Oh, geez. Mike Adams is at it again.
I know, I know, saying that Mike Adams has just laid down yet another hunk of napalm-grade–nay, hydrogen-bomb grade–burning stupid is akin to saying that the sun rises in the east and sets in the west, that water is wet, that we need oxygen to survive, or that the moon goes around the earth. It’s part of nature and a well-established fact. Even so, sometimes Adams surpasses even himself. Sometimes, when doing so, he even gives me an opportunity to discuss a scientific study and thus look as though I’m actually blogging about peer-reviewed research instead of having fun laying down some not-so-Respectful Insolence on a quack.
Actually, the beauty of the blogging niche I’ve created for myself is that, sometimes, I can do both in one post.
This time around, Mike Adams has gotten himself into a fine lather about a study published in The Lancet Infectious Diseases by investigators from the Center for Infectious Disease Research and Policy, the Department of International Health, and the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University; and the Epidemiology Research Center, Marshfield Clinic Research Foundation. Basically, it’s a systematic review and meta-analysis of influenza vaccines entitled, appropriately enough, Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. I’ll speak more about the study itself in a moment, but I can boil its conclusion down to three main findings:
- Pooled efficacy of influenza vaccination over several years at preventing the flu was approximately 59%; efficacy of the H1N1 vaccine was 69%.
- Flu vaccines are more effective in children (83%)
- Efficacy of the flu vaccine against seasonal influenza is highly variable and is low in some years.
Mike Adams, however, is shocked–shocked, I say!–that “60% efficacy” doesn’t mean that flu was prevented in 60% of all subjects in the trials used for the meta-analysis. I kid you not. Look at the title of his post: Shock vaccine study reveals influenza vaccines only prevent the flu in 1.5 out of 100 adults (not 60% as you’ve been told).
Congratulations, Mike. You actually appear to understand the difference between absolute and relative efficacy, at least when it is to your advantage to do so. Too bad that’s about all you understand. Basically, Adams builds a Tokyo-sized straw man and then makes like Godzilla with his radioactive breath to burn it down:
What we found is that the “60% effectiveness” claim is utterly absurd and highly misleading. For starters, most people think that “60% effectiveness” means that for every 100 people injected with the flu shot, 60 of them won’t get the flu!
Thus, the “60% effectiveness” claim implies that getting a flu shot has about a 6 in 10 chance of preventing you from getting the flu.
This is utterly false.
In reality — and this is spelled out right in Figure 2 of the study itself, which is entitled, “Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis” — only about 2.7 in 100 adults get the flu in the first place!
No scientist claims that “60% effectiveness” means that for every 100 people injected, the flu will be prevented in 60 of them. That’s what Mike Adams thinks scientists are saying. While Adams might have a tiny point in that a lot of people probably don’t fully understand the difference between relative and absolute risk reduction (I’ve pointed out myself the difference in discussions of how effective chemotherapy after surgery for cancer is at reducing the risk of cancer recurrence), in the name of “educating” his readers about this difference, he tries to convince you that scientists are intentionally deceiving the public by not pointing out that 60% risk reduction does not mean that 60% of the population who receive flu vaccines will have the flu prevented.
Before I have more fun dismantling Adams’ spin, let’s take a look at the study itself. It’s a pretty straightforward meta-analysis that used rigorous inclusion criteria for the studies it ended up pooling. Basically, only studies that confirmed diagnosed cases of influenza with positive viral cultures or positive RT-PCR for the influenza virus and that also ruled out influenza through negative viral cultures or RT-PCR for the virus were included. The authors also looked at two kinds of studies, observational studies (effectiveness studies) and randomized clinical trials from 1967 to 2011 looking at either trivalent inactivated vaccine (TIV) and live attenuated influenza vaccine (LAIV). Among the latter, they only looked at studies that included a control arm where the subjects received either only placebo or a different vaccine for something other than influenza. (So much for a frequent anti-vaccine claim that there are no “randomized placebo-controlled studies” of vaccines! There were a total of 73 RCTs identified, of which 17 met the inclusion criteria.) Included studies also had to look at vaccine efficacy against all circulating strains of the flu during the year of the study. In other words, this is a pretty solid meta-analysis, as far as the rigor of the inclusion criteria for studies to be pooled.
So let’s look at the dreaded “Figure 2”:
The studies and the relative risk ratios calculated from them are, as you can see, divided up into pediatric age groups and adults. You can also see that for children, all of the studies have relative risk values with error bars that do not overlap 1.0, while for the adults, the majority of the studies don’t overlap 1.0. When the studies are pooled, what the investigators found was that the pooled vaccine efficacy was 59%, with a median efficacy of 62%. Again, the efficacy of the H1N1 vaccine from a pooled analysis of five observational studies was 69%. All in all, this study indicates that flu vaccines are moderately effective. Personally, I consider the results not too shabby, given how often the predominant circulating flu strains change every year and how the CDC, WHO, and other health agencies in essence have to make an educated guess every year as to which flu strains to include in each year’s vaccine stock.
