Archive for Influenza
Before we answer to question of how much, we should probably look at whether or not vitamin D can help with infections in the first place.
While vitamin D supplementation has been attributed to any number of health effects, there are a few situation where vitamin D seems to shine. This includes long term (10 years or more) risk of cancer, vascular health (heart disease, stroke, dementia) and immune balance. Vitamin D has also been shown in multiple studies to help with respiratory issues (pneumonia, influenza, asthma), but I’m not sure if the benefit is from an actual effect on the respiratory system, or indirectly from vitamin D’s immune effects. Either way, vitamin D has a pretty solid acceptance to support and balance immune function.
This aspect I find interesting, because every flu season there is a massive, expensive push to get every breathing person vaccinated for influenza, but never is there a mention about how to support the immune system through interventions such as vitamin D supplementation.
Doctors think they are doing the right thing by checking patients’ vitamin D levels. There are three problems with this:
- Very, very few patients are at optimal levels (60-100 ng/ml).
- Testing, when insurance is billed, is expensive.
- Even when patients come back deficient, doctors rarely know how much vitamin D to give and what the best forms to give are.
Between these three, we are wasting money testing patients who have a very high likelihood of being less than optimal and when we spend the money to confirm it, we’re not fixing it correctly. No wonder healthcare is so expensive.
Basically, checking vitamin D levels is getting into the realm of functional medicine (much like checking testosterone). I feel very strongly that no doctor should be checking these values unless they fully understand to nuances that go along with functional testing. Consider the mess we’ve gotten into with testosterone, another lab value that I have had more and more patients come in who have had it tested by his or her primary care doctor. Patients who have low testosterone are given some form of testosterone (injections, cream, pills, pellets) rather than fixing the problem in the first place.
But I digress.
Back to this particular study looking at vitamin D’s ability to lower the need for an antibiotic prescription in a group of 644 Australian residents aged 60–84 years of age who were given monthly doses of a placebo or 30,000 IU of vitamin D3 (1,000 / day) or 60,000 IU D3 (2,000 / day) for up to a year. Here’s what the researchers found:
- Those taking 60,000 IU were 28% less likely to have had antibiotics prescribed.
- Specifically, in subjects old than 70 years of age, this group was 47% less likely.
- In those aged 60-70, they werere only 7% less likely.
When you consider that the senior population, who are the most likely to suffer complications from influenza, benefit the least from the influenza vaccination, it makes the findings of this study even more important.
One last note—2,000 IU / week of vitamin D is still a very low level. This is the dosage I start patients on who already get decent sun exposure and little risk of chronic disease. Makes you wonder how much more powerful the study would have been at levels of 4,000 or 6,000 IU per day.
Fatty acid composition and measures of immune cell function.
With so much worry out today about the SARS virus and the flu and West Nile Virus we are looking for emergency cures when we seem to forget that a healthy lifestyle is still one of our most powerful tools in the battle against foreign invaders. In this study, the researchers found markers of effectiveness of immune cells were reduced with saturated and with high omega-6 to omega-3 ratios.
AJCN — Abstracts: Kew et al. 77 (5): 1278
Being a parent, there are few things that hurt me as deeply as someone losing a child. But to use this to scare the population into flu vaccination infuriates me.
Every fall begins the push by the drug companies and the vaccine manufacturers to get vaccinated for influenza. These efforts are supported by doctors, pharmacists and the gas stations (ok..so maybe not the gas stations yet, but just you wait…). And fear is behind it all. Fear of getting the flu, fear of getting sick, fear of being out of work and fear of death. Especially in a child, because we know that children die of the flu. But if you knew the real numbers you’d be sick over how much we’ve been played.
But first, we need to identify just how effective the flu vaccination is. I have covered this topic many times in the past, but one of the strongest articles can be found by clicking here. Here is the summary from that post:
The greatest risk of influenza complications occur in the elderly and yet there is almost no evidence that available vaccines work in the group we really need it to work in.
Healthy adults showed strong evidence ONLY for the dead virus vaccine, but, in general, this group is the least likely to suffer complications.
The only group that showed high protection was 6 months to 7 years using the live vaccine (the nasal spray) , but this type is only licensed here in the US from 2 years on and is not commonly used.
With this in mind, we need to look at this particular article, which is directly from the CDC’s numbers. Researchers looked at the number of influenza-related deaths in children (under 18 years of age) over the course of 8 years (2004-2012). Here are the details:
- There were 830 pediatric influenza–associated deaths (104 per year), and the average age was 7 years old.
- 35% of children never made it to a hospital.
- 43% had no high-risk medical conditions (about 45 per year).
- Surprisingly, children without high-risk medical conditions were more 90% likely to die before hospital admission. This may be due to a secondary bacterial infection, which was found to be very common.
I will again note that ANY childhood death is awful. But to put our efforts and money into a disease that takes 45 children per year and we don’t really have a good way to protect is almost as sinful as the loss of these children.
What if the energy went, instead, to educating about refined carbohydrates? Ensuring adequate levels of vitamin D? The massive danger of antibiotics in children, especially infants? The return on investment would dwarf that associated with influenza vaccination. It’s frustrating. In Arizona alone in 2011, 33 children died as a result of being improperly restrained in a car seat during an accident. We could buy a car seat for every parent and save more lives at a cost of millions of dollars less and not side effects.
Return of Haemophilus influenzae type b infections
It still amazes me how blindly the vast majority hop in line for vaccinations regardless or type or need. Everyone assumes that vaccinations are completely safe, and, furthermore, fully effective. Here the author suggests that the use of HIB vaccines may be setting the stage for more severe and frequent outbreaks in the future.
The flu shot. Influenza vaccine effectiveness. Doesn’t matter what you call it, it is the center of controversy. There are the opponents, and then there is seemingly every public health recommendation and forced mandatory vaccination in many hospitals across the country.
