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Influenza Deaths: The Hype vs. The Evidence

Posted: 10/3/2012 12:16:17 AM | with 37 comments

By Barbara Loe Fisher

It's that time of the year again when drug companies, doctors, government officials and media conduct a national advertising campaign to sell flu shots to every American.1, 2, 3 You can't pass by a pharmacy,4 enter a supermarket,5 shop in a "big box" store6 or catch a plane7 without seeing the "flu shots for sale" signs trolling for customers.

The pharmaceutical industry is cutting out the M.D. middleman and going straight for the gold in places where we shop for toothpaste, clothes and food.8 Even on the evening news, flu shot commercials are becoming as frequent as political campaign ads.

Up until the year 2000, flu shots were not recommended for everyone. Back in the 1990's, doctors were telling seniors over age 65 and younger people with chronic illness to get vaccinated. 9

No Flu Shot? No Job or Daycare!

Now, doctors at the CDC tell every man, woman and child over six months old they need an annual flu shot10 and it is OK for health care workers to be fired if they don't get vaccinated every year.11, 12, 13, 14

In the states of Connecticut and New Jersey, mandates are already in place that force parents to give their six-month old babies a flu vaccine or be banned from daycare.15 This, as state health department officials join with medical trade association lobbyists in many states to severely restrict or eliminate medical, religious and conscientious belief vaccine exemptions for all children.16, 17

The vaccine liability shield that Congress gave doctors and drug companies in 198618 and the public-private business partnership between government and the pharmaceutical industry that Congress created after Sept. 11, 2001,19, 20 is paying big dividends for liability free drug companies and liability free doctors selling flu shots to more than 300 million Americans.

It doesn't matter if 80 percent of all flu-like illness is really caused by other viruses and bacteria and not influenza,21, 22 or that flu vaccine efficacy is estimated at 60 percent to 80 percent, depending upon age and what kind of vaccine is given.23

Selling Big Mortality Numbers to Sell Flu Vaccine

The selling of influenza vaccine has a lot to do with selling big morbidity and mortality numbers. So how bad were those numbers in the late 20th century to justify government taking a "no exceptions" cradle to the grave approach to flu shots for every American in the 21st century? Let's take a quick look at the hype versus the evidence.

The first experimental influenza vaccines were given to soldiers in World War II. It wasn't until the 1957-58 and 1968-69 influenza pandemics that the vaccine was marketed to civilians.24 Between 1970 and 2000, the trivalent influenza vaccine containing two strains of type A influenza and one strain of type B influenza was primarily recommended for the elderly. That is because respiratory infections, especially with pneumonia complications, have always been a leading cause of death for people at the end of their life span.25

There was only one deadly influenza pandemic in the last 100 years that killed the young and healthy in great numbers and that was the 1918 Spanish Flu. It turns out that bacterial pneumonia is what killed most people, young or old, in the 1918 pandemic. Today, antibiotics would have prevented most of those deaths.26

But just how bad is seasonal influenza today?

Is It 200,000 Influenza Hospitalizations or 37,000?

The CDC has been telling the public for nearly a decade that there are more than 200,000 estimated hospitalizations and 36,000 estimated deaths from influenza in the U.S. every year.27

But are those figures accurate? Well, it all depends upon use of the word "estimate." The U.S. Agency for Healthcare Research and Quality reported that, in 2004, there were about 37,000 Americans hospitalized for either influenza or another illness in addition to influenza, and patients over age 85 were twice as likely to die.28

Now, 37,000 influenza hospitalizations is five times less than the 200,000 hospitalization figure the CDC uses. That is because what CDC employees did to come up with their influenza hospitalization "estimate" was to count a lot of people hospitalized between 1979 and 2001 – not just with influenza but also with pneumonia, respiratory and circulatory illnesses – which they counted as probably associated with influenza.29, 30

And they got away with it.

Counting Influenza Deaths & A Whole Lot More

In 2003, CDC employees also used a convoluted statistical modeling scheme to "estimate" that 36,000 people die from influenza in the U.S. every year. Again, they counted not just influenza death cases but also threw in other respiratory, circulatory, cardiac and pulmonary deaths they thought might have been associated with influenza.31

And they got away with it.

In 2005, a young PhD candidate at MIT published an article in the British Medical Journal and asked the question: "Are U.S. Flu Death Figures More PR Than Science?"32 He analyzed the U.S. Vital Statistics Mortality Data, which has been carefully recorded for more than a century by the National Center for Health Statistics. I recently looked at that Vital Statistics data, too, and created a chart of influenza and pneumonia deaths recorded between 1940 and 2010.33

Recorded Influenza Deaths Dropping in 21st Century

Here is what I found: Since 1940, the highest number of influenza deaths recorded in a single year was 21,047 deaths in 1941. In fact, the mortality rate from influenza was NOT rising in the late 20th century – as the CDC employees have alleged – it was dropping.

