Flu vaccination is most certainly not a ‘no-brainer’

The winter heralds ‘flu season’, and many will be urged to get them themselves adequately protected through vaccination. A recent piece in the British Medical Journal [1] by Dr Peter Doshi (from the John Hopkins University School of Medicine in Baltimore, US) makes the point that public health campaigns often present flu vaccination as a no-brainer: we’re all at risk of flu and its complications, the flu shot is risk free, and vaccination saves lives. However, as Peter Doshi goes on to explain, all these assertions are open to question.

Dr Doshi questions the trend for increasing numbers of people being defined as ‘at risk’. In 1960, this definition only applied to individuals aged 65 or older. By 2010, this definition had extended to everyone over six months of age.

It is often claimed that flu vaccination saves lives. This claim is based on so-called ‘epidemiological’ evidence which finds that those who receive the flu vaccine are less likely to die than those who don’t. Risk reductions of 30 – 50 per cent are sometimes quoted. However, as Peter Doshi points out, flu only accounts for about 5 per cent of wintertime deaths. How, on earth, then can flu vaccination reduce the overall risk of death by those previously quoted figures? Answer: it can’t.

Dr Doshi also points to evidence that finds flu vaccination is linked with reduced risk of death outside winter. This does not point to flu vaccination having a real effect here, either. The likely explanation? That health-conscious and generally healthier individuals are more likely to opt for vaccination – the so-called ‘healthy user’ effect.

Some people claim that the evidence for the life-saving effects of flu vaccination are to be clearly seen in the figures showing declining mortality in recent years. However, as the following graph shows, flu mortality dropped dramatically and started to ‘bottom out’ well before flu vaccination became widespread.

Screen Shot 2013-11-22 at 14.47.35

Dr Doshi even asks questions about the safety of flu vaccination. He points out that:

Australia suspended its influenza vaccination program in under five year olds after many (one in every 110 vaccinated) children had febrile convulsions after vaccination. Another serious reaction to influenza vaccines—and also unexpected—occurred in Sweden and Finland, where H1N1 influenza vaccines were associated with a spike in cases of narcolepsy among adolescents (about one in every 55 000 vaccinated). Subsequent investigations by governmental and non-governmental researchers confirmed the vaccine’s role in these serious events.

Currently, legal action is being taken on behalf of 38 individuals who appear to have developed narcolepsy as a result of vaccination with GSK’s ‘Pandemrix’ (for swine flu). The UK Government has admitted that there does indeed appear to be a genuine link here. For more on this story, see here.

Dr Doshi’s analysis goes us a great service,  I think, and may cause many to consider when flu vaccination is really the ‘no-brainer’ its often presented to be.


1. Doshi P. Influenza: Marketing vaccine by marketing disease. BMJ 2013;346:f3037

37 Responses to Flu vaccination is most certainly not a ‘no-brainer’

  1. Ed Terry 22 November 2013 at 3:57 pm #

    Also check out “Review of the United States universal varicella vaccination program: Herpes zoster incidence rates, cost-effectiveness and vaccine efficacy based primarily on the Antelope Valley Varicella Active Surveillance Project data” by Goldman G.S. et al (2012) Vaccine” for an enlightening discussion of the unforeseen consequences of varicella vaccinations.

  2. jimmy 22 November 2013 at 3:59 pm #

    So is it safe to fall back to the ’60’s recommendations of 65y and older?

  3. Deane Alban 22 November 2013 at 4:01 pm #

    The flu vaccine contains mercury and aluminum amongst other things you don’t want injected into your body and is implicated in Alzheimer’s. All excellent reasons to avoid getting flu shots.

  4. Robert Park 22 November 2013 at 4:18 pm #

    There are a number of natural products that can prevent or cure virus infections (and rapidly) but which the NHS opt to ignore yet to recognise them would be economical so who is running the country; Rockefeller?

