Study Questions Value of Flu Shots

10.26.06, 12:00 AM ET THURSDAY, Oct. 26 (HealthDay News) --

The flu vaccine is much ado about nothing, according to a new study that contends the annual shots aren't as effective as billed.

"We've got an exaggerated expectation of what vaccines can actually do," said study author Dr. Tom Jefferson, coordinator of the Cochrane Vaccines Field in Rome, Italy. "I'm hoping American and European taxpayers will be alerted and will start asking questions."

He published the findings in the Oct. 28 issue of the British Medical Journal.

Most developed nations and many rapidly developing countries have influenza vaccination programs in place. The programs are believed to reduce the number of cases of flu as well as related hospital admissions and deaths.

In the United States, health authorities recommend that the flu vaccine be given to children aged 6 to 23 months; anyone 50 or older; people with chronic health conditions such as asthma, diabetes, heart disease or HIV; and health-care professionals, caregivers and people who have household contact with individuals at high risk. And for the first time, U.S. health authorities this year are recommending that children aged 23 months to 5 years old also be vaccinated against the flu.

"Recently there's been a real increase in recommendations to prevent what they call influenza with the use of inactivated [dead virus] vaccines," Jefferson said.

For Jefferson, the question is whether such policies are justified.

Previous papers published by Jefferson found that the flu vaccine is only mildly effective in the population for which it is supposedly most critical, the elderly. He also concluded that there is no good science to back new American and Canadian policies of vaccinating children under the age of 2.

For the latest study, Jefferson looked at all the systematic reviews in the world that he could find on the effects of inactivated vaccines. In other words, he looked at published papers that did not generate new data but analyzed existing studies.

"These are reviews of studies, not single studies," he explained. "Systematic reviews are the gold standard for evaluating effectiveness."

Overall, Jefferson concluded, influenza vaccines have little or no effect on many influenza campaign objectives, such as hospital stay, time off work, or death from influenza and its complications.

"I looked at the evidence described by systematic reviews and confronted it with policy and I found that there is a massive gap," Jefferson said. "Almost none of the benefits that these policy documents list are actually given by inactivated vaccines or, if they are, they are given in slighter measure."

Why? He's not sure.

It could be confusion between influenza and influenza-like respiratory illnesses, or inadequate surveillance systems.

"In most surveillance systems, you actually have an almost year-round epidemic which, in fact, is not influenza," Jefferson stated. "It's caused by other agents."

Jefferson also found that many of the existing studies are weak.

But another health expert disagreed with Jefferson's findings.

"The flu vaccine works about 70 to 90 percent of the time in preventing infection in children and young adults and about 40 or 50 percent to 70 percent in the elderly," said Dr. Peter Gross, an influenza expert and chairman of medicine at Hackensack University Medical Center in Hackensack, N.J.

Gross was referring to the body's immune response to the vaccine or whether the vaccine produces enough antibodies to confer protection. "To say that the influenza vaccine is worthless is misleading," he said.

Gross said the evidence is more compelling in favor of flu shots.

"My message is definitely go out there and get the flu vaccine if you're an older individual," Gross advised. "If you're elderly and feel as though you're getting a flu-like illness, speak to a physician to consider an anti-influenza drug because the vaccine is not 100 percent effective in this group."

An estimated 20 percent of Americans get the flu each year. More than 200,000 people are hospitalized from flu complications, and as many as 36,000 die from the infection each year, according to the U.S. Centers for Disease Control and Prevention.


Doctors 'wasting time giving flu jabs to some patients'


DOCTORS are wasting their time giving much-vaunted flu vaccines to many patients, an expert has warned.

Leading health researchers claimed today that giving them to children under the age of two has the same effect as giving them a dummy drug.

And there is little clinical evidence that the vaccines have an impact on hospital stay, time off work, death in healthy adults, or even those with conditions like asthma and cystic fibrosis.

Tom Jefferson, co-ordinator of the vaccines area of the highly-respected healthcare researcher Cochrane Collaboration, said an "urgent" review was now needed of the Government's vaccination campaign.

As Britain approaches the winter, when vulnerable groups are advised to take the vaccines to reduce the chances of developing severe influenza, Mr Jefferson cast doubt over whether preventative drugs can work.

He said influenza viruses mutate and vary from year to year, making it difficult for scientists to study the effects of vaccines.

And he said there is little comparative evidence on the safety of the vaccines.

He believes that often illnesses are listed as flu when they are not because there is a difficulty in distinguishing between flu and flu-like illnesses.

Writing in the British Medical Journal, he said: "The large gap between policy and what the data tell us is surprising. The reasons for this situation are not clear, and may be complex.

"The starting point is the potential confusion between influenza and influenza-like illness, when any case of illness resembling influenza is seen as real influenza, especially during peak periods of activity.

"Some surveillance systems report cases of influenza-like illness as influenza without further explanation. This confusion leads to a gross overestimation of the impact of influenza, unrealistic expectations of the performance of vaccines, and spurious certainty of our ability to predict viral circulation and impact."

Mr Jefferson said he believed that sometimes health boards issue vaccines just so that they can be seen to be dealing, or attempting to deal, with a situation.

In a separate background paper, he made the call for a re-analysis of the approach.

He said: "Given the huge resources involved in yearly vaccination campaigns, a re-evaluation should be undertaken."

The flu jab is given to high-risk groups first, including the over-65s, people with respiratory conditionsand chronic conditions such as diabetes.

Responding to Dr Jefferson's paper, flu vaccination provider Doctorcall insisted that its products were effective.

Its medical director Dr Charles Levinson said: "It is essential that those who require a flu vaccination do not panic as a result of this announcement and ask their GP or medical adviser for advice."

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Last updated: 27-Oct-06 13:32 BST