Here we go again. As flu season approaches, everyone will be urged to get a shot. Vaccinations against influenza are supposed to keep us from getting sick and protect us from potentially lethal complications.
That’s the promise. What’s the reality?
Last year’s flu vaccine was a big bust.
Every year the flu shot is supposed to protect against three different strains of influenza virus. Public health officials have to guess eight months in advance which flu viruses are likely to be causing trouble.
Last year they guessed wrong. Two out of three strains did not match the bugs that made people sick. Perhaps that is why a Harris Poll found that people who got the shot last year were just as likely to have suffered flu as those who skipped the vaccine.
This is not the first time the vaccine has failed to match. Several years ago the shot only protected 38 percent of those at high risk because it did not include the dominant strain of influenza that year.
But even when the crystal ball predicts correctly, the benefits of flu vaccination may have been oversold, especially for the elderly. Older people have been warned to get their annual flu shots or risk an early appointment with the Grim Reaper.
While it is true that older, frail adults are more likely to come down with pneumonia and other complications of influenza, it’s not clear that vaccination will protect them. A study in The Lancet (Aug. 2, 2008) concluded that even when the vaccine was a good match for flu viruses circulating in the community, it did not reduce the risk of pneumonia in the elderly.
The investigators point out that many previous studies of vaccination were flawed because they did not take into account the “healthy user effect.” Seniors who are health conscious—eating properly, exercising regularly, not smoking—are more likely to request flu shots. They are also more likely to survive the flu whether they are vaccinated or not. This skews the statistics when public health officials look at the effectiveness of vaccination.
Even younger healthy adults may not get much benefit from flu shots. Research published in the British Medical Journal (Oct. 28, 2006) showed that flu vaccination for healthy people under 65 “did not affect hospital stay, time off work, or death from influenza and its complications.”
What about kids? Children are little virus factories. They catch lots of colds and other infections in day care and kindergarten and bring them home to the rest of the family.
Unfortunately, the data for vaccine effectiveness in young kids are surprisingly thin. The non-profit, highly-regarded Cochrane Collaboration published a review concluding that in children under two, flu shots are no better than placebo and safety has not been established.
Maybe we’ll be lucky this year and the flu shot will match the viruses that cause illness. Prescription flu drugs like Tamiflu, Flumadine (rimantadine) and Relenza can sometimes speed recovery. Vitamin D may enhance the immune system. Before there were flu shots, grandmothers used to insist on cod liver oil, high in vitamin D, for everyone in the winter. Maybe those old wives were wise.
