233. Time for the ‘Flu Jab?

I have just had a letter from my GP, which informs me that:

“Flu vaccination provides the best protection against an unpredictable virus, which infects many people and may cause serious illness and deaths each year.”

The NHS Choices website tells us that:

Flu vaccination is available every year on the NHS to help protect adults and children at risk of flu and its complications.
Flu can be unpleasant, but if you are otherwise healthy it will usually clear up on its own within a week.
It can be severe in those over 65, pregnant women, children and adults with poor health (such as heart or respiratory disease) and a weakened immune systems.

Anyone in these risk groups is more likely to develop potentially serious complications of flu, such as pneumonia (a lung infection), so it’s recommended that they have a flu vaccine every year to protect them (1).

A recent leaflet from Public Health England says that:

“But the best way to avoid catching and spreading flu is by having the vaccination before the flu season starts.

Flu is unpredictable. It is not possible to predict fully the strains that will circulate each year, and there is always a risk of a change in the virus. However, this does not happen very often. During the last ten years the vaccine has generally been a good match for the circulating strains.

The vaccine still provides the best protection available against an unpredictable virus that can cause severe illness.”(2).

The most recent UK Government ‘Flu Plan states that:

“The national flu immunisation programme is a key part of the plan. We are aware that concern has been expressed in the past about the lack of effectiveness of the flu vaccine. Provisional data show that in 2015/16 the vaccine was well matched to the circulating strains. Throughout the last decade, there has generally been a good match between the strains of flu in the vaccine and those that subsequently circulated. Flu vaccination remains the best way to protect people from flu.” (3).

It goes on to comment on the effectiveness of the vaccination programme:

“In recent years, we have typically seen around 50% (ranging from 25 to 70%) effectiveness for the flu vaccine in the UK, with generally a good match between the strains of flu in the vaccine and those that subsequently circulate. While it is not possible to fully predict the strains that will circulate in any given season, flu vaccination remains the best protection we have against an unpredictable virus which can cause severe illness and deaths each year, particularly among at-risk groups.”

It is clear that there is a huge effort to persuade people to be vaccinated and that it is well worth taking up the offer. The underlying assumption is that it will be beneficial and that it represents value for money on the part of the state.

What is the evidence?

In this blog I will dig into the background to see if the use of the vaccine is justified. This subject has been evaluated in a Cochrane review (4) by a team which includes Tom Jefferson, who played a key role in the Tamiflu investigation (5). The Tamiflu study was notable for the efforts made by the investigation team to extract information from the manufacturers that revealed doubts about the NICE evaluation because it did not have access to results of all the trials, which had been done. Once the full picture emerged it was evident that the government strategy could not be justified.

One of the major difficulties in devising a strategy for flu vaccination is that the virus is continually changing. This means that it has to be accepted it is impossible to produce a vaccine which will be effective against all the different strains that exist at any given time. The Cochrane review examined all the available evidence up to 2013.

There are over 200 viruses which cause flu and Influenza-like Illnesses (ILI). Laboratory tests are needed to distinguish between the two, which last for a few days and rarely cause death or serious illness. Vaccines are prepared which may be effective against influenza A and B. At best, vaccines may only be effective against influenza A and B, which represent about 10% of all circulating viruses.

There are two types of vaccine:

An inactivated one, which has been treated with a chemical to “kill” I, and is normally administered by into the muscle;
A live attenuated vaccine prepared by growing the viruses in a cell culture or animal embryo. These vaccines are treated so that they cannot replicate in the human body but can boost the immune system. These are usually administered as an aerosol into the nostrils.

Based on the results of 116 studies, it was found that for the inactivated vaccine:

At least 40 people would need vaccination to avoid one ILI case;
71 people would need vaccination to prevent one case of influenza;
Vaccination shows no appreciable effect on working days lost or hospitalisation.

For the live aerosol vaccine, the results were similar: 46 people would need to be treated to avoid one ILI case.

There was also concern about the quality of the data, which was available. Only 10% was judged to be of “good methodological quality”, whereas 20% had a high risk of bias. For the remaining 70%, the impact of bias could not be determined.

What do we know about adverse side effects?

This study could find no evidence of undesirable side effects but there is no doubt that some people may be affected. Data from the USA confirms that a small number of those treated with the flu vaccine have developed Guillain-Barre Syndrome, which can cause permanent disability including paralysis. This has been accepted by the authorities because compensation has been paid out.

Conclusion

All the indications are that the benefits of the flu vaccine have been hyped up while the side effects have been disregarded. This is just another example of government kow-towing to the pharmaceutical industry. There is little or no improvement in public health and some people may suffer serious damage. On top of all this, valuable resources are being wasted, which could more usefully be spent in other ways.

Needless to say, I will not be having the vaccine. There are many other ways of boosting my immune system such as exercise, plenty of Vitamin D and a diet low in sugar and refined carbohydrates.

References

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