Re: Belief not science is behind flu jab promotion, new report says
In January 2000, just before the ACIP added annual flu shots to the U.S. immunization schedule for young children, Kenneth McIntosh said: "Randomized trials of the safety, effectiveness and cost-effectiveness of influenza vaccination of infants and toddlers should be conducted in populations large enough to identify any risks of rare adverse events and should be continued through several epidemics--long enough to establish their worth....Such studies would enable us to evaluate the benefits, risks and economic effects before we consider any national recommendation....The benefit-risk ratio would need to be very high, given the relatively small proportion of cases of severe respiratory illness that would be prevented, the probable need for more than one dose, the uncertainties and unpredctability of antigenic variability, and the need to immunize during a period when many other vaccines are given." (Editorial. NEJM 342:275, 2000) Dr.McIntosh's advice was ignored and we now recommend annual flu shots cradle-to-grave. The recent CIDRAP report just asserted that the expansion of flu vaccine recommendations in recent decades has NOT been based on scientifically sound data.
In spite of influenza vaccine's enormous commercial success we still lack the data to know if they have done more good than harm. Prior receipt of seasonal flu shots significantly increased the risk of pH1N1 infections during the 2009-10 pandemic (Skowronski. PLoS Med 2010) and Bodewes and colleagues refer to the "double-edged sword" of yearly influenza vaccinations because they prevent the induction of heterosubtypic immunity to pandemic strains in animals and children. (Lancet Inf Dis 9:784,2009. J Virol 86:11995, 2011) The question may become moot if, as some of us hope, a universal flu vaccine is forthcoming.
I believe that the flu vaccine juggernaut is one factor that undermines public confidence in the vaccines we really need.
Rapid Response:
Re: Belief not science is behind flu jab promotion, new report says
In January 2000, just before the ACIP added annual flu shots to the U.S. immunization schedule for young children, Kenneth McIntosh said: "Randomized trials of the safety, effectiveness and cost-effectiveness of influenza vaccination of infants and toddlers should be conducted in populations large enough to identify any risks of rare adverse events and should be continued through several epidemics--long enough to establish their worth....Such studies would enable us to evaluate the benefits, risks and economic effects before we consider any national recommendation....The benefit-risk ratio would need to be very high, given the relatively small proportion of cases of severe respiratory illness that would be prevented, the probable need for more than one dose, the uncertainties and unpredctability of antigenic variability, and the need to immunize during a period when many other vaccines are given." (Editorial. NEJM 342:275, 2000) Dr.McIntosh's advice was ignored and we now recommend annual flu shots cradle-to-grave. The recent CIDRAP report just asserted that the expansion of flu vaccine recommendations in recent decades has NOT been based on scientifically sound data.
In spite of influenza vaccine's enormous commercial success we still lack the data to know if they have done more good than harm. Prior receipt of seasonal flu shots significantly increased the risk of pH1N1 infections during the 2009-10 pandemic (Skowronski. PLoS Med 2010) and Bodewes and colleagues refer to the "double-edged sword" of yearly influenza vaccinations because they prevent the induction of heterosubtypic immunity to pandemic strains in animals and children. (Lancet Inf Dis 9:784,2009. J Virol 86:11995, 2011) The question may become moot if, as some of us hope, a universal flu vaccine is forthcoming.
I believe that the flu vaccine juggernaut is one factor that undermines public confidence in the vaccines we really need.
Competing interests: No competing interests