There were only between 600 and 750 influenza deaths recorded annually between 1995 and 1997.34 The most influenza deaths recorded in a single year since 1979 was about 2,900 deaths and that was in 2009, the H1N1 swine flu pandemic year! (see table here)

CDC Expanding the Flu Vaccine Market Between 2000-2010

But that didn't stop CDC policymakers, along with drug company and medical trade association lobbyists ever present at the policymaking table, from using inflated influenza hospitalization and mortality estimates to justify expanding the influenza vaccine market:

  • In 2000, CDC policymakers voted to expand flu shot recommendations to all healthy Americans over age 50.35 Out of a population of 300 million, there were 1,765 recorded influenza deaths that year.
  • In 2002, CDC voted to add all healthy babies from six to 23 months.36 There were 727 recorded influenza deaths that year.
  • In 2006, CDC voted to recommend flu shots for all healthy children up to five years old as well as all healthy pregnant women in any trimester.37 There were 849 recorded influenza deaths that year.
  • In 2007, CDC voted to add all healthy children up to eight years old.38 There were 411 recorded influenza deaths that year.
  • In 2008, CDC voted to recommend annual flu shots for all healthy children up to age 18 years.39 There were 1,722 recorded influenza deaths that year.
  • In 2009, the Secretaries of Health and Homeland Security declared a national emergency because they said pandemic H1N1 swine flu was sweeping the country and tens of thousands of people could die. Liability free drug companies were told to rush an experimental swine flu vaccine to the market.40
  • In 2010, a year when there were 494 recorded influenza deaths, the CDC officials finally reached the ultimate goal of their long game: they told doctors to give annual flu shots to every American, healthy or not, from the year of birth to the year of death.41

And they got away with it.

CDC Does Not Require States to Report All Influenza Cases or Deaths

They got away with it because the CDC does not require states to "report individual seasonal flu cases or deaths of people older than 18 years of age."42 That's right – the CDC is not actually asking for the information they need to accurately assess influenza morbidity and mortality in the U.S. It would be funny if people weren't actually losing their jobs or being denied daycare or becoming paralyzed43, 44 by this "no exceptions" flu shot policy.

Global Flu Vaccine Market: U.S. Biggest Customer

Today, the global market for seasonal influenza vaccine is $3.6 billion and forecasters have recently reported that the U.S. is the single biggest and most profitable market in the world.45 They say the huge U.S. market is "driven by price increases" and high vaccine coverage rates generated by the 2009 influenza pandemic and the government's "universal" flu shot recommendation in 2010. They add that "campaigning by U.S. authorities" will continue to drive up flu shot sales.

CDC: We Don't Know How Many Influenza Deaths There Are

Meanwhile, doctors at the CDC now quietly admit on their website that the "CDC does not know exactly how many people die from seasonal flu each year."46 Having gotten that cradle to the grave flu shot recommendation firmly in place, they are backing away from the 36,000 influenza death figure. CDC now says that "only 8.5 percent of all pneumonia and influenza deaths and only 2.1 percent of all respiratory and circulatory deaths" are influenza related.

You can almost hear those liability free drug companies and doctors laughing all the way to the bank.


1 Bowsher K. Should You Get a Flu Vaccine? MoneyTalksNews Sept. 18, 2012

2 Smartspendingspot.com. Flu Shots – List of Locations and Special Offers, Deals, Promotions – 2012. September 2012

3 Price J. Flu Shot Season Starts with a Bang at Triangle. News Observer (NC). Sept. 18, 2012

4 CVSCaremark. CVS/pharmacy and Minute Clinic Give Consumers Five Reasons to Get a Flu Shot. Press Release Aug. 20, 2012

5 Peebles M. It’s Time for Flu Shots. KTUU-TV (AK). Sept. 2, 2012

6 Christensen D. Walmart Offering Low-Cost Flu Shot Clinics in Stores. Sun-Sentinel Sept. 22, 2011

7 Baskas H. Get Your Flu Shot at the Airport. Stuckattheairport.com. Nov. 11, 2010

8 Martin TW. Retailers Jockey to Market Swine Flu Shots. Wall Street Journal Dec. 29, 2009

9 CDC. Prevention and Control of Influenza – Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR May 15, 1992; 41(RR-9)

10 CDC. Influenza Vaccine Information by Age Group [and name of vaccine manufacturer] – United States 2012-13 Influenza Season. Aug. 23, 2012

11 Fisher BL. Forcing Flu Shots on Health Care Workers: Who Is Next? NVIC Vaccine E-Newsletter. Sept. 29, 2010

12 Fisher BL, Wrangham TK. Public Comment of the NVIC on Draft Recommendations of the Health Care Personnel Influenza Vaccination Subgroup of the NVAC

