Since the press release was originally issued on Thursday by now surely most of you have seen the news stories that popped up beginning yesterday morning with headlines like “CDC Warning: Flu Viruses Mutate and Evade Current Vaccine“, or “Flu vaccine protects against wrong strain, US health officials warn“, or “Flu shots may not be good match for 2014-15 virus, CDC says“, or “Health Officials Warn This Year’s Flu Vaccine Won’t Prevent New H3N2 Strain Of Influenza“. You get the idea. This year, apparently, the flu vaccine isn’t as effective as health officials and physicians would like. How could this have happened?
Those of you who are knowledgeable about the flu vaccine know that, as useful as it is, it’s not one of the greatest vaccines as far as effectiveness. Actually, that’s not true. Its effectiveness can and does vary considerably from year to year. The reason is simple. There are many strains of influenza, and the vaccine as currently formulated generally only covers a handful of strains. Basically, every year the World Health Organization, in collaboration with the CDC and other health organizations throughout the world, has to make an educated guess which strains of influenza will be circulating the following winter. Many months’ lead time is required because vaccine manufacturers require it to develop and test the new formulations and then to ramp up their manufacturing capabilities and distribute the vaccine. Generally, the WHO chooses the three strains it deems most likely to cause significant human suffering and death in the coming flu season. Specifically, the chosen strains are the H1N1, H3N2, and Type-B, although, starting with the 2012–2013 Northern Hemisphere influenza season, the WHO has also recommended a second B-strain for use in quadrivalent (four strain) vaccines. Basically, the WHO coordinates the contents of the vaccine each year to contain the most likely strains of the virus to attack the next year. Wikipedia has a helpful article that lists the formulations of all the flu vaccines recommended for the Northern and Southern Hemispheres dating back to 1998, to give you an idea what’s been recommended in the past. Also, there are exceptions. In the 2009-2010 season, for example, the H1N1 pandemic was occurring, and it was recommended that everyone be vaccinated against H1N1 in addition to the normal flu vaccine.
As you can imagine, predicting many months in advance which strains will be circulating in the following flu season is a dicey proposition under the best of circumstances. When the WHO gets it right, the flu vaccine is maximally effective. When it doesn’t, we have a situation in which the vaccine is not as effective as we would like. As this news story relates:
Much of the influenza virus circulating in the United States has mutated and this year’s vaccine doesn’t provide good protection against it, federal health officials are warning.
Flu season’s barely starting, but most cases are being caused by a strain called H3N2 this year, the Centers for Disease Control and Prevention said in a health warning issued to doctors Wednesday night.
The flu vaccine protects against three or four strains of flu — there’s always a mix of flu viruses going around — and H3N2 is one of them. But the strain of H3N2 infecting most people has mutated and only about half of cases match the vaccine, CDC said.
Basically, all the news stories to which I linked above report the issue in a similar way. One of the major strains in the vaccine is H3N2, a strain that normally circulates in pigs and can cause serious outbreaks. Unfortunately, based on its initial observations and data collection, the CDC has concluded that the H3N2 strain that’s causing most of the disease has undergone what is referred to as “genetic drift,” changes in the genetic makeup of the virus that make them different from the strain used many months ago to determine the recommended formulation. Personally, when I see stories like this, I like to go to the source. When the story is about a scientific study, that source is the original peer-reviewed scientific article. When it’s about something like this, the source is the CDC press release:
So far this year, seasonal influenza A H3N2 viruses have been most common. There often are more severe flu illnesses, hospitalizations, and deaths during seasons when these viruses predominate. For example, H3N2 viruses were predominant during the 2012-2013, 2007-2008, and 2003-2004 seasons, the three seasons with the highest mortality levels in the past decade. All were characterized as “moderately severe.”
Increasing the risk of a severe flu season is the finding that roughly half of the H3N2 viruses analyzed are drift variants: viruses with antigenic or genetic changes that make them different from that season’s vaccine virus. This means the vaccine’s ability to protect against those viruses may be reduced, although vaccinated people may have a milder illness if they do become infected. During the 2007-2008 flu season, the predominant H3N2 virus was a drift variant yet the vaccine had an overall efficacy of 37 percent and 42 percent against H3N2 viruses.
