Health and Science News for Parents
Oct
28

Setting the record straight: Debunking ALL the flu vaccine myths

written by Tara Haelle

It’s that time again — that time when dozens of spurious articles pop up all over the web touting all the dangers of the flu vaccine. Articles on unreliable, alarmist, misinformative sites like Natural News, Mercola, chiropractic blogs and other such sites rail against the “toxins” in the vaccine, or claim the flu vaccine doesn’t work, or that it causes this or that horrible disease, or that the flu itself just really isn’t all that bad. (I’m not going to link to any of them. They get too much attention as it is.)

Anxious about the flu shot? No reason to be. Learn about the many myths and inaccuracies spread every year about the influenza vaccine. Image from Shutterstock.

I could be wrong, but I’d venture to guess there is more nonsense and misinformation about the flu vaccine than any other vaccine out there. Perhaps it’s because it’s a once-a-year vaccine, so that cyclical nature brings out new myths each year. Or maybe it’s because it’s for an illness that many people have had, even more than once, and survived, so they mistakenly assume a vaccine is unnecessary.

Whatever the reasons, I’ve decided a comprehensive post addressing every myth I’ve been able to find is long overdue. I plan to update this post as necessary, and I’ll likely republish it each year as a reference. Note all the links where I provide my sources — more than half of these go directly to peer-reviewed medical research.

To make it easier to navigate, I’ve listed all 25 myths here at the top with links to that myth’s debunking explanation.

First, an important note: I am a science journalist but not a medical doctor. I’ve compiled research here to debunk common myths about the flu vaccine. You should always consult a reliable, trusted medical professional with questions that pertain specifically to you. For the CDC recommendations on the 2013-2014 flu vaccines (including information on which vaccines pregnant women, the elderly and children under 2 should *not* get), please consult the CDC site directly.

Myth #1: The flu vaccine gives you the flu or makes you sick. (No, it doesn’t.)
Myth #2: Flu vaccines contains dangerous ingredients, such as mercury, formaldehyde and antifreeze. (Not exactly, and the ingredients aren’t dangerous.)
Myth #3:  Pregnant women should not get the flu shot. (They should.) / The flu shot can cause miscarriages. (It doesn’t.) / Pregnant should only get the preservative-free flu shot. (Nope.)
Myth #4: Flu vaccines can cause Alzheimer’s disease. (They can’t.)
Myth #5: Flu vaccines provide billions of dollars in profits for pharmaceutical companies. (Maybe, maybe not, but so what?)
Myth #6: Flu vaccines don’t work. (Um, they do work.)
Myth #7: Flu vaccines don’t work for children. (Again, they work.)
Myth #8: Flu vaccines make it easier for people to catch pneumonia or other infectious diseases. (No, they make it harder.)
Myth #9: Flu vaccines cause vascular or cardiovascular disorders. (No, they don’t.)
Myth #10: Flu vaccines can break the “blood brain barrier” of young children and hurt their development. (No, they can’t.)
Myth #11: Flu vaccines cause narcolepsy. (Not the seasonal flu vaccine, and not most others.)
Myth #12: The flu vaccine weakens your body’s immune response. (It actually strengthens it.)
Myth #13: The flu vaccine causes nerve disorders such as Guillain Barre syndrome. (Extremely rarely – and more commonly with flu infections.)
Myth #14: The flu vaccine can cause neurological disorders. (No, it can’t.)
Myth #15: Influenza isn’t that bad. Or, people recover quickly from it. (Uh, it’s pretty bad.)
Myth #16: People don’t die from the flu unless they have another underlying condition already. (Actually, healthy people DO die from the flu.)
Myth #17: People with egg allergies cannot get the flu shot. It will kill them! (No, it won’t, and there’s an egg-free vaccine.)
Myth #18: If I get the flu, antibiotics will take care of me. (No, they can’t.)
Myth #19: The flu shot doesn’t work for me, personally, because last time I got it, I got the flu anyway. (It still reduces your risk.)
Myth #20: I never get the flu, so I don’t need the shot. (You can see the future?)
Myth #21: I can protect myself from the flu by eating right and washing my hands regularly. (No, you can’t.)
Myth #22: It’s okay if I get the flu because it will make my immune system stronger. (Selfish, much? And no, it doesn’t.)
Myth #23: Making a new vaccine each year only makes influenza strains stronger. (No, it doesn’t.)
Myth #24: The side effects of the flu shot are worse than the flu. (No, they aren’t.)
Myth #25: The flu vaccine causes Bell’s palsy. (No, it doesn’t.)

Myth #1: The flu vaccine gives you the flu or makes you sick. (No, it doesn’t.)

This is by far the most common myth I hear – even though it’s biologically not possible from the inactivated vaccine. Are there people who become sick right after having gotten the flu shot? Of course, and it’s an illness they had likely caught before the shot and it took a a few days for symptoms to appear, or it’s just coincidence (and it may or may not be the flu). The flu shot takes two weeks to confer protection, and it takes 2-5 days to incubate a flu virus. A person who does come down with the flu within a week of getting the shot was already infected when they got the vaccine.

Even with the live vaccine in the nasal spray, the weakened virus cannot cause the flu. However, it is theoretically possible to “shed” the virus after receiving the live vaccine, thereby infecting others, though no serious cases have been reported of this occurring.

Edit: One thing worth noting is that some people may feel “under the weather” or generally crappy for a few days after the shot or a week or two later. A headache, nausea, fever, etc. can be a result of the side effects of the vaccine, usually from the immune system ramping up and producing antibodies against those influenza strains. Some may consider this feeling “sick,” but you are not sick in the sense that the flu vaccine caused you to fall ill from a pathogen, and the vaccine certainly didn’t give you the flu.

Myth #2: The flu shot contains dangerous ingredients, such as mercury, formaldehyde and antifreeze. (Not exactly, and the ingredients aren’t dangerous.)

Single dose-shots of the flu vaccine and the flu vaccine nasal sprays do not contain any mercury compounds. The multi-dose flu shot does contain a preservative called thimerosal, which breaks down into 49% ethylmercury and used to prevent bacterial contamination of the vaccine container. Ethylmercury, as I’ve discussed before, is processed differently by the body than methylmercury, the neurotoxin that can build up in the body and is found in fish. (Keep in mind the difference a letter can make in chemistry: methanol is anti-freeze while ethanol is a Chardonnay.) Ethylmercury is made of larger molecules that cannot enter the brain and exits the body within a week.

There is no danger in receiving a vaccine with thimerosal – they’re given all over the world and it’s been extensively studied, even for cumulative effects on children over several years. And, keep in mind, if you’re just one of those paranoid types, you can easily request and get a flu shot without the preservative.

Formaldehyde is used in safely small amounts in several flu vaccines (Fluarix, FluLaval, Agriflu and Fluzone) to inactivate the virus so it cannot cause disease. It is not in other influenza vaccines (Afluria, FluMist and Fluvirin). Formaldehyde also occurs naturally in fruits and vegetables even is produced by the human body for a variety of functions, including making amino acids. The amounts of formaldehyde in these vaccines vary from 5 µg per dose (Fluarix) to 25 µg per dose (FluLaval) to 100 µg per dose (Fluzone). For reference, a pear contains about 39 to 60 mg/kg of formaldehyde (1000µg = 1mg, so pears contains approximately 39,000 to 60,000 µg/kg.) A typical pear weighs about 220g, or 0.22 kg. That means a single pear would contain 0.22 times the 39 to 60 mg/kg, or 8.6 to 13.2 mg (8600 to 13200 µg). (Meanwhile, a single dried shiitake mushroom contains 100-406 mg/kg of formaldehyde.)

The claim of antifreeze being in vaccines comes from the use of octylphenol ethoxylate (Triton X-100) (in Fluzone) or octoxynol-10 (Triton X-100) (in Fluarix) used to inactivate those viruses or to purify other vaccines. Polyethylene glycol by itself is one component of antifreeze but is not antifreeze itself, just as water is a component of antifreeze. But these are not the same as polyethylene glycol and involve the use of Triton X-100 as a splitting agent, which has been shown to be safe. Learn more about specific components of flu vaccines here, but remember, again that ONE LETTER can make a huge difference in what you’re talking about.

Myth #3A:  Pregnant women should not get the flu shot. (They should.)

I’m pregnant, and I got the flu shot last week, as should all pregnant women without medical contraindications, as the CDC recommends. The flu shot is safe for pregnant mothers, and even after their child is born, mothers who got the flu shot while pregnant have provided their babies with a bit of extra protection against acute respiratory infections. They also may reduce children’s risk of other conditions, such as bipolar disorder, associated with prenatal influenza exposure. And, moms who get the flu shot also offer their babies some protection against the flu from birth, even if they plan to breastfeed.

Myth #3B: The flu shot can cause miscarriages. (It doesn’t.)

Not only does the flu shot not cause miscarriage, this non-pharma-funded study in the New England Journal of Medicine actually shows that the flu shot *decreases* the risk of a miscarriages/stillbirths in pregnant women, not least because having influenza itself during pregnancy is linked to miscarriages. Interestingly, the flu shot can even reduce women’s risk of other birth complications, such as a preterm birth or an underweight baby.

Myth #3C: Pregnant women should *only* get the preservative-free flu shot. (Nope.)

The inactivated flu vaccine, with or without the preservative thimerosal, is safe for pregnant women, exits the body quickly and will not cause developmental problems (or any other problems) in the fetus. The shot I got last week had thimerosal, and I’m certainly not going to do anything to hurt my developing baby. I discussed thimerosal in greater detail above at Myth #2. (Bonus side note: Even though ethylmercury and methylmercury are quite different, it’s worth noting that even a pregnancy diet high in fish, which may expose a woman to more methylmercury, has not been found to have an effect on children’s development.)

Myth #4: Flu vaccines can cause Alzheimer’s disease. (They can’t.)

This myth is even addressed on the Alzheimer’s Association website, where they note the 2001 study showing a *reduced* risk of Alzheimer’s among those who had received flu vaccines, the polio vaccine and the tetanus and diphtheria vaccines. In fact, the risk for developing Alzheimer’s was half as much for those receiving these vaccines. The myth originated with a quack named Hugh Fudenberg who has no evidence for the claim.

Meanwhile, seniors are at a higher risk for flu complications and death and are recommended to get the flu vaccine each year, particularly the inactivated (not live) vaccine for those over 65 years old. The intradermal flu vaccine is also not recommended for those over 65. (Side note: some worry about aluminum in vaccines causing Alzheimer’s — except that flu shots don’t contain aluminum and aluminum does not cause Alzheimer’s.)

Myth #5: Flu vaccines provide billions of dollars in profits for pharmaceutical companies. (Maybe, maybe not, but so what?)

There is no question that pharmaceutical companies are for-profit companies and that they really rake in the billions. If they didn’t make a profit off vaccine, they wouldn’t manufacture them. However, the profits they earn from vaccines are a drop in the bucket when considered along with chronic condition medications such as blood pressure meds and mental health drugs, not to mention the cash flow from medications like Viagra.

But the recommendations for vaccines come from public health organizations such as the Centers for Disease Control and similar public health, government and academic institutions across the world. Unless you think all those countries’ governments and public health officials are involved in a huge conspiracy or money-making scheme with Big Pharma (and if you think that, read this), then the fact that vaccines offer a profit to pharma companies isn’t a reason not to get vaccinated. In fact, influenza itself is quite costly, costing the US about $4.6 billion annually in direct medical costs and as much as $87 billion annually in all costs.

Myth #6: Flu vaccines don’t work. (Um, they do work.)

Flu vaccines are not 100% effective. (Actually, no vaccine is 100% effective.) But they do reduce the risk of catching the flu even if they cannot eliminate the risk. And there are tons of studies showing this. Unfortunately, the effectiveness of the flu vaccine varies quite a bit from year to year and is among the less effective vaccines compared to ones such as the measles-mumps-rubella vaccine, whose effectiveness is in the high upper 90%s. (The more people who get the vaccine, though, the better herd immunity is and the more effective it can be.)

There are a couple things to keep in mind about the effectiveness of the flu vaccine that vaccine researcher Jessica Atwell mentioned to me. First, the flu vaccine has historically protected against only three strains each year (the live vaccine FluMist this year protects   against four for the first time this year), but there are many more strains circulating each year. The World Health Organization make educated guesses by February about which strains will be circulating later that fall: some years their algorithms for picking the strains are better than others.  Yet in even the years when their estimates fall short, the flu shot is worthwhile: a meta-analysis looking at 34 randomized, controlled trials across 47 flu seasons found that even when the strains in the flu vaccine do not match the strains circulating that year, the flu vaccine offered a measure of protection against the circulating strains.

Next, the effectiveness of the flu vaccine varies for different age groups, partly because of the way the immune system ages. “Generally speaking, your immune system peaks in early adulthood and goes downhill from there – hence less than ideal efficacy of standard flu vaccines in the elderly,” Atwell said. Yet even studies showing low overall effectiveness — this one found anywhere from 33 to 100 adults need to be vaccinated each year to prevent one case of the flu — still show a reduced risk of the flu in vaccinated individuals. Coming at it from a different angle, another recent study estimated that vaccination prevented anywhere from 1.1 million to 5 million flu infections during each flu season over six years.

Again, some years, the flu vaccine’s effectiveness is very low. Other years, it’s better. But just because it does not work 100% all the time for all people does not mean it’s worthless or ineffective. Some days, I feel like I’m only operating at 50% human capacity — but I still need to be a mother to my son, and I’m better than no parent at all for him. Or, for a simpler analogy: If there is a 50% chance it’s going to rain, do you take along the umbrella even if it’s an inconvenience? Some do because they don’t want to get wet if it does rain. Some bring it, but it’s a bad storm and they get a little wet anyway. Others don’t bring the umbrella. The difference? By not getting yourself vaccinated, you potentially put others at risk for catching the flu from you, if you catch it.

The Holy Grail, of course, is a universal flu vaccine to provide protection against many or all influenza strains. It’s a goal that many flu vaccine researchers have been working toward for years, but there are many challenges to such a vaccine and success has been elusive.

Myth #7: Flu vaccines don’t work for children. (Again, they work.)

As noted above, the effectiveness of the flu vaccine varies by age and by which vaccine (live or inactivated) a person gets, but there is no doubt that it offers some protection against the flu. As Melinda Wenner Moyer points out in this Slate piece, the live vaccine (FluMist) is more effective for kids aged 2 to 7, up to 83% effective (meaning kids who get the vaccine are 83% less likely to get the flu than gets who aren’t vaccinated). To put that study’s finding in absolute number terms, 16% of unvaxed kids got the flu compared to 3.4% of those who received the live vaccine.

Meanwhile, the (inactivated) shot only offered 48% effectiveness in another study. (Moyer’s article is worth reading in full for more details about flu vaccine effectiveness in children and teens.) Another review of the research found that, for children under 6 years old, one child would be prevented from contracting influenza for every six who were vaccinated with the live vaccine. For children over 6, one case of flu could be prevented for every 28 kids who received the inactivated vaccine.

Moyer also notes that the research on the effectiveness of the flu for kids aged 6 months to 2 years is weak, mostly because there isn’t much data available. (That’s based on a Cochrane review whose only data set on children under 2 was a study with 16 infants.) It’s true the data is thin, but it’s not entirely nonexistent. The CDC notes that one study found the flu vaccine to be 66% effective in preventing lab-confirmed influenza in children aged 6 months to 2 years old. (While this study did not find the flu vaccine to help prevent ear infections, others have found that.) Another study has found a good immune response to the vaccine among children (including infants). In another, focused specifically on children aged 9 months to 3 years, only 4% of vaccinated children under age 2 caught the flu compared to 12% of the unvaccinated children, for another finding of 66% effectiveness.

Myth #8: Flu vaccines make it easier for people to catch pneumonia or other infectious diseases. (No, they make it harder.)

This myth is just bizarre. For one thing, catching the flu will weaken your immune system while you’re sick, during which it’s easier to become ill from other bugs. But more importantly, pneumonia is among the most common complications to occur as a result of a flu infection, so getting the flu shot *reduces* your risk of pneumonia, a leading cause of death among those who die from influenza complications.

Myth #9: Flu vaccines cause vascular or cardiovascular disorders. (No, they don’t.)

This is another myth that should be flipped on its head. There is no evidence that the flu vaccine causes vascular disorders. Meanwhile, the vaccine has been shown in multiple studies to reduce individuals’ risk of heart attacks, stroke and other cardiovascular events.

Myth #10: Flu vaccines can break the “blood brain barrier” of young children and hurt their development. (No, they can’t.)

There is no evidence that flu vaccines can hurt children’s development or that children’s neurovascular structure are affected by flu vaccines. A child’s blood brain barrier is formed in utero and is functional from birth in regulating what can and cannot pass into the brain. Researchers at Stanford University and the University of California – San Francisco discovered in 2010 that pericytes are required for blood-brain barrier development and that pericytes are present in the fetal brain. This research shows that an infant’s blood brain barrier is developed before birth. The physiology of the blood brain barrier and how it functions at that level of development make it highly implausible that any vaccine components could penetrate the barrier.

Myth #11: Flu vaccines cause narcolepsy. (Not the seasonal flu vaccine, and not most others.)

This is one of the few myths that is rooted in a small amount of fact, though it’s often misrepresented or blown out of proportion. Narcolepsy is a  neurological disorder in which the brain in unable to regulate sleep-wake cycles. Several studies, first in Finland and then in other European countries, found and confirmed a link between narcolepsy and the 2009 H1N1 flu vaccine called Pandemrix, manufactured by GlaxoSmithKline Europe and used in several European countries (but not in the US or Canada). It was not used before 2009 or since the 2009-2010 season, and no links to narcolepsy have been found for US-manufactured H1N1 or seasonal flu vaccines. The CDC is sponsoring an international study on the link between the 2009 H1N1 flu vaccines and narcolepsy, expected to be completed in 2014.

One hypothesis for the link relates to an adjuvant called ASO3, an oil-in-water emulsion. Adjuvants are substances added to a vaccine to increase the body’s immune response to that vaccine; US influenza vaccines do not contain adjuvants. Other possibilities for the narcolepsy risk include immune stimulation from the vaccine itself, immune activation from H1N1 infection or another infection present at the time, or a combination of these factors. It’s also possible the narcolepsy risk is related to the H1N1 virus itself, which could means the flu infection could increase the risk of narcolepsy — but these are all conjectures at the moment. Recommendations in Europe were initially revised for the vaccine and then Pandemrix was suspended after the evidence came to light. The increased risk was estimated at an additional 3 to 7 cases of narcolepsy for every 100,000 vaccinated children (the link was only seen in those under 21).

Myth #12: The flu vaccine weakens your body’s immune response. (It actually strengthens it.)

Vaccines do not weaken the body’s immunological responses or cause other infections. They actually strengthen the immune system, activating a response that leads to the production of specific antibodies against the disease the vaccine is designed to protect against. The immune system is like a muscle and vaccines are like the exercise. The vaccines train your immune system for a future attack just like exercise strengthens your muscles and makes you body stronger.  (The flu, on the other hand, does weaken your immune system while your body tries to fight it.)

Myth #13: The flu vaccine causes nerve disorders such as Guillain Barre syndrome. (Extremely rarely  – and more commonly with flu infections.)

Guillain Barre syndrome (GBS) is an autoimmune disorder in which the immune system mistakenly attacks a person’s own nerve tissue, causing muscle weakness and sometimes temporary paralysis. The disorder affects approximately one person out of every 100,000 individuals. Causes are not well understood, though the disorder has been linked to viruses including cytomegalovirus, Epstein Barr and influenza (as well as the bacteria campylobacter).

This myth, like the one about narcolepsy, is partly based on fact because the 1976 H1N1 flu vaccine was found to be linked to a higher risk of GBS that year – approximately 10 additional cases of GBS for every 1 million people vaccinated. Since then, GBS risk has probably been the single most studied adverse event from the flu shot in the history of flu shot research, and the majority of it has shown no increased risk with seasonal flu vaccinations. One study that investigated the risk of GBS from the flu shot among more than 30,000 million “person-years” (30 million people over an 11-year period) found no increased risk for the flu shot. Based on numerous studies, the independent Institute of Medicine “concluded that there was sufficient evidence to reject an association between influenza vaccination and GBS.”

Another study specifically on the 2009-2010 H1N1 vaccine did find an increased risk of GBS — but not as high as the risk of GBS from the flu itself (or the risk of death from the flu). It found a risk of 1 additional case of GBS per every 1 million vaccinations and 17 additional cases of GBS for every 1 million influenza infections. That flu season, the H1N1 influenza killed about 280,000 worldwide (more than 12,000 of whom were in the US, which recorded 61 million H1N1 infections during 2009). Finally, one study did find a slightly higher risk – 1.6 cases of GBS per 1 million vaccinations – for seasonal flu vaccines and the H1N1, but this increased risk in seasonal vaccines has not been found in other studies.

Myth #14: The flu vaccine can cause neurological disorders. (No, it can’t.)

There is no evidence that the flu vaccine can cause neurological disorders, but there is evidence that influenza can. Meanwhile, children with neurological disorders or other neurodevelopmental conditions are especially encouraged to get the vaccine because they are at a higher risk of complications from influenza than other children. Almost half of the children who died from the flu during the 2009 season had underlying neurological disorders, such as epilepsy or cognitive dysfunction.

Myth #15: Influenza isn’t that bad. Or, people recover quickly from it. (Uh, it’s pretty bad.)

Influenza is a serious illness. The symptoms are similar to other illnesses, so people often mistake milder illnesses for the flu. Some lucky folks do recover in a few days, but most are down for a week or two, and complications can be life-threatening, especially complications in children. Not everyone gets a fever, but having the flu isn’t pleasant, especially given the minor side effects or low risks for serious side effects from the vaccine.

Myth #16: People don’t die from the flu unless they have another underlying condition already. (Actually, healthy people DO die from the flu.)

People die from the flu. Every year. This includes children with no underlying conditions (plenty of unfortunate stories here). In fact, a study published just today in Pediatrics reported that 43% of the more than 800 children who died from the flu between 2004 and 2012 had no underlying medical conditions. Often, influenza might contribute to a death but not be listed on the death certificate if the individual died from complications of the flu, such as pneumonia.

Myth #17: People with egg allergies cannot get the flu shot. It will kill them! (No, it won’t, and there’s an egg-free vaccine.)

Before debunking this myth, it’s important that people know the flu vaccine Flublok, available for the first time this year, is manufactured without eggs. Recommended by the CDC earlier this year, Flublok is recommended only for those aged 18 to 49.

For those not in that age range, or if the new vaccine is unavailable, the American College of Allergy, Asthma & Immunology states clearly, “People with egg allergy are not at any additional risk of having a reaction when given the flu vaccine even though the vaccine may contain some amount of egg protein.” This statement is based on the evidence in their influenza vaccination recommendations (paywall), summarized here.

Myth #18: If I get the flu, antibiotics will take care of me. (No, they can’t.)

Influenza is a virus. Antibiotics fight bacteria (anti = “against”; biotics = “of life,” referring to living bacteria, not to viruses). All the antibiotics in the world won’t help you fight off a flu infection.

Myth #19: The flu shot doesn’t work for me, personally, because last time I got it, I got the flu anyway. (It still reduces your risk.)

As noted further up, getting the flu vaccine does not guarantee you won’t catch the flu. It does reduce your risk of getting the flu, and it can lead you to have a milder course of the illness than if you hadn’t been vaccinated. It’s also entirely possible that you catch a strain of the flu not covered in the vaccine.

Myth #20: I never get the flu, so I don’t need the shot. (You can see the future?)

Millions of people have never gotten into car accidents. They still wear seat belts and carry insurance.

Myth #21: I can protect myself from the flu by eating right and washing my hands regularly. (No, you can’t.)

Influenza is an airborne virus, so although hand-washing is important and can reduce your risk of becoming ill from other germs, it does not affect your risk of catching the flu. Eating a healthy, balanced diet is also important, and certainly being healthy makes it easier for your immune system to fight off new infections. But simply eating well cannot magically prevent you from being exposed to the flu virus.

Myth #22: It’s okay if I get the flu because it will make my immune system stronger. (Selfish much? And no, it doesn’t.)

As noted above, your immune system is weakened while you’re ill from the flu. While your immune system may be strengthened after you recover against that particular strain, a vaccine primes your immune system to fight off influenza strains in the same way (without the week of fever, chills and vomiting). Additionally, if you catch the flu, you are contagious to others. Being vaccinated helps keep herd immunity levels higher in your community, especially protecting those who are weaker or cannot be vaccinated.

Don't fall for one of these myths.

Don’t fall for one of these myths.

Myth #23: Making a new vaccine each year only makes influenza strains stronger. (No, it doesn’t.)

This myth is a challenging one to address succinctly without oversimplifying the science. The short answer is that current vaccines are not going to create more dangerous variants of a flu strain.

Influenza virus strains are evolving and changing on a regular basis in two main ways: “antigenic drift and antigenic shift.” Drifts are small, gradual changes that happen all the time in response to environmental pressure and even within our own bodies. The influenza virus has a segmented genome: its genome is in eight parts which can randomly re-assort. When the virus infects an individual, it can “exchange” these gene segments and change within that one individual. Our own immune response can invoke a selective pressure on the virus that contributes to drifting, with or without a vaccine. If the virus didn’t change at all from year to year, the flu vaccine would never need to be reformulated each year (and that Holy Grail of a universal flu vaccine would be less elusive).

It is possible that a vaccine could be among the environmental pressures influencing antigenic drifts, but no more so than what already occurs in our own bodies and most likely to a lesser extent. There is not evidence that vaccines cause major changes in the virus, such as an antigenic shift. A shift is much more troublesome change, leading to a dramatically different strain that our immune systems are not usually prepared for. A shift is what happened with the 2009 H1N1, and it’s what happened with the Spanish flu epidemic in 1918-1919. That pandemic only lasted a year, but it was far worse than a typical flu season, killing an estimated 3% of the world population. (More on how viruses work can be found in this book.)

Interestingly, some believe it’s possible that high levels of herd immunity could reduce antigenic drift. This researcher explains, “As herd immunity increases, we should expect to see more antigenic drift; however, if immunity is high enough to prevent the population-wide spread of the pathogen, the epidemic cannot take off and the virus does not evolve.” Regardless, current vaccines are not going to create more dangerous variants of a flu strain.