  5. RadiantLux 22 November 2013 at 4:32 pm #

    How interesting that the flu is only 5% of wintertime deaths. it seems crazy to worry about such a low risk.

  6. Tim 22 November 2013 at 5:02 pm #

    I appreciate your wanting us to view “no-brainers” with a critical eye. Don’t we wish science was that easy… However, I see this as one mans opinion, despite the fact that it comes with a Johns Hopkins credential. Personally I will wait for mounting evidence before forgoing the annual flu shot. Am I crazy?

    New York

  7. Liz Smith 22 November 2013 at 5:10 pm #

    Local supermarket last week offering flu vaccinations 9.99 in Surrey but my niece in Oz said there did not seem to be many flu infections in their area of Oz, WA. this last winter. She works in school and has four of her own children.

  8. Dr John Briffa 22 November 2013 at 5:13 pm #


    The BMJ piece is not really just an ‘opinion’, but quite thorough examination of the evidence, I think.

    If you have a stack of evidence to refute what Peter Doshi says then, no, I wouldn’t call that ‘crazy’.

    • Liora 5 September 2014 at 12:12 am #

      Dr. Doshi has many, many published papers about Influenza (vaccine, prevalence, etc) in the best journals in the world (JAMA, BMJ). If you go to pubmed.com and do a search for DOSHI P influenza a ton of papers come up. You can read them. He is not an “Opinion” he is looking at broad swaths of data and basing his conclusions upon that.

  9. Diane 22 November 2013 at 5:41 pm #

    I came accross this article the other day. I am not sure how genuine or trustworthy this evdience is but it woul dbe well worth further investigation and if it is indeed correct then it raises very serious questions about the ‘benefits’ of the flu vaccination.


  10. Jack 22 November 2013 at 5:58 pm #

    But even if we put aside risk of death, flu is an awful thing to get. The last time I had it as a healthy 40 year old, I was incredibly ill with it for a good 10 days.
    Surely most people have the flu jab to prevent them suffering from flu, not just to prevent them dying from it.
    So what I would like to know is: does the vaccination protect against catching flu in most cases, what are the exact risks of having the vaccination in a normally healthy adult in the UK, and is it true that the vaccination contains aluminium and mercury? And if so, in what quantity per jab?

    • Liora 5 September 2014 at 12:24 am #

      no. The Cochrane collaboration published a huge meta study looking at perhaps 15 or 20 large influenza vaccine trials. They concluded that out of 100 people receiving the vaccine, only ONE case of influenza would be prevented. The other 99 people got the risk of the vaccine with zero benefit. That’s pitiful. Another thing I recall from the excellent graphics, is that 8 out of 100 people will have “Influenza” but really is not true vaccine strain influenza but other things: Norovirus, etc. known as “Influenza-Like Illnesses” or ILI’s. Only one out of 100 will contract actual influenza, hence the 1/100 rate of “prevention by vaccine” .

      The common and uncommon risks of influenza shot are well documented. The serious ones are life altering. They detail them in the paper, but can also be read in any package insert (all are available here http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093833.htm) Narcolepsy, blood clotting disorders, immune system disorders, neurological damage like Guillain Barre syndrome (paralysis, can be permanent, my High School classmate’s son got it after a flu shot at age 5 or 6 and never recovered), heart arythhmias and infarction which often leads to death. Heart stopping was the mode of death of that 7 year old girl who died 1.5 years ago in Vermont. Her name was Kaylynne Matten. She got sick just after her flu shot and died 3 days later. Her story is here. http://vaxtruth.org/2012/01/death-by-flu-shot-7-year-old-receives-flu-vaccine-dies-4-days-later/

  11. Rita 22 November 2013 at 6:02 pm #

    Reading your blog over a period of time, I’ve come to the tentative but disturbing conclusion that epidemiology is so unscientific that it’s barely worth paying attention to. This always comes down to the fact that it’s impossible to control all our diet and lifestyle variables in order to focus in definitively on one single, isolated cause / effect. The phenomenon of the “healthy user” effect that you mention above is a good example. And on the other side, the “biased scientist” effect, i.e., the doctor with ties to Big Pharma, often taints the outcome of supposedly objective research.

