brand new study shows that mandatory flu vaccines are not “evidence-based”

The first is a study from PLoS One (Influenza Vaccination of Healthcare Workers: Critical Analysis of the Evidence for Patient Benefit Underpinning Policies of Enforcement), the second is by Helen Branswell writing for the medical daily, STAT (Contentious Flu Vaccine Policies at Hospitals Are based on Flawed Research…), and the last is by Dr Mike Edmond, writing for his blog, Controversies in Hospital Infection Prevention — the post itself is called It’s Really Time to Fix This.  I would agree with Edmond’s assessment. It really is time to fix this debacle.  And for those of you who may not realize how severely and unfairly many HEALTHCARE WORKERS have been affected by this law (HERE is an example from someone I know personally), we can only hope that this situation is rectified soon.

The PLoS One study is something we’ve seen before.  The authors (nine Canadians and one French researcher) looked at four large trials that had all come to the conclusion that vaccinating healthcare workers against influenza provided great benefit to patients in the form of less flu.  In Cherry-picked fashion (my usual modus oporandi), we see that the authors of today’s study thought otherwise. “Realistic recalibration based on actual patient data shows that at least 6,000 to 32,000 hospital workers would need to be vaccinated before a single patient death could potentially [emphasis on potentially] be averted.  The impression that unvaccinated healthcare workers place their patients at great influenza peril is exaggerated.  Current scientific data are inadequate to support the ethical implementation of enforced healthcare worker influenza vaccination.”  Again, nothing new, although it’s vindicating to see it coming up in the medical community again and again and again.  Of the three papers being discussed today, the best by far comes from Dr. Edmond.

Edmond is, by any measure, a sharp guy.  He’s authored over 350 papers, abstracts, and book chapters.  He is an MD with masters degrees in both public health (MPH) and public affairs (MPA).  And according to his bio he is currently Chief Quality Officer and Associate Chief Medical Officer for University of Iowa Health Care as well as being the Clinical Professor of Infectious Diseases at the University of Iowa Carver College of Medicine.  Not surprisingly, he’s held a whole bunch of prestigious positions in other states he’s lived in (Virginia and Pennsylvania) as well.  Like I said, sharp guy.

What he discusses in HIS SHORT BLOG POST is similar to what I have shown you over and over again on my site. Seven years ago, SHEA (the Society for Healthcare Epidemiology of America) proposed new guidelines “suggesting” that if you want to work in a healthcare facility, either get vaccinated against the flu or get out.  CMS (Centers for Medicare & Medicaid) took this paper and ran with it in ways that look rather foolish in light of what peer-review actually says on the matter.

Much of it has to do with the fact that some of the people who created these guidelines stood to profit handsomely from a flu vaccine mandate.  Edmond wrote about this back in 2010 saying, “If you are a guideline author recommending a vaccine and have received money from a vaccine maker, that IS a conflict of interest, not a potential COI or the appearance of COI.  Other sources define COI differently, but I do agree that the conflict clearly exists in the case of the vaccine guideline. Whether it had impact is a different question. I do think it looks bad, and gives the anti-vaccine crowd ammunition.  By the way, I think the guideline is based more on emotional arguments than real data.”

We see a couple of things in Edmond’s quote.  The first is that he is definitely not one of those evil “ANTI-VAXXERS” like many would call me.  He is actually a very pro-vaccination physician who is, unlike most, being honest about the science.  And secondly, we can’t trust guidelines that authors are making money off of — potentially huge money — even when they TRY AND CLAIM the money does not influence their decisions, which they always do.  In fact, on many different occasions I’ve dealt with the crazy number of financial conflicts of interest that can be found in our NATION’S NUMEROUS MEDICAL GUIDELINES — Guidelines that are all too often for sale to the highest bidder.