Myth #24: The side effects of the flu shot are worse than the flu. (No, they aren’t.)

The most common side effects of the flu vaccine are aches, itching, fatigue, headache, fever, hoarseness, sore or red and itchy eyes, a cough and soreness, redness or swelling where the shot was given and aches. Young children may, in rare cases, develop a high fever (a febrile seizure) that can result in a short seizure, not causing long-term damage. The most serious risk is an allergic reaction, possible in approximately 1 out of every 1 million doses. In the H1N1 vaccines already noted above, Guillan Barre syndrome may be an increased risk for 1 to 2 of every 1 million doses, though it’s many times more common from influenza itself.

The flu itself, as noted above, is much more serious and can cause death.

Myth #25: The flu vaccine causes Bell’s palsy. (No, it doesn’t.)

As I was writing this post, a friend notified me that their spouse had developed Bell’s palsy following the flu shot. I have not heard this mentioned as a myth, so I investigated it. It appears that one flu vaccine used in Switzerland during the 2000-2001 season might have been linked to an increased risk of Bell’s palsy (46 cases). An investigation of US reports in the decade prior also appeared to show a risk, which led to a more in-depth study. That in-depth one found no increased risk, which a report from the independent Institute of Medicine found as well. In addition, a study looking specifically for Bell’s palsy risks in children after a flu vaccination found no increased risk. Sometimes it can be tough to separate cause from correlation and to determine whether two things that happen at the same time are related or coincidence — hence the reason for multiple studies.

However, it is important that adverse events occurring after any vaccine is given are reported to the Vaccine Adverse Event Reporting System (VAERS) so that researchers can follow up on conditions that are reported multiple times. It’s best that a doctor make the report since medically confirmed events are generally given better weight. Most likely, based on the research known to date, the friend’s spouse developed Bell’s palsy for another reason that occurred unfortunately at the same time as the flu shot (the condition can be caused by a wide range of viral infections, including the flu itself). Since the report occurred this year, there is insufficient evidence to determine for certain if it is related to the flu shot or not; it’s only possible to hypothesize that it wasn’t based on past evidence. But the friend should report it to VAERS nonetheless. This is how new associations, such as the narcolepsy link with the European 2009 H1N1 Pandemrix vaccine, are identified.

 

Please ask questions, provide new information, etc. in the comments. However, any comments which include inaccurate information posing as “warnings” or “countering” accurate info will be deleted. I encourage debate but not the dispersal of misinformation.

For another great debunking of flu myths about the H1N1 vaccine, which also apply to some of the myths of the seasonal flu vaccine, check out Emily Willingham’s post here.

If you’ve read the alarmist “Should I Get the Flu Shot?” post from “Food Babe,” here’s a great, in-depth debunking of that piece.

Special thanks to the extensive research for this post goes to Kathy McGrath, Nathan Boonstra, Jessica Atwell, Rene Najera, Amber Bickford Cox and Emily Willingham.

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368 Responses to “Setting the record straight: Debunking ALL the flu vaccine myths”

  1. Dorit Reiss

    Thank you, real public service.

    • Ken Collins

      Riddle me this. Each and every year, the only time I would get sick with flu-like symptoms is after I received the shot. Every year – at the exact same time – after getting the shot – and no other time – not even the common cold. But . . . when I stopped getting the shot in the mid 90′s, I haven’t had the flu again – not once – not even when I’ve been exposed to those with the flu. I don’t know the actual cause – but that is WAY too much of a coincidence to me. I never get sick – ever. So I stopped getting the shot because it was the only time I ever got sick.

      • Perhaps… you thought you would get flu like symptoms after each shot and thus felt them. If I convince myself I have cancer symptoms, I will feel cancer symptoms.

      • the flu shot has no mechanism for making you sick. You certainly might feel crappy and under the weather as the immune system revs up to make antibodies, but you won’t “get sick” because you had a flu shot. Yes, it’s actually a coincidence.

        • SmilingAhab

          ” You certainly might feel crappy and under the weather as the immune system revs up to make antibodies”
          I think this is the single largest contributor to the myth – people have forgotten how to tell the difference between immune reactions and full-blown illness.

          • Oliver

            Fly shots are great. However, no one us obligated to get them. Everyone should remember that. So far, no laws have been past that make this shot mandatory. Guilt tripping others about herd immunity is disrespectful and just selfishness disguised as altruism. The fact is that I don’t trust profit hungry corporations to do clean research, though I am sure a lot if their research it clean. I also don’t trust the governent, though ditto there. Non-profits and other NGOs are just as iffy. But the truth us hidden in the kernels somewhere. IMHO, I don’t care about the research. I don’t take the fly shot because I have an acute phobia of needles. I don’t take any shots unless they are absolutely vital. I only pray to the Moon that I never get diabetes.

          • Tara Haelle

            I don’t get fly shots either, Oliver. I’m generally not bothered by flies unless I’m having a picnic outside. But I do believe in the importance of herd immunity, and it’s completely within my right and others’ rights to educate our communities about the importance of taking responsibility for one another. There is also the option of FluMist nasal spray if you don’t like needles.

          • Dayna

            Oliver — Herd immunity protects the individuals who can’t themselves be immunized, or whose immune systems aren’t up to the task of fighting off the bugs. If I’ve got a young kid with leukemia, undergoing chemo, unable to keep up with the standard vaccine routine and with a chemo-ravaged immune system, you better believe I’m going to be selfish enough to hope that the majority of the people around us have been vaccinated. They are the firebreak between the kid and the diseases.

            By the way, you can get this handy spray-it-up-the-nose version of the flu vaccine, now. No needles required.

          • Lawrence

            Oliver, you don’t seem to understand the difference between selfishness and altruism. Selfishness is acting on one’s own behalf without concern for others, while altruism is putting others’ needs ahead of one’s own. Asking an individual to make a small contribution to public health is neither selfish nor altruistic; it is an attempt to enforce altruism in someone else, but the person doing the asking stands to gain so little that calling it selfish is just silly.

            Given the availability of the flu vaccine as a nasal spray, you really have no case.

        • Dorit Reiss

          There is a new vaccine not made in eggs. And most people with egg allergies can safely receive the vaccines made in eggs. http://www.cdc.gov/flu/professionals/vaccination/vaccine_safety.htm.

        • SS

          First off, your comment of “you certainly might feel crappy and under the weather as the immune system revs up to make antibodies” is confirming exactly what sickness is. when you get sick your body makes antibodies so no, sorry you cannot actually disprove that this person was not getting sick. They may not have been getting sick from the vaccine or the flu but since you’re not taking blood samples from them you cannot purely say this person did not get sick. Also your comment of “If I convince myself I have cancer symptoms, I will feel cancer symptoms.” is ignorant. this statement is portrayed to be saying that all illnesses are mind controlled. Certainly there are hypochondriacs out there in the world but once again, I’m presuming you are not a doctor and have not met this person so close your mouth and stop trying to sound like a smart ass, you have no idea what you are talking about.
          Every individuals response to an illness, infection or vaccine is completely different. For all of you who say “people who don’t get the vaccine are crazy” well that is your personal opinion. If you want someone to value your opinion to get it then you should respect theirs as well. That’s the problem with this world, everyone wants someone else to conform to their beliefs and values. AND also some individuals do have adverse events concerning vaccinations and therefore it prevents them from receiving them should they actually want them. You should consider all the possibilities before trying to make an argument on a topic you have not researched in depth.

          • Lori

            The flu vaccine does not cause illness- it can’t. End of story. There’s no speculation as to whether the vaccine caused the illness- it’s just not the way things work. This person was either coming down with something at the time of the vaccine or feeling symptomatic after the vaccine. Period.

          • Chris

            The crappy sick feeling and reving of immune system is in response to the Ag from the vaccine but NOT from the virus actually trying to kill you. If it was the actual flu he’d feel more than crappy.

          • Me

            Yes, you need to reread the article. The flu vaccine cannot, does not, will not make you sick. Blood samples are not necessary…

          • Jsme

            To those of you who say the flu vaccine cannot make you sick you are wrong.. In my case it could make me sick enough to kill me. I and ( it is estimated) abkut 2 percent of the population could suffer an influenza related Stevens. Johnson Syndrome Reaction. SJS attacks the skin and mucous membranes. Have any of you ever read the allergy warnings on some drugs? Yeah, that disclaimer telling you to discontinue the drug and go to an emergency room immediately if you develop a sudden rash? It is very real and can cause a slow death on a burn unit. SJS is a symptom of a very complicated histocompatibility complex disorder. If you have certain genetic markers for SJS you can have this type of reaction to specific drugs, bacteria, chemicals, viruses, fungi, etc. Well, in 2007 medical scientists finally got around to discovering the link that shows that people who have had a Mycoplasma Pneumoniae related case of SJS stand and 80% chance of another and more drastic SJS reaction to the influenza vaccine. That is not bunk. It is fact. Further, I have had the aforementioned reaction related to mycoplasma pneumoniae. I suffered 16 months of daily wet debridement, constant petroleum jelly and antibiotic ointment on my entire body, public humiliation and bullying and lifelong intestinal and lung tissue damage. From a vanity perspective i was one of the lucky ones. It took all that time for a then 12 year old girl to do what a team of 18 physicians and 40 residents could not or were too lazy to do. RESEARCH. I diagnosed myself cortectly, bloodwork was done , over four months of high dose antibiotics taken and I was pronounced cured, but i still have the markers. I grew tired of research. I do not consider myself selfish for not taking the flu shot. After all of you go take a look at images of SJS and TENS ask yourself if you were in my skin would you “suck it up” and take the shot as so many who are uneducated as to the possible outcome for me have so blithely stated i should do? Would you? In addition, even though medical science states that this defect only affects 2% of the population, how many are undiagnosed? By that I mean stop and think. I don’t by any means want to sound like a conspiracy tbeorist, but given the fact that SJS and TENS leave the skin open to opportunistic infections like strep and MRSA, I for one have to wonder why EVERY SINGLE YEAR just after the big push for children, healthcare workers and everyone else to run out and get a flu shot, why is there suddenly a new flesh eating disease outbreak or a new designer drug ( krokodil ring a bell?) that is being blame for cases of flesh rot? Hmmm, seems to me some of those cases should have been investigated as an SJS reaction to the influenza virus.

          • Tara Haelle

            When people say “the flu vaccine made me sick,” they are nearly always meaning the flu vaccine “gave them the flu.” That is inaccurate. Nowhere in this article do I claim that the flu vaccine is risk-free. It’s not. No vaccine is. (In fact, I state known risks related to Guillain Barre syndrome and narcolepsy with one particular vaccine in Europe. In an unrelated post on my blog, I discuss the risks at length of intussusception from the rotavirus vaccine.) The purpose of this article was to debunk the myths associated with the flu vaccine, not to explore all the possible outcomes. The flu vaccine most definitely can lead to anaphylactic (allergic) reactions. This is actually why you are required to sit in the doctor’s or pharmacist’s waiting area after receiving the shot — they want to be sure you do not have an allergic reaction. Usually, gelatin in the vaccine is what concerns most folks, but a person can have an allergic reaction to any element (and I know at least one person with an allergy to thimerosal, so they *have* to get the preservative-free flu vaccine).

            SJS is basically a very severe type of allergic reaction. It is pretty horrible, and I’m sorry you went through it. While I was unable to find research directly related to the flu vaccine and SJS — probably because SJS is so rare — much of the literature about SJS notes that it’s commonly caused by a medication and that immunizations have been implicated in these cases. I would like to see an actual research study looking at it because it seems like something that should be added to the VIS as a possible allergic reaction if they can find a potentially causal mechanism. Either way, yes, allergic reactions and related disorders are possible, if extremely, extremely rare, with the flu vaccine and with other vaccines. I am interested in learning more about SJS after your comment here, but I do not believe your experience or comment discounts any of the information I have provided here.

            EDITED TO ADD: After a bit more digging, I’ve been able to find more research related to SJS in general and to SJS and vaccines. First, SJS occurs to approximately 1 to 7 out of every 1 million people each year, regardless of exposure to vaccines or not. That’s an extremely, extremely, extremely tiny number. It’s awful to those who ARE in that number, but that’s an extraordinarily low background rate of a disease occurring independently of vaccines. Then we look at those causes. As I noted, it’s already known that SJS can occur as a result of medications. It’s also been reported after immunizations, but that does not mean it was caused by the immunization. The only study I’ve been able to find that looks specifically at SJS and vaccination was this one in PLOS One, which is freely available to read: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0068231

            Basically they do not find a correlation with vaccines. Everything else I’ve been able to find says that it has been reported after vaccination, and a single case study from 2012 shows that SJS occurred after the chickenpox vaccine (http://www.ncbi.nlm.nih.gov/pubmed/22409681), but we don’t know either way about causation.

            If you consider the background rate of SJS – again, 1-7 per million Americans a year – then finding a correlation with the flu vaccine would require us to find more than 6-7 cases of SJS per 1 million vaccinated individuals (probably over 400 cases a year). That has not been found in the flu vaccine surveillance information. Therefore, at present, we cannot say that there is evidence that the flu vaccine or other vaccines causes SJS. That doesn’t mean it’s not possible for a vaccine to cause SJS. It may be, but it would require a biological mechanism that needs to be described, and it would need to be found in the research literature, neither of which currently exists.

            In addition, 1-7 people per 1 million is so incredibly rare – as a background rate – that it should in no way dissuade anyone from the flu vaccine. In other words, not getting the flu vaccine, or anything other vaccine, because of a fear of SJS is not a valid reason to skip the vaccine.

          • bonnie

            @Jsme, sounds you are exactly among the reasons other people should vaccinate to protect you, who can’t.

      • Devarate

        Refer to myths 1, 12, 19, and 20!

      • Allison

        Let us make a little comparison, shall we? I got my flu shot last week – as a VERY pregnant asthmatic at high risk for flu complications, I’d be a fool not to. The day afterwards, I felt even more tired than I usually do these days, with a stuffy nose, a headache, and general achyness. Thought about calling in sick, but was too stubborn to do it. That’s an immune response – my immune system saw dead viruses, and went appropriately nuts, producing the antibodies which will protect me and my unborn son. Two days later, I was fine.

        By comparison, the last time that I DIDN’T get a flu shot, I got hit hard with a respiratory virus. Feverish, achey, nose set to ‘faucet with clogged drain’, too exhausted to go to the store to buy more kleenex, barely had the energy to microwave myself some chicken noodle soup. It sprouted a sinus infection and, while still on the antibiotics for my sinuses, developed into the worst case of bronchitis I have had in my life – and I’m QUITE prone to bronchitis. I wound up in the ER twice in three days, struggling to breathe. It was a week before I was back at work, and two weeks before I really felt human again. THAT… that was the flu. Given the timing, it may or may not have been H1N1 – it was just before they started testing for it. That taught me – I’ve gotten the flu shot every year since – no flu so far.

        • Tara Haelle

          That’s a GREAT comparison! Thank you for sharing.

        • Penny

          You are selectively interpretting a situation based on your own beliefs – aka confirmation bias. It is utterly unscientific. Lets turn this around to reflect my confirmation bias shall we? I’ve never had influenza, I have never had a sick day off work for a respiratory infection. Now the one and only year I took the flu vaccine in 2001 I had an occulorespiratory crisis where I experienced acute shortness of breath x48hrs and developed red, burn like circles around my eyes. I spent 6 hours in an emergency room and I took two days off work.
          I have not considered the vaccine since then of course…

          Now this makes your angry right? I am being a jerk because your beliefs are not being supported by my perspective. Confirmation bias is for people who can’t argue

          • Dorit Reiss

            I can’t speak for the author, but while I’m not angry by your comments, I found them problematic because they’re unscientific. You’re basing your views on your sole experience, a sample size of one. What you’re doing is the equivalent of saying “I’ve never been in a car accident while driving without lights at night,” the implication being that it’s safe to do so. I’m glad you never had influenza, but that does not mean the author is wrong to point out the vaccines decreases your chance and while not perfect is better than no protection: you were still at higher risk of the disease.
            As for the second part – you are suggesting those symptoms were caused by the vaccine. Do you have any medical evidence for that? Not everything that happens after the vaccine is because of it.

            In short, the author relies on scientific literature and provides careful, referenced information. You provide your own personal experience and an unsupported claim of causation. Not the same thing at all.

          • Dorit Reiss

            And by the way, personal experiences are way more vulnerable to confirmation bias than drawing on external studies.

          • Allison

            No, actually. That doesn’t sound like flu at all – that sounds like an acute allergic reaction. Most likely to the vaccine, if it occurred a few days later. If you are vaccine-allergic, it makes perfect sense to avoid vaccines – any sane person would.

            My point is that it is not scientifically possible to get the flu from the flu shot – the virus is dead, it cannot infect anyone. If you get sick after getting it, that means one of two things. If you feel mildly bleh for a couple of days, that’s likely an immune response from your system producing antibodies as intended. If you get seriously ill two days after getting a flu shot, either you were already coming down with something, or you are allergic to a component of the vaccine. And if you get seriously ill two months after getting the shot, that’s just bad luck – a virus, flu or otherwise, not covered by the shot.

            There is exactly one vaccine which is designed to deliberately make you sick. That vaccine is smallpox, which is a live and active culture of a much less serious but closely related virus. However, that vaccine has not seen common use for longer than I’ve been alive – if you were born after 1980 and do not work for either the CDC or the US military, ten to one, you have not had it. All other vaccines are either completely dead or weakened to the point that they cannot cause infection except in individuals who are severely immunocompromised – individuals who cannot be vaccinated in any case.

            And for the record, while my personal experience is a useful illustration, no, that isn’t what I base my beliefs on. I am a scientist – I’m just about to head off to work and put on my lab coat. My beliefs are based on many, many scientific studies. The fact that I inadvertantly added an extra data point in 2009? That was me being an idiot.

          • Ash

            Very well said Penny!

        • wesley

          You are only crazy if you claim that the vaccine is designed to make you sick so that big pharma can profit.

          • Any time I read a comment about how the evil corporations are trying to kill us all so they can have a larger slice of the pie, or how big-anything is trying to hurt me to make a profit, I realize the author is probably insane or at best stupid, and I ignore anything else they say as well.

      • Jay S

        Same here. It really doesn’t matter to me whether what I feel is caused by ‘being sick’ or my immune system ‘ramping up’ or whatever. When I’ve gotten the flu shot? Two days later, I feel like I have the flu, and I feel that way for a week+. Would rather take my chances.

        • Baldrz

          Two days later, you came down with the flu you’d been exposed to before you got the shot.

        • bonnie

          It takes two weeks to build an immune response to a flu virus, which leaves a window between a shot when you can still catch it. And most of the time, you catch it at the doctor’s office on the same day you got the shot- no surprise here. Flu takes only 24-48 hours to incubate. Personally I vaccinate before the epidemic starts, in the autumn. So I don’t catch it at the doctors office in the height of epidemic. Hey, it works.

      • wesley

        If you don’t like them don’t get them, but don’t say you didn’t get the flu since. You obviously do.

      • Mark Fromberg

        I agree with you. I recall getting sick repeatedly after each of my hepatitis vaccinations, and, as a physician, I have long noted that, although I exposed to the viruses of the season all day and every day at work, I would only get sick when I was run down, sleep-deprived, or stressed in some way.
        So, in my view, I would add a comment to Myth #1 (which is actually acknowledged to some degree in Myth #8): Getting a flu shot stimulates your immune system, which can not only make you feel under the weather as your immune system ramps up its defense and surveillance systems (which takes metabolic energy just like fighting an illness does), but also may leave you vulnerable to catching another illness, most often just a common cold, since your immune system is “distracted”, if you will, with what it is being stimulated to do.
        Unfortunately, the vast majority of people do not know the difference between a cold and a flu, so they tend to be a little trigger happy by suggesting that they caught a “flu” right after a flu shot, since that would make sense to them.

      • Laura

        If it’s a sort of backachy chills-y “”blaaaah” feeling, you’re most likely feeling the increased production of immune agents such as Interferon. Your immune system is supposed to do that when you get sick, that means it’s working.

      • Otto

        Tried following most of the links. I am still reading but most were not as clear cut as described in the article.
        from Lancet volume 12 issue 1:
        Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking. LAIVs consistently show highest efficacy in young children (aged 6 months to 7 years). New vaccines with improved clinical efficacy and effectiveness are needed to further reduce influenza-related morbidity and mortality.
        Curious that it statues “moderate protection” (still reading the background studies to find what that means) but “greatly reduced or absent” in “some” seasons. I found similar results in the other links. A study of 630 kids in Finland is only a good start. The elderly review/study actually stated NO effectiveness.
        From Lancet Volume 366
        In homes for elderly individuals (with good vaccine match and high viral circulation) the effectiveness of vaccines against influenza-like illness was 23% (95% CI 6—36) and non-significant against influenza (RR 1·04, 0·43—2·51).
        So this one study from a link in the article to prove effectiveness actually states it is NOT effective (“not significant”) ??
        I am still reading but the first 4 links I clicked in the article didn’t get me solid in either direction and hasn’t confirmed anything. I guess the good news is nothing shows a higher negative outcome, just not as effective as advertised… Time for more research. yay.
        great resources links though so I don’t have to find the studies the hard way. thanks.

        • Tara Haelle

          Hi Otto, yes, the evidence is often difficult to follow. I did not link to all the studies I looked at and certainly not all the studies out there. There are even variations among the meta-analyses. It’s also true that we have the least evidence for children because they’re harder to study, for logistical and ethical reasons. In general, the flu vaccine is less effective for the elderly than for younger folks because older immune systems don’t mount an immune response to the vaccine as robustly as younger immune systems do. In fact, this is one of the reasons that public health officials encourage everyone who can medically do so to get the flu vaccine — because it helps prevent the spread of flu to those who are more vulnerable (including the elderly and children). The good news here, however, is that even if a person who got the flu shot then gets the flu, they usually have a much milder course of it than they would have without the vaccine. Therefore the benefits still outweigh the risks when it comes to the elderly getting the vaccine.

          In general, the flu vaccine is, unfortunately, not a great vaccine. I allude to that several places in the article and certainly here in the comments. It’s among our least effective vaccines (perhaps the least effective) because the influenza virus is a slippery, tricky one and it mutates so quickly. The good news is that the flu also doesn’t tend to have as high a mortality rate compared to other disease we vaccinate against, but it still kills thousands of people, and a pandemic can kill even more. (That’s putting aside lost time, money and productivity while ill and overall resources used for the flu.) Is the vaccine a great vaccine? No. Will it prevent all cases of the flu? No, not even close. Is it the best weapon we have to fight the flu at this point? Yes. Does it reduce cases of influenza and protect some from getting it? Yes. Does it lessen the severity of the illness even if you get the flu? Yes. Do the benefits offered by the flu vaccine outweigh the risks, for a typical person without underlying conditions that counter-indicate the vaccine? Yes. Should every person get the flu vaccine? That is up to them and their medical caregivers to decide.

          • Bill B.

            Your comment about the pandemic casualties rang a real bell with me. I lost my grandfather and my aunt in 1918. Even though the current influenza vaccines may not be as effective as we’d like (for the reasons you stated), they are a lot better than nothing, and if they prevent another pandemic those who feel a bit “under the weather” are helping protect the herd.

        • The Scientist

          Otto, many of the links only go to abstracts of the article. The abstract is intentionally brief and only gives a summary of the research or findings. More detailed findings and descriptions are in the actual article, but these are very expensive to get unless your institution has subscriptions to the scientific literature, as mine does. However, do know that The Lancet is a very prestigious journal.

      • Jessica

        Sounds like a classic nocebo reaction to me.

      • Mel

        So what are you expecting, Ken? That your opinion and anecdotal story telling trumps scientific consensus? Piles and piles of scientific evidence are wrong because you didn’t feel well after getting shots decades ago? Are flu-like symptoms the flu?

      • Jake

        As the article points out, the flu shot activates your immune system which makes you feel sick. In that sense it depends on how you define being sick. If you define it as experiencing symptoms and discomfort then yes you are sick. If you define it as if your body is under attack by a pathogen or disorder then no you are not sick. Your body doesnt actually have a red light to tell you that you are sick, you only “feel” sick as a result of immune response. You have the symptoms of being sick but do not actually have an illness putting your life in danger.

      • Me

        That’s already addressed in the article. In fact, it’s the first response. You may feel “under the weather”. It’s a side effect and not the actual flu.

      • brendan everingham

        Mate, you are most likely referring to side effects, they can be more or less severe depending on the person. It is physically impossible to catch the virus from the vaccine. If you were to read the whole article you would have had that little riddle answered for you. Unfortunately those who don’t read are no better off than those who can’t, so individuals like yourself will remain puzzled and keep pedaling your bullshit. Riddle me this, why do you think your individual subjective study of yourself. without any accurate data,.. as you pointed out “flu like”, your subjective opinion of what the flu feels like. How do you think that stacks up against decades of actual hard study and facts backed up by real evidence and data collected from millions of people in the receipt of the vaccine? Keep in mind that hospitals have labs that can determine “flu like” from flu as people will come in complaining that they feel as though they have the flu when they are actually referring to a much more benign common cold. I’ll be willing to bet your doctor told you that what you were experiencing was certainly not the flu. Riddle solved mate?

      • Jen

        Vaccines can make anyone feel “under the weather” (a natural response from the immune system). Sometimes this response can, ironically, mimic some flu symptoms, but it is not Influenza that you have contracted (most likely that is). Ask any pharmacist and they will confirm. Physicians on the other hand seem to be woefully mis or under-informed.

      • Magsie

        I’ve had the flu vaccination since 2000 and never had any side effects at all. I think if you’d ever really had the flu Ken you’d want the vaccination as it’s a very serious illness indeed. I’ve had it twice in my life once aged 12 and then aged 24 and I was so very poorly, barely able to drag myself to the toilet. Some people think they have got flu when they have a viral infection or a common cold but they will know the difference if they ever get the real thing.

