Fear, The Flu And The Vaccine Debate…

Why can’t we intelligently debate vaccines?

It’s because of FEAR.

FEAR on both sides of the debate.  FEAR that takes real numbers and twists them until the numbers and logic don’t matter and so all we’re left with is FEAR.  Case in point ….. this article I came across recently…

A piece recently in the Boston Globe Health section is an example of the problem. In it the author Ms. Carey Goldberg says :

I love vaccines. The other day, at my 4-year-old son’s annual check-up, a physician’s assistant asked me whether I had any questions before she shot him up with a half-dozen varieties, including polio, mumps-measles-rubella and flu, and I said, “Heck no, bring them on!”

That’s an unusually enthusiastic response to the question but God bless her, she obviously is a fan of the vaccines, and if she left it there … no problem.

However, she doesn’t leave it there and instead crawls up on the soapbox to proclaim a myriad of “facts” such as :

Last year, 83 children nationwide – four in Massachusetts – died of flu. Overall, 36,000 Americans a year die of it. That puts it up close to breast cancer as a killer.

Now, to continue her argument you have to assume those number are correct.   Based on CDC estimates they appear to be ….. but that’s based on estimates.  Sooooo, let’s look at the number a bit more closely but here’s the problem – you can’t.

You see there’s a bit of a lag in accurately reporting what we all die from (I suppose this is because it’s kind of a complicated thing to figure and there’s a lot of us that die every year). As a matter of fact preliminary data just came out for 2006 in June and the final numbers for 2005 only came out in April of 2008. (check it out for yourself) Hmmmmm, so let’s attack this problem another way and look up past years to see if the 36,000 figure holds up.

So we check out the CDC final data for 2005 and it shows …..

Deaths from Influenza in 2005 : 1,812 ( Wow, must have been a good year )

Okay, well let’s look back historically (source) and get a feel for what’s happened. Maybe 2005 was just a really healthy year for us all:

Deaths From Influenza

1979: 604

1981: 3,006

1983: 1,431

1985: 2,054

1987: 632

1989: 1,593

1991: 1,137

1993: 1,044

1995: 606

1996: 745

1997: 720

1998: 1,724

1999: 1,665

2000: 1,765

2001: 257

Those numbers are low too.

Did a huge flu outbreak occur last year that killed 36,000 people?

Did 34,188 more people die from the flu in ’07 than in ’05? (I doubt it, it seems that would have made the news)

So why the HUGE difference in numbers – it’s simple, those deaths included other causes of death ~ most frequently pneumonia.

Pneumonia?

Is pneumonia the flu? No.

Is there a separate vaccine for Pneumonia? Yes.

If they’re not the same illness and they have different vaccines why add them together ?  Because 36,000 is a much scarier number.

The “official” reason / argument goes that a lot of the pneumonia deaths wouldn’t have happened if not for the flu so they just kind of smoosh the numbers together (hey, close enough right?).

This “fact” smooshing conveniently gets left out when reporting the numbers and conveniently it also two major things:

• It makes the flu sound a lot scarier
• It increases the number of people getting flu shots.

If you run out and say “almost 2,000 people died from the flu” it doesn’t sound nearly as good as:

Overall, 36,000 Americans a year die of it. That puts it up close to breast cancer as a killer.

As for the breast cancer figure ….. well, that’s a little off also.

According to the American Cancer Society estimates for the number of people in 2007 that died from breast cancer equaled:

• 40,515 women
• 400-500 men

So, the actual breast cancer count comes to approx. 41,000 deaths which is 5,000 more than the flu totals if you accept the 36,000 (which we know is wrong so the difference is closer to 38,000).  However, if you accept the 36,000 count and therefore realize the total is only off by 5,000 that’s still a big difference between flu and breast cancer.  But hey, more people can relate to breast cancer and it sounds scarier so it works.

However, if you want the facts it it turns out that dying from the flu isn’t in the same class as breast cancer but more like death from:

• Hernia : 1,639
• Water, air and space, and other unspecified transport accidents : 1,241

Ms. Goldberg did acknowledge that even if you get the Flu Vaccine it’s not perfect …

Vaccines do not offer perfect immunity, and flu is a particularly tricky virus to block. Last year’s vaccines were only around 44 percent effective on average, though this year is looking better.

I’m not sure where Ms. Goldberg is quoting from but here’s what the CDC said about last year’s vaccines :

The biggest problem was with influenza B: of 350 virus isolates that were antigenically characterized by the CDC, only 6 matched well with the strain used in the vaccine.

and…

For influenza A/H1N1, 66% of the 407 viruses analyzed by the CDC were similar to the vaccine strain.

not sure if “similar” means it worked or “close but no cigar”, but they went on..

for influenza A/H3N2—the predominant strain for the season—only 23% of 404 viruses that were characterized matched well with the vaccine strain.

So the flu vaccine was:

• A 23% match if it was Influenza A/HN2
• A 66% chance of being “similar” if it was Influenza A/H1N1(which was the predominant strain

Again though, if we accept her 44% number than you have to acknowledge that for 66% of the folks the vaccine DIDN’T WORK.

As for her assertion that :

this year is looking better

That’s certainly optimistic ….. baseless, but optimistic. However, she and the CDC should be optimistic. After all, if you thought your product was going to be  close to being able to work only 23% – 66% of the time you’d probably hate your job. 

