The Flu Vaccine Works

Duke University Medical Center released a study a couple of weeks ago that showed 91% of patients who are in the intensive care unit (ICU) with influenza this season did not have a seasonal flu vaccine. Another 67% of those admitted to the hospital with less severe cases of the flu also weren't vaccinated. The bottom line is, the flu vaccine works.

The study examined only 55 patients who were admitted to the Duke Medical Center between November of 2013 and January of 2014. But, the cases were well documented. 47% of patients were Caucasian, 42% were African-American and 6% were Hispanic. 49% of patients were in the 18-49 age range, with the median age at 28.5. 33% of the patients were ages 50 to 64.

Duke's numbers are consistent with the national trend this year, that the flu is affecting young or middle aged adults more than infants, toddlers and seniors, who are always at high risk. Patients who were vaccinated but still had the flu had disorders that rendered them immunocompromised, therefore causing the vaccine ineffective.

Cameron R. Wolfe, M.D. was co-author of the study and stated: "Even if you get influenza, the vaccine reduces the likelihood of truly serious disease. These people on the intensive care unit are very sick. If you end up there, you're going to be battling a month or more of hospitalization." Five of the 22 ICU patients had died by the time the study was published.

It's not too late to get a flu vaccine. The FluView shows the states that are still having high flu activity levels. The vaccine generally takes 10-14 days to become effective. Vaccine Watch encourages people with questions and concerns to consult their physician about the flu vaccine options available.

Pediatrician & Mother Talks About Flu Vaccine

This was originally posted on The Mom's Guide to San Diego and was written by Dr. Jaime Friedman.

As a local pediatrician, and part of the medical group that partners with the Mom’s Guide to San Diego, I felt it was very important to respond to a recent thread of posts on the Mom’s Guide Facebook page regarding flu vaccines. The media often highlights extreme medical cases for the sake of the “story”, sometimes without providing thorough information on the topic for the viewer to come to their own educated conclusion.

Every year many thousands of people become ill with influenza.  Of those, hundreds to thousands die.  Unfortunately, while the very old, very young and chronically ill are most severely affected, many who die of influenza are perfectly healthy.  Influenza should not be confused with the common cold or a viral illness causing vomiting and diarrhea.  It is more severe, causing sudden onset of high fever, body aches and fatigue.  Many people also experience a cough, headache, sore throat, or diarrhea. The illness is very uncomfortable and can result in pneumonia, bronchitis or sinusitis.  It also can exacerbate chronic illnesses including asthma.  Most people are sick for 1-2 weeks.

The best ways to prevent the flu are good hand washing and vaccination.  The vaccine was first introduced in the 1940s for the military.  Since then it has repeatedly been perfected and proven to be safe and effective.  In fact, each year the vaccine is altered to keep up with the mutating virus.  The vaccine works by introducing proteins from the surface of the virus into the body so that the individual can make their own antibodies to the virus.  The injected vaccine is NOT a live virus and one cannot get the flu from the vaccine.  Because the vaccine is given during respiratory virus season many people develop other illnesses around the same time as vaccination and mistake that illness for “getting the flu from the shot”.  Also, it takes 2 weeks for the vaccine to be effective so exposure to the virus around the time of vaccination can still result in illness.  Some common side effects include soreness at injection site, feeling achy and low grade fever for 1-2 days.  These symptoms are far less severe than actually having an influenza infection.  There is also a live attenuated vaccine available that is sprayed into the nose. While this is a live virus it is weakened so that it does not cause infection.  However, side effects may be more prominent than injection, including runny nose, headache and wheezing.  It should not be given to people with a history of asthma.  

While serious reactions, such as allergy or anaphylaxis, are rare they do occur.  Do not get the vaccine if you have had a reaction in the past or if you have a severe allergic reaction to eggs.  Signs of a severe reaction include hives, paleness, dizziness, difficulty breathing and racing heart rate.  The number of severe reactions to the vaccine is far less than the number of severe infections that occur every year.  