      • Look it up

        it’s called confirmation bias

    • steve

      Hi Tara I saw your work in IO9, and immediately posted it on my blog.
      http://thinkingaboot.blogspot.ca/2013/10/25-myths-about-flu-vaccine-shoot-up.html and in tribute to Lou Reed added the byline Shoot up Dummies.
      You might also add this to your post
      http://www.sci-tech-today.com/story.xhtml?story_id=130002R3B7QO
      You might enjoy this post by me about how dumb we used to be, and sometimes I think we were far smarter in other ways then.
      http://thinkingaboot.blogspot.ca/2011/06/we-used-to-be-stupidboys-are-stupid.html
      As John Prine said
      Common Sense it dont make no sense no more

      • Tara Haelle

        Thanks for that “stupid stuff” link — it’s great! Also, I did link to the study re: the reduced cardiovascular events risk. I actually wrote about that study last week :)

    • G

      Actually you are wrong on number 10. My husband is a lawyer and is working on a case right now where the child had the vaccine and the next day had a seizer. I have to be honest with you and say although your article is well researched, flu vaccines are relatively new and have not had enough testing to determine if they truly work or not. The clinical trials are only done by the drug companies that created the flu shot, so therefore the information is not truly authentic because they have to report to the FDA that the flu shot is safe and harmless or it doesn’t not get approved for human use. So of course they are not going to say it is not safe.

      • kelly

        Pharmaceutical companies are not the only ones performing clinical trials – the NIH and National Institute of Allergy and Infectious Diseases (part of NIH) conduct safety research. And it is not in a company’s best interest to lie about possible safety concerns as they would be held liable in a court of law for neglect, injury and/or worse.
        Myth #24 above actually mentions that children are more susceptible to febrile seizures after vaccination.

        • You’ve apparently never heard of the US vaccine courts and related law, which puts the US taxpayer on the hook for any vaccine related injuries.

          • I’d rather have the US taxpayers provide comensation for (genuinely proven and substantiated) vaccine related injuries. Who pays families when loved ones die from the flu?

          • Darwy

            Actually, it’s not the US taxpayers who are ‘on the hook’ for the vaccine court.

            The funds for the vaccine court come from a surcharge placed upon the vaccines administered. So, it is those of us who vaccinate who pay for the funds in the vaccine court – not the general taxpayers.

      • Tara Haelle

        Myth #10 is not biologically possible, but a seizure after a vaccination *is* possible. It’s rare, but it’s the result of a high fever and is called a febrile seizure, as I note in this post under Myth #24. Febrile seizures look scary and can last up to 30 seconds. Fortunately, they do not lead to any long-term neurological or developmental damage.

        Meanwhile, safety, effectiveness and monitoring trials are also conducted by public health and governmental agencies, both within the US and in other countries. Unless a person believes that every developed country’s government and public health institutions are all working together with all the world’s pharmaceutical companies (that’s one heck of a conspiracy), then it would be pretty tough to conceal information about the flu shot’s safety and effectiveness.

        ETA 1/10/14: Febrile seizures can last longer than 30 seconds. I’m not sure why I said “up to 30 seconds” in this comment when I first wrote it a few months back, but as the link I included in the post even notes, febrile seizures typically last a minute or two and can last much longer. As already stated, however, there is not evidence that febrile seizures lead to long-term neurological or developmental damage or that they are linked to or able to cause epilepsy. Sorry for the error. The link is here: http://www.ninds.nih.gov/disorders/febrile_seizures/detail_febrile_seizures.htm

        • “Febrile seizures look scary and can last up to 30 seconds. Fortunately, they do not lead to any long-term neurological or developmental damage.”

          I’m not an expert on this issue by any stretch of the imagination, but my neurologist gave me the impression that febrile seizures can lead to increased risk of epilepsy later in life.

          This pattern happened with me. But again, I don’t really know anything about this. Great post!

      • Reply to “G”

        The flu vaccine is not new. It’s been around since the 1940s and its safety profile is very well established. Several hundred million doses are administered worldwide every year. Numerous safety studies have been published (including by pharma-independent groups) as well as some very big meta-analyses. All conclude the flu vaccine is very safe and the risk: benefit ratio is overwhelmingly in favor of vaccination.

        Yes, drug companies do perform initial safety studies to get their products (vaccines in this case) licensed. These are very stringent and the results reviewed by independent panels of experts. The process is transparent and ever-improving (i’m certainly not making the case that big pharma always has its hands clean but it in the case of the flu vaccine it would be almost impossible to suppress knowledge of adverse reactions). After licensing additional studies are usually performed by independent groups and on bigger samples and often more information, good or bad, is revealed.

      • KR

        And as noted in the text for #10, seizures in children may happen as a result of fever. THIS IS RARE. How rare? 1 in 1 million rare.

        One anecdotal instant of adverse reactions — which occur with ALL medicines — does not disqualify the benefits.

    • This article is very selective in its choice of research. The fact is that there are compelling studies showing both epidemiological evidence and plausible biological mechanisms sufficient to raise questions about the safety of the US vaccination schedule for all children. Making such blanket statements as the headline to this article does is a disservice to your readers.
      You really should be more cautious in your proclamations. Children’s lives are at stake.

      • Tara Haelle

        You’re right — children’s lives ARE at stake. Children such as Emily Lastinger, who despite being healthy with no underlying conditions, died from the flu when she was 3. (See: http://www.familiesfightingflu.org/member-families/the-lastinger-family/)

        If you believe the research here to be incomplete, feel free to find, explain and defend studies that raise the questions you claim. The independent Institute of Medicine — the gold standard in evaluating major medical research questions — has reviewed the entire body of research on children’s vaccines and found the CDC immunizations schedule to be safe.

        • user5

          I you think a vaccine would have saved her , how can you or anyone know that for sure?

          you seem to be having an emotional reaction.

          • Darwy

            We don’t know that a vaccine would have saved her specifically – however the overwhelming majority of pediatric flu deaths occurred in unvaccinated children.

            Had they been vaccinated, the outcome might have been different.

          • ss

            I agree, it seems you are overlooking the fact that the vaccine may not have been able to do much for her. It is extremely unfortunate for those who lose loved ones to simple illnesses, especially young children. However it is not just the flu that is doing all the damage, it is the fever and dehydration that really shut the body down. This can happen with any illness. Also there are research articles that prove that the vaccine is only effective against similar virus strains.

            So if you happen to get a vaccine for Flu B (example) your only developing antibodies for Flu B. If you come across Flu A that Flu B vaccine will not help you.

            However, (I am not endorsing actually getting the flu or telling you to not get the vaccine this information is provided just for knowledge – so please calm down before everyone overreacts) If you actually contract the flu, it naturally protects you against dozens of strains not just A or B.

            In the end everyone needs to do what they believe is best for themselves and their families. It will not be the same in every house or country but neither is religion, budgeting or any other major decision people make every day. It is unfair to ask someone to put your needs and concerns above their own beliefs and ideas of how to protect their family whatever those may be.

          • Tara Haelle

            Actually, there has been evidence that the flu shot is protective against influenza even during years when the strains are a mismatch. I note this in the article above with this citation: http://www.biomedcentral.com/1741-7015/11/153/abstract

            I am not aware of evidence showing that getting one flu strain then makes you immune to “dozens of strains” of the flu. Getting one strain can provide lasting immunity to that single flu strain, demonstrated, for example, by the research in this article about the lasting immunity in survivors to the Spanish flu epidemic strain: http://content.time.com/time/health/article/0,8599,1835907,00.html. However, if it were true that getting one strain of the flu then protected you against all the others, given the lasting immunity described in that article, you’re implying that a person would only need to get the flu once and would then be immune to most other flu strains and not get it again. I have not seen evidence for this. You will need to provide actually evidence for that claim.

          • SS, you say: “If you actually contract the flu, it naturally protects you against dozens of strains not just A or B.” How does it do that, SS? I guess I’m wondering why the immune response to a live virus (which is clearly only one type) would be broad, while an inactivated vaccine constructed from the same type would be narrow?

    • Dorit Reiss

      To remind you, women have miscarriages even without the flu shot. So the fact that a woman had the flu shot and a miscarriage does not show causation. The real question is how the rate of miscarriage after the shot compares to the rate with the shot. Contrary to what you say, there are many studies examining the flu shot in pregnancy, collected here: https://www.facebook.com/notes/chillin-out-vaxin-relaxin-all-cool/studies-of-influenza-vaccine-in-pregnancy/494141367316459 and the results are clear, consistent and reproducible: women who get the flu shot are not more likely to have miscarriages, still births, or low weight births than those that do not. Influenza, on the other hand, can harm the fetus.

    • Dorit Reiss

      In addition to my comment about miscarriages, note that there is no aluminum in flu vaccines – and yes, it is mentioned when it’s in vaccines. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf.
      I urge you to reexamine your sources.

    • Dorit Reiss

      I’m glad you and your daughter were lucky enough not to get the flu although you declined to vaccinate. But I’d like evidence that anyone died from the flu shot – including actual evidence of a causal connection, please. In contrast, we know that last year 164 children died from flu, the majority of them unvaccinated: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html. And an unknown number of adults. That’s pretty bad. And no, it is not correlated with any birth defects – studies consistently found it safe for pregnancy: https://www.facebook.com/notes/chillin-out-vaxin-relaxin-all-cool/studies-of-influenza-vaccine-in-pregnancy/494141367316459

    • Dina

      Tara, you write for Scientific American.
      Which is owned by Georg von Holtzbrinck GmbH publishing group.
      Whose Deputy Chairman of the Supervisory Board is Dr. Bernd Scheifele, LLM.
      Who also serves as a Member of Advisory Board of PHOENIX Pharmahandel GmbH & Co KG.
      Phoenix Group itself is majority-owned by pharmaceutical conglomerate Merckle Group.
      Ludwig Merckle – His most valuable holding is pharmaceutical distributor Phoenix, one of Europe’s largest. Profits grew 50% in 2011 to $320 million on sales of nearly $29 billion and contributed to the $2 billion rise in FORBES’ estimate of Merckle’s net worth.

      Serious conflict of interest you got going on there, wouldn’t you say?

      • Dorit Reiss

        A. Quite the six degrees of separation there. Somewhat tenuous, I’d say: http://www.youtube.com/watch?v=CZd_YyFzPD0.

        B. Attacking the writer is a really bad substitute to arguing evidence or facts. Is there anything in the article that you think is inaccurate? http://badskeptic.com/?p=750

      • Tara Haelle

        By that logic, Kevin Bacon should be sending me a check with a percentage of his royalties from Footloose any day now… Pretty SERIOUS stuff there, all right…

        • Jani Jousselin

          Cheers Hun..finally someone tells it straight….I am sick (lol) and tired of the false reports of the flu shot..yes, every year:( ppl can be so badly informed ..I have shared this .
          Thank you .

      • Dina, let me see if I can follow the tortured logic of your conspiracy theory. Okay, so this multinational pharmaceutical corporation worth billions of dollars wants to promote their fake flu vaccination which is actually designed to ____________ (insert insane theory), and they decide that the best vehicle to advance their brainwashing campaign would be the personal blog of a freelance journalist who occasionally contributes to a magazine that is like six degrees of separation from their industry. Scandal!

      • Kody

        You can chain anyone to anyone. That proves nothing. She is probably chained to me as well if you want to dig hard enough.

    • I didn’t see on here if you addressed people with auto immune disorders receiving the flu vaccine if it would cause issues. Myself I have taken the flu vaccine every year for over 15 years either by shot or the flu mist, however last year for the first time I did take the flu vaccine as always and even though I did not come down with the flu like symptoms MANY people report they get from taking the flu vaccine I did suffer a reaction. Within 20 minutes of receiving the vaccine I broke out in hives and began vomiting. That is not a coincidence. The doctor ended up having to give me a shot due to the allergic reaction to the vaccine and once he gave me the shot the allergic reaction abated after a few hours. People who have a compromised immune system due to auto immune disease must decide if they want to play Russian roulette I’m afraid when it comes to any vaccine. It can make them sick and it can cause an allergic reaction in people with auto immune disorders. It is something that should be noted. Had the doctor not given me something to abate the allergic reaction I might have died from it due to my tongue was swelling. So saying people can’t die from the vaccine is not true and having an allergic reaction to it can happen no matter if it is a small amount of whatever is in it. Now, will I get the vaccine again. Yes because that is my choice and I will try one of the different one’s out this year because I have had the flu before and it is horrible but at least I know that I can and most likely will have a allergic reaction to the vaccine in some way and will have to ensure that I stay at the doctors office to get something to take care of the allergic reaction quickly. People with auto immune diseases must be careful with vaccines of any kind as their immune system is compromised and they must take precautions when taking any vaccine. Some people have told me with auto immune disorders they will not take the vaccine as it is not recommended by their doctor to do so as it can make them sick with the flu because their immune system is malfunctioning. For me however I would rather take the vaccine than risk getting sick from the flu and suffer the reaction but for the auto immune disorder people it is a much higher risk and some do not want to put themselves through the reaction it could potentially cause.

      • Tara Haelle

        Donna, thanks for mentioning this. Yes, an allergic reaction is most definitely a known and possible risk. Nowhere in this post did I say that allergic reactions are not possible or that there are no risks to the flu vaccine. There *are* risks to the flu vaccine, just as they are to all vaccines. Some are bigger risks than others. I do explain that, in the aggregate, the benefits outweigh the risks, but, like any other decision in life, it is a risk-benefit calculus that each individual must do for themselves.

        The risk of an allergic reaction, as described in two of my links above to the CDC site, is approximately 1 case per 1 million doses of the vaccine. This risk is also clearly stated on the Vaccine Information Sheet that a person is required by federal law to receive before receiving the vaccine. If 30 million people get the flu vaccine, we *would* expect to see 30 individuals have an allergic reaction that is caused by the flu vaccine. In theory, some of these reactions could be fatal. That possibility is actually the reason that you are required (by most practitioners) to sit at the doctor’s office or pharmacy and wait a specified amount of time before you’re allowed to leave after getting the shot. That waiting period is required specifically to see if the individual receiving the vaccine has an allergic reaction. (Not all clinics, practices, pharmacies, etc. will have the waiting period, but many do.) If the person does have an allergic reaction, the person who administered the vaccine has treatment on hand and immediately available to treat the reaction. No deaths have been officially reported from an allergic reaction such as this, but statistically, it is likely that someone somewhere at some point has died from it. These days, because of the waiting period afterward at most places, that’s pretty unlikely.

        The potential for an allergic reaction is also not limited to people who already have an autoimmune disease. They may be at higher risk since their immune system is already a little primed to attack itself, but healthy individuals with no other underlying conditions may also experience an allergic reaction. Fortunately, the waiting period and requirement to have treatment on hand is set up to be prepared for this small but real risk.

      • Allison

        Strictly speaking, anyone can develop an allergic reaction to anything at any time. I have an autoimmune disease (asthma), and, in addition to common environmental allergens, am severely allergic to several different common antibiotics. My mom also has an autoimmune disease and is much more seriously allergic to a different common antibiotic. My dad has no autoimmune diseases, but he was deathly allergic to peanuts before it was cool – indeed, before anyone had heard of such a thing. My middle sister also has no autoimmune diseases. For years, her favorite food was hummus. Then suddenly, she ate something with garbanzo beans and it dang near killed her. Any of us could develop a(nother) life-threatening allergy to vaccines tomorrow. But to avoid the possibility of developing a life-threatening allergy, we would have to avoid… everything. Literally, EVERYTHING. The vaccine allergy is rare enough that, in the absense of such an allergy, we’re safer with vaccines than without them.

    • Molly Quinn

      I am a serious asthmatic, and always get a flu shot. However, every year I plan to have a day free afterwards, because I always get incredibly fatigued, to the point of not being able to function, and a slight fever after receiving the vaccine. Other members of my family experience similar symptoms, so although it is true that you are not “sick with the flu” after receiving the shot, like many other vaccines or drugs, the side effects can manifest more seriously in some individuals, so if you have never had the shot, make sure you can take it easy afterwards.

      • Tara Haelle

        That’s a good point, Molly — people can plan for feeling crappy after getting the shot. Many individuals on this comment thread appear to think I am dismissing their side effect symptoms because I’ve said the flu shot cannot make them sick. I’m not dismissing those symptoms. They are real. I make it clear in my post that possible side effects include fatigue, fever, headache, a cough, etc. Of course, a person can feel crappy after a flu shot and that most certainly CAN be caused by the flu shot. That does not, however, mean the person is “sick.” If I only get 3 hours of sleep for two days in a row, I will feel really crappy. I’ll be fatigued, I’ll probably have a headache, I’ll likely have some nausea, and I may develop a raspy voice with a slight cough. That doesn’t mean I’m sick. It means I’m sleep deprived. In clinical terms, “sick” means having a pathogen — a virus, fungus or bacteria — in your system that your immune system must fight off. THAT kind of sick — the clinical types of “sick” — cannot be caused by the flu shot.

    • I know that a single incident is far from real proof, but I am the incident. The last time I had a flue shot was over then years ago. Within two weeks, I had the flu. Since then, I have never had another one and have never had the flu, either. I’m 71 now and as healthy as I have been for years.

      My stance is, the fewer medications you take the better. Nonetheless, if I’m really sick, I don’t hesitate. Maybe that’s why when I do have to take antibiotics, pain killers, or muscle relaxants, they do work for me.

      • Tara Haelle

        As I noted in the post, it is certainly possible to get the flu in spite of having the flu shot. It does not have a high level of effectiveness, and if a person contracted the virus before getting the shot (the symptoms do not show up right away), then getting the shot will not prevent that person from going through that infection. So, you either had contracted the virus before getting the shot, and the symptoms began after you got it. Or, you had the shot and then caught the flu anyway. Both of those are coincidences. They are not a result of getting the flu shot itself.

        • Melly

          So you are arguing that we should all go get a vaccine that “does not have a high level of effectiveness” against a disease we may or may not contract.

          I, like many others here, have had the experience of getting a flu shot then becoming ill with a strain that was not covered by the shot later in that same season. I certainly don’t believe the flu shot caused my illness, but I do think it was dumb bad luck. That said… if the two times I actually bothered to get a shot, I still got flu anyway, I am going to err on the side of not putting medicines in my body that are not likely to be effective. I think that’s just good practice in general.

          I also find it amusing that you want “evidence,” but people’s personal experience is not evidence, you unilaterally categorize it as “confirmation bias.” While that may be true in some cases, denying someone’s experience as evidence because it did not take place in a lab is at the very least dismissive.

          • Tara Haelle

            I am not arguing that anyone should get the vaccine. Whether you choose to get the vaccine is a personal medical decision that should be made by you with the consultation of your medical provider. I am debunking the myths associated with the vaccine.
            Regarding the “evidence” question,” individuals’ experiences are anecdotes. A commonly used term for that these days is “anecdata.” It is empirical evidence, but it is not scientific evidence. Even in case studies published in peer-reviewed medical research journals, it would be a stretch to consider an individual case as anything other than evidence of possibility of the existence of something, and that does not address causation. It does not qualify as scientific evidence that can be generalized to the wider population or used to explain a phenomenon with causation. So no, a person’s experience is not “evidence” in the way that scientific evidence is used to evaluate scientific questions.
            A personal cannot become ill from a pathogen (fungus, bacteria, virus) BECAUSE OF the flu shot. They CAN experience the side effects, which can include feeling crappy, fever, headache, etc., as I’ve noted several times. Saying so does not dismiss their experience. It clarifies the difference between “being sick” (an illness caused by a pathogen which requires the immune system to fight it) and the not-fun side effects. It’s a matter of precise wording so that people are aware of what the real risks are, and aren’t.

    • Russ

      If you are high risk or not and want to get a vaccine by all means go ahead. If you don’t want to get a vaccine and you have your reasons then don’t. It is up to you. Educate yourself and make your own decisions…..Then….don‘t try to force your opinion…which is what it is….on others. Thank you.

    • Nicole Clerisse

      Thank you for the information. This was interesting to read, and makes me think a bit more about the flu shot. I so have mixed feelings toward the shot . My middle son got very ill 3 times after getting the shot. It could just be a coincidence but it is not easy to see your child get so sick a week after the shot. He has not had the shot again the last 2 years and has not got sick. He is currently 6, but each year I try to do resource about the flu shot to see if it is best or not for me and my children. It is a tough choice.
      2 of my 3 children are terrified of needles and since I am a teacher and pay for my insurance my insurance does not cover my children to get the nose spray vs they have to get the shot. Not fair when others on government programs not having to pay get the choice. Not sure about other states but in California that us how they do it.

      • Tara Haelle

        I understand that it can feel like a difficult choice. That’s one of the main reasons I don’t tell an individual, “YOU should get the shot.” (The more important reason I don’t do that is that I am not a medical doctor and I do not know their medical history.) My intention is hopefully for people to better understand what the actual risks are and what they are not. It sounds as though your son probably experiences the side effects described on the CDC site – fever, headache, nausea, etc. When the symptoms do not look/feel any different from symptoms of actually being sick, it’s certainly not fun.

    • phil

      #1 is hilarious – it’s impossible to get sick from the vaccine, then in the edit – well, you can get nausea, headache, fever as SIDE EFFECTs. Wait…isn’t that just…the flu?….

      • Tara Haelle

        No, that’s not the flu. I added the edit because of exactly the misconception you have brought up here. I had mentioned the vaccine’s possible side effects lower in the post, but I decided to mention them here as well because of readers’ misunderstanding about what it means to be “sick” versus experiencing known side effects. Nausea, headache, fever, etc. are known possible side effects that some (not all) people can experience after getting the vaccine. However, experiencing these do not mean you’re “sick” — you have not contracted a virus, bacteria or fungus from the flu vaccine that your body must fight off. And the flu itself is far worse than the side effects, as Myth #24 addresses.

    • Scott

      When you claim that the flu shot cannot make you sick, I assume you mean “sick with the flu.” I have had the flu shot three times. Every time, I have had exactly the same reaction, in the exact same time frame. I come down with a fever about 4 hours after it, then at about the 12 hour mark I get explosive diarrhea, nausea, and (to a lesser degree) vomiting. The illness lasts about 36 hours.

      It isn’t the flu that I get from the flu shot. But it IS something. And it is caused by the shot. I suspect I have a mild egg allergy, and this is how my body reacts to the shot. But I really don’t know. I have yet to try one of the new egg-free vaccines.

    • Leah

      Sorry, not all true (#14).I had some changes in cognitive function from a flu vaccine last year that I have still not recovered from. I have been followed by a neurologist for the past year because of it and he agrees with a direct cause and effect.

      • Tara Haelle

        Without further information, it is impossible to comment on this, but it is highly suspect that a neurologist simply said, “Yes, this condition you have was caused by the flu vaccine” unless it was a condition that already has an established link in the medical research literature to the flu vaccine. Frankly, if that were my neurologist, I would get a second opinion and probably a new doctor because it would be immediately evident that they were not practicing evidence-based medicine. An event or condition that occurs after receiving the flu vaccine, even in close proximity (the next day, the next week, the next month), does not mean the two are related in any way except in time.

    • Elizabeth

      I was just wondering what about the Myth that vaccines cause Autism, I was fully expecting that to be on the list but it’s not there… was it overlooked??

      • Tara Haelle

        I did not include the autism myth on this particular list because it’s usually a part of myths about vaccines in general (the childhood schedule) or about the MMR vaccine in particular. I haven’t seen folks try to link autism specifically to the flu vaccine (though I admit it wouldn’t surprise me if they did). They *have* tried to link autism to thimerosal, and I addressed concerns about thimerosal (ethylmercury) in this post. Meanwhile, I’m working on a lengthy post looking at myths for the HPV vaccine, and I may do a post later about myths about vaccines in general. I will definitely address autism if I do the latter one! :)

    • Rebecca

      Thanks so much for a well-written, well-documented post. I’m sharing it.

    • simone hug

      Worst article I have read in a long time. The personal taint in the content is misleading and not at all well researched.

    • Ashley

      Thank you for posting the first sensible article ive seen on the flu shot yet.

    • Joseph Deegan

      I got the flu shot on December 2, 2013. Within a day or two I started getting severe haedaches. I also got Bells Palsey and am still going through a slow recovery. I have always been healthy. I have never had anything close to this severe. My neurologist and I are working toward a recovery but it is slow in coming.

      The only thing that changed in my life around that time was the flu shot. Too much coincendnece to say it was not the cause. I had to cancel my vacation trip to Asia and take medical leave. This is a very painful virus and if you are having to attend meetings, speak publicly this can disable you so that you cannot work.

      This has effected my speech, my hearing, my eyesight and my taste. I do not have symmetry in my face, so confience level is low in public.

      I plan to file a claim with the CDC on flu vaccine. I disagree with those who say the flu shot does not cause Bell’s Palsey. I am proof it does.

      • Tara Haelle

        I am sorry to hear about your pain and Bell’s palsy. It is, indeed, an awful experience. Yet, you are, unfortunately, not “proof” that the flu shot causes it. The power of correlation in our heads is strong; in fact, it’s the reason our species has survived. If we did not learn that getting eaten was what followed the roar of a saber-toothed tiger (to use a somewhat flip example), then we wouldn’t have made it. We are evolutionarily programmed to associate X happening before Y with X causing Y. Yet, that’s not always the case and coincidences DO occur in remarkable amounts. (Consider: Native Americans do a rain dance. It rains. Therefore doing a rain dance causes rain…?)

        The headaches you describe very well could have been caused by the flu shot. Those are an established, known side effect. To date, the evidence for a flu shot association with Ball’s palsy does not support the idea that the flu shot gave you Bell’s palsy, which is a mysterious ailment whose causes are not fully understood. What is known about Bell’s palsy is that it can occur out of nowhere and without any warning. Its close proximity in time to your flu shot is indeed, based on the evidence to date, a coincidence. That said, I am glad you are filing a report with VAERS. That is important for continued surveillance. Please be sure your doctor files a VAERS report because doctor reports are usually taken more seriously than patient reports, but you’re both able to submit it. I hope you recover soon and that your pain subsides.