13 Wrangham T. NVAC Says: Mandate Flu Shot for Health Care Workers. NVIC Vaccine E-News. Feb. 12, 2012

14 Mirza B. Is Requiring Flu Vaccination Worth the Risk? Society for Human Resource Management. Feb. 23, 2012

15 NVIC. Map of States and State Vaccine Requirements

16 Fisher BL. Turning Vaccine Exemptions Into Class Warfare. NVIC Vaccine E-Newsletter. Sept. 14, 2012

17 Hawthorne H, M.D. Non-Medical Vaccine Opt-Outs on the Rise. ABC News. Sept. 19, 2012

18 Fisher BL. The Health Liberty Revolution and Forced Vaccination. NVIC Vaccine E-Newsletter. Aug. 23, 2011

19 Biosecurity Commons. Project Bioshield. Mar. 29, 2012

20 Guyton J, Niyogi DG. White Paper: Meeting Public Health Needs Through Public-Private Partnerships. PWC’s PRTM Management Consulting

21 FDA. Feb. 20, 2003. Vaccines & Related Biological Products Advisory Committee Meeting Transcript

22 El-Solh AA, Sikka P et al. Etiology of Severe Pneumonia in the Very Elderly. Am J Respir Crit Care Med 2001. 163(3): 645-651

23 Osterholm MT, Kelley NS et al. Efficacy and effectiveness of influenza vaccine: a systematic review and meta analysis. The Lancet 2011; 12(1): 36-44

24 College of Physicians of Philadelphia. The History of Vaccines: Asian Influenza Pandemic (1957) and Vaccine for Hong Kong Influenza Pandemic (1968)

25 Rozzini R, Sabatini T, Trabucchi M. Is Pneumonia Still the Old Man’s Friend? Arch Intern Med 2003; 163(2): 1491-1492

26 National Institutes of Health. Bacterial Pneumonia Caused Most Deaths in 1918 Influenza Pandemic. Press Release: Aug. 19, 2008

27 Reinberg S. Flu Season Off to A Very Late Start: CDC. HealthDay/U.S. News. Feb. 23, 2012

28 AHRQ. Influenza Most Deadly for the Very Elderly. Press Release Nov. 7, 2006

29 CDC. Seasonal Influenza Associated Hospitalizations in the United States. June 24, 2011

30 Thompson WW, Shay DK et al. Influenza Associated Hospitalizations in the United States. JAMA 2004; 242(11): 1333-1340

31 Thompson WW, Shay DK et al. Mortality Associated with Influenza and Respiratory Synctial Virus in the United States. JAMA 2003; 289(2): 179-186

32 Doshi P. Are U.S. Flu Death Figures More PR Than Science?BMJ 2005; 331 (7529): 1412

33 NVIC. Influenza & Pneumonia Reported Deaths in U.S. 1940-2010 (Chart)

34 National Center for Health Statistics. U.S. Vital Statistics Mortality Data 1979-1998 (Unpublished Worktables). National Vital Statistics System

35 CDC. Prevention and Control of Influenza – Recommendations of the Immunization Practices Advisory Committee (ACIP), 2000.MMWR April 14, 2000; 49(RR03)

36 Prevention and Control of Influenza – Recommendations of the Immunization Practices Advisory Committee (ACIP), 2002.MMWR April 12, 2002; 51(RR03); 1-3

37 CDC. Prevention and Control of Influenza – Recommendations of the Immunization Practices Advisory Committee (ACIP), 2006.MMWR July 26, 2006; 55(RR10)

38 CDC. Prevention and Control of Influenza – Recommendations of the Immunization Practices Advisory Committee (ACIP), 2007.MMWR July 13, 2007; 56(RR06)

39 CDC. Prevention and Control of Influenza – Recommendations of the Immunization Practices Advisory Committee (ACIP), 2008. MMWR Aug. 8, 2008; 57(RR07)

40 Fisher B. Politics, Profits & Pandemic Fear Mongering. NVIC Vaccine E-Newsletter May 1, 2009

41 Prevention and Control of Influenza with Vaccines – Recommendations of the Immunization Practices Advisory Committee (ACIP), 2010. MMWR Aug. 6, 2010

42 CDC. Estimating Seasonal Influenza-Associated Deaths in the United States: Questions and Answers. June 24, 2011

43 NVIC. Flu Vaccine Reaction Leaves Former Nurse a Quadriplegic. NVIC Vaccine E-News. Oct. 31, 2011

44 Schonberger LB, Bregman DJ et al. Guillain Barre Syndrome Following Vaccination in the National Influenza Immunization Program, United States, 1976-19

45 PR Newswire. Market Forecasts: Seasonal Influenza Vaccines. Reportlinker.com Newswire. Sept. 20, 2012

46  CDC. Estimating Seasonal Influenza-Associated Deaths in the United States: Questions and Answers. June 24, 2011.    

Posted: 10/3/2012 12:16:17 AM | with 37 comments


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