The Flu Shot, why I don't take it, and why I don't think anyone else should.

I've never gotten a flu shot.

It just seems contra-indicated that for something so basic, as long as you are a healthy individual, there really is no reason to get one. This includes the "Great Pandemic" year caused by H1N1, or the Swine Flu. HERE is the data list from the CDC "Estimates of Deaths Associated with Seasonal Influenza - 1976-2007"

Full disclosure-- I am not a medical specialist, this is not medical advice. I am very much for vaccinations.

First, to knock the "Pandemic" year off of its perch--

According to the data linked to above, here are the major numbers with regards to total deaths attributed to flu across all age groups [USA totals]--

Average -       6903
Minimum -       961
Maximum - 14,715

In the year of the Swine Flu Pandemic, there were 3,433 (Not included in the above study, but the data is from here, which has a nice summary state by state.)

3,433

That's it. That's not even pushing the average.

So those are confirmed cases. Even going hog wild and saying they are off by a factor of 2, that puts us right at the average. Doubling that doesn't even get us to the Maximum number year in the study period (2003-2004 season, which is associated primarily with the H3N2 strain. Actually, taking a fast mental snapshot of the data, that strain is generally associated with the highest total deaths per year. Hm.)

So, call me a pessimist.

I am a regular reader of Chris Kresser's blog www.Chriskresser.com. It used to be titled "The Healthy Skeptic," so you can see I would fit right in.

Here is his transcript from his podcast on the flu shot. I'll break down the interesting parts here.

The money paragraph is his adding up all the pieces towards the end--- I'll just quote him.

"So, let’s summarize everything that we’ve covered so far.  Number one, in general, flu vaccines are not effective for adults.  You have to treat between 33 people when the vaccine and infecting strain are well matched, which is rare, and 100 people when they’re not well matched, which is much more common, to prevent a single case of flu.  Nor have vaccines been shown to prevent complications or transmissions.  Vaccines have not been shown to be more effective than placebo in kids under 2 years old and may have significant risks that are not yet well understood.  As for the elderly, the most recent Cochrane review suggested that there’s no evidence vaccines are effective, and randomized clinical trials are needed to clarify the issue.  So, almost all of the evidence in the case of the elderly is epidemiological in nature, which as we know, is not sufficient to prove the safety or efficacy of a drug.  The FDA could never come out in public and say — You know, imagine for a drug like an antidepressant or something for heart disease that they would just take two groups of people and give one group the drug — or just let the drug out in the general population and then 10 years later do a study and see, did the people who took the drugs fare any better than the people that didn’t?  That’s not how drug approval works.  That would be a disaster for all the reasons that we already said.  And yet that’s exactly what’s happening in the case of flu vaccine and the elderly."

Here we have an nice study published in 2012 on Vaccines for Preventing Influenza in Healthy Children. I've read through the study, and if you want a real 'barn burner' of a study (Guaranteed to Put you to Sleep in 15 minutes of Your Money Back!!)

They included data from 75 studies covering about 300,000 observations. They included studies funded by industry (They have drug company $$ pushing the results,) and independent studies also. Here is some of what they find (My running commentary is in brackets such as this - [comment,] and the things I consider important are in bold. )---

"Evidence from RCTs shows that six children under the age of six need to be vaccinated with live attenuated vaccine to prevent one case of influenza (infection and symptoms).

We could find no usable data for those aged two years or younger. [This was in the drug company controlled studies.]

Inactivated vaccines in children aged two years or younger are not significantly more efficacious than placebo. [Doctors, Pediatricians, are pushing for vaccinations for children under 2 and as low as 6 months... but there is zero evidence that it has any effectiveness. WTF, docs?!?!?]

Twenty-eight children over the age of six need to be vaccinated to prevent one case of influenza (infection and symptoms). [28 need to be vaccinated to prevent a single case. This is when the vaccine matches up perfectly with the virus, which is exceptionally rare. Statistically speaking, it is closer to 100 need to be vaccinated to prevent a single case. Remember, these studies (showing 28-1) are on a specific known virus... after all, they are injecting the virus into the test subjects to begin with.]

Eight need to be vaccinated to prevent one case of influenza-like-illness (ILI).

We could find no evidence of effect on secondary cases, lower respiratory tract disease, drug prescriptions, otitis media [Ear aches/infection]and its consequences and socioeconomic impact.

Extensive evidence of reporting bias of safety outcomes from trials of live attenuated influenza vaccines (LAIVs) impeded meaningful analysis. [The people/groups/financiers running the studies monkeyed around with the results.] One specific brand of monovalent pandemic vaccine is associated with cataplexy and narcolepsy in children and there is sparse evidence of serious harms (such as febrile convulsions) in specific situations. [In addition to no serious benefit over placebo, they can hurt your kids. Awesome.]"

 Here is a bit from the conclusion--

"If immunization in children is to be recommended as a public health policy, large-scale studies assessing important outcomes, and directly comparing vaccine types are urgently required."

Basically, if we are going to recommend immunization in children in general, more large-scale studies are needed to see if it is worth the outcome, given the cost and possible side effects.

But they are already recommending immunization for everyone over the age of 6 months. Yet, there is little (seriously little) to no evidence that immunization will prevent the flu in anyone.

I heard a Pediatrician from University of Chicago recommending (AM Radio, on my drive to work,) that all children 6 months or over through all adults thru all elderly should get vaccinated.

Show me a non-industry funded study that recommends that, honestly.

What is amazing, is those above results include studies funded by industry... and... even though they tended to have by far the most reporting bias, those were the studies most cited in the public realm.

No, I do not think it is an attempt by the Star Chamber to take over our lives. I know that 99% of the docs out there, especially the pediatricians, are doing their best, and using their best talent, to help our children stay healthy, and heal them when they are not.

But they don't have time to actually read all of the studies that are out there. I flew with a youngish FO who had been a pharmaceutical sales rep. He had told me that when they went into the doctor's offices, or from office to office, they had the studies proving what they were trying to push the doctors on ready to go. He had no idea what was even really in the studies, just that they backed up whatever it was he was supposed to convince the doctors to use. All those studies, of course, are generally funded and run by the pharmaceutical company, and in a number of cases (like in the study I cited above,) they are known to monkey (fuck around with) the results. It is hardly the doctors fault that they are pressed for time in the office... they have patients to see, paperwork to fill out, everything that is involved in their doctoring.

We need to be able to make informed decisions about the health of our children as well as ourselves.
I am a big believer in simply asking a doctor (or anyone else, for that matter,) for proof.

What studies are cited that show this is an effective course of action in this case? What are the complications, and what circumstances appear to drive those complications? Are there alternative courses of treatment available that have proven to work with fewer complications? 

I'll leave with this quote from Chris--

"As always, you have to make your choice.  But it’s important that you have the right evidence before you do make a choice.  And unfortunately, I just don’t think that that’s happening.  I think a lot of the people have the wrong impression about what the evidence actually says about the efficacy of the flu shot."

Stay healthy, my friends....

Scott