Study Sheds Doubt on Usefulness of Flu Vaccine
22 September, 2005 15:25 GMT
'I want to know why more effort isn't put on getting our vaccination method up-to-date instead of stockpiling millions of doses of vaccine and sending a fear message. We need to see reality.' The flu vaccine, a cornerstone of public health policy, is only mildly effective in the population for which it is supposedly most critical: the elderly.
According to a study appearing in the Sept. 22 online issue of The Lancet, vaccines against influenza are only "modestly effective" in people in long-term care facilities and even less effective for elderly people still living in the community. That research is twinned with another flu study, which found more bad news: that resistance to drugs used to treat influenza has risen 12 percent in the past decade.
This finding, the authors stated, raises questions about the government's policy of stockpiling such drugs.
'Not a Panacea'
Strong opinions on the vaccine study came from all sides of the issue.
"The vaccine doesn't work very well at all," said study author Dr. Tom Jefferson, an epidemiologist with the Cochrane Vaccines Field in Rome. "Vaccines are being used as an ideological weapon. What you see every year as the flu is caused by 200 or 300 different agents with a vaccine against two of them. That is simply nonsense."
Dr. Marc Siegel, author of False Alarm: The Truth About the Epidemic of Fear, agreed. "We have set up a situation where a fear is created, and then we try to create the treatment for this fear. The public gets the idea that the flu is going to kill them and the vaccine will save them. Neither is true," he said. "The flu vaccine has use in cutting down on deaths from complications in the chronically ill and people at great risk, but it's not a panacea." The US Centers for Disease Control and Prevention responded strongly on the other side.
"We certainly do hope that people will not be sidetracked from this important point. There are studies that show that the vaccine is effective in preventing serious complications of the flu," said CDC spokesman Tom Skinner. "This is not going to change the fact that we each and every year recommend people in high-risk categories to get the vaccine."
Protection for Elderly
Health officials worldwide, including those at the CDC, push to get as many elderly individuals as possible vaccinated against the flu each year. According to the study, in 2000, 40 of 51 developed or rapidly developing countries recommended vaccines for all individuals aged 60 and older. In 2003, 290 million doses of vaccine were distributed worldwide.
Earlier this month, US health officials starting urging all eligible persons to get a flu shot, with priority given to the elderly and certain other groups. And to avoid last year's flu vaccine shortage, US health officials have planned for a total of 97 million doses of vaccine. The current study provided no new data but, rather, looked at 64 existing studies which looked at the effectiveness of the flu vaccine over 96 flu seasons.
For elderly people living in the community, inactivated influenza vaccines prevented up to 30 percent of hospitalizations for pneumonia but were not effective against the flu, flu-like illnesses or pneumonia. "The vaccines didn't seem to prevent influenza," Jefferson said. For elderly people living in long-term care facilities, the picture was slightly brighter, with vaccines preventing up to 42 percent of deaths caused by influenza and pneumonia only. "We have to concentrate our resources elsewhere or invest in better vaccines," Jefferson stated.
Overuse of Antiviral Drugs
The authors of the second study screened 7,000 influenza A isolates for gene mutations known to confer drug resistance to the antivirals amantadine and rimantadine.
Overall drug resistance increased from 0.4 percent in 1994-95 to 12.3 percent in 2003-04. Also, 61 percent of resistant viruses isolated since 2003 were from people in Asia. Some Asian countries had drug resistance frequencies exceeding 70 percent, possibly a reflection of different prescribing practices.
Strikingly, more than 84 percent of all resistant viruses during the 10-year period under question were identified since the 2003 flu season.
This highlights the importance of continuing to expand surveillance of the emergence of resistance to these drugs, said Rick Bright, lead author of the study and a research scientist with the CDC.
"This is a warning that overuse of antiviral drugs leads to resistance," Siegel said. "The drugs should be specifically used for influenza that is a problem in terms of duration and possible risk of death, not for everybody."
Rising Rates of Resistance
The study authors voiced concern that rising rates of resistance will render amantadine and rimantadine ineffective for treatment or prevention in the event of an influenza pandemic. That, in turn, would render government stockpiles useless.
"I question stockpiling these drugs. You're going to have to discard or overuse them. It's sending a message to the public that these are lifesaving drugs," Siegel said. "Antivirals should be considered in high-risk cases," but in other cases they may only be of limited effectiveness, he said.
"We have to differentiate between potential risk and something that clearly is in the offing. Fear is a warning system that is supposed to protect us against imminent danger such as a gorilla hanging over us," he added. "I want to know why more effort isn't put on getting our vaccination method up-to-date instead of stockpiling millions of doses of vaccine and sending a fear message. We need to see reality."