        • Lola Smith

          Yes you can’t conclude that the vaccine definitely caused this man’s Bell’s Palsy, but you can’t conclude that it didn’t either. I think the medical community is unwilling to believe that any ill effects come from the flu shot and so just immediately dismiss someone’s reactions as being coincidence. Seems highly probable that this vaccine caused his Bell’s Palsy since he was healthy otherwise and that is the one thing that had changed for him recently. When people report things like this to their medical professionals, it should be mandatory that it be reported to VAERS, and when a trend is noticed that it be investigated. Instead, doctors, just so “no can’t be, the flu vaccine is safe, it is just coincidence”, and the incident does not get reported. Because things like this are not mandatory to be reported, no link will ever be found, even if it is there. Doctors also don’t report when someone who was vaccinated ends up dead or on a ventilator with the flu, but they are quick to point out when an unvaccinated person ends up in the same condition. They don’t want people to question the efficacy of the vaccine, and particularly this year, when it is very clear that the H1N1 component of this year’s vaccine is a very poor match, they are not reporting it.I work in a hospital,and most of our patients hospitalized with H1N1 (lab onfirmed) had been vaccinated this fall.

          • Tara Haelle

            You are correct that it cannot be conclusively determined either way. If you read my comment carefully, you will see that I said he is not “proof” that the shot caused the Bell’s palsy — that is true — and that I said the “evidence to date” does not support the idea that it caused it. I did not say his Bell’s palsy was definitely not caused by the flu shot. I cannot say that and did not attempt to. (Note my language: “To date, the evidence for a flu shot association with Ball’s palsy does not support the idea that the flu shot gave you Bell’s palsy” and “Its close proximity in time to your flu shot is indeed, based on the evidence to date, a coincidence”). My point in my response is that the particular event he experienced is among those that have been studied, and the evidence to date has shown that the flu shot is not linked to Bell’s palsy. Further, Bell’s palsy is known for appearing suddenly and mysteriously, without warning, and without known causes, so it is as likely as not that it wasn’t caused by the flu shot. If he had never been in a car accident in his life, and he had gotten into a car accident within a few days of getting the flu shot, would we presume the car accident was likely caused by the flu shot? Of course not. This is a similar situation, and the evidence we have currently points to this being an unfortunate coincidence.

            Doctors *are* expected to report adverse events that occur to VAERS, and those who don’t are shirking this responsibility. It is not a doctor’s role to assign blame for the event to a vaccine, and an experienced, good doctor would neither blame the vaccine nor avoid reporting it just because he thinks the event isn’t caused by the vaccine. Any and all adverse events are expected to be reported to VAERS, regardless of whether it’s something that could or might have been caused (or not) by a vaccine. Clearly, many doctors are following through on their responsibility since there are even car accidents listed among the reports in VAERS. You have not provided any evidence for your cynicism about what doctors do and don’t do (you speak generally as though “doctors” are this monolithic group who all do the same thing), so I suspect you have a bias against the medical establishment that prevents you from seeing clearly just how seriously the medical community takes possible reactions. Read my post on the rotavirus vaccine to learn just how much they ARE concerned about watching for and investigating possible vaccine reactions.

            Finally, the H1N1 vaccine this year IS a match for what was in the vaccine. The CDC site lists the specific strains that were in the trivalent flu vaccine. The flu vaccine’s effectiveness varies in percentage from the 30s to the 70s, so it is never 90% or 100% effective. Therefore, there will always be people each year who received the flu shot and get the flu. That doesn’t mean the shot is worthless. It reduces the risk of infection. It does not and cannot guarantee 100% prevention.

          • Lola Smith

            I can’t find the reply button to post under our discussion about Bell’s Palsy. But I am not at all distrustful of the medical establishment. I have my BSN and have been a labor and delivery RN for 22 years. I am part of the medical establishment. I am also not anti vaccine.I am anti mandatory vaccination. I am for vaccinations that actually work and are safe. I work with physicians on a daily basis and most will not report anything they don’t believe to be actually caused by the vaccine. How many physicians do you actually talk to about their reporting practices? I am well aware that this year’s vaccine has an H1N1 component in it. The H1N1 portion is a slightly different strain. In the hospital I work in we have many patients currently admitted with H1N1 that were vaccinated in the fall. That is why I believe this to be a poor match. I have seen many I’ll patients come through this year who received the vaccine. Working closely with physicians for 22 years, I know them to be leery of reporting adverse reactions that they can not say for certain are a direct result. Unfortunately, this leads to underreporting of many reactions to medications and vaccines. That is one of the reasons medicines can be on the market for many years and then be removed for bad reactions only after enough bad consequences have happened.You are naive if you think doctors report reactions frequently.

          • Tara Haelle

            Fair enough – I apologize for drawing an incorrect conclusion regarding your bias. I do talk to a lot of physicians – it’s part of my job – but I doubt either you or I has an adequate sample size to assess what the frequency of reporting is. It seems like something that would be excellent to investigate in a research study. I am not naive, however. Doctors come in all stripes; some will report anything at the drop of a hat, and others are leery of reporting even obvious things that ought to be reported. As I stated before, I think a doctor who doesn’t report an adverse event, regardless of his professional opinion about its causation, is shirking his responsibility. I believe ALL adverse events should be reported so that we have as much data as possible to start from. I am grateful, however, that VAERS accepts reports from patients as well, so that at least provides an opportunity for those who experience the events to report what happened if they have a less-than-conscientious physician.

          • Lola Smith

            We agree that all adverse events should be reported. I too am glad they take patient reports but like you said, they put more weight in physician reports. I also wish exact numbers of hospitalized patients with influenza and deaths from influenza with and without vaccination were reported but the only mandated reportable deaths are pediatric and they don’t have to report vaccine status.

          • Tara Haelle

            ” I also wish exact numbers of hospitalized patients with influenza and deaths from influenza with and without vaccination were reported but the only mandated reportable deaths are pediatric and they don’t have to report vaccine status.” I also *completely* agree with you here. It hampers research considerably and prevents us from better understanding effectiveness, which is already all over the place for the flu shot. I think it’s clear it does reduce risk of the flu, but the extent to which it does obviously varies by season and by age group, and the issues with differing results (indeed often related to funding sources) is frustrating.

    • Donna

      Flu shots given in the US really do not have adjuvants in them? Where can I find proof of that?

    • Rebecca Hanford

      Ok so growing up I was vaccinated. Of course that means influenza. As a child EVERY TIME I got the flu shot, I would lose about ten lbs because of throwing up. I would get the headaches, the fever and just non stop puking. I was kept very ignorant of the world (super bible thumping upbringing) so not once did I ever suspect ti was the vaccine that made me sick. since I was 18 I have yet to take a flu vaccine. Guess what? I NEVER GOT THE FLU! Until my son got his first flu vaccine. Oh man did I get sick. He didn’t so there is something in that shot that makes me sick. Also my husband gets pukey from the shot too. Hmmmm…

      • Tara Haelle

        It sucks that you appear to have such a reaction to the shot. It’s a risk-benefit analysis, and some people respond more poorly to the shot in terms of side effects than others. Just because you haven’t gotten the flu so far doesn’t mean you will continue not to get it, but I can understand why you are making the decision you are making in terms of your experience. I’m certainly glad your son does not appear to have the same reaction as you!

    • Paul Judge

      I acquired GBS from vaccinations I received in preparation for an overseas trip. Your statement that there is no proven link between GBS and flu vaccinations, is uninformed and irresponsible. While it may be true that for financial reasons, certain parties choose to ignore the scientific data and argue the point, it is only because they seek to protect there interests and avoid liability and financial exposure.

      There is a lot about GBS that is not know. The full understanding if the causes, is still not clear. But it is absolutely a FACT that vaccinations are a trigger that can result in GBS for 1 out of every 200,000 people.

      • Tara Haelle

        Perhaps you should reread the section on GBS in my post. At no point did I say “there is no proven link between GBS and flu vaccinations.” In fact, I pointed out that there WAS an increased risk for GBS with two particular flu vaccines: the 1976 swine flu vaccine and the 2009-2010 H1N1 vaccine, though in the latter case, the risk of GBS was higher with the flu infection than with the vaccine (and the risk was higher with the vaccine than without).

        My exact words, quoted from my post: “This myth, like the one about narcolepsy, is partly based on fact because the 1976 H1N1 flu vaccine was found to be linked to a higher risk of GBS that year – approximately 10 additional cases of GBS for every 1 million people vaccinated. Since then, GBS risk has probably been the single most studied adverse event from the flu shot in the history of flu shot research, and the majority of it has shown no increased risk with seasonal flu vaccinations.” In addition, my final statement in that section is as follows: “Finally, one study did find a slightly higher risk – 1.6 cases of GBS per 1 million vaccinations – for seasonal flu vaccines and the H1N1, but this increased risk in seasonal vaccines has not been found in other studies.”

        It behooves one to actually read what I wrote before attacking it as inaccurate.

    • Great article. I was thinking about doing something like this on my blog, The Wikiton Post. I’m really sick and tired of reading all the false information about the FLU vaccine. Although, I personally don’t prefer the flu vaccine, I don’t believe in putting out patently false information that deliberately misleads people like the shock media crap about how the flu vaccine causes all sorts of problems, especially in babies. Again, good article.

    • Darin Selby

      In my estimation of what you’ve written, you have a know-it-all chip on your shoulder towards any suggestion that injecting a toxic, foreign substance into your body could not possibly be harmful.

  2. Bobina

    Brilliant. Sharing it now! Thanks.

  3. I hear so many of these I was tempted to make such a list myself. Glad you beat me to it! Thanks!

  4. You’ve done a fantastic job putting this information together: a great public service. Well done.

  5. TheDudeAbides

    thank you for being a voice of reason amongst the nonsense out there.

  6. shay

    Can you site your sources for the above article? I tend not to believe blogs that do not cite their sources.

    • Tara Haelle

      Shay, all my sources are linked to in the article itself. There are 109 links in there, and more than half of them are directly to peer-reviewed studies in medical research journals. (The others are to explanations of concepts such as herd immunity and ethylmercury, to other blog posts or news stories or to CDC and FDA webpages.)

      • Danea

        I actually LOL’d at Shay’s comment. Nearly spit out my tea. Kinda makes you wanna bang your head against the wall, no? Hahaha

        • B

          Shay, the underlined words are actually the links Tara is talking about. They may not have shown up as such in the window of a smaller smart phone or tablet. Good and legitimate question as others may have had the same problem.

    • krista

      thank YOU for being a voice of reason!

  7. Here’s one that is rare but does exist: If a pregnant woman gets the vaccine, her child when born is “covered” for that season’s flu. Since the vaccine uses the adaptive immune system, which doesn’t develop for ca 6 months after birth, this does not work. Very few antibodies get through the lactational barrier. New borns are at risk.

    I’ve seen this used by family members where there is a new infant and the parents ask (during flu season) for people who are not immunized to wait to see the baby or at least wash their hands etc.

    • Tara Haelle

      Interesting — maybe I’ll add that somewhere above. I know the studies show that babies do have some added protection, as noted above in the post, but I could definitely mention the value of cocooning in the family, as is recommended with pertussis vaccines.

    • Greg, There is a class of antibody known as Immunoglobulin A (IgA) that is secreted in the colostrum (mother’s milk). This will provide protection to the infant for the duration of breast feeding. The same antibody is found on mucosal surfaces (gut, lungs etc) and secretions (tears, saliva). The presence of this antibody is one reason to encourage mothers to avoid formula milk if possible in the early stages of infancy. It’s basic immunology and can be verified from many sources but there’s a decent description on Wikipedia. Having said that, it’s still prudent for parents to adopt reasonable hygiene measures when an infant is in the family.

      • John, mucosal IgA is not necessarily sufficient, protection against influenza in and of itself (based on the peer reviewed papers I’ve read … I’m not big on Wikipedia, tends to water down all the PhD training and stuff). Colostrum in regular and high doses (artificially) can actually out perform the vaccines. But in order to tell a mother that her new born is protected against the flu you have to be pretty sure that a lot of things have happened just right. The total transfer of immune products to an infant from breast milk may be somewhat overstated, or at least people are often over-optimistic about it.

        I know YOU know this but for those reading this, to avoid people being misinformed. When a person gets a flue immunization, that immunization mobilizes that person’s adaptive immune system to develop a future resistance to the flu (or more accurately, a much more rapid response to the flu strain(s) addressed by that vaccine). But an infant does not have an adaptive immune system, so that infant’s body is not being prepped for exposure to the flu.

        In short, and to put it very simply, an infant does not get a “two for” flu shot when the mother gets a flu shot prior to birth (or after birth). The infant is not immunized because the infant can’t be immunized until it is a bit older because that part of the immune system has not developed yet.

        I am very suspicious of the transfer of immune products from mother to offspring. I’m familiar with the literature, but haven’t done any research in this area, having supervised a few student projects on this but only one PhD student (it is not my area). But my understanding is that while colostrum is good, breast feeding is good, etc. etc. the total effect on the immune system is unclear and, most importantly, may be highly variable from case to case.

        When we get to the infant, the relative ineffectiveness of the vaccine (it is not 100% as mentioned above in this excellent blog post) translated to the not 100% perfect response a woman may have translated to the small proportion of immune product that may get through lactation, and we are very far from “don’t worry, if you had a flu shot your infant is protected” being good advice. In fact, it is bad advice.

        Where my research does come in a bit is in lactational failure. There is a very high rate of this, giving general advice to rely on lactation is not necessarily good because, before birth, you can’t say how that is going to go.

        Certainly, when a baby is just born, and lactation hasn’t kicked in yet (that can take quite a while) there is absolutely zero chance that the infant is protected from the flu, regardless of any immunization the mother has had, or the hope of colostrum doing something helpful, etc.

        I saw the advice (from a non-scientist non-MD relative) that you get a “Two for” when mom gets vaccinated during our H1N1 scare a few years ago. The Pediatricians, nurses, midwives, etc. were very worried about flu (my son was born in the middle of that almost-epidemic). Cacooning was very much advised!

        It is a good idea to encourage mothers to breastfeed, there are a lot of good reasons to do it. However, a significant percentage of women don’t manage to be able to do it, and it is not because they did it wrong . Most likely there is a high natural rate of failure on first child breast feeding and in our “EEA” this was addressed by cross nursing (this is what I observed in the field with hunter gatherers). Since our society does not do that, this high failure rate turns into stigma, and that is unfortunate. Meanwhile, since there is a certain rate of failure, we have to be careful about relying on those positive effects in addressing the epidemiology.

        • Tara Haelle

          Greg, I’m not an immunologist, a virologist or a medical doctor, so I can only go off of what I read in the peer-reviewed research. Some of that appears to contradict some of what you’re saying here. It’s certainly true that a breastfed infant does not have 100% protection against the flu if the mother had been vaccinated while pregnant, if only because the mother herself is not protected that much. (As I noted above, the flu has lousy effectiveness compared to our vaccines, though it’s better than nothing and some years better than others.)

          However, to presume that NONE of the antibodies, for influenza or targeting any other disease, whether natural or from vaccination, do not reach the infant contradicts the research. For example, the reason the Tdap is now recommended for women during the 2nd or 3rd trimester is to offer the baby a bit of extra protection, in addition to cocooning, during the two months before the first well-child visit when the baby gets his/her first DTaP. See, for example, this citation (though there are others): http://pediatrics.aappublications.org/content/131/6/e1748

          You also state, “The infant is not immunized because the infant can’t be immunized until it is a bit older because that part of the immune system has not developed yet.” Do you mean that the infant’s immune system is incapable of developing antibodies and responding to a vaccine? If so, that makes no sense — the hepatitis B vaccine’s first dose is given at birth and has effectiveness from the first dose. Or am I misunderstanding what you meant by that statement? Did you mean in the womb? (If so, I’ve never seen it implied that the baby’s immune system responds to the mother’s vaccination by making its own antibodies and would agree that there is nothing in the literature to support that. However, there is research to support the theory – if not the mechanism (I’m uncertain what is out there in animal studies) – of the mother’s antibodies being transferred to the child, both prenatally through the placenta and via colostrom and breastmilk.

          • I definitely am not presuming that none of the antibodies get through. The problem has to be looked at from the opposite point of view. In a normal immunized adult, are the antibodies 100% effective? Not likely. Is there a blind study that shows the effectiveness of virus-related antibodies across the lactational barrier? No.

            Trusting that the transfer of immunity from mother to offspring is sufficient, especially for an especially virulent flu, is based on faith in lactation. I happen to think that our faith in lactation is overdone a bit because we spend so much effort earnestly encouraging women to breast feed, as a (good) reaction to people (enigmatically) not breastfeeding. That there are benefits to breast feeding is not in question .That they are 100% what we hope they are is probably not true, however.

            Comparing pregnancy vaccination to postpartum vaccination fits with what I’m saying, of course. The infant’s adaptive immune system is yet to develop at birth in a way that would allow protection.

            I think the problem here is reference to absolutes. People are cynical about the flu vaccine because it is not perfect (in fact, it is kind of disappointing). People want mothers to breast feed because it is the perfect thing to do. People want to know “yes or no” will my infant have immunity. But an imperfect vaccine being delivered indirectly through an imperfect mechanism is not going to become a perfect solution to anything.

            Regarding early vaccination, I’m probably guilty of absolutes there as well. A new born does not have an immune system as developed as an adult. It actually takes years for some of the immune system normal healthy adults enjoy to be fully up to speed. If you look at any vaccination chart you’ll see that there are very few vaccinations given in the first weeks. This is probably a combination of lack of safety evidence/overreaction and the fact that early vaccinations are not as effective. For many vaccines we get one early and a booster later. That is probably effective because the early vaccine helps, and works, but does not fully realize life long protection, while the second, booster, does (though life long is not really life long) though that can also be for other reasons.

            I assume the hep B vaccine is so early because it is very important but notice that that is usually the first of three or so vaccinations given for that . I think ALL of the pre six month vaccines are given in multiple doses that extend to or past a year.

            Influenza is not recommended for infants under 6 months old, there is no evidence of the level of immunity conferred by mother’s vaccination, there are empirical reasons to not assume that a mother’s vaccination will have an effect. That does not mean that there is a 0% chance of immunity, but it certainly does not mean that there is perfect immunity, or even the level that the mother has.

            Keep in mind as well that the mother, if she’s gotten flu shots combined with exposure to flu over the years probably has immunity to a wider range of flu than the infant will have. So for many strains including the prevalent strains, there are potentially flues assailing the infant that mother has immunity to .

            Also, and this is important, the mother’s immunity refers to her ability to produce antibodies. If the infant is exposed to the flu and the mother is not, she can’t pass on copious quantities of antibodies to the infant, most likely, because her immune system has not reacted to the flu.

            Given that you can catch the flu and be mortally ill in a few days, that different people will get exposed at slightly different times in a social environment, that flu exposure is through air and direct contact and every single person who visits kisses, holds, and hugs the baby but the mother does not get that attention, etc. etc. the possibility of the infant being exposed and not being immune is very high.

            The only safe assumption is to assume that regardless of immunization, an infant under 6 months old, not immunized yet, is susceptible to the flu during flu season.

        • Tara Haelle

          Unrelated to above, I’m very interested in what you wrote above regarding lactational failure. I promote breastfeeding but become very frustrated with the guilting of women who cannot or choose not to breastfeed. Is this something you can share more about, or perhaps offer a guest post on?

          • I haven’t written anything about breastfeeding, but Laura Hauff, at Santa Clara, has published variously the results of the work she did that I supervised. She was looking mainly at failure and obesity.

            A guest post might be interesting at some point in a few weeks when I’m past certain high demand projects, related to the forager and failure issue. (I have written a bit on that on my blog but only indirectly)

            Which reminds me of something else: Chances are the globally circulating flu phenomenon is fairly recent in evolutionary time not more than a few centuries old, so we may be bad (as a species) at dealing with it. This can impinge on the mother-infant immunity issue as well. I can’t think of a particular reason that our immune system does not do a better job of cross-generational learning. That could also be a basic mammal problem.

        • Chelsey Ryan

          Greg, IgA is a mucosal antibody, and as such would be effective against the air-borne influenza virus. Even if it wasn’t, IgG crosses the placenta to the fetus before it’s born. That gives it 2 antibodies that are specific to whatever the mother has been exposed to. In regards to your comment about antibodies not being 100% effective I’m unsure of what you mean? Do you mean they’re not perfect in the sense that they cannot fight everything? Or that they’re not perfect at fighting what they were essentially raised against?

          Obviously antibodies need to be made before they can fight any kind of infection, but once they have been made they are incredibly specific. Using the flu vaccine as an example, antibodies made by the mother after being immunized against that particular strain of influenza will be specific enough to work. Antibodies can actually undergo somatic hypermutation to make themselves even better at binding that specific strain of influenza antigen, making them incredibly good at fighting it off and very unlikely to “fail”. The whole point of a vaccine is to build memory, and that memory will be passed from mother to fetus.

        • Greg, You make a lot of points and I’m not quite sure what your take home message is other than to not overstate the case for maternal-transferred antibody. Fair enough. But some things to remember (i) the protective properties of IgA are unequivocal and have been demonstrated in numerous disease models (ii) while it’s impossible to demonstrate how efficient maternal IgA is in protecting humans neonates against flu, there is at least one animal study that shows a very high degree of protection (it’s late -forgive me if I don’t provide the primary reference) (iii) there is also evidence that there are other, as yet unidentified, components of breast milk that can stimulate gamma interferon production and thus the innate immune response. Of course advice to vaccinees should be given with all the necessary caveats stated. No vaccine is 100% and currently flu immunization is relatively inefficient but if the mother responds to the antigen and is breast feeding then the infant will have some degree of protection. And the challenge of slow/no lactation, with concomitant lack of protection, remains until the infant reaches 6 months. All in all there is a lot of work that still needs to be done on flue vaccines.

  8. Jen

    I wish we’d see more sense like this on the news so everyone could learn a little. I’ll be sharing it for sure, and I hope many others do too. Unfortunately, you can’t reason someone out of a belief they didn’t reason themselves into, and the people who most need this aren’t likely to pay it any mind.

  9. Daniel minkow

    Thank you for your post on the flu shot. I still have questions based solely on the below Cochrane review. Hopefully you will find this accurate. First, I would like to see stronger evidence about safety, especially for young children.
    Next, I wonder about the overall public health effect. Is all the money put into flu vaccinations every year worth it? Meaning, could the healthcare money be better spent on something with a greater public health impact?
    Finally, it does bug me that company sponsored trials produce different results vs independent trials.

    “Vaccine use did not affect the number of people hospitalised or working days lost” … “Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited”

    http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001269.pub4/abstract;jsessionid=E0ECE754F525D97D81CCFF24577466C7.f04t01

    • Tara Haelle

      Daniel, thanks for your comment. It’s true that the data for kids under 2 is very sparse. I actually link to that same Cochrane Review and discuss it up in Myth #7. Do we have strong evidence for its efficacy in children? No, we don’t. We have moderate evidence. Interestingly, the best evidence is actually not for influenza but for other things, such as pneumococcal-related illnesses and ear infections. It’s difficult to do large-scale trials on children, especially young children, for a wide range of reasons, and it’s frustrating that more data is not available. In the Cochrane Review, they have very strict selection criteria and often leave out studies that might shift their findings. That is why I cited a couple of other studies that showed efficacy. Of course, a meta-analysis is nearly always preferable to single studies, but meta-analyses are not immune from bias (especially selection bias) either.

      Yes, we definitely need more efficacy and effectiveness studies that are independent. I do think there is a bit of poisoning the well in some of the studies, so we have to do the best we can with what we have. Given the good safety profile (we have better evidence on that), the risk-benefit analysis in my mind is on the side of getting the shot. No doubt the flu vaccine is among the least effective (if not THE least effective) that we have, which is unfortunate, but I believe something is better than nothing given the low risk of adverse events.

      Regarding the public health effect, I am not a health economist and have not crunched those numbers. I do cite a study above that looked at cost savings, and there are others out there. I have not compared those savings to the cost of the vaccine or the cost of other public health efforts.

      I was surprised to read the Cochrane Review’s findings on days of work lost. I don’t have a good answer for that one because it contradicts every other study I’ve seen on the question. I have the full text of the Cochrane Review, but I have not reviewed all the individual studies included in it.

      I hope this addresses all your questions! I always emphasize to people: the flu vaccine is not perfect. It’s among the worst vaccines we have, really — BUT, it does offer more protection than any other method we have, and given the safety profile, I think something is better than nothing, as I said above.

      • Daniel minkow

        Yes, thank you very much for taking the time to write this article and answer my concerns.

        I’m sure you’ve seen the recent JAMA study saying how the Influenza vaccine was associated with a lower risk of cardiovascular events. I’m still trying to get my brain around how that protective effect is even scientifically possible. I thought at first maybe its from a cohort study where perhaps people who get vaccinated tended to be healthier than those who don’t, but its a meta analysis of RCT so that shouldn’t happen..Right? Seems to be something with the plaque in the heart and arteries. Its not clear to me. Any ideas?
        http://jama.jamanetwork.com/article.aspx?articleid=1758749

        • Tara Haelle

          Daniel, I actually wrote about that study, though I did not go into detail on it where I wrote about it: http://www.dailyrx.com/flu-vaccine-reduced-cardiovascular-event-risk-patients-heart-disease

          I’ve also written about past studies showing similar reductions in cardiovascular risk: http://www.dailyrx.com/flu-vaccine-reduced-heart-attack-risk
          And
          http://www.dailyrx.com/fewer-cardiovascular-events-and-deaths-occurred-among-individuals-getting-flu-shot

          References are at the bottom (though one is just a press release because it was presented at a conference and the abstracts were not online).

          Regarding the reasons: the primary reason is that people who are already at cardiovascular risk are at higher risk for experiencing a heart attack or stroke while sick with the flu — it really runs down the body. So protecting yourself from the flu thereby protects you against other health-related problems that can occur while you’re sick.

          Specific reasons for why they are more at risk while sick with the flu is less clear. One possibility is mentioned in the discussion section of that meta-analysis from JAMA: “Although acute influenza infection is an independent risk factor for fatal and nonfatal cardiovascular events, the mechanism underlying that risk is less clear, but may relate to triggering the rupture of a vulnerable atherosclerotic plaque, fluid overload heart failure, myocarditis, arrhythmia, or the susceptibility of a frail and vulnerable patient. Several observational studies support a potential association between the proximity of an acute respiratory infection and an increased risk of acute cardiac and cerebrovascular events. Whether influenza vaccination can prevent these events remains controversial.59 As we reviewed the literature, there appeared to be a considerable amount of evidence supporting an association between influenza vaccination and a lower risk of major clinical outcomes, such as cardiovascular mortality or nonfatal cardiovascular events, based on case-control, case series, cohort studies, and limited prior reviews of RCTs with inherent potential for confounding and bias.”

