Influenza Virus (flu), Vaccination and Naturopathic Practice

by: Dr. Hal Brown, originally published in NDNR

 

Influenza: from the French word, influentia, this refers to the belief that epidemics were caused by the influence of the stars.

 

Patient Care

 

In my practice as I suspect in most others, many patients each year ask whether I think they should receive the flu vaccine.  Others inform me that they have just received one, and blithely assume this as an act of preventative health, like exercise and taking vitamins.  Still others request a homeopathic “vaccination” as an alternative protection or request a protective immune enhancing protocol.   Many patients are fearful of the flu for themselves or their elderly relatives and young children, and yet many are accepting of assumptions made by allopathic physicians and in the media regarding the “normality” of getting an annual flu shot. 

 

Still other patients are concerned about getting the “shot” because of negative concerns.

They may question the vaccinations’ effectiveness because the formulation cannot be specific for the current virus.  There may be concern that negative effects may occur many months or years later. These concerns are based on anecdotal evidence and although there may be a basis for these concerns, to date, a cause and effect relationship has not been proven. Vaccines are a combination of ingredients including egg protein, aluminum (thimersol use has been limited) and formaldehyde.  Patients may react to the de-activated virus, toxins or potential allergens in the vaccination.  They may also question its effectiveness.

 

We also see many patients who have received “their shot” come down with the flu and others who claim they haven’t been sick since receiving it.  Still others report reactions and illness in relation to the shot.

 

The Flu

 

Influenza, commonly known as the flu is often mistaken for almost anything that makes us feel ill.  Influenza is different from the common cold or other respiratory or viral conditions.  It is an infectious disease, primarily of the upper airways and lungs in mammals and is caused by an RNA virus of the Orthomyxoviridae family . The most common and characteristic symptoms of influenza in humans are fever and chills, pharyngitis, myalgia, severe headache, coughing, burning eyes and malaise.  It should not be confused with “stomach flu”, which is characterized by vomiting, nausea and diarrhea. The flu differs from the common cold in both its rapid onset and the potentially serious and/or life threatening complications that may occur especially in babies and the elderly.  It is a potentially serious illness and as many as 36,000 to 69,000 persons in the U.S. have died in a year. The flu epidemic of 1918-19, known as the Spanish flu, took an estimated 20-40 million lives , more than those that died fighting in WW I. The diagnosis of the flu is usually made by the presence of similar symptoms in the community.

The Flu Vaccine

Each year the influenza virus changes and different strains become dominant. Due to the high mutability of the virus, a particular vaccine formulation is considered to work only for about a year.  The World Health Organization co-ordinates the contents of the vaccine each year attempting to predict the most likely strains of the virus suspected to attack the next year.  Typically this vaccine includes material from two influenza A virus subtypes and one influenza B virus strain.   The flu vaccine is usually recommended for anyone in a high-risk group who would be likely to suffer complications from influenza.

Evidence for the benefits of flu vaccination:

Measuring of the efficacy of influenza vaccines can be done by immunizing adult volunteers and then challenging with virulent influenza virus. In studies such as these, influenza vaccines showed high efficacy and produced a protective immune response.  The meta-analyses examined the efficacy and effectiveness of inactivated vaccines in adults, children, and the elderly. ,   In adults, vaccines show high efficacy against the targeted strains, but low effectiveness overall, so the benefits of vaccination are small, with a one-quarter reduction in risk of contracting influenza but no effect on the rate of hospitalization. In children, vaccines again showed high efficacy, but low effectiveness in preventing "flu-like illness", in children under two the data are extremely limited, but vaccination appeared to confer no measurable benefit In the elderly, vaccination does not reduce the frequency of influenza, but may reduce pneumonia, hospital admission and deaths from influenza or pneumonia. ,  The measured effectiveness of the vaccine in the elderly varies depending on whether the population studies are in residential care homes, or in the community, with the vaccine appearing more effective in an institutional environment. This apparent effect may be due to selection bias or differences in diagnosis and surveillance.

