Your Doctor Recommended the Flu Vaccine For a Reason—It Saves Lives

 
 
This post grew out of a Facebook exchange this week on whether it’s a good idea to get vaccinated for the flu, both during and outside of pregnancy. The person I initiated a dialogue with posted a link to a fake news site arguing against receiving the annual influenza vaccine on the grounds that its risks have not been thoroughly communicated and its benefits overstated. The original poster, an expectant mother, appeared to draw from this the conclusion that they had made the right choice in foregoing the vaccine, against the recommendation of their doctor.

What follows is my expanded response, along with some additional resources for deeper study.

Mind the Source

Before rushing to certain conclusions being pushed by this story, we might want to first consider, among other things, the source. I immediately recognized this story when I saw it pop up in my feed, because it was debunked three years ago. Before I share a bit about the efficacy and importance of the flu vaccine, let’s examine the sources behind this story. Who’s promoting it, and who’s being held up as an expert? Are they credible?

Tracing the story backward in time, we can see that it was first published by fake news site RealFarmacy.com back in 2014, and has since been circulated by a number of similarly fishy sites. The linked article, despite being published last month, is derived entirely from a December 2015 article by Your News Wire. (These sites tend to feed off each other and recirculate clickbaity stories without any notice to the reader.)

Your News Wire is a well known fake news & conspiracy site with a long record of airing inaccurate, debunked, and outrageous information. Notably, it was one of the websites that promoted Pizzagate in the run-up to the 2016 election. They also spread a story that 25 million fraudulent votes were cast for Hillary Clinton and that Bernie Sanders unendorsed Clinton. Equally ridiculous canards they’ve peddled include the claim that Hitler faked his suicide and instead fled to Argentina, and the claim that the DARPA program HAARP employs weather modification technologies on a global scale — even going so far as to claim recently that reputed physicist Michio Kaku blamed Hurricanes Harvey and Irma on HAARP, despite the program being shuttered in 2014. As one might expect, the site has a history of trafficking in 9/11 “truther” and Illuminati memes as well.

You can find a full archive of their debunked stories at Snopes. CBS News has also ID’d the site as a hoax site. FactCheck.org, meanwhile, maintains its own Misinformation Directory, which reserves a spot for Your News Wire, describing the site as “a prolific poster of misinformation and conspiracy theories.” Suffice to say, there are few worse places one could turn for reliable and trustworthy information.

So it seems clear that the websites promoting this story are awfully suspect, but how about the underlying claims? What about the original source on which all these articles are based? Did hoax sites like Your News Wire magick their claims out of thin air, or is there in fact a “there” there?

As it turns out, they all terminate in a 2013 article published in the British Medical Journal (BMJ) by one Peter Doshi. Doshi has a long history of advancing unfounded anti-vaccination and miscellaneous conspiratorial claims. Notably, Doshi signed a petition denying the link between HIV and AIDS and has spoken at a number of anti-vaxx conferences over the years. He has repeatedly challenged the idea that influenza represents a major public health threat, despite the fact that it infects tens of millions of people, including 3-5 million cases of severe illness, and causes 290-650,000 deaths every year, including 20,000 in the US alone. He has also accused the CDC of inflating mortality rates and engaging in a “marketing of fear.”

Importantly, Doshi has no scientific training in any of the relevant fields, including immunology, virology, epidemiology, microbiology, or public health, and has published no research in any of these areas. He lacks the necessary background to speak authoritatively either about the influenza vaccine in particular or vaccination and public health more generally. He’s an anthropologist who simply completed a fellowship at Johns Hopkins. You can find a more comprehensive post at Skeptical Raptor debunking Mr. Doshi and his 2013 article.

The original article also mentions a Russell Blaylock, who as Snopes points out has a sordid history of spreading dubious and conspiratorial claims, including claims related to chemtrails, aspartame, cookware, and dental amalgams. Blaylock is also on record as claiming that the ACA (Obamacare) was a depopulation effort and that H1N1 is a man-made virus engineered by the “Illuminati Depopulation Agenda.” Blaylock is a regular guest on Alex Jones’ show. I trust that is all we need to know about Mr. Blaylock.

You can find Snopes’ debunking of this story here, where they also explode the myth about vaccines being moneymakers for pharmaceutical companies.

Finally, Johns Hopkins actually issued an official statement about this story after the pronounced traffic it received, dismissing the original article as a “rumor”:
 

“Johns Hopkins Medicine in no way endorses an article published in July 2013 by a former fellow at our school of medicine questioning the validity of the annual flu vaccine. The writer has no scientific affiliation with Johns Hopkins, nor is he employed by any of the Johns Hopkins Medical Institutions.”

 
On to the science.

Mind the Science

As many of the sources I link to above emphasize, the benefits of flu vaccination in terms of reducing the risk of catching the flu have been overwhelmingly established. It remains the case that the annual flu vaccine is the best way to prevent transmission. According to the CDC, the latest evidence indicates that the annual flu vaccine reduces children’s risk of ending up in a pediatric ICU by 74%. The agency reported in 2013 that 90% of children who died from the flu in the previous season had not been vaccinated.

Vaccine efficacy remains high even when there is not a “good match” between the wild virus and the vaccine compound (i.e., a suboptimal match between the viral antigen and the circulating strains). The seasonal and annual flu vaccine treatments developed by the CDC typically contain antigens specific to not just one but three or four separate viral strains. This “trivalent” or “quadrivalent” approach can confer cross-protection from similar strains, even if the injection isn’t a perfect match for an individual strain. The better the match and the quicker populations are vaccinated, the stronger the herd immunity effect.

There is also no evidence in favor of spacing out vaccines or delaying beyond the recommended practice. Indeed, you are actually endangering your child by prolonging the period of vulnerability to disease.

