Flu Vaccines

I (Joanna Karpasea-Jones) recently recieved a letter from my GP surgery asking me to go in for a flu jab. Here's what the letter said:

The doctors recommend that all patients in the following groups be 'immunised' against this serious illness -

Long term chest problems, including asthma
Long term heart problems
Kidney disease
Diabetes
Lowered immune system
Patients over the age of 65

As a patient in one of these categories you are more vulnerable (written in bold). Should you develop flu you are at risk of contracting really serious illnesses, including pneumonia, which in many cases requires hospitalisation. The best line of defence is vaccination (written in bold).

As you will know from recent press, hospital based bugs, ie MRSA are becoming more prevalent and infections are becoming resistant to antibiotics, making them harder to treat.

The injection is given free of charge and will cover you for a whole year. The vaccine does not cause flu (written in bold).

Drs L, T and G.

Exploring The Dr's Claims And Medical References Re Flu Vaccine

Firstly, I don't have chest or heart problems, kidney disease or lowered immune system. I am not asthmatic, I don't have diabetes and I'm only 31. So I'm not even in their catchment group of people they want to vaccinate. It made me wonder how many other times a surgery makes a mistake like this?

Symptoms of Flu

According to Dr. Trishna Macnair, from BBC's 'Ask the Doctor', flu has the following symptoms:

Fever
Chills
Muscle Aches and Pains
Severe headache
Weakness and tiredness
Loss of appetite
Sore throat
Chest pain
Cough.

Okay, so everyone knows it's not nice to have flu and you feel lousy, but it's not a 'serious' disease in the majority of cases.

How Long Does Flu Last?

Symptoms last about a week.

The illness usually lasts about seven to ten days, with the fever and aches improving after two to three days and the cough and sore throat lasting longer.

Dr. Macnair goes onto say that some people get depression lasting for weeks. Out of the dozens of flu documents and books on flu I have read, this is the first time I've seen 'depression' listed as a flu symptom. If this is the case, I would guess that it is not related to flu and you should seek a counsellor or good friend or just slow down and give yourself some TLC if you're feeling depression or 'down' feelings.

How Do I Treat Flu?

Rest is best

Until just recently, there were no specific medicines for flu. Most people got better on their own with simple relief for their symptoms. For example:

Rest. The most important thing in flu is to give your body a chance to heal itself by resting. Lie down and sleep if possible.

Keep well-hydrated with plenty of warm fluids.
Remedies for sore throat, headache and blocked nose.

She also recommends paracetamol but there are medical studies which have shown that anti-pyretics during an illness can worsen it and cause complications (VAN is planning a web page on this subject).

Flu vaccination

Remember, the vaccines are based on the types of flu that were causing problems among the human population the previous year. The flu virus constantly changes and the vaccine may be ineffective against new types of flu that have just appeared.

Flu Vaccine Manufacturer's Information

Indications and Usage:

This indication is based on immune response elicited by FLULAVAL, and there have been no controlled trials demonstrating a decrease in influenza disease after vaccination with FLULAVAL.

Ingredients of Flu Injection

LULAVAL is a trivalent, split-virion influenza virus vaccine prepared from virus propagated in the allantoic cavity of embryonated hens’ eggs. Each of the influenza virus strains is produced and purified separately. The virus is inactivated with ultraviolet light treatment
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followed by formaldehyde treatment, purified by centrifugation, and disrupted with sodium deoxycholate.
FLULAVAL is a homogenized, sterile, colorless to slightly opalescent suspension in a phosphate-buffered saline solution. FLULAVAL has been standardized according to USPHS requirements for the 2006–2007 influenza season and is formulated to contain 45 micrograms (mcg) hemagglutinin per 0.5-mL dose in the recommended ratio of 15 mcg HA of each of the following 3 strains: A/New Caledonia/20/99 (H1N1), A/Wisconsin/67/2005 (H3N2), and B/Malaysia/2506/2004. Thimerosal, a mercury derivative, is added as a preservative. Each dose contains 25 mcg mercury. Each dose may also contain residual amounts of egg proteins (≤1 mcg ovalbumin), formaldehyde (≤25 mcg), and sodium deoxycholate (≤50 mcg).