Here at Children’s Physicians Medical Group we believe that vaccination is safe and the best way to prevent infection.  Our doctors offer the vaccine to children 6 months and up.  For more information, and to determine which type of flu vaccine is best for your child, please contact your pediatrician or go to the CDC website www.flu.gov.  

Pregnant Nurse Fired for Refusing Flu Vaccine

Photo: Miller, Los Angeles

Horizon Healthcare Service in Lancaster, Pennsylvania has fired a pregnant nurse who received a company mandated flu vaccine. Dreonna Breton was three months pregnant when she refused the vaccine, and after suffering two miscarriages in the past, did not want to take any chances with her pregnancy.

The company requires all workers to be vaccinated to protect patients and other employees from catching the flu. Horizon Healthcare Services stated: “Like our requirements for TB skin testing and MMR (measles, mumps and rubella) vaccination as a condition of employment, mandatory flu immunization protects our patients, employees, and community from getting this potentially serious infection.”

“Not only does the flu shot offer some protection to the pregnant woman, but there is a bonus – the pregnant woman can pass some of that prevention into her newborn baby,” notes William Schafner, an infectious disease doctor at Vanderbilt University.

The American College of Obstetricians and Gynecologists also advises all pregnant women be vaccinated against the flu, calling it an essential element of prenatal care. There have been no adverse consequences of flu vaccine in pregnant women or their offspring.

Reports on flu outbreaks from the Centers for Disease Control and Prevention (CDC) for the week of December 21, 2013 say the flu is now widespread in Alabama, Alaska, Kansas, Louisiana, Massachusetts, New York, Pennsylvania, Texas, Virginia and Wyoming.

Flu activity is also picking up in Tennessee, the CDC report notes. They further state that 1,156 flu-associated hospitalizations have been confirmed since October 1^st, but that many hospitalizations could be prevented by vaccination.

“Nationwide, seasonal flu causes an average of 250,000 hospitalizations and up to 36,000-49,000 deaths in a severe influenza season. Typically, flu season increases in January and peaks in February or early March,” states Anne Roche, a spokeswoman for the Massachusetts Department of Public Health.

Flu Shots for Everyone

Last year, four influenza vaccines were available to the public. But as technology expands – so do the options and six different flu vaccines will be available this season. “Instead of a one-size fits all approach, we are moving to vaccines…for individual patients,” states Dr. Greg Poland, director of the Mayo Clinic Vaccine Research Group.  “The flip side of that,” he continues, “is that this will be a confusing year.” Doctors and patients may have questions about which vaccine is best for them.

The six vaccines available include: an egg-free shot, a micro-needle shot, a nasal spray, a high-dosage shot, and two forms of the standard shot. The egg-free shot is for those with egg allergies, the micro-needle shot is for people afraid of needles – it is less painful and only penetrates the skin. The nasal spray is for toddlers and children, while the high-dosage shot is for senior citizens. The standard shot comes in a three-strain version and a four-strain version. The four-strain version can cost up to 30% more than the three-strain version.

Statistics report that up to 20% of the U.S. population gets sick with the flu every year. By creating new shots that reach more people, medical professionals hope to get more than the usual 40% of the population immunized this year. Dr. Michael Shaw of the Centers for Disease Control and Prevention (CDC) says that in a few years, all of the vaccines will offer the four-strain protection at a standard price, and concludes that more vaccine options will lead to fewer flu cases. Fewer flu cases can save both lives and health care costs.

CDC states that approximately 24,000 people die from the flu each year and recommend the vaccine for nearly everyone 6 months and older. An estimated 139 million does of flu vaccine will be produced this year, with 30 million of those being the four-strain flu virus. The CDC estimates that as many as 485 deaths will be prevented by the four-strain vaccine.

In an effort to encourage vaccination, medical professionals across the country are getting creative. For instance, Vanderbilt University hosted its third annual Flulapalooza on September 25^th. The event lasts for twelve hours and offers free flu vaccines to faculty, staff and students.

