The dearth of controlled research on seniors stems in part from the fact that the U.S government considers such clinical trials unethical. Based on an idea known as clinical equipoise, scientists can’t test, in a randomized controlled trial, a treatment that the larger medical community already considers to be effective, because doing so would involve denying treatment to half of the participants, potentially putting them at risk. “We’re in a difficult spot,” Shay says—since the CDC already recommends flu shots to seniors, the agency can’t suddenly turn around and ask them to participate in a clinical trial that might deny them the standard of care.
What about kids? In 2010, the U.S. Advisory Committee on Immunization Practices began recommending flu vaccination for all healthy children older than six months, an expansion that they claimed was “supported by evidence that annual influenza vaccination is a safe and effective preventive health action with potential benefit in all age groups.” Yet a July 2012 Cochrane Collaboration systematic review concluded that for kids under the age of two, the currently licensed vaccines “are not significantly more efficacious than placebo.” The review highlighted a single small study conducted on children under two—the only controlled study that has evaluated the efficacy of the shot currently licensed for young kids—which found, overall, that vaccines provided no statistically significant protection over the course of two flu seasons. “One season, the vaccine did something to prevent some symptoms, but in the second, nothing,” says co-author Tom Jefferson, an epidemiologist with the Cochrane group. In kids older than 2, however, flu vaccines do seem to work; according to the Cochrane analysis, the shot reduces the absolute risk that a child will catch the flu by about 3.6 percent, whereas the live (inhaled) vaccine reduces the absolute risk by about 17 percent.
In healthy adults under the age of 65, flu vaccines work, too. A 2010 Cochrane review, also co-authored by Jefferson, estimated that during “good” vaccine years—when the vaccines match the circulating viral strain well, which Jefferson says happens about half the time—the vaccine reduces the relative risk that an adult under 65 will catch the flu by about 75 percent. In absolute terms, however, this means adults have about a four percent chance of catching the flu if they don’t get the vaccine and about a one percent chance if they do. Shay notes that while this estimate is reasonable, some flu seasons are worse than others, so the risk may be higher than 4 percent in some years (and some people) and lower than 4 percent in others. (And of course, the vaccine won’t protect against the nearly 200 viruses that cause flu-like symptoms but aren’t actually the flu.) Although scientists generally believe that the flu vaccine slows the spread of the virus through communities, there are no data showing that this is true, because “those studies are very difficult to do,” Shay explains.
So should people still dutifully line up for their flu shots? Older kids and healthy adults do get some protection from them; just perhaps not as much as they want or expect. But for seniors and toddlers, there may never be a clear answer to this question, particularly because the U.S. government is unlikely to conduct additional clinical trials. On Monday, Osterholm and a group of five other scientists at the University of Minnesota’s Center for Infectious Disease Research and Policy published a report highlighting the need for better alternatives. Although the current options may—for most people—be better than nothing, “we can no longer accept the status quo,” they wrote. “The perception that current vaccines are already highly effective in preventing influenza is a major barrier to pursuing game-changing alternatives.”
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Add Comment"One oft-cited claim, based on several large meta-analyses published more than a decade ago, is that seasonal flu shots cut the risk of winter death among older people by half. But the research behind that claim has been largely debunked. A 2005 study published in the Archives of Internal Medicine noted that influenza only causes about 5 percent of all excess winter deaths among the elderly—which works out to one death from flu per 1,000 older people each season—so it’s impossible for the shot to prevent half of all their winter deaths."
Reply | Report Abuse | Link to thisThis 'debunking' at least as stated here makes no sense. Saying that something halves your risk of death is not the same as saying that it prevents half of deaths. Even a single person can halve their risk of death. You don't need two people for that. For example, if I flip a coin before committing suicide, and only go through with it if I flip heads, then using the coin has halved my risk of death, and I am only one person. Also the '1 per 1000' formulation is arbitrary, one could just as easily say '2 per 2000' and then it is very easy to see how halving the risk will likely work out. I really doubt that this can truly be the basis on which anything was 'debunked'.
The point is that if influenza accounts for 5% of excess winter deaths, then even a 100% effective influenza vaccine cannot halve your risk of death.
Reply | Report Abuse | Link to thisThis is what the meta-analysis concluded:
"Influenza vaccine was effective in reducing influenza-like illness by 35% (95% confidence interval (CI) 19-47%), hospitalization for pneumonia and influenza by 33% (CI 27-38%), mortality following hospitalization for pneumonia and influenza by 47% (CI 25-62%); and mortality from all causes by 50% (CI 45-56%)."
