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Medium Read: Does the Vaccine Matter?

October 23, 2009

My family was having a conversation earlier this week about whether it was worth it to get the swine flu vaccine. The discussion was piqued by my dad, who said that someone at a meeting that day had told him that we were being bad citizens by not getting the flu shot. My mom, who spends a good amount of her time learning about health-related issues, has never let us get the flu shot because she doesn’t believe it works and because it has a considerable amount of mercury in it, which has a toxic effect on humans.

According to the article Does the Vaccine Matter? from the November Atlantic, she’s basically right. Proponents of the vaccine point to statistics they believe show that the flu vaccine reduces mortality by 50%. However, Lisa Jackson, a doctor and researcher at the Group Health Research Center looked at the data in a novel way to show that other factors were coming into play:

In 2004, Jackson and three colleagues set out to determine whether the mortality difference between the vaccinated and the unvaccinated might be caused by a phenomenon known as the “healthy user effect.”

Jackson’s findings showed that outside of flu season, the baseline risk of death among people who did not get vaccinated was approximately 60 percent higher than among those who did, lending support to the hypothesis that on average, healthy people chose to get the vaccine, while the “frail elderly” didn’t or couldn’t. In fact, the healthy-user effect explained the entire benefit that other researchers were attributing to flu vaccine, suggesting that the vaccine itself might not reduce mortality at all.

Ultimately, it seems to me after reading this article that our flu defense policy amounts to little more than snake oil and a handout to government-connected flu manufacturers – but do read it yourself to see what you think.

2 Comments leave one →
  1. Tim permalink
    October 23, 2009 11:46 am

    I have to say that I am supremely unconvinced by this article. If the argument is simply that we should have more placebo-controlled studies, then fine, I’m all for it. I don’t think it’d really be that big a deal either (hell, I’d sign up for it). But the authors keep alluding to data that suggests the vaccines and drugs don’t work but then falling back on the crutch, “I’m not saying they don’t work, I’m just saying we don’t know for sure.” The most conclusive things they can say in rebuttal are vagueries like “the drug [Tamiflu] may have been responsible for 50 deaths” over a six year period – or maybe not? Out of how many? A million? – and “about one in five children will have neuropsychiatric side effects, possibly including anxiety and suicidal behavior,” which, for all I know means means 99% of 1 in 5 feel bored, and .0001% had suicidal thoughts. “Possibly,” of course. Maybe it’s more serious, I have no idea, but frankly, I’d expect something a little more concrete from people who spend and 90% of the article poking holes in other people’s studies.

    (Also, the line “In exchange for a slightly shorter bout of illness, as many as one in five people taking Tamiflu will experience nausea and vomiting”? Flu medicine causes symptoms of the flu? Something seems wrong here. Plus, again, the phrase “as many as”. Real helpful.)

    And how do you find fault with hospitals and government for the over-prescription of drugs causing resistant strains and then say the drugs don’t work? Who cares if we make diseases resistant to drugs that never worked in the first place?

    Moreover, the idea that people are going to forget to wash their hands or stay at home when they get sick because they got the vaccine is ludicrous. Like you haven’t heard those health tips over and over again in recent months (“Sneeze into your elbows!”). And I wouldn’t be worried that people have been hoodwinked. There is a more than healthy vaccine-skepticism around.

    So fine, do more studies. Like I said, I’m all for it. But as long as, the vast majority of public health experts advise you to get the vaccines, while three other people say, “Hey maybe this doesn’t work, we’re not sure, but feel bad for Jeff here because no one eats lunch with him,” I’m gonna go with the experts.

    P.S. Facts and figures aside, it’s worth noting that every vaccine-skeptic is “renowned” and from the “prestigious” or “famed” such and such, which is far more credentialed than those sketchy institions, the World Health Organization, the Center for Disease Control and the National Institute of Health.

  2. Somerset permalink*
    October 23, 2009 4:39 pm

    You make a good point that an appeal to one authority is perhaps not the best way for this article to go about taking another authority.

    But what about costs? If we were to suppose that there were in fact no substantial negative consequences to Tamiflu and the vaccine – i.e. the suicidal thoughts are overblown, the specter of drug-resistant strains makes the argument against the vaccine contradict itself, the amount of mercury in the vaccines won’t cause discernible harm to someone who gets the vaccine yearly – that still doesn’t justify undertaking an action. Just because eating dirt doesn’t kill me doesn’t mean I’m going to do it. The studies cited in this article, which, of course, could be cherrypicked, make me believe that there are conversely no positive effects of the vaccine. It simply doesn’t save lives. Considering how much debate there is currently on Capitol Hill about reducing the cost of the healthcare reform and the projections that healthcare will bankrupt us in the coming decades, why are we spending so much money on something that doesn’t seem to work?

    Thinking this through, though, brings me to another point the article doesn’t address which is the effects of the flu vaccine in matters less grave than death. Whether the flu vaccine spares from you a couple days of vomiting is a question that most of us would ask, even if it were established that if you’re at risk to die from the flu the vaccine won’t really help.

    But the question would still be: is it worth the dough?

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