“It’s too early to say for sure that this will be a severe flu season, but Americans should be prepared,” said CDC director Tom Frieden, M.D., M.P.H. “We can save lives with a three-pronged effort to fight the flu: vaccination, prompt treatment for people at high risk of complications, and preventive health measures, such as staying home when you’re sick, to reduce flu spread.”
I can see what’s coming. In fact, I’m very surprised that, as I write this, it hasn’t come already. If there’s one vaccine that antivaccinationists love to hate, it’s the flu vaccine, because, compared to other vaccines, it’s the easiest target, given that it tends not to be as efficacious as many other vaccines. Heck, it’s the vaccine that Bill Maher likes to hate on (or at least show contempt for). Contrary to what antivaccinationists and cranks like Bill Maher would have you believe, the flu vaccine is not dangerous, and it does work. It might not work as well as some vaccines, and, until a universal flu vaccine is developed that targets antigens common to all strains of flu is developed, it never will be. But it’s still worth getting.
No, the flu vaccine is not worthless, but you know that hysterical antivaccine articles claiming that to be the case are coming.
- A/California/7/2009 (H1N1)pdm09-like virus
- A/Texas/50/2012 (H3N2)-like virus
- B/Massachusetts/2/2012-like virus.
- BBrisbane/60/2008-like virus (only included in some vaccines)
As this story on how this happened relates:
Since Oct. 1, 82% of the influenza virus samples subjected to laboratory testing have been H3N2 viruses, according to data from the CDC. And only 48% of these samples are closely related to the A/Texas/50/2012 strain that was picked for the flu vaccine distributed in North America.
Most of the rest of the H3N2 samples were similar to another strain called A/Switzerland/9715293. That strain was picked for the flu vaccine for the Southern Hemisphere, but not the one here.
Unfortunately, although the “drifted” (as in genetic drift) A/Switzerland/9715293-like strains were detected in late March 2014, which was after the World Health Organization (WHO) recommendations for the 2014-2015 Northern Hemisphere vaccine had been made in mid-February, their prevalence increased enormously by September, by which time it was far too late to revise this year’s flu vaccine formulation for the Northern hemisphere:
Health experts charged with monitoring flu viruses first detected strains of the A/Switzerland virus in the U.S. in March, Frieden said. By then, “it was already too late to include them in this season’s vaccine,” he said.
Besides, at that time, the A/Texas strains were still “by far the most common of the H3N2 viruses,” he said. The A/Switzerland strains didn’t appear in large numbers until September, he said.
Twice each year, the World Health Organization issues a recommendation for a flu vaccine — one for the Southern Hemisphere and one for the Northern Hemisphere. This approach gives health planners two opportunities to plan a vaccine.
Putting it all together, what this means is that the remaining 18% plus the remaining 48% of the H3N2 strains that are close matches to the vaccine H3N2 strain (0.48 x 0.82 = 0.39 or 39%), for a total of 57% constitute a good match for what’s out there. How did this happen this year? The same way it happens on any year when the flu vaccine isn’t as good a match as we would like to the strains circulating: Health officials made the best prediction they could at the time, but the virus changed in the six or seven months between when they had to commit to a formulation of the flu vaccine and the start of the flu season.
Another aspect of this is that it is likely that the H3N2 component of this year’s flu vaccine is still good enough to confer partial immunity to the A/Switzerland/9715293-like strains, so that, while it doesn’t protect against becoming sick by these strains it could make the illness less severe. This is important because the H3N2 strains tend to be associated with severe flu seasons.
Surprisingly, as I write this, the antivaccine crank blog Age of Autism has published only one brief mention of this news story in a link roundup and no characteristic screed about how this means that the flu vaccine is “worthless.” On the other hand, not surprisingly, everyone’s favorite quack, antivaccinationist (but I repeat myself), and all-purpose conspiracy theorist, Mike Adams, has weighted in under a rather restrained (for him) title, “CDC issues flu vaccine apology: this year’s vaccine doesn’t work!“, complete with a link to this video:
Contrary to what Gary Franchi of NextNewsNetwork claims, it should be emphasize that, no, the CDC did not just “apologize” and “admit” that the flu vaccine doesn’t work. It really didn’t. It just said that we can expect it to be less effective this year because it’s not as good a match as we would like. What’s with this concrete thinking among quacks? It’s the Nirvana fallacy in action: If a “Western” medical intervention isn’t 100% effective, to them it must obviously be pure, dangerous crap. Funny how they don’t apply that standard to the woo they normally like to pedal. On second thought, no it isn’t.
