I saw this story yesterday on the BBC’s website. It concerns a consultant chest physician, Dr Peter Hockey, who gives himself a slap on the wrist for not getting a flu jab. He ended up being hospitalised and couldn’t work for five months. He’s kicking himself for contracting a condition which he describes in the piece as “completely preventable”. His chagrin also relates to the fact that he infected a pregnant colleague of his – Dr Rachel Anderson – who thankfully went on to have a healthy baby. She is quoted as saying: “I was really lucky. When I found out I had swine flu I was given Tamiflu [an antiviral flu drug] straight away.”
On the face of it the message shouted loudly from this piece is this that we should all get our flu jabs and thank heavens for Tamiflu. One slight oddity about this article is that we are told that Dr Anderson was infected with swine flu, but there’s no mention of Dr Hockey ever having swine flu himself. Of course this may be down to reporting error.
More importantly though, let’s see what research, rather than rhetoric, tells us about the wonders of flu vaccination and Tamiflu (oseltamivir).
Well, if you were reading this site a couple of weeks back you’ll know already that flu vaccination doesn’t work as well as some would have us believe. http://www.drbriffa.com/2011/10/27/roll-up-for-the-flu-vaccine-i-think-not/
If when Dr Hockey refers to flu as ‘completely preventable’ he’s suggesting that the vaccination provides 100 per cent immunity then he’s very wide of the mark here. I know we doctors sometimes like to give the impression (and perhaps believe) that immunisation gives blanket protection, but it doesn’t.
And what of the Tamiflu Dr Anderson was ‘lucky’ to receive in such a timely manner? The effectiveness of this drug was reviewed in the British Medical Journal in 2009 . One of findings of this study is that Tamiflu reduces the duration of flu symptoms by about a day. The authors describe this as a ‘modest benefit’.
Another outcome assessed by this review related to the complications of flu including chest infection. The best data available to the authors showed “… no benefit for oseltamivir against complications.” In other words, there really is not good evidence that Tamiflu reduces the risk of complications.
The authors did concede, too, that data on the potential toxicity of Tamiflu was inadequate, commenting that the available evidence: “… could not answer concerns about the toxicity of neuraminidase inhibitors, especially oseltamivir. Governments should set up studies to monitor the safety of neuraminidase inhibitors.”
Let’s strip away the rhetoric from the piece I link to above and make an assessment based on actual research.
One doctor tells us that flu is completely preventable but it isn’t as far as vaccination is concerned (far from it). The other tells us how lucky she was to get Tamiflu though this drug has modest benefit, does not prevent complications of flu and has unknown toxicity. These facts, of course, have been completely lost in a piece which trumpets the supposed benefits of flu vaccination and Tamiflu but only tells us one side of the story.
1. Jefferson T, et al. Neuraminidase inhibitors for preventing and treating influenza in healthy adults: systematic review and meta-analysis. BMJ 2009;339:b5106