      • Wow Tara, I love this lame retort ” Its not perfect but its the best we got” Thank God we were not as complacent for the polio vaccine. The flu vaccine is a dismal failure.

        “Today more than 500 infectious diseases are known to occur in humans, yet in the United States, public health officials recommend routine childhood or adult vaccinations for only 17 of these diseases. And, for only one of these diseases is there a recommendation for universal annual vaccination: namely, influenza. In a recent review in the CDC’s Morbidity and Mortality Weekly Report (MMWR), 15 vaccines were highlighted for their significant role in reducing morbidity in the last 60 years. Of note, the influenza vaccine was not one of these, despite accounting for 26% of the citations in the review” ( see reference 6 Osterholm’s CIDRAP report to the CDC chapter 7 page 51)

        Sorry, dear but the flu vaccine has done nothing to reduce our morbidity/mortality over the past 30 years for target groups despite vaccination increasing from 15-65% see Simonsen’s meta analysis at http://www.ncbi.nlm.nih.gov/pubmed/17897608

        IT DOESNT WORK!

        So if it doesnt work,why the hell would even think of taking it? The 2010 Cochrane review on vaccines for preventing influenza in healthy adults concluded that, “Although serious harm from vaccination may be rare it cannot be ignored and conclude that the results of their literature review discourage the utilization of vaccination against influenza in healthy adults as a routine measure.”

        There is an endemic publication bias for this vaccine that has seen us provided with poor quality, cherry picked studies by the CDC based on good intentions, not science. Please read chapter 7 of the CIDRAP report to the CDC regarding the farce criteria that started “vaccine recommendations for healthcare workers at http://www.cidrap.umn.edu/cidrap/files/80/ccivi report.pdf

        ( CIDRAP conducted the biggest INDEPENDENT influenza systematic review and out of 5707 studies over 30 years only 31 met criteria to be cconducted without bias and with proper scientific acumen)

        and it cant make you sick?

        Really? A study in February 2013 Clinical Infectious Diseases found, there was no evidence that vaccination prevented household transmission once influenza was introduced; adults were at particular risk despite vaccination and shockingly, annual vaccination was found to leave participants at “SUBSTANTIALLY HIGHER”risk to contract influenza (Ohmit et al at http://www.ncbi.nlm.nih.gov/pubmed/23413420)

        and how about the very scary vaccine enhanced respiratory syndrome where those exposed to a s at http://www.ctvnews.ca/health/study-raises-red-flag-for-universal-flu-vaccine-1.1431159

        Your suggestion that we should po po nacrolepsy etc because its not “this vaccine” is troubling.. Who will tell us when the vaccine arrives that will cause narcolepsy? Did they know the 2009/10 flu vaccine would cause it? Were parents who are now dealing with nacroleptic children who were guilted and terrified into vaccinating them for the swine flu”pandemic” in 2009/10 told that their kids would be suffering to this day? We cannot trust our government to track subacute and late onset autoimmune phenonomen from this year, or any years flu vaccine which is currently followed for just 14 days after the shot. See http://www.express.co.uk/news/uk/433453/Payout-hope-for-girl-who-nods-off-30-times-a-day-after-swine-flu-jab

        Please don speak in black and white terms when you have only been provided with the sweet, mindless studies that make the useless flu vaccine look credible. Its a 2 dressed up as a 9

        BTW, flu incidence and death rates are also a big dramatic lie based on unscientific models see http://www.cbc.ca/news/health/flu-deaths-reality-check-1.1127442
        Peter Doshi from the Cochrane estimates flu deaths are exaggerated by as much as 10x the actual numbers

        (btw, before you slam me as conspiracy theorists, know this clearly I am NOT anti vaccine, i am anti poor science. I gladly take credible vaccines and I have my children vaccinated for credible vaccines, this is NOT one of them.

  10. Eric Roberts

    Great article. Anti-vaxers put people at risk of disease because they break up what is called “herd immunity” and it gives viruses a medium to thrive and grow. I would understand if there were actual risks, but every argument I have ever seen against vaccinations was based on utter BS and conspiratorial misinformation. I wish they could outlaw sites like Natural News and Mercola…all they do is dupe people into believing false information and play on people’s ignorance and paranoia.

    • Tara Haelle

      As a journalist, I tend to spurn censorship. That said, if I became ruler of the universe, I don’t think I’d have the restraint not to abolish Natural News, Mercola and all their sister sites off the face of the planet. I’d somehow even make sure they didn’t make it to other planets and poison the minds of any passing aliens ;)

    • Angela

      If the vaccines work so wonderfully why would you care that the non-vaccinated get sick? As a vaccinated individual- you’d be safe!

      • Jessica

        Wrong. Re flu vaccine, because it is not 100% effective, you CAN get flu (just less likely); it is even MORE unlikely if everyone vaccinates.
        However, the primary reason for caring is that young infants cannot be vaccinated, and yet are at increased risk. Yes, breastfeeding confers some immunity (if the mom’s been vaccinated), but it’s not fullproof, and of course, not all babies are breast fed. (This problem is far worse for MMR which cannot be given until 12 months at earliest. Some fool who doesn’t vaccinate their older children can easily cause the death of a baby who is too young to receive the vaccine.)
        Same goes for anyone else who has not been able to get the vaccine.

      • Jessica

        Wrong. Re flu vaccine, because it is not 100% effective, you CAN get flu (just less likely); it is even MORE unlikely if everyone vaccinates.
        However, the primary reason for caring is that young infants cannot be vaccinated, and yet are at increased risk. Yes, breastfeeding confers some immunity (if the mom’s been vaccinated), but it’s not foolproof, and of course, not all babies are breast fed. (This problem is far worse for MMR which cannot be given until 12 months at earliest. Some fool who doesn’t vaccinate their older children can easily cause the death of a baby who is too young to receive the vaccine.)
        Same goes for anyone else who has not been able to get the vaccine.

      • Zach

        Angela, While you might be inclined to just let the anti-vaccine crowd get sick, the beneficiaries of herd immunity include infants who are to young to get shots, or those who cannot get shots because their immune systems do not work properly. Herd immunity only works if the large majority of those who can get vaccinated do so.

      • PH Guy

        Of course the first answer that pops to mind is “herd immunity”. There is truth to that. That’s like saying you don’t need police around because no one you can see is commiting a crime at that instant. Really you need them around as a deterrent and available to respond to the inevitable crime.

        The vaccine can only be so effective for now, until it evolves to the point it cures or absolutely prevents the disease. Reduce the spread of disease and, by proxy, you prevent the disease in those who cannot or will not get vaccinated. Doesn’t anyone understand the end goal of public health? Reduced mortality and morbidity are essential stepping stones. Ultimately we wish to end up at one place… disease eradicated. It isn’t just about individual health. It’s about societal disease prevention, and it happens one person at a time.

  11. Rene

    I’ve noticed people on facebook worrying about antifreeze and formaldehyde in the flu vaccine too, in case you want to address those.

  12. Sima Leah

    Sorry, babe, you drunk the kool aid. Bull hicky.

    • Tara Haelle

      I often delete anti-vaccine comments (though oddly so far, none have come to this post yet) because I don’t believe in poisoning the well with misinformation. But yours actually made me laugh out loud so I’m going to leave it. If that’s the best someone can offer, then I’ve clearly done a bang-up job of it, so thanks!

    • Sima: please document what aspects of Tara’s post are “kool aid” and provide peer reviewed citations to make your case.

  13. Tseng

    I know I will probably get shit for this, but I have to disagree with the flu shot doesn’t make you sick. Every year I got the flu shot I ended up sick as a dog, I haven’t gotten the flu shot in 9 years.. I haven’t been sick once and I have changed nothing in my daily life.

    It is hard to believe that at least for me that it was coincidence that I got sick shortly after the shot but the years I never got the shot I have been the healthiest I have ever been.

    Also the nasal version of the flu vaccine does ‘shed’. The Marine corp has been using the nasal version and nearly everyone that has gotten it in my husband unit have become sick and they have spread it to those that have yet to get the shot or nasal.

    • Tara Haelle

      I’m not going to give you crap, Tseng, but I will tell you quite simply that the flu shot has no mechanism for making you sick. You certainly might feel crappy and under the weather as the immune system revs up to make antibodies, but you won’t “get sick” because you had a flu shot. Yes, it’s actually a coincidence. Sorry.

      However, regarding the shedding of the live vaccine, you are correct — it does shed. I state that in my post above. I said that documented cases of others becoming seriously ill from the shed virus of a vaccinated individual have not been reported (ie, to CDC, etc.) but that it is theoretically possible to shed the virus and for someone else to become ill.

      • PH Guy

        You aren’t the first person I’ve heard this from. Here’s my theory (and it is only a theory)…

        You did not get the flu, as Tara covered adequately. That you get sick every year without fail means you might be sensitive to one of the ingredients in the vaccine. It’s not an allergic reaction, per se, but an untoward (undesirable) reaction.

        Try getting the Flucelvax or a preservative free version, or even try the FluMist (these didn’t exist 9 years ago when you stopped getting the flu shot). They are not made the same as a standard flu vaccine and may not cause you so much grief. If you do that and still have problems, talk to your doctor about not getting a flu vaccine and be prepared to share exactly what you feel (aches, rash, malaise, etc.) so they can document it and give you the best advice. Good luck, and I hope you get a new flu shot this year!

      • What type of control groups, and degree of statistical significance qualifies a “coincidence”? Personally, I consider feeling “crappy, and under the weather”, the most common descriptions in America for being “sick”.

        • gzach

          I’m in the same boat–got very “sick” after the vaccine. Whether it was the actual flu or a vaccine side effect, the fact of the matter is I had a high fever and chills and nausea and was out for a few days. I’ve always defined “sick” as “not feeling well.” Hence the vaccine made me “sick.” As a general rule, I am in favor of vaccines and all of my children have been vaccinated on schedule. But after feeling that sick from the flu vaccine, I am very wary of it, especially since the actual flu has never been a problem. And yes, I get that things aren’t a problem until they are, but I feel like the amount of ill I would feel from a case of the flu would not be greater than the total amount of ill I would feel from the vaccine each year. And I don’t think this reaction to the vaccine is all that rare. So whether it is the actual flu or just a reaction, the fact of the matter is the vaccine CAN make a person very unwell, and telling them it’s a reaction instead of the flu doesn’t actually make the symptoms go away. I think it’s at least worth giving this fact some validity instead of brushing it off like people are hypochondriacs.

          • Jennie

            I’m going to come down on the side of cultural amnesia here. We are, as a population, generally so healthy that three days of fever and feeling crappy feels “sick” to us. After watching my then-6-year-old get the ACTUAL FLU in 2009, I now understand what “sick” really is: 103+ fever for 8 days. He did not leave his bed other than to use the bathroom for 8 days. We took him to the ER after he got moderately dehydrated from the vomiting – a nice IV and he perked up enough to get some sleep. He ate almost nothing for those 8 days. He lost two pounds (a remarkable percentage of his body weight.) He was so sick he did not even want to watch tv. He barely spoke. He did not have a bacterial infection. He was not critically ill. We were in good touch with his pediatrician throughout. There was no danger to his life. AND YET: 8 days of high fever. 2 pounds lost. It was a full month after his temp was back to normal before he was back to his old self. And again – this was not life-threatening disease. This was THE FLU. Not a cold, not a stomach virus – which can make you genuinely feel crappy for a few days. But I think we’ve lost all perspective on what “illness” is really like. I’m not suggesting that Tseng did not feel awful. I’m just suggesting that “feeling awful for three days” is *not* “getting the flu” – or, at the very least, it’s a mild case of the flu.

          • Tara Haelle

            As already noted, the flu vaccine can cause side effects in some people that include nausea, headache, fever and chills. This doesn’t mean you got sick, as in you fell ill with a pathogen. And you did not get the flu. Perhaps you are quibbling over the semantics of the word “sick.” If you consider that sick, that’s fine, but you did not become ill from a virus, bacteria or fungus that your immune system had to fight off because of the flu vaccine, which is typically what it means to “get sick.”

          • gzach

            I feel like everyone just ignored what I said. Anyway, the way I look at it is–do I take a shot that has a 100% chance (based on past experience) to make me FEEL very sick for two days, so that I can have an 80% chance of being protected against a disease that I have a 5% chance of contracting that will make me very sick for 8 days? If you don’t experience vaccine side effects, then that’s great. But if you DO, then it is something to take into consideration. To my knowledge, I’ve had the flu only once in my life. It sucked. But coming down with the flu once every 30 years is personally preferable to feeling like complete crap for 2 days out of each of those 30 years.

    • MC

      I’m one of the people who’s never had a flu shot. I actually came to this page to try to convince myself to start. I have a coworker who’s been pestering me about it, but she’s one of those people that gets it every year and then subsequently feels sick and complains about it. I’ve seen her sick with cold/flu symptoms 3 different times this year, yet I haven’t been sick in almost 2 years. PLEASE if you’re someone being obnoxious to others about getting the flu shot, make sure you have a leg to stand on first. (Sorry, that last sentence was really an indirect attack toward my annoying coworker, haha)

      In all seriousness, I have a question: Can I still carry & spread the flu virus even if I personally don’t experience any symptoms? (meaning is it possible to have the flu without realizing it?)

      Sorry, it’s been hard to convince myself to walk right up and potentially “make myself sick” every year when I normally don’t get sick otherwise. And yes, I know it’s not the flu, but it seems to me the side effects are similar to those of having a cold or flu. Feeling miserable is miserable no matter what the reason.

      Oh, one more question: When someone experiences a runny nose or sneezing from flu shot side effects, is there anything contagious coming out of them? Or am I to believe that their body is expelling “clean” mucus and there’s nothing to worry about if they come to work?

      • Tara Haelle

        I won’t tell you that you should get the flu shot. That’s up to you and/or your doctor. However, I will try to answer both your questions. To the first question, you are contagious while the flu virus incubates in you before you know you have it (before clinical symptoms occur). According to the CDC, the flu virus incubation period is 1-4 days (http://www.cdc.gov/flu/professionals/acip/clinical.htm). Therefore, during those 1-4 days, you could transmit the flu to others. However, after that, you should experience symptoms yourself. Symptoms vary from person to person. They usually knock a person pretty flat — much worse than the cold. There are certainly those lucky few who manage to get over it in less than a week. I don’t know whether a person can have the flu and never experience symptoms because there would be no way to know that. (That person would have no reason to go to a doctor or get a flu test, and it would be an expensive use of research funding to test 1,000 healthy people in flu season to see if any of them happened to have the flu virus without symptoms.)

        You’re right that you can feel crappy/miserable after the flu vaccine if you’re one of those who experiences those side effects — headache, nausea, fever, etc. If you’re prone to that, I understand your hesitation. Whether a person might be contagious with any bug during those side effects depends on whether they received the inactivated vaccine (the flu shot) or the live vaccine (the nasal spray). If you get the live vaccine, it is possible to “shed” the virus. There have not been reported cases of people becoming very ill from being around a person who received the live vaccine, but it is theoretically possible and it’s possibly happened and not been reported. If it happened, it would be a mild illness (though I can see that being little comfort to the person who became ill). This kind of shedding does not occur with the inactivated flu shot. And again, even with the live vaccine, it’s rare enough that there aren’t reported cases.

        • MC

          Alright, thank you. Seems a lot of people who sit near me have been sick lately, most of whom got the shot while at work and had to call off sick the next day. So they’re not the most convincing people, haha. But it’s nice to find a site like this full of actual sources.

        • kw

          Re: ” I don’t know whether a person can have the flu and never experience symptoms because there would be no way to know that.”
          Subclinical/ asymptomatic infections are possible… http://www.ncbi.nlm.nih.gov/pubmed/23466910 notes viral shedding in asymptomatic health care workers (HCW), and an older 1993 study notes antibody development in HCWs with no recall of symptoms (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2352563/). There may be newer studies.
          So while the individual might not be “sick” with influenza, particularly if they are healthy adults, they MAY be carriers, and put others at risk, particularly the young/ elderly.

  14. Thank you very much Ms. Haelle for taking the time to compile this list. It addresses the many excuses healthcare workers hear on a daily basis from patients and even from other co-workers. Love how it’s stuffed with the appropriate references and citations to support the explanations. Your link has been shared on the http://www.facebook.com/nurseswhovaccinate page with the hope that HCWs use this as a quick reference to educate patients coming in with concerns about the influenza vaccines. Thank you for your hard work and keep it up!

  15. Alexandra Fawcett

    Tara, I think I love you. :) I will be sharing this post. Thank you for it.

  16. What if I just don’t like needles?

  17. Ben

    There’s still another issue I have.

    Most years there seems to be a lineup to get vaccines, which seems like evidence that vaccines are often in limited supply. I’m 21 years old, I don’t have any underlying conditions, and I spend little to no time around children, the elderly, or pregnant women. If I were to get the flu, the odds seem pretty good that I would bounce back fairly quickly, and I’m in a position where I can afford to avoid human contact while I’m sick. Should I still get vaccinated, knowing that it means that someone else (possibly a child, elderly person, or pregnant woman) will have to go without a vaccination?

    • Eric

      As far as shortages are concerned, the shortages are more to do with regional variation, if the CDC is to be believed. While the vaccine is often available in late September, early October, people tend to wait until flu reports start cropping up close to home, which leads to localized shortages. However, if there is demand for the vaccine, there will be enough doses to go around.

      As far as your bounce-back theory, while the Spanish Flu was a pandemic of historical proportions, it has been found that in cases of novel flu strains, it’s actually the young and hearty who die. That’s not to say seasonal flu will do that every year, but children die at a much greater frequency than you would expect, as they are not immunocompromised. In the case of the Spanish Flu, the theory is that a healthy immune system was too potent, and ended up killing the body it was trying to protect. That was the fear with H1N1, as well as other variations circulating along with the seasonal flu. Obviously, it’s up to you if you want to get the vaccine, but I would not assume you would bounce-back nor that you would be taking a dose from someone else.

      • Ben

        “As far as your bounce-back theory . . . it has been found that in cases of novel flu strains, it’s actually the young and hearty who die . . . . the theory is that a healthy immune system was too potent, and ended up killing the body it was trying to protect.”

        Can you give me an example of a demographic that ISN’T hit particularly hard by the flu? Also, does that mean that a person with a WEAK immune system is LESS likely to die?

    • Terri

      I had the flu when I was in my early 20′s. It took me 3 months to get back to normal. Don’t assume that your youth will protect you from the flu or that you will just ‘bounce back’ from it. It is a serious illness.

  18. William

    Hi Ben
    It’s important that as many people as possible be vaccinated. You can still spread the virus without feeling symptoms or before the onset of symptoms.

    • Ben

      That doesn’t really answer my question, or even address my central point. If there weren’t lineups, it would be a nonissue and there’d be no reason not to get vaccinated, but in reality, people rush each year to get a limited number of vaccines, especially when something like H1N1 shows up in the news. Should I get a vaccine knowing that there’s a LIMITED SUPPLY and there exist other people who need to be immune more desperately than I do?

      • Tara Haelle

        There is not a straight-forward answer to your question because it depends on where you are in the country and whether there is the potential for an actual shortage in that area. One option is to wait until the end of the flu shot season but before flu season hits hard to ensure that the elderly, pregnant women and children have all had time to get their shots. If there is a sincere concern of a vaccine shortage in the area, then I think it makes sense to ensure you’re “at the back of the line,” as it were.

        Keep in mind, however, that just because you’re standing in a line does not mean there is too limited supply or the potential for a shortage. It could be the time of day or the number of facilities available. You would need to call around and ask pharmacies regarding the actual potential for a shortage.

        Not sure of your age, but if you’re on a college campus, then it’s a good idea to get the shot because you’re at higher risk for the flu (close quarters to so many other students) and the shots are allotted specifically for the university/college. I hope this answers your question.

  19. Maruja

    It is true that antibiotics only fight bacteria, but your etymological reference is wrong, biotics doesn’t mean “bacteria” it means “of life”.

  20. Thank you so much for this comprehensive list (complete with peer-reviewed research and credible sources!). I’m currently a biomedical communications / medical illustration student, and am starting up an illustrated science blog with some classmates. Is it OK if we use information from your list (descriptions & sources) to create illustrations? You will be credited and linked back.

  21. Alistair

    I’d believe this more if it wasn’t so apparently biased. This is unfortunate as at this time of year parents will be struggling with the “to vaccinate or not” dilemma for their children.

    For example “Flu vaccines don’t work for children”.
    The evidence is given as the best possible scenario, ie “up to 83% effective” then followed up with an example based on that best case scenario. “(meaning kids who get the vaccine are 83% less likely to get the flu than gets who aren’t vaccinated)”. Here explaining an obvious bit of math is used to exaggerate the best possible result.

    When targeting doubters, it would have been better to quote the worst case scenario as clearly the example given is false, ie you could not possibly find any scientist to support a claim that “83% (of kids) are less likely to get the flu” after taking a flu vaccine – which is exactly what the example says. Indeed the CDC states that some years there may be NO benefit. That’s a fair bit off 83%.

    One more example, but there are more.

    “The flu vaccine gives you the flu or makes you sick. (No, it doesn’t.)”, uhm yes it does, well at least according to the vaccine literature that accompanies parent consent forms in the UK. Side effects can include a runny nose and headaches. Hardly major symptoms, but for this article to appear unbiased, rather than fail to mention side effects at all, it should have been mentioned in this section.

    This list stretches to 25, but really when deciding on the jab for themselves, or the spray for their kids, adults want to know two things.

    1. How effective is it?
    2. What are the risks if I don’t take it?

    The answers in brief are, I believe,

    1. From zero to 83% chance of offering any protection depending on factors outwith our control i.e. the actual strain of virus in any one year.

    2. Minimal.

    I’d would really have liked to see this article cover these points, impartially, however it can be seen that clever wording has been used to justify the authors stance in some sections.

    In particular I personally would really have liked to read stats supporting an answer to the risks of not taking the vaccine for children aged 10-13 approx. i.e how many flu fatalities in this age group, and a comparator with other causes of death with the same incidence rate. I don’t know the answer. even after this 25 point FAQ, unless I missed it….? EDIT, yes indeed the report does link to a CDC report, which if I read correctly states there is a 0.1 chance in every 1 million for children under the age of 19. I think that equates to 1 in 10 million?!

    Although my children have taken all recommended vaccines thus far, I drew the line the flu, for me it does not add up. Particularly as the supporting evidence I was supplied stated the vaccine was primarily to stop children SPREADING the virus to older adults as kids do not cover their mouths when sneezing!

    If my kids have to take a vaccine, it will be for their own safety, recommend by the health authority, and clearly justifiable with obvious and severe risks. I’m just not getting that for the flu vaccine…

    Correct me if I am wrong and I’ll happily make the appointment though.

  22. Whiskeyjack

    I just wanted to point out one thing.
    I get the flu vaccine every year. Every year, I get a bit sick for a day or two after taking it — fatigue, headache, general don’t-want-to-get-out-of-bed-itis. It’s been explained to me by a nurse that what’s happening is a general sort of immune response to having something shot into me — not the flu itself. So it can happen that the vaccine will make you “sick” — just sick in the sense that you don’t feel great, not in the sense that you’re actually infected with something that will kill you, or that can be passed along to another victim. I think it’s important to acknowledge that this can happen, and it’s a legitimate physical response — but that the day or two of feeling out of sorts is a small price to pay considering the alternative.

    Anyway, it’s a great article, and I’m glad to share it. :) Keep up the good work!

  23. Kate

    Still others wonder why anyone should care about their personal choice on whether to vaccinate or not. If your choice only affected you, people wouldn’t care so much. However, by not getting vaccinated, you decrease herd immunity, and you have the potential to hurt others as well! Vaccination is so important!

  24. SmilingAhab

    Here’s one I heard from a raging libertarian a few weeks ago: “I don’t get the flu shot because the Government puts mind-numbing agents in it to make people more susceptible to seasonal advertising, thereby increasing sales for their corporate masters and making people dumber and more compliant to march to the State’s orders.”

    So yeah, this is a thing.

    • Tara Haelle

      Wow… yea… I’m not sure I even have the imagination to debunk that one :) It does inspire me to possibly write a companion piece of unlikely myths: “The flu vaccine turned me into the Incredible Hulk” (an actual VAERS entry, really!). Or “The flu vaccine made all my body hair fall out at once.” Oh, the fun to be had…

      • jsme

        Or, the flu vaccine made all of my skin fall off, caused rectal prolapse, blindness, deafness, my nose and lips rotted off etc. Yeah, responding here as I did not see my original post related to Influenza related Stevens Johnson Syndrome and Toxic Epidermal Necrosis Syndrome. Yes, those are two very rare, nonetheless very real possible side effects to getting a flu vaccine. It has been proven. Medical Science has proven that approximately two percent of the
        Population contains the genetic markers for this outcome. Really, parts of your article are good and factual. I just dont care for the flippant disregard you seem to have in regards to things which actually could be caused by the vaccine.

        • Tara Haelle

          You didn’t see your original post because I hadn’t gotten to it yet to approve it. I take up to 24-48 hours to approve posts, depending on my time — I don’t get paid for this blog except occasionally a pittance from advertising you see on the blog through Google AdSense or through BlogHer. (I have also expressly forbidden the BlogHer network to run pharmaceutical ads on my site, and I receive no money from any pharma-related companies or entities.) So it can take a while for me to get to read them and approve them, and your first post was only an hour ago. Plus, once I approve them, they may not show up right away because of the cache. I had to implement a caching program shortly after that post to deal with heavy traffic.

          In any case, I think I addressed everything in my other reply. The article is not intended to be flippant about real risks. This post grew out of a frustration with seeing tons of false and misleading articles about the “dangers of the flu shot” for the general population. A reaction like SJS, if it was caused by the flu shot (and again, we don’t have evidence that it is/was/can be), is very serious and to be taken seriously. It is also extremely rare and not something that should be used to dissuade the ordinary person on the street from getting the vaccine. They should be aware of rare adverse events, and each person must make their own risk-benefit analysis, and those who may have a susceptibility to certain conditions or allergic reactions should not get the flu shot. None of that changes the information I’ve provided here.

