As flu season approaches, claims that the flu vaccine is a 'waste of money' are being widely reported. The Daily Telegraph declares that 'flu vaccine effectiveness [is] exaggerated,' while the Daily Mail claims that 'flu jabs are a 'waste' of taxpayer's money.'
Both headlines are exaggerations based loosely on a new report from researchers at the University of Minnesota.
While the news stories go on to offer measured coverage of the report, the suggestion that the vaccine is of limited effectiveness in older people and a 'waste of money' is spurious and misleading when read out of context in the headlines.
The report by a team of researchers at the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota covers multiple aspects of the flu vaccine in the US. It includes evidence of the vaccine's effectiveness, research and development efforts, vaccine production, and policy surrounding who gets the vaccine.
While the flu vaccine is not 100% effective, the flu vaccination programme in the UK has proven effective at preventing deaths. Claims that the flu vaccine is in some way over-hyped are based on the report's finding that the perceived level of effectiveness may be putting vaccine manufacturers off investing in research into new types of flu vaccine.
Multiple strains of the flu virus may be circulating in any given year. Current efforts to prepare for and combat flu epidemics include the widespread production and use of a yearly flu vaccine. This vaccine is developed to protect against three strains of the virus that experts predict will circulate during the upcoming winter flu season.
The UK Department of Health (DH) reports that the current trivalent inactivated influenza vaccine (the seasonal flu jab) has an overall efficacy, or success rate, of 59% among adults aged 18 to 65 years. Protection may be lower in the elderly. The type of flu vaccine recommended for children (a 'live' vaccine as opposed to an inactivated vaccine) is thought to be more effective, with a reported efficacy of 83% for children. The DH figures correspond with those reported in the current CIDRAP report.
The report was produced by the Center for Infectious Disease Research and Policy (CIDRAP). CIDRAP is a research unit based at the University of Minnesota in the US, which says it aims to "prevent illness and death from infectious diseases through epidemiological research".
CIDRAP carried out an extensive review of flu vaccine efforts. The report authors reviewed studies published between 1967 and 2012 that looked into the effectiveness of flu vaccination. This report covers:
The CIDRAP review reports 10 key findings, only some of which feature in current media coverage.
The report says that the current flu vaccine offers "substantially lower" protection than that offered by most routinely recommended vaccines. However, the report has concluded that during some flu seasons, the jab offers substantially more protection for most people compared with not being vaccinated at all.
It says that for one form of the vaccine (trivalent inactivated influenza vaccine, or TIV) the evidence surrounding protection varied:
For the other type of vaccine (live attenuated influenza vaccine, or LAIV), CIDRAP found:
The review found that commonly cited figures regarding flu vaccine effectiveness are largely based on studies with poor methodology, and studies employing better methods have not reported protection levels as high. The authors suggest that this perception of vaccine effectiveness prevents research into the development of highly effective vaccines.
Over the last 50 years in the US the groups of people recommended to receive the annual flu jab have expanded beyond those at high risk of complication. The study authors report that these recommendations were often based on professional judgement and not scientific evidence.
New approaches to flu vaccine development may offer increased protection against seasonal flu, but more research support is needed to determine whether these approaches could result in "game-changing vaccines".
The media did not cover the report findings concerning vaccine policy, financing, production and distribution.
The CIDRAP report recommends:
These are broad recommendations and it is unclear at this point how and whether they will be implemented.
The media coverage of this report in the UK was poor for two main reasons:
Due to both of these facts, there are a number of important points that need to be stressed:
Overall, the report found that while the protection offered by the current annual flu jab is less than ideal when compared to other vaccines, for most people it is still better than not being vaccinated.
The report certainly does not conclude that flu vaccination be abandoned, or is a "waste of taxpayer's money".
But it does suggest that a new approach be taken to the development of the annual vaccine by both drug companies and governments, so that the protection it offers can be brought up to the standards we see with jabs for other diseases.
The report also recommends that more resources need to be put aside so that in the event of a future flu pandemic an appropriate vaccine can be produced quickly and distributed to the public.