Non-Clinical Toxicology of Vaccine

FLULAVAL has not been evaluated for carcinogenic or mutagenic potential, or for impairment of fertility.

(They don't know whether it causes cancer, can mutate into other illnesses or if it causes infertility).

No controlled trials demonstrating a decrease in influenza disease after vaccination with FLULAVAL have been performed.

Animal reproduction studies have not been conducted with FLULAVAL. It is also not known whether FLULAVAL can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.

It is not known whether FLULAVAL is excreted in human milk.

Adverse Reactions To Flu Vaccine Injection

Pain, redness, headache, swelling, fatigue, myalgia, fever, malaise, sore throat, reddened eyes, cough, chills, chest tightness, facial swelling, Pharyngolaryngeal pain, upper respiratory infection, Arthralgia, Nasopharyngitis, back pain, Injection site erythema, diarrhoea, nausea, nasal congestion.

Mmmm, a lot of those symptoms sound like flu, don't they?

The data sheet further goes on to say:

Blood and lymphatic system disorders: Lymphadenopathy.
Eye disorders: Conjunctivitis, eye pain, photophobia.
Gastrointestinal disorders: Dysphagia, vomiting.
General disorders and administration site conditions: Chest pain, injection site inflammation, rigors, asthenia, injection site rash, influenza-like symptoms, abnormal gait, injection site bruising, injection site sterile abscess.
Immune system disorders: Allergic edema of the face, allergic edema of the mouth, anaphylaxis, allergic edema of the throat.
Infections and infestations: Pharyngitis, rhinitis, laryngitis, cellulitis.
Musculoskeletal and connective tissue disorders: Muscle weakness, back pain, arthritis.
Nervous system disorders: Dizziness, paresthesia, hypoesthesia, hypokinesia, tremor, somnolence, syncope, Guillain-Barré syndrome, convulsions/seizures, facial or cranial nerve paralysis, encephalopathy, limb paralysis.
Psychiatric disorders: Insomnia.
Respiratory, thoracic, and mediastinal disorders: Dyspnea, dysphonia, bronchospasm, throat tightness.
Skin and subcutaneous tissue disorders: Urticaria, localized or generalized rash, pruritus, periorbital edema, sweating.
Vascular disorders: Flushing, pallor.

Anaphylaxis has been reported after administration of FLULAVAL. Although FLULAVAL contains only a limited quantity of egg protein, this protein can induce immediate hypersensitivity reactions among persons who have severe egg allergy. Allergic reactions include hives, angioedema, allergic asthma, and systemic anaphylaxis (see CONTRAINDICATIONS [4]).
The 1976 swine influenza vaccine was associated with an increased frequency of Guillain-Barré syndrome (GBS).

Guillain-Barre Syndrome And Flu Vaccination

Guillain-Barré syndrome after influenza vaccination in adults: a population-based study.

Whether influenza vaccination is associated with Guillain-Barré syndrome (GBS) remains uncertain. METHODS: We conducted 2 studies using population-based health care data from the province of Ontario, Canada. In the first study, we used the self-matched case-series method to explore the temporal association between probable influenza vaccination (adults vaccinated during October and November) and subsequent hospitalization because of GBS. In the second study, we used time-series analysis to determine whether the institution of a universal influenza immunization program in October 2000 was associated with a subsequent increase in hospital admissions because of GBS at the population level. RESULTS: From April 1, 1992, to March 31, 2004, we identified 1601 incident hospital admissions because of GBS in Ontario. In 269 patients, GBS was diagnosed within 43 weeks of vaccination against influenza. The estimated relative incidence of GBS during the primary risk interval (weeks 2 through 7) compared with the control interval (weeks 20 through 43) was 1.45 (95% confidence interval, 1.05-1.99; P = .02). This association persisted in several sensitivity analyses using risk and control intervals of different durations. However, a separate time-series analysis demonstrated no evidence of seasonality and revealed no statistically significant increase in hospital admissions because of GBS after the introduction of the universal influenza immunization program. CONCLUSION: Influenza vaccination is associated with a small but significantly increased risk for hospitalization because of GBS.

