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This week we're tackling the debate over the influenza vaccine, and whether it’s good or bad for you.
Infectious disease specialist Meenal Patel, MD and infection preventionist Megan Durkin, MPH with Banner Boswell Medical Center say the benefit of getting the vaccine is not only to protect yourself, but also to protect those that you encounter. Patel and Durkin say even if you become ill despite receiving the vaccine, the severity of illness may be mitigated.
Katie Weisman, director of communications and public policy for Coalition for SafeMinds, says the blanket recommendation for influenza vaccination for the entire population is currently unsupported if the criteria are both safety and efficacy. According to SafeMinds.org, reliable evidence on influenza vaccines is thin.
So, is the influenza vaccine good or bad for you?
Click "next page" to read the first of two positions, "Influenza vaccine raises significant concerns."
Influenza vaccine raises significant concerns: By Katie Weisman, director of communications and public policy for Coalition for SafeMinds
The question regarding influenza vaccine should not be whether it is good or bad for you, but rather whether it is both safe and effective. Since 2002, the Centers for Disease Control have rapidly expanded their recommendations for annual flu shots to now include the entire population. SafeMinds’ significant concerns with this policy are:
1. That the majority of flu shots in any given year (80-90%) still contain thimerosal, an ethyl-mercury preservative.
2. That research into efficacy has not shown the major benefits in all populations that one would assume based on CDC recommendations, especially for pregnant women, infants and children.
I will briefly try to summarize our concerns.
The majority of the public mistakenly believes that the mercury has been removed from all influenza vaccines when, in fact, only flu vaccines produced in single-dose syringes are typically thimerosal-free.
A second fallacy is that the amount of mercury in flu vaccines is so small that it is insignificant. If this were true, then leftover flu vaccines would not qualify as hazardous waste. Typical mercury-containing flu shots have a concentration of 50 parts per million mercury which is 250 times the EPA’s standard of 0.2 parts per million. There are multiple studies showing toxic effects on immune and nerve cells, using mercury blood levels that are easily induced by a single mercury-containing vaccine.
These studies are particularly concerning in their implications for fetuses and young children due to their low body weight and poor ability to detoxify heavy metals.
Background mercury levels in the blood of the US population are rising as evidenced by the CDC’s NHANES results. Our mercury exposures through dental amalgam, fish consumption and emissions from coal-fired power plants are already significant. Given data that mercury appears to concentrate in cord blood, EPA estimates that as many as 1 in 6 women of childbearing age already has a mercury blood level that potentially puts her fetus at risk of neurological injury. Adding more mercury to this load through flu shots is illogical.
Even in those 7 states that have passed laws against giving mercury-containing vaccines to pregnant women and young children, the protection is not adequate since the laws are waived when a public health “emergency” is declared. Here is an example: “While New York State Public Health Law 2112 usually restricts the use of thimerosal-containing influenza vaccines for pregnant women and children under the age of three years, the Commissioner has waived these restrictions to respond to shortages of both seasonal and 2009 H1N1 vaccine…Consent specific to vaccine containing Thimerosal is not required;…”.
In other words, there was no requirement to tell the mothers that they were receiving a flu shot with mercury.
In response to those who have supply concerns, influenza vaccine manufacturers claim that they can make the supply of influenza vaccine mercury-free if there is enough demand.
Influenza vaccines are a dollar or two cheaper per injection if produced in multi-dose vials with thimerosal. We respond with two thoughts. First, manufacturers should care enough about their customers to take the mercury out and absorb the cost.
Second, we should stop hearing inaccurate claims from health officials that “the mercury has been taken out of vaccines” because the demand will never change without public awareness.
Knowingly injecting a well-established neurotoxin into any person is simply wrong. It is time to stop fudging and truly get the mercury out of all vaccines.
Our second concern is that the blanket recommendation for influenza vaccination for the entire population is currently unsupported if the criteria are both safety and efficacy. Such broad policy should be based on rigorous science.
