Rev (2): CD005187. doi:10.1002/14651858.CD005187.pub3. PMID 20166073.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Thomas RE, Russell M, Lorenzetti D (2010). "Interventions to increase influenza vaccination rates of those 60 years and older in the community". Cochrane Database Syst Rev (9): CD005188. doi:10.1002/14651858.CD005188.pub2. PMID 20824843.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Chang CC, Morris PS, Chang AB (2007). "Influenza vaccine for children and adults with bronchiectasis". Cochrane Database Syst Rev (3): CD006218. doi:10.1002/14651858.CD006218.pub2. PMID 17636836.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Goossen GM, Kremer LC, van de Wetering MD (2009). "Influenza vaccination in children being treated with chemotherapy for cancer". Cochrane Database Syst Rev (2): CD006484. doi:10.1002/14651858.CD006484.pub2. PMID 19370636.{{cite journal}}: CS1 maint: multiple names: authors list (link)

The following four are currently cited in the article: CD001269, CD004876, CD004879, CD005187. Gabbe (talk) 10:49, 22 December 2012 (UTC)

Mechanisms of manipulation of this article / NPOV

Could an objective editor help me theorize on how this article is so sickeningly subjective? I mean is it just the sheer number of people posting biased propaganda, or is there some complex politics with people donating money to Wikipedia to somehow achieve ground? I'd like to help the article be more unbiased but what can I do as an individual against the sheer magnitude of this violation of the spirit of Wikipedia?

Just Google "flu shot dangers" and up come a staggering plethora of reputable objective sites with serious well-referenced cons, not some message board hogwash of a few individuals ranting about poorly-backed conspiracy theories. Cross-referencing all those sites with this article, particularly the side effects section, yields a baffling discrepancy. I can't begin to regurgitate all the details, but I think anyone objective having a good sense of identifying objectivity from bull should be able to see the staggering difference in the total weight of the medical statistics and studies quoted in the anti- flu shot articles, and this article.

The "side effect" section uses intrinsically structurally questionable wording akin to "Although [trivialized concerns]...the CDC says [there's nothing to worry about]", without mentioning the CDC's advisory committee on the matter has a vested financial interest in promoting flu shots. It's a basic fallacy via omission of key information. The entire article in general promotes a flu shot, so at the absolute least, a "side effect" section should solidly represent negatives.

Could an objective editor who's taken the time to thumb through all the negative articles on the net help me understand why they're so underrepresented? My big question is whether working to make the article more objective/NPOV will even yield any results, or will my edits just be mysteriously deleted with no justification by the entities who've obtained control of the article. How can Wikipedia allow this? Squish7 (talk) 23:45, 27 March 2013 (UTC)

Googling "flu shot dangers" doesn't seem to generate "reputable objective sites." The article reflects the scientific consensus, as it should. The side effects section lists the side effects reported for the vaccines with sources. If there are more that can be sourced reliably they should of course be added. I suspect that the reason why "all the negative articles on the net" are so underrepresented is that they are not accurate. NPOV does not mean giving equal weight to differing views, but the weight due to a position. For medicine articles, one should ensure that the article represents the scientific consensus. --Synaptophysin (talk) 02:30, 28 March 2013 (UTC)

Firstly, the controversy itself intrinsically warrants documentation. If there was a riot of 10 thousand people in a major city protesting flu shots, that event itself constitutes important factual information.

Secondly, reporting a consensus while representing a minority is entirely different than an article full of 99% propaganda. An enormous array of reputable doctors voice serious concerns against the flu shot, many completely opposed to it. The fact that the very first "side effect" listed starts with the word "mild" snowballs a tone with no objectivity. This thing is a massive article containing only a few half-sentences trivializing any objection. (The ratio of propaganda to opposition is what makes this ridiculous, not just the mere lack of representation.) Alternative medicine doesn't have to have a consensus in the medical community to be of substance.

Third, a scientific consensus is much different than an objective scientific consensus. The CDC's ACIP has a known vested financial interest in promoting the flu shot. Therefore every mention of the CDC in this article is committing a fallacy of appeal to widespread belief without presenting objective information. Just in general, the medical community has a financial interest in promoting and selling these flu shots. An example of objective scientific consensus would be multiple universities identifying a strain of cancer who have nothing to gain from proving or disproving the existence of the strain. The medical community is SELLING something, and you're saying that the consensus among the very people selling something for profit should not just be prominent, but completely override the notable spectrum of objections by objective parties.

A good example of what I'm talking about is the article on mobile phone cancer. It's an entire thorough article on the debate, even though most of the sources you call credible (e.g. WHO) have completely discounted any potential cancer. Now undeniable evidence has surfaced proving a link with cancer; this instance alone of the WHO being proved wrong taints their objectivity and shows that objective minorities speaking against entities who have an interest in hiding the truth, may often be correct from the beginning. That gives minorities a right to be represented in articles such as this one, not completely cut out. It's just not balanced.