More information: The National Institute of Allergy and Infectious Diseases has a fact sheet on the flu.
Doctor worried about flu vaccine preservative
By KRISTI L. NELSON, firstname.lastname@example.org
October 3, 2005
About a dozen people, most alternative health practitioners or parents, gathered last week at Rarity Bay in Loudon to hear a Cleveland physician speak on flu vaccine. Family practitioner Dr. David Adams presented "Flu Shots and Vaccines: What You Need to Know!" and moderated an informational discussion at the forum sponsored by Wholistic Wellness Network.
Among Adams' chief concerns was that the majority of flu vaccine in America still contains thimerosal, a preservative used since the 1930s that's almost 50 percent mercury.
Though the federal government decided in 1999 to begin phasing out mercury in childhood vaccines, an adult dose of most flu shots still contains 25 micrograms of mercury. Pediatric flu shot doses are about half the size of adults'.
The Centers for Disease Control and Prevention states, "There is no scientific evidence that thimerosal in vaccines is harmful," but some national groups claim a link between mercury in immunizations and rapidly escalating rates of autism in 1990s. Some parents allege the government has covered up a link between vaccines and autism.
"You're injecting yourself with a neurotoxin which the EPA would be horrified if you ate " enough mercury-containing fish to have the same levels in your body, said Adams, who believes his son's autism was caused by ingredients in vaccines.
Dr. Lori Patterson, infectious disease physician for East Tennessee Children's Hospital, said the risk of flu -- which kills 40-60 U.S. children a year and sickens millions more with influenza and secondary infections -- is higher than the risk of harm from trace amounts of mercury.
"Regular influenza kills people, including children -- sometimes even previously healthy children," she said. "It's heartbreaking because it's totally preventable."
Flu vaccine without mercury is available, but the government has said it's more expensive to manufacture and is thus less in demand. Parents can request it, but realistically, less than 10 percent of flu shots available in America are thimerosal-free, though the FluMist nasal spray -- which uses a live but deactivated virus that is adapted to live only in the colder temperatures of the nasal lining, not in the body -- contains no thimerosal.
Parents present at the forum, including Kelly Riggs of Halls, expressed concern over the county's plan to administer FluMist in public schools this year with parents' consent. Riggs said that even though she would not consent for her child to have FluMist, she was afraid her child could get the virus from another FluMist-vaccinated child.
There have been no documented cases of a FluMist-vaccinated person making another person sick with influenza.
(Except for on the package insert)
Flu jab death: inquest call
The husband of a Dundee woman who suffered a rare fatal reaction to a flu jab was meeting legal chiefs today to call for an inquiry into her death, writes Steven Bell.
Grandmother Sylvia Thomson (56) died in hospital late last year, and subsequent tests have concluded the cause was a routine vaccination at her GP’s practice.
Her husband Robert was due to meet officials from the Procurator Fiscal’s office in the city this afternoon to ask that a Fatal Accident Inquiry be held. “I would not want what happened to my wife to happen to anybody else,” said Robert today. “I feel that I need an inquiry to ascertain if the drug has been properly tested. “From what I have been told, a lot of these drugs are manufactured in China and India then brought into Britain through middle-men.
“I will be asking for an FAI, although whether I get it or not we’ll have to see. The letter I got from the fiscal’s office seems to be quite sympathetic.”
Officials have admitted that, although Mrs Thomson’s reaction to the injection was rare, it could happen to other people. Depute fiscal Arthur Wheelan said in a letter, “The cause of death is extremely unusual, but it is clear that other persons will be predisposed to this type of reaction from the flu jab.
“One consideration is how the conclusion regarding this type of death is put to best use with a view to saving lives in future.” Former PE teacher Sylvia only went to her GP for a flu vaccination in November “as a precaution”, as she was suffering with an intermittent chest infection.
Around a week later she was taken into hospital suffering from encephalitis, swelling in her brain. Her condition deteriorated and she died on December 2. “As soon as I took her up to the hospital they took her to the infectious diseases ward and started treating her for suspected encephalitis,” recalled oil worker Robert, who was married to Sylvia for 30 years.
Initially doctors were unsure of the cause of Sylvia’s illness, but after she died Mr Thomson insisted the post mortem focus on the flu vaccination. The Scottish Executive and Health Protection Scotland, which oversees the flu jab programme, have described adverse reactions to the seasonal vaccine as rare.