GBS occurs after flu vaccination in 1 in 100,000 cases.

Arch Intern Med. 2006 Nov 13;166(20):2217-21.

Contraindications To Flu Injection (people who should not have it)

Hypersensitivity
FLULAVAL should not be administered to anyone with known systemic hypersensitivity reactions to egg proteins (eggs or egg products), to chicken proteins, or to any component of FLULAVAL, or who has had a life threatening reaction to previous influenza vaccination.

4.2 Acute Neurologic Disorder
Immunization should be delayed in a patient with an acute evolving neurologic disorder but should be considered when the disease process has been stabilized.

5 WARNINGS AND PRECAUTIONS
5.1 Guillain-Barré Syndrome
If Guillain-Barré syndrome has occurred within 6 weeks of receipt of prior influenza vaccine, the decision to give FLULAVAL should be based on careful consideration of the potential benefits and risks.

5.2 Persons at Risk of Bleeding
FLULAVAL should not be given to individuals with bleeding disorders such as hemophilia or thrombocytopenia, or to persons on anticoagulant therapy unless the potential benefit clearly outweighs the risk of administration. If the decision is made to administer FLULAVAL to such persons, steps should be considered to control the risk of hematoma following the injection.

Altered Immunocompetence

If FLULAVAL is administered to immunocompromised persons, including individuals receiving immunosuppressive therapy, the expected immune response may not be obtained.

5.4 Preventing and Managing Allergic Vaccine Reactions

Prior to administration, the healthcare provider should review the patient’s immunization history for possible vaccine sensitivity, previous vaccination-related adverse reactions and occurrence of any adverse event-related symptoms and/or signs, in order to determine the
existence of any contraindication to immunization with FLULAVAL and to allow an assessment of benefits and risks. Epinephrine injection (1:1,000) and other appropriate agents used for the control of immediate allergic reactions must be immediately available should an acute anaphylactic reaction occur.

Summary of Flu Vaccine Injection

1. Flu feels horrible but is rarely serious and usually clears up in a week to 10 days.

2. Rest and recuperation is the best tonic for flu.

3. There has been no double-blinded scientific study proving that flu vaccine reduces flu.

4. Flu vaccine can cause symptoms identical to flu and also additional symptoms more severe than flu.

5. There is a recognised increased risk of Guillain-Barre Syndrome after flu vaccination (a paralysing disease).

6. Flu vaccine injection contains thimerosal which is 50% pure mercury. This has been proven dangerous and removed as an added ingredient from childhood vaccines (although it is still used as an expicient and may be present in trace amounts in childhood vaccines).

7. Flu vaccine injection contains formaldehyde which is a class 1 carcinogen proven to cause throat and nasal cancers.

8. Flu vaccine injection is recommended for people with weakened immune systems, yet the vaccine may not work in people who are immuno-compromised.

9. Flu vaccine injection is recommended for people who are asthmatic, yet it is known to cause allergic asthma as listed in the side-effects.

Source: GlaxoSmithKline Fluaval vaccine data sheet, 2006.

Flu Mist Live Flu Vaccine Nasal Spray

Flu Mist Ingredients

The data sheet lists 3 types of live flu virus, monosodium glutamate, porcine gelatine (pig bones), sucrose, dibasic potassium phosphate, monosodium phosphate, gentamicin.

Adverse Reactions To Flu Mist Nasal Spray Vaccine

In children aged 6-23 months, wheezing requiring bronchodilator therapy or with significant respiratory symptoms occured in 5.9% of flu mist recipients, compared with 3.8% of the control.