I might add that your vacant profile and minimal presence on Wikipedia intrinsically casts some doubt on your objectivity here (i.e. paired with these absurd objections to the sound concerns on this page). While not auto-convicting by any means, it stands that it's common for people with a motive for manipulating information on the web for their own purposes, to create new and mysteriously ambiguous accounts for editing or posting, because if they said who they actually are, they'd be revealing a conflict of interest. I have a 15-year web presence as a writer, songwriter, comedian, and freelance artist, i.e. someone with absolutely nothing to gain and everything to lose (i.e. personal time that could be devoted to other things) by taking time to address this issue. Further, I have a tentatively compromised immune system, so I'm someone with a motive to convince himself that a flu shot is a good idea. That my research has yielded serious concerns and doubts is more evidence I'm being objective. Obviously none of this factors into the final weight of my editing, just an FYI someone reading this page might want to take into account.

Squish7 (talk) 20:52, 28 March 2013 (UTC)

A page on the controversy is probably appropriate, but it's very much a minority that has real concerns about this. There is a long history of anti-vaccine sentiment, going back to the very first vaccines. The more recent upswing was in part to articles that suggested problems with the MMR vaccine. The Doctor involved in that has been discredited, and his work was deceptive. As opposed to a conspiracy theory that suggests that a major governmental organization somehow profits from the sale of vaccines, the doctor had a very direct way to benefit. Secondly, the scientific consensus does not amount to "propaganda". The fact is that influenza vaccine programs exist because the benefits DO outweigh the risks. The medical community isn't selling anything - pharmaceutical companies do, but the medical community does't, and government agencies like the FDA don't profit from vaccine sales, except in perhaps extremely indirect ways. To your third point, I have yet to see this "undeniable evidence" linking phones to cancer. Also, being wrong (if a group is wrong) doesn't "taint their objectivity"; that's science. Science is self correcting - errors get made, and get corrected by accumulation of evidence. Being wrong is part of doing science. Minority opinions do not belong in science and medicine articles if they are fringe and deny the evidence. An astronomy article is no place for a section devoted to how the sky is a carpet painted by God, nor is it pertinent to have sections on baraminology in the various pages on animals and their evolution.

My profile isn't the issue, and any well cited source is acceptable. I make edits to areas I have knowledge of - I happen to know health and science information thanks to my education and work experience. By citing when we make edits, it helps to prevent exactly what you are suggesting. --Synaptophysin (talk) 19:44, 29 March 2013 (UTC)

Requesting early objective intervention

[This discussion begun on talk pages then moved here where noted:]

What's the best method of requesting objective review of material? I and others think the flu shot page is riddled with bias, but I fear the bias is of people who would revert my edits. I can't post a dispute beforehand, but if I'm pretty sure now that it will cause a dispute, can I invite intervention politely of draft material? I have a short fuse for back-and-forth bickering wars.

Please see the relevant talk page section. At the end is my draft paragraph for a new article section "Cons and controversies" that will be merely a base for a thorough section or even new article entirely. I'd like the sources and intended article reviewed by an objective party, but I fear the talk page is monitored primarily by biased parties. THANKS for your help! Squish7 (talk) 00:37, 29 March 2013 (UTC)

If you're looking for wider community input, you could put a (neutrally worded) note at relevant WikiProjects' talk pages, here probably WT:WikiProject Medicine and WT:WikiProject Viruses. That said, I would expect that your problem is not so much the bias of editors but the problems inherent in your proposed addition. For example, Infowars.com has been deemed not reliable before in other contexts, and none of your sources is the equal of the peer-reviewed scientific papers used for much of the rest of the article. If you want to cover the social controversy, you should use sources reporting on controversy, not participating in it. If you want to add information on the scientific basis - say, the effectiveness - you should use scholarly sources, not news reports and random persons' private websites.

As a completely unrelated aside, I'd suggest putting your draft in a new section at the bottom of the talk page. In a section that was inactive for months it might be overlooked. Huon (talk) 02:19, 29 March 2013 (UTC)

Thank you for your response. It's helpful, but please consider my following rebuttal.

Putting aside the less credible sources of the 12, why does a random Wikipedia editor have so much greater credibility for objective research than reputable media sources such as CNN, Washington Times, Forbes magazine, well-established experts/authors such as Dr. Mark Hyman, etc., etc.? Doesn't the latter have greater credibility for accessing the main journals and reporting about their entire balance? We aren't even allowed original research because we don't have the credibility for reporting it; a credible newspaper or magazine or author does have credentials. If a magazine says "thousands of journals have made (point)", is a WP editor supposed to track down the 1000s of journals in order to confirm this? A credible source doesn't have to list every reference they utilized for the article; there's a huge amount of trust we can place in entities who've earned it. There are so many studies about just about everything that anybody can make a case by tracking down specific evidence while leaving out other evidence. E.g., 2 articles I list point out that the CDC's advisory committee on the flu shot have a financial interest in promoting it. That tiny fact casts allllll the statements and research by the CDC in a questionable light. You might even say it discounts the CDC for being a credible source entirely by WP standards.