Oh goodie ! I just got my flu shot yesterday; double strength as I'm 70. Spent last night under lots of cover as it felt like I had fever. So today we get the news that it may all be for naught. Joking. I'm a believer as I'm pretty sure I've never caught the flu in a year where I got a flu shot. This article belongs in the comment section of the recent article by Otto about antiscience, as announcements like these provide fodder for those who would like to claim we shouldn't trust science or vaccines. "The bring out your dead" scene from Monty Python's Holy Grail would have been all too common before modern science/medicine.
Reply | Report Abuse | Link to thisMaybe the effectiveness in elders is the immune challenge.
Reply | Report Abuse | Link to thisOTOH, this is an article that speculates a lot and says. little except that "in the absence of evidence any theory is true and false".
Those who accept whatever the drug companies say about vaccines safety and effectiveness are in fact not being empirically logical. Rigged studies are the rule with the for profit pharmaceutical industry. Vaccines can be made as individual units without neurotoxin chemical preservatives. In fact the rich can get individual unit vaccines being made in small batches in Europe without neurotoxins.
Reply | Report Abuse | Link to thisHow well flu vaccines work can vary significantly from season to season, depending on how well-matched vaccine viruses are to the viruses that are spreading that season and who is being vaccinated. In general, the flu vaccine works best among young healthy adults and older children. Some older people, children younger than 2 years and people with certain chronic illnesses might develop less immunity than healthy young adults after vaccination. Scientists and manufacturers are working to produce better vaccines. However, existing scientific evidence supports the benefits of vaccination with current influenza vaccines for these groups of people, especially during years when the vaccine is well-matched to circulating viruses. Any suggestion that people should not get a flu vaccine does a disservice to public health. Flu is a serious disease that places a significant burden on the nation’s health in the form of illness, hospitalizations and deaths. There is broad agreement in the public health and scientific community that while better flu vaccines are needed, a yearly seasonal flu vaccine is the best preventive method we have against influenza at this time.
Reply | Report Abuse | Link to thisDr. Dan Jernigan
Deputy Director
Influenza Division
National Center for Immunization and Respiratory Diseases
The Centers for Disease Control and Prevention
As executive director of Families Fighting Flu, a non-profit organization comprised of families who have first-hand experience with and many who have lost children to the flu, I urge readers to look at
Reply | Report Abuse | Link to thisall of the many years of research that support flu vaccination for everyone 6 months and older. Data just released last week by the CDC at a national infectious disease conference shows how deadly the flu can
be to children. If the data is not enough of a reason, visit our website at www.familiesfightingflu.org to learn about those families who, over the course of days, went from watching their children learn to walk, at basketball practice or dance lessons, to planning their
funeral.
There are no dangers associated with the flu vaccine, but there are very real dangers if you choose to skip vaccination. Please protect yourself and your children and get vaccinated for the flu every year.
Check out some of the Antiviral Diets that can protect seasonal flu :
Reply | Report Abuse | Link to thiswwwdotmadezeedotcom/foods-antiviral-diets-to-fight-seasonal-flu-viruses/
The article comments that is is difficult to do an ethical test for new procedures because of the risk to the unvaccinated. Here's an approach:
Reply | Report Abuse | Link to thisfor the elderly, compare morbidity/mortality for the following groups:
>>just the current seasonal flu vaccine at dose for the elderly, as now
>>current seasonal flu vaccine plus flu mist (the one given to children)
Where are these vaccines being made? And who is making them? Are they artificial? What are the natural, God given remedies and preventative measures we can take to put a snap to poking each other with retail?
Reply | Report Abuse | Link to thisI definitely think the pharmaceutical companies are pushing this. I have worked in a hospital over the last 24 yrs and have seen a huge surge in patients with MRSA, usually meaning they have run through the complete cycle of anti-biotics currently available. These people now have a compromised immune system. Part of the reason for this is the push by drug companies over the past few decades to use anti-biotics even though they weren't always necessary...And physicians all bought into this idea, not considering the long term effects. Now, the influenza issue has been another boon for the industry.
Reply | Report Abuse | Link to thisThe sources of study were cited by the journalist of this article. The point of being a skeptic is to accept evidence despite your belief. If you happened to not have had the flu without flu shots or with flu shots, it can't be attributed to any single testimonial or claim. But, a peer reviewed study is to falsify all hypothesis or claims thereof, so that when you get the results, they don't lie. Therefore, studies show that you do not decrease your chance of death from the elderly, who by nature, have less of an efficient immune system than their younger counter-parts. Just accept the studies or stop pretending that its conspiracy theory if you can't accept peer review.
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