The Flu – To vaccinate or not to vaccinate…

December 13, 2010

This time of year, this is the number one question at our clinic.  While it is hard to give a direct and easy answer, I thought I would take a minute to describe our naturopathic philosophy about the flu vaccine.  As always, if you have individual concerns, please schedule an appointment with your doctor to discuss this issue more thoroughly.

First, let’s discuss the flu.

Influenza is a potentially dangerous disease, particularly for the very young, the very old, and the immunocompromised. With influenza, one is more likely to develop secondary bacterial infections, such as pneumonia, otitis media, and sinusitis.  In rare cases, flu can even lead to serious infections of the blood, called sepsis.  Flu is not something that should be treated lightly; it is important to seek medical care if you develop symptoms such as:

  • A persistent fever of 101 degrees or higher for greater than 3 days;
  • Severe pain;
  • Severe lethargy;
  • Rash; or
  • Behavior changes.

Saying all this I do recommend the flu shot for specific patients, especially those that fit into the criteria of immunocompromise and those who are pregnant.  These patients may have a difficult time fighting off the flu virus as well as the more dangerous bacterial infections.

However, MOST healthy people have an immune system that can fight the flu very well, and as a result, they gain antibodies that help protect the person against flu in subsequent years.  It is okay to push the immune system a little to respond to viruses and bacteria, as long as we can intervene at the appropriate time.    The flu vaccine in the shot form is manufactured by guessing which flu strains will be coming around in that year.  As a result, the ingredients are often not the same strains and the flu vaccine does not provide the antibodies to fight the flu.  That is why many people who get the vaccine still get the flu.

There is mercury (thimerosol) used in the manufacture of the flu shot, (however, there is a small stash of mercury free vaccine for kids and pregnant women) which may potentially cause problems, esp. in children and if many vaccines are given over time.  The flu mist form of vaccine is mercury free, so that is good, but it is a live virus vaccine, which means that most people who get it will actually get a small touch of the flu and potentially spread it to others around them.

Furthermore, there is recent evidence that the flu vaccine only modestly improves patient symptoms and days of work lost. This study also showed that secondary bacterial complications from influenza were not reduced by the vaccine.

Here is the link to this study: http://www.ncbi.nlm.nih.gov/pubmed/20614424 and the main results and conclusions are shown below.

MAIN RESULTS: We included 50 reports. Forty (59 sub-studies) were clinical trials of over 70,000 people. Eight were comparative non-RCTs and assessed serious harms. Two were reports of harms which could not be introduced in the data analysis. In the relatively uncommon circumstance of vaccine matching the viral circulating strain and high circulation, 4% of unvaccinated people versus 1% of vaccinated people developed influenza symptoms (risk difference (RD) 3%, 95% confidence interval (CI) 2% to 5%). The corresponding figures for poor vaccine matching were 2% and 1% (RD 1, 95% CI 0% to 3%). These differences were not likely to be due to chance. Vaccination had a modest effect on time off work and had no effect on hospital admissions or complication rates. Inactivated vaccines caused local harms and an estimated 1.6 additional cases of Guillain-Barré Syndrome per million vaccinations. The harms evidence base is limited.

AUTHORS’ CONCLUSIONS: Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.WARNING: 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. The content and conclusions of this review should be interpreted in light of this finding.

If you don’t do the vaccine, what else can you do?

We know that there is good evidence that there are other things that can protect us from the flu equally as well as the flu vaccine.

One of these is taking probiotics as a daily supplement, at 10 billion organisms per day for adults or children.  http://pediatrics.aappublications.org/cgi/content/full/124/2/e172

Another is taking Elderberry syrup (1 tsp.per day for kids and 2 tsp. per day for adults). http://www.reuters.com/article/pressRelease/idUS119205+10-Sep-2009+PRN20090910  (from the July 2009 issue of the peer-reviewed scientific journal Phytochemistry , Volume 70, Issue 10).

Whether you choose to vaccinate with the flu vaccine this year, you certainly have our wish for good health this season!

Tamara Cullen, ND

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