If all the public health officials and departments as well as the hospitals are pushing it so hard, everyone else has to be delusional, right?
Count me in the delusional group. It is not that influenza cannot be dangerous; it certainly can. But the number of deaths associated with influenza is far, far fewer than most realize and the government proposes.
Given that I’m a self-proclaimed research junkie and that influenza vaccination effectiveness is always on my watch list, what does the research actually say about the effectiveness of the flu vaccine?
The single most recent and comprehensive review I have come across was the subject of a massive review funded by the federal government that was published in December of 2012 (I reviewed this review back in December and that can be read by clicking here), Here is a summary of the results:
- The greatest risk of influenza complications occur in the elderly. That means that there is very little evidence that either vaccine works in the group we really need it to work in.
Healthy adults showed strong evidence ONLY for the dead virus vaccine, but, in general, this group is the least likely to suffer complications.
The only group that showed high protection was 6 months to 7 years for the live vaccine, but the live vaccine (LAIV) is only licensed here in the US from 2 years on.
Let’s put the risks into perspective. In 2003-04, according to the CDC’s own numbers, 42 children died of the flu. 40% of these had underlying chronic conditions that adversely affected their health. You can read this info in a previous block post by clicking here.
Taking all of this together, can anyone actually tell me just why any hospital should have mandatory vaccination???
There is an underlying movement to bring medical back from the brink of chaos. A movement to restore the concept of “first do no harm.” The esteemed British Medical Journal has created the “Too Much Medicine” campaign to take a hard look at how much we have created diseases in an attempt to medicate them.
This particular review is part of this process and shines the bright light on our world’s obsession with the influenza vaccination despite paltry results at best. Remember this next time your doctor suggests that flu jab.
Expansion of Eligibility for Influenza Vaccine for Children’s Program
I’m sorry, but the arrogance of medicine never ceases to amaze me. For the entire history of man, our immune systems, with complexity and wisdom modern science can only dream about, have dealt with countless assaults by viruses, bacteria and foreign chemicals. But now we feel that this is not good enough–we have to immunize everyone whether they are at “risk” or not. Thank you…I feel much better having vented…
Notice to Readers: Expansion of Eligibility for Influenza Vaccine Through the Vaccines for Children Program.
It’s flu season Again. Time to run out and get your flu vaccine 2012-13 version before you too become infected. Everyone’s doing it, but does it work?
As a result of the near universal recommendation from your physician and the seemingly endless barrage of advertisements on the radio, TV and print media, you decide that the influenza vaccination must be effective.
As you reach for the car keys to run to your nearest drug store for your life saving vaccination, thoughts run through your head of smoking promotion for health (yes–for many years we denied the evidence that smoking was harmful), ineffective and even dangerous hormone replacement therapy for women and the marketing ploy that suggests that milk does a body good.
Is marketing and scare tactics running cover for an ineffective flu vaccine?
In case you haven’t been convinced by the evidence I have presented in previous blog posts that can be found here, you may want to pay attention here.
This particular report commissioned by the Federal Government at the University of Minnesota’s Center for Infectious Disease Research and Policy is described as one of the largest ever reviews of the influenza vaccination and the politics, recommendations and effectiveness surrounding it. I will not go into the specific details (they are available in the report), but just take my word for it that the undertaking was nothing short of massive.
The findings of the committee may be a little surprising to some. The committee looked at the evidence for both types of vaccines in use. The trivalent inactivated influenza vaccine (TIV) uses a dead virus, while the live-attenuated influenza vaccine (LAIV-aka Flumist) uses a weakened, but still alive, virus. The TIV is given via injection while the LAIV is given as an intra-nasal injection. Since the LAIV is still alive, it has the potential to cause the flu in those with weakened immune systems.
With this in mind, here is what the committee found for TIV:
Moderate protection (about 59%) for healthy adults 18 to 64 years of age.
Inconsistent evidence of protection in children age 2 to 17 years.
Almost no evidence for protection in adults 65 years of age and older
For LAIV, the results weren’t too much better:
High protection (about 83%) for young children 6 months to 7 years of age.
Inconsistent evidence of protection in adults 60 years of age and older.
No evidence for protection in individuals between 8 and 59 years of age.
The bottom line needs to be summed up in a short list:
The greatest risk of influenza complications occur in the elderly. That means that there is very little evidence that either vaccine works in the group we really need it to work in (Tweet this).
Healthy adults showed strong evidence ONLY for TIV, but, in general, this group is the least likely to suffer complications.
The only group that showed high protection was 6 months to 7 years, but LAIV is only licensed here in the US from 2 years on.
Despite the strong push to vaccinate our children despite the weak evidence, few pediatricians will share the evidence on probiotics, vitamin D or green tea on lowering the risk of upper respiratory tract infections in children, all of which I have reviewed in previous blog posts that can be read here.
Overall, does this sound like the evidence is there to back up the massive push our country makes every single year for influence vaccination?
Inactivated Intranasal Flu Vaccine and Risk of Bell’s Palsy
For those of you unfamiliar with Bell’s Palsy, it is paralysis of the facial nerve which results in one half of the face drooping. This damage can be permanent in some instances. Usually takes several months to resolve. Here we have a vaccine for the flu–which, unless you are immunocomprimised in some way I cannot see the rationale for getting–gives you a 19 times greater risk of developing Bell’s Palsy.
For those of you really interested, I have included a piece done prior to release of the vaccine, when the manufacturer was aware of an increased risk of Bell’s Palsy but downplayed the risk to the FDA. Some much for government agencies protecting the public…
NEJM — Use of the Inactivated Intranasal Influenza Vaccine and the Risk of Bell’s Palsy in Switzerland.