My mother would always joke that we could tell the difference between a cold and the flu by imagining a £20 note lying on the ground outside. If you had the energy to get up and grab it, then you didn’t have the flu. Now, however, we are inundated with news of a new “more dangerous” strain every few years and whilst the elderly and vulnerable have been offered flu vaccines for a number of years already, recent moves to vaccinate pregnant women and young children have underlined the new stance on flu as a dangerous illness.
But is there any truth in this?
The risks of influenza are mainly in the secondary infections that can develop such as pneumonia, particularly in the elderly. Studies have shown that elderly individuals who have been vaccinated against the flu are often healthier than those who weren’t, but a more recent study in the Lancet discovered that, actually, elderly people who are healthier are less likely to suffer secondary infections regardless of vaccine status. It is currently in question just how effective vaccines are at protecting against complications of influenza in the elderly.
In America, it is advised that children over 6 months are vaccinated against the flu. However the is little evidence to suggest that the vaccine is effective in children under the age of 2. Over the age of 2, the vaccine’s efficacy is demonstrated as being different from year to year though at best it is never more than 90% effective and more often somewhere between 70% and 90%. Each year the vaccination is altered based upon predictions of the main strains that are likely to be circulating. Often, they get it wrong and even when they don’t they don’t protect against every strain.
The risks posed by influenza to the general population appear to be exaggerated, with most believing that we are all at risk and vulnerable. Whilst certain individuals are more vulnerable than others, on the whole the mortality rate is much lower than we are led to believe. With scarily large numbers such as 36,000 reported to be dying annually from the flu in the US alone it’s unsurprising that people are afraid. But, in the US with a population of 313 million roughly 500 people die directly from the flu every year. The number of people who die from pneumonia as a secondary infection that is directly related to influenza is, however, almost impossible to know. Whilst 36000 deaths are estimated to occur as a result of influenza and associated pneumonia in the US each year, the model used to estimate is considered controversial as it does not use laboratory confirmed tests and states are not required to report each case. Even so, 90% of these deaths are reported to be in the elderly leaving 3500 deaths in the remaining population of 270 million. These deaths include all other ages and also include individuals with other, underlying, health conditions such as diabetes, cancer and heart disease. This makes for a mortality rate of 0.001%.
As for how likely we are to contract the flu in the first place. Most seasonal influenzas have an infection rate of just roughly 20%. The most aggressive influenza on record still rolls in at under 50%, meaning that even if you come into contact with a sick person and take no safety precautions your chances of contracting the illness yourself is far from a certainty.
The risks it would appear are actually quite low which, coupled with the unpredictable reliability of the vaccines calls into question just how necessary they are for the average individual. But, there is of course still a risk that many may feel uncomfortable taking and the safety net of a vaccine can provide great comfort despite the risk that it still may not provide protection.
Official sources suggest that vulnerable individuals are a priority for vaccination. These include:
• Anyone over 65
• Anyone with diabetes
• Anyone with Asthma/Bronchitis/COPD
• Anyone with chronic heart, kidney or liver disease
• Anyone with a weakened immune system as a result of conditions such as HIV/AIDS or treatment such as steroids and chemotherapy
• Pregnant women
Naturally, a great deal of controversy exists about the vaccination of pregnant women with flu vaccines reported as being of greater risk since the addition of H1N1 to the seasonal vaccination. Though real world results are difficult to find in unvaccinated individuals, the most reputable study to date suggests that the vaccine is safer than H1N1 itself. Each strain varies.
Ultimately, however, the available information (no matter which side of the vaccine debate you are on) suggests that the overwhelming majority are at very little risk. Regardless of pressure to vaccinate in order to potentially protect others, the decision is entirely personal and one that should be considered after weighing up all of the information on the understanding that nothing is risk free.
For those at low risk, and certainly anyone at increased risk who wishes to explore more natural options, there are many ways to boost the immune system in order to further reduce the risk of developing common colds and influenza.