That said, the general medical community as a whole is itself intrinsically questionable, as the flu shot is something that the community in general sells. How is this general consensus by people selling something any different than a manufacturer of a medication or vitamin supplement assuring people that they're own research of their own product proves it works? I read two statistics that said that said 50% of doctors do not receive the flu shot (one of them said even higher than 50%). That (somewhat) discredits statements made by all those doctors, as their behavior does not back up their stated opinions to patients and journals.

Obviously the medical community in question is enormous and contains much objective research, but how much? 1/3? 1/2? 2/3? The article is about 99% pro- flu shot. It's not just the ratio of pros to cons in the short "side effects" section, it's the enormous skyscraper column of text of the article that pits against the 1% cons (or whatever). The controversies outlined by the more credible though granted secondary sources I list, create enough bulk for a quite substantial cons section to balance the 99% propaganda. If you look at the talk page there are multiple other people expressing the same thing I am, that the article is not balanced by sheer weight ratios.

For a good example of balance of controversy, consider the mobile phone cancer article. This is a very similar topic, yet it has an enormous article dedicated to the controversies and cons. Note that the WHO's statement that mobile phones cause cancer has been debunked by recent conclusive studies. This gives the minority that opposed the WHO with little or no medical journal evidence credibility for gauging the truth in such matters, and lessens the credibility of the WHO to make statements denying dangers of what it's reporting about or has investigated itself. Together with the financial interest of the CDC, this casts all the statistics in the flu shot article researched by the CDC and WHO, i.e. all this research you say is credible, in a questionable light. Hence, when uninvolved and objective parties like XYZ news source report negatively, this in some ways and cases (clearly not all) is more objective/credible reporting than the top dogs' statements.

Thanks for any reply. Squish7 (talk) 06:40, 29 March 2013 (UTC)

I could reply in detail here, but I don't see how a private side discussion will be helpful - we should centralize the discussion at Talk:Influenza vaccine. Huon (talk) 16:00, 29 March 2013 (UTC)

[Discussion moved at this point to this talk page.]

Recommended edits for this article

In reading over this article, it appears it has accumulated some sections that might best be moved off to separate articles. I recommend creating:

• "History of the Influenza Vaccine"
• "Influenza vaccines in veterinary use." (I don't recommend keeping the title "Flu vaccines for non-humans."

It seems it would benefit from editing of sections that seem to duplicate and/or present material not directly related to the influenza virus. For example, sections that address vaccinations in general are best moved off to articles related to that topic. Malke 2010 (talk) 19:19, 6 April 2013 (UTC)

I have restructured the article for better compliance with the Manual of Style. Right now, I would recommend keeping the History and Veterinary use sections in the interest of comprehensiveness. They're really not long enough to merit splitting to new pages. Fvasconcellos (t·c) 14:22, 7 April 2013 (UTC)

Have also expanded the lead section, which was not an adequate summary of the article. Still needs some work. Fvasconcellos (t·c) 14:54, 7 April 2013 (UTC)

Cons and controversies new section draft

I've begun a section multiple people have expressed above should be in the article, called "Cons and controversies". The first paragraph below contains the 12 base sources I've gathered for the article. Not all are entirely against the flu shot, but all have a ratio of pros to cons that makes the balance of this article look absolutely absurd. I realize some are more reliable than others, but in general it represents a body of opinions broad enough that it's ridiculous not to include more of them in the flu shot article than are included now. Squish7 (talk) 23:52, 28 March 2013 (UTC)

The flu shot has caused a constant, widespread spectrum of controversy alive now as much as ever. Serious cons or even completely negative reviews, have been published and reported across mainstream newspapers, top-level cable news, respected magazines, radio hosts, high-profile alternative medicine doctors, nonprofit organizations, top-level environtmental news, and various online news or medical websites.

I disagree - you are essentially arguing using Argumentum ad populum and appeals to authority (inappropriate authority, as Mercola, Oz, and others are not particularly trustworthy). Any text will need to meet WP:GEVAL and WP:DUE. "Keep in mind that, in determining proper weight, we consider a viewpoint's prevalence in reliable sources, not its prevalence among Wikipedia editors or the general public." (emphasis mine) Check WP:SCICON - just because a view is prominent in the public and on the web/newspaper does not imply that it deserves inclusion. Wikipedia:Identifying_reliable_sources_(medicine). There is a whole page devoted to Vaccine_controversies, and perhaps a more detailed section on the flu vacicne could be made there. --Synaptophysin (talk) 20:03, 29 March 2013 (UTC)

It's for reasons like this that I posted this here as a draft and not immediately to the main arrticle. I know some sources here may not be usable, that's why I'm drafting it. There's also a reason I machine-gunned a single sentence with a wide spectrum of a dozen sources of completely different natures, fields, and publishing mediums. Pointing out a few unreliable sources just points out what needs to be pruned; it doesn't discredit all 12 and says nothing about the whole of the suggested new section.

