The Narrow Scope of Flu Vaccine Usefulness

Friday, January 11, 2013
By: Byron J. Richards,
Board Certified Clinical Nutritionist

In October 2011, The Lancet published a study from top immunologists at the University of Minnesota who essentially said the flu vaccine fails to meet the hype. In fact, they couldn’t find any credible data to show that the flu vaccine did anything effective at all in individuals over age 65.

The study found that in healthy adults the flu vaccine was only 59 percent effective, and some years it was far less effective than that. No high quality study on the effectiveness of the flu vaccine in children or pregnant women could be located, which is somewhat odd for a belief system that expects the population to have unwavering confidence in them. It wasn’t that the researchers didn’t try to find credible research. They looked at 5,707 studies over the past 45 years, and settled on only 31 that met appropriate criteria. 

The citizen databases associated with socialized medicine in Europe make it easier to get hard data on flu vaccine effectiveness.  In the last flu season (2011-2012) the flu vaccine was 43 percent effective for the general population.  However, in the at-risk groups that public health officials strive to get vaccinated, effectiveness had fallen to less than 10 percent by the end of the flu season.  This typical and dismal showing for the flu vaccine is seldom touted by public health officials.

Perhaps many people expect too much from a flu vaccine.  Let’s assume for the moment that a textbook flu vaccine is actually produced.  Let’s put aside our concerns about its potential toxicity from mercury, adverse side effects, or the difficulty in getting a vaccine that actually looks like the current flu problem.  Let’s focus on a more fundamental question:  Would such a vaccine work for you?

The public health version of vaccine theory is quite simple; a vaccine gives your immune system a heads-up on what is likely to come around so that you are better able to mount an immune response if the real villain actually shows up.  Such a rudimentary presentation of immunity to the general public is more fairy tale than fact.

A vaccine is essentially a tool for improved recognition of a specific virus.  It is like having a surveillance system on your home that has been tweaked to profile the specific look of a known criminal.  Sure, that’s nice.  But is it needed?  After all, humans already have the highest powered surveillance system, one that has been dealing with viral infections since time immemorial.  This is one reason why we, as a race, have managed to survive.  Once again, for the sake of a focused discussion, let’s assume that the vaccine is important in its surveillance role and has value as an upgrade to your surveillance system.

Imagine, you are in your home and your security alarm sounds.  Your surveillance system has detected a criminal invader, in this case with the help of a vaccine.  Now what are you going to do?

Maybe the invader is a smart one, the kind who knows how to cut your phone lines and jam your cell phone so you can’t dial 911, (which would be like a nasty pandemic type that confuses your dendritic cells).  Maybe you start to think you should have taken those self-defense classes. Other questions come to mind: Is there is a gun in the house?  Do you have ammunition for it?  Do you know how to use it?  Are you going to be involved in hand-to-hand combat?  Or would your immune system rather sit around and talk about the glory days while you hide under the bed?

My point is rather simple.  There is no guarantee that just because your immune system happens to see something, it has the ability to do something about the problem.

Vaccine Failure is Common

Let’s connect this analogy to the real world of our often-vaccinated elderly population, the group that always suffers the most flu-related deaths in any one year.  We can make two broad divisions in this group: the healthy elderly, and those in a state of clear decline.

Those in a state of clear decline are at the mercy of their invader.  They are often protein malnourished, antioxidant depleted, and in a state of locked-in inflammatory decline.  This means their battlefield is already littered with trash, their supply lines have run dry, their guns are rusted and jammed, they lack ammunition, and food for the few troops that remain is in short supply.  Seeing an invader “better” is essentially meaningless.  Their only real hope is that a truly nasty invader doesn’t come calling.  And this is why the flu or its pneumonia-related secondary infections kill so many elderly people every year.

Normal healthy aging is associated with a significant amount of physical wear and tear.  Even for the healthy elderly group, this is also a potential handicap to efficient immune function.  Researchers have known for a long time that the ability to fight infection declines with age. 

Inefficiency in the high powered adaptive immune response1 (cell-mediated immunity) is common in the elderly.  This is marked by a lack of mature T cells2 (CD3+), and too many immature T cells (CD2+ and CD3-).  This is like having too many poorly trained troops and not enough energy to send them to school to finish their education.  At the same time, the elderly immune system is marked by a lot of storytellers (memory T cells) at the expense of immune cells that need to get to work clearing out infected cells (CD8+subsets – killer T cells).  Researchers have shown that if a healthy elderly person is lacking vitamins and minerals3, then these changes in T cells translate to an impaired immune response. 