(It wasn't a real control as according to the data sheet the control had been given an injectable flu vaccine by Sanofi Pasteur, rather than a harmless sugar pill or nothing at all).

Hypersensitivity, including anaphylactic shock has occured post-marketing.

Percentages Of Children With Hospitalisations And Cases Of Wheezing After Flu Vaccines

In babies aged 6-23 months: there were 4.2% who required hospitalisation after flu mist vaccine spray and 3.2% after injectable flu vaccine.

In children aged 24-59 months there were 2.1% who required hospitalisation after flu mist vaccine spray and 2.5% after injectable flu vaccine.

In babies aged 6-23 months there were 5.9% who suffered wheezing after flu mist vaccine spray and 3.8% after injectable flu vaccine.

In children aged 24-59 months there were 2.1% who suffered wheezing after flu mist vaccine spray and 2.5% after injectable flu vaccine.

Adverse Events Occuring Within 10 days after dose 1 of vaccine or control vaccine

Runny nose/nasal congestion:

51% of children vaccinated with flu mist vaccine spray and 42% of children vaccinated with injectable flu vaccine developed runny nose/nasal congestion.

13% of children vaccinated with flu mist vaccine spray and 12% of children vaccinated with injectable flu vaccine suffered decrease in appetite.

12% of children vaccinated with flu mist vaccine spray and 11% of children vaccinated with injectable flu vaccine suffered irritability.

7% of children vaccinated with flu mist vaccine spray and 6% of children vaccinated with injectable flu vaccine suffered lethargy (decrease in activity).

5% of children vaccinated with flu mist vaccine spray and 6% of children vaccinated with injectable flu vaccine suffered sore throat.

3% of children vaccinated with flu mist vaccine spray and 3% of children vaccinated with injectable flu vaccine developed headaches.

2% of children vaccinated with flu mist vaccine spray and 2% of children vaccinated with injectable flu vaccine developed chills and muscle aches.

6% of children vaccinated with flu mist vaccine spray and 4% of children vaccinated with injectable flu vaccine had a fever of 100-101 F

4% of children vaccinated with flu mist vaccine spray and 3% of children vaccinated with injectable flu vaccine had a fever of 101-102 F.

Adverse Events In Adults

A trial was conducted on adults aged 18-49, but it wasn't a true scientific trial as the placebo was flu mist as well!

The control group had regular refridgerated flu mist and the placebo had FROZEN flu mist.

44% of adults vaccinated with flu mist vaccine spray and 27% vaccinated with the frozen variety experienced runny nose.

40% of adults vaccinated with flu mist vaccine spray and 38% vaccinated with the frozen variety developed headache.

28% of adults vaccinated with flu mist vaccine spray and 17% vaccinated with the frozen variety developed sore throat.

26% of adults vaccinated with flu mist vaccine spray and 22% vaccinated with the frozen variety suffered from weakness and tiredness.

17% of adults vaccinated with flu mist vaccine spray and 15% vaccinated with the frozen variety developed muscle aches.

14% of adults vaccinated with flu mist vaccine spray and 11% vaccinated with the frozen variety got a cough.

9% of adults vaccinated with flu mist vaccine spray and 6% vaccinated with the frozen variety developed chills.

Other Adverse Reactions Post-Trial

Exacerbation of mitochondrial encephalomyopathy, gastrointestinal disorders - nausea, vomiting and diarrhoea.

Immune system disorders, hypersensitivity reactions, anaphylactic shock, facial edema, urticaria.

Nervous system disorders, Guillain-Barre Syndrome, Bell's Palsy.

Respiratory, thoracic, and mediastinal disorders, epistaxis.

Skin and subcutaneous tissue disorders, rash.