If you want to deem the whole thing unreliable you have to discredit every source. You're using a sort of logical fallacy yourself in pointing out particular flaws and concluding the entire suggestion fails completely. If you want to discredit my entry entirely, you have to point out how the reliable sources do not support my paragraph or fail for this specific scenario.

Another thing you have to tackle to discredit my proposed section/article is why organizations that have financial ties to the things they're promoting (CDC and much of the general medical community) pass for reliable in the scenario they're selling something. The medical community is selling the flu shot. That means every source in the article ("reputable journal", etc.) becomes more questionable than their reliability for reporting other things they don't benefit from. How do we even know specifically who benefits and doesn't from the flu shot? The only people we can trust as fully objective have to at least have the attribute of being entirely removed from the financial benefits of it. That puts alternative doctors and main news sources (CNN, Washington times, Forbes magazine, Dr. Mark Hyman) way up there on objectivity in a way no financially-related source can be without serious proof that they're entirely disconnected from the financial benefits of the sale of something so widely sold, and how can you really do that? Squish7 (talk) 02:32, 6 April 2013 (UTC)

Am I the only one who thinks "The flu shot has caused a constant, widespread spectrum of controversy alive now as much as ever" is POV? nerdfighter 03:29, 6 April 2013 (UTC)

@Nerdfighter. No.

@Squish7. There might, perhaps, be more information on the popularity of the the minority, bordering on fringe, view that there is a downside. There is no reason for more "information" on the "downside". — Arthur Rubin (talk) 03:44, 6 April 2013 (UTC)

It's not POV intrinsically, it's only so in your own personal POV formed from the main article, which I'm contradicting here. You can't just blindly state the sentence seems biased purely due to its opposition to the main article. You have to discredit my sources in this scenario, not appeal to the potential absurdity of its contents without examining or evaluating it intrinsically. Other people on this talk page have said the same things I have. It's not some wild lunatic blow from nowhere. Someone has yet to tell me why parties financially tied or tied by agenda to promoting something (the general medical community in this case, particularly the CDC and WHO) are objective and reliable. Squish7 (talk) 03:58, 6 April 2013 (UTC)

You have to explain why (fringe) alternative medicine providers, who have an interest in eliminating "conventional" medicine so that they can sell their remedies/vaccines for flu, should be considered as even potentially reliable, given your assertion that conventional medical journals should be considered unreliable because they are "tied by agenda" with conventional medicine. — Arthur Rubin (talk) 04:14, 6 April 2013 (UTC)

In particular, Dr. Hyman and Dr. Mercola should only be considered for the assertion that they oppose (among other conventional medicine) flu shots. Some of the mainstream sources you use might have relevant information, but your statement about controversy requires reliable sources about the controversy, not just examples of controversy, which is what you seem to be using them as. — Arthur Rubin (talk) 04:20, 6 April 2013 (UTC)

• I agrew with Arthur Rubin. As I said in the comment copied from my talk page to the section above, I'm skeptical of this proposed addition, to put it mildly. For a section on the controversy I'd like to see sources discussing the controversy, not participating in it. In particular, the Washington Times piece seems an editorial to me, Forbes actually advocates getting the flu shot, and CNN seemed rather balanced to me, except for the by now outdated and debunked thimerosal issue. Many other "sources" are rather dubious, including a surgeon writing on a rock band's website - that is not a reliable source at all. There seems to be an inverse correlation between the sources' reliability and the amount of criticism on vaccines. Similarly, it seems to be much easier to find medical experts critical of the flu shot if their area of expertise is far removed from immunology. We have a few family practicioners (who live by heavily promoting their own "wellness" brands, so much for selling things), a cardiac surgeon, a chiropractor. Huon (talk) 04:21, 6 April 2013 (UTC)

Let me revise/rephrase my suggestion. What I'm primarily talking about is the clarity of presentation of the ratio of pros to cons, and the tone of the article. I'm perfectly aware the Forbes article promotes the flu shot, but if you look, the 3rd sentence includes the phrase "bearing in mind that in the best case scenario, the vaccine is between 60 to 70 percent effective". The most promotional of my sources presents a negative immediately and clearly for a reader to know, and the rest present a more negative picture. Even the outdated CNN article isn't so much so that all the negatives have been drastically reversed. Now look at this article; every single section and subsection of the article is worded positively or neutrally. You have to comb the article to find negatives and they're so buried that your average reader could spend hours with it and still have no idea about the ratio of pros to cons.

When a reader opens this page, they're hit with thirty lines of Contents links of which none present a negative section; only potential possibilities such as "side effects" and even that trivializes any negativity.

Even the most promoting of all my sources clearly states that at the best the flu shot is about 2/3 effective. If you go to the "effectiveness" section in this article you're hit with a sudden onslaught of technical jargon that's a mess to get any clear answer out of the question, "How effective is it?" Maybe the person that started "More info on controversies to clarify the issue" currently at the top of this talk page put it best in the first sentence: "It would be nice if this article did not read like a mindless propaganda for getting the flu-vaccine, with no clear section delineating controversies. Anything negative is so buried in the article, such that the article seems only to sing the praises of the vaccines."

