Long-time readers of this newsletter are aware of my skepticism regarding the flu vaccine. At the same time, headlines shouting about the looming flutastrophe can’t fail to grab my attention.
The other day I walked past one of the televisions at my gym, and a graphic about hospitals turning away flu victims caught my eye. How horrible! Oh, wait. The routine emergency room advice in flu season is to “stay away”, because 1) most likely there is nothing an emergency room doc can do for you, 2) the flu is almost certainly not a medical emergency but 3) you WILL pass the illness along to other people waiting in the hospital. Some of them are barely clinging to life and so, please, just leave before your unpleasant illness leads to someone else’s death.
It is strange that my viewpoint seems so out of sync. After all, the scientific evidence is that influenza vaccine does not do the job. In the past 10 years the flu vaccination rate in the US has doubled, but the death rate is unchanged. All evidence points to the fact that those who are most likely to die from the flu, the elderly and infants, are the least likely to be helped by flu vaccination. There is limited evidence that the vaccine is of significant benefit in any way.
Furthermore, there have been a series of controversies and governmental hearings in Europe and the US about medical organizations acting as advertising agents of companies producing influenza-related vaccines and drugs, abdicating their ethical responsibilities.
ONE possible explanation for vaccine ineffectiveness arises from the nature of the ever-mutating flu virus. Each year a panel of experts determine which specific forms of flu virus are likely to be the cause of the coming year’s epidemic. Then manufacturers produce that year’s vaccine against those strains. They have not been able to be particularly accurate, probably then compromising the vaccine.
This year the CDC claims that the vaccine is spot on. That makes me unusually receptive to the possibility that this year’s vaccine might be effective. HOWEVER, such predictions have been wrong many times in the past. Furthermore, the CDC is not the independent body it should be. The Influenza Division at the CDC receives funding from the companies that make flu vaccines and antiflu drugs. Just as with the antiflu drugs, the CDC Influenza Division has ignored the determinations of truly independent experts, like the Cochrane Collaboration, when those determinations have been unfavorable to influenza vaccine. I have difficulty blindly trusting their pronouncements at this point.
Another example comes from the Center for Infectious Disease Policy and Research at the University of Minnesota, http://www.cidrap.umn.edu/cidrap/files/80/ccivi%20report.pdf
In the preface to the 150 page report, the leader of the group (former head of the Minnesota Department of Public health) Michael Osterholm included a pertinent quote –
“The greatest obstacle to discovering the shape of the earth, the continents, and the oceans was not ignorance but the illusion of knowledge.”
The CIDPR report noted that the ineffectiveness of the present vaccine should lead us to look for a better vaccine or some better approach. In an interview with the New York Times, Osterholm commented, “I’m an insider. Until we started this project, I was one of the people out there heavily promoting influenza vaccine use. It was only with this study that I looked and said, ‘What are we doing?’ ”
That is an excellent question and reassurance that my own judgment is sound. Go ahead and get the vaccine if you wish. This year the vaccine might actually work, but that would be something new. Just make certain that you take a healthy dose of skepticism along with the vaccine.