    I assume that sometimes useful information comes from epidemiological research. But it seems to boil down to trends and assumptions rather than cold, hard facts. Am I missing something?

  12. Lorna 22 November 2013 at 6:30 pm #

    What about subsidising veg and fruit and taxing processed food? Hear a lot about the importance of good diet and lifestyle but no action on making them attractive alternatives to cheap, nutrient-light foodstuffs. IAs diet is so important, what about helping to re-direct habits rather than encouraging us to take medication in its many forms?

  13. A 22 November 2013 at 7:43 pm #

    This is how efficient flu-vaccines are:
    “Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations.”

  14. Frederica Huxley 22 November 2013 at 10:04 pm #

    Interestingly, there does not seem to be readily available research to show any meaningful effectiveness of flu vaccines given to the over 65s – in fact all that I can dredge up is distinctly hazy: http://www.ncbi.nlm.nih.gov/pubmed/20166072
    I had always understood that those of us who lived through – and quite often had – the Hong Kong flu were immune to most, if not all, subsequent flu variants to date! Personally, I rely on a good vitamin D level to ward off influenza.

  15. Raylene 22 November 2013 at 10:43 pm #

    Agreeing with Frederica…. the main reason why they are pushing to have healthy adults vaccinated is because the over 65’s immune system does not create the protection from the jab. Of course, the actual main reason is because they make money from it.

    And to respond to Jack…Of course the flu is really awful to get, but the truth of the matter is that there only 3 strains of flu that you are becoming “immune” to, but hundreds of different bugs can make you sick with the “flu”. When they are saying that the vaccine was “this” amount effective, or that a certain amount of people died from the flu…well, they are counted in two different ways, neither being scientific. People’s bugs are not routinely cultured to find out what actually they have and in the case of deaths, it is a number generated from a computer with parameters put in. It’s absolutely impossible to make an informed decision based on the information that the health authorities put out. Of course, the dumber you are, the better they like it.

  16. Elizabeth Addison 22 November 2013 at 11:36 pm #

    At 75 & 77 respectively, neither my husband or I can ever remember having flu!!
    We follow a sensible life-style with diet & exercise, plus carefully selected supplements.
    I would never have the flu jab, it makes no sense to contaminate the body with the toxins included in these jabs if you don’t need it, whatever your age

  17. Robert Park 23 November 2013 at 1:25 am #

    I commented earlier that there are a number of natural substances that are effective against most viruses including colds and influenza which have been known to the medical profession but regretfully the information is marginalised and kept out of the public arena. Lauric acid, a fatty acid of breast milk and of coconut destroys the envelope of protein in which viruses hide from the immune system and this allows the immune system to do its job which it does effectively and efficiently. Almost any coconut product will do although its oil is recommended. My family use creamed coconut block from the oriental shelves of the supermarket which prior to the government’s quantitive easing programmes of late cost between 60-75p. It has a long shelf life. It takes between 10-12 hours to cure the severest symptoms. If added to this some olive leaf extract the symptoms will disperse in around 7-8 hours but if oregano oil (not the culinary stuff) is also added then those three products are synergistic and will rid the symptoms in around 5 short hours! It is best not to use it as a prophylactic as viruses are adaptable and it will require larger doses of the cocktail to work nature’s magic. If in company with anyone who has the symptoms or if the snuffles appear then take a lump of the coconut block which is often effective. Local GP practices will often suggest that patients become involved in the management of their own treatment so here is the answer which cost a few pence and is around 99.9% effective with no known side effects.