If you think the CNN article seemed "balanced" minus a point or two when the title of the article is worded neutrally or arguably negatively ("Read this before you get a flu shot"), you've completely proven my point because the balance of that article and this one is night-and-day. Again, I ask, why should zero out of thirty contents lines--on some monitors taking up the entire screen when first visited--delineate there even exist negatives, opposition, educated alternate opinions, etc.? As to your skepticism of my sources (some is sound, that's why it's a draft, to seek that information from objective editors like you), you're not factoring in the weight on the other side of the medical community being itself subjective. The sources you say are questionable or opinionated have a sincere plus in that they're removed from circles upholding the CDC and WHO as entirely reliable. You have to factor in those pluses in your general final weighing of the reliability of those sources. The potential subjectivity of the CDC and WHO give my sources more weight as a counter-balance. Squish7 (talk) 05:41, 6 April 2013 (UTC)

The view that Flu Vaccinations are inherently dangerous or at least more dangerous that this article presents is a WP:FRINGE belief. These types of vaccinations are gauged based off their societal effects and thus far the academic research shows a positive societal effect of flu vaccinations. Of the sources you provided above, only the first 3 are reliable sources and none of them frame the issue in the manner which you are presenting. That said, I do sympathize with those that do not want to get vaccinations or think that there is something nefarious about their presumed safety. I personally don't like to get them because I personally have noticed that I seem to have become more sick in the years I have than in the years than I have not. Plus I don't like anything in which I am forced to comply (as flu vaccinations are becoming). However, I have done quite a bit of research into antigenic shift and antigenic drift to understand that the fear of a truly deadly influenza outbreak is not misplaced even if the yearly shot would be unlikely to be of much benefit to a newly highly virulent strain which would cause the most global damage. Find some actual respected medical journals that show the societal benefit of Flu Shots are negative and you will have something worth adding. Arzel (talk) 16:14, 6 April 2013 (UTC)

The gist of WP:FRINGE seems to stress the notion that the fringe theory not be given undue weight in an article. It doesn't say it should be entirely cut out. Half the issue is the article's organization. A lot of people that would agree with the fringe theory or minority view would want the information I present above. If I forwarded those 12 articles to any friend I had who had little information about the flu shot, it would sincerely shift their opinion on the matter. If it's really some off fringe theory despite all the doctors and authors supporting it that a large portion of the population trust, then there should be a clearly marked section presenting those opinions. What if the information that the PCP is financially motivated to report the way its reporting (as 2 sources above that you deem unreliable say), can be verified through reliable research? Wouldn't that change your opinion of what the PCP reports? Other than magnitude, I don't understand the difference between the above information, and a clear-cut CNN reporting stating with total proof that the CDC/WHO has a strong financial interest in this matter. Would that not completely rule out the CDC/WHO as sources that can be quoted in this matter? How would I go about verifying such information? Shouldn't the claim/point by multiple parties that the CDC's 15-member advisory board on the matter has financial ties to the flu shot, raise an eyebrow or two? Squish7 (talk) 16:53, 6 April 2013 (UTC)

So your argument is that if you tell someone, that is uninformed, that something is bad it would affect their perception of that thing to be bad. That is hardly a persuasive argument. Also, I am not sure why you think the CDC/WHO are part of some financial scheme. Neither the CDC or the WHO manufacture the flu vaccine, they are produced by private companies. Now the HHS, which administers the CDC may currently have some political motivations, but the scientists at the CDC are respected for their impartiality with regards to this kind of work. If it were to be determined that they were doing research in a way to financially benefit themselves it would be a huge story and not contained within conspiracy theory circles. This is drifting off into an even more fringe theory which makes me think of the movie Contagion where Jude Law is a conspiracy theorist pushing Forsythia as a cure. Arzel (talk) 18:07, 6 April 2013 (UTC)

Let me give a more specific example. My brother treats Dr. Mark Hyman's book "Ultra Mind Solution"--New York Times bestseller advocating healthy dieting and the like to beat depression and anxiety--like a bible. He actually keeps extra copies on his bookshelf to just give to people who might benefit from it. I think it's a bit overboard and that he should consider the established benefits of psychiatric medication, particularly for his ADHD, but he won't have any part of it, however, that doesn't mean he has some absurdly illogical or fanatic viewpoint that mood can be affected by diet. It's a very simple and widely-shared viewpoint whether or not it fits the simple majority of scientific consensus. He and many other people like him, when coming to the flu shot article looking for minority information, would like to be able to easily discover the people who advocate healthy living as an alternative to the flu shot. That makes allll those doctors with that view that don't happen to form 51% of the medical community, worthy of mentioning so that people like my brother can find information on them. The article's content lists literally 30 lines of links of which none denote where to find information about cons, downsides, controversies, or the like. I just found out via the parallel debate on the reliability talk page, that there's a whole group of articles on vaccine controversies because I missed Synaptophysin's sentence above that directed me there. That's an error on my part (and my browser which makes it difficult for me to locate links within context), but the absurdity stands that an editor spend all this time inquiring/writing/etc in order to find out where to locate controversy information here. At the absolute least, there should be one section out of the vast forest of them clearly labeled that discusses controversies, even if it's just a stub section that links to the main vaccine controversies page. Squish7 (talk) 20:03, 6 April 2013 (UTC)

