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: http://dx.doi.org/10.1136/bmj.e7856 (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 http://www.bmj.com/content/345/bmj.e7856

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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.

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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.

www.cidrap.umn.edu/cidrap

/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.

www.cmaj.ca/content/early

/2012/10/29/cmaj.121679.citation/reply