Does the Influenza Vaccine Work?

From http://www2.cochrane.org/reviews/en/ab001269.html

Vaccines for preventing influenza in healthy adults

Jefferson T, Di Pietrantonj C, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E


Vaccines to prevent influenza in healthy adults

Over 200 viruses cause influenza and influenza-like illness which produce the same symptoms (fever, headache, aches and pains, cough and runny noses). Without laboratory tests, doctors cannot tell the two illnesses apart. Both last for days and rarely lead to death or serious illness. At best, vaccines might be effective against only influenza A and B, which represent about 10% of all circulating viruses. Each year, the World Health Organization recommends which viral strains should be included in vaccinations for the forthcoming season.

Authors of this review assessed all trials that compared vaccinated people with unvaccinated people. The combined results of these trials showed that under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid one set of influenza symptoms. In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms. Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations. Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited..

This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 12, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

This record should be cited as: Jefferson T, Di Pietrantonj C, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E. Vaccines for preventing influenza in healthy adults. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD001269. DOI: 10.1002/14651858.CD001269.pub4

Editorial Group: Acute Respiratory Infections Group

This version first published online: October 25. 1999...

Abstract
Background

Different types of influenza vaccines are currently produced worldwide. Healthy adults are presently targeted mainly in North America.
Objectives

Identify, retrieve and assess all studies evaluating the effects of vaccines against influenza in healthy adults.
Search strategy

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2010, issue 2), MEDLINE (January 1966 to June 2010) and EMBASE (1990 to June 2010).
Selection criteria

Randomised controlled trials (RCTs) or quasi-RCTs comparing influenza vaccines with placebo or no intervention in naturally-occurring influenza in healthy individuals aged 16 to 65 years. We also included comparative studies assessing serious and rare harms.
Data collection and analysis

Two review authors independently assessed trial quality and extracted data.
Main results

We included 50 reports. Forty (59 sub-studies) were clinical trials of over 70,000 people. Eight were comparative non-RCTs and assessed serious harms. Two were reports of harms which could not be introduced in the data analysis. In the relatively uncommon circumstance of vaccine matching the viral circulating strain and high circulation, 4% of unvaccinated people versus 1% of vaccinated people developed influenza symptoms (risk difference (RD) 3%, 95% confidence interval (CI) 2% to 5%). The corresponding figures for poor vaccine matching were 2% and 1% (RD 1, 95% CI 0% to 3%). These differences were not likely to be due to chance. Vaccination had a modest effect on time off work and had no effect on hospital admissions or complication rates. Inactivated vaccines caused local harms and an estimated 1.6 additional cases of Guillain-Barré Syndrome per million vaccinations. The harms evidence base is limited.
Authors' conclusions

Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.

WARNING:
This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding.



Yes, the flu vaccine makes billions of dollars for the manufacturers. But no, it has little effect on anyone's health. The few percent shown to be helped by the vaccine (and keep in mind that these results only occurred when the vaccine was perfectly matched to the current circulating virus, which is seldom the case) does not seem to justify vaccinating the entire population, which is the current goal of the medical industry.

I will ask this. When are doctors going to stop taking the word of pharmaceutical companies and demand a real, independent analysis before jumping on the vaccination bandwagon?

We haven't gotten our flu vaccines this year.  Time and again we are questioned by medical proffessionals if we've been immunized and the doctors and nurses are quite disappointed that we haven't.  They feel that we are jeapordizing lil A's well being by not getting the flu shot ourselves, and by not getting him the shot - because along with having thalassemia - he has also been suppressed with rituxan and steroids (in the recent past). 

Personally, I am afraid of the flu shot itself because of the response lil A, myself and other members in my family had to the flu shot itself last year.  We were all running high fevers and very sick for at a least a week following the flu shot.  I don't know what to think of the flu shot, and I don't think we have enough appropriate data to make that decision. 

Sharmin

Thanks Andy for sharing this information. Actually i stopped these vaccines more than 3 years ago and we are still doing very fine

manal

This year's flu vaccine is a mix of vaccines including the H1N1 vaccine, so if you already have reacted to this vaccine, keep that in mind when making a decision this year.

Thanks for the information Andy   Yes, considering the reaction we had last year - I am not enthusiastic about getting the shot this year.  My only worry is lil A's immune status.  Does that put us in a different category?

I have been immunized against the flu ONCE in my entire life and it was against some Asian-specific strain because I was going to be traveling overseas.  I was in my early teens at the time.  I ended up getting a mild flu because of the vaccine.  Awesome.

I have actually caught the flu ONCE in my entire life (earlier experience aside) and that was because my kid sibling had caught it first.  I was in my mid twenties.

Yes, the flu was AWFUL and it took me well over a month to get rid of it completely if not longer.

But I've only ever caught the flu once and I seem to catch everything BUT the flu.

For a whole host of reasons, I refuse to vaccinate.

Hi Sharmin,

This is a difficult decision. I am well aware that the official stance from the thal doctors is always to have the flu shot. They believe in it, although I do wonder how much of this is based in real experience and how much of the view of doctors is colored by the big pharma companies who supply the studies. I was very troubled by the findings of this report that this vaccine had zero effect on complication rates, as my own doctor has told me I need the vaccine because I have asthma and a history of pneumonia. If the vaccine does not reduce this risk, I don't know why I should take the vaccine.

I would say ask your doctor about the findings of this study before agreeing to the vaccine.

Thanks Andy, I will do that .