What's new ---- Thoughts on Flu Jab
It is very interesting that the "experts" can not agree on what is best as far as flu vaccines as aprotetive tool against the influenza...
Enjoy the article......But remember: Prevention is the name of the game and that is always healthy nutrition and active lifestyle.
PH
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BMJ
News
Belief not science is behind flu jab promotion, new
report says
BMJ 2012; 345 doi: (Published 19 November 2012)
Cite this as: BMJ 2012;345:e7856
Jeanne Lenzer
Author Affiliations
1 New York
An independent meta-analysis of vaccines against influenza has found that claims of
benefit have been significantly exaggerated.
The report, released last month by the University of Minnesota’s Center for Infectious
Disease Research and Policy, was based on a comprehensive review of data published
from 1967 to 2012.
1
Evidence for “consistent high-level protection is elusive,” the researchers concluded.
Although vaccination was found to provide modest protection from infection in young
healthy adults who rarely have complications of flu, the authors found that “evidence for
protection in adults 65 years of age and older [who represent over 90% of deaths from
flu] . . . is lacking.”
The authors also analyzed recommendations issued by the federal Advisory Committee
Belief not science is behind flu jab promotion, new report says | BMJ
1 of 4 12/15/2012 12:10 PM
on Immunization Practices, which provides expert advice to the US Centers for Disease
Control and Prevention and which are “often considered the standard of practice . . .
around the globe.” The report cited 30 instances in which its advisory statements “did not
apply current standards of scientific rigor . . . and did not cite relevant work.”
The report’s lead author, Michael Osterholm, a former CDC consultant and an
internationally recognized expert on flu, told the
BMJ that a Dutch study cited by the CDC
as evidence of vaccine efficacy was seriously flawed and constituted a “sales job.”
Nevertheless, Osterholm said, the current jab does offer some protection and should be
used until a more effective vaccine can be developed.
Joseph Bresee, chief of the epidemiology and prevention branch in CDC’s Influenza
Division, told the
BMJ, “I do not agree that CDC has inflated the benefits of influenza
vaccine.” He added that he agreed with Osterholm that until better vaccines were
available the current ones should be recommended.
That recommendation, however, has come under fire from the authors of a Cochrane
analysis that also found little to no benefit from flu vaccination.
2 Tom Jefferson, lead
author of several Cochrane reviews, told the
BMJ, “Based on more than a decade of
Cochrane reviews in adults, children, [the] elderly, and healthcare workers, there is no
credible evidence that the inactivated vaccines have any effect other than saving on
average half a working day in healthy adults and avoiding symptoms in those who least
need it: healthy adults and adolescents. Depending on the season, you need to
immunize 33 to 99 adults to avoid one set of symptoms.”
Osterholm criticized the methods of the Cochrane analysis, saying that the reviewers’
inclusion of studies that used serology titers rather than reverse transcription polymerase
chain reaction or cultures to diagnose flu meant that its results were highly inaccurate.
However, he acknowledged that the direction of bias caused by use of serology titers
would be to make a vaccine seem far more effective than it was, a surprising bias for a
meta-analysis that found no benefit for flu vaccines. The Cochrane reviewers also stated
in their meta-analysis that the studies reviewed were “at high risk of bias.”
A growing number of healthcare facilities and states now require healthcare workers to be
vaccinated against flu or face being fired or forced to wear masks and identification tags
stating that they may be infectious.
Belief not science is behind flu jab promotion, new report says | BMJ
2 of 4 12/15/2012 12:10 PM
A recent editorial in the journal of the Canadian Medical Association,
CMAJ,
recommending mandatory flu jabs for healthcare staff triggered strong criticism, including
a letter to the editor from Peter Doshi, a postdoctoral fellow at Johns Hopkins University,
and several Cochrane reviewers, who said that the recommendation was based on a
misrepresentation of Cochrane data.
3 4
Doshi opposes compulsory vaccination. He told the
BMJ that health officials “risk losing
credibility by continuing to promote the fiction that mandatory influenza vaccination
policies are based on solid evidence. They are not, and it is time for healthcare
institutions to do their own rigorous assessment of the evidence rather than continuing
this dangerous game of follow the leader.”
Osterholm agreed that scientific evidence, not professional opinions, should guide policy.
He told the
BMJ, “I don’t think the data warrant mandated vaccine. If it was up to me,
there are a hundred other things I’d mandate first, like mandating that sick healthcare
workers don’t come to work. That is far more likely to be effective.”
News: Bias alone could account for benefit attributed to flu vaccine, study
finds (2008;337:a1550, doi:
10.1136/bmj.a1550); Observations: A jab in the dark
(2012;345:e5313, doi:
10.1136/bmj.e5313)
References
1. Osterholm MT, Kelly NS, Manske JM, Ballering KS, Leighton TR, Moore KA. The
compelling need for game-changing influenza vaccines: an analysis of the influenza
vaccine enterprise and recommendations for the future. University of Minnesota Center
for Infectious Disease Research and Policy, Oct 2012.
/center/mission/articles/ccivi-landing.html
2. Thomas RE, Jefferson T, Demicheli V, Rivetti D. Influenza vaccination for healthcare
workers who work with the elderly. Cochrane Database Syst Rev2006;(3):CD005187.
3. Flegel K. Health care workers must protect patients from influenza by taking the annual
vaccine. CMAJ 29 Oct 2012. doi:
10.1503/cmaj.121679.
4. Doshi P, Abi-Jaoude E, Lexchin J, Jefferson T, Thomas RE. Inappropriate citation gives
misleading evidence. Reply to: Flegel K. Health care workers must protect patients from
influenza by taking the annual vaccine. CMAJ 29 Oct 2012.
/2012/10/29/cmaj.121679.citation/reply