I will cite three examples that do not support the efficacy of influenza vaccine for all. A study in approximately 50,000 pregnant women and their infants over five flu seasons (Black et al. 2004) found no difference in the risk for developing influenza-like illnesses among those who received the influenza vaccine during pregnancy and those who did not receive the vaccine. The study did not report a significant benefit for either the mothers or their children on the outcomes measured.
Second, reviews in the medical journal, The Lancet, found a lack of health benefit of influenza vaccine for children under two and significantly increased rates of vaccine-related adverse events in children.
Lastly, the independent Cochrane Collaboration recently performed a review of influenza vaccination studies in healthy adults and came to the conclusion that “Influenza vaccines have a modest effect (2-5%) in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.”
Cochrane Collaboration also included this warning based on their previous work: “This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size.
Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies.”
Lastly, one needs only read the package inserts from influenza vaccinations to learn that they have never been tested in combination with other vaccines that might be given concurrently (a concern particularly for children) and that, according to all the flu vaccine manufacturers, its safety and efficacy have never been established in pregnant women.
SafeMinds believes that, as with all medical procedures, vaccination should be subject to risk/benefit analyses. We support safe, efficacious vaccination and we demand that the science supporting vaccination be done rigorously and without conflicts of interest, particularly since vaccines are typically given to healthy people.
All references are available on www.safeminds.org
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C lick "next page" to read the second position, "Influenza vaccine protects you and others"
Influenza vaccine protects you and others: By Meenal Patel, MD, infectious disease specialist and Megan Durkin, MPH, infection preventionist with Banner Boswell Medical Center
Influenza, or the flu, is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness which can result in death. The best way to prevent the flu is by getting the influenza vaccine each year.
The flu is unpredictable and severity of illness can vary widely depending on what flu virus strains are circulating, how much flu vaccine is available and when vaccine is given. The flu has a large impact on one’s body and can lead to complications such as bacterial pneumonia, ear infections, sinus infections, dehydration and worsening of chronic conditions such as diabetes, congestive heart failure and asthma. Influenza can cause death.
During last year’s H1N1 flu pandemic, approximately 12,000 deaths occurred, 90% of them in people younger than 65 years of age. The seasonal flu is the eighth leading cause of death in the United States with roughly 36,000 flu-associated deaths annually. Last year in Arizona, 13,032 flu cases were reported which resulted in 122 deaths, most due to the H1N1 pandemic strain. If the H1N1 vaccine had not been administered to so many people, the death toll may very well have been higher.
The most at risk groups are those younger than 5 years of age, especially those under 2, those over 65 years of age, pregnant women and those with chronic medical conditions such as: asthma, chronic lung disease, heart disease, cancer, diabetes, chronic kidney and liver disease and the morbidly obese. The benefit of getting the vaccine is not only to protect yourself, but also to protect those that you encounter with the above conditions.
As with any vaccination campaign, a large benefit of getting the flu vaccine as a community is to provide herd immunity. There are members of the community who are not able to get the vaccine or may not have access to the vaccine. Therefore the more people in the community that receive vaccine will in effect help to protect those who are unable to receive the vaccine.
Even if you become ill despite receiving the vaccine, the severity of illness may be mitigated.
Healthcare providers, day care providers and other types of personal care providers will be able to protect those they care for by not spreading influenza.
This year there will be plenty of flu vaccine available across the state such that everyone who wishes to receive vaccine should be able to. Arizona has already seen its first confirmed flu case of the season, making it imperative for everyone to visit their physician or one of the many mini-clinics and get vaccinated! If you are unsure whether you are a candidate to receive vaccination, please discuss your condition with your healthcare provider.
Centers for Disease Control and Prevention. (2010) Seasonal Influenza. www.cdc.gov/flu
Maricopa County Department of Public Health. (2010) www.WeArePublicHealth.org
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