The rest of his paper discusses the PLoS One study, showing that the data SHEA originally used for their recommendations had been cooked.  And here’s the thing folks; when it comes to research, cooking the books is simple, with ANY NUMBER OF WAYS to get results to come out exactly how you want them to, which is exactly what SHEA did (and if they don’t come out as planned, HERE’S WHAT BIG PHARMA DOES WITH THEM).  Remember the stats I showed you a few paragraphs ago showing how many people would need to be vaccinated to “potentially” prevent a single death from influenza?  Dr E shows how bad things are.

“Estimates of numbers needed to vaccinate were so flawed (off by as much as 4,000-fold) that if extrapolated to all healthcare workers in the US, more deaths would be averted than occurred in the 1918 influenza pandemic.  Here’s the bottom line per the authors: ‘Each of the four cluster RCTs used to champion compulsory healthcare workers influenza vaccination policies reports benefits that are mathematically impossible under any reasonable hypothesis of indirect vaccine effect. It’s hard to imagine a stronger conclusion’.   As I see it, unless SHEA cites alternative facts, it has three choices: change its position to recommending (not mandating) annual influenza vaccine for healthcare workers, articulate a damn good reason to support its current policy despite the evidence (hard to imagine what that would be), or simply retire the guideline (as it has quietly done for the 2003 highly controversial MRSA/VRE search and destroy recommendation).”

Next comes Branswell’s piece in STAT.  The best part of her article is definitely the comment section, where one individual chimed in with a long list of the studies showing flu vaccine to be ineffective.  She did, however, shed some light on a point brought up by Dr. Edmond.  Branswell provides a first-hand glimpse of how the evidence was “cooked” for this particular study, and how far from the truth their results really were.

“One the studies, from Britain, calculated that one influenza death would be averted for every eight staff members vaccinated. But if that were correct, vaccinating the estimated 1.7 million health care workers employed in long-term care [nursing homes] in the United States should prevent 212,500 flu deaths a year among residents. There’s an obvious problem though, the paper noted. Nowhere near that many people die from flu in the US [HERE].  If the calculation is applied to the 5.5 million hospital workers, mandatory flu shots should avert 687,500 deaths each year — more than the number of Americans who died in the 1918 Spanish flu…”

Today you get a bonus fourth paper.  The same issue of PLoS One carried a misguided defense of their work by one of the authors of one of the original nursing home studies that was being attacked by all comers.  Other than admitting that nursing home studies cannot be extrapolated to healthcare settings like clinics or hospitals, the author desperately clung to his refuted research, saying that, “Influenza vaccine is effective at preventing influenza in healthy young adults. The strategy to encourage influenza vaccination for health care workers is partly based on the simple notion that this can reduce the risk of staff acquiring and transmitting influenza to vulnerable patients and thereby reduce associated morbidity and mortality.  Despite high levels of resident vaccination, low vaccine efficacy in the elderly means that they remain vulnerable to influenza and its complications. Residents have very high rates of mortality and hospitalization especially during periods of influenza circulation.”  Want to see how false this simple cherry-picked paragraph really is?

First, according to the gold standard of gleaning the main conclusions from lots of studies and data, then crunching it into something usable — COCHRANE — it takes seventy one “healthy” people being vaccinated to prevent a single case of flu (HERE).  Secondly, when we factor in the elderly and most particularly the “frail elderly,” although their rate of vaccination is relatively high compared to the rest of the population, the rate of vaccine efficacy hovers around the level of placebo / sugar pills — just slightly better than zero (HERE).  In other words, vaccine efficacy for the elderly is admittedly far worse than for healthy adults.

Thus, you can see how adding these two facts together could not possible bring anyone with even an iota of intelligence to the conclusion that vaccinating healthcare workers could somehow prevent flu in the elderly. In fact, every single metric available shows how futile it really is to vaccinate any group against the flu (CHILDREN, healthcare workers, PREGNANT WOMEN, etc).  For the studies backing this up, you can either click these links, read through my FLU VACCINE POSTS one at a time, or you can see them altogether, crunched into my FLU VACCINE SUPER-POST.