Most health insurance programs and Medicare cover flu shots and some plans don’t require a co-pay. This simple preventative measure can save you from battling a nasty case of the flu or ending up in the hospital. Vaccine Watch encourages everyone to consult his or her physician about getting a flu shot this fall.

Flu Vaccine Debate Continues

The anti-vaccine movement has been around as long as vaccines. While most people associate the anti-vaccine movement with the linking of vaccines to autism, this wasn’t the first protest of vaccines.

In the 1800s, countries began mandating smallpox vaccines for children. While many rushed to vaccinate their children, substantial numbers of people also refused to be vaccinated.  After a huge protest in Leicester, England in 1885 the Vaccination Act of 1898 gave parents the choice to conscientiously object to vaccines.

Evidence shows that vaccine laws increase the number of people that are vaccinated and decreases the rate of disease. After the measles outbreak in Wales, more people are arguing for mandatory vaccination. Others argue that in countries where vaccination rates are relatively high, educating and gently persuading parents to vaccinate their children may be a better approach.

Researchers from the UC Davis Health System, the Monroe County New York Department of Public Health, the University of Rochester Medical Center and the Centers for Disease Control and Prevention (CDC) found that elementary schools offering flu vaccination programs can increase the vaccination rate.

A 13.2 percent increase in vaccination rates was found in children who had access to school-located vaccination clinics.  Byung-Kwang Yoo of UC Davis was lead author of the study and noted, “Primary care practices may not have the capacity to vaccinate all U.S. children against seasonal influenza. If the CDC’s recommendations were followed, primary care offices would have to accommodate 42 million more patient visits during the five-month window for each flu season. Our goal is to find ways to ensure that the best prevention is as accessible as possible.”

Oregon State University conducted a study that found children in school and young adults do most of the flu transmission. Researchers noted there is a huge value in vaccinating more children and young adults for the flu by limiting the cycle of transmission. They also recommended vaccinating children at school.

In 2009, the Loyola University Medical Center in Illinois adopted mandatory influenza (flu) vaccination as a condition of employment. A multidisciplinary task force created the policy and presented their results at the 40^th Annual Conference of the Association for Professionals in Infection Control and Epidemiology in June. In addition to the new policy, educational materials like videos were also created for hospital staff and volunteers on the importance of vaccination.

Dr. Jorge Parada is a professor of medicine at Loyola and author of the study and has been working with the policy since 2008. “Near-universal flu immunization is achievable and sustainable with a mandatory vaccination policy,” Dr. Parada said. “Our employees and associates now understand that this is the way we do business. Just as construction workers must wear steel-toed boots and hard hats on job sites, healthcare workers should get a flu shot to work in a hospital. We believe that patient and staff safety have been enhanced as a result.”

Loyola was one of the first hospitals in the nation to adopt the mandatory flu shot policy and other hospitals have followed. Over 65 hospitals in North Carolina require doctors, nurses and vendors to be vaccinated for the flu. The vaccine debate will likely continue, and Vaccine Watch urges those with concerns to seek education from their primary care physician.

Vaccines, Swine Flu and Paralysis

The H1N1 (swine flu) vaccine that was administered in 2009 received a lot of attention after a recent study linked it with a rare, paralyzing disease. People given the H1N1 vaccine had a small increased risk of developing Guillain-Barré Syndrome (GBS), a disorder that affects the peripheral nervous system. The disorder was originally linked to vaccines in 1976 with a vaccine created for a swine flu epidemic.  Doctors have stated that the benefits of the vaccine outweigh the risks.

GBS is a rare autoimmune response where a person’s own immune cells attack the protective coating on nerve fibers; specifically those that control movement and respiration. It’s characterized by symmetrical weakness, usually affecting the lower limbs first and then progressing to other parts of the body. It affects one person in every 100,000 and can lead to paralysis, but is usually temporary and 80% of patients have a full recovery.  Most GBS cases occur after a bacterial or viral infection and take a few days or weeks to develop.

The US Department of Health and Human Services conducted the study, with Dr. Daniel Salmon of the National Vaccine Program Office leading the research.  Twenty-three million people were vaccinated for H1N1 in 2009 and data was gathered from six different adverse monitoring systems.

