How Government Sells Sickness: The Case of the Flu

clinical outcomes are not being addressed

Many of us think we know about the flu vaccine. We believe it prevents the flu or, at the very least, reduces complications from the flu, thus reducing deaths. A new study even claims the flu vaccine may reduce complications from Covid.

The flu story we think we know is not supported by medical evidence. The history of the flu vaccine is a cautionary tale about government promoting the products of the pharmaceutical industry.

Peter Doshi, a University of Maryland pharmacy professor, in his 2013 British Medical Journal article "Influenza: marketing vaccine by marketing disease" writes, "Promotion of influenza vaccines is one of the most visible and aggressive public health policies today."

In 1990, according to Doshi, "32 million doses of influenza vaccine were available in the United States." During the upcoming 2021-22 flu season, the  Centers for Disease Control and Prevention (CDC) estimates manufacturers will supply almost 195 million doses of influenza vaccine.

For some, this is government at work protecting the public health. For others, this is a case of government expanding the market to protect vaccine manufacturers.

The CDC, Doshi writes, pledges "to base all public health decisions on the highest quality scientific data, openly and objectively derived." With flu vaccines, this is hardly the case. The facts show, Doshi writes, "although proponents employ the rhetoric of science, the studies underlying the policy are often of low quality, and do not substantiate officials' claims." Flu vaccines, Doshi continues, "might be less beneficial and less safe than has been claimed, and the threat of influenza appears overstated."

Through the 1990s, the “at risk” population was the elderly; promotion campaigns were aimed at them. Today CDC guidelines have expanded the "at risk" population and called for everyone older than six months to get the vaccine. Today, we are warned by the CDC, "even healthy people can get the flu, and it can be serious."

Fanciful claims are made for the effectiveness of the flu vaccine. Doshi reports on one study in the New England Journal of Medicine making the misleading claim that flu vaccines reduce deaths from any cause by 48%. The study was funded by the National Vaccine Program Office and the CDC. Doshi argues, “there is a reason CDC does not shout this from the rooftop: it’s too good to be true.” He continues,  “Since at least 2005, non-CDC researchers have pointed out the seeming impossibility that influenza vaccines could be preventing 50% of all deaths from all causes when influenza is estimated to only cause around 5% of all wintertime deaths.”

Tom Jefferson is an epidemiologist and physician associated with Cochrane. Cochrane is an international network of researchers dedicated to compiling and evaluating medical evidence. They too find evidence that the effectiveness of the flu vaccine is overstated. Jefferson explains, "For a vaccine to reduce mortality by 50 percent and up to 90 percent in some studies means it has to prevent deaths not just from influenza, but also from falls, fires, heart disease, strokes, and car accidents. That's not a vaccine, that's a miracle."

Studies of the flu vaccine are corrupted by the "healthy-user effect." Doshi explains the "healthy-user effect" is "a propensity for healthier people to be more likely to get vaccinated than less healthy people." As a result, observational studies of the vaccinated population are biased. In fact, one study suggested "the healthy-user effect explained the entire benefit that other researchers were attributing to flu vaccine, suggesting that the vaccine itself might not reduce mortality at all."

The CDC itself admits that observational studies are tainted:

Studies demonstrating large reductions in hospitalizations and deaths among the vaccinated elderly have been conducted using medical record databases and have not measured reductions in laboratory-confirmed influenza illness. These studies have been challenged because of concerns that they have not controlled adequately for differences in the propensity for healthier persons to be more likely than less healthy persons to receive vaccination.

Doshi asks, "If the observational studies cannot be trusted, what evidence is there that influenza vaccines reduce deaths of older people—the reason the policy was originally created?" Doshi answers, "Virtually none." He continues,

Theoretically, a randomized trial might shine some light—or even settle the matter. But there has only been one randomized trial of influenza vaccines in older people—conducted two decades ago—and it showed no mortality benefit (the trial was not powered to detect decreases in mortality or any complications of influenza). This means that influenza vaccines are approved for use in older people despite any clinical trials demonstrating a reduction in serious outcomes.

Doshi was perplexed by "officials' lack of interest in the absence of good quality evidence." He found approval of a flu vaccine is not tied to reduction in serious outcomes. Doshi reports, "Approval is instead tied to a demonstrated ability of the vaccine to induce antibody production, without any evidence that those antibodies translate into reductions in illness."