  18. Maureen 23 November 2013 at 6:41 am #

    We, as Elizabeth and her husband, are similiar ages, 75 and 76. We try to lead a reasonably active life, use a selection of vitamins etc suitable for our age and try to follow a good healthy diet (not paragons of virtue, we do have a treat now and again). I have had one bad flu experience about 16 years ago and nothing since. (I hope I am not tempting providence my mentioning that)!

    Both of us elected, when reaching the age for ‘free’ flu injections to opt out having seen both my mother and father suffer every year after having the regularly yearly injection. I might add this never did seem to shake off the dreaded ‘bug’ either.

    We remain solid in our decision and do not follow the ‘free flue injection’ yearly race that most of our friends appear to take part in. Time will tell, are we right or are we wrong?

  19. steve 23 November 2013 at 10:56 am #

    You know what my friend?

    You got ‘guts’!

    The fact the you are presenting Dr Peter Doshi’s point of view, on flu vaccination, should provide plenty of “food for thought”, to your readers..

    Good work.

  20. Christopher Palmer 23 November 2013 at 2:39 pm #


    No, you are not crazy.

    Urban concentrations of populations, urban lifestyles, and, as yet, largely unrecognised ‘environmental factors’ make life easier for the transmission of many a virus, and undermine the capacity of many a persons immune system to deal with pathogens.

    But, you are complicit in something which is not a good trend, and by being complicit, in a sense you add to the general madness.

    Interventionist policies, such as offering and taking the jab, are always second best, functionally speaking, while being first rate, commercially speaking. The thing to recognise that policy is second best just so some company can make a sale, generate a profit, and swell peoples pensions savings.

    Intervention, in the sense of adding some innovation, to the mix is generally not the best way to go, for it adds to complications and consequence. As an individual you may think the jab is advantageous, and on the balance of risk-benefit analysis it may be for you.

    But risk-benefit analysis can be performed at the systemic or population level, and not for your singular position of self-interest.

    It is at this level matters can look so different. How? Well, as already said the virus has it easy, in some ways, because transmission is made easy or easier.

    So one way to go forwards is to plug these gaps and make life difficult for the virus. It is called a low-input solution, though we have to understand the weak spots and challenge them. Low-input doesn’t automatically mean easy. Then for reasons I won’t go into few people living in an urban environment have immune systems that are working at their best, Now this is leading edge stuff that challenges dogma on one hand and introduces some radical ideas on the other, but all said I do think there are a number of prominent ways in which the modern human is no longer living in tune with nature’s ways. This has implications for our hormonal balance, immune function, and even genetic expression by bearing upon the dynamic switching layer we call the epigenome.

    It is getting very silly, and all because experts generally insist upon looking down the wrong end of the telescope, as indeed you do (non intended).

    The number of ‘mutant’ genes that have been identified is alarming. Our genes are the most adaptive asset we have, it is the environment we have fashioned for ourselves that is no seen as being ‘mutant’ by human physiology. We do not have to forsake modernity or technology, but we would do well to realise how some aspects of the modern world are no longer seen as being agreeable by our physiology and our genome. Remove these factors and you remove the cause that impedes natural (former) levels of immunity and resistance. This still ranks as intervention, but it intervenes where it matters, at the level of cause and effect. Intervene any where else than at the origin of cause and effect and it is a near certainty the intervention will result in added effects or ‘side-effects’.

    It is the case, that merely being complicit contributes to the madness.

    Zombie capitalism requires the complicity of zombies. The zombies, I am sad to report, represent the majority, which is why democracy never attains its full potential.

  21. Galina L. 23 November 2013 at 7:06 pm #

    Immunity protective diet does not require a lot of fruits and vegetables, just serious limitation of carbohydrates. Probably, some people end up eating more veggies (not fruits) when they choose cabbage over pasta as a side dish, but I don’t think government involvement could be helpful in a such diet change. I suspect that the subsidies you propose would go to juice producers, potatoes growers, to the manufactures of snacks which contain dried fruits and similar nonsense. Bureaucracy has a tendency to produce regulations which defy a common human logic and and impossible to justify on individual level.