Among elderly persons living outside chronic-care facilities (such as nursing homes) and those persons with long-term (chronic) medical conditions (such as asthma, diabetes, or heart disease), the flu shot is 30%-70% effective in preventing hospitalization for pneumonia and influenza. (source :CDC)

So by the CDC’s best guesstimate the vaccine for older, sicker people is 30-70% effective in keeping them out of the hospital (that seems like a HUGE window doesn’t it).  Interestingly enough that means that for the older, sicker folks it doesn’t keep 70%-30% out of the hospital.  The rational for the flu vaccine isn’t really stopping the flu (which is obvious when you look at the numbers) it’s reducing death and complications ….. specifically in the older, sicker population.  The reason they want you to immunize your kids is because it turns out that the little crumb crunchers are notorious for passing germs and bugs along to everyone (specifically in this case Grandma and Grandpa).  Now if I said don’t take your shots just drink a glass of orange juice and it will be 30-70% effective at keeping you out of the hospital I’d be laughed out of the room … and there’s no real danger from orange juice.

Ahhhhh, the risks of the shots …. which in fairness Ms. Goldberg also addresses, well, sort of…

I asked Dr. Joseph Bocchini, chairman of the American Academy of Pediatrics’ Committee on Infectious Diseases. The common risks are sore arms and feeling lousy for a day or two, he said. In perhaps one in a million cases, a vaccine can prompt a life-threatening allergic reaction, he said. Similarly, in perhaps one in a million cases or less, flu vaccines have appeared to be linked to a paralyzing neurological disease called Guillain-Barre syndrome.

But the odds of dying from the flu are far greater – as those 83 pediatric deaths last year demonstrate.

Let’s run the numbers here quickly….

• Estimate of flu deaths children in 07-08 : 83 kids
• Estimate of flu deaths in children in 06-07 : 68 kids
• Estimate of flu deaths in children in 05-06 : 35 kids

Number of children in the US under 18 (according to the US Census): 73,652,027

• “One In A Million” Chance of Life Threatening Allergic Reaction According To Dr. B : 73 kids

(This estimate by the good doctor is obviously not based in a fact – but we’ll take it as an educated opinion and assume he’s right – kind of scary though that that’s how nailed down he has the risk of a life threatening reaction for your kid though, huh? )

• So 83 kids die from the flu.

However, according to the CDC t least 6% of these kids studied were vaccinated : 83x 6% = 5 kids

• So 78 unvaccinated kids died from the flu (but the CDC couldn’t determine exactly if they were or not, so we’ll have to assume again)
• But, 73 kids (at least) would suffer a life threatening allergic reaction.
• Plus 73 or so would risk a paralyzing neurological disease

So, if all of the kids that died were …

• unvaccinated AND
• died from the flu AND
• would have lived with the vaccine (even though for at least 5 vaccinated kids that didn’t happen)

that means that five more children (78-73) would have been saved from death with the vaccine than the number of kids that would have either had a life threatening allergic reaction or risk a paralyzing neurological disease . Now this is only if all of the negatives with the flu happened, all of the positives happen with the vaccine and no other complications occurred.

So the vaccine program has the potential to save ….. maybe ….. 5 more children a year than not vaccinating the children.

BUT we can only assume that if we also assume that they would have also received the right flu strain in the vaccine (which happened last year 23%-66% of the time) and the flu shot works (which happens 44% of the time according to Ms. Goldberg’s sources) and your child doesn’t have a negative adverse reaction to the shot.  Not really great odds.

Now there’s some who make the “greater good” argument.  According to them you do it for the greater good of society and if it doesn’t help your kid, well, maybe it will protect THEIR kids.  So it might not help my kids but it will help theirs (in high school we were taught this was “peer pressure”)

So we create a national policy to protect what amounts to:

• Unvaccinated Children Who Died From The Flu:  78 Children
• And Divide That By The Total Number of Children In The US Under 18:  73,652,027 Children
• We get a total percentage of ……….

.000106%

or

1 in every 944,257 children

Ahhhh, but what about the adults ….. surely we save some of them too, right?

• Take the highest count in the last 10 years from the totals above:    1,765 deaths
• Divide that by the total US Population                                           :    299,398,484
• We get a total percentage of ………….

.00059%

or

1 in every 169,631 US Citizens

Which literally means you’re more likely to die from (source):

• Falling Down (1 in 246)
• A dog attack (1 in 147,717)
• Snake, bee or other Venomous Bite or Sting  (1 in 100,000 )
• Lightning Strike (1 in 83,930)
• Tornado  (1 in 60,000)
• Flood  (1 in 30,000)
• Electrocution  (1 in 5,000)

than the flu.

But as it turns out that’s not even accurate either because many of the folks that died of the flu death died not from the flu but rather the flu and other contributing infections or complications….

The percentage of those (children who died) who also had bacterial infections …(was) almost 36 percent. Most had staph infections, and 60 percent of those involved the dangerous MRSA bug, which is resistant to antibiotics.

(cnn.com)

The simple fact is that the flu does kill people, but the paranoia that we’ve drummed up and the insane vaccination rush to prevent it is based more (much, much, more) on fear than real numbers.

As long as we are basing policy on fear, instead of real numbers, our policies will be built and manipulated by those in a position to benefit the most by promoting intense fear to a large percentage of the public.

As a point of comparison 195,000 people die in the US due to preventable, in-hospital medical errors per year.

So, technically you’re more likely to die from going to the hospital to get your shot than you are from the flu.

Links Related To This Story:

Autism Fears Are Not Reducing Immunization Rates – American Academy Of Family Physicians
Child Vaccination Rates Hit Record Levels - Reuters
Forgoing Vaccines Has A Social Cost – Cary Goldberg
CDC Says 83 Children Died Of Flu In 2007-2008 – CIDRAP
National Vaccine Injury Compensation Program
In Hospital Deaths From Medical Errors at 195,000 Per Year - Medical News Today
How Effective Are Flu Shots? – Michelle Malkin
National Centers For Health Statistics – CDC
Cancer Death Rate Statistics – American Cancer Society
Deaths: Final Data For 2005 – CDC

Tagged as: flu vaccine, Vaccines