A DOCTOR SPEAKS

© MMXX V.1.0.0
by Morley Evans

I received this from a doctor friend of mine a few days ago and I'd like to share it with you.

Hi Morley: Regarding the flu shot. It is correct that the majority of cases of influenza are not confirmed by a lab analysis but they don’t need to be and here’s why. As Head of several large Hospital Laboratory Medicine Departments for almost forty years, paradoxically much of my life has been dedicated to teaching medical students and overenthusiastic young doctors not to order lab tests. Ticking every box on the Form ‘just in case’ is counterproductive and places an unnecessary burden on limited services. My golden rule became, “Before you order a test, ask how the result will affect the treatment of the patient?”

The reason I am telling you this is that testing for and identifying the type of influenza virus does not affect treatment. If it’s mild then fluids, bed rest and isolation should be adequate, if it’s severe then the patient may need everything up to ventilation in an ICU. It’s irrelevant whether it’s A(H1N1), A(H3N2) B etc. What we do know is that in a typical flu season up to 1/3 of the world’s population may be mildly affected, 4 million seriously enough to require medical attention and 300 to 600 thousand will die.

So if we’re not testing for it, how do we measure the efficacy of a vaccine? Simply we compare the number of known complications between vaccinated and non-vaccinated groups. Let me give you a few examples of undisputed relevant studies:

Mild to moderate influenza illness is reduced by 40% - 60% in the general population when the virus is reasonably well-matched to the vaccine.

In 2017-2018, vaccines prevented an estimated 90,000 hospitalizations.

In 2010-2012, flu vaccine reduced children’s risk of Pediatric ICU admissions by 74%.

In 2012-2015, flu vaccine among adults reduced the risk of ICU admissions for flu-related conditions by 82%.

In a meta-analysis comparing clinical trials of vaccinated versus non-vaccinated patients, the vaccinated group reduced their risk of a serious cardiac event by 46%.

In separate studies, once again comparing vaccinated groups with otherwise comparable non-vaccinated groups, the former had significantly reduced worsening and hospitalization for people with lung disease such as COPD and hospitalization for those with diabetes.

In a 2018 study, of influenza seasons from 2010-2016, vaccination reduced a pregnant woman’s risk of flu-related hospitalization by 40% and further reduced the risk to her newborn in the few months after birth when the baby is too young to benefit from vaccination.

A 2017 study found that flu vaccination significantly reduced a child’s risk of dying from the flu.

Another 2017 study found that flu vaccination reduced deaths, ICU admissions, ICU length of stay and overall duration of hospitalization among hospitalized flu patients. This confirmed our clinical impression that vaccination reduces the severity of illness among those who get vaccinated but still get the flu.

And finally, we should all get vaccinated pro bono public. This will protect people around you including those more vulnerable to serious illness and even death such as babies, very young children, the elderly and those with certain health conditions particularly suppressing the immune system e.g. cancer patients on chemotherapy.