Saturday, January 19, 2013

Flu: Yes, the Vaccine Works

If you have been stranded on a desert island the past month, you may not be aware that this year's flu season has been, to use not fully professional terms, a bitch. "Thirty states and New York City are reporting high ILI activity, an increase from 24 states last week," the CDC says in its typically restrained fashion ("ILI" stands for "influenza-like illness"--since a good percentage of these illnesses turn out on closer inspection to be due to other viruses such as metapneumovirus or parainfluenza). The city of Boston declared a state of emergency last week, and plenty of other places are buckling under the strain that the epidemic has placed on hospitals, nursing homes, doctors' offices, and pretty much everywhere else too.

I've been hearing various comments, sometimes from health professional colleagues, that the magnitude of the outbreak is the fault of a lousy vaccine--as many patients these docs and nurses have encountered with lab-confirmed flu did receive the vaccine. (I've seen about three such patients myself.) Hard not to conclude that we just had a dud of a vaccine, and if it weren't for that, we'd be in for smoother sailing this winter.

But it's worth noting that the influenza vaccine does, in fact, actually work. The data this year, while preliminary, indicate that the vaccine is about 60 percent effective--which means (roughly) that for every 10 people who would become sick from influenza infection as a matter of course, only four would become sick if those 10 people were vaccinated. That may not sound hugely effective but that's well within the range of a typical influenza vaccine, as this report demonstrates. And from a public health standpoint, a 60 percent effective vaccine translates to a tremendous preservation of resources.

That is, assuming people actually take the vaccine. Currently the vaccination rate appears to be hovering around 30 percent. Wouldn't it be fiendish if we charged higher copays for unvaccinated people who get hospitalized for influenza? Or made them pay full cost for oseltamivir (aka Tamiflu) once they develop symptoms? Now that might serve as a motivator to get people to offer their arms for the vaccine needle!

Also worth noting, since vaccines are so wildly misunderstood, that while the flu vaccine is only 60 percent effective, most other vaccines--especially the ones we offer children like the MMR--have effectiveness rates in excess of 95 percent. And there is no proof--none--that vaccines cause autism. For further reading, see here.

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