Influenza: Some Provocative Reading

I’m still seeing one or two children each day with Swine Flu symptoms and can reassure you that the government and the media are engaging in scare tactics rather than presenting the facts.

No lengthy newsletter to read today. Just a couple important medical articles. One from the lay press and one from a serious medical journal.

Please invest 15-20 minutes reading these two articles in full. I’ve given brief summaries of some of their information below.

One article is from a well-respected periodical and the other is from the most respected medical journal (BMJ) in the world and the Cochrane Collaboration which is the “gold standard” in medical information.

We expect H1N1 flu vaccines to arrive in our office in a week or two. I am willing to give them to high risk children. Tamiflu has side effects which give me great pause.

“Tom Jefferson, a physician based in Rome and the head of the Vaccines Field at the Cochrane Collaboration, a highly respected international network of researchers who appraise medical evidence, says: “For a vaccine to reduce mortality by 50 percent and up to 90 percent in some studies means it has to prevent deaths not just from influenza, but also from falls, fires, heart disease, strokes, and car accidents. That’s not a vaccine, that’s a miracle.”

“Jackson’s findings showed that outside of flu season, the baseline risk of death among people who did not get vaccinated was approximately 60 percent higher than among those who did, lending support to the hypothesis that on average, healthy people chose to get the vaccine, while the “frail elderly” didn’t or couldn’t. In fact, the healthy-user effect explained the entire benefit that other researchers were attributing to flu vaccine, suggesting that the vaccine itself might not reduce mortality at all. Jackson’s papers “are beautiful,” says Lone Simonsen, who is a professor of global health at George Washington University, in Washington, D.C., and an internationally recognized expert in influenza and vaccine epidemiology. “They are classic studies in epidemiology, they are so carefully done.”

“As with vaccines, the scientific evidence for Tamiflu and Relenza is thin at best. In its general-information section, the CDC’s Web site tells readers that antiviral drugs can “make you feel better faster.” True, but not by much. On average, Tamiflu (which accounts for 85 to 90 percent of the flu antiviral-drug market) cuts the duration of flu symptoms by 24hours in otherwise healthy people. In exchange for a slightly shorter bout of illness, as many as one in five people taking Tamiflu will experience nausea and vomiting. About one in five children will have neuropsychiatric side effects, possibly including anxiety and suicidal behavior. In Japan, where Tamiflu is liberally prescribed, the drug may have been responsible for 50 deaths from cardiopulmonary arrest, from 2001 to 2007, according to Rokuro Hama, the chair of the Japan Institute of Pharmacovigilance.”

“In summary, evidence presented here points to influenza being a relatively rare cause of [influenza-like illnesses] and a relatively rare disease. It follows that vaccines may not be appropriate preventive interventions for either influenza or ILI.”

Jay Gordon, MD, FAAP