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Going against the establishment on flu vaccines

The influenza vaccine has been a scientific, medical, and epidemiological sacred cow for a while now. Every respectable person in any of these fields will tell you that it is the best way to prevent influenza each and every year. I agree. However, I agree because it is the best we have while knowing that it is not the best we could have.

A report written last year by the Center for Infectious Disease Research and Policy (CIDRAP) came to several conclusions about the influenza vaccines that we use today:

“Among the findings was the observation that the injected and the nasal spray influenza vaccines provide different levels of protection based on age. For the injected influenza vaccine, the group found “1) evidence of moderate protection (pooled estimate of 59%) for healthy adults 18 to 64 years of age, (2) inconsistent evidence of protection in children age 2 to 17 years, and (3) a paucity of evidence for protection in adults 65 years of age and older.” With regard to the nasal spray influenza vaccine, the group found “(1) evidence of high protection (pooled estimate of 83%) for young children 6 months to 7 years of age, (2) inconsistent evidence of protection in adults 60 years of age and older, and (3) a lack of evidence for protection in individuals between 8 and 59 years of age.” Another finding was that the perception of the vaccine’s efficacy (the reduction in the number of cases of the disease) has kept new influenza vaccines from being developed.”

(Confession: I wrote that article on “History of Vaccines.”)

As you can see, based on some very good evidence compiled by a bunch of very good researchers, the flu vaccine is good, but it’s not as good as it can be. It certainly is not bad, deadly, or useless, like many anti-vaccine people and groups would have you believe. But even saying that the vaccine wasn’t good enough raised some eyebrows among my colleagues in the world of public health. The sacred cow was being “attacked,” except that it wasn’t. What the report and those of us who agree with it are saying is that we need to stop being complacent about the sacred cow and demand better from it.

The technology that we use to make the vaccine is antiquated. Chicken eggs? Really? Yes, there are new flu vaccine technologies coming online, but they’re not happening as fast as they could.

There is nothing wrong with saying that we can improve on something that works. What is wrong is to be happy with the status quo.

I’m never happy with the status quo, and neither should my colleagues. If we can do better, we must.

Featured image photo credit: Sanofi Pasteur / Foter.com / CC BY-NC-ND

13 Comments

  1. Yes, please. A better flu vaccine – and pertussis vaccine – would be very nice.

  2. I cannot agree more! 59% can and should be improved upon.
    My eldest daughter, a Registered Nurse, came down with influenza this year. Her immunization didn’t protect her.
    Fortunately, it protected both of her young children and her husband.

    But, at the current failure to provide protective immunity rate, it still beats no attempt to protect! Something she and I also agree fully on.
    Of course, you were thinking of chicken eggs for vaccine manufacture, earlier today I was pondering:
    We can put a man into space and have him live there for an entire year and safely return him home.
    We have aircraft that can circumnavigate the globe without refueling.
    We have repeatedly put men on the moon and safely returned them.
    But, our best dialysis is around 12% as effective as a kidney and causes its own litany of issues.
    We can do better! On all human health matters.
    But, that takes time, having scientists available and funding for their research.

  3. Today I learned there is a new “hero” in the anti-vaccine camps, Peter Doshi. He article, http://www.bmj.com/content/346/bmj.f3037, is now being promoted as a reason to not get the flu vaccine. You might run into him at Johns Hopkins (by the way, his background is in history).

    By the way, I have not had a serious “flu like” illness in the last five years, and I figure it is because I get the vaccine.

    • I had several back and forth emails with Dr. Doshi. He’s not an epidemiologist, and his way of arriving at some conclusions is suspect. Why he is being called a “top researcher” is beyond me. Then again, they call Andrew Wakefield a “doctor.”

  4. The article by Peter Doshi is rather disingenuous, to put it mildly.
    Cherry picked data, comparing percentage groups of samples without noting the increased number of samples analyzed, ignoring the fact that antibiotics caused the lower influenza death toll (largely in the elderly) and the growing problem of multiple antibiotic organisms.
    Truly telling is this question he asks, “Could influenza—a disease known for centuries, well defined in terms of its etiology, diagnosis, and prognosis—be yet one more case of disease mongering?”
    He thinks it is, ignoring the hell of the Spanish Influenza pandemic and its phenomenal toll in lives lost.

    Missed my influenza immunization this year. Ended up getting an annoying B strain from my grandson, after he was nice enough to cough into my mouth while I was feeding him. :/
    But, my father got his immunization and he failed to become ill.
    A good thing, as he’s thoroughly deconditioned, due to a long hospital stay for pneumonia that was secondary to kidney failure.

    • I get the sense from Dr. Doshi that he started his research not with a theory but with a conclusion, and then he worked his way backwards from there. The more I read his stuff, the more I scratch my head on how he came to those conclusions. Anyway, I stopped corresponding with him via email because I can see it ending badly, with one of us offended. Maybe I’ll run into him at Hopkins. Maybe I won’t. All I know is that plenty of qualified people (most of them epidemiologists) have responded to his writings.

      Then again, I might be inclined to take one of his papers and deconstruct it just for fun and frolic.

  5. Well, in Wakefield’s favor, he *was* a physician.
    Unfortunately for him, he has some extremely serious ethics problems that resulted in his losing his medical license.
    So, now he sells bovine fertilizer and snake oil.

    • He has no favors with me. He burned every last bridge to redemption with his continued stupidity. I wonder how his court hearing went today?

        • I’m sorry, but he does not lack standing. For standing there are three requirements: injury, causation and remedy. Wakefield has an alleged injury; the infringement caused it; and the court can offer a remedy (money damages). Standing is not the problem. The court may not have jurisdiction, or the case may fail on the merits, but there is no standing problem here.

          • My error. Misread it a bit, confusing two different things I was reading while trying to fix a badly confused update server here.

          • NP, when I make an error, I appreciate the correction. :)
            As an information security type, I rely on the legal types to keep operations away from legal problems.

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