    Since I went to a Low Carbohydrate diet at November 2007, I didn’t get any seasonal flue or a urinary tract infection. My mom follows the same diet for three years with the same result.

  22. Christopher Palmer 24 November 2013 at 3:32 pm #

    “Immunity protective diet does not require a lot of fruits and vegetables, just serious limitation of carbohydrates.”

    An excellent observation.

    Actually, provided the carbohydrate quotient present in the dietary mix comes from medium and low GL sources, that by definition come with native soluble fibre, then carbohydrate should be reasonably well tolerated. Adequate fat in the meal also helps.

    If we liken the guts to a nuclear reactor (they are not – but the comparison is effective) then the fibre and or fat from the meal that’s present in the chyme that is about to be digested work like control rods to prevent over-rapid digestion.

    If we discount the value of plant matter in the diet to health we discount the possibility that the relationship we have with bacteria in the gut is one which is symbiotic.

    In my rush to go HFLC I tended not to consider the benefit of plant matter, cooked and raw. Including a bit of raw’ helps attenuate the rate of digestion. The passage of each of the macro-nutrients over the GI divide may be slowed, but the passage of glucose over the GI divide would be slowed significantly.

    I’m sure I picked up along the way that the action of gut bacteria feeds into signalling pathways and bears upon the sympathetic nervous system / immunity – and of course Yakult and suchlike are sold of that general paradigm. Then in common parlance the nervous system / anxiety / fear can bear upon transit times! People have written about gut dysbiosis / symbiosis. and I think I must venture in to what has been written as I’d hate to throw baby with bathwater by missing something.

    Despite that Teresa S Wiley is a controversial figure today with two smudges staining her name It was nonetheless quite progressive of her to be fairly plain that a HCLF diet degraded the functioning of the immune system. She did so from an endocrinological perspective and pre-dated the work of the late Barry Groves.

    The consumption of energy at the level of collective mitochondria demand may be around 1 calorie every 40 seconds, and the pattern is essentially flat-line. Eat a meal of pizza, soda, and cookies, and the meal may come to 700 cals in one sitting, but crucially a lot of glucose is passed over the GI divide very soon after eating. The ‘peaky’ supply of glucose is the killer, not a modest and attenuated supply, I’d hazard to reason.

  23. Christopher Palmer 24 November 2013 at 3:34 pm #

    Think raw carrot sticks = control rods !!

  24. Lorna 24 November 2013 at 5:56 pm #

    I was thinking more of encouragement to growers, especially organic producers. Good nutrition to provide optimum health, is surely about awareness of, and access to, a variety of quality, unprocessed food. If governments spend our taxes on campaigns for flu jabs and low fat diets then encouraging and supporting proactive life choices on diet seems like a good way to spend money and is an investment in a population mindful of the connection between nutrition and health.

  25. Galina L. 25 November 2013 at 2:52 pm #

    I guess, the main thing which concerns a government (besides elections and re-elections) is the economy. Taxing processed food producers may have a negative impact on an economy and giving tax brakes to small farmers will not improve public health, so it will not reduce public health spending. Eating processed food is more expensive then coking from a scratch already, so even poor people are not deferred by an extra expense when it comes to an extra convenience . Manufactures provide what people demand. In US trans-fats were gradually removed from manufactured foods due to a consumer demand, until recently got banned by the government. It is difficult to find even a 2% Greek yogurt in stores because most customers want to buy 0 fat one due to an anti-fat propaganda. I think that giving tax break to small farmers could be only done as a result of public pressure as a jest to improve electability.

  26. Harold Sargeant 25 November 2013 at 10:00 pm #

    I am sure that we can all benefit from a healthy lifestyle including nutrition and exercise but I have yet to see any scientific evidence that it can prevent or cure influenza. It is a viral infection and it can take you down quite low whilst your body works out how to destroy it. The healthier you are, the quicker the recovery.

