What are the true odds of adverse reactions to flu shots?

Factual Questions
1

The CDC is full of excuses, but Id like to see some numbers.
They say “Some people will die but they probably would have died anyway. People die without shots, so you have to ignore that.” Okay, but there’s still some additional problems.
And then to distract further, they say “You might have a sore arm or slight fever but that will pass”. Okay nobody considers those adverse. But there are other reactions.

I know they wouldn’t put it out there without real comparable numbers, the sort of double blind tests they are famous for.

What’s the chance of dying and what’s the chance of other adverse reactions?

2

I don’t have any numbers (no one does), but one thing I do know is that the odds of adverse reaction to a flu shot are orders of magnitude lower than the odds of adverse reaction to flu. I am talking about something more than sore arm, but the chances are really getting sick and even dying.

That said, there is just no way to evaluate the statement that if you die from the inoculation you probably would have died from the flu. There may be some truth to it, but to me it sounds a bit like saying that if you get killed in a plane crash, you probably would have died in a car crash had you driven. Because adverse reactions to flu shots are probably not from the dead flu viruses, but from something used in preparing the vaccine. My wife always gets a sore arm, but our doctor says that is most likely due to egg protein, not that she has any egg allergy when she eats them.

IMHO, resistance to vaccination is part and parcel of opposition to evolution, to deep time, to GM food, to irradiated food (so die from virulent strains of E. coli), and reaction against science in general.

3

The CDC is fairly cagey, but they do offer this one stat
"Severe problems:

* Life-threatening allergic reactions from vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the shot.
* In 1976, a certain type of influenza (swine flu) vaccine was associated with Guillain-Barré Syndrome (GBS). Since then, flu vaccines have not been clearly linked to GBS. However, if there is a risk of GBS from current flu vaccines, it would be no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe influenza, which can be prevented by vaccination."

So, at maybe 150 million doses produced, maybe two to three hundred people will die of GBS this year? And does that include people who get the flu from the live nasal vaccine? They don’t have any stats with that product, although I’ve heard on TV news it’s only half as effective.

4

Yes, people have numbers. It’s patently absurd to think “no one does”. Don’t you think they have to approve the vaccine? Do you really think they release it on the public by the hundreds of millions of doses with no numbers? How absurd. And to say asking for those numbers is anti-science is super absurd. I am a scientist. I have spent my entire life working on government science projects. I am not opposed to evolution as you are, but then I never attended a single church sermon. The attitude of “trust the leaders, never question authority, the government needs no transparency because it is always right” is a religion of its own, called fascism.

5

No, nobody has numbers. You cannot extrapolate one in a million reactions from tests on thousands. A new vaccine has unique problems in that it must be applied immediately on tens of millions and that will reveal adverse reactions nobody saw coming. I’m sure that the testing process was rigorous but you cannot defeat the laws of large numbers.

Asking for the numbers is not anti-science. Being a scientist and not understanding the problem is the issue. And misreading a post out of anger doesn’t help. A comment on others being opposed to both vaccines and evolution is nothing like a statement of opposition to evolution.

We’ll find out the numbers after they happen. That will help in the production of future vaccines, but won’t make the predictions about this one happen in advance. That’s not a conspiracy, it’s proper science.

6

IMHO (since I’m not in the business) I would think that the people who need the shot the most (low immune system) are probably also the people most likely to die from it. Without checking any sites I imaging that the live version is probably not given to these people.

7

Not everyone who gets Guillain-Barré Syndrome will die from it.

8

I recall back in the 90s, when I’d get a flu shot, the nurse would ask that we wait 30 minutes after getting the shot in the office. That way if we had a reactions she could help us.

9

I had assumed definitive figures would be available fairly soon. I read about this program some time ago. From the article:

*The government is starting an unprecedented system to track possible side effects as mass flu vaccinations begin next month. The idea is to detect any rare but real problems quickly, and explain the inevitable coincidences that are sure to cause some false alarms.

“Every day, bad things happen to people. When you vaccinate a lot of people in a short period of time, some of those things are going to happen to some people by chance alone,” said Dr. Daniel Salmon, a vaccine safety specialist at the Department of Health and Human Services.

“The recurring question is, ‘How do we know it’s safe?’” said Dr. Gregory Poland of the Mayo Clinic.

Enter the intense new monitoring. On top of routine vaccine tracking, there are these government-sponsored projects:

_Harvard Medical School scientists are linking large insurance databases that cover up to 50 million people with vaccination registries around the country for real-time checks of whether people see a doctor in the weeks after a flu shot and why. The huge numbers make it possible to quickly compare rates of complaints among the vaccinated and unvaccinated, said the project leader, Dr. Richard Platt, Harvard’s population medicine chief.

_Johns Hopkins University will direct e-mails to at least 100,000 vaccine recipients to track how they’re feeling, including the smaller complaints that wouldn’t prompt a doctor visit. If anything seems connected, researchers can call to follow up with detailed questions.

_The Centers for Disease Control and Prevention is preparing take-home cards that tell vaccine recipients how to report any suspected side effects to the nation’s Vaccine Adverse Event Reporting system.*
**
It is being treated as an opportunity to see if Guillain-Barre is linked to vaccinations:**

*Very rare side effects by definition could come to light only after large-scale inoculations begin — making this the year scientists may finally learn if flu vaccine truly is linked to Guillain-Barre, an often reversible but sometimes fatal paralysis. It’s believed to strike between 1 and 2 of every 100,000 people. It often occurs right after another infection, such as food poisoning or even influenza.