The authors conclude, quite reasonably and cautiously:
Seasonal influenza is an important public health and medical challenge. Pandemic influenza would cause a substantial burden of disease and seriously threaten the global economy. Based on a track record of substantial safety and moderate efficacy in many seasons, we believe the current influenza vaccines will continue to have a role in reduction of influenza morbidity until more effective interventions are available. However, evidence for consistent high-level protection is elusive for the present generation of vaccines, especially in individuals at risk of medical complications or those aged 65 years or older. The ongoing public health burden caused by seasonal influenza and the potential global effect of a severe pandemic suggests an urgent need for a new generation of more highly effective and cross-protective vaccines that can be manufactured rapidly….Active pursuit of this goal now will save lives every year and when the next influenza pandemic occurs. In the meantime, we should maintain public support for present vaccines that are the best intervention available for seasonal influenza.
In other words, our current generation of vaccines are far from perfect, but they do pretty well and, given how safe they are, currently represent the best defense we have against influenza. That’s why we should be trying to develop better vaccines and interventions; in the meantime, we should continue to use our current generation of flu vaccines.
Of course, reasonable is not what Adams is ever about, as you can see here:
Let’s start with the actual numbers from the study.
The “control group” of adults consisted of 13,095 non-vaccinated adults who were monitored to see if they caught influenza. Over 97% of them did not. Only 357 of them caught influenza, which means only 2.7% of these adults caught the flu in the first place.
The “treatment group” consisted of adults who were vaccinated with a trivalent inactivated influenza vaccine. Out of this group, according to the study, only 1.2% did not catch the flu.
The difference between these two groups is 1.5 people out of 100.
So even if you believe this study, and even if you believe all the pro-vaccine hype behind it, the truly “scientific” conclusion from this is rather astonishing:
Flu vaccines only prevent the flu in 1.5 out of every 100 adults injected with the vaccine!
Give that man a cookie! He can do simple arithmetic! Talk about thermonuclear burning stupid! Does Adams know that pretty much the same can be said of any preventative measure? The vast majority of people will not get the disease protected against by whatever modality, be it a vaccine, a drug, or–yes–a supplement or dietary intervention of the sort that Mike Adams promotes on his website. All preventative measures, be they vaccines, dietary or lifestyle interventions, or whatever, involve having a large number of people undergo them knowing that on an absolute basis few will actually benefit. That’s why risk-benefit ratios become so important. For the flu vaccine the risk is very, very low indeed, which is one reason why vaccination against this disease makes sense.
Another reason is the flip side of Adams’ “reasoning.” Adams uses absolute benefit numbers rather than relative risk reduction numbers in order to try to make the benefit of flu vaccination seem negligible. However, small absolute numbers, on a percentage basis, can easily represent large numbers of people when applied to populations. For example, there are estimated to be around 312 million people in the U.S. as of the 2010 census, of which approximately 235 million are adults aged 18 and over. If 2.7% of those adults get the flu every year, that’s roughly 6.3 million cases of flu every year. Preventing 60% of those cases translates to preventing 3.8 million cases of the flu every year. That’s nothing to sneeze at, if you’ll excuse my choice of phrasing. Of course, I know that nowhere near 100% of American adults are vaccinated against the flu every year, but even if only 50% were the number of cases prevented would still be huge.
Adams also claims:
The overall “60% effectiveness” being claimed from this study comes from adding additional data about vaccine efficacy for children, which returned higher numbers than adults (see below). There were other problems with the data for children, however, including one study that showed an increase in influenza rates in the second year after the flu shot.
Uh, no. The 2.7% risk of getting the flu in the control groups came from only adult studies, as did the estimate of 1.2% risk of getting the flu in vaccinated groups. The reduction in risk in adults in the pooled data was 59%. The data in children were analyzed separately. As for the other study, Adams is referring to this study. First off, a negative efficacy doesn’t necessarily mean that the vaccine increased the risk of flu. In fact, let’s look at what the study says:
The efficacy of the vaccine against culture-confirmed influenza was 66% (95% confidence interval [CI], 34%-82%) in 1999-2000 and −7% (95% CI, −247% to 67%) in 2000-2001; however, influenza attack rates differed between these 2 periods (in the placebo group, 15.9% and 3.3%, respectively).
-247$ to 67%? That’s a hell of a confidence interval! But what really matters is that it overlaps zero, which means that in that year, for whatever reason, in that population the flu vaccine didn’t reduce the risk of flu, not that it increased the risk. It’s also only one study.
