If anyone is confused about what sealioning looks like, here's a really excellent example.

Multiple physicians, including pediatricians and infectious disease specialists, have presented evidence showing this assumption is incorrect. But he's "just asking questions."
About half of pediatric flu deaths occur in previously healthy children.

Here's a summary on the 2019-2020 flu season in kids:

Feigin and Cherry's Pediatric Infectious Diseases also notes the following:
In other words, flu often doesn't act alone. Co-pathogenesis with bacteria is not all that rare, and the virus itself provokes immunological derangements and can remodel the microenvironment of the respiratory tract to promote disease.

This idea that influenza can only be a problem for children who have some kind of immunological defects is completely asinine, ableist, and demonstrates a complete failure to understand how infectious diseases work.
To initiate productive infections, pathogens have to subvert host defenses to replicate in spite of them. Influenza has well characterized mechanisms for accomplishing this.
These include:
- subversion of interferon responses
- becoming insensitive to the interferon effectors
- preventing recognition of virus by the immune system
- forcing cells to die via apoptotic death that prevents effective inflammatory responses needed to combat infection
- within host evolution selecting for escape variants
- infection of cells of the immune system resulting in their death
- prevention of stress granule formation

among others.

The immune system is great. That doesn't mean that pathogens are helpless against it.
The thing people always ignore is that we all evolved together, and influenza is furthermore zoonotic which means that as the host species changes, its adaptations to the environment of one host can make it especially dangerous for other species (e.g. avian influenza in humans).
Vaccination is by far the most important and best way we have to prevent flu, with a possible role for universal masking to be revisited at some point.

So yeah, healthy children die from flu and that's not the shocking thing that people think it is. Vaccination can go a long way towards helping prevent that (although unfortunately about 20% of pediatric flu deaths are vaccinated).
Addendum: I'd like people to take note of what happens when you engage people like this.

On being presented evidence on why previously healthy children could succumb to influenza, it was dismissed as them not being healthy because they had some underlying immunological issue.
This is called a goalpost shift, and it's an attempt to preserve the tautology:

1. healthy children don't die of influenza
2. these apparently healthy children died of influenza
3. these children could not have been healthy
4. return to 1
Here's the problem with that thinking: firstly, it's inherently unscientific, as scientific claims must be falsifiable. It is useless to waste time on something that can't be proved false under some form of evidence.

see: Russell's teapot.
But in a more practical sense here's why this is dishonest: when recommendations get made about treatments and screening for flu, it is important to consider who is at risk. Knowing that someone has no apparent risk factors can still succumb to this is important for their care.
If you go by the tautology formulated above, these patients may receive important interventions too late for them to be effective. Maybe a portion of them have occult immunological problems that don't manifest until they catch influenza but that doesn't matter.
As far as we can tell, healthy children can and do die of flu, and it happens a non-trivial amount of time. If new information to show why these children are dying and it's detectable and can be intervened upon that's great. Until then, healthy children can die of flu.

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More from @ENirenberg

23 Feb
*Long thread warning*

Because people seem to be confused I thought I could throw in my own explanations about the possible effects of vaccines on transmission. Let's imagine an arbitrary scale of vaccine efficacy for a minute, like this one that I made up: Image
Let's now consider what the absolute perfect vaccine might do on this scale.

Well ideally, the immune response it induces is so rapid and so robust that it is able to keep you from even getting infected. This is called sterilizing immunity. Image
Sterilizing immunity does not have anything to do with sterility in the reproductive sense; it refers to being able to maintain a sterile (i.e. not contaminated) environment. This is as good as things can get. Why don't we just make all of our vaccines do this?
Read 24 tweets
30 Jan
Let's talk about the US's vaccine adverse event reporting system (VAERS), with emphasis on its misuse by bad actors.

VAERS is a self-explanatory system. I mean that literally: it tells you exactly how to use it (and how not to).

VAERS is a spontaneous (passive) reporting system. Anyone can submit a VAERS report, and certain events for certain vaccines are required to be reported by healthcare providers under the NCVIA law. Herein however lies one of the limitations.

As an adverse event is anything bad that happens following the receipt of a pharmaceutical, it need not be causally related to the vaccine. If you look hard enough you can find VAERS reports for things that are obviously unrelated. For instance:
Read 17 tweets
20 Dec 20
I have a bigger audience now (still don't get how that happened) than I'm used to so I need to clarify some things about me.

Firstly, I am not a public health expert, nor an expert on COVID-19, pandemics generally, virology, infectious disease, or medicine.
I have a BSc in Biochemistry and I did a lot of coursework in immunology at a fairly high level and some labwork and journal clubs therein too.

It would also be delusionally hubristic of me to claim that I were an expert in either immunology or biochemistry or vaccines.
I know some things and have some experience with them.

I am comfortable enough with these things that I can pick up most papers about them and have at least a basic idea of what's going going on. I might also be able to offer criticism if it's a topic I am very familiar with.
Read 13 tweets
20 Dec 20
Some reminders after a disheartening thread:

- Depression is a real psychiatric condition that in addition to cognitive and emotional hallmarks produces changes at the cellular level within the brain and may include pharmacotherapy as part of a treatment plan.
- Behaving as though there is artistry and meaning in a person's suffering to get them to revel in it and neglect their wellbeing, furthermore as a means of remuneration, is grotesque and depraved. Feigning innocence and ignorance at being confronted with this truth is shameful.
- Antiretroviral therapy saves lives. Good compliance with ART can lead HIV patients to a normal life expectancy and prevent transmission of virus to partners. Convincing people not to take indicated ART robs people of years they could have spent with loved ones.
Read 5 tweets
17 Dec 20
I've seen a bunch of people talk about vaccine hesitancy lately but the people doing it seem to be getting some important things wrong.

Firstly, vaccine acceptance is a continuum, as shown in the attached image.

My good friend, @lizditz has a post:
Most people fall somewhere in the middle. You generally don't see people calling for no vaccines at all, and it's relatively rare for someone to unquestioningly accept all vaccines.

Those people in the middle, they are hesitant.

Messaging about vaccines should focus on them.
That said, the people in the far left of that diagram are what some people might call "anti-vaccine."

This term for some reason has invited a bunch of controversy in its use. I don't think there's anything wrong with the term, but I do think many use it incorrectly.
Read 21 tweets
15 Dec 20
So I'm told that there's some confusion going on about what placebos for vaccine trials should be.

Let's chat about this one.
It's really common to hear from anti-vaccine people that a lot of vaccines are not tested against "true placebo," which is saline apparently.

This is a fallacy with many components to it.
Fundamentally the point of a placebo is to give you information about whether or not a treatment works.

There are a lot of different kinds of placebos; in vaccine trials it's a sham treatment- something that looks like the vaccine but isn't.
Read 16 tweets

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