Pamela A. Popper, Ph.D., N.D.

Wellness Forum Health

It’s still flu season, and the drug companies, the medical profession, and major retailers like Kroger and Wal Mart are still aggressively promoting flu vaccines. The current recommendations from the Advisory Committee on Immunization Practices and the American Academy of Pediatrics are for all healthy individuals 6 months of age or older to get a flu vaccine. Medscape recently posted an article written by two pediatricians who present an alternative and refreshing view of the value of the flu vaccine.[1] Eric Biondi, M.D. and Andrew Aligne, M.D. are both associate professors of pediatrics with the University of Rochester Medical School.

The article included a quote from Tom Jefferson, head of the Vaccine Field Group at the Cochrane Collaboration, who said in an interview “The vast majority of the studies [are] deeply flawed. Rubbish is not a scientific term, but I think it’s the term that applies.”[2]

The authors also included data from Cochrane reviews, including one from 2012 that reported “…industry-funded studies were published in more prestigious journals and cited more than other studies, independent of methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to [influenza] vaccines… reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies.”[3] A 2014 Cochrane review of the effect of flu vaccines on healthy adults including pregnant women concluded, “[Influenza] vaccination shows no appreciable effect on working days lost or hospitalization.”[4]

The authors state that several factors have contributed to the insistence that everyone receive a flu vaccine, including the high death rate from the 1918-1919 flu pandemic, which resulted in almost 50 million deaths; and the Asian flu epidemic in 1957, which caused between 1 and 2 million deaths. Attempts to develop effective flu vaccines were largely unsuccessful but released for use in the general population anyway. Instead of admitting that the vaccines don’t work, vaccine advocates claimed that the failure of the vaccine program was due to less-than-optimal efforts to vaccinate the public. As a result, by the 1960’s national health authorities started recommending flu vaccines for everyone even though there was little evidence to support the practice.

In 1964 the Centers for Disease Control looked at efficacy rates for the flu vaccine, concluding that it was virtually useless and questioning whether or not costs for continuing immunization programs could be justified. Nothing changed. A randomized, double-blind trial performed by the CDC in 1968 confirmed that the vaccine was useless. Nothing changed.

In 1976, fear of an epidemic of swine flu resulted in a large campaign to immunize as many Americans as possible. There was no flu epidemic, but the vaccine did lead to an epidemic of Guillain Barre Syndrome in vaccinated people.  Finally the program was cancelled.

In 1995, the FDA admitted that there were serious methodological flaws in studies showing that the vaccine was beneficial, and in 2000 the CDC reported the results of another placebo-controlled trial which showed that the vaccine was useless most years.

Ignoring this information, the American Academy of Pediatrics recommended annual flu vaccines for young children and mandatory vaccines for healthcare providers, which was the first step in expanding flu vaccine recommendations, which have become broader and more aggressive each year.

The body of evidence showing the flu vaccine is useless continues to grow.  A 2005 analysis showed that even when during pandemics, the flu vaccine was useless.[5] In 2012 a research group reported that the original “recommendation to vaccinate the elderly was made without data for vaccine efficacy or effectiveness.”[6]

Many studies show that there is no benefit in terms of outcomes, but they are still used to promote flu vaccines because of the vaccine’s ability to generate an antibody response, which is represented as evidence of benefit. Even the definition of flu is skewed in some studies, with reduction in symptoms indicative of colds used as a benchmark instead of complications or deaths from flu.  Studies consistently fail to control for self-selection bias – that people who choose to get a flu shot often make many other health-promoting choices too. Fewer complications or deaths in this group may have nothing to do with the flu vaccine.

The authors say that after decades of use, they cannot find any evidence that flu vaccines have had a positive impact on public health. While these docs continue to support childhood vaccinations, they question the investment in promoting flu vaccines when the money could be invested in other activities that would improve public health.

[1] Eric A. Biondi, MD, MS; C. Andrew Aligne, MD, MPH “Flu Vaccine for All: A Critical Look at the Evidence.” Medscape December 21, 2015

[2] Brownlee S, Lenzer J. Does the vaccine matter? The Atlantic. November 2009. http://www.theatlantic.com/doc/200911/brownlee-h1n1

[3] Jefferson T, Rivetti A, Di Pietrantonj C, Demicheli V, Ferroni E. “Vaccines for preventing influenza in healthy children.” Cochrane Database Syst Rev. 2012;8:CD004879. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004879.pub4/abstract

[4] Jefferson T, Di Pietrantonj C, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E. “Vaccines to prevent influenza in healthy adults”. Cochrane Database Syst Rev. 2014;3:CD001269. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001269.pub5/abstract;jsessionid=96780A7CC76A9AF58372894444AE3F04.f02t03

[5] Simonsen L, Reichert TA, Viboud C, et al. “Impact of influenza vaccination of seasonal mortality in the U.S. elderly population.” Arch Intern Med. 2005;165:265-272

[6] Osterholm MT, Kelley NS, Sommer A, Belongia EA. “Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis.” Lancet Infect Dis. 2012;12:36-44