  25. All the comments about “It made me sick” are interesting …. I know many people who claim that to be true.

    So we have a situation where lots and lots of people say one thing, the science says something else. There are two likely explanations for that, one already pointed out; this is confirmation bias or coincidence, or in some cases (not mentioned above as far as i know but I’ll say it) people exaggerating or being inaccurate for one reason or another.

    A claim of always getting sick can be quite sincere, but if it comes along with a rant about how vaccines are bad for you etc. etc. it should not be taken seriously as it is probably just denialist rhetoric.

    The second possibility of course is that there is a real cause for that, but dead vaccine can’t give you the flu. I wonder about things like just getting poked with a needle. There may be some literature on that since there are double blind studies where people get poked. But there may not be a third non-poked control group.

    • Tara Haelle

      I suspect a large part of it may be related to the typical side effects while the immune system ramps up and into action. (I just added a paragraph to that effect under Myth #1.) That, combined with confirmation bias and actual occasional coincidences could all contribute to those sincere recollections of experiences. I have not looked at the rates of adverse events in placebo groups versus real-vaccine groups in RCTs, but I’d imagine there’s a fair number of similar side effects that occur in both groups, sort of a reverse placebo effect.

    • Leslie

      “denialist rhetoric” Wow, you guys have ingested every tired line that big pharma has fed you? Does the flu vaccine make you sick? most people absolutely not, however do not for one moment treat this vaccine and the people who have suffered serious ramifications from it like it is some walk through the candy aisle.

      The 2010 Cochrane review on vaccines for preventing influenza in healthy adults concluded that, “Although serious harm from vaccination may be rare it cannot be ignored and conclude that the results of their literature review discourage the utilization of vaccination against influenza in healthy adults as a routine measure.”

      Why would I put me or my family at risk for a vaccine that doesn’t work? And to top it off why vaccinate for a virus that is so utterly misrepresented and poorly tracked? All seasonal ills are called “the flu” when in fact influenza only account for anywhere from between 10-20% of what makes us sick. The Public Health Agency of Canada estimates that, in a given year, between 2,000 and 8,000 Canadians die of influenza and its complications, depending on the severity of the influenza season. Yearly, there may be up to 20,000 hospitalizations related to influenza,

      Again, have you critically examined how this astounding number is derived? How does anyone profess to know accurate mortality of morbidity rates?

      See the fabulous article by Crowe for the CBC at
      http://www.cbc.ca/news/health/flu-deaths-reality-check-1.1127442

      “In fact, there were only 300 deaths per year across Canada where physicians actually documented “influenza” as a cause of death between 2000 and 2008….The 2009 H1n1 proposed “pandemic” mandated that all samples be properly laboratory confirmed by culture. The final death count in 2009? 428 – a number closer to the proposed seasonal average of 300 rather then the “2000-8000” estimated by computer models which are a statistical guess.. Public Health Canada uses these flawed models to derive the 2000-8000 number. One model counts all respiratory and circulatory deaths — that’s death from heart and lung failure — as flu deaths. At the lower end of that model they count the number of deaths officially listed as “influenza” on the death certificate, plus all deaths from pneumonia — even though not all pneumonia is caused by flu. Another model assumes that every extra death that happens in the winter is a flu death. Winter deaths (minus) summer deaths = death by flu virus. That includes winter deaths from slippery sidewalks, snowy roads, freezing temperatures, plus all the winter heart failure, lung failure and deaths from cancer.
      For proof of how models keep changing their estimates, look back at Canada’s flu files. More than a decade ago, flu was estimated to kill about 500 to 1,500 Canadians every year. But in 2003 Health Canada changed models, and the estimates jumped to “700 to 2,500 per annum.” The 2,500 deaths at the upper end of that range quickly became the lower end, when an even newer model was tried in 2007, pushing the upper limit to 8,000 based on the severe flu seasons of 1997 to 1999.” (

      The truth is we have no idea how many people die of influenza every year. It might be 300 it might be 10,000. The only reality is that scaring people appears to justify evidence free policies.

      This is an insignificant statement as vaccination of HCW for influenza has never been proven to be an effective initiative.

      a

  26. Sara

    This is a fantastic, useful article with sound information. However, I don’t know whether you debunked the myth that vaccines damage the blood brain barrier. You simply mentioned some random facts about the bbb (there are pericytes! It is fully developed at birth!). I suppose you may have been implying that vaccines don’t alter the development of the bbb — which is probably true. But lots of things can damage the bbb. We have found in our lab that high-calorie diets can damage the bbb of rats (increased permeability, lower expression of tight junction proteins). Diet is just one example, but my point is that the bbb can be damaged by everyday events, and you didn’t point to a study that tested vaccine / vaccine components on bbb permeability, vascular integrity, cerebral blood flow, etc.

    For the record, I can’t imagine a scenario where one of our modern vaccines would induce this type of damage (even if something were harmful, it would likely be too small of a dose, not prolonged enough). But I feel like the best you can say is that there is no evidence that the neurovasculature is harmed by flu vaccines.

    Sorry to nitpick!

    • Tara Haelle

      Sara, that’s a valid nitpick given my goals. My intention was to show the implausibility of the vaccine penetrating the BBB based on the physiology and mechanics of it. I would need to dig deeper to see if studies have been conducted explicitly to test this. Most likely, they would be animal model studies as well, which, as you know, are limited in what they can tell us about the homo sapiens brain. However, I did make a few edits based on your comment that hopefully clarify the point while retaining accuracy and easing people’s mind that this should not be a concern.

  27. Barnesm

    Thank you for putting all this together in the one spot and please keep up the good work on such an important public health issue

  28. Kris Sargent, MD

    Thanks for putting all these together. This is a great compilation. Unfortunately, there is a TON of misinformation out there about this and all other vaccines. Much of this seems to stem from mistrust of the government and/or corporations, and that’s pretty unlikely to change. Thanks for putting Reality in one place.

    The flu vaccine almost certainly can’t hurt you and has a reasonable chance of saving your life or that of someone you love. That’s about as complicated as it needs to be. I tell people all the time, “I don’t get the flu shot because I’m afraid of dying from the flu. I get it because I’m never going to be the guy who brought the flu to Grandma and killed her.” This goes for babies as well. I helped take care of several people who died from H1N1 in 2009. Of course, we had a healthy 28-year-old family friend die of flu last year, so maybe I should think about myself, too.

    Incidentally, the last sentence of Myth #13 makes it sound like the H1N1 vaccine killed people (I believe you mean the “infection”, not “vaccine” there). Anyhow, thank you for putting this all together and trying to save a few lives.

    • Tara Haelle

      Ouch! That was a pretty major typo! I’ve fixed it now, so thanks for pointing it out. And thank you also for your conscientiousness in protecting others. I’m pregnant and due in April. Although that’s past when flu season is usually a concern, I’m very aware that I rely on those around me in the community to be vaccinated to ensure that my child is at a lower risk of contracting diseases until he is old enough for his immunizations.

  29. C Cohen

    I too get sick after every flu vaccine. But not sick with the flu. I asked my doctor about this. She explained that I probably had an over-active immune response to the vaccine and while my immune system was on ‘high alert’ it then over reacted to some other virus I came in contact with thus making me ‘sick’. If my immune system hadn’t already been in such a high state from the response to the vaccine it is possible that the exposure to the cold virus would not have been noticed. Also, what is the definition of ‘sick’ that people are using? Maybe this is some cause for people saying they get sick after a vaccine -what I feel is sick may not be your definition of sick.

    • Tara Haelle

      Interesting point. I noted in the comments elsewhere that it’s not uncommon to feel crappy after the shot as the immune system ramps into action. (Hence many of the common side effects.) It does make sense that the ramped-up immune system might go into overdrive if you already had a bug or if one comes by around the same time you get the shot. I agree that the definition of “sick” that people are using likely varies greatly as well.

  30. Talking about how people’s definition of ‘sick’ varies widely, this is a good visual showing what the symptoms of influenza are vs the side effects of the influenza shot.

    https://www.facebook.com/photo.php?fbid=594246710645342&set=a.414675905269091.96547.414643305272351&type=1

  31. Talking about how people’s definition of ‘sick’ varies widely, this is a good visual showing what the symptoms of influenza are vs the side effects of the influenza shot.

    https://www.facebook.com/photo.php?fbid=594246710645342&set=a.414675905269091.96547.414643305272351&type=1

  32. [...] Setting the record straight: Debunking ALL the flu vaccine myths [...]

  33. Not a sheep

    Go ahead all of you sheeple, get your flu shot that is a best guess at the strain that the current year’s flu will be. You have all been brainwashed by big pharma and sounds like the author may be paid by one to write this article. Research who funded the studies and you will see it goes back to big pharma and of course the results will be in their favor. There are more deaths from car accidents then from the flu. When you get sick and fight off a virus or illness on your own you are building your immunity to fight off the virus even quicker the next time. But enjoy your shot and lining the pockets of big pharma.

    • PH Guy

      More deaths from car accidents than the flu? My gosh! We must be doing it right then! Thank you for validating public health’s campaigns to eradicate disease!

    • Tara Haelle

      Oh boy! If I have a shill check coming that no one told me about, I can’t wait to get it because I sure could use some cash. As it is, I’m just a mom and science reporter whose sole interest is in getting out accurate information, correcting misinformation and keeping myself and my family safe — even when it means I spend many unpaid hours on a Saturday to research and write posts like these. That’s why I got the flu shot this fall while pregnant, why my son got the FluMist, and why my husband got his shot.

    • novalox

      Uh, yeah, citations needed for your comments.

  34. Doug

    #16: I can tell you that several young doctors I know are being taught the opposite, and that deaths from the flu are extremely rare without other far more serious complications. Your 1st link is to a CDC website listing estimated deaths with 2 varieties of underlying complications. Your 2nd link is to story about 1 girl who died with severe underlying complications. Your 3rd link doesn’t work. Your 4th link is a CDC description explaining that severe underlying complications usually exist in fatal situations. All of the evidence goes against your claim that the flu kills without underlying complications. Several of your other “debunked myths” are just as deceptive or inaccurate.

    • Tara Haelle

      Deaths from the flu in healthy individuals is not common. That’s true. But it does happen. The second link goes to a story about Emily Lastinger, who had NO underlying conditions when she came down with the flu. She was a healthy 3-year-old with no other medical conditions. She died from complications that developed AS A RESULT of her influenza infection. (I have interviewed her family at length.) The third link has been updated. Here it is: http://pediatrics.aappublications.org/content/early/2013/10/23/peds.2013-1493

      Are there all kinds of healthy people dropping dead from the flu? No, and I do not claim this. But I do state, accurately, and with evidence, that healthy people can and do die from the flu, even if it is uncommon compared to the number of infections that occur each year. To claim that no one healthy with no underlying conditions ever dies from the flu is false and disingenuous. There are also plenty of similar stories at Families Fighting Flu (http://www.familiesfightingflu.org/).

      • Pszczolka

        While I generally agree with your points and I think that some people are fanatically anti-vaccine, I think that the flu vaccine should not be administered to healthy adults (over 18 and under 65) without underlying conditions, not because it’s harmful but because there’s very little point.

        As Doug wrote above, it’s VERY rare that a healthy adult with no underlying conditions will die of flu (probably as rare as a child getting a febrile seizure after the flu vaccine). As he pointed out, the CDC article you quote only looks at subjects with underlying conditions and in fact, even among those the conclusions are quite uninteresting, scientifically speaking, as most deaths occur from pneumonia and not flu.

        “Based on an average annual count of 74,363 for all pneumonia and influenza deaths, and an average annual estimate of 6,309 deaths associated with influenza in this category, 8.5% of all pneumonia and influenza deaths were influenza associated. Based on an annual average count of 1,132,319 for all respiratory and circulatory deaths and an average annual estimate of 23,607 deaths associated with influenza in this category, 2.1% of all respiratory and circulatory deaths were influenza associated.”

        So while I agree that vulnerable populations (children, seniors, people with compromised immune systems) and those who work with them (doctors, care staff, etc.) should get the vaccine, it is in fact a ‘myth’ to state that a large amount of healthy people die from the flu.

        • Tara Haelle

          One major advantage for healthy adults to get the flu shot is to be a part of increasing herd immunity and to decrease the risk of passing it along to one of those vulnerable individuals. If you have the flu, you’re infectious — including in the days before you have clinical symptoms and before you know you have it. Any interaction with the elderly, children, immuno-compromised individuals, etc. (even if it’s just shopping in the grocery store or stopping by the bank) exposes them to the virus.

          In addition, avoiding death is not the only reason to get the flu shot. It’s also to avoid other infections, missed days from work and other concerns with becoming ill. In addition, if a strain from an antigenic shift (described in Myth #23) led to a pandemic like the Spanish flu strain, then healthy adults actually can be susceptible to death, as that pandemic demonstrated.

          • Offthepink

            Tara Haelle
            October 31 2013

            In addition, avoiding death is not the only reason to get the flu shot. It’s also to avoid other infections,

            What “other infections”? It’s supposed to JUST protect from the flu. Story’s falling apart the more pressure you get…

          • Tara Haelle

            Um, not quite. If you read my full sentence in context, you can see that I am saying that getting the flu shot – and hence avoiding the flu – prevents the OTHER things that happen when you get the flu (such as missing work, secondary infections, etc.). That is, if you get the flu, you are more susceptible to additional infections, including pneumonia. If you don’t get the flu, you are not at risk for developing those complications.

  35. towi

    I actually do not have a fixed opinion about whether or not people should get a flu shot or not, because it is a difficult subject.

    But what I am really amazed of is how black-and-white you describing things. “No it’s not.” sounds pretty sure — but really: “it’s not” that simple.

    A) the absence of evidence is not proof (which applies to some of your statements), and even if, then B) with all the current discussions about pharma companies only publishing studies that actually support their product should make us more then skeptical about any “this study shows…” and “there is not study that shows…”

    The latter is the difficult question, and therefore I find your de-mysthification here great, but I can only see it as one more opinion in the pool.

    • Tara Haelle

      My intention is not to tell anyone they should get a flu shot. I make it very clear at the top that I am not a doctor and I am not dispensing medical advice. My concern is to correct the massive amounts of misinformation out there by making it clear where the evidence points at the present. The reason I have provided references and links for every single assertion is to provide others the opportunity to see the exact same resources I am using. This post compiles what we know at present, to the best of our knowledge. Science is a process and may uncover new data in the future. Your concern about “absolutes” is simply a commentary on my style of writing and tone, which does not reflect my content and is not my concern.

  36. Richard Holmes

    ” For reference, a pear contains about 39 to 60 mg/kg of formaldehyde (100 ug = 0.1 mg, so pears contains approximately 39,000 to 60,000 ug/kg) A typical pear weighs about 220g, or 0.22 kg. That means a single pear contains approximately 39-60 ug.” Error here. A 0.22 kg pear would contain 0.22 times (39 to 60 mg/kg) or 8.6 to 13.2 mg (8600 to 13200 µg).

  37. Christopher

    Thank you for this wonderful article. I do have one quibble though. It is not helpful to pooh-pooh people who feel like crap after the shot. Yes, they could have already been infected, yes they could be pyschosomatic, but it’s also very possible, as you eventually noted, that the process of becoming immunized makes people feel like crap. I know what it’s like because it happens to me every year. Saying “you’re not sick” or “the shot didn’t do that” makes people dismiss the other arguments too.

    From the perspective of the patient, being technically “sick” (ie infected) and merely having sick-like symptoms is an irrelevant distinction. Be upfront about it. Don’t just say “It won’t make you sick, and if you do get sick it wasn’t from the shot” (a completely accurate statement) say “the shot won’t make you sick, although you may feel cold-like symptoms as your body responds to the vaccine.”

    • Tara Haelle

      I added a paragraph that better addresses this. Yes, it does suck to feel icky, whether it’s officially caused by a bug or not. But the intention is to clarify primarily that the vaccine itself does not give you the flu.

  38. Liz

    Tara, is it also true that each year’s shot that you get protects you from that strain of the flu for quite a long time, maybe even life? Therefore in a year in which the vaccine does not match up well because of the virus mutating, someone who has had many years of shots, may still be protected if past strains are similar to the current virus’ strain.

  39. Sam

    Tara,
    As someone who has worked in the medical field for almost 10 years, studied and research evolution and have published papers on it, I find your claim #23 very irresponsible.
    There is no such claim in the book you reference, yet you make your own conclusions.
    In fact, there is quite a bit of literature that counters your claim.
    Not only you are spreading misinformation, you are actually lying by referencing books that have no mention of your own conclusion. You are not qualified to make such conclusion, but at least you should know that a journalist should not reference a book and putting your own conclusion on it!!!!

    • Tara Haelle

      The book explains how viruses have worked throughout history in general. I am aware that some researchers have been looking into vaccine-induced viral evolution. I’m also aware that much of the research is theoretical and inconclusive and that this is a controversial area of research. If you are aware of studies that contradict this myth, I would like to see them. I have oversimplified the answer for the reason that writing for laymen does not always allow for nuance. Based on what we know presently, manufacturing flu shots does not cause all sorts of mutations of new strains in a greater amount than what already occurs naturally. I may update this particular explanation with more detail.

      • sam

        Hi Tara,
        I am sorry, there is very little in the book you reference regarding your claim. I have no problem with you making this conclusion, obviously everyone is entitled to their own opinion, however, I find the way you have written it to be very troubling. There is no entire book written about this, since nowhere in the book there is a conclusion that flu shots don’t accelerate antigenic drift.
        On the other hand there are countless studies that have found it does make the drift faster, for example this is from the Virology Journal
        “Vaccination programs produce faster antigenic drifts of human and avian influenza viruses”
        http://www.virologyj.com/content/5/1/15

        I also recommend you read this MIT article, which talks about the same thing: web.mit.edu/newsoffice/2011/preventing-flu-vaccine-mutations-1220.html

    • @Sam, Can you explain why you think myth #23 explanation is misinformation and why you are making such a harsh claim that the author is lying. In his book, Oldstone seems to make a pretty good job of explaining flu virus reassortment (pg 319 et seq) so I’m curious to know what your objections are.

      • sam

        John,
        I am not sure if you are referring to the old text or new one. The old text was worded as if the book being referenced explains how vaccines have no impact on antigenic drift. The book doesn’t talk about that at all, but rather talks about the history of the virus and touches slightly on antigenic drift and three hypotheses one being re assortment. That’s my objection. Tara has since revised the text, but I still disagree with point #23 being a myth: the jury is still out, in fact there are quite few studies that show increased drift due to vaccinations, including one of the links referenced in the update here that hypothesizes “vaccinating too many people can have negative consequences”
        So it is more likely this is not a myth, and it is actually a fact. I would rather have that point removed, because it really takes away from the rest of the article which debunks many other outrageous myths.

  40. David Hall

    Tara, this is the best flu shot myth article I have ever read. And I have read a lot of them. I work as an occupational and preventive medicine physician. Every fall, I have frequent contacts with patients and other healthcare personnel who give me all kinds of reasons why they will not get the flu shot. While I respect their wishes not to be forced to have the vaccine, I often don’t respect their explanations because they have no basis in the scientific medical literature. Thanks for taking all the time to publish this very helpful essay.

  41. David Hall

    Tara, thank you so much for this timely and well researched article. It is the best flu vaccine myth buster that I have ever read (and I have read a lot of them). I work as an occupational and preventive medicine physician. Every Fall, I have frequent contact with patients and healthcare workers that have a variety of reasons (usually excuses) about why they don’t want to get the flu vaccine. I respect people who don’t want to be forced to vaccinate against their will, but most people seem to refuse for reasons that are not supported by the medical literature. You have done a great job summarizing all the various flu vaccine “accusations” and explaining what the scientific medical literature evidence actually shows.

  42. Bobby

    As biochemist, I appreciated the article, but myth 22 is a bit overstated. Immunity from an actual infection is generally a bit stronger and a bit longer lasting than what you get from a vaccination. Due to how memory lymphocytes are formed and selected for reproduction, you end up with a larger/high binding specificity pool of memory lymphocytes if you have a full infection and all the chemical signals from that are present. This is why there is interest in adjuvants – they mimic the natural process where things other than antigens enhance the activity of immune response (e.g. cytokine production, dendritic antigen binding, etc.) Likewise, actual infections can result in longer antigen exposure so competitive lymphocyte clonal expansion results in greater antigen specificity.

    That being said, the upside of these effects comes AT THE RISK OF DYING. If you run the numbers right, young adults might be further ahead to catch the flu and get prolonged exposure to antigens, chemokines, and the works – ultimately resulting ultimately in more memory lympocytes with higher binding affinity in their antibodies. The downside is that even with optimal returns (which is less than obvious with influenza) they become statistically more likely carriers who expose people at greater risk (the young, the old, anyone with immune complications, etc.) to a higher risk of DEATH.

    • Tara Haelle

      It is true that when writing for laymen, nuance of scientific concepts can become oversimplified. I’m aware of the differences in immunity that can be conferred by different methods. However, as I noted, WHILE one is sick with the flu, their immune system is pretty weak, and the strengthening that occurs afterward may or may not help them in an encounter with other flu strains. All in all, the risk-benefit ratio here is pretty clear, as you noted. I have to balance how I present the science with who my audience is.

  43. denise

    You can say that many of the illnesses experienced after receiving a flu vacc were bugs already in incubation. But you cannot say that no flu vaccine ever gave anyone the flu or never will. Myself and half of my coworkers who received a flu vaccine on the same day were sick that afternoon. Now, I grant you that this was an unusual happening and the general public never received that vaccine because of the reaction of the military given the shot. The swine flu vacc in the late 70′s.

    • Doug

      The flu vaccine will elevate your interferon levels. Interferon is used by your body to initiate an immune response. This makes you feel terrible and does damage to your body. (yes your immune system works by causing lots of collateral damage) So while you aren’t infected you have the symptoms and damage similar to being infected. The flu vaccine is nearly guaranteed to cause harm and only has a 50-60% effectiveness rate. Combine this with a 5-20% chance of getting the flu and it will reduce your chance of getting the flu by about 11% in the best case scenario, and 2.5% in the worst. You have to determine whether the tradeoffs are worth it. For me they are clearly not.

    • Tara Haelle

      If you and half your coworkers received a flu vaccine in the morning and were sick that afternoon, you have actually provided perfect evidence that the flu vaccine did NOT cause the illness. You were all working together — which means you likely all became ill with the same pathogen that was already in your system. The flu, the cold and other viruses (and most bacteria) do not work so quickly that your body shows clinical symptoms half a day later. With viruses in particular, they incubate in your body for several days. So, in fact, the flu shot did not cause you and your coworkers to become sick. You all had that bug before you got the shot. It was a coincidence.

      Alternatively, some of you may have been experiencing side effects, as I described, but you did not “become sick” from the flu shot.

  44. Mary

    Regarding so-called myth #3 – The linked study about the flu shot being “safe” for pregnant women only addresses specific adverse events in the forty-two days following the shot. It does not address potential harm to the baby (or “fetus” if you prefer). The link about how it won’t have any developmental effect on the baby only addresses ASD. The package inserts specifically state that safety and effectiveness have not been established for pregnant women. You can’t make the bold claim that it is definitely safe, based on studies that are *very* limited as far as the effects that were examined, when the package insert itself says that it is unknown. You are way overstating the claims of your very own links. The best you can say is that we don’t know what the risks for pregnant women or their babies are. When you make sweeping statements and use very limited studies to back them up, you appear untrustworthy.

    • Tara Haelle

      Flu vaccines have been extensively studied in pregnant women, and if you look at Myth #3B, you will see several links that address a lower risk of miscarriages, stillbirth, preterm birth, small-for-gestational-age and other complications in women who get the flu vaccine compared to those who don’t. Vaccine package inserts are written by lawyers, not by researchers, immunologists or doctor. Not only are flu vaccines safe for pregnant women AND their fetuses, but they are highly recommended because the risks associated with the flu while pregnant are substantial — including potential loss of the baby.

  45. I think your article raises a lot of interesting points and is well done. However, I am always nervous when anyone writes in terms of absolutes. The reality is that people can and do react differently to an array of medications and vaccines and to imply otherwise is not only dismissive but potentially dangerous.
    We vaccinate. We always have – except now for flu. My daughter received a combo vaccine (including H1N1) and within days was diagnosed with Henoch-Schonlein Purpura. We saw specialists at Children’s Hospital and St. Christopher’s for her kidneys, joints and blood for months. It was a very scary time; I watched my kindergartener pee blood, vomit every day and have joints so swollen that she could not walk. Over a period of more than a year, we met with some of the best kidney doctors and pediatricians in the country about her condition. It turns out that there are a number of cases where patients have presented with vascular symptoms after certain vaccinations. Most of the research is outside of the US on this issue – and one of my good friends who works in drug testing found inserts for the vaccines in Canada and other countries which explicitly includes vasculitis and vascular disorders as potential side effects of the H1N1 flu vaccine in particular. I also know that it has been reported to the CDC in the US – we did it (and they did follow up) at the encouragement of several doctors.
    I write this not to counter your article – which again, I think was nicely done – but to suggest that there still is a great deal that we don’t know about certain vaccines, especially more recent ones like the H1N1 vaccine. And while I don’t believe that parents should live in fear of vaccines (my old doctor who was crippled by polio as a child can attest to the value of vaccines), I do think a healthy dialogue about potential issues rather than dismissal is important.

  46. Tyburn Cross

    The problem with conspiracy theorists is that they feel ‘enlightened’ by whatever theory they have discovered and are convinced that anyone who raises any points against them are a part of whatever conspiracy it is they subscribe to. The feeling of ‘knowing something *you* don’t’ is too powerful for some people, so they just disregard any evidence to the contrary.