One study involving 233 healthy seniors found that following flu vaccination there was a 51 percent rate of malfunctioning front line immune troops (innate immunity) and a 70 percent rate of defect in the higher powered immune response (adaptive immunity).  The researchers believe this is the reason that flu vaccines5 only work in the elderly 30 percent - 50 percent of the time.

Part of the problem of aging is a cumulative antigenic load that helps provoke ongoing inflammation (especially when combined with stress and/or obesity).  When the front line troops of your immune system (innate immunity) engulf and destroy an invader it is broken down into pieces, called antigens. They are presented to your high powered immune system (adaptive immunity) so that antibodies can be produced that will bind the antigen as part of how your body destroys an infection, including the flu.  Antigens also get various innate immune cells to make inflammatory signals as part of this natural process.  Many foreign antigens are not infectious (such as pollen), and the wear and tear of body tissue can sometimes form antigens (promoting an autoimmune response). 

Over the course of one’s lifetime this antigen load tends to be ever-increasing, which in turn provokes innate immune cells to dwell in the inflammatory mode6.  The decline in this function parallels your decline in stress tolerance7, a key symptom of excess antigen load with concurrent inflammation.  Scientists believe that this problem causes a “weakened host” that is more susceptible to an infection gaining a toehold and causing problems.  It could be said that a more aggressive inflammatory response in younger years is needed to help battle various infections.  However, if a person survives into older years then the cumulative burden of excess inflammation8 is a clear immune system handicap.  This means the elderly must be very good at managing wear and tear of all types (definitely don’t sweat the little things).

Yet another study showed that giving the flu vaccine to elderly individuals with documented pre-existing viral-related inflammation9 (a common problem in the elderly) simply made the inflammatory problem worsen, thereby further reducing the person’s ability to fight the flu.

The most recent study reviewing the reasons for vaccine failure10 in the elderly points out that simply testing antibody response (antibody titers) to a vaccine to predict its effectiveness, the current “gold standard,” fails to identify the large number of seniors who are unlikely to respond to the vaccine due to age-associated defects in their immune systems.

Science clearly shows that the elderly immune system is akin to many old soldiers sitting around the table who prefer to talk about old war stories.  They would rather sing Glory Days than the Marines’ Hymn.  There is limited wherewithal and very little desire to fight any new battles. 

Even in the very healthy elderly there is a tendency toward impaired immune function, which results from the wear and tear of a lifetime.  Then there is a sliding scale of immune system inefficiency that directly parallels the health status of the individual.  As an elderly person moves more toward a lack of general fitness, in the direction of frailty, the degree of compromised immunity increases.

To make matters worse, many medications commonly taken by the elderly add to the problem.  It is now a proven fact that antacids and statin drugs increase the risk for pneumonia in the elderly.  This means that if older people get the flu, they are more at risk for getting a secondary serious infection, which is often what actually kills them.  Common drug use places them in harm’s way.  This is one main reason why the purported benefits of statins to reduce mortality are readily offset by the number of people who die from infection while taking them.  In fact, any medication taken by an elderly person that induces fatigue as a side effect will reduce the function of the immune system.  Is it any wonder that faith in Western medicine is in a state of rapid decline?

Flu Vaccines Interfere with Normal Immune Development in Children

On the other end of the age spectrum are children, whose immune systems have not had enough schooling for flu vaccines to work well.  This was confirmed in a detailed analysis of the 2003-2004 and 2004-2005 flu seasons in three counties across the U.S.  Researchers could not prove11 that in children ages 6 months to 5 years having the flu vaccine was effective compared to not having the vaccine.

In November 2011, virology researchers at the Erasmus Medical Center in the Netherlands demonstrated that a regular flu vaccine in children actually worsens a key aspect of their flu fighting immune system. This research was not conducted by scientists who disliked vaccines. Rather, it was conducted by pro-vaccine researchers who have spent their careers trying to develop better vaccines. Lead author Rogier Bodewes delivered the sobering message as he explained it, that flu vaccines “have potential drawbacks that have previously been underappreciated and that are also a matter of debate.” 

