Flu Vaccine Cost Benefit for Adults

Here is a 2014 Cochrane Report on
Vaccines for preventing influenza in healthy adults
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001269.pub5/pdf/abstract

Key results
The preventive effect of parenteral inactivated influenza vaccine on healthy adults is small: at least 40 people would need vaccination to avoid one ILI case (95% confidence interval (CI) 26 to 128) and 71 people would need vaccination to prevent one case of influenza (95% CI 64 to 80). Vaccination shows no appreciable effect on working days lost or hospitalisation. The protection against ILI that is given by the administration of inactivated influenza vaccine to pregnant women is uncertain or at least very limited; the effect on their newborns is not statistically significant. The effectiveness of live aerosol vaccines on healthy adults is similar to inactivated vaccines: 46 people (95% CI 29 to 115) would need immunisation to avoid one ILI case.
The administration of seasonal inactivated influenza vaccine is not associated with the onset of multiple sclerosis, optic neuritis (inflammation of the optic nerve of the eye) or immune thrombocytopaenic purpura (a disease that affects blood platelets). The administration of pandemic monovalent H1N1 inactivated vaccine is not associated with Guillain-Barré syndrome (a disease that affects the nerves of the limbs and body).
Evidence suggests that the administration of both seasonal and 2009 pandemic vaccines during pregnancy has no significant effect on abortion or neonatal death.

Quality of the evidence
The real impact of biases could not be determined for about 70% of the included studies (e.g. insufficient reporting details, very different scores among the items evaluated). About 20% of the included studies (mainly cohorts) had a high risk of bias. Just under 10% had good methodological quality.

OK, so the Cochrane reports that it takes a lot of flu vaccines to prevent any influenza, and the evidence demonstrating even this gain is fairly crummy, so maybe it might not be real at all. They found no appreciable impact on working days, for example.

Kind of a contrast to the constant media blitz.

But here’s my problem with this: its hellaciously optimistic. It assesses the benefits of the vaccine, and finds them minimal if that, but IMO it doesn’t adequately assess the costs.

The costs I would worry about most, would be that the vaccine might damage the immune systems of the recipients, and that mercury or contaminants in the vaccines might add to total load and cause long term problems. Previous posts here have suggested these possibilities should not be overlooked.
I have not seen research I would say shows these things are happening, but also I haven’t seen the long term studies I think there should be asking the question either, so I have no confidence they aren’t happening. They represent a risk, IMO.

I think its worth pointing out that the Cochrane, pessimistic as it is, is not based on studies looking at long term health.
If the vaccine were to damage your immune system, you may suffer from that every year till you die.
If the total metal load is a problem, you may suffer from that every year till you die.
Any conceivable benefit of the flu vaccine, however, is almost certain to come in the first year, because after that the flu strain will have moved on.
I would like to see studies on flu vaccine recipients’ health in the 2nd year after the vaccine.
There is a bias in the literature, that these extended costs are not being considered, so far as I can tell, in cost-benefit estimates of the value of the vaccines.

6 thoughts on “Flu Vaccine Cost Benefit for Adults

  1. Seriously, you’re damaging your credibility with two things.
    – You keep using ‘damage the immune system’ which is too generic a term, similar to the way that nuts use ‘toxins’. You need to be specific about the issues involved.
    – Flu vaccines are not adjuvanted. I quote: “Seasonal influenza vaccines used in the United States do not contain adjuvants.” from http://www.cdc.gov/vaccinesafety/concerns/adjuvants.html

    If you want to say differently, you need to cite.

    1. Thanks for pointing that out. I’ll X out aluminum. I have not made much of a study of flu vaccines, particularly adult ones. I also haven’t seen any studies on long term effects, suspect they don’t exist.

      But about damage, that’s what I mean. I’m not claiming to have proof the flu vaccine damages immune systems. I’ve pointed out there’s evidence some have in the past. Shouldn’t there be some evidence they are safe? Absent that, how do you assess the risk? When you assess the risk, I was pointing out, you should weight it relative to the benefit according to the likelihood it will persist for years.

      1. No. You keep claiming extraordinary things without extraordinary evidence, and doing so sloppily. You, the outsider, claiming that the established process is broken, need to present more cleanly and carefully if you want to not be dismissed immediately by all right-thinking people. There are too many quacks out there to believe yet another one.

        There is a vaccine safety process that is followed, there is a VAERS system, which despite problems, does exist. If you want to make claims about the problems of the system (at least and have me listen to them any farther – this is my last attempt to engage with you, and I have been trying very, very hard, much harder than anyone else), they need to be carefully limited to claims limited to the evidence at hand.

        Your evidence for damage from flu vaccines is extremely weak. Your claim about aluminum in a flu vaccine context is just flat out wrong. Yes, there’s evidence that the flu vaccine isn’t particularly effective, but when you conflate that, your weak evidence against flu vaccines, and aluminum all together, you become just another quack.

      2. The statement ‘I’ll X out aluminum’ is extremely disturbing in this context.

        http://lesswrong.com/lw/js/the_bottom_line/

        Your comment reads to me like this:

        “I’ve made up my mind about vaccines being bad, and I’m going out and finding the evidence, and oh, hey, you pointed out a major problem with this subargument I was making, but whatever, my mind is made up, I’ll just remove that piece of the evidence and continue on with my argument.”

        1. I’m sorry you feel that way. I corrected the argument, because I’m not looking for evidence to make vaccines look bad, I’m looking for evidence that bears on the subject one way or another, and you provided some, so I integrated it into my picture.
          I’m not really sure what more you think would be a more appropriate response. The weight of the evidence after integrating your point is what it is.

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