But the vaccine concern stems from 1976, when 500 cases were reported among the 45 million people vaccinated against that year’s swine flu. Scientists never could prove if the vaccine really caused the extra risk. The CDC maintains that if the regular winter flu vaccine is related, the risk is no more than a single case per million vaccinated.*

10

Right, and the risk of dying from this year’s swine flu is worse than 1 in 10000 if you get it (maybe as bad as 1 in 1000 or worse? Really hard to tell. But in any case a far cry from 1 in a million); and I’ve seen projections that roughly half the population will get it within the next few years.

11

The difficulty in all this is proving causation. That is the point about the “would have died anyway” bit. Someone gets a shot, they die sometime later. Across the world there will be hundreds of people that die the day they get their flu shot. Last month a young girl in England died after receiving a shot for HPV, which causes cervical cancer. This made big news. As it turned out she had a large malignant tumour in her heart and lungs, and it looks as if, indeed, she would probably have died that day anyway.

There is an implicit social contract in medicine that not many people stop to think about. A vast amount of medical progress is made by working the statistics. Arguably not enough is done this way. One term is “evidence based medicine.” Simply put, procedures, drugs, and treatments should be based upon statistical evidence that they work. When you receive treatment you are the beneficiary of a huge amount of research, and experience. You need both. Experience only comes with making mistakes. A vast underpinning of medical science comes from things that went bad. Lots of things that on the face of it should have been the right thing turn out to be the wrong thing, sometimes for the most arcane reasons. The body is not well engineered. You benefit from this. But you also contribute. The study of the swine flu immunisation is just this. Nobody knows the numbers, or the full set of risks. It just isn’t possible without a statistically meaningful trial. Anyone who claims otherwise simply needs to brush up on basic undergraduate statistics.

But there is every reason to believe that the benefit vastly outweights the risks. Life is all about making those choices. What you see here is a valuable contribution to understanding those risks, and thus enabling even better informed choices in the future. Every person who gets the flu shot and contributes to the after effects survey adds to the body of knowledge. In some ways you can see this as putting back a little of what you owe into the body of experience that you depend upon for your healthcare.

12

While this vaccine has been tested, useful numbers (of, for example, one in a million reactions) can come only after many millions have been vaccinated. As for the rest of your ad hominem attack, I reject it completely. I gather you are anti-vaccination, but can give no numbers to justify that positionl

13

Well… not exactly.

Those with a low immune system do need the vaccination most, but aren’t necessarily those most likely to die from a vaccination. Definitely, live vaccine is NOT given to people with impaired immune systems, but most flu vaccine is not live.

Probably, in the case of flu vaccine, those most likely to die are those with an allergy to eggs, which are used as an incubation medium at one point in the manufacturing process. That is not to say someone with an egg allergy will die from flu shot, but they most certainly are the group most likely to do so.

14

Well, little man, I reject you completely. You are the one on the attack, and you have FALSELY accused me again of something the EXACT OPPOSITE of what I stand for and am trying to establish. The EXACT OPPOSITE. I am NOT anti-vaccination. I’ve gotten every shot known to man, yellow fever, malaria, typhoid, paratyphoid, DPT, flu, polio, you name it, and I just got the H1N1 shot! Why do you think I find it odd that for the first time in many decades they are not releasing the data? Your blind religious faith in authority completely undermines your faint wish to appear scientific. Science is not based on authority figures but experiment and data and peer review publication thereof.

15

Did I say conspiracy? No. That was Hari Seldon’s false assumption about me. I said the CDC is sending out partial information, like the pharm companies who advertise the benefits of their pill in big print and the side effects in tiny print on the inside of the box. Before you believe Hari Seldon’s assertions about what I believe, check the OP again. It is NOT about hating vaccines, but wondering why this time the fine print data is missing. And you are wrong that “Nobody has the numbers” They did every other year and they will this year. But you may have to dig, or ask at a site like this one, or a more scientifically oriented one. “Nobody has the numbers” - I wonder whether you have blind faith in the government or no faith in it at all. Don’t you think they calculate these things any more?

16

I’m sure they have calculations, because I also have seen them in past years. There is a lot of data about the flu epidemic that Gerald Ford famously had people scurrying over that never became as big as predicted. But the trick is how to pose the question, or what sites to look on. I think Google has a special site for scientific journals, if you can figure what to ask for, but then many just show abstracts and not the actual data.

17

On the subject of Guillain-Barre syndrome (GBS):

This disorder, as previously mentioned, occurs after some types of infections, after surgery, and possibly following vaccination. It has an incidence of about 1-2 per 100,000 people. It’s been estimated that about one case occurs per every 1,000,000 vaccinations.

Most people who get GBS survive; the in-hospital mortality rate is about 2.5%. Recovering from the weakness/paralysis can take weeks or even a few years, and some people have permanent weakness as a result.

It’s a serious disorder. The bottom line is that 1) it’s rare 2) getting sick from an infectious disease like influenza can cause it 3) possibly the flu vaccine might cause it 4) flu vaccines are on a par as far as hazards go with other vaccines, which is to say that there’s a very very low incidence of associated serious reactions.

My personal take is that I’d much rather run the miniscule risk of any flu shot reaction than go unprotected and have a substantial risk of getting horribly sick with the flu and have the accompanying low risk of being permanently impaired or dying of influenza.

My fearless prediction for what it’s worth (not much) is that this flu season will turn out only slightly different from what we’ve experienced in recent years. There will be tens of thousands of flu deaths, more than usual in younger healthy people due to the characteristics of H1N1. Health experts will be thankful for attention to mass vaccination for preventing worse problems. Anti-vaxers will trumpet the numbers