A hundred years ago doctors practiced experience-based medicine. That is, they relied on the wisdom of past practices and what they observed with their own patients. There weren’t many scientifically proven remedies for common ailments like colds or flu.
These days, doctors have embraced evidence-based medicine. They look for randomized controlled trials of the medicines they prescribe and they seek rational evaluations of treatments.
The trouble is that even today, the evidence doesn’t always line up with the belief that something works.
Consider vaccinations against influenza, for example. Public health experts urge almost everyone to get a flu shot now, since the current flu season began early. After all, thousands of people die from influenza every year. Many of these deaths occur among older people at high risk for complications such as pneumonia.
It is disappointing so little data demonstrate that influenza vaccines protect elderly people from the flu. An analysis of 75 studies conducted by the Cochrane Collaboration, an independent and objective nonprofit organization, concluded that: “The available evidence is of poor quality and provides no guidance regarding the safety, efficacy or effectiveness of influenza vaccines for people aged 65 years or older.” (Cochrane Database of Systematic Reviews, Feb. 17, 2010).
We spoke with Tom Jefferson, MD, the lead author of two key flu analyses by the Cochrane Collaboration. He noted that vaccination can reduce symptomatic illness but cautioned, “That does not mean that there is evidence that [flu shots] prevent deaths or person-to-person spread or pneumonia…but the evidence is of extremely poor quality.”
Most people assume that if they get a flu shot they won’t get sick. That is the implied promise from public health officials. Dr. Jefferson suggests that may be overly optimistic. He points out that in healthy young adults for whom the shots work best, “you have to vaccinate between 33 and 99 healthy adults to avoid one case of influenza…In healthy adults, the vaccines shorten duration of illness by half a working day.”
Based on the available evidence, influenza vaccines are not as helpful as most people imagine. If you have to vaccinate scores of people to protect just one from fever, muscle aches and pains and all the other symptoms of flu-like illness, those are not great odds.
What about anti-viral drugs? A recent review by the independent Medical Letter on Drugs and Therapeutics (Dec. 10, 2012), concludes that oseltamivir (Tamiflu) or zanamivir (Relenza) can be useful for treating people who come down with influenza and need to be hospitalized. The authors suggest pregnant women and those at high risk for complications could benefit from such drugs.
Staying away from infected people is the best way to avoid catching the flu. That is easier said than done. Frequent hand washing is essential. Keep hands and fingers away from the face. Take at least 2,000 units of vitamin D3 every day during winter months because this hormone is essential for proper immune function. Probiotics may also be beneficial in reducing the number of respiratory tract infections people experience (Cochrane Database of Systematic Reviews, Sept. 7, 2011).

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  1. DT
    Reply

    I am required by my job to get the flu vaccine. I have no problem taking it. I just don’t understand why everyone is encouraged to get the flu vaccine if their are limited cases that show it is effective. I understand it decreases the severity of the illness if you get it but with so many strands of influenza out there does it financially and logically keep that many people from getting the flu.
    I guess I don’t understand the big push of getting the flu vaccine?

  2. gle
    Reply

    I did not intend to ‘shoot’ anybody, but I was honestly asking for clarification of the intent of your quoted statement. I would be glad to read the full article you linked to, but it seems to be behind a paywall.
    I understand you are summarizing some interesting research, but it is done in a way that leads the reader to question whether they should get a flu shot, even if they are http://www.cdc.gov/flu/protect/keyfacts.htm
    I really enjoy your show and articles, so I hope you will take these comments the way they are intended. I just do not think this article gave this serious topic the considerate treatment that it warrants.

  3. Barbara
    Reply

    Last night on Houston television channel 13 there was a news story about the flu racing through Houston, TX. The news reader said that although most of the people who have gotten the flu had the flu vaccine, we should all go out and get a flu shot immediately. This makes no sense to me and I never get flu shots. And I have had what was diagnosed as flu only once in my life, about 35 years ago. It was a very unpleasant upper respiratory infection with fever.
    Is the reason flu shots are not effective because flu viruses mutate and the drug companies have no way of knowing in advance which flu virus to put in their vaccines?
    Drug stores and grocery stores have big signs telling people to get their flu shots there. Why the big push for flu shots if they don’t protect against the flu? Are they that profitable?
    Will wearing a surgical mask when going out protect against the flu?
    I see photos of people in China wearing surgical masks in crowds and wonder if this is flu protection.

  4. gle
    Reply

    Regarding the statement, “In healthy adults, the vaccines shorten duration of illness by half a working day.”
    Are you saying that a healthy adult that received the flu shot and was exposed to a flu strain that was in the vaccine is still likely to get sick with only a slightly reduced duration? That is what is implied, but I suspect this is more of average over the entire vaccinated population.
    I was concerned to see this article in my local paper, convincing people not to get the flu shot, without a lot of specifics to back it up.
    PEOPLE’S PHARMACY RESPONSE:
    Please do not shoot the messenger. We were quoting Tom Jefferson, MD, who led the team that did the research:
    Most people assume that if they get a flu shot they won’t get sick. That is the implied promise from public health officials. Dr. Jefferson suggests that may be overly optimistic. He points out that in healthy young adults for whom the shots work best, “you have to vaccinate between 33 and 99 healthy adults to avoid one case of influenza…In healthy adults, the vaccines shorten duration of illness by half a working day.”
    We encourage you to actually read the report:
    An analysis of 75 studies conducted by the Cochrane Collaboration, an independent and objective nonprofit organization, concluded that: “The available evidence is of poor quality and provides no guidance regarding the safety, efficacy or effectiveness of influenza vaccines for people aged 65 years or older.” (Cochrane Database of Systematic Reviews, Feb. 17, 2010).
    http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004876.pub3/abstract

  5. fbl
    Reply

    Every year while in the military I had to get flu shots. No excuses. Every year I got very sick. I haven’t had a flu shot since I was discharged and no flu or colds!
    What do I do? I take vitamin C daily, an Ester C 1000 mg 4X a day and I take vitamin D daily.
    When I am around people who are sick I take a preventative dose of Grapefruit Seed Extract. There was one person constantly sick where I go for therapy. That meant all the machines and things were contaminated. I gave them a bottle of the Nutribiotic GSE and that stopped the colds and flu. Now the Dr. carries it in the office!

  6. DS
    Reply

    You do not even go into the dangers of vaccination.
    As for doctors these days, they “go with the flow” of whatever the drug reps suggest.

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