Pregnancy and the Flu Vaccine

Like the person who posted this article, many expecting mothers raise additional questions and concerns over whether it is safe to vaccinate while pregnant. Here again, the science is firmly established in terms of both safety and efficacy. In fact, the recommendation to vaccinate is stronger while pregnant because pregnant women are not only at higher risk of catching the flu, but are more likely to undergo severe cases of the flu as well. And without the acquired antibodies facilitated by the vaccine and passed from mother to fetus, the child is less protected from circulating strains once they are born.1

Per the CDC:
 

Is it safe for pregnant women and their developing babies to get a flu shot?

“Yes. Flu shots have been given to millions of pregnant women over many years with a good safety record. There is a large body of scientific studies that supports the safety of flu vaccine in pregnant women and their babies.

[…]

Flu is more likely to cause severe illness in pregnant women than in healthy women who are not pregnant. Changes in the immune system, heart, and lungs during pregnancy make pregnant women (and women who have given birth during the past 2 weeks) more prone to severe illness from flu, including illness resulting in hospitalization. In addition, studies have shown that vaccinating a pregnant woman also can protect a baby after birth from flu. (Mom passes antibodies on to her developing baby that will protect against flu for the first several months after birth.)

[…]

Getting vaccinated reduces mothers’ risk of getting sick and of passing the flu on to their babies, thus protecting their babies from flu also. This is especially important for children younger than 6 months old since they are too young to receive influenza vaccine themselves.”

 
When women become pregnant, their immune system undergoes a number of changes, some of which make them more susceptible to a range of diseases, including the flu. A pregnant mother who declines to vaccinate raises not only their own health risks but their unborn child’s as well. The most recent study on this (Newsome et al. 2019) found that influenza-infected mothers were more likely to experience adverse birth outcomes — such as premature birth, low birth weight, and low Apgar scores — relative to vaccinated mothers and mothers who did not have the flu. The researchers further found that for ICU patients these risks were quadrupled.

“The findings support the importance of pregnant women receiving the influenza vaccine, and of prompt treatment with antiviral medications for pregnant women suspected of having influenza,” said the lead scientist on the study, Kim Newsome. Despite this strong consensus that flu shots lead to healthier mothers and unborn babies, only about half of all pregnant women today opt for the vaccine.

Vaccination Matters

The long and the short of it is this: anyone over the age of six months should annually get vaccinated for influenza. This is an accepted recommendation by every national and international scientific society with an interest in public health and pandemic prevention. Moreover, vaccines in general, not just influenza, are safe, and one of the greatest developments in public health history.

We’ve seen in recent years outbreaks of preventable diseases like measles because uninformed and misinformed parents chose to waive vaccination for their children. This fueled its resurgence by short-circuiting the herd immunity such protection confers. What these parents failed to realize is that before the measles vax was introduced, the disease killed 2.6 million people around the world every year, including 380 American children every year. The vaccine brought the former figure down to 134,200 and the latter figure down to an average of one per year (per 2015 data). Between 2000 and 2015, this single vaccine has saved an estimated 20.3 million lives.

Going against the science isn’t merely a personal decision, it’s a public health risk. Parents have a social responsibility to think beyond the orbit of their immediate family and consider the safety of others who depend on the immunized for their safety. Many people are either too young or too old to be vaccinated or are unable to be vaccinated due to physiological concerns, such as immunocompromised children. When parents forego vaccinations for their child, they are directly increasing the risks not only for their child but for the unvaccinated community writ large, as this Scientific American piece underscores:
 

“We live in a crowded, fast-moving world, and disease travels easily. The data is clear: Failure to immunize a child comes with a much more formidable risk—leaving children vulnerable to contracting a potentially debilitating or lethal illness. Some children are too sick or too young to receive inoculations, so they remain at risk. If those children or other unvaccinated kids come into contact with someone else who was not protected against certain microbes, that can set off a wave of disease like the measles outbreak currently spreading in the U.S. Maladies that have become uncommon, such as polio and measles, can also quickly reappear if we stop vaccinating against them, particularly when they are unintentionally imported across geographic borders.”

 
Conspiracists and fake ‘experts’ like Doshi often play hide the ball when it comes to vaccine efficacy by setting up a false dichotomy with “perfectly effective” on one end and “actively dangerous” on the other. They tend to start with an uncontroversial claim like “vaccines don’t work for everyone” then proceed to an uncontroversially false claim like “the flu vaccine isn’t effective.” What each of these folks have in common is the utter lack of evidence for their claims, and the throngs of uninitiated consumers gullible enough to fall for them.

When someone shares a story from a fake news site as evidence against commonly accepted public health advice, we have good reason for concern. This action suggests the person isn’t using the facts about vaccination to make their decision. And without facts, what else are they to rely on besides a gut feeling or anecdotes from friends, family, and online strangers? When citizens subordinate the best available scientific evidence to personal whim and instinct, this has historically led to poor and often deadly outcomes. We have every right — and indeed every ethical incentive — to push back against misinformation and those disseminating it, no matter how well meaning they might be.

 

FactCheck.org has a helpful resource on vetting sources and honing your fake news barometer: How to Spot Fake News.

Further reading:

This post was featured on HuffPost’s Contributor platform.

Feature image credit: Reuters/Brian Snyder

 

  1. While a small percentage of antibodies are passed between mother and child, there is no guarantee that your offspring will inherit the particular antibodies to combat the disease for which they were produced, which is why epidemics can occur every few generations (epidemics are, definitionally speaking, periodic events). Even if the offspring does inherit the right antibodies, the pathogen may have evolved just enough to combat those previously effective antibodies and reinfect successive generations. Viral evolution can be very rapid. In these cases, offspring cannot rely on the inheritance of antibodies and must acquire their own.
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