I don't doubt that diet can effect mental acuity in many areas, the most simple being sugar. However, your premise of 51% being in favor of flu vaccines is woefully short of the true number. From my considerable experience it is closer to 95%. If you really want to look at an issue where the jury is still out I suggest you go look at Strep Throat where the possibility of harmful side effects may actually outweigh the benefits of treatment in adults. Arzel (talk) 20:20, 6 April 2013 (UTC)

Let's settle on 5% against. The 30 lines of links in the contents section a reader is hit with is 0% negative. Someone looking for negatives or controversies has to go investigating all the neutrally-worded sections where there might be a mention of negatives, controversies, etc., in order to stumble across hidden links to the entire group of vaccine controversies articles. By absolutely every standard of balance here, there should be a hard-core clear-cut way for any reader to reach the controversies section from this page. Maybe one of those stub sections that have a link like " main article: Vaccine controversies". Just the idea of another editor going through the same days of headaches and debates to finally find out there exists information on Wikipedia about the controversies they thought were nonexistent, makes my head want to puke in pity for them. Squish7 (talk) 21:02, 6 April 2013 (UTC)

<5% is Fringe in my opinion. I only use 95% because statistically speaking I am 95% positive from my experience that this is not an issue in the least. Those that need worry are made aware before the shot is even given. Arzel (talk) 21:17, 6 April 2013 (UTC)

What isn't an issue, the vaccine controversies so thoroughly covered here that there's an enormous article on the matter? Could you or someone please clarify this discrepancy between the total rejection of my proposed draft (written without knowing there was already an extensive article on the matter), and the fact that the article (that I might have otherwise started) is extremely extensive? Why aren't you all just saying "Oh yah, that's a great idea, but it's already been done"? I just can't harmonize this absolute rancid total rejection of my concerns and the fact that they're absolutely justified by the existence of multiple extensive articles on the matter. It's the fact that I had to go through an entire editing war just to find out they existed that should warrant immediate mental registering that the flu shot article is in massive need of restructuring, or at the infinite least, a dead clear-cut way for someone coming here looking for controversy information, to go exactly where they want. Even one of those simple links at the top of the page that says "This article is about [medical journal etc etc]. If you're looking for controversies, go here" would solve a good deal if not the majority of the points I and others have been raising. Squish7 (talk) 23:39, 6 April 2013 (UTC)

[cont] My point can't be stated more clearly than to observe that in the entire section at the top of this page entitled "More info on controversies to clarify the issue." there still isn't mention of the fact that controversy articles exist!! A passing editor, never mind reader, even if they click over to the discussion page and read through all the discussion at the top of this page, still isn't directed to the controversies articles! I'll rectify it in a minute myself but do you realize how ridiculous it is that it hasn't been done yet and that I'll be the first one to even post that information there? You can't imagine how stupid it feels spending a dozen hours researching and debating to find what I was trying to input already exists. I suppose maybe as an editor I should have combed every inch of the flu shot article in order to find such a link before I started drafting new material, but the general aforementioned absurdities on the whole stand as a beacon to the fact that people even coming to this talk page still aren't being properly directed to the multiple controversies articles that they want to get to, never mind some random Joe Schmoe who isn't specifically looking for controversies but who would want to know of their existence, e.g. via a Contents sections anything more than a black hole of a lack of signification of the matters. Squish7 (talk) 00:11, 7 April 2013 (UTC)

Please note the ongoing discussion on the reliable sources board. — Preceding unsigned comment added by Squish7 (talk • contribs) 15:44, 6 April 2013 (UTC)

As other editors have already stated, none of those 12 references is a suitable secondary source per WP:MEDRS.

On PubMed, the best recent analysis of influenza vaccine harm I found is in this paper by Manzoli. It is a little tricky to extract the relevant information, but this is often the way with meta-analysis. Axl ¤ [Talk] 00:05, 7 April 2013 (UTC)

To be crystal to anyone sifting through the above, I wrote the draft before I was aware there were already full articles on the controversies. I tentatively withdraw it and the sources as a draft for inclusion, but I leave it intact here as a monument to the absurdity of how poorly editors never mind average readers are directed to the material. Squish7 (talk) 00:33, 7 April 2013 (UTC)

I've put a redirection tag at the top of the article. If it's removed I'll likely file a dispute claim. That 3 or 4 editors have come to the talk page and still not been made aware of whole controversies articles stands as absolute justification for all the readers not able to get there. The editors who've torn apart my concerns have completely lost site of the point of view of the reader. If you weren't so programmed at tearing apart things you don't like you might have noticed the root concern of a basic redirection problem. You have to learn to induce the reader's experience from the concerns of lesser-experienced editors. Basic math will tell you, looking at this page, that a dizzying number of readers every single day are coming to the flu shot article looking for this information and not finding it. You just plain need more empathy with the reader's experience. Squish7 (talk) 01:04, 7 April 2013 (UTC)

The article already had a link to the thiomersal controversy; I've removed that one. I've also moved the vaccine controversies link to the "see also" section; ideally it too should be included in the article proper. A hatnote is not the right place for them either way. Huon (talk) 01:57, 7 April 2013 (UTC)

That's correct. According to our guideline on hatnotes (which is what those redirection tags are called), that's not the appropriate place. A note is certainly appropriate, but the best place would be the "Side effects" section—which could probably be renamed "Safety" for consistency with similar articles.