    Here is an opposing view about vaccination agains flu, also by a doctor, and pretty recent.


  27. Galina L. 26 November 2013 at 1:09 pm #

    Before antibiotics were invented, people noticed the difference between nutrition and resiliency to infectious diseases. Weston Price (http://gutenberg.net.au/ebooks02/0200251h.html) during his journey all around the world it the search of different healthy traditional societies, reported on many occasions the strong connection between health and nutrition. For example, when he collected the data on the Islands of the Outer Hebrides, he encountered the phenomenon when whole populations of some small icelands were wiped out with a rampant outbreak of tuberculosis after a grocery store started to operate, selling products made out of refined flour and sugar .Gaelics people who lived there traditionally ate mostly fish and some oats , cod lived was consumed regularly.
    During World War II, one of my distant relatives got healed from tuberculosis by eating eggs, salted pork fat and butter he was buying on a black market after selling all his possessions.
    It looks like the healthy life style which prevents illnesses consists of eating fatty animal products, avoiding refined carbohydrates, having enough sleep, a sun exposure, physical activity.
    Human body can be immune to influenza and healed itself more successfully on the right food.

  28. Harold Sargeant 28 November 2013 at 10:26 pm #

    Or as I put it:
    Before antibiotics were invented, people noticed the relationship between good nutrition and resilience (ability to recover) after infectious diseases.

    Surely not all of the some 25 million people killed in the 1918 flu pandemic were poorly nourished individuals. Like recent outbreaks many young people caught it.

    As an over 70 year old I probably have some resistance because previous infections have left me with some of the needed anti-bodies like quite a few of the people commenting here. I haven’t had flu for years — maybe because I have the jab. Who knows?

  29. Robin Nixon 29 November 2013 at 8:56 am #

    Two words: Vitamin D

    I have taken 5,000IU of vitamin D every day for about 5 years now and in all that time have had only 2-3 colds or flu, all of which lasted less than 48 hours. Sometimes I get a tickly throat and take a further 50,000IU, and the symptoms are gone within a couple of hours.

    After a couple of years my wife and children followed suit and now she is almost immune to colds and flu too, as are our children. Truly it’s amazing. We all used to get several colds or flus each year, generally lasting 10 days or more – the difference for the last few years has been wonderful.

  30. Robert Park 29 November 2013 at 3:21 pm #

    Harold, I read your reference from ‘sciencebasedmedicine.org’ and the writer says the following at the commencement to his comment: ‘Words are important. I try and choose my words carefully when writing so that they accurately reflect not only my thoughts but reality.’ then thereafter what he writes is a tad confusing although the thread of his views can just about be followed by the lay person. The responses too were interesting yet no one addressed the benefits of natural products and it is in the field of natural products that the cure for viruses exists and it has the backing of medical research. Regretfully, I do not possess the references to the supporting science but it exists yet manifestly has been judiciously marginalised. See my earlier comments on the benefits of some of those products which nature has provided and which the cartel of pharmaceutical companies do not want this to be generally known by the public. Incidentally and interestingly, Jung, the behavioural psychologist, observed that researchers create the answers to which they seek so could his observations be accepted as science based?

  31. Galina L. 3 December 2013 at 2:41 am #

    @Harold Sargeant,

    The Spanish flu was unique in the regard that it caused disproportionately strong response from immune system , so mostly young people died from the lungs edema caused by the overdrive of their immune system . I doubt most people were well-fed during World War I when the epidermic took place.

  32. Thaddeus Buttmunch MD 9 December 2013 at 3:48 pm #

    I DO get the flu vaccine and advise most of my patients to do the same. I, personally, have only had One problem..with the swine flu vaccine in 1976 (I got a high fever three days later.) HIs statement about the vaccine not preventing 50% of flu deaths is misleading-they are talking about those who GET the Flu.


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