    Though that’s just my theory…

  47. Julia

    Explain how the results of other studies and reviews on flu vaccine effectiveness in specific population groups are even more dismal:

    A study published in the Archives of Pediatric and Adolescent Medicine found no evidence of the flu vaccine’s effectiveness in preventing flu-related hospital or outpatient visits in children younger than 5 years of age during the 2003-2004 and 2004-2005 flu seasons. (http://www.ncbi.nlm.nih.gov/pubmed?orig_db=PubMed&cmd=Search&term=%22Archives+of+pediatrics+%26+adolescent+medicine%22Jour+AND+2008%2F10pdat+AND+Szilagyiauthor)

    Another Cochrane Database Review of 51 studies involving 263,987 children on influenza vaccine effectiveness and efficacy found that in “children under two, the efficacy of inactivated vaccine was similar to placebo.” (http://www.ncbi.nlm.nih.gov/pubmed/16437500)

    A study published in the American Journal of Respiratory and Critical Care Medicine found no decrease in death from the flu or pneumonia in vaccinated elderly patients. (http://www.ncbi.nlm.nih.gov/pubmed?orig_db=PubMed&cmd=Search&term=American+journal+of+respiratory+and+critical+care+medicineJour+AND+527page+AND+2008pdat)

    A study published in the Lancet found no evidence that the flu vaccine impacted risk of pneumonia in the elderly. (http://www.ncbi.nlm.nih.gov/pubmed?orig_db=PubMed&cmd=Search&term=%22Lancet%22Jour+AND+398page+AND+2008pdat)

    Another study published in the Lancet found no decrease in mortality among influenza vaccinated elderly people. The researchers concluded “that frailty selection bias and use of non-specific endpoints such as all-cause mortality have led cohort studies to greatly exaggerate vaccine benefits.” (http://www.ncbi.nlm.nih.gov/pubmed?orig_db=PubMed&cmd=Search&term=%22The+Lancet+infectious+diseases%22Jour+AND+658page+AND+2007pdat)

    And yet another Cochrane Database Review on the effectiveness of flu vaccination of healthcare workers in preventing influenza among elderly patients in long term care facilities concluded that “there is no evidence that vaccinating HCWs prevents influenza in elderly residents in LTCFs.” (http://www.ncbi.nlm.nih.gov/pubmed/20166073)

    It is also worthwhile to note that in 2004 a supply shortage caused a 40% drop in influenza vaccination rates, and yet there was no rise in mortality.
    In similar fashion, 1968 and 1997 also saw no change in mortality rates even though the circulating influenza viruses had changed by winter and did not match the antigen strains in the vaccines.

    And even though influenza vaccination rates among senior citizens has risen from 15% in 1989 to 65% today, death rates from influenza among that population group have not decreased. (http://www.theatlantic.com/magazine/archive/2009/11/does-the-vaccine-matter/307723/?single_page=true#)

    These damning reports can be pretty confusing in light of the 60% effectiveness rate for all ages combined that the CDC claims. (http://www.cdc.gov/flu/about/qa/vaccineeffect.htm)

  48. Dayna Kay

    I have a question! I am a school teacher who used to get the flu shot every year. I rarely had symptoms (other than an insanely sore arm for the rest if the day!)

    I no longer get the flu shot, mostly because it just hurt, and I haven’t had anything worse than strep throat in years. Even that was over 4 years ago. The only other illness I get is allergies.

    Now, this year I went for a weekend outing with a very close friend of mine. I ate after her, and slept next to her in the same bed. That night she began displaying flu symptoms. Later in the week she was admitted for dehydration and doctors determined that it was the H1N1 flu strand, a strand I have not been vaccinated for. Despite doing all the things that would make others sick, I did not even get a headache.

    So my question is this: is it possible for adults to have built up immunities to the virus? And would it be worth it to check titers instead of submitting to the flu shot haphazardly?

    • Tara Haelle

      You can be around exposure to a virus and not become ill from it. There are any number of reasons this can happen. One does relate to immunity — perhaps she had a strain you had an immunity to? Or, it was close enough to one you had an immunity to (since the flu virus evolves a great deal). One of the most contagious diseases in the world is measles: if 100 unvaccinated people are in a room with a person with measles, 90 of them will catch the measles. But the other 10 won’t. Flu is nowhere near as contagious as measles. Measles has an R of 12-18 where as influenza has an R of 2-3. R is the basic reproduction number – the average number of cases one ill case generates over the course of a person’s infectious period in an uninfected, unimmunized population. (http://en.wikipedia.org/wiki/Basic_reproduction_number). So only 2-3 people that your friend comes into contact with during her entire infectious period would have been likely to get the flu.

    • PH Guy

      Dayna Kay, interesting question. For Influenza Type “A”, there are 16 H’s and 9 N’s for subtypes (this is how we get “H1N1″ or “H7N9″, etc.). This means there are 144 subtypes just to Influenza A. I don’t know how many there are to Influenza Types B and C, as they are generally less potent and prolific. In addition to the Types and Subtypes, there are innumerable strains, so H1N1 from 2009 may not be the same as H1N1 next time it comes back around, and it isn’t the same as the previous big H1N1 outbreaks.
      It’s like saying you took English Lit in college. What year, what semester, which professor, which session did you take it? Not all English Lit classes are the same.
      You “MAY” get carryover immunity but it isn’t likely you will have been exposed to enough different types of flu viruses and either just plain survive, or even have immunity to a broad base of Influenzas. Just having a flu immunity doesn’t make you immune to further outbreaks, and you can still be a asymptomatic vector (carrier with no noticable symptoms) to pass on an infection to someone whom it would be harmful or deadly. Titers are not practical due to needing to check for literally hundreds of different subtypes and strains of Influenza. Plus, immunity has variable memory, so for instance Noroviruses immunity is only about a year, so vaccines are virtually ineffective. Most vaccines give several years to decades of immunity memory.
      In regards to taking your chances, that would be your choice, but it’s like not brushing your teeth because you’ve never had a cavity before, or not wearing a seatbelt because you’ve never been in a collision before. If you are in a significat collision, the seatbelt may hurt you as you jolt around, but most likely you will survive with much less trauma, or even walk away from the wreck. You may also still die, as the seatbelt can’t protect against everything, but you are statistically WAY more likely to survive with only minor injuries. (Citations: National Safety Council at http://www.nsc.org/safety_road/DriverSafety/Pages/SeatBelts.aspx and CDC at http://www.cdc.gov/motorvehiclesafety/seatbelts/facts.html)
      I’m sorry your arm was sore, but mine was too, and so were my family’s when I vaccinated them, but I’m giving them a significantly higher chance.

  49. Max

    I’ve got to say, I’m impressed. Not only by the amount of research that you did (which may not have been referenced APA-style, but is certainly there in the links as you noted in an early reply), but also by the time and care you’ve put into your replies. For some reason I doubt I will ever understand, some people lose their damn minds about vaccination which are tied for the greatest invention of the modern era to me (tied with air conditioning because I’m a shallow hedonist sometimes and have no shame in admitting it). I think it’s f’ing criminal that people who don’t have the least shred of the sort of journalistic integrity that you have demonstrated are actually listened to when they spout dangerous crap that can end up costing lives. Thanks for putting the data out there where lazy folks (like me) can find it without having to go digging too hard.

  50. I haven’t gotten a flu shot in about 10 years. And I’ve never gotten the flu. I don’t see the need to get a flu shot if I’m perfectly healthy and if I rarely ever get sick. Exercise and diet plus sufficient sleep have made all the difference in my health. I feel like I get sick less often these days so I don’t plan on getting a flu shot or any vaccine. The human immune system is quite resilient.

    • Kyle C

      The human immune system was equally resilient in 1918, look how that turned out.

      The fit and healthy can get sick, just like those with a predisposition to illness, they’re just more likely to shrug off simple diseases, but the flu is not a simple disease.

  51. Great article! Question: what do you say to anti-vax advocates that argue that there’s no such thing as herd immunity. This line of “reasoning” is absolutely maddening to me.

    • Tara Haelle

      To be honest, I don’t spend time arguing with anti-vax advocates who don’t believe in concepts such as herd immunity. That tells me they don’t believe in basic science and critical thinking and that they are “true believers” I’m unlikely to convince. I only engage in conversations with those who are sincerely seeking information or on the fence. Or, if I respond to an anti-vax advocate’s claim that herd immunity doesn’t exist, then I’m only doing it for the sake of lurkers and fence-sitters and then I link to several pages (as I did above) explaining what it is for those individuals who are listening to reason. I agree, though, that it’s maddening.

  52. Merelina

    Whenever I had a flu jab I got far more colds than usual. I have a friend who experiences the same problem.

  53. [...] science journalist, took a stab (pun intended) at researching and responding to what she terms the 25 major myths about the flu vaccine, and set them forth in Red Wine and Applesauce (Health and Science News for Moms).  She clearly [...]

  54. [...] ran across this blog, Setting the record straight: Debunking ALL the flu vaccine myths. It appears to be very well done and I thought it was worth sharing with [...]

  55. Angela

    I would like to get my family vaccinated yearly, but in the UK only at risk groups get offered vaccination. What can I do?

  56. [...] Debunking all flu vaccine myths. [...]

  57. [...] about them, finds they’re now worth $886k – Watch 15 Vintage MS-DOS Viruses in Action – Debunking flu vaccine myths – 6 Ridiculous Science Myths You Learned in Kindergarten – Are We Still Evolving? – The Tragic Tale [...]

  58. Chris

    Flu Vaccines Found To Increase Heart Attack Risk

    For example, a concerning study published in 2011 in the International Journal of Medicine revealed a fact rarely addressed by conventional health authorities, or the mostly uncritical mainstream media, namely: flu vaccines result in inflammatory cardiovascular changes indicative of increased risk for serious heart-related events such as heart attack.[ii]

    Titled, “Inflammation-related effects of adjuvant influenza A vaccination on platelet activation and cardiac autonomic function,” their study concluded:

    Together with an inflammatory reaction, influenza A vaccine induced platelet activation and sympathovagal imbalance towards adrenergic predominance. Significant correlations were found between CRP [C-reactive protein) levels and HRV [heart rate variability] parameters, suggesting a pathophysiological link between inflammation and cardiac autonomic regulation. The vaccine-related platelet activation and cardiac autonomic dysfunction may transiently increase the risk of cardiovascular events.

    The four main areas of concern mentioned above are:

    Platelet Activation: An indicator of increased risk for pathological clotting and/or obstruction of a blood vessel, e.g. heart attack, embolism or stroke.
    Sympathovagal imbalance towards adrenergic predominance: An indication of disturbed autonomic regulation within the heart.
    Elevation of C-Reactive Protein: An indicator of inflammation-mediated cardiovascular disease risk.
    Reduced Heart Rate Variability: An indicator of increased heart disease risk.

    Flu Vaccines Found To Adversely Affect Pregnant Women

    This study is not, however, the first to raise concern over states of pathological inflammation caused by flu vaccines, and vaccines in general.

    In 2011, the journal Vaccine published a study titled, “Inflammatory responses to trivalent influenza virus vaccine among pregnant women,” which found that flu vaccination causes measurable increases in inflammation in pregnant women which may increase the risk of preeclempsia and other adverse outcomes such as preterm birth.[iii] In this study both CRP and tumor necrosis factor (TNF)-α levels increased to concerning levels between one to two days after vaccination.

    • Tara Haelle

      The first study you’ve listed here includes a total of 28 patients. That is an extremely tiny population for a study — too small to get clinically and even statistically significant results. In addition, the patients all have type II diabetes. A population of 28 individuals with a metabolic disorder cannot be generalized outside of those 28 individuals. This is something a researcher or person with a basic background in epidemiology would tell you. It is well-established that vaccinations can cause an inflammatory response — the very common redness and soreness at the injection site is an inflammation. This study states that the “platelet activation and cardiac autonomic dysfunction *may transiently increase the risk of cardiovascular events*.”

      So, in a study of 28 patients, two biological markers for the potential of a cardiovascular event is theoretically possible. No cardiovascular events are documented, and markers do not mean something will happen. Therefore, additional studies would be necessary. Fortunately, there HAVE been additional studies — with many, many more people than 28, with a wide range of good health and underlying conditions. In fact, there has even been a meta-analysis of multiple studies. Those studies found that the flu vaccine REDUCED the risk of cardiovascular events, as I noted in the post above:

      559 participants: http://heart.bmj.com/content/early/2013/08/06/heartjnl-2013-304320.abstract

      A meta-analysis involving six clinical trials with 6,735 patients: http://jama.jamanetwork.com/article.aspx?articleID=1758749

      Regarding the second study you listed on pregnant women: again, this is a tiny study (maximum 46 individuals, depending on whether each group was exclusive of the others) showing an inflammatory response (a documented, known effect of vaccination) with no adverse clinical outcomes. In other words, fewer than 50 pregnant had the flu vaccine and experienced the expected inflammation and had nothing bad happen to them.

      What is this supposed to prove? They note that “pre-eclampsia and preterm birth have an inflammatory component,” so they hypothesize that one of these could be triggered by a different inflammatory response. This is a hypothesis; it needs to be tested. And so, fortunately, it has been. Many studies have looked at effects of the flu vaccine in pregnant women and found not only that it does not cause adverse effects but that it DECREASES pregnancy and birth complications, including preterm birth:

      117,347 participants; reduced risk of stillbirth: http://www.nejm.org/doi/full/10.1056/NEJMoa1207210

      55, 570 participants; *reduced* risk of underweight baby, stillbirth and preterm birth: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2011.300606?journalCode=ajph&

      340 participants; *reduced* risk of underweight baby: http://www.cmaj.ca/content/early/2012/02/21/cmaj.110754.abstract?sid=2df7b422-acb0-487f-b2b5-f92774b17935

      I’m pretty sure clinical outcome data (stuff that ACTUALLY happened) from a combined 173,257 pregnancies, in just three of many studies, outweighs the theoretical possibilities of a hypothesis generated from a study of 46 or fewer women.

      In commenting with other studies, please explain the clinical significance of the study rather than simply quoting them. Cherry-picking studies that sound scary and mean very little does not help readers make an informed decision about whether to get the flu vaccine.

      Note: The final sentence of this original comment has been deleted to remove a factually inaccurate statement.

  59. itoosly

    OK, can someone please explain something to me? There’s a lot of confusion over which kinds of flu the vaccine protects against. I understand that every year it’s reformulated and protects against only certain strains, etc. But what I don’t get is that some people call aches, fever, chills and upper respiratory problems “the flu”, while others think it’s aches, fever, chills and vomiting.
    Which one is it? Do different strains cause different symptoms? Some weirdos seem to think “the flu” is barfing and having a head cold at the same time, and I’ve never seen that happen to anyone.

    • Tara Haelle

      The flu manifests in different people in different ways. Most people get a fever; not everyone does. Many people experience vomiting; others do not. Most will have a headache; some don’t. Many will be down for at least a week, others for two weeks, and others may have a subclinical infection in which they do not experience symptoms. This is partly a result of different strains, but it is more a factor of each individual’s immune system and physiology. Just as a head cold or measles or food poisoning will affect different people in different ways.

      ETA: Vomiting can occur but is rare with the flu.

      • Lola Smith

        Influenza very rarely causes any intestinal illness. Vomiting is not at all common with influenza. Flu is a respiratory ailment. Symptoms are headache, body aches, cough, and fever. You left out the coughing part which is one of the worst symptoms of the flu, and the one that causes transmission of the virus. You also made it sound like vomiting is common, which it is not. It is the respiratory symptoms that most commonly cause hospitalizations and death. When people talk about “stomach flu” they actually are talking about norovirus or another gastrointestinal virus.

  60. itoosly

    I’m by no means anti-vaccine, and I am very much a skeptic when it comes to people freaking out about shots more than pandemics. But I do have to say that in the four years that I’ve gotten flu shots, I do get sick shortly thereafter. I don’t claim that this is the flu, but I do feel that the shot either a) lowers my immune system’s ability to fight other (common cold) infections, at least temporarily or b) causes a strong enough inflammatory reaction that it’s pretty unpleasant.
    I have a pretty crappy immune system, anyway, but because of that I’m very vigilant about vampire sneezing (into the crook of one’s elbow), hand-washing, and not sticking my fingers in my mouth or eyes. I don’t get sick often, and I do feel like I get sick more when I get the flu shot.
    I want an honest discussion of this as it sounds like some other people on here have experienced the same. I’m not “primed” to expect the shot to make me sick. I’m sure the symptoms I get are way better than dying of Spanish flu. I don’t think the shot is “giving me the flu”. But I do feel like it has some side effects that people should explore. I feel shittier after a flu shot than if I go without one, so it’s hard for me to force myself to get one every year.

    • Tara Haelle

      I have responded to this concern multiple times, and I will repeat here what I have written elsewhere: Many individuals on this comment thread appear to think I am dismissing their side effect symptoms because I’ve said the flu shot cannot make them sick. I’m not dismissing those symptoms. They are real. I make it clear in my post that possible side effects include fatigue, fever, headache, a cough, etc. Of course, a person can feel crappy after a flu shot and that most certainly CAN be caused by the flu shot. That does not, however, mean the person is “sick.” If I only get 3 hours of sleep for two days in a row, I will feel really crappy. I’ll be fatigued, I’ll probably have a headache, I’ll likely have some nausea, and I may develop a raspy voice with a slight cough. That doesn’t mean I’m sick. It means I’m sleep deprived. In clinical terms, “sick” means having a pathogen — a virus, fungus or bacteria — in your system that your immune system must fight off. THAT kind of sick — the clinical types of “sick” — cannot be caused by the flu shot.

      Is it possible that your immune system is weaker after getting the shot? Well, it’s working hard to build antibodies against the flu, so I would expect it is theoretically possible that resources could be diverted from the immune system that might be used to fight off a different infection you contracted just before or just after the shot that you would ordinarily fight off. I’m not an immunologist, and I do not have the expertise to discuss that possibility or its likelihood. However, the flu vaccine cannot GIVE a person an illness, which was the myth I was busting above.

  61. [...] ran across a blog, “Setting the record straight: Debunking ALL the flu vaccine myths“. Given that we are in the midst of the flu season, I thought it would be worth sharing this [...]

  62. Baerchen

    While I am very happy getting myself and my children vaccinated for anything available (they have all had the full works, including HPV) I am not happy with the setting of vaccinations.

    Here, anyway. OF COURSE people will get sick, if the vaccinations are done in a small Dr’s Office, cramped full of people. Some there for vaccinations and some because they are ill. If you get seriously sick after your vaccinations, don’t blame the wee thing, but look into the setting where you received it. A small, hot room full of sick people and no hand sanitiser in sight is a catastrophe. We have an immuno-compromised child in the extended family and I am VERY uncomfortable going and getting vaccinations and then bring God knows what back from the surgery.

  63. [...] flu vaccine myth debunked. Bam. Bam. BAM. A very linkable resource from Tara [...]

  64. Rebecca

    The only ones that really matter from a public health tradeoff perspective are #6 and #7. Unfortunately ABSOLUTE efficacy numbers are not good at all. I love it when journalists cannot read scientific literature well. http://minnesota.publicradio.org/

  65. Jessica B

    I think your Myth 13 on Guillain-Barré syndrome is misleading. You say the flu vaccine does not cause the syndrome. It can. It would be more correct to say the risks of Guillain-Barré syndrome after seasonal influenza vaccination are LOWER than those after influenza illness.

    This still favors being vaccinated! But we can’t say for certain that it won’t cause GBS. See this article in The Lancet: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(13)70104-X/abstract

    • Tara Haelle

      I actually linked to that study above and originally had a different parenthetical. I agree the current parenthetical is misleading and will tweak it.

  66. [...] to sniff at. Every freakin’ flu vaccine myth debunked. Great work by Tara [...]

  67. Alex

    Is ingesting formaldehyde the same as injecting it?
    There are a lot of tings I injest that I would think would be a very bad idea to inject…..
    Not a smart-arsed question- genuinely wondering

    • Tara Haelle

      It is a reasonable question. Yes, ingesting and injecting, in terms of a vaccine that goes into the muscle or fat, are essentially no different. Some people mistakenly believe that vaccines are “injected into the bloodstream.” Certainly the blood gets involved, but a vaccine injection is not injected right into the bloodstream in the sense that an IV is. (ie, the nurse isn’t seeking out a vein to prick).

      Here is some additional information from this source: http://www.chop.edu/export/download/pdfs/articles/vaccine-education-center/vaccine-ingredients.pdf
      “Some people wonder about the difference between aluminum injected in vaccines versus aluminum ingested in food. Typically, infants have between one and five nanograms (billionths of a gram) of aluminum in each milliliter of blood. Researchers have shown that after vaccines are injected, the quantity of aluminum detectable in an infant’s blood does not change and that about half of the aluminum from vaccines is eliminated from the body within one day. In fact, aluminum causes harm only when kidneys are not functioning properly or at all (so aluminum cannot be effectively eliminated) AND large quantities of
      aluminum, such as those in antacids, are administered.”

      • Alex

        Thanks for the quick reply:) Yes- I think that make sense…? Why don’t we just ingest the vaccine, if that’s the case though? ( + yep- I know polio is/was taken by mouth…but others?). It’s still counter intuitive to me that breaking the skin and introducing a substance, without all the “sentry stations”- tonsils, gut lining, etc, is the same as taking by mouth. Presumably it’s *because* you want the body to recognise a definite “intruder”( the virus )…but doesn’t that kinda say that it is more of a ‘confronting’ entry method for the body, just right there? By all means point me to papers.

        • Tara Haelle

          Another good question, but not one I am qualified to answer on my own since I’m not an immunologist, a vaccine developer or a virologist. However, I did some quick research and asked a few experts. We don’t use more oral vaccines because they need to survive the digestive tract, which is a pretty inhospitable place. The weakened (attenuated) or dead (deactivated) pathogen (bacteria or virus or bacterial protein) need to be able to survive the digestive system and all those juices in order to then stimulate the immune system. Rotavirus – the only oral vaccine I can think of offhand that is still given in the US – is a pretty hardy one, so it can make it.

          • Alex

            Yes- ok. That makes good sense- virus cells are biological structures, and digestion would disintegrate them into componenents( since that what digestion *is*!), whereas a chemical, like for example a vitamin, can be absorbed in several ways,including through skin or muscle. Goddit. (Or at least that *bit*).
            I am really impressed with your site, and your thinking – not because it’s my thinking, but because it’s really level headed, and linked back to the ‘best we have to date’ in terms of evidence . *Really* great to come across:) I am no longer a new mum, but I am a returning student, in a ‘science-y’ field, lol. I will be visiting;)

          • Tara Haelle

            Thanks very much! I try not to overstate (or understate) things, and I try to rely on the evidence. I do not pretend to be a doctor or a researcher myself, but I am trained in how to research, read, understand, translate and communicate the evidence, so that’s what I focus on!

      • Alex

        Ack- sorry! Only just realised your first answer went on, and contained links!

  68. [...] familiarize yourself with these common mistruths, and what the science actually says about them. This is the best resource I’ve seen on the subject recently. The post debunks many of the myths about vaccines, [...]

  69. [...] Every flu vaccine myth debunked – Tara Haelle smashes it out with this excellent resource. [...]

  70. Richard

    You might make all kinds of arguments for or against flu shots – however I have based my decision not to get one on logic. I’ve gotten the flu many times in my life and survived every time. I see no reason to get a flu shot to prevent a mild inconvenience. I don’t know what is in a flu shot, I don’t know know who made it, where it was made, and since there is plenty of uncertainty left for unhealthy effects of the flu shot I will skip it.

  71. [...] Setting the record straight: Debunking ALL the flu vaccine myths [...]

  72. Great post Tara. Brings out the wackos in a most entertaining manner.

  73. [...] Setting the record straight: Debunking ALL the flu vaccine myths « Red Wine & Apple Sauce It’s that time again — that time when dozens of spurious articles pop up all over the web touting all the dangers of the flu vaccine. Articles on unreliable, alarmist, misinformative sites like Natural News, Mercola, chiropractic blogs and other such sites rail against the “toxins” in the … [...]

  74. Jennifer

    CDC did a study about using “flu myths debunked” approaches to educating the public and found they had the opposite effect. People remembered the myth more than the facts. Never repeat bad information, even if you explain why it’s bad. Just say the facts–over and over and over. We obviously need help learning about this issue!

    • Tara Haelle

      I’m familiar with that study, and thank you for mentioning it. I labored over how to present these. I initially had only the myths. Then I added the parentheticals. Two other possibilities were to ask a question (“Does the flu shot cause Alzheimer’s?”) or to make a declarative negative statement (“The flu shot does not cause Alzheimer’s.”) I did not choose these methods because more in depth research showed that they are not any different, in a person’s brain/memory, than stating the myth. (It’s like saying, “Don’t imagine an apple.” Boom – you already did.) Also, because I’m familiar with that study and with the “sleeper effect,” the name for the social psychology phenomenon, I decided this route was the best one of the four because of the punchiness (It does X. No, it doesn’t. — it sticks better) and because of the details of both the sleeper effect and the study.

      First, the study was done on a page that was formatted differently: the CDC set up different assertions and then said “true” or “false” afterward. Some were true and others were false. So they essentially mixed up the info. It makes sense that people would not easily remember which ones were true and which were false. Here, all of them are false, so the consistency differentiates it. Also, the sleeper effect applies moreso to a person seeing information that is unreliable and then forgetting where they saw it — in a credible source or a non-credible one. As they dissociate the source, they become unable to recall which. I’m doing the opposite.

      Finally, considering that declaratives (as described above) are the same as stating the myth with parentheticals or having questions, the only option is to say “The flu myth is safe. The flu myth is effective.” And then going from there… That’s problematic for three reasons. One, it doesn’t allow me to address *specific* questions people have about the flu. Second, it makes it sound definitive and that would be misleading. “Safe” is a relative term, and no vaccine is 100% safe. They all have risks. Similarly, no vaccine – and especially not the flu vaccine – is 100% effective.

      All in all, I decided this was the best route to go even though it is still problematic. I did, however, give considerable thought to all these concerns and what we know about cognitive biases and social psychology phenomena :)

  75. [...] Myth #1: The flu vaccine gives you the flu or makes you sick. (No, it doesn’t.) [...]

  76. Jacob

    Dear Tara. I cannot argue with the points you made. I’m no doctor, just like yourself I’m a journalist too and what I can say is that – in defence of our profession – I find it totally unacceptable for you to credit yourself as “scientific journalist” in such pharmaceutical PR article, reduced to some statements that are “scientific facts”. Anything other than that it is a myth, a superstition. I think it is also disrespectful to all people whose exprience with vaccines is different than the industry wants them to be known for.