While this study group was rather small, it involved highly advanced scientific evaluation of the immune system. The researchers collected blood from 27 healthy, unvaccinated children with an average age of 6 years old, and from 14 children with cystic fibrosis who received an annual flu shot. The unvaccinated children were found to have a superior immune response, giving them broader protection against what they might face in an actual flu season, including pandemic strains. 

The researchers found that the CD4 T helper cell response to the flu influenza A was present in both the unvaccinated and vaccinated children. On the one hand this means that in healthy children a vaccine was not needed to elicit a T helper cell response to the flu.  Such helper cells coordinate the higher powered adaptive immune response so that antibodies can destroy the virus. On the other hand it means that the T helper cell response in children with respiratory disease was comparable to the healthy children, potentially offering them some protection against whatever viral strains happened to be in the flu vaccine.

It is important to understand that children need to develop a healthy immune system, just like they need to go to school to get an education. Another aspect of the flu fighting immune system is the CD8 T cells, also called cytotoxic T cells, which destroy virally-infected cells as well as cancer cells. This is also a vital part of a robust anti-viral immune response.

In the healthy unvaccinated children a rise in these cytotoxic T cells was seen as the children got older.  This gave them important broad based protection against any type of flu strain, as well as a healthier immune response for knocking out any mutant cancer cells. The immune systems in the unvaccinated children were learning to become more effective as the children grew older.

In contrast, the gradually increasing CD8 cytotoxic T cell response that was present in unvaccinated children was absent in the regularly vaccinated children with cystic fibrosis. Regular flu vaccines appeared to interfere with the healthy development of the immune response in a way that left a child more vulnerable to flu. This means children who got flu vaccines got some protection against whatever was in the vaccine that year, but would have reduced protection against anything that wasn’t in it, and this problem would get worse as the child grew older. It is common that vaccines don’t cover all the viruses in any given season, especially a suddenly emerging pandemic strain. It is also typical that viruses mutate rapidly in any given flu season, making vaccines limited tools of effectiveness.

Wildly False Claims of Reduced Mortality from Flu Vaccines

A number of weak and slanted studies, which have been highly touted in the media, claim that the flu vaccine has reduced all-cause mortality in the elderly by 50 percent.  However, a detailed study12 that controlled for bias and confounding variables found this not to be the case. 

The researchers state, “While such a reduction in all-cause mortality would have been impressive, these mortality benefits are likely implausible. Previous studies were likely measuring a benefit not directly attributable to the vaccine itself, but something specific to the individuals who were vaccinated—a healthy-user benefit or frailty bias.  Over the last two decades in the United Sates, even while vaccination rates among the elderly have increased from 15 to 65 percent, there has been no commensurate decrease in hospital admissions or all-cause mortality. Further, only about 10 percent of winter-time deaths in the United States are attributable to influenza, thus to suggest that the vaccine can reduce 50 percent of deaths from all causes is implausible in our opinion.”

Another study13 detailing the health records of one health insurer for nine flu seasons confirms that the 50 percent reduction in all-cause mortality is wishful thinking.  Once all bias and confounding variables were controlled for, there was a 4.6 percent reduction in all-cause mortality, which is far below the 50 percent bogus claim.

A Dangerous and Slanted Public Health System

The public health system in the U.S. and around the world requires blind faith and herd mentality to achieve the limited “success” of any vaccination program.  Public health measures are never in the best interests of any one person.  The logic is always about the greater good for all, based on the rather flimsy assumption that a vaccine that matches the invader is always for the greater good. 

Such rationalizations make injury from vaccines acceptable as collateral damage.  The blind faith that is required for such campaigns is of course questioned when there are serious side effects affecting many of those who participate, as was the case in the last swine flu vaccination effort in the 70s.

Since it is quite true that if the population in general has a better immune response to the flu it will be in the best interests of everyone, you would think that our government would be interested in identifying those who are not likely to respond to the flu vaccine and figure out how to help them respond better.

In the scientific sense, this would require testing an individual’s immune cell ratios to determine who in the population has the pattern of immune inefficiency associated with the risk for vaccine failure.  Of course, this would make the ridiculously expensive vaccine campaign even more expensive—a cost that the government does not want to undertake.  They would rather shoot first and ask questions later.