Contraindications To Flu Mist Vaccine Spray

You shouldn't be vaccinated if:

1. You have a history of anaphylactic shock after vaccines.

2. Allergy to egg or egg proteins.

3. Allergy to gentamicin (antibiotic).

4. Allergy to gelatine or arginine or with life threatening reactions to previous flu vaccines.

5. Children aged 2-17 who are taking asprin should not have flu vaccine because of the risk of Reyes Syndrome.

6. Flu mist should not be administered to any individuals with asthma.

7. It should not be given to children under the age of 5 who have a history of recurrent wheezing.

8. It should not be given to anyone with an underlying illness or disorder.

9. Administration of flu mist, a live virus vaccine, to immuno-compromised individuals should be based on careful consideration of the benefits and risks.

(VAN UK'S COMMENT: In all other medical documents we have read, live vaccines are absolutely contraindicated in immuno-suppressed people).

10. If you have had Guillain-Barre Syndrome within 6 weeks of a previous vaccination, flu mist should only be given based on careful consideration of the benefits and risks.

(This is because there is a higher rate of Guillain-Barre Syndrome cases occuring after flu vaccination).

Non-Clinical Toxicology of Flu Mist

Flu mist vaccine has not been evaluated for it's carcinogenic or mutagenic properties or it's potiential to impair fertility (ie, they haven't studied whether it causes cancer, can mutate into other illnesses or cause infertility).

It is not known whether the flu mist is excreted in human milk. There is a possibility of shedding of vaccine virus. Care should be taken with nursing mothers and infants.

It is not known whether flu mist can cause fetal harm or affect reproduction capacity.

Use of Flu Mist Vaccine In People Over 65

Flu mist is not indicated in this age group.

Subjects in this age group who had underlying medical conditions which would predispose them to the risks of flu, were studied for safety and they were found to have much higher rates of sore throat after vaccination.

It is also not indicated in people aged 50-64 because it is not effective in that age group.

Flu Vaccine Doesn't Work In The Elderly

Influenza vaccines may save fewer elderly people's lives than generally claimed.

The reason is that estimates of a 50% or greater reduction in all-cause mortality have emerged from cohort studies fraught with selection bias, asserted a review article in the October issue of The Lancet Infectious Diseases.

But the real effect with flu shots for those 65 and older during December through March could not have been any greater than 5% to 10%, said Lone Simonsen, Ph.D., of George Washington University here, and colleagues. That's the flu-related mortality burden found in studies of excess all-cause mortality.

Aside from these cohort studies, the evidence is too weak to show any mortality benefit in older adults, who account for 90% of influenza deaths each year, Dr. Simonsen and colleagues added.

Vaccination policies may need to be revisited, commented Tom Jefferson, M.D., and Carlo Di Pietrantonj, Ph.D., both of the Cochrane Vaccines Field in Alessandria, Italy.

"We must never again allow layers of poor research to mask substantial uncertainty about the effects of a public-health intervention and present a falsely optimistic view of policy," they wrote. They called for placebo-controlled trials.

The "illusory" estimates arose primarily from methodologically weak cohort studies, the GWU researchers said.

These studies used nonspecific endpoints, typically all-cause mortality and non-laboratory-confirmed influenza outcomes, while attempting to adjust for selection bias in multivariate models with health-status covariates defined by diagnostic codes.

Source: Medpage Today, 25 September 2007.
Studies cited were:

Simonsen L, et al "Mortality benefits of influenza vaccination in elderly people: an ongoing controversy" Lancet Infect Dis 2007; 7: 658-66.

Jefferson T, Di Pietrantonj C "Inactivated influenza vaccines in the elderly-are you sure?" Lancet Infect Dis 2007; 7: DOI:10.1016/S0140-6736(07)61389-0.

It should be noted that 90% of the flu death rate is in people over 65 years of age, when the vaccine is not effective anyway

Flu Vaccination Rates Up And So Is Flu - A 206% increase in calls relating to colds and flu

Just over half of patients aged over 65 have received their annual flu vaccination, according to the first uptake figures published for this season’s campaign.

Provisional data released from NHS Immunisation, derived from 7,139 (86%) of the 8,330 GP practices in England, shows that by then end of October 55.9% of patients aged 65 years and over had received their flu jab – up slightly from 54.7% at the same time last year.

