I’m no Chicken Little, but I admit the H1N1 situation has me faintly concerned this year. It strikes me as a different animal from the Mad Cow and Bird Flu frenzies in that this one’s actually shown up in people. A few I’ve actually known.
Doomsday sites are claiming that we’re staring down the barrel of a Spanish Flu sized cataclysm where hundreds of millions of people will die unless we get everyone vaccinated (and even that won’t stop it entirely). More reasonable estimates seem to be saying under 100,000 dead this season, and that’s still pretty scary.
The Atlantic has an article ruminating on whether or not the vaccine matters. I’ll leave it to you to decide.
Nonetheless, in 2004, Jackson and three colleagues set out to determine whether the mortality difference between the vaccinated and the unvaccinated might be caused by a phenomenon known as the “healthy user effect.” They hypothesized that on average, people who get vaccinated are simply healthier than those who don’t, and thus less liable to die over the short term. People who don’t get vaccinated may be bedridden or otherwise too sick to go get a shot. They may also be more likely to succumb to flu or any other illness, because they are generally older and sicker. To test their thesis, Jackson and her colleagues combed through eight years of medical data on more than 72,000 people 65 and older. They looked at who got flu shots and who didn’t. Then they examined which group’s members were more likely to die of any cause when it was not flu season.
Jackson’s findings showed that outside of flu season, the baseline risk of death among people who did not get vaccinated was approximately 60 percent higher than among those who did, lending support to the hypothesis that on average, healthy people chose to get the vaccine, while the “frail elderly” didn’t or couldn’t. In fact, 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. Jackson’s papers “are beautiful,” says Lone Simonsen, who is a professor of global health at George Washington University, in Washington, D.C., and an internationally recognized expert in influenza and vaccine epidemiology. “They are classic studies in epidemiology, they are so carefully done.”
It’s a three-pager, worth the time.
Now my first thought was “well even if the vaccines aren’t flawless, better safe than sorry, right?” That does, however, raise the question of if this all truly is unnecessary, it means we’re pumping money and resources into the wrong solution.