    • Tara Haelle

      Jacob, I honestly do not understand what you mean here. I am a science journalist. Just as one is a political journalist or a sports journalist or an educational policy journalist, I am a science journalist. Journalists use terms to describe their specialty or beat all the time. (You said “scientific journalist” here, which is not the same word, and I’m not sure what you mean by that.) This is also not a “PR article.” Last time I checked, a pharma PR piece does not include 120+ links, including ones to peer-reviewed research. I have no connections with any pharma companies. It is not disrespectful to report on the facts and communicate them. In fact, that is my job as a journalist. It would be irresponsible NOT to do that. So, you’re not exactly defending our profession. You’re disparaging it.

  77. [...] for you? Read all the flu vaccine myths – and get the facts – in these articles and blog posts: Setting the record straight: Debunking ALL the flu vaccine myths – Red Wine and Applesauce It’s Time for Flu Shots – Seattle Mama Doc Top 13 Flu Myths – [...]

  78. [...] That’s about right.  Science isn’t the be all end all, but just because you’re not good at it [...]

  79. [...] Link T stated: “chatslang.com says that two “at” symbols is how I roll my eyes on facebook. @@” [...]

  80. Nixon

    I’m just going to say that my friend got the flu twice in 5 months after the shot so obviously she wasn’t starting to get sick when she got it and I got the flu 2 months after receiving it 13 years ago. I’m just saying it doesn’t seem to be that effective but I have not gotten a flu shot since nor have I had the flu since. That is all

    • Tara Haelle

      As noted in the post, it is certainly possible to get the flu despite having received the flu shot. It is not 100% effective and can have a low effectiveness rate (40% ish) some years. It is possible that a person has a milder course of the flu than they otherwise would have if they had received the vaccine, but this is impossible to test for a single person within one season.

  81. [...] Tara Haelle ha compilato una lista di tutti i miti associati al vaccino contro l’influenza. Poi ha provveduto a confutarli uno per uno. [...]

  82. [...] a science writer did a terrific job of demystifying the rumors about flu shots, and you can read that article here, but for the sake of brevity, we saw some interesting, new information we wanted to highlight on [...]

  83. Sally Linda

    WOW! Excellent post. Thank you for taking the time to address all these specific myths. I wish the time would soon come where we wouldn’t have to do this anymore. It gets so frustrating, answering the same questions and debunking the same myths OVER AND OVER again. Thank you!

  84. Chris

    This is amazing, and you are wonderful for writing it. Passing it along, as a teacher dedicated to providing a healthy learning environment for my students.

  85. Laura

    It would probably help if people knew the proper definition of the “flu” in the first place. The “24 hour flu” where you get chills/fever/throw up a lot is not the flu. That’s most likely food poisoning.
    Influenza is more like the Worst Cold You’ve Ever Had and it just doesn’t wanna go away. I lost my voice for an entire week when I got the flu proper, it felt like my windpipe was lined with broken glass. Coughing hurt like hell but I couldn’t not cough. The flu is nothing to mess around with, so IF you can tolerate the shot, please get it.

  86. [...] Setting the record straight: Debunking ALL the flu vaccine myths … http://www.redwineandapplesauce.com/It's that time again — that time when dozens of spurious articles pop up all over the web touting all the dangers of the flu vaccine. Articles on unreliable, alarmist, misinformative sites like Natural News, Mercola, chiropractic … [...]

  87. Rob

    I’ve read all the “myths” and I’ve read all the “debunking” the myth articles.

    I am not remotely interested in taking a the flu shot. I’ve seen coworkers in their bed for a week or more after taking the flu shot – many times – in fact, too many times to count.

    I’m not interested.

  88. Scott Anderson

    Personally, as a doctor, I respect everyone’s freedom to avoid vaccination. That said, I’d have no problem with mandatory mask wearing for those choose that option.

    After all, in the hospital where I work, we see many immunocompromised patients who may die by your exposure to them (and countless do). In this same hospital all employees have the freedom to not get it. If you don’t, you have to wear a mask 24/7 in the hospital as someones life may be at stake.

    Food for thought to those who said we are the ones being selfish.

  89. The influenza immune response is well documented to cause a decrease in streptococcal immunity and are highly correlated with subsequent strep infections. As narcolepsy is strongly correlated with strep infection, this is probably the mechanism for the association with the vaccine. If you think whooping cough is bad- you should try narcolepsy. It destroys glucose metabolism, causes major depression and makes us want to commit suicide. Your blanket recommendation of the flu vaccine is as extreme as the deniers.
    As someone who worked for Chiron at the time, I remember the shortage and the fact that in order to get other pharmas to produce flu vaccine, the FDA guaranteed customers to other companies willing to produce it. I am not antivax in any way, but the flu shot mania is about Pharma Revenue, not health.
    My post on narcolepsy, flu and strep is here: http://zombieinstitute.blogspot.com/2013/02/h1n1-flu-virus-may-cause-narcolepsy-via.html

    • Tara Haelle

      The only evidence of increased risk of narcolepsy followed H1N1 vaccination were in the vaccine administered in Europe, which I described factually above with multiple links to the studies finding the link, which does appear to be causal. None of that was disputed in my post. I have also nowhere in these nearly 4,000 words offered a “blanket recommendation of the flu vaccine.” I have set out to debunk myths about the vaccine and clarify misinformation, and I have clearly stated that any questions an individual has regarding their own decision to get or skip the flu vaccine should be discussed with a medical professional, which I am not. I do not make blanket recommendations, or even personalized recommendations, for any vaccine.

  90. [...] Debunking All The Flu Vaccine Myths [...]

  91. Monique Le Duc

    Tara, You are to be commended for taking the time and effort to address this very important issue in such a comprehensive and well-researched manner. As an occupational health policy analyst with the Government of Canada (now retired), I encouraged the annual flu vaccination given on-site to employees. In a former life, as a Public Health Nurse, I was a strong proponent of vaccinations having immunized hundreds of babies against other infectious diseases. There was no hesitation in having my own three children immunized; my oldest son was likely one of the last children to receive the small-pox vaccine in North America given that vaccinations had achieved eradication of the disease on this continent. Now 75 years old in good health, I still receive my annual flu shot and encourage others to do the same.

  92. [...] robust collection of links to answers to questions, and evidence , regarding the flu vaccine. Share [...]

  93. I think that before anyone says that the flu vaccine is safe really needs to research Immune Thrombocytopenic Purpura and The Flu Vaccine prior to stating such so lightly. It is becoming more and more common to get this after receiving the vaccine every year. Research it. It is all over the web. You will see page after page of cases all around the world. Some countries have even banned the vaccine because of this. I already have ITP. As for me, I do not believe receiving the vaccine would be anywhere near safe. And as far as I am concerned ANYTHING that causes me to feel”crappy” isn’t safe. Your body is either rejecting it or having to put up a fight to recover from whatever you just put in it. Science can not argue with case after case of people getting severely sick or dieing immediately after the shot was administered. Getting the Flu shot is like playing a game of roulette. Good luck. I’d rather wear a face mask.

    • Tara Haelle

      I approved this comment not because the information is accurate — it is not entirely accurate — but to take the opportunity to show that the risk of ITP is actually a reason that individuals SHOULD get the flu vaccine. If a person is already at risk for ITP (known or not), their risk of developing it is far greater with an influenza infection than with the influenza vaccine. This case study, which describes a child who developed ITP following the vaccine, mentions exactly that: http://www.ncbi.nlm.nih.gov/pubmed/20539239 The authors concluded, “As the risk of thrombocytopenia after natural influenza seems to be much higher than after immunization, annual influenza vaccination is advised for patients with personal history of ITP who at risk of influenza-related complications owing to underlying medical problems.” This doesn’t mean there is absolutely no risk of ITP with influenza vaccination — I’ll get to that in a minute — but the risk-benefit calculus is similar in concept to that of Guillain Barre Syndrome: the risk of the condition is greater with infection than with vaccination and so the benefit of vaccination outweighs the risk of vaccination.

      Regarding what the risk of ITP is with the flu vaccine: Although this case report would indicate that the child could have develop ITP as a result of the flu vaccine (it is not possible to determine causality with certainty, but it is certainly likely that the vaccine caused the ITP in this case), a case report is insufficient for establishing risks for a population. For that, you have to look at studies involving large numbers of children. A study in Pediatrics in 2012 did exactly that and found no increased risk for ITP in 1.6 million children. That means that if there is any increased risk at all, the risk is LESS than 1 in 1.6 million. Here is that study: http://pediatrics.aappublications.org/content/129/2/248

  94. Sarah

    Having had the actual flu once, the difference between feeling sick after the shot and the actual flu is so insanely huge that words barely describe it. I’ll try: the flu lasted 8 days. My fever was around 104 the entire time. I was hallucinating that the grass was growing from our ceiling. I lost 9 pounds. I could not move except to vomit or “use the restroom” or nurse my then 9 month old, who thankfully didn’t get the flu. (Yeah, that was the year I was “too busy” to get the shot. I did actually have it while pregnant with him, though. I’m never too busy anymore.). Feeling sick after the shot is a minor inconvenience that keeps me from feeling like I was knocking on death’s door.

    Tara, I love you. I wish my non vaccinating friends could read this without preconceived notions and biases. :/. I just pray they don’t get it and prove me right because I wouldn’t wish the real flu on anyone-

  95. Manny

    I am sorry, I just cannot take this blog seriously. The thing that bothers me is the words “SCIENTIFICALLY” and “IMPOSSIBLE” in the same sentence.

    Someone please correct me if I am wrong, but iscience doesn’t determine what is IMPOSSIBLE or what is not. We carry out experiments (as controlled as possible) to test out hypotesi. Eventually after getting the same out come we formulate THEORIES. And what is a THEORY?

    A THEORY IS “a supposition or a system of ideas intended to explain something” but a theory can be disproven by a single experiment which outcome contradicts the theory.

    Sorry for the science lesson, but it bothers me when people throw science around as it was the absolute law on any topic. Educate yourselves darlings.

    • Tara Haelle

      This is a good point. I’ve edited the post to change that phrase.

    • Max

      You’re making one major mistake of your own, Manny; you’re using the wrong definition of theory. When discussing a scientific theory, the word doesn’t mean a supposition. A scientific theory must be based on knowledge that has been repeatedly observed and tested. It’s not the same as a hypothesis. It’s confusing and I feel that the lack of clarity in what “theory” means in the given context is one of the underlying causes of the casual dismissal of scientific evidence that some people have.

    • Matej

      Yes Manny, gravity is also a theory and I don’t see you jumping from the 20th floor, do I? :) Thanks for education though :P

      • mynameis

        Actually, I think his definition of theory is pretty correct. If an experiment was carried out that proved that, in 100 cases out of 100, people who jumped out of windows fell up and there were no other forces supposed to be acting other than gravity, the theory of gravity would have to somehow be flawed.

  96. mike brummit

    ethanol is also used as anti-freeze. but neither ethanol, nor methanol are the anti-freeze most people think of in their automobile, as they are both flammable.

  97. Erich

    Counter to the only argument I care about: They don’t work.

    The CDC, with varying interpretations of it’s estimate (based on various confidence intervals) estimates that it is 60% effective. Further, it’s 60% effective across a population, meaning it’s some margin (likely significant) less effective for the lower and middle age brackets.

    Using the mortality statistic the CDC (and you) use : when you divide it out; roughly 1 in a million people die each year from the flu; this is with as much as 45% coverage with the vaccination.

    This is not to say it’s wholly ineffective; but preaching everyone should waste their time and money to help 0.000001% of the population* for a total cost of nearly a Billion dollars; is a bit much. It wouldn’t even be that high if we instead educated people to eat well, exercise, etc. Instead you advocate mass drugging of the population to hold back temporary, treatable disease.

    *Derived from the mortality statistic, it’s between 1E5 and 1E6. Billion comes from an estimated $25 cost across the population.

    • Tara Haelle

      Your statistic of 1 in a million people is inaccurate. That would imply that approximately 317 people in the US die from the flu each year. The actual mortality stats for the flu range from a couple thousand to the tens of thousands each year, which includes those who die of pneumonia developed as a complication of influenza. Most of these individuals are elderly, followed by children and immune-compromised individuals, but healthy individual die every year as well. A 29-year-old healthy mother of three recently died from one of this year’s strains: http://gma.yahoo.com/healthy-texas-mom-dies-flu-29-leaves-three-111358838–abc-news-health.html Another healthy man was among four deaths from the flu in California this week: http://www.mercedsunstar.com/2014/01/09/3432445/h1n1-flu-claims-lives-of-two-valley.html There are others being reported across the US right now.

      Meanwhile, eating well, exercising and maintaining other healthy habits are important to a healthy lifestyle and may contribute to a healthy immune system, but those habits cannot prevent a person from catching a virus. Flu is not temporary for those who die from it, and a flu shot is not “mass drugging.”

      • Lola Smith

        Do we know that those deaths occurred in unvaccinated people? The 5 year old in Oregon who died last month was fully vaccinated. Also a young man in Utah died after slipping into a coma 3 days after he was vaccinated this year. Doctors will not blame the vaccine but were unable to find any other cause for his death. He was a healthy young man getting ready to go on a mission trip.

  98. Meagan

    Um Tara, febrile seizures can and do last for more than up to 30 seconds. I know this after my son has had 8 simple seizures total and I have spoken with multiple doctors in this topic. Complex febrile seizures last longer than 15 minutes and/or occur more than once in a 24 hour period.

    • Tara Haelle

      I’m approving this comment from my phone and therefore cannot see what it’s in response to. I don’t recall every stating that febrile seizures only last 30 seconds, and I can’t search the post on my phone, so I’ll need to come back to look. In any case, you’re right that febrile seizures can last longer than 30 seconds (hence my confusion that I apparently said otherwise somewhere?), as noted on the NIH website: http://www.ninds.nih.gov/disorders/febrile_seizures/detail_febrile_seizures.htm
      If I said something different somewhere, that is a mistake and I’ll need to correct it when I’m back at my computer.

      ETA: Okay, so this was bothering me so much (I could not remember the 30-second comment) that I booted up my computer to search for where I had said that. I found it in the comments, and I updated that comment to reflect accurate information. I’m not sure why I had said that when the link in my post is the same one as above. I apologize for the error. Thanks for pointing it out!

  99. TJ BRo

    Thank you for the info. A very good read indeed.

  100. Lola Smith

    Actually the real evidence supporting the influenza vaccine as not being effective is that if it were, the rates of hospitalizations and deaths from influenza as well as rates of transmission would have gone down since the 1970′s when widespread use of the vaccine became popular. This is not the case. Other vaccines like MMR, Tdap,polio, etc clearly show that they are effective. Those illnesses rarely occur now and mostly in those who are unvaccinated. The influenza transmission rates, morbidity and mortality have remained relatively constant over the years. Yes, it varies from year to year. Some years the virus is more virulent than others, as has been the case throughout history. But overall the rates are completely unchanged. This is quite strong proof of the ineffectiveness of the vaccine. If it were effective, death rates, hospitalizations and overall transmission would decline.

    • Tara Haelle

      I have not looked up historical rates in terms of infections, but even if they have remained constant, that does not mean the vaccine is ineffective. For a specific disease’s incidence to see the kind of declines you are talking about, which have been seen with other diseases, you must have a high level of herd immunity with a highly effective vaccine. The take-up for flu immunization has always been low each season, and it’s already been established that its effectiveness ranges each year but rarely exceeds 70%. Nearly every other vaccine we have has effectiveness over 95%, some up to 98% or 99%. Without a vaccine at that level of effectiveness, which has not been achieved with the flu, and without very high levels of immunization that can maintain herd immunity, we will never see significant reductions in the flu.

      • Lola Smith

        There is no other medication or vaccine we would accept as being 60% effective (and that is in a good match year). Until we have an effective vaccine I won’t risk the possibility of a reaction. Look at Cochrane Collaborative for information about deaths and hospitalizations remaining unchanged with/without vaccination.

        • Alex

          Actually that’s about the rate for most anti-depressants- you know, the ones that get prescribed by every GP who’s been to a half day seminar( or even ones who haven’t). I’m talking Prozac, Zoloft, Paxil, etc etc. The “it” drugs. I am not anti meds- far from. I’m studying psych, with a biochem major- hoping to go into neuro psych, and very much hoping legislation will change so I am able to prescribe( areal possibility, in my country). This true fact though. Scary, but true.

          • Lola Smith

            I should amend my statement then, that I would definitely not accept any medication that has 60% or less efficacy, and I think many medications are over prescribed, including SSRI’s. I think if you look at people with true diagnosed depression the efficacy of SSRI’s would be higher, but you are right that they are given out like candy. I am a healthcare worker and I believe the influenza vaccine is touted too much by the CDC as being beneficial when there is no clear evidence of that at all. I think that the fact that they keep saying it is the best way to prevent influenza, is preventing other more effective vaccines from being developed and also creating false reassurance to people who have been vaccinated that they can’t get influenza and can’t die or be hospitalized if they received the vaccine. This false reassurance contributes to the spread of more influenza because vaccinated people with flu symptoms don’t stay home when sick because they think it can’t be the flu. The best prevention is NOT the vaccine, The best prevention is quarantining the sick person till fever free over 24 hours, proper handwashing, and having the affected person wear a mask to prevent droplet transmission. Masks do little to stop you from breathing in the droplets, but have been shown to be effective at keeping droplets from escaping if the sick person wears it. Until a better vaccine is made that truly lowers the hospitilization and death rates I won’t recommend them to anyone. I will give them the information that it won’t make them get the flu, has few life threatening risks, and might help if it is a good match that year. But I will be sure to say it really is only 60% effective when it is a good match, and it is rarely a good match.

  101. joanne stober

    Thanks for this, good to see something so well laid out and backed up with peer-reviewed evidence. I just wanted to note that perhaps I am in the paranoid category but I did try to get the single dose, non-thermosil, vaccination in Canada and you cannot request it and get it as you suggest. I was told by my own family doctor and numerous other doctors and pharmacists and Public Health (who administers the supply of vaccine) that a prescription cannot be filled, no dosing of vaccine to a member of the public will occur. The vaccine can only be administered at a pharmacy or doctor’s office. For children 5 and under it must be in a doctor’s office. Whatever the office was given (multiple or single dose) is what they can administer. In my case, I found single dose for adults at my local supermarket pharmacy but I was unable to find single dose for my son who is 4.

    • Tara Haelle

      That is interesting and disappointing. I was writing from the perspective of being in the US, so I am not aware of the policies in other countries, but thanks for letting me know about this. I suppose you could call around to different doctors’ offices to find one without the thimerosal, but I don’t know if you’re able to do that. I guess the good news is still that the thimerosal-containing vaccines do not cause harm (I got one a couple months ago while in my first trimester of pregnancy), but I also know at least two individuals with a thimerosal allergy, and they *cannot* get thimerosal-containing vaccines. I wonder if doctors’ offices in Canada would be able to accommodate them given what you’ve said here?

  102. Heather Neufeld

    Thank you for your peer reviewed evidence and clearly stated information. It’s refreshing and reassuring to see well stated facts with references. :)

  103. […] There is an awful lot of misinformation I have read online, but that deserves to be tackled in a blog entry of its […]

  104. David C

    Quick question. You stated above that the post-vaccine waiting period is required by federal law. I have gotten my flu vaccination at a well-known chain pharmacy for the last few years and they never make me wait. In fact, they jab you and pretty much tell you to leave. As someone aware of the possibility of an allergic reaction, I found this practice to be dodgy and possibly dangerous. Are they breaking the law by not making people wait after the vaccination?

    • Tara Haelle

      I looked into this and found that it is not, in fact, federal law to require a waiting period for allergic reactions. It is, however, wise, and most doctors’ offices, clinics, retail pharmacies, etc. should be doing it. I recently got my Tdap and my flu shot at two different local retail pharmacies. Both asked me to wait for 10 minutes to ensure there was no allergic reaction. However, none are required to do so. I amended my previous comment for accuracy.

  105. […] I could be wrong, but I’d venture to guess there is more nonsense and misinformation about the flu vaccine than any other vaccine out there. Perhaps it’s because it’s a once-a-year vaccine, so that cyclical nature brings out new myths each year. Or maybe it’s because it’s for an illness that many people have had, even more than once, and survived, so they mistakenly assume a vaccine is unnecessary. Whatever the reasons, I’ve decided a comprehensive post addressing every myth I’ve been able to find is long overdue. I plan to update this post as necessary, and I’ll likely republish it each year as a reference — via Red Wine & Apple Sauce […]

  106. […] are unsure if the vaccine is useful, have a look at this video at Khan Academy. And no, there is nothing normally toxic in the vaccine, though some people may not be able to take it for various health reasons. If you […]

  107. Karl Baba

    I’d like to hear you comment on the adjuvants in vaccines not mentioned in this piece like aluminum and peanut oil.

    • Tara Haelle

      Note: I have edited this comment to remove the second half, which included a link to a post an anti-vaccine/pseudoscience site which misinterpreted and cherry-picked peer-reviewed research to present inaccurate and intellectually dishonest conclusions regarding vaccines. I have left the first part because it is a question others may have as well.

      To address that question: no flu vaccines used in the U.S. use adjuvants, including aluminum. Aluminum salts are used as an adjuvant in other non-influenza vaccines, which is beyond the scope of this post and is addressed elsewhere. Peanut oil, on the other hand, is not used in any vaccines for children or adults. All vaccine ingredients are clearly listed on package inserts and on the CDC site, and no peanuts or other tree nuts are used in any way for the production of any of them.

  108. Peter S.

    The ten millionth post I have read on some scientific topic featuring evidence-based medicine on one side trotting out the usual tropes to defend the establishment (government/pharma), alarmists trotting out the usual conspiracy theories and one-off anecdotes to attack it, and never, ever, ever a consensus or clear direction for an open-minded person. I see this play out just over and over and over and over again on every single topic out there. It is so frustrating.

    • Tara Haelle

      I find it interesting that you consider presenting scientific information from peer-reviewed studies as “trotting out the usual tropes to defend the establishment” when you admit yourself it is evidence-based medicine, something we should all be striving to follow. And then you appear to imply that this “side” is equal to the “usual conspiracy theories and one-off anecdotes” that attack it… while lamenting no “consensus or clear direction for an open-minded person”? You’ve addressed your own complaint if you stopped for a moment to think about it, so I’m not sure what’s so frustrating. It’s pretty simple for an open-minded person who recognizes the value of relying on evidence: you ignore the conspiracies and anecdotes and you follow the science, as much as it’s able to tell us (which will always be incomplete and imperfect). You have set up a false equivalency here. There *is* a scientific consensus, and it therefore presents a clear direction. If you can recognize the two sides and not see the clear direction, then you are the one who is confusing and frustrating yourself. If you’re holding out for a time when scientists and conspiracy theorists arrive at a consensus together, you’re going to be waiting a while. Til the end of time, probably.

  109. […] Foam rolling is one of those things that doesn’t have a lot of scientific support behind it, but it certainly has a lot of anecdotal benefit and it just feels good.  Well at least after you’ve done it for awhile.  At first it hurts like hell.  Here are some of the most important spots to hit when you’re starting out.  http://www.builtlean.com/2013/11/06/foam-rolling-exercise-busy-professional/ Flu shots and vaccines have gotten very controversial in the past few years.  There is a lot of misinformation floating around out there.  Check this article out.  If you’re still interested in learning more, come listen to Dr. Ben Rowley speak at the gym on Saturday, December 7th at 10am.  He’ll discuss these issues in more depth and answer any questions you may have.  http://www.redwineandapplesauce.com/2013/10/28/setting-the-record-straight-dubunking-all-the-flu-vac… […]

  110. […] Debunking ALL the myths about the flu vaccine.  Great links here, too for sources for her research.  Studies and actual results. […]

  111. […] Setting the record straight: Debunking ALL the flu vaccine myths « Red Wine & Apple Sauce […]

  112. […] Setting the record straight: Debunking ALL the flu vaccine myths – Übersicht und Erklärung warum die 25 häufigsten Mythen über die (Grippe) Impfung falsch sind […]

  113. […] just saw this awesome article by Tara Haelle that debunks all the flu vaccine myths that fly around this time of year. Definitely go check it out, she covers 25 common myths and cites […]

  114. […] the usual BS about vaccines and autism, one specific claim that I’ve heard probably a couple dozen times in the last five years is […]

  115. […] foster the spread of diseases that were once all but eradicated—before celebrities regurgitating frequently debunked Internet garbage dovetailed with Obama-age anti-government paranoia—Schneider has now been dropped by the […]

  116. […] foster the spread of diseases that were once all but eradicated—before celebrities regurgitating frequently debunked Internet garbage dovetailed with Obama-age anti-government paranoia—Schneider has now been dropped by the […]

  117. […] Invisible Threat: A documentary about the science of vaccines Another open letter to anti-vaxxers Debunking the myths of the flu shot Antivax 101: Tactics and Tropes of the Antivaccine Movement  Growing Up Unvaccinated Could parents […]

  118. […] Tara Haelle, spent numerous hours putting together the Top 25 Myths about the flu vaccine, which she published here (and I rewrote and republished). Read it, because it blows most of the myths completely out of the […]

  119. Jay Bland

    I know some places, employers, school and organizations give the flu shot out for free, but if it is “needed” and/or safe, why isn’t it just free for everyone?

    • Tara Haelle

      It is in many countries, but not here. That has more to do with the American system of healthcare than anything else. There is a Vaccines for Children program here which ensures that anyone who cannot afford recommended vaccinations can still get them, and I believe (I’m not certain and would need to confirm) that the flu vaccine is included in that program. It would be wonderful if we lived in a country where the healthcare system made vaccines available to everyone free of charge.

  120. […] Haelle (@tarahaelle) is a freelance journalist probably best known for her excellent article that debunks flu myths. She’s written extensively on science and the need for accuracy in media imagery and […]

  121. j.c.taylor

    I became sick the afternoon with first chills, went to bed then fever even with Advil. Finally had to put cold (icy) cloth to forehead – temp 102. I was very sick and weak days after… I have taken the flu shot for 2 decades and never anything like this. Never again.

    jct

    • Tara Haelle

      I hope you feel better. Your illness had nothing to do with the flu shot. You either already had an illness that had not yet begun or you caught it in the doctor’s office. It’s called a coincidence.

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