Lack of Scientific support: flu shots and the elderly

from the blog Trust the Evidence which is an evidence based blog based at Oxford University:

You would think that a health policy of that scale would be firmly grounded on scientific evidence. Well think again.

Because influenza vaccines are produced and tested using surrogate outcomes (antibody stimulation) ahead of each influenza “season”, past performance is probably the only reliable way to predict future performance. A new Cochrane systematic review looked through over 40 years of experimental and non-experimental studies of effectiveness of flu vaccines, and found very poor evidence for effectiveness of flu vaccination in the elderly. Of the 75 studies included in their analysis, they found only one recent randomised controlled trial which used “real” outcomes (e.g. actual flu cases or deaths from flu), as opposed to surrogate outcomes (e.g. influenza antibodies). All other studies were of low quality and open to bias. Current flu vaccines prevented 45% of pneumonia cases, hospital admissions and flu-related deaths in long-term care facilities (for example, nursing homes), compared to 25% vaccine efficacy in community settings. Tom Jefferson, lead author of the review, said, “Our estimates are consistently below those usually quoted by economists and in decision making.” He calls for “an adequately powered publicly-funded randomised placebo-controlled trial run over several seasons”, and emphasis on “strategies to complement vaccinations”, such as personal hygiene, food and water. for more:

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