Dr. Salmon’s group found that 77 people developed Guillain Barré syndrome within 91 days of receiving the vaccine. The vaccine accounted for an extra 1.6 people per million developing the condition. However, in 2009, the H1N1 “Swine Flu” pandemic infected 61 million people and caused 12,470 deaths. The vaccine is credited with preventing nearly a million cases of H1N1 and saving 500 lives.

“Clinicians, policy makers, and those eligible for vaccination must consider the overall risks and benefits of vaccination, as defined by epidemiological studies,” Dr. Salmon concludes. “But [people] should be assured that the benefits of influenza A (H1N1) 2009 monovalent inactivated vaccines greatly outweighed the risks.”

Another group of researchers spent 13 years compiling data on millions of patients and have found no link between vaccines and GBS. Researchers studied tetanus, hepatitis, pneumonia and flu vaccines and found no heightened risk for GBS.

Most studies done since 1976 have found no link between GBS and vaccines. Only a couple studies have shown a small increase in risk among people who received flu vaccines, including the 2009 shot against H1N1. Dr. Roger Baxter, the co-director of the Vaccine Study Center at Kaiser Permanente in California was the lead author on the study and noted that because GBS is so rare, its extremely difficult to determine whether a particular vaccine could have caused increased cases, which is why this study looked at millions of patients.

“There’s definitely a connection in people’s minds that vaccines cause this syndrome. But if you look at the (medical) literature, that doesn’t bear out,” Dr. Baxter states. “The bottom line is we think vaccines are very safe for this outcome, that they do not result in GBS, and if they do, it’s so rare it’s nothing to be worried about.”

The study notes that there were 415 cases of GBS from 1995 to 2006, and two-thirds of those had a documented gastrointestinal or respiratory infection in the weeks before developing GBS. Only 25 people had received a vaccine of any kind within six weeks of the onset of GBS. It was also noted that GBS cases were 50 percent more common in the winter, mirroring seasonal rates of infections like the flu and other respiratory illnesses.

Dr. Daniel Salmon of the Institute for Vaccine Safety at John Hopkins University said, “The take home message is vaccines are not causing Guillain-Barré Syndrome at a rate, if at all, that would possibly make the benefits of vaccination not worthwhile.”

Natural News Spreads Misinformation About Flu Epidemic

Natural News continues to spread misinformation about vaccines to readers.  In a recent post, writer Mike Adams declares that most people with the flu are those that received the flu vaccine.

Using the very unscientific method of “…making phone calls to a large network of friends and professional contacts…” has led Natural News to state that two-thirds of people vaccinated against the flu, have the flu.  Natural News uses this “data” to deduce that the flu shot makes people more susceptible to the flu.

Natural News continues that vaccinated people are acting irresponsibly, and that drug companies have zero ethics and are trying to make people sick.  Natural News urges readers to prevent the flu through Vitamin D supplements.

Using the article in Natural News as a source, World Truth TV published a similar article.  World Truth TV stated that the study by the Lancet that is used to determine effectiveness is being misinterpreted by world health organizations.  World Truth TV failed to note the final sentence of the Lancet study, which states:  “New vaccines with improved clinical efficacy and effectiveness are needed to further reduce influenza-related morbidity and mortality.”

In yet another article, Health Impact News Daily blasts the flu shot as only 10% effective while causing harm to the heart, infant and fetus.  Vaccine Watch checked the sources linked to the article and found that some of the scientific articles being referenced were published as far back as 1975, while others were from foreign countries.

The Centers for Disease Control and Prevention (CDC) has reported that this year’s vaccine is 62% effective. Widespread illness reached 47 states, partly due to a lack of vaccination.    As of early January, twenty children had died from the flu epidemic.   Adults aged 65 and older have been hardest hit by the flu this season. The flu virus changes quickly and is therefore difficult to create a 100% effective vaccine for.

