Heroes Not Zombies

At this time of year there are queues of patients in the GPs’ surgeries standing in line waiting for flu jabs. I routinely receive emails from my employer (the NHS) exhorting me to have the flu vaccine.

I’m not joining in.

An elderly patient told me recently she attended her GP for a routine BP check from the nurse who asked her if she had been vaccinated for the flu yet. She said no, and as last year she had felt unwell for a few days afterwards, she said she would come back for it after a planned weekend break. The nurse said, nonsense, the flu jag doesn’t make you feel unwell, picked up a syringe in injected it into the patient’s arm. She was furious, and said she wasn’t well enough to enjoy her weekend away afterwards. I’m sorry, but this is no way to deliver health care.

Here’s where the story gets worse.

The Center for Infectious Disease Research and Policy in Minnesota has reviewed the evidence for the claims made about flu vaccination. What did they find?

Based on a comprehensive review of data published from 1967 to 2012, they found evidence for “consistent high-level protection is elusive,” the researchers concluded. Although vaccination was found to provide modest protection from infection in young healthy adults who rarely have complications of flu, the authors found that “evidence for protection in adults 65 years of age and older [who represent over 90% of deaths from flu] . . . is lacking.” Apparently in otherwise fit, healthy young adults flu immunisation can reduce their experience of illness by half a working day. In the elderly there is no evidence is protects them. (This study was reported in the BMJ with the headline “Belief not science is behind flu jab promotion, new report says”)

Yet, the NHS heavily pushes this immunisation.

On a related subject let’s think about Tamiflu which Roche persuaded governments around the world, including the UK, to stockpile supplies costing billions of dollars, on the basis of an evidence base which they continue to refuse to publish. In 2005, the UK agreed to buy £200 million of Tamiflu.

However, the evidence that Tamiflu would actually significantly prevent either the spread of flu, or the incidence of complications has all been based on studies carried out by Roche itself. The BMJ and the Cochrane Collaboration are leading a campaign to get Roche to release the data from their 8 out of 10 unpublished trials. In fact, the BMJ has set up a website.

When it comes to flu, the government seem prepared to promote and purchase, at huge cost, treatments with very, very sparse evidence bases.