Flu vaccines fail the eldery
Weekly Health Bulletins
Friday, April 2nd, 2010
What's Wrong with This Picture? Flu vaccination for all adults endorsed for 2010-2011 season yet . . . data is sparse on value of flu vaccines for elderly
Everyone aged 6 and older should get a flu vaccine starting with the 2010-2011 season, according to the Advisory Committee on Immunization Practices of the Center for Disease Control and Prevention. Medical organizations seem pleased because the recommendation will simplify the process for busy doctors.
Yet . . .
STUDIES SHOW NO BENEFIT A comprehensive review of flu vaccine studies recently conducted concluded that data are too "flawed, dated or limited" to show any effectiveness in preventing either influenza or pneumonia in health facilities for the elderly.
A BIG WASTE OF MONEY? Two large reviews looked at 75 studies over 100 flu seasons. According to epidemeologist and lead author Dr. Tom Jefferson, "Can we draw a conclusion? No, we can't. Yet all this money is being spent. It's a very costly form of hopefulness."
DRUG COMPANY SPIN Furthermore, according to Dr. Jefferson, "the vast majority of these studies are of poor quality, associated with optimistic conclusions not supported in the actual data." He believes the optimism may be due to the sponsors of the studies. In a recent British Medical Journal article (BMJ 2009, 338), Dr. Jefferson analyzed 274 studies and found "evidence of widespread manipulation of conclusions." Not surprisingly, studies sponsored by vaccine manufacturers tended to present more positive findings compared to studies sponsored by public health agencies.
That's not all. Industry sponsored studies enjoyed better placement in prestigious first line medical journals, compared to studies with public funding.
Because of concern that vaccines may be less effective in the elderly, there has been an emphasis on vaccinating health care workers in order to prevent spreading flu to elderly patients.
MINIMAL BENEFIT IN HEALTH CARE WORKERS Although four randomized controlled trials looking at vaccinating health care workers reportedly showed it reduced influenza-like illness and resident [elderly patient] all-cause mortality", Dr Jefferson states "There was no effect on the outcomes of direct interest, namely laboratory proven influenza, lower respiratory tract infections, admissions to hospitals and deaths from pneumonia."
Dr. Jefferson calls for more large, multiseason, publicly funded, randomized controlled trials to ascertain the real value of flu vaccines in the elderly. The studies he has conducted "highlight serious problems with the current evidence base."
Dr. Jefferson in fact disclosed owning shares in GlaxoSmithKline and receiving consultancy fees from Sanofi Synthelabo and Roche, evidence that some researchers such as Dr Jefferson are able to remain objective in the face of potential conflicts of interest.
DISHONESTY PREVAILS Designing reliable studies that accurately evalute large-scale public health measures such as flu vaccination is challenging. It is expensive, cumbersome and time consuming. It is not surprising that many studies on this important subject have come up empty-handed. What is troubling is the fundamental dishonesty of the public health authorities who push these vaccines while they fail to acknowledge the flawed evidence base.
A COMMON DECEPTION I propose to you that this happens routinely in medicine. The virtues of "scientific medicine" are trumpeted when in fact most medical practices are not supported by solid scientific evidence -- less than 20% according to some estimates.
Neither the general public nor the media have the ability to accurately analyze such claims, frequently touted by so-called "thought leader" experts and self-appointed committees of various sorts sullied by Big Pharma payola. Unfortunately, many doctors also lack the skills to analyze the data.
Dr. Jefferson's excellent work highlights a common, basic flaw in our health care system, which the current health care reform bill is unable to address.
Derived from Internal Medicine News March 15, 2010
April 2nd, 2010 at 5:33 pm
I once told a doctor, "You are a doctor of medicine, and I am a doctor of philosophy, and as a fellow doctor, I have to tell you, you have a very sick philosophy that urgently needs professional care.
All doctors should be required to take 2 years to investigate some phenomenon that has no connection at all to a human issue,
and do basic research. The great power of basic research is that it makes you realize that most the time you're wrong and that there is no causal relationship between conviction, faith, knowing, etc., and truth.