Now, coming from an uninvolved perspective. If the controversy itself is notable (I personally think so), then we can mention it in the article, but in a way that is neutral, does not give it undue weight, is integrated into the text rather than given its own section and is supported by reliable sources.

I would support a neutrally worded mention of the fact that yes, controversy exists about influenza vaccination—but the arguments advanced in this controversy have been thoroughly debunked by the best available evidence. Good sources to support such a mention could include this NEJM piece on the thimerosal controversy by Paul Offit and this excellent article that was published in the Journal of the American Medical Association last month. There is also controversy as to the actual benefits of the flu vaccine in the elderly in terms of preventing mortality. These concerns have been widely covered in reputable, reliable sources, and our article already covers this (see e.g. the passage starting "The group most vulnerable to non-pandemic flu, the elderly, is also the least to benefit from the vaccine..."), in a way that is neutral and integrated into the rest of the page. Could it be improved? Yes, but to say the article is "0% negative" is inaccurate and misleading. Basically, it is as negative as it should be.

For what it's worth, I would strongly recommend use of the excellent meta-analysis posted by Axl above (which has Professor John Ioannidis among its authors) to improve the article. Fvasconcellos (t·c) 02:09, 7 April 2013 (UTC)

This is unacceptable. The fact that 5 editors including myself expressing concerns over a span of almost 17 months altogether were not even informed a vaccines controversies page existed until I made the note above today as the result of days of researching/inquiring/debating to finally figure it out, is an atrocity, not something warranting a footnote at the end of the entire article. You have to do the math and multiply the absurdity of an editor having to go this far into the editing/revising/inquiring process just to finally become aware that there exists information that, we now know retroactively, is being thoroughly sought by passing readers daily on the page, people examining the Contents section for negatives, controversies, cons, anything... Yes, the contents is literally 0% representative of flu shot negatives; it's literally 30 lines of links that present absolutely no clear way of navigating to downsides or controversies. The thimerosal controversy link was already in the article version that the very first person expressing this concern read; this didn't help them or anyone else get there or we wouldn't have expressed such thorough concerns about such a total apparent lack of controversy coverage. That link and one in the "See Also" section just isn't enough to match the ridiculousness of me wasting days of time to figure out this stupid piece of information. Squish7 (talk) 03:19, 7 April 2013 (UTC)

Squish7, you're obviously passionate about this, but in circles where the vaccine is actually studied the "controversy" is about as significant as flat earth theorists in geography. The fact that a belief is popular does not give it any credibility. The coverage of vaccine controversy deserves about as much space in an article as the moon landing hoax accusations do on the moon landing page, of of flat earth theory on the Earth page - an acknowledgement that the beliefs exist, and promptly dismissing them by citing evidence. Nobody would deny that vaccines have side effects, or that contamination of a vaccine could cause harm - but that's true of any medication.--Synaptophysin (talk) 12:39, 7 April 2013 (UTC)

None of that is relevant to the navigation to find the article. All but every single person who wants to get to controversy issues surrounding the flu shot is not going to specifically search for "vaccine controversy", they're just going to search for "flu shot" and expect the information to be integrated with the article. The sheer hideousness of you knowing that this information existed and refraining from letting any of five people in a row specifically inquiring on the talk page about the matter, discredits you (personally) from making any judgement in this manner. How can you possibly say that the issue of controversy surrounding XYZ is so removed from XYZ itself that people specifically asking "I wish I could find controversy information on XYZ" should still not even be redirected unless they want to research and draft a stub article to earn the right to know where the page is. Your view that people inquiring about a page should be told about the page until they waste days of their personal time investigating the matter torpedoes your credibility for announcing what the proper method of redirection is to the article.

There's a hatnote directing people to an episode of a comedy show. Even if vaccine controversies should be completely segregated from vacccine science articles--which still I think is ridiculous--then you should at least put a note directing people to the article that they will not otherwise find. It's not like it's 3 Contents lines "1. Benefits 2. History. 3. See also". It's thirty lines of Contents that show absolutely no sign that controversy/etc/etc exists. The "see also" might be a tolerable place for such a link if the article was really short or easy to navigate. As it is, someone who starts from the top and works their way down to search for this information has to read the entire article to find it. This is absolutely unacceptable by all means.