Yet, as pointed out in many of the study links in preceding sections, adequate nutrition can go a long way toward correcting the age-associated decline in immune system function.  The science is clear enough that many basic nutrients14 are vital for a healthy immune response in combating the flu.  This includes adequate dietary protein, B vitamins, vitamin A (and carotenes), vitamin C, vitamin D, vitamin E, and zinc.  I’m not talking about the plethora of fancy immune boosting nutrients that are also available; I’m simply taking about “Nutrition 101,” something you would think our government and the FDA could understand.

For example, zinc is woefully lacking in the elderly population.  Even a marginal zinc deficiency has a deleterious effect on elderly immunity15, causing inherent age-associated immune weaknesses to magnify (zinc deficiency is proven to decrease vaccination response).  Zinc supplementation has been shown to restore the vigor to immune cells16 that must deal with the stress of combating an infection.  Zinc has been proven to offset the excess inflammatory pattern17 that is a key part of the elderly defective immune response.

New research on zinc shows that zinc adequacy primes immune cells, even in healthy people, to be more efficient if and when the flu is encountered. 

It is obvious that zinc, as well as other nutrients, especially vitamin C and vitamin D, are vital to basic immune function and could drastically reduce the severity of any flu in the general population.  Interestingly, they would significantly help any government vaccination campaign work better.  So why doesn’t our government tell people to take basic nutrients to reduce their flu risk and improve the overall public health?

A book could be written answering that question.  The bottom line:  our government mistakenly thinks it would lose its grip on herd mentality.  Profits for the flimsy paradigm of Western medicine would be shaken at their core.  Vested interests with a stake in maintaining the status quo want to keep things as they are, even though doing so needlessly kills Americans and makes their own vaccination programs less effective.

Western medicine, acting alone, is a dying paradigm.  Vaccines as the ultimate solution to a serious infection are the pillar of this dying paradigm. There is no need for you to die along with these stale ideas, turning a blind eye to the obvious science.

Granted, I have a bias against flu vaccines; I have never had one – and I don’t ever get the flu.  I would reluctantly consider one if I thought it was safe, if I thought it was effective, and if I thought the flu virus coming around was a vicious killer of healthy people, (which the current swine flu does not appear to be).  On one hand, because of my general nutritional adequacy, I am the type of person most likely to benefit from such a vaccine.  On the other hand, because I do not get a flu vaccine each year does not mean I am working against the greater good.  To the contrary, by being healthy I contribute to the greater good by making sure I am not part of the problem.

Understanding Your Personal Flu Risk

While many of you reading this are not elderly, the underlying message is of immense importance to you. You should understand that it is the process of aging or the increased rate of aging that is detrimental to an efficient immune response.  This process or rate, which is inflammatory driven, can happen to any person at any age when his or her stress tolerance checkbook does not balance.  Following a period of high stress, it is all too common that a person looks in the mirror and says, “Wow, I’ve aged 10 years.”  In direct proportion to the amount of such internal feelings of wear and tear, and external visible signs of wear and tear, the efficient function of your immune system is reduced and your risk for getting the flu increases.

The CDC has already warned that obesity is a risk for the serious swine flu.  Why?  Because being overweight is highly inflammatory, especially if you are currently gaining weight.  Likewise, too much stress is highly inflammatory.  These factors can give you an “elderly-like” immune response problem. 

This could be a short duration issue due to acute challenges (excess pressures of one type or another).  Or it could be due to a longer-term wear and tear trend in your health.  Or it could be both. 

The inability to efficiently recover from stress18 is the key sign of risk for a faltering immune system.  Stress comes in many shapes and sizes.  It could be the stress of a previous infection not fully recovered from.  It could be the stress of a poor diet.  It could be the stress of a messed up digestive tract, ongoing sinus problems, or some nagging inflammatory ache or pain.  It could be the stress of not sleeping.  Or it could be excessive emotional stress, financial stress, marital stress, work stress, and/or substance abuse stress.  The list of possible stressors is almost endless.