But back to Adams. Hilariously, after touting a “story” from a crank news source and criticizing the CDC for supposedly producing a defective vaccine and then using its ineffectiveness to sell help drug companies sell Tamiflu at a high cost, Adams pivots to promoting his own execrable science. Truly the man is without self-awareness:
Mercury tests conducted on vaccines at the Natural News Forensic Food Lab have revealed a shockingly high level of toxic mercury in an influenza vaccine (flu shot) made by GlaxoSmithKline (lot #9H2GX). Tests conducted via ICP-MS document mercury in the Flulaval vaccine at a shocking 51 parts per million, or over 25,000 times higher than the maximum contaminant level of inorganic mercury in drinking water set by the EPA.(1)
The tests were conducted via ICP-MS using a 4-point mercury calibration curve for accuracy. Even then, the extremely high level of mercury found in this flu shot was higher than anything we’ve ever tested, including tuna and ocean fish which are known for high mercury contamination.
In fact, the concentration of mercury found in this GSK flu shot was 100 times higher than the highest level of mercury we’ve ever tested in contaminated fish. And yet vaccines are injected directly into the body, making them many times more toxic than anything ingested orally. As my previous research into foods has already documented, mercury consumed orally is easily blocked by eating common foods like strawberries or peanut butter, both of which bind with and capture about 90% of dietary mercury.
This was, of course, one of the silliest things Adams ever did with his new toy (his mass spectrometer). If you don’t believe me, you should read why in detail here.
Adams then goes on to tick off a litany of antivaccine tropes, using a typical antivaccine technique known as “argument by package insert.” The central fallacy of such an argument is that package inserts are legal documents, not so much scientific documents, and are thus hyper-conservative in listing any reaction that’s ever been reported after a drug or vaccine, whether there is good scientific reason to believe that reaction is due to the vaccine or drug or not. He trots out the old claimed link with Guillain-Barre syndrome that is almost certainly not real. He even trots out the formaldehyde and toxin gambit!
It all builds up to a crescendo of Mike Adams’ spittle-flecked invective belied by the relatively tame (for him) title of his post:
Trusting a flu shot made by a corporation of felons is a lot like trusting the purity of heroin you buy from a street dealer. Both flu shots and street heroin have at least one thing in common, by the way: neither has ever been tested for safety.
We also know that flu shots contain neurotoxic chemicals and heavy metals in alarming concentrations. This is irrefutable scientific fact. We also know that there is no “safe” form of mercury just like there is no safe form of heroin — all forms of mercury are highly toxic when injected into the body (ethyl, methyl, organic, inorganic).
The only people who argue with this are those who are already mercury poisoned and thus incapable of rational thought. Mercury damages brain function, you see, which is exactly what causes some people to be tricked into thinking vaccines are safe and effective.
Technically, you’d have to be stupid to believe such a thing, as the vaccine insert directly tells you precisely the opposite.
At least Adams always entertains. No one can quite reach the level of ranting faux outrage with such hyperbole, with the possible exception of his mentor Alex Jones. But notice his not-so-subtle sucking up to his audience. Adams (and, by extension, those who believe him) are not “sheeple”! They’re not “brain-damaged” by mercury! Oh, no! Only they understand and avoid the evil pharma cabal. Everyone else is a mercury-damaged sheeple lining up placidly to receive more poison. (Look for some antivaccine activist to quote mine that last sentence.) Meanwhile, elsewhere, another antivaccine rant, “Flu Shot Fail: Vaccine Chiefs Forced to Admit it Won’t Work“, even tries to paint a blog post by a certain friend of this blog as “feverish attempts by pro-pharma internet gatekeepers to save the flu shot’s sinking reputation.”
It’s good to be recognized, isn’t it?
This year’s flu vaccine might well be suboptimal. Unfortunately, until there is a universal vaccine that targets the parts of the virus that don’t mutate so rapidly, the flu vaccine will always be suboptimal. Of course, companies and scientists are frantically working on just such a vaccine. If it weren’t so incredibly hard to do, they would have produced one already. In the meantime the flu vaccine, as imperfect as it is, is the best we have, and it is still very much worth receiving because the flu still can kill healthy individuals.