The Case against the Vaccination Evidence

An analysis and comment on public health in the British Medical Journal, 2006, written by Tom Jefferson, co-coordinator 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”. He finds three serious problems with the current research claiming efficacy. The first is heavy reliance on non-randomized studies that are suggestive of protection, but its extent was impossible to measure because of the weak methods used in the primary studies.  The second problem is either the absence of evidence or the absence of convincing evidence on most of the effects. In children under 2 years inactivated vaccines had the same field efficacy as placebo, and in healthy people under 65 vaccinations did not affect hospital stay, time off work, or death from influenza and its complications.   The third problem is the small and heterogeneous dataset on the safety of inactivated vaccines, which he finds surprising given their longstanding and widespread use.  Also it is noted that there appears to be no evidence that annual revaccination is safe, such a lack of knowledge he also finds surprising.

In response to the Canadian government proposing to make universal immunization available to the population, the Globe and Mail published an article: “Universal flu shots;
the $125-million question”, in November, 2004.  It was written by Alan Cassels a drug-policy researcher with the University of Victoria and Jim Wright a professor in the departments of pharmacology and therapeutics, and medicine at the University of British Columbia.

 “A recent systematic review of more than 25 studies of flu immunization came to conclusions quite different than those recent front-page headlines would suggest. The internationally recognized Cochrane Collaboration (which accepts no money from the pharmaceutical industry) did a systematic review of all randomized trials studying the effectiveness of influenza vaccination and concluded that the evidence does not support universal immunization of healthy adults. This study found that the flu shot reduced the incidence of clinical influenza on average by 6 per cent, but there was high variability in effectiveness. There were not enough hospitalizations or deaths in the data to come to any conclusions as to what kind of payback the vaccines are delivering.  So the jury is still out on whether a flu shot for all Canadians is a good use of scarce health-care dollars.”

Allopathic Treatment for Flu

The usual advice is to get bed rest, drink plenty of fluids and take aspirin to diminish the fever.  Many physicians routinely prescribe antibiotics to treat the flu, a viral infection, although secondary bacterial infections may benefit.  There have been several anti-viral drugs developed. The FDA has approved Tamiflu to treat the flu.  Several studies have shown Tamiflu to be effective in preventing and treating the influenza virus. It is up to 92% effective in preventing influenza in adolescents, adults and the elderly. (Peters et al. 2001). As well, Ribavirin (Rebetol), a Hep C drug, has been used for over 20 years to treat the flu.

Naturopathic Therapy

Naturopathic treatments and preventative approaches to treating the flu are numerous. I like to joke that for every dozen NDs there are two dozen flu treatments.  The principles are similar, but everyone has their own favourite approach; homeopathic prophylaxis and remedies, hydrotherapies, immune enhancing diets, herbs, vitamins, injections, mushrooms, hormones, and many other nutrient supplements.  Philosophical variations occur with the Pasteur “viro-centric” perspective which utilizes natural therapies to stimulate immune function and provide anti-viral treatments.  This may be contrasted with the milieu model and the homotoxicology approach, which states that the terrain is everything.  In this model the influenza infection is categorized as being in the cellular impregnation phase of mesenchymal tissue.  In this phase inflammation is present and decomposition of the mesenchymal basic substance has occurred. The inflammation is due to the overload of homotoxins and the virus may be considered to be a homotoxin itself.  The reversal or regressive vicariation to a more benign phase begins by allowing the “stimulation therapy” of the fever.   The disease symptoms and the healing effects are viewed as being part of a “unified reaction process of the ‘holistic body’”.     

However varied our therapeutic approaches are, many are the result of collective anecdotal experience, therapeutic and philosophical biases, home remedies, a synthesis of available research or the last seminar attended.  No matter the approach, the naturopathic physician certainly has much more to offer a patient than just bed rest, fluids and aspirin.

Final Question, To Vaccinate or Not?

It is the policy of the B.C. Naturopathic Association to neither advocate for or against vaccination.  This, I believe is the right position to take.  The decision is one for the patient to make based on the most reliable information available to them.  It is our ethical responsibility to assist the patient in making their own decisions, without influence of our own opinions or biases and to continue care no matter their choice.  Many doctors are understandably passionately anti-vaccine, but keep in mind that the patient is asking for our advice and educated opinion, not a rant against a cavalier “medical-industrial” pharmaceutical industry.   

 


 

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