Study Finds Little Evidence to Support U.S. Flu Vaccine Policy

[Celebration]

http://www.bloomberg.com/apps/news?pid=20601102&sid=apstgklhhVh8&refer=uk

Research on the efficacy of vaccines on either children or the elderly, two main targets of the policy, are either flawed or don't show a clear benefit, according to the study, published today in the British Medical Journal. The U.S. Centers for Disease Control and Prevention on its Web site says getting a shot is ``the single best way to protect against the flu.''

``The large gap between policy and what the data tell us is surprising,'' the author, Tom Jefferson, coordinator of the Cochrane Vaccines Field, wrote in the paper. The organization, which is part of the U.K.-based Cochrane Collaboration, was founded to facilitate the gathering of evidence on inoculations.

Jefferson examined systematic reviews of known studies of flu vaccines, rather than the results of any single trial, and found the studies had three problems. One was a reliance on trials that were not randomized, giving leeway to systematic errors. The second was an absence of evidence supporting vaccination's efficacy. Lastly, the studies didn't provide a large amount of data on the safety of inactivated vaccines.

This ``policy gap'' is rooted in part in confusion between influenza and influenza-like illnesses, which are often both reported as the same sickness, Jefferson's study found. A lack of surveillance systems to monitor circulating viruses exacerbates this effect. In addition, Jefferson wrote, policy makers tend to intervene with what is available.

[Ian David]

1. "... policy makers tend to intervene with what is available."

"In addition, Jefferson wrote, policy makers tend to intervene with what is available."


I am so not surprised.

[Celebration]

3. it is a kind of mindset

Oh, there is a problem here (people getting flu). What can be done about it? Big pharma replies--Well we have a flu vaccine!! That's right!! A flu vaccine. We are very smart and we invented one. Oh, well we don't have many great studies on it but we don't have any other options. Well, let's just go for it then!! It becomes policy and a sort of modern mythology that flu vaccines work, though solid evidence is lacking. Why does this happen? Because it is available. Oh, and supported by a lot of $$$ as well.

[Ian David]

6. I don't care if it works. I just enjoy being stuck with needles. n/t

[Suich]

2. I'm not familiar with Bloomberg.com. How reliable are they?

I have felt the same way about the flu shots for several years

:hi:

[Celebration]

5. this is reported several places

What you really might mean is--Is the British Medical Journal reliable?

[Ian David]

7. Bloomberg is very reputable. n/t

[Warpy]

4. I think it's strange to give vaccine to people who aren't elderly

or chronically ill. I find it very odd to give to children.

Yes, the flu is miserable and inconvenient. However, the point is that catching it when you're young enough to fight it off confers a lifetime immunity to that strain of flu. The vaccine only confers a very temporary immunity, one that lasts for less than a year.

The 1918 influenza demonstrated that quite clearly. Members of a certain age cohort, young adults to early middle age, suffered the most illness and mortality. Elders had at least a partial immunity to it from cases of milder influenza in their youth. Children may have been the same. Young adults were unprotected.

So let your conscience be your guide. People just need to be aware they're not doing themselves and their kids a favor by not allowing their immune systems to function when the illness is not a serious one. Most vaccines prevent serious illness. The flu vaccine only prevents serious illness in people most likely to develop it: the sick and elderly. It's just a nasty nuisance to everybody else.

[kestrel91316]

8. It's called "herd health". If enough of a population is protected

by vaccination, the disease can't propagate through the population at all, or only a little, so we want to protect maximum numbers and in doing so everybody else (unvaccinateds) is also protected, sort of "by proxy".

Of course healthy adults don't get deathly ill and die of the flu, but they can spread it to those who will. So getting a flu shot is sort of a civic responsibility.

No man is an island. It's not just about ME.

[Ian David]

10. I agree. I just hope the vaccine is effective in preventing the spread.

Most doctors don't get sick if they don't wash their hands after they poop.

But it's a good idea not to put their poopy-hands on their sick and elderly patients.

So, most doctors will wash their hands after they poop.

[kestrel91316]

16. No relationship between poopy hands and flu........

it's SNOTTY hands and flu that's the problem. Influenza virus is shed via the respiratory tract secretions that are SOOOOOO abundant during the flu, lol. It's our hand to face to doorknob or telephone habits without handwashing that get us into trouble with flu.

[Ian David]

17. I was just using that as an example...

of how people take responsibility upon themselves for protecting others.

But your example is better.

[Warpy]

13. That's true for serious illnesses like measles

(and I almost died from measles encephalitis when I was six), but less so for milder illnesses like the flu.

You're weighing two things here, a healthy immune system capable of fighting future strains off versus a weak immune system and a temporary immunity that will get you through one season.

It's your choice. Just don't let a bad public health policy dictate it.

[Ian David]

15. We need good scientific data to determine what is good health policy

And unfortunately, lobbyists get in the way.

Add that to this administration's unprecedented War On Science, and we're pretty well screwed.

I'm glad someone is looking into this.

Sometime during the next administration, we'll hopefully get honest answers.