According to CDC researchers:  "…these early [vaccine effectiveness] estimates underscore that some vaccinated persons will become infected with influenza.  Therefore, antiviral medications should be used as recommended for treatment in patients, regardless of vaccination status."

Blatant misreporting like the articles on Natural News, World Truth TV, and Health Impact News Daily serve no purpose except to scare people and create an atmosphere of fear and mistrust.   Epidemics like the 2011 measles outbreak are caused by fear-based propaganda leading to a lack of vaccination.  Sound research has proven that vaccinations are effective.

Flu Epidemic

This year, the flu has reached epidemic levels earlier than usual across the United States.  Sarah Kliff posted a blog on the Washington Post website about why 64.8 percent of Americans didn’t receive a flu vaccine.

The Washington Post points out that while 95 percent of students that entered kindergarten last year were vaccinated for measles, mumps and rubella (MMR), the Centers for Disease Control and Prevention (CDC) stated that only 36.5 percent of Americans received flu vaccinations by November 2012.  That percentage has been rising over the course of the flu season.

This statistic is not new or shocking to researchers.  The Washington Post spoke with Lori Uscher-Pines from the RAND Corp., who has studied flu vaccine rates.  Uscher-Pines points out that adults are not in constant contact with their health-care system like children are, and other than getting the flu; most Americans face no negative consequences if they aren’t vaccinated. But the flu itself can be serious, especially in the very young, elderly, and chronically ill.

The Rand Corp. also found negative perceptions about the flu vaccine in their 2011 study.  Statements like “I don’t need it” and “I don’t believe in flu vaccines” were used by over half of unvaccinated adults in the study.

The flu vaccine does have a lower efficacy than other vaccines; this year’s flu vaccine is 62% effective, whereas the MMR vaccine is 95 percent effective.   This year the flu vaccine is a particularly good match to the season’s influenza virus. There is a much better chance of not getting the flu when vaccinated, so why aren’t more people vaccinated?

Wake Forest University researchers studied flu vaccine trends by having participants play a video game that simulated the spread of the flu.  They earned points by staying healthy, and could use some of those points to buy a vaccine.  If the price of the vaccine was lower, participants were more likely to buy it.  As more people in the game became infected with the flu, vaccination rates increased.

According to the Financially Digital blog, coming down with the flu will cost the average person between $180 and $200.   That cost will rise if a small child is sick with the flu. This figure takes into account: missed work, medicine and other variables.  Neither blog mentioned how miserable being sick with the flu really is.  The protection that high vaccination rates bring to entire communities was also not highlighted. Vaccine Watch recommends making an informed decision about the flu vaccine; the odds are in favor of the vaccine.

Hospitals Flu Shot Mandates Met With Resistance

Hospitals around the country are mandating that employees receive the flu shot.  While many hospitals already have high vaccine rates, the new mandates are being met with resistance from some employees. 

The American Hospital Association recommended all hospitals create universal flu vaccination programs in July 2011.  The policy is intended to protect employees and patients.  The Center for Disease Control and Prevention (CDC) has identified that health care workers are frequently the source of transmission of influenza in health care settings.   

Hospital patients are already in an immune compromised state and their risk of contracting influenza is higher.  Employees with known egg allergies, severe reactions to previous flu shots or religious beliefs are exempt from these mandates and required to wear a mask and take other precautions.

Helen Darling, the president and CEO of the National Business Group on Health supports the mandates.  “The virus can be transmitted to patients by both symptomatic and asymptomatic health care providers.  One in four health care workers shows evidence of having the flu each year.  And 70 percent of them continue to work despite having flu-like symptoms.”

While some resistant employees argue that the flu shot makes them sick, or they don’t trust substances like formaldehyde that are in flu shots, many are arguing that it’s a violation of their civil liberties.  Brandon Hostler is a registered nurse in West Virginia and is always one of the first at his hospital to receive the vaccine.  He says if the vaccine becomes mandatory, he will quit or switch jobs.  “We are health care professionals.  We know the risks and the benefits, and to force us to do something like that and not to have a say in it, I think it would be offensive.”