What is the difference between having the search "flu shot" bring up an infinite mess of scientific jargon while poorly directing elsewhere, and having "flu shot" bring up the controversy page, and then providing a "see also" note to your scientific jargon page? Outside of context of this discussion page and of your behavior you might have a gram of credit to state "nobody searching for 'flu shot' is going to want to get to 'flu shot controversies' ", but knowing about the article and failing to tell five people over a period of time specifically inquiring about it when you're obviously monitoring this page like a hawk, shows disgusting violation of the spirit of neutrality of Wikipedia. You're all but convicted of manipulating the scenario toward your personal agenda, which almost vindicates the objections that people have toward this vaccination. You're practically proof of what people are objecting to because you're committing all but perjury to withhold information like that.

That there was no mention of controversy nor any link in the article to it is already ridiculous, but your actions of actually fighting off people trying to find the information is all but legal perjury. Just supposing it were shown you had financial connections to the selling of vaccinations, it would be just about illegal to come here and conceal information for your financial agenda. Fine maybe that's not the case, but it might as well be.

I'll say it again because it's even more prominent now. I have solid credentials as a 15-year online comedian and writer for having absolutely no motivation to be promoting an agenda one way or the other. You have extremely little personal information about you online and a history of concealing information making you very suspect to the sins that people at the head of these controversies are speaking against. Of course I'm "passionate" after having wasted days of my personal time on this and now still have to sit and go through a long dispute process because I'm going to file a dispute now, just because I feel committed to the endeavor of free, open, balanced, neutral information. I could practically sue you for my time. You should have your accounted deleted for this behavior because it discredits you as any sort of objective editor Squish7 (talk) 16:26, 7 April 2013 (UTC)

First item on a google search for Flu Shot Controversy goes right to the Vaccine controversies article here. If people can't find out about this it is on them, not WP. Several people have addressed your concerns and politely pointed out the WP:FRINGE nature of this particular issue. If you want to be an Advocate about flu shots, fine, but WP is not the place to do it. Arzel (talk) 16:49, 7 April 2013 (UTC)

In addition to agreeing with multiple editors above that the situation is best dealt with by a proper understanding of due weight and application of MEDRS (which the proposal lacks), I would also like to point out that over the top rhetoric such as suggesting this is an "atrocity" and "legal perjury" shows a disturbing lack of perspective. Yobol (talk) 17:11, 7 April 2013 (UTC)

@Arzel: If you're going to promote a general place where people can ask basic questions and get help, you can't pick and choose the questions you think are stupid or not. If an editor camping out on a page sees five people come to a talk page and ask "I can't find information on XYZ", they can't sit and think to themselves "those people are so stupid they didn't even think to go to Google and search for XYZ in order to find the right Wikipedia page, so none of them deserve to be answered; I'll bicker with them anyway though and hope they don't figure out I have the information they want". Yes, it's on WP in this case because even outside of the absurdity of not answering questions that were directly asked, it was perfectly natural to ask those questions given the page was not structured well. It's written tolerably now that I had to waste 25 hours of my time to draw enough attention to the issue for it to be addressed, but the behavior of camping out on a page and fighting off people asking questions is in basic violation of proper editor conduct and retroactively reflects poorly on the way the article was being managed.

@Yobol: It's not lack of perspective, it's emotion. How would you feel taking a half day of your work hours to draft an article for no reason because an editor was consciously manipulating a situation? You'd be angry. Fine, it's not per se legal perjury, but it's isomorphic to perjury, e.g. there's a perfectly realistic scenario in which Synaptophysin has a personal financial agenda to manipulate the article/talk page. If it's not the case, fine, but it's basic violation of proper editor conduct. Fine, it's not an "atrocity", it's just generally structurally absurd for people to be so poorly directed to information that they begin discussions on the lack of information, to still not be even told where the information is until someone actually starts researching to fill in the apparent hole. Squish7 (talk) 17:52, 7 April 2013 (UTC)

Squish7, your comments have descended into repeated personal attacks on your fellow Wikipedia editors. Your behavior isn't excused by suggesting that one or more other editors might have some hypothetical – and likely imaginary – conflict of interest; if anything, that sort of unsupported attack on the integrity of other volunteers reflects even more poorly on you. Be aware that you are very close to being blocked from editing. TenOfAllTrades(talk) 18:51, 7 April 2013 (UTC)

Squish7, I have no duty to post anything about myself on wikipedia. My edits have citations to support them, which is all that is required, and I was providing advice about what policies would apply to the section you were proposing. I don't have time to always be watching this page (or others), and you'll note I am the one who pointed out the vaccine controversy page to you - so when I was aware that someone wanted it, I did point it out. I have read the WP:CONFLICT section, and I don't fit the categories of obvious COI listed there. If you have serious concerns about me, I will happily communicate with an admin and disclose more about myself in a private manner. Cheers, --Synaptophysin (talk) 01:13, 8 April 2013 (UTC)

I apologize for much of my behavior toward you. I can't say anything specific at the moment as I'm drained of energy discussing the matter on my talk page. Squish7 (talk) 05:35, 8 April 2013 (UTC)