30.6% of patients aged under 65 and in a clinical risk group had received their flu jab by the end of October, another modest increase from last year’s figure of 28.4%.

So far the flu vaccination campaign has not been dogged by the shortages of vaccine seen in previous years. But the latest weekly report on influenza, compiled by the HPA and including data up to December 7th, warns that 'influenza activity across the UK appeared to be increasing.'

The more recent data included in the HPA's weekly report puts flu vaccine uptake at 71.4% in the over 65s and 43.4% in the under 65s.
Click here to find out more!

The HPA report also states threshold for NHS direct have been exceeded, and the service has seen a 200% increase in the volume of cold and flu-related calls to their hotline.

From September 8 to December 7 NHS Direct experienced a 206% rise in callers ringing to seek medical advice about colds, flu, coughs and fever.

Source: Pulse doctor's magazine, 11th December 2008.

Nurses Don't Want To Take Their Own Medicine

'It's a basis right to say what is and isn't put into your body.'

Providence Alaska Medical Center has implemented a new policy telling its employees to either get a flu shot or get fired, and some workers are fighting it.

According to Providence, the Centers for Disease Control said it is unethical for health workers to not get a flu vaccine.

Providence said flu vaccination rates among its employees were not as high as they should have been, so a new policy has been put into place, forcing all employees to get a shot.

But the new rule has caused controversy, especially among nurses, and the nurses' union has filed a grievance protesting the policy.

"It is a basic right to say what is and isn't put in your body," said Debbie Thompson, president of the Alaska Nurses Association. "There is so many mixed studies on the flu vaccination study right now that it's hard to say what its success rate is."

Source: 2 News, KTUU.com, by Lori Tipton, 10 December 2008.

VAN UK'S Comment: Nurses say it's a right to decide what is put in the body yet in the States parents cannot choose until they file exemptions, some of which are denied, so it seems as if there is one rule for parents and another for the medical profession.

60% of Doctors Don't Have The Flu Shot (or spray)

the truth is, some doctors and nurses might talk the talk without walking the walk.

According to the most recent data from the Centers for Disease Control and Prevention, a significant chunk of health care professionals declined to get vaccinated against the influenza virus during the 2006-07 flu season, with only about 40 percent opting for a jab. It's an "abysmal and profoundly sad" statistic, according to Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt Medical School in Nashville, Tenn.

"Both the professional and ethical responsibility of all health care workers is to be vaccinated annually against influenza," Schaffner said.

Vaccination serves to protect both patient and health care provider from becoming infected with influenza, as well as from transmitting the contagious virus to others.

There are legitimate reasons to steer clear of the needle. People with an egg allergy might avoid getting the vaccine because viruses for the flu shot are grown in eggs. People with Guillain-Barre syndrome -- a disease that results in nerve damage -- should avoid getting vaccinated as well, since respiratory illnesses can trigger an episode.

Source: ABC News, 9th December 2008.

Summary of Flu Mist Spray Vaccine

1.The flu viruses in the spray vaccine are live. As well as live viruses it contains antibiotics which depress the immune system, harmful food additives and pig bones, making it unsuitable for vegetarians.

2. 4.2% of children vaccinated are hospitalized with breathing difficulty and upto 5.9% have wheezing.

3. The flu vaccine (both mist and injection) has side-effects identical to flu and other affects more serious than flu, in both adults and children.

4. The flu mist spray has a rate of side-effects higher than the injection.

5. The flu mist spray can cause anaphylactic shock and death.

6. The flu mist spray can trigger Guillain-Barre Syndrome, a paralysing disease.

7. It is not known whether flu mist spray causes cancer, affects unborn babies, mutates into other illnesses or causes infertility.

8. There has never been a placebo-controlled, double blinded trial of any flu vaccine to see if it works.

9. The flu vaccine is ineffective in the elderly - the very group who are at heightened risk from flu.

10. 60% of doctors and nurses refuse to get the flu shot or spray and many think it does not work, yet they still recommend it to the public.