Amy Garcia, the chief nursing officer for the American Nurses Association counters that on an individual level, having a flu vaccine is an ethical responsibility.  “Part of nursing’s code of ethics is that the patient comes first.  So we believe if there is a chance that a nurse could expose a patient, it is the ethical responsibility of the nurse to be protected by vaccinations.”

The Waterbury Hospital in Connecticut recently adopted a flu shot mandate.  Part-time employee Pam Curley states, “I think it’s about choice.  If you want it, go ahead and get it, but I don’t think there should be these drastic strong arm measures where you are threatened by the loss of a job.”

Dr. Steven Aronin is the Chief of the Infectious Disease Section at Waterbury Hospital and says the mandate is to protect the public, patients and the health care workers.   Patient care is trumping the right of employees to choose.  “There are other things we ask of our employees when they get hired by Waterbury Hospital,” Dr. Aronin notes. 

Waterbury Hospital is not the only hospital seeing resistance.  The University of Massachusetts Memorial Medical Center implemented the rule this year and nurses are protesting.  At UMASS, nurses that don’t comply will be required to wear a mask, but will not be fired.

Health care providers who have their own hesitations about vaccines should not influence their patients to not get vaccinated.   Vaccine Watch believes hospital supervisors and administrators should be aware of how their staff feel about getting vaccinated themselves, and be aware of what they may be saying to patients about getting vaccinated.

USC Student News Advises to Think Twice About Flu Vaccine

The University of Southern California’s student newspaper, The Daily Trojan, published a blog viewpoint in October recommending that students think twice before receiving the flu shot.  While the author, Annie Wanless, did not mention any reasons the vaccine is recommended, she did present several arguments against the flu vaccine.

The article begins by pointing out that the flu vaccine can cause several of the symptoms that people are trying to avoid with the vaccine, like a fever and a headache.  She then mentions that vaccines contain trace amounts of dangerous chemicals like mercury, formaldehyde and aluminum.  Although a source for this fact isn’t included in the article.

A little more research does prove that Formaldehyde is listed in the ingredients for Fluarix, the most popular flu vaccine for 2012.  The vaccine states that each dose may contain residual amounts of formaldehyde and other ingredients from the manufacturing process.  The Environmental Protection Agency (EPA) listed formaldehyde as a human carcinogen in 1987, and numerous other agencies have since supported this statement.  Neither aluminum nor mercury is mentioned in the Food and Drug Administration (FDA) information on Fluarix.

A second argument that Ms. Wanless has against the flu vaccine is that it is cultured in fertilized chicken eggs.  She states, “According to the Center for Consumer Freedom, it takes three eggs to produce one vaccine.  The Center for Disease Control wants 70% of Americans to be vaccinated.  This requires nearly 645 million chicken eggs, placing excessive demands on an industry already condemned for raising birds in deplorable conditions.”

Further reading into this subject brought Vaccine Watch to the National Academy of Engineering website, where we read the following statement:  “…flocks associated with vaccine production are under strict contract and must be completely housed, monitored by veterinarians, and raised under biosecurity regulations.  With government support, Sanofi Pasteur has also established contingency flocks as a backup against avian influenza and other risks.” The conditions under which animals are cared for should be held to the highest standards, but we cannot choose a flu vaccine in the same way we can shop for humanely produced eggs.

The closing argument of the article is that researchers have argued that excessive use of the flu vaccine and other anti-flu drugs can create “super viruses.”  The article does not mention who these researchers are, and further investigation only found a Dutch researcher who created a super virus, and other researchers trying to create a super virus vaccine.

The article concludes by offering advice on natural ways to boost the immune system.  She admits that the flu vaccine does help prevent the contraction of influenza, but urges students to learn more about the vaccine before receiving one.

Influenza outbreaks on college campuses can run rampant given the close quarters students keep in classrooms, dormitories, and dining halls.  It is in these environments that the flu vaccine may most effectively serve a community.  Universities should not be misinforming students and promoting anti-vaccine messages.