Stress in and of itself isn’t even a bad thing.  Rather, it can be viewed as a type of fitness or challenge.  However, if you have too much stress you cross the line and enter into a state of inflammatory wear and tear that is highly immune suppressive regardless of your age.  Your energy is not as good, the internal feeling of vibrant health is lacking.  You may struggle with mood and be prone to easy irritation and “power outages” in response to the stressors in your life.  If you snack on sugar or eat meals too high in junk food in response to feeling crummy, then you really push your immune system to the brink

The bottom line, regardless of whether or not you make the personal choice to get or not get a flu vaccine, is that you must be prepared so that you give your immune system the potential to be effective in a time of need.  Quite frankly, you want a ruthless killer operation.  No questions asked.  Shoot on sight.  You want a gun in every room.  You want to be well supplied with ammunition.  You want nourishment for your troops.  You want intact supply lines.  You want a communication system in place to coordinate your efforts.  And you want all of these things running in tip-top efficiency.  The only way to accomplish this is with nutritional adequacy, enough to offset whatever stress you are under and to shore up the trend of your longer-term health issues.

As Benjamin Franklin put it, “An ounce of prevention is worth a pound of cure.”

Originally published 11/21/2010

 


Referenced Studies:
  1. ^ Nutritional Status Influences Elderly immune Response  J Nutr Health Aging.   Lesourd B.
  2. ^ Nutritional Status and the Elderly Immune Response  J Nutr Health Aging.  Ahluwalia N.
  3. ^ Nutrient Repletion Can Help Immunity in Deficient Elderly  Proc Nutr Soc.  Lesourd B.
  4. ^ Many Healthy Elderly Have Defective Immune Response to the Flu  Vaccine.   Bernstein E, Kaye D, Abrutyn E, Gross P, Dorfman M, Murasko DM.
  5. ^ Reason Behind the Poor Rate of Flu Vaccine Response in the Elderly  Exp Gerontol.   Role of humoral and cell-mediated immunity in protection from influenza disease after immunization of healthy elderly.
  6. ^ Inflammation and Immunosenescence  Ann N Y Acad Sci.   Franceschi C, Bonafè M, Valensin S, Olivieri F, De Luca M, Ottaviani E, De Benedictis G.
  7. ^ Longevity and the Innate Immune System.  Rejuvenation Res.  Candore G, Colonna-Romano G, Balistreri CR, Di Carlo D, Grimaldi MP, Listì F, Nuzzo D, Vasto S, Lio D, Caruso C.
  8. ^ Inefficient Immune Worsens with Age  Aging Cell.   DeVeale B, Brummel T, Seroude L.
  9. ^ Flu Vaccines Can Make Inflammation Worse  Vaccine  Trzonkowski P, Mysliwska J, Szmit E, Wieckiewicz J, Lukaszuk K, Brydak LB, Machala M, Mysliwski A.
  10. ^ Features of Immune Problems in the Elderly  Aging Clin Exp Res.   Grubeck-Loebenstein B, Della Bella S, Iorio AM, Michel JP, Pawelec G, Solana R.
  11. ^ Flu Vaccine Not Effective  Arch Pediatr Adolesc Med.  Peter G. Szilagyi, Gerry Fairbrother, Marie R. Griffin, Richard W. Hornung, Stephanie Donauer, Ardythe Morrow, Mekibib Altaye, Yuwei Zhu, Sandra Ambrose, Kathryn M. Edwards, Katherine A. Poehling,
  12. ^ Flu Shots Fall Miserably Short of Hype  American Journal of Respiratory and Critical Care Medicine  
  13. ^ Flu Vaccine Has Limited Benefits  Am J Epidemiol.   Fireman B, Lee J, Lewis N, Bembom O, van der Laan M, Baxter R.
  14. ^ Nutritional Supplementation Helps Elderly Immune Response  JPEN J Parenter Enteral Nutr.  Bunout D, Barrera G, Hirsch S, Gattas V, de la Maza MP, Haschke F, Steenhout P, Klassen P, Hager C, Avendaño M, Petermann M, Muñoz C.
  15. ^ Low Zinc Impairs Elderly Immune Response  Biogerontology.  Haase H, Mocchegiani E, Rink L.
  16. ^ Zinc Improves Stress Response Within Immune Cells of the Elderly  Exp Gerontol.  Putics A, Vödrös D, Malavolta M, Mocchegiani E, Csermely P, Soti C.
  17. ^ Zinc Reduces Inappropriate Immune-Related Inflammation in the Elderly  Rejuvenation Res.   Kahmann L, Uciechowski P, Warmuth S, Plümäkers B, Gressner AM, Malavolta M, Mocchegiani E, Rink L.
  18. ^ Stress Response, Immunity, and Aging  Aging Cell.   Butcher SK, Lord JM.

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