The antibody argument should sound familiar. In the case of the Covid vaccine one doctor admitted, “if an antibody test comes back with a certain number, nobody knows what that means.”

In their The Atlantic article Does the Vaccine Matter?, Shannon Brownlee and Jeanne Lenzer quote Fauci saying it "would be unethical" to do a placebo-controlled study of influenza vaccine in older people. Fauci's tautological reason echoes other "experts”: Since the CDC "standard of care" is a flu vaccine, placebo recipients would be deprived of a potentially life-saving medical intervention.

Jefferson's work about the flu vaccine raised questions that no doubt should be asked again about a COVID-19 vaccine:  Is the “vaccine necessary for those in whom it is effective, namely the young and healthy? Conversely, is it effective in those for whom it seems to be necessary, namely the old, the very young, and the infirm?" Jefferson’s response, in the case of the flu vaccine, is no:

Unfortunately, the very people who most need protection from the flu also have immune systems that are least likely to respond to vaccine. Studies show that young, healthy people mount a glorious immune response to seasonal flu vaccine, and their response reduces their chances of getting the flu and may lessen the severity of symptoms if they do get it. But they aren't the people who die from seasonal flu. By contrast, the elderly, particularly those over age 70, don't have a good immune response to vaccine—and they're the ones who account for most flu deaths.

In other words, as Doshi explains, "No evidence exists, however, to show that this reduction in risk of symptomatic influenza for a specific population—here, among healthy adults—extrapolates into any reduced risk of serious complications from influenza such as hospitalizations or death in another population (complications largely occur among the frail, older population)."

Dr. Jefferson says, "We have built huge, population-based policies on the flimsiest of scientific evidence. The most unethical thing to do is to carry on business as usual." Yet, the “experts” “carry one” as they continue to recommend flu vaccines.

In 2018, Dr. Jefferson and his colleagues continued to report findings from their multi-decade monitoring of flu vaccinations programs that showed a lack of evidence to support widespread flu vaccinations: "The largest dataset to have accumulated to date is from trials conducted in the population least likely to benefit from vaccines but most likely to produce immunity: healthy adults. In healthy adult trials a high serological response is matched by a very small clinical effect.”  

A review of the evidence by Jefferson’s research team shows “71 healthy adults need to be vaccinated to prevent one of them experiencing influenza.” Jefferson and his colleagues are clear: "Vaccination selection and production programmes are based on aetiological assumptions which are neither explanatory nor predictive."

Since "massive worldwide machinery is needed to produce new vaccines every year to address viral antigenic changes, and to address the poor persistence of the antibody response in individuals," we can ask, Are we spending billions for nothing in return? Jefferson and colleagues write:

Current yearly registration of candidate influenza vaccines is based on their ability to trigger a good antibody response. But antibody responses are poor predictors of field protection. This is another example of the use of surrogate outcomes in biomedicine, where effects on clinically important outcomes remain unmeasured or unproven from randomised trials: complications and death by influenza.

While pharmaceutical companies daily hawk medications on television, the government promotes flu vaccines to combat “a threat of great proportions.” Doshi writes,

The CDC's website explains that 'Flu seasons are unpredictable and can be severe,' citing a death toll of '3000 to a high of about 49,000 people.' However, a far less volatile and more reassuring picture of influenza seems likely if one considers that recorded deaths from influenza declined sharply over the middle of the 20th century, at least in the United States, all before the great expansion of vaccination campaigns in the 2000s, and despite three so-called 'pandemics.'

Incredibly, Doshi writes, "most ‘flu’ appears to have nothing to do with influenza. Every year, hundreds of thousands of respiratory specimens are tested across the US. Of those tested, on average 16% are found to be influenza positive." In other words, flu-like symptoms do not mean you have the influenza virus.

Jefferson observes about published flu death, "The standard quoted figure of 36,000 yearly deaths in the US is based on the 'respiratory and circulatory deaths' category including all types of pneumonia, including secondary to meconium ingestion or bacterial causes."

You might say if the flu caused pneumonia, merging the two death figures is a fair thing to do. In his British Medical Journal essay, Are US flu death figures more PR than science?, Doshi points out that the CDC admits that when "influenza causes death" most such cases "are never tested for virus infection."

