Every year as the cold and flu season approaches, panic is peddled, and angst arises - patients frequently ask me whether or not they should get the influenza vaccine. This year I decided to publish my response. Vaccination is a highly charged subject, ranking right up there with religion and politics. The decision to vaccinate is a personal choice. My personal choice based on the evidence is to not get it. Let’s dig a little deeper to see why that’s the case.
What is influenza, anyways?
Influenza is a contagious respiratory infection that can be caused by several different viruses.1 Respiratory droplets produced when an infected person coughs or sneezes spread the viruses. These droplets can be inhaled or acquired from other contaminated surfaces. They infect the nose, throat and lungs. Symptoms can include fever, chills, muscle aches, coughing, congestion, headache, sore throat, swollen lymph nodes, nausea, or chest pressure. While influenza generally makes you feel like the floor of a New York taxicab, most folks are better in a week or two. Those at the extremes of age or who suffer from chronic illnesses are at greater risk of developing complications, of which pneumonia is one. At times, those complications can lead to death.
Whoa now, buckaroo! You mean folks could die and you don’t recommend vaccination, this intervention “proven” to prevent the flu and/or reduce its complications? Well pardner, just hold your horses and ride with me to the end of this here trail.
If the vaccine were an effective and safe intervention, that would be a different story. Let’s examine the facts.
An immunological guessing game
The Center for Disease Control (CDC) is the entity in the U.S. that, along with five other international members of the World Health Organization (WHO), meets biannually and collaborates to decide which viruses to recommend for this year’s vaccinations. These recommendations are based on data collected from one hundred international influenza-monitoring sites. The CDC presents this data to the FDA, who makes the final decision about the strains to include in the final vaccination. 2
There are four types of influenza viruses, A, B, C, and D, with A-C causing disease in people. The viruses A and B are the most concerning for possibly causing epidemics; C typically causes only very mild symptoms. 3 Type A, the really problematic one that infects humans, birds, and other animals, can be further broken down into one hundred and forty-four different serotypes.4
The current season’s vaccine is comprised of the three (trivalent vaccines) or four (quadrivalent vaccines) most likely suspects according to the best guess of the WHO collaboration. Once the vaccine is produced, it is hard to switch gears as it can take six months to make any meaningful quantities of vaccine. Influenza is one of the most changeable viruses known and can turn on a dime, making the vaccine useless.
Effectiveness is in the eye of the beholder
The track record for vaccine effectiveness according to the CDC’s own best estimates is not so awesome (my words, not theirs). The adjusted vaccine effectiveness from 2004-2005 season to the 2017-2018 season has been at best 60% and at worst 10%, the average being 40.8%. The last 2 recorded seasons were 40%. It is very interesting how they have chosen to graph this data. If perfect effectiveness were 100%, I would think that would be represented on the graph, but for some reason they chose 70% as the upper value.5 I wonder, did they present the data this way to make 60% look at lot more favorable than just a little over a coin toss?
How is this “effectiveness” determined? The gold standard for medical studies is the randomized controlled trial (RCT). This where there are at least two groups are studied with folks randomized into one group that will receive an intervention (like the flu vaccine) and a control group not given the intervention or given a placebo. However, the CDC doesn’t use RCTs. Since 2010, their guidelines have recommended vaccination for everyone from the age of 6 months and older; it has therefore been deemed unethical to deprive anyone of the vaccine. RCT’s are also described as “too expensive.” According to the CDC, this leaves observational studies as the only means by which to study influenza vaccine effectiveness. 6 Any medical statistician worth their salt will decry these types of studies as fraught with bias, making them the least reliable of any type of study and not as useful for making firm evidence-based recommendations.
There are randomized controlled trials of vaccine effectiveness and Cochrane, the organization recognized as the leader for the systematic and unbiased reviews of RCTs to facilitate evidenced-based medical decisions, has analyzed them. The most recent analyses have been completed this year. They tell a drastically different story of effectiveness. These three meta-analyses (evaluations of multiple studies over many years) included healthy children (ages 3-16), healthy adults (including pregnant women), and the elderly. They show minimal to modest reduced risk comparing unvaccinated or placebo to vaccinated: 30% versus 11% 7; 2% versus 1% 8 ; and 6.4% versus 2% 9, respectively.
So, how safe are these vaccines? Is it worth the risk of vaccination? What are the potential complications?
Adverse effects from vaccines in general are severely underreported, to the tune of eighty to ninety percent. The influenza vaccine is not immune to this.
The most common adverse reactions to the influenza vaccine represent activation of the immune system and include fever, headache, fatigue, and painful joints. These reactions can last several days.
Guillain-Barre Syndrome (GBS) is an immune-mediated painful and disabling neurological disorder involving inflammation of the peripheral nervous system. It can cause temporary or permanent paralysis that may lead to death. GBS can be caused by infection or vaccination. This entity is less likely to occur with the nasal form of the vaccine. Other neurological complications can include inflammation and dysfunction of isolated nerves, including those providing vision.
Adult influenza vaccine injury claims are now the leading claim submitted to the federal Vaccine Injury Compensation Program (VICP), with GBS as the leading alleged injury.
There is data to suggest that the more often that you get the vaccine, the more susceptible you are to the influenza virus and other viruses in the future.
At times, there has been an increased risk of miscarriage with certain types of the influenza vaccine.10
This is a quote from the conclusions of the Cochrane study on influenza vaccinations in the elderly, one of the groups the CDC is the most keen on vaccinating:
The available evidence relating to complications is of poor quality, insufficient, or old and provides no clear guidance for public health regarding the safety, efficacy, or effectiveness of influenza vaccines for people aged 65 years or older. Society should invest in research on a new generation of influenza vaccines for the elderly.9
Parting shots (pardon the pun)
There are many other questions and concerns that I have regarding the influenza vaccine and vaccines in general. However, books have been written on this topic and it is not my intent to reproduce them here (reader breathes a sigh of relief). It is incumbent on you to be educated about what you allow to be put into your body and it is our goal to help you. The National Vaccine Information Center (www.nvic.org) is a good resource toward this end.
Please stay tuned for our next post where we will give you practical tips for boosting natural immunity which provides the best and safest protection for yourself and your loved ones during this cold and flu season.