Flu vaccine: promote facts not fear

Despite a mountain of evidence that demonstrates influenza vaccination is both effective and safe, only 50% of health care providers are vaccinated. Unfortunately, there are consequences. Up to 23% of providers working in a hospital will be infected with influenza sometime during the flu season and many hospitalized patients will become ill and some will die from influenza they contracted from a health care provider. As a result, the American Academy of Pediatrics now endorses mandatory influenza vaccination for health care workers.

Dr. Bob Sears takes issue with the American Academy of Pediatrics and their recommendation in his recent opinion piece in Huffington Post. He feels health care workers shouldn’t be subject to mandatory vaccination and his argument focuses on possible vaccine risks.

Dr. Sears lists the following as potential side effects of influenza vaccination: “bleeding from low platelet blood cell counts, severe anaphylactic allergic reactions, Guillain-Barre [sic] Syndrome (temporary paralysis), seizures, inflammation of the brain and spinal cord, dysfunction of the nerves in the eyes, face, or arm, inflammation of blood vessels, shortness of breath, Stevens-Johnson syndrome (severe allergic reaction involving the skin and some organs), and chest pain.” He makes no mention of the actual incidence of these potentially serious conditions, but there is innuendo that they are significant problems. Perhaps so many health care workers choose to forgo vaccination, he opines, “Because they’ve all read the vaccine product insert.”

What Dr. Sears fails to mention is the very side effects described with the influenza vaccine are also seen with a multitude of both prescription and over the counter medications. For example, serious adverse effects of penicillin include the following: bleeding, severe anaphylactic allergic reactions, diarrhea that is watery or bloody, seizures, agitation, confusion, unusual thoughts or behavior, Stevens-Johnson syndrome (severe allergic reaction involving skin and some organs), inability to urinate (empty the bladder), weakness, and yeast infections. Penicillin causes more than a thousand deaths from anaphylaxis each year.

Every medication carries some risk, but due a multitude of studies and the National Adverse Event Reporting System we have hard facts when it comes to vaccines.During the 2009 influenza season approximately 82.4 million doses of the H1N1 vaccine and 125.5 million doses of the seasonal influenza vaccine were administered. The rate of serious adverse events was 8.8 per 1 million doses for the H1N1 vaccine and 4.1 per 1 million doses for the seasonal influenza vaccine. Each serious adverse event was reviewed to determine if it was directly related to the vaccine or not. For example, there were 48 reported deaths among people who received the H1N1 vaccine, although after review, none were found to be vaccine attributable. Once all the 2009 data was analyzed, the risk of death from influenza vaccination was calculated to be less than two for each 1 million doses administered. To put these numbers in perspective, last year 47 people died in New York City alone from H1N1. Nation wide there are more than 30,000 influenza related deaths each year and 281 children died from influenza in 2009, more than twice as many as 2008.

What about Guillain-Barré syndrome, a serious neurological disorder with a fatality rate of approximately 5%? Dr. Sears fails to mention that not all studies have identified an association between Guillain-Barré and influenza vaccination. The background rate of Guillain-Barré in the population is 1-2/100,000 and the best estimate of the risk from influenza vaccination is an additional one case per 1 million doses of vaccine.

It’s easy to be afraid when you don’t have all the information. Fortunately, studies clearly show influenza vaccination is both safe and saves lives. What a sad state of affairs, given all the hard science, that the American Academy of Pediatrics has to make a statement reminding doctors of their obligation to promote evidence-based healthcare and patient safety instead of being vectors of misinformation and disease.

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