William Thompson, of the CDC admits in a Journal of the American Association article, "Based on modelling, we think it's associated. I don't know that we would say that it's the underlying cause of death." Doshi adds, "This stance is incompatible with the CDC assertion that the flu kills 36 000 people a year—a misrepresentation that is yet to be publicly corrected.”

Doshi concludes, "If flu is in fact not a major cause of death, this public relations approach is surely exaggerated. Moreover, by arbitrarily linking flu with pneumonia, current data are statistically biased. Until corrected and until unbiased statistics are developed, the chances for sound discussion and public health policy are limited."

It's no accident that the CDC promotes the flu vaccine by increasing fear of the flu. CDC edicts, Doshi explains, work "in manufacturers' interest by conducting campaigns to increase flu vaccination." At one vaccine conference, Glen Nowak, a communications specialist at the National Immunization Program (NIP), advocated for generating fear by predicting "dire outcomes" and fostering "the perception that many people are susceptible to a bad case of influenza."

There is a revolving door between the CDC and pharmaceutical companies through which crony capitalists come and go. Jeremy Hammond explains the connection in his essay Why You Can't Trust the CDC on Vaccines.

Perhaps the most infamous example is how the head of the CDC from 2002 to 2009, Julie Gerberding, left her government job to go work as president of Merck's $5 billion global vaccine division. Merck's CEO understandably described Gerberding as an "ideal choice". She held that position until 2014 and currently holds the Merck job title of ‘Executive Vice President & Chief Patent Officer, Strategic Communications, Global Public Policy and Population Health’. That is to say, the former CDC director is now in charge of Merck's propaganda efforts. One might say she's basically doing the same job now that she did for the CDC, but even more lucratively. Apart from her salary, in 2015, Gerberding sold shares of Merck worth over $2.3 million dollars.

Hammond gives another example from 2018 example: “CDC Director Brenda Fitzgerald was forced to resign after Politico reported that, after assuming leadership of the CDC on July 7, 2017, she ‘bought tens of thousands of dollars in new stock holdings in at least a dozen companies’—including Merck.”

The general public, not having explored the history of vaccines, might say, So what?  The flu vaccine can't hurt and might help. I understand this thinking; everyone needs a talisman or two to get through life.

Millions take supplements such as echinacea to prevent colds and the flu. Governments with ties to the pharmaceutical industry are not spending billions to promote echinacea as a remedy to boost immune response to the flu. I doubt if the evidence for echinacea would stand up to a Cochrane review. Importantly, no person is prevented from taking echinacea and no person is forced to take echinacea to keep their job or go to school.

Flu vaccines, like all vaccines, can cause adverse reactions. Doshi reminds us, "In October 2009, the US National Institutes of Health produced a promotional YouTube video featuring Fauci. Urging US citizens to get vaccinated against the H1N1 influenza, Fauci stressed the vaccine's safety: 'the track record for serious adverse events is very good. It's very, very, very rare that you ever see anything that's associated with the vaccine that's a serious event.’"

Fauci's assurances turned out to be wrong:

Months later, Australia suspended its influenza vaccination program in under five year olds after many (one in every 110 vaccinated) children had febrile convulsions after vaccination. Another serious reaction to influenza vaccines—and also unexpected—occurred in Sweden and Finland, where H1N1 influenza vaccines were associated with a spike in cases of narcolepsy among adolescents (about one in every 55,000 vaccinated). Subsequent investigations by governmental and non-governmental researchers confirmed the vaccine's role in these serious events.

In my essay, Why "Operation Warp Speed” Could Be Deadly, I covered the deadly consequences of the rushed to market 1976 swine flu vaccine.

Given the ineffectiveness of the flu vaccine, Jefferson’s research team is standing by “to see whether anyone has the interest or the courage to develop effective ways to control upper respiratory viral syndromes.” If not, they conclude, “Our reviews will remain as a testimonial to the scientific failure of industry and governments to address the most important clinical outcomes for patients.”

You don’t need a mandate to get a jogger to buy good running shoes. You don’t need a mandate for a committed keto eater to seek grass-fed beef. No mandate is needed to convince a vegan of the advantages of eating organic kale.

Crony capitalists selling cures need government mandates forcing compliance. Using the rhetoric of science, government and industry cover up for their scientific failure to address the most important clinical outcomes for patients.