[kestrel91316]

18. IMHO vaccination for flu is not "bad public health policy".

However, you don't want to get me started on the wisdom of vaccination for common (and usually harmless) childhood diseases like mumps and chickenpox. You'd think we would have learned our lesson from smallpox - by eradicating a common disease from the population (and then down the road no longer vaccinating for it because it's "gone") we just leave ourselves sitting ducks for biowarfare using the disease we worked so hard to eradicate.

[depakid]

19. healthy adults don't get deathly ill and die of the flu ???

In 1998, I had the nasty A strain that was going around. 105 fever, chills, sweats searing migraines and bone aches that felt like someone beat me all over with a baseball bat. For several days, I was too weak and had too much vertigo to stand. I literally had to crawl to the bathroom.

And of course, my lungs were on fire. This went on for over a week, and was followed by a secondary brochial infection- basically pnuemonia- the kind where you gasp for air. Even after a full course of anti-biotics, I was still hacking over a month later.

My ex- she got vaccinated- and didn't get so much as a sniffle. That's empirical enough for me.

It took three months- until mid April before felt in reasonably good strength, but unfortuntely, the illness left me clinically depressed until mid-summer.

When I got this stuff, I was a workout holic- mountain biked and/or went to the gym damn near every day. I was 38, lean & mean- in the best shape of my life.

So- words to the wise:

Give influenza the respect it is due. It can indeed lay the very healthiest of you really low- and can even kill you.

Now of course, I get vaccinated every year.

[kestrel91316]

20. It's much less likely than the very old and very young dying of it.

[Ian David]

9. Sometimes even healthy people get un-lucky when they catch the flu

And you never know if there is a hidden medical defect in somebody that you didn't know about.

You'd hate for Junior to get the flu, and then discover that he's got some kind of cardiac birth defect.

[Warpy]

11. The way it kills younger folks is by secondary

bacterial infection. That's something that can be treated by antibiotics.

Why should we put 99.9% of the population at risk to save 0.1%? Besides, the flu might be what alerts parents to cardiac defects while they're fixable instead of wondering why Johnny dropped dead during football practice.

[Bodineian]

21. Young and Elderly Immune Systems

The young having a not fully developed immune system and the elderly having a weakening immune system could be a reason for the flu shots not working as effectively.

[Ian David]

12. The Cocharane Collaboration MIGHT be a bunch of alt-med kooks

I'm not sure if they're credible.

But even if they're a bunch of crystal-clutching flakes, that doesn't necessarily mean that they're wrong. Even crazy idiots are right sometimes.

I'm going to do more research and get back to this:

The Cochrane Collaboration
The Complementary Medicine Field is an international group of individuals dedicated to facilitating the production of systematic reviews of randomized clinical trials in topic areas such as acupuncture, massage, chiropractic, herbal medicine, homeopathy and mind-body therapy. The Complementary Medicine Field is coordinated by the University of Maryland Center for Integrative Medicine.
http://www.compmed.umm.edu/Cochrane/



It doesn't help that their site has missing pages and stuff still "under construction.

Staff & Advisory Board
http://www.compmed.umm.edu/Cochrane/staff&advisory.html

Links & Resources
http://www.compmed.umm.edu/Cochrane/links.html
Coming

[Ian David]

14. Cochrane Collaboration ARE a bunch of alt-med kooks. Doesn't mean they're wrong

The fact that they got published in The British Medical Journal strongly suggests that this particular blind squirrel may have actually found a nut.

One of the dead give-aways is that they link from their page to The National Center for Complimentary and Alternative Medicine, but not to The Scientific Review of Alternative Medicine (SRAM)
http://www.sram.org/

Also, they don't carry the United Nations HONcode certification on their site:

Health On the Net Foundation is the leading organization promoting and guiding the deployment of useful and reliable online medical and health information, and its appropriate and efficient use. Created in 1995, HON is a non-profit, non-governmental organization, accredited to the Economic and Social Council of the United Nations.
http://www.hon.ch/visitor.html

[astral]

22. I haven't seen the vaccine prevent the flu!

My mom gets vaccinated for the flu every year, yet she had the flu this year which went into her lungs and was the hurt-to-cough stuff. My elderly uncle swore he got deathly sick from the flu vaccine about 3 or 4 years ago and wasn't going to get it again, of course he normally does NOT get sick. I of course won't get a vaccine and don't usually catch the bugs going around anyway.

Getting vaccinated to prevent other people getting sick does not make sense to me --- am I giving other people the flu by not being sick?

The idea that healthy people need to get a flu vaccine came out of some really fuzzy logic. I would like to see where the evidence is that that statement is true.

[trotsky]

23. Are you serious?

First off, the flu vaccine is an attempt at protecting the population from a flu bug. There are many varieties, and new mutations all the time. So based on studies, researchers try to predict which strain is going to produce "the flu" in any given year. They develop the vaccine to fight that particular virus (along with some other past viruses), and roll it out. Sometimes they're wrong. It'll never be an exact science, guessing which particular strain is going to spread, and from where. But they try. In the vast majority cases, a person who got the flu shot will NOT get the flu for that particular strain. Oh, you can still get the flu - a different strain, a mutation, or maybe your body didn't react, or react sufficiently, to the vaccine to make enough antibodies to protect you.

There is room for criticism and debate of flu vaccine policy, but claiming it can't prevent the flu anyway is denying reality.