Honesty – And the Flu Vaccine

December 5, 2012 • Prescription Drugs • Views: 4407

 As a pharmacist people turn to me for answers.  They ask if they should get the flu shot or not.  They ask if it is safe.  They ask if it causes autism and numerous other childhood diseases.  Some are enormously skeptical of the pharmaceutical industry to begin with – but especially so of any type of vaccine.  I understand.  There are those who believe that the flu vaccine is right for everyone – and some that believe it is right for no one

What’s the truth? 

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Let me ask you a questionCan you handle the truth?  Can I?  Or are we- quite possibly – so sold out to our opinion on this subject that no amount of evidence, facts or statistics will ever convince you to change your personal belief?  Do we have a vested interest in “who” we believe?  I find that more often than not – we humans prefer to believe what we want to believe and are very slow to change views that we have worked hard to establish and maintain.

Allow me to ask another question:  What is an effective medication?  In other words, what does a drug/medicine/etc. have to do to be classified as “effective” in your opinion?  Does it have to work 100%?  If not, how about 80%?  60%?  40%?  Whether you are talking about the latest biotech drug to hit the market – or gandma’s home-remedy for indigestion – what determines if it is effective in your opinion.  This is important.  If it works for you…does that mean it is effective for everyone?  If it doesn’t work for you – will it not work for anyone either?  This question is more important than you may think.  It gets to the heart of our thinking views on health and medicine. 

Allow me to ask you just 1 more question.  What makes a medication – any medication – dangerous and inappropriate?  Are any side-effects acceptable?  If so, how many and how often?  Will 1 serious side-effect in 100 patients be acceptable?  How about 1 in 500?  1 in 1000?

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I ask the above questions for this reason.  Medicine is not God.  Medicine is not perfect.  Neither is nature.  And neither are we.  With every treatment there will need to be a risk vs. benefit evaluation made by individuals.  What is an acceptable amount of risk for a predicted amount of benefit?  This is not an easy question for anyone to answer.  In fact, to be HONEST, there is no answer.  If I happen to be the 1 person in a million that has a fatal reaction to an otherwise helpful drug…that would be 1 too many for me.  But that would not make the risk/benefit unacceptable for the other 999,999 people who were fine. 

Now, what are the facts related to flu and the flu vaccine?

Let’s be honest…shall we?

1)  How many people die from the flu every year?  Honest answer:  We don’t know.  Really, we don’t.  How could we?  It is easy to tell how many people die per year from auto accidents.  The car crashed.  They died.  Of course…even here…some of those people may have had fatal heart attacks which caused the crash…and we might not know about that.  Deaths by drowning or plane crashes or falling elevators are easy too.  But the flu, like many other infectious diseases is different.  When your body fights an infection, it can precipitate the worsening of other conditions like heart disease or asthma or diabetes.  What actually killed them?  Years ago physicians would write on the death certificate of uncertain deaths that a person died from “a visition of God.”  Yep.  That was about as close as we can get.  But even if we cannot know exactly how many people die from the flu, it is not entirely impossible to make estimates. 

An article from the CDC explains some of these complexities, and comes up with a round figure of about 25,000 deaths per year on average. 

Is that number perfect?  Of course not.  Is it close?  Maybe.  Some years maybe more than others.  But that isn’t the point.

2)  How many people simply GET the flu each year?  This is a very important question too.  It doesn’t have to kill you to have a serious impact on your life and the lives of others.  If you do get it, you can pass it on to others.  The honest answer is..like the above…we don’t know.  How could we?  Many will get the flu, be sick for a week or two, then go on with their lives.  But experience allows us to make some reasonable estimates.  We know that about 200,000 people will be hospitalized (on average) due to the flu each year.  We know – statistically speaking –  that from 5% to 20% of the population will actually come down with the flu each year.  That is a LOT of missed days of school, work, etc.  Not to mention the costs and risks involved in treating the symptoms associated with the flu.

3)  Does the flu vaccine work?  Here we go…wait for it….YESsometimes.  Really.  Thats the truth.  It sometimes works.  Listen, there are 4 types of people in the U.S.  Everyone will fall into 1 of these 4 categories (lets call them a,b,c,d):

a) There are those who will get the shot…and get the flu.  It will happen. 

b) And there are those who will get the shot and NOT get the flu. 

c) There are those who will NOT get the shot and get the flu

d) And there are those that will NOT get the shot and not get the flu

That’s it. 

The VAST majority of people are in category “d.”  They won’t get the shot and they won’t get the flu. 

The smallest group are those who GET the shot and ALSO get the flu.  It happens. 

The flu vaccine is not an exact science.  It is different than the vaccine for smallpox, polio or measels (ever had those? Probably not).  It changes year to year. 

The best studies that are available suggest that the flu vaccine will reduce the chances of a person contracting the flu.  The chances are low already.  We know that.  The flu vaccine makes it a bit lower.  About 2.7 people per 100 get the flu.  With the vaccine – and all other things being equal – vaccinated individuals get the flu at a rate of about 1.2 per 100.  Not a big difference.  But a difference none the less. 

The BIG difference comes when we begin to multiply.  Let’s be conservative.  No study suggests the flu vaccine works as poorly as I shall propose.  But just to err on the side of the skeptic for a moment.  Let’s say that with NO vaccine, 2 people per 100 get the flu.  With the vaccine we shall say 1 person per 100 gets the flu. 

So, vaccinating everyone would mean 1 person instead of 2 get the flu out of 100.  Doesn’t sound like much.  But now multiply.  My little state of Massachusetts has about 6.5 million people who live here.  Using those VERY SAME figures, vaccinating everyone would result in 65,000 FEWER flu cases.  65,000!  That is big.  And that is just 1 little state.  I hope that makes the point a bit clearer.

What about all the noise about flu vaccines causing all sorts of illness and sickness and diseases? 

Doesn’t the flu vaccine cause autism? 

The simple answer is that there is no study which demonstrates a cause/effect relationship between vaccination and other illnesses.  I have looked at the “proof.”  The studies are not studies at all.  One website asks patients to “self report” their illnesses anonymously and indicate if they were ever vaccinated.  This is not science.  This is not a study. This is silly.  But worse, it is dishonest. 

So should you get a flu vaccine?  Personally, I do.  Not because it is a miracle cure and guarenteed protection against the flu.  I get the shot because behind the shot there is a principle I believe in.  We were created with an amazing immune system with the capacity to protect and heal.  It isn’t perfect, but it can be utilized.  And the principle of vaccination is just that.  It utilizes our God-given immune system to combat infectious intruders into our body.  The principle is good.  The principle is proven.  The “practice” is not always perfect.  It won’t ever be.  Medicine is not God.  And neither am I.  For that we can all be thankful.

 

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Author: Jason Poquette

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