Patients have been asking me lately about whether or not they should get the flu vaccinations, both regular seasonal flu vaccination and the H1N1 swine flu vaccination.
I think the short answer for most of my patients is no. However, this is not a simple question, so I’m going to take a round about way of answering it, and first discuss vaccinations in general.
Even if every bad thing you have ever heard about the effect of vaccinations on individuals is true: (vaccinations contribute to autism in children, they can cause auto-immune disorders, people often get sick immediately after getting vaccinated, some of the additives in vaccines can contribute to cancer or neurological diseases); even then, from a public health perspective, vaccinations are still often beneficial. The benefits to the general public of not getting epidemics outweigh the individual negatives. Over the course of the 20th century vaccinations have apparently helped reduce the incidence of infectious diseases such as smallpox, whooping cough, and polio. At the same time, for most individuals there seems to be very little immediate negative effects from getting vaccinated.
So what we have to do is find a reasonable balance between the severity of the epidemic threat, the effectiveness of the vaccine against the epidemic threat, and the potential harm to the individual from getting vaccinated.
At this time, for the regular seasonal flu vaccine, there is little or no evidence that the flu shot is even effective at reducing the incidence of flu. You can see a very interesting article in this month’s Atlantic magazine, titled “Does the Vaccine Matter?” (Available online at: http://www.theatlantic.com/doc/200911/brownlee-h1n1 ). The years that the flu vaccine has been a good match for the seasonal flu have no difference in outcomes from the years in which the flu vaccine has been a poor match. No large scale double blind testing has ever been done. There is a widespread belief that flu shots reduce the incidence of flu, but very little evidence that this is true.
For the H1N1 swine flu vaccination (now just starting to be available) here is the situation: While the virus spreads easily, the sickness itself is so far relatively mild and most people have developed no lasting problems. At the same time, the effectiveness of the vaccine is unknown and the risk of potential harm from a new, relatively untested vaccine is higher than normal.
So it seems that for both seasonal flu and H1N1 swine flu, there is very little benefit from getting the vaccinations and very little risk incurred from not getting the vaccinations. This is why I have been recommending that patients not get flu shots and that patients instead take other steps to build their immune systems naturally.
Aside from the lack of benefits, there are potential downsides to getting the flu vaccinations. These downsides apply to most other vaccinations as well, and that is why vaccinations should be individually evaluated for benefits and risks. There is no effective treatment that doesn’t potentially cause some problems.
Here is a partial listing of some of the potential downsides of vaccinations:
Mercury in the form of Thimeresol is used as a preservative in many vaccines. Mercury is a known neurotoxin and can combine with other factors to induce neurological and auto-immune disorders.
If you are already sick, getting a vaccination may throw your immune system further out of balance and cause long lasting problems. Never get a vaccination when you are feeling sick. This is a particular problem with young children since their immune systems are not fully developed. Likewise, receiving multiple vaccinations at once is not a good idea. Children in this country receive far more vaccinations than in other countries with some evidence that their overall health is worse.
Introducing an infectious agent directly into the blood stream means that it is not mediated by the normal immune protections. In addition, some vaccines contain aluminum, formaldehyde and other toxic substances. These substances can cause allergic reactions that can lead to auto immune disorders in those who already have compromised health. Even non-toxic vaccine additives such as squalene or egg whites can induce allergic reactions when introduced directly into the blood.
There are many more potential downsides. Some people will develop either immediate or long term problems after getting vaccinated. Of course, most relatively healthy people will have no problems whatsoever with the vaccines.
In the case of the seasonal flu or H1N1 flu vaccinations, the risks of getting the vaccine are not balanced by the potential rewards.
The answer for other diseases or for future pandemic diseases could be different.