After his scorched earth policy using burning stupid, Adams then tries to play the “risk-benefit balancing game.” The problem, of course, is that he inflates risk beyond anything science will support and, when he can’t come up with accepted risks shown by science, makes up risks. For example:
It’s very likely that upon injecting 100 adults with vaccines containing chemical adjuvants (inflammatory chemicals used to make flu vaccines “work” better), you might get 7.5 cases of long-term neurological side effects such as dementia or Alzheimer’s. This is an estimate, by the way, used here to illustrate the statistics involved.
So for every 100 adults you injected with this flu vaccine, you prevent the flu in 1.5 of them, but you cause a neurological disorder in 7.5 of them! This means you are 500% more likely to be harmed by the flu vaccine than helped by it. (A theoretical example only. This study did not contain statistics on the harm of vaccines.)
Notice that here Adams doesn’t present any studies from the peer-reviewed literature. In fact, he even points out that his example is “a theoretical example only.” I wonder why. The answer is obvious: There are no studies suggesting that flu vaccines cause a neurological order in 7.5% of people who receive them. In fact, there’s no good evidence that flu vaccines cause significant neurological complications at all, except for equivocal evidence that in roughly one in a million it might cause Guillan-Barre syndrome. He basically pulled that figure out of his nether regions. He then throws in the scientifically discredited claim that vaccines cause autism to make the flu vaccine seem even riskier. In other words, if he can’t find a real risk from a vaccine, he makes one up, while proclaiming the vaccine-autism link as “provably quite real and yet has been politically and financially swept under the rug by the criminal vaccine industry (which relies on scientific lies to stay in business).”
Adams then concludes with seven “problems” with this study, all of which are typical anti-vaccine tropes, including the complaint that the control groups got vaccines as well:
In many of the studies used in this meta analysis, the “control” groups were given so-called “insert” vaccines which may have contained chemical adjuvants and other additives but not attenuated viruses. Why does this matter? Because the adjuvants can cause immune system disorders, thereby making the control group more susceptible to influenza infections and distorting the data in favor of vaccines. The “control” group, in other words, wasn’t really a proper control group in many studies.
Actually, the control groups were indeed proper control groups. In fact, let’s for the sake of argument assume that Adams’ lies are true and that adjuvants can cause immune system disorders making the control group more susceptible to disease. That would actually distort the data not in favor of vaccines because the same adjuvants are in the vaccine test group. In fact, the very reason placebos for vaccines often contain everything except the antigen used to provoke the immune response is to produce the best control group possible.
Adams’ other complaints include the usual litany, such as no comparison with completely unvaccinated controls (a complaint I’ve dealt with before); that there are no long term studies of the effects of vaccines (also not true); that flu vaccines were not tested against vitamin D (which is silly, given that a head-to-head comparison of vaccines against vitamin D was not the purpose of the study). The last three are even sillier. For example:
99.5% of eligible studies were excluded from this meta-analysis
Yes, but that’s because the inclusion criteria were very rigorous. They were also spelled out in the methods section. It is very typical of meta-analyses that the vast majority of studies will not meet the inclusion criteria, at least if the inclusion criteria are rigorous. Of course, Adams is free to do his own meta-analysis and include the studies that were excluded from this study. It will be crap, but he can do it if he wishes.
I haven’t had time to follow the money ties for each individual study and author included in this meta analysis, but I’m willing to publicly and openly bet you large sums of money that at least some of these study authors have financial ties to the vaccine industry (drug makers). The corruption, financial influence and outright bribery is so pervasive in “scientific” circles today that you can hardly find a published author writing about vaccines who hasn’t been in some way financially influenced (or outright bought out) by the vaccine industry itself.
In other words, Adams doesn’t know. He just assumes. Perhaps he should have taken the time to “follow the money” before spouting off. Of course, even if some of the authors of some of the studies have ties to vaccine manufacturers that doesn’t invalidate the studies. One has to look at the methods. In any case, it is rather hilarious to see Adams rant that “The Lancet is, itself, a pro-vaccine propaganda mouthpiece funded by the vaccine industry!” Funny how one of the most famous anti-vaccine studies of all time (Andrew Wakefield’s case series from 1998) was published in The Lancet.
I can’t help but conclude with Adams going into full paranoid mode, letting his freak flag fly higher than ever:
The purpose of flu shots is to “soft kill” the global population. Vaccines are population control technologies, as openly admitted by Bill Gates (http://www.naturalnews.com/029911_v…) and they are so cleverly packaged under the fabricated “public health” message that even those who administer vaccines have no idea they are actually engaged in the reduction of human population through vaccine-induced infertility and genetic mutations.
Vaccines ultimately have but one purpose: To permanently alter the human gene pool and “weed out” those humans who are stupid enough to fall for vaccine propaganda.
And for that nefarious purpose, they probably are 60% effective after all.
If only there were a vaccine against the quackery, paranoia, conspiracy theories, and utter nonsense that is concentrated into the density of a black hole in the form of Mike Adams.