By: Randy Naidoo, M.D.
There has been a significant amount of attention in the news regarding the influenza virus, and the effect it is causing in our community. Many times, as a medical professional with many years of experience in pediatrics and with many years of being well read in the literature regarding immunology and vaccines and the human body regarding physiology, I see a disconnect. I see the media that has no insight or knowledge into understanding human physiology and disease speak in quick 5 minute excerpts and short editorials about the dangers of the flu virus and death and need to get the vaccine and hysteria about shortages of vaccines and on and on and on. And frankly, it is disheartening. It is frustrating as a physician to have to deal with the same questions regarding some issues that are not in agreement with the literature or statistics. Sorry if I sound somewhat callus but there are much bigger issues in healthcare than the flu virus. We have children at an all time high with neurosensory issues, allergies and asthma on the rise as never before, patient with horrible skin issues and dry skin and eczema, and behavior issues causing wait times to see psychiatrist as long as 3-4 months.
We have injuries as the leading cause of death followed by heart disease and cancer and then issues such as homicides, suicide, asthma issues and then the flu. We have other issues to address in medicine than to have to deal with flu issues. Our emergency rooms are inundated with injuries, burns, foreign body, bites, stings, and several other issues that are not flu related. There is so much focus on the flu from December to March that we are distracted from the main issues during the winter season. How to be well. How to deal with issues that affect our youngest children such as the respiratory syncytial virus that causes high rates of hospital admissions.
Regarding the flu, since we have been able to keep statistics on flu, the vaccine has an effective rate of 50% and many would say that if you did not receive the vaccine, you possibly will pick up the infection 50% of the time. So whether you do the vaccine or you don’t, you have about a 50% chance of getting the flu. What the media needs to focus on is educating the public as to whether the death of an individual from the flu received the flu vaccine or did not and whether the individual had other medical conditions and whether the individual had been seen by a medical provider in the days leading up to the death. This information is not made privy to the public and therefore much of the media’s statements are speculation and nonsense. Without further facts, do not tell the public to get a flu shot when many of the people dying from the flu had their flu shot. And if 3 people die from the flu, don’t focus on the 1 who did not but focus on the 2 who did receive it. The 2 that did receive it will help us learn why the disease is severe and what we can do better as physicians and public health officials to protects people from the fatality of the flu. To simply end the news or editorials or internet columns with….. GET THE FLU VACCINE does not provide any worthwhile service for me as a physician.
Here is the hard data. The CDC states the vaccine effectiveness is 60%. This number stands for the decrease in patients: Coming to the doctors office, urgent care or ER with a confirmed positive test for flu. So first, understand what is being measured. This is not measuring deaths being prevented or how many people get sick. So if I have a patient who comes into my office and has flu symptoms but I don’t test them for the flu, I can’t put them in the flu vaccine category for effectiveness.
The problem with vaccine effectiveness is the bias we have as patients and physicians. You the patient get the vaccine and don’t think you have the flu virus when you are ill. I the physician see you in the office and do not check you for the flu because you received the vaccine. THIS IS THE PROBLEM, it’s healthcare and patient bias. If we tested patient’s for the flu who received a flu shot or mist, then we would know the true effectiveness of the flu vaccine. The problem, we DO NOT test patients as aggressively for the flu if they have had the vaccine and some physicians just treat with Tamiflu if the patient has flu-like symptoms so we further have no idea about whether the patient had the flu or not.
Last winter of 2012 and 2013, I worked in the urgent care at Pediatric After Hours and Urgent Care for Kids and I tested several patients for the flu who had the flu vaccine and they came back positive. I don’t need elaborate studies to help me understand the issues with the flu. People dying from the flu is not a simple issue of getting the flu vaccine. If we tested every patient coming through our offices and ERs for flu-like illness, then we will better understand how effective the vaccine is for the flu.
It is critical during this time of fear among the flu that you understand what you can do to help increase your immune system response to infection, what other means besides Tamiflu will help us deal with the effects of a virus on our bodies. If that means throwing the kitchen sink at someone with specific herbal, homeopathic, antiviral, nutritional aids and whatever else, then that is what we need to do.
We must move the discussion away from ONLY vaccines for the flu and give our patients a more complete recommendation of what to do against the flu in addition to the vaccine. If you are a patient or parent of SHINE, then we will be more than welcome to have that discussion.