We are having lots of viral illness going around, and I was asked to comment on the flu vaccine again. Certainly, with the flu virus circulating this season, flu-phobia is everywhere. Plus, there is a shortage of flu vaccines, so what are we to do? The answer is eat right, get enough sleep, and keep your hands away from your face (until right after you wash them). It is very difficult to get a significant viral inoculum if you do not put your hands near your mouth and nose. Remember, when you are in public, such as at work or school resist the temptation to touch your face or put your hands near your nose or mouth. That works, because you can’t get enough virus in the orifices of your body just by breathing the air, unless someone coughs right on you.
Plus, the flu shot is not very effective anyway. Please consider that over 200 viruses cause influenza and influenza-like illness; both produce the same symptoms, such as fever, headache, aches and pains, cough, and runny nose. Laboratory tests are required for doctors to tell the two illnesses apart. Both illnesses last for days and both rarely lead to death or serious illness. Even in the best-case scenario, vaccines might be effective against only some influenza A and B, but those represent less than 10% of all circulating viruses.
Each year, the World Health Organization makes recommendations for which viral strains should be included in the upcoming year’s flu vaccinations. So the vaccines may have some effectiveness against specific viral strains, but the degree to which the vaccine-included strains match the virus actually in circulation varies from year to year.
So that means that even if you are in that 10 percent of sick people with flu-like symptoms who really have influenza A or B, only about half of those vaccinated will be helped by the vaccine because the other half will have strains that were not included in the vaccine.1 And even with the best matching conditions the vaccine may diminish your symptoms somewhat, but not necessarily preclude you from catching the flu. The internationally renowned Cochrane Collaboration investigated this issue directly by reviewing all the relevant studies, involving over 70,000 participants. The most impressive thing about this meta-analysis was that the authors were completely independent from the U.S. vaccine manufacturers and the powerful pharmaceutical and vaccine lobby, so the reported results were unbiased.
They assessed all trials that compared vaccinated people with unvaccinated people. The combined results of these trials showed that even under ideal conditions (vaccine completely matching circulating viral configuration), 4% of unvaccinated people and 1% of vaccinated people became infected – the vaccine had only a minor benefit. They authors estimated that under average conditions, 100 people need to be vaccinated to avoid one set of influenza symptoms or you would have to be vaccinated every year for 100 years, to save yourself one flu episode. Interestingly, the study showed that flu vaccine did NOT significantly affect the number of people hospitalized or working days lost, and did not prevent flu-associated complications or those rare flu-associated deaths.1, 2 So even though the vaccine had some very slight effects, the benefits were very small. In fact, in children two years and younger they found the effectiveness of the vaccine was no better than a placebo.3
The Cochrane review’s authors were highly critical of the U.S. Centers for Disease Control, with its members having financial ties to the pharmaceutical companies. They noted that industry-funded studies were more likely to report findings favorable to the vaccines, that there was evidence of “widespread manipulation of conclusions” in those studies. The authors disagreed with the CDC’s recommendation for universal vaccination at all ages without clear evidence of significant effectiveness and safety. Certainly the elderly, the group most vulnerable to non-pandemic flu, should benefit the most, but this also is not observed as the vaccine does not work well in the elderly because of their decline in immune function.3, 4
To summarize, the vaccine does have some slight effects in reducing flu incidence and severity, but in those at most at risk, the very young and the very old, it is not yet clear whether the vaccine has any protective effect at all.
Those of us that are healthy need not worry about the dangers of the flu anyway. No treatment, drug or vaccine is without risk, and you only have to read the circular with the vaccine to be informed of those clear risks. Also, if you do get a flu shot, never get a shot from a multi-use vial, which contains more mercury and preservatives than the single dose vials.
On the other hand, eating your G-BOMBS has no known side effects.
Image credit: Flickr - paulswansen
1. Cochrane Summaries: Vaccines to prevent influenza in heatlthy adults. [http://summaries.cochrane.org/CD001269/vaccines-to-prevent-influenza-in-healthy-adults]
2. Jefferson T, Di Pietrantonj C, Rivetti A, et al: Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev 2010:CD001269.
3. Jefferson T, Rivetti A, Di Pietrantonj C, et al: Vaccines for preventing influenza in healthy children. Cochrane Database Syst Rev 2012;8:CD004879.
4. Jefferson T, Di Pietrantonj C, Al-Ansary LA, et al: Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev 2010:CD004876.