On the Efficacy of Flu Vaccine

The Atlantic is running a major article questioning the received wisdom about flu vaccines and antivirals, for both seasonal flu and H1-N1. "When Lisa Jackson, a physician and senior investigator with the Group Health Research Center, in Seattle, began wondering aloud to colleagues if maybe something was amiss with the estimate of 50 percent mortality reduction for people who get flu vaccine, the response she got sounded more like doctrine than science. 'People told me, "No good can come of [asking] this,"' she says... Nonetheless, in 2004, Jackson and three colleagues set out to determine whether the mortality difference between the vaccinated and the unvaccinated might be caused by a phenomenon known as the 'healthy user effect.' Jackson's findings showed that outside of flu season, the baseline risk of death among people who did not get vaccinated was approximately 60 percent higher than among those who did, lending support to the hypothesis that on average, healthy people chose to get the vaccine, while the 'frail elderly' didn't or couldn't. In fact, the healthy-user effect explained the entire benefit that other researchers were attributing to flu vaccine, suggesting that the vaccine itself might not reduce mortality at all." Read below for more excerpts from the article.
The annals of medicine are littered with treatments and tests that became medical doctrine on the slimmest of evidence, and were then declared sacrosanct and beyond scientific investigation. ...

This is the curious state of debate about the government's two main weapons in the fight against pandemic flu. At first, government officials declare that both vaccines and drugs are effective. When faced with contrary evidence, the adherents acknowledge that the science is not as crisp as they might wish. Then, in response to calls for placebo-controlled trials, which would provide clear results one way or the other, the proponents say such studies would deprive patients of vaccines and drugs that have already been deemed effective. ...

In the absence of better evidence, vaccines and antivirals must be viewed as only partial and uncertain defenses against the flu. And they may be mere talismans. By being afraid to do the proper studies now, we may be condemning ourselves to using treatments based on illusion and faith rather than sound science.

Comments

It's not that simple

[Rix]

Flu vaccines do save lives, just not necessarily the lives of the people who get them. By not getting the vaccine you expose other, more vulnerable people to higher risk.

Not getting vaccinated is highly irresponsible, and anyone who doesn't should be quarantined.

Re:article is BS

[Anynomous Coward]

36,000 die of complications from the flu annually in the US

Only if you count all the weak that would have died a day later from old age were it not for $SCARE, yes. If you'd add up all the numbers of people reportedly dying from the gaggle of scares, the streets should be overflowing with bodies as we speak. Quid non.

Re:The Scientific Method

[demachina]

"...and those people will get other people killed..."

On the other hand we live on a planet with 6+ billion people which is heading to 9 and some where along the way we will run out of resource like food, water and energy and we will have a major crash that will make a flu pandemic look benign by comparison.

I'm not sure I subscribe to the idea that its really such a great idea to work so hard to short circuit all the natural biological mechanisms for population control. Those mechanisms were developed over billions of years of evolution because they were extremely necessary to prevent biological organisms from overpopulating and exhausting their environment. Keeping everyone alive at all costs no doubt gives everyone the warm fuzzies but something that seems like a near term win-win could in the long run be cataclysmic.

I'm all for wiping out disease, preventing aging and have everyone live past 120 which seems to be where we are heading. at least in the places that can afford it. but.... if you are going to do that you also need to either:

A. Institute draconian birth control and allow no more births than their are deaths to achieve a stable or probably even better, gently declining population

B. You need some major technological breakthroughs to stretch a biosphere that is already showing signs of cracking, or you need to terraform a nearby planet and create more biosphere (which is a long shot solution at best).

I'm starting to have a serious problem with a society that is hell bent on wiping out all disease and keeping people alive at all costs using expensive medical technology to the point it bankrupts economies and robs young people of their future because they have to support politically powerful seniors who paid in next to nothing when they were young and are now milking their grandchildren of their future. We also seem hell bent on wiping out famine and every other natural mechanism for population control but we are also completely unwilling to institute equally effective, mandatory if necessary, birth control regimes.

I seriously don't want to live on a planet that looks like Soylent Green and that is where we are heading. Either you vote for living to 120 and you forgo having children, or if you wanna breed like rabbits then you should be willing to die like one at a relatively early age.

Re:The Scientific Method

[RichardsSites]

Frankly, it is just such efforts to shush shush any doubt at all that throws gasoline on the fires of doubters such as myself. Your desire to achieve the percentage of vaccination required for "herd immunity" at all costs, including freedom of discourse is not helpful to your own cause. It isn't just you - the real fear I have are the doctors who implement all of this. They, along with the CDC and state health agencies want us all to "shut up" also. If they could be trusted to defer from vaccinating those with potential immunity issues, that would be great. But in the rush to crush the "nutty fringe" they would rather err on the side of vaccinating everyone they can. When something does go wrong, they do not admit error - how can they in today's rush to sue? Nor will their pride allow them to admit error anyway. Arrogance in this field may not be a conspiracy, but the resulting pain and anguish is the same. I have seen a family destroyed by social services, when their children were taken from them, falsely accused of trying to harm their children. Why, because a 3 month old child had seizures within 24 hours of a vaccination. There was plenty of family history to suggest caution, but the pediatrician brushed it aside. In addition the child was experiencing a cold at the time; again the doctor brushed aside the concerns of the mother and assured her that it was the right thing to do. When the child began the seizures (my wife was in the home of our friend at the time) they rushed the child to the hospital, and immediately they were sent on to the major Boston hospital. The seizures continued for several days before they were brought under control; the result was permanent brain damage. However, a neurologist at this Boston hospital could not explain the cause of the seizures, since in her mind vaccinations are safe and as I see it, her arrogance reigned supreme. She filed a complaint with Social Services and the child and siblings were removed from the parents. She couldn't see the link. She couldn't even have the humility to say "I don't know why this child had seizures." It was better to close ranks with the pediatrician. She "assumed" the parents were either willful or negligent. In my view, the pediatrician was negligent. Once Social Services are involved, the family is assumed guilty until proven innocent. This is how the process works. Even if you could gather medical expert testimony, it is cost prohibitive for most families and the system works against the accused. The children were separated from the parents for several years. They were forced to give up the brain injured daughter to adoption in exchange for the return of the other older sibling.... and they had to agree to say nothing about the "deal" to the press. It was a nightmare. Of course the reality is that the CDC definition of at risk people is very narrow, that very few doctors would be brave enough to contradict their eminent leaders about the risk of vaccination to certain groups. You may not want to use the word conspiracy and I also think it is unwarranted if it should mean that it is somehow orchestrated. Rather it is the result of pressure to reach the herd immunity goal that creates the various state guidelines that generally conform to CDC guidelines. The pediatric associations and other professional groups respond like you -- they want to disregard even the warnings on the vaccine labels in their effort to avoid looking like a wuss. They want to discredit and silence those who express concern, just as you have expressed. The issue of protecting those with immunity problems is far more complex than limiting the concern to those with HIV and one or two other conditions. If the guidelines took that into consideration and if doctors were encouraged to exercise care and good judgement, there would be a greater sense of trust, instead of distrust and suspicion. I am not against all vaccinations. But I don't think we need a vaccination for every disease out there. And most certainly we need to encourage doctors to use judgement in exempting