Healthy Skepticism Library item: 2744

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Publication type: news

Carey E.
Are flu vaccines shots in the dark?
Toronto Star 2005 Nov 4
http://register.thestar.com/LoginPage.aspx?SID=JuQ7&RID=3075&CU=aHR0cDovL3d3dy50aGVzdGFyLmNvbS9OQVNBcHAvY3MvQ29udGVudFNlcnZlcj9wYWdlbmFtZT10aGVzdGFyL0xheW91dC9BcnRpY2xlX1R5cGUxJmM9QXJ0aWNsZSZjaWQ9MTEzMTA1ODIwMTUzOCZjYWxsX3BhZ2VpZD05NjgzMzIxODg0OTImY29sPTk2ODc5Mzk3MjE1NCZ0PVRTX0hvbWU%3d

Keywords:
flu influenza vaccination

Notes:

Ralph Faggotter’s Comments:

How did it come about that the value of the annual influenza vaccination has been so significantly overstated? —

“ The review found 19 per cent of those who had a flu shot got sick with
influenza, compared with 23 per cent of those who didn’t, and those
vaccinated lost an average of just 0.16 fewer days from work. In other
words, about 5 per cent of those vaccinated avoided missing three days of
work because of the flu. There was no benefit in the other 95 per cent
vaccinated because most people don’t get the flu. “

Full text:

Toronto Star
Nov. 4/05

Are flu vaccines shots in the dark?

Effectiveness in reducing spread of disease still in doubt
Healthy adult’s chance of getting sick reduced by `small amount’

ELAINE CAREY
MEDICAL REPORTER

It’s November and the flu shot police are out, urging all of us to roll up
our sleeves to prevent getting and spreading the dreaded bug.

But how effective is the flu vaccine in keeping you from getting sick – or
even dying? Surprisingly, nobody really knows for sure.

Two recent reviews of all the available studies have found few have actually
analyzed whether the flu shot prevents getting the flu or dying from it. In
fact, there is “substantial uncertainty” about what they found.

One study that reviewed 12 randomized control trials of the impact of the
flu vaccine on healthy adults under 65 found it didn’t meet any of its
specific goals – to reduce the spread of the disease, the number of days
lost from work or deaths and hospitalization from it.

“Universal immunization of healthy adults is not supported by the results of
this review,” concluded the study by the Cochrane Collaboration, an
international not-for-profit organization that analyzes the effects of
health care.

The review found 19 per cent of those who had a flu shot got sick with
influenza, compared with 23 per cent of those who didn’t, and those
vaccinated lost an average of just 0.16 fewer days from work. In other
words, about 5 per cent of those vaccinated avoided missing three days of
work because of the flu. There was no benefit in the other 95 per cent
vaccinated because most people don’t get the flu.

Despite 64 studies over the past 35 years, we don’t know how well flu shots
work to prevent serious illness and death in the elderly, concluded a survey
by the Veterans Administration Outcomes group in Vermont, which also
analyzes medical interventions.

Most of the studies were observational, where scientists counted the number
of flu-like illnesses among people who did or did not get the flu vaccine,
explained Dr. Steven Woloshin, a member of the group and faculty member at
the Dartmouth Medical School.

The link between the vaccine and the flu can’t be proven because people who
get the flu shot are generally healthier to begin with, he said.

The chance of dying from the flu in seniors older than 65 in the U.S. is one
in 1,000, slightly lower than the chance of dying from a fall, the study
shows.

Despite a rapid increase in vaccination among the elderly between 1980 and
1998 – from 20 to 65 per cent – the death rate in that group in the U.S. has
remained flat, Woloshin said.

In Canada, 500 to 1,500 people, mostly seniors, die from pneumonia related
to the flu every year, according to Health Canada and “many others die from
other serious complications.” That compares to 75,000 who die each year from
heart disease, the leading cause of death.

Alan Cassels, a University of Victoria drug researcher, has repeatedly
called for a randomized control study to find out definitively if flu
vaccine works.

“Let’s answer the $125 million question – that’s how much we’re spending on
flu vaccine every year without any evidence it’s doing what people say it
is,” he said. In Ontario, 5.25 million people – or 44 per cent of the
population – got a flu shot last year. At a cost of about $10 a shot, that
works out to $52.5 million.

The lack of evidence doesn’t mean people shouldn’t get the flu shot,
Woloshin said. “We’re trying to present the basic data so people can make
the decision on their own.”

Last year, the U.S. ran short of flu vaccine, people panicked and the
government had to change the message and say `don’t worry, you won’t get
sick anyway,’” Woloshin said.

“Our conclusion is that both the rate and the benefit of the shot are
exaggerated. If you want to get it, it probably reduces your chance of
getting sick by a small amount and missing work by a small amount.”

Ontario is the only place in the world where the flu shot is available free
of charge to everyone, regardless of their age or health. All other
provinces target specific groups such as the elderly and people with chronic
health problems.

“I think the whole country and many others are waiting to see if we can get
something interesting and useful out of the Ontario data,” said Dr. Theresa
Tam, associate director of Health Canada’s immunization and respiratory
infections division.

Dr. Allison McGeer, a microbiologist and director of infection control at
Mount Sinai Hospital, said she’s tired of the message being put out that “we
shouldn’t be using flu vaccine because it’s not perfect. That’s like saying
`I shouldn’t use antibiotics because some people die when I give them
antibiotics.’”