At one time, vaccines were not very controversial. In the 1950s, parents were overjoyed to vaccinate their children against polio. I should know. My parents feared I would die because I caught polio when I was a child. I spent weeks immobilized in traction in a polio ward. That was in 1947 and 1948, before there was a polio vaccine. Children were dying all around me of a disease that could not be cured. That experience left lasting scars. That’s why I care a lot about vaccine effectiveness. What do you need to know about various vaccines and how well they work?
The Anti-Vax Movement Is Gathering Steam:
There is a tremendous anti-vaccine movement that has evolved over the last two years. A great many people have turned the COVID-19 vaccine into a political litmus test.
To better understand this vaccine, it is worthwhile to step back and compare COVID-19 vaccines to past vaccines. For example, how do the various mRNA vaccines compare to the influenza vaccines? Read on to learn more. But first, a very quick vaccine overview.
Polio Vaccine Effectiveness:
Very few Americans have a clue what polio was like. That’s because this killer virus disappeared from the United States in 1979.
Children get three doses of the polio vaccine before the age of two. A booster is administered between ages 4-6 years. That provides 99% to 100% vaccine effectiveness.
Parents no longer have to watch children die from paralysis. Kids are no longer locked in iron lungs to help them breathe. They don’t have to wear braces on their legs to help them walk. Trust me when I tell you that polio caused panic every summer when it emerged with a vengeance.
Does anyone want to see a return of this dread disease? Of course not! The inactivated polio vaccine (IPV) has pretty much eliminated this scourge from the planet, though there are still a few countries where it lingers: Pakistan, Afghanistan and Nigeria.
Smallpox Vaccine Effectiveness:
Smallpox existed on the planet for thousands of years. This disease caused untold misery and death. It is estimated that 30% of the people who caught the “pox” died. The survivors were often left with horrific scars. Some of them were blind as a consequence of the infection.
We have no way of knowing how many people died from smallpox. In the last century alone, hundreds of millions of people were lost to this virus.
A vaccine actually helped eradicate smallpox from the face of the earth. It is 95% effective in preventing infection. Thanks to this vaccination, smallpox disappeared from the US in 1972. That’s when children here stopped getting vaccinated. The last case identified in the world was in 1977 in Somalia, thanks to a coordinated worldwide vaccination effort.
What About Tetanus?
Tetanus is a potentially life-threatening disease caused by Clostridium tetani. People can get the spores through exposure to contaminated soil or a puncture wound. The classic example is stepping on a rusty nail.
Without immunization, the result can be “lockjaw.” This involves involuntary muscle spasms in the jaw, stomach or other muscles. People have trouble swallowing and can develop seizures or die. There is no cure for tetanus, but the vaccination is roughly 100% effective according to Johns Hopkins Medicine (Sept. 3, 2021).
What About Whooping Cough (Pertussis)?
Once I recovered from polio, my parents were always on alert for any other serious infection. But vigilance did not protect me from whooping cough. It too is a childhood killer.
The bacterium that causes this potentially fatal respiratory disease is Bordetella pertussis. The cough is very distinctive, and it freaked my parents out. They were afraid that they would lose me to whooping cough after I survived polio.
I did manage to overcome this disease, but it left me with a twitchy respiratory tract. Every time I started coughing as a child, my parents would look anxious.
The pertussis vaccine is usually administered with both a diphtheria and tetanus shot. The DTaP vaccines do not provide 100% protection against these diseases, but they do provide 80 to 90% vaccine effectiveness.
Measles, mumps and German measles (rubella) once caused a lot of childhood illness, sometimes with serious complications. For decades, though, most children were vaccinated against these three viral infections without a great deal of controversy. That has changed in recent years, in part due to anti-vaccination campaigns.
How Effective Is Influenza Vaccine Effectiveness?
Influenza vaccination has become a routine fall ritual. Unlike the other vaccines, though, you need a new flu shot every year. That’s because the virus mutates. As a result, last year’s flu shot may not protect you from this year’s strain of influenza.
That seems to be what happened in the 2021-2022 influenza season. According to the CDC, the shot was only about 16 percent effective. That is not statistically significant and is lower than the usual 40 percent effectiveness rate for the average influenza vaccine.
Do you find an overall flu vaccine effectiveness rate of 40% disappointing? We do. Here are the CDC numbers upon which we base that calculation:
Vaccine Effectiveness in Past Years:
2004-2005: Vaccine Effectiveness was: 10%
2005-2006: Vaccine Effectiveness was: 21%
2006-2007: Vaccine Effectiveness was: 52%
2007-2008: Vaccine Effectiveness was: 37%
2008-2009: Vaccine Effectiveness was: 41%
2009-2010: Vaccine Effectiveness was: 56%
2010-2011: Vaccine Effectiveness was: 60%
2011-2012: Vaccine Effectiveness was: 47%
2012-2013: Vaccine Effectiveness was: 49%
2013-2014: Vaccine Effectiveness was: 52%
2014-2015: Vaccine Effectiveness was: 19%
2015-2016: Vaccine Effectiveness was: 47%
2016-2017: Vaccine Effectiveness was: 42%
2017-2018: Vaccine Effectiveness was: 38%
2018-2019: Vaccine Effectiveness was: 29%
2019-2020: Vaccine Effectiveness was: 39%
2020-2021: Vaccine Effectiveness was not calculated in part because there was so little influenza.
2021-2022: Vaccine Effectiveness was: 16%
Overall Effectiveness (not including 2021-2022): 40%
The CDC concluded (MMWR, March 11, 2022):
“This analysis indicates that influenza vaccination did not reduce the risk for outpatient medically attended illness with influenza A(H3N2) viruses that predominated so far this season”
It’s a good thing there was very little influenza activity this season, since there was an apparent mismatch between the vaccine and the strains of flu virus that were circulating.
This year’s flu shot was especially disappointing, but even in a good year, the vaccine is rarely more than 40 percent effective. Nonetheless, getting a flu shot has not been controversial. Many of the people who don’t think twice about getting a flu shot are dead set against the COVID-19 vaccine.
How About COVID-19 Vaccine Effectiveness?
The COVID vaccinations have been divisive almost from the very beginning.
A new study, however, showed that (MMWR, March 25, 2022):
“Analysis of data on severe COVID-19 outcomes from a multistate hospital network found that receipt of 2 or 3 doses of a COVID-19 mRNA vaccine conferred 90% protection against COVID-19–associated IMV [invasive mechanical ventilation] or in-hospital death among adults.”
These results are impressive by any vaccine yardstick.
What About Vaccine Complications?
Vaccines are not without side effects. We are as concerned about adverse reactions from vaccinations as we are about any medication.
The flu shot can cause some people to feel ill for days. Readers of our column have reported lasting shoulder pain, especially if the shot is not administered correctly. Read about this complication at this link.
The mRNA COVID vaccines have also triggered a range of reactions. Some people report tinnitus (ringing in the ears), headache, muscle and joint pain, fever and fatigue. In rare cases, young men have developed inflammation of the heart muscle. There are also other complications of the various COVID vaccinations. The vaccines are not risk-free by any means.
Vaccines vs. Drug Side Effects:
All drugs have the potential to cause some side effects in some people. That is a fact of life. There are always trade-offs. If you watch any television, you know that prescription drug commercials describe some amazingly horrible adverse reactions. Here, for example, is a warning that comes with a drug for rheumatoid arthritis called Rinvoq:
“Rinvoq can lower your ability to fight infections, including tuberculosis. Serious infections and blood clots, sometimes fatal, have occurred, as have certain cancers, including lymphoma, and tears in the stomach or intestines and changes in lab results.”
FDA has also announced that drugs in this class (JAK or Janus Kinase inhibitors) can cause:
“…an increased risk of serious heart-related events such as heart attack or stroke, cancer, blood clots, and death.”
This is just one example of medications that can cause life-threatening adverse reactions. It is not meant in any way to diminish the serious side effects of vaccinations. It is just a reminder that there are benefits and risks to every medicine and procedure.
At last count, over 80 million people in the US have caught COVID-19 and nearly 1 million have died. Worldwide, over 6 million have died. As we mention in this article, the actual numbers are probably much higher. An analysis in The Lancet (March 10, 2022) concludes that the actual death toll is “3.07 times higher than the reported number of COVID-19 deaths.”
The authors conclude:
“Our findings indicate that the full impact of the pandemic has been much greater than what is suggested by official statistics.”
Final Words About Vaccine Effectiveness:
We wish that vaccinations had not become politicized. We would also appreciate more transparency about the effectiveness and the side effects of all vaccines. That way people will be more capable of determining for themselves when a vaccine, like the flu shot, makes sense.
What do you think? I would like to get your opinion about polio, whooping cough, smallpox or tetanus. If there were a Lyme vaccine, would you consider it? How about an mRNA influenza vaccine that was 95% effective? Would you consider it?
If you had crippling rheumatoid arthritis that prevented you from doing the things you love, would you consider drugs like Humira, Enbrel or Rinvoq, even if such drugs have potentially serious side effects? How do you weigh benefits vs. risks?
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Joe Graedon is a pharmacologist and was:
- Founding member of the Society for Participatory Medicine
- Co-editor of the Journal of Participatory Medicine
- Founding member of Patient Advocacy Council and member of the Patient Safety and Clinical Quality Committee of the Duke University Health System from 2003 to 2011
- Doctor of Humane Letters Honoris Causa from Long Island University in 2006 as “one of the country’s leading drug experts for the consumer”
- Fellow in Pharmaceutical Sciences of the American Association for the Advancement of Science (AAAS) for “exceptional contribution to the communication of the rational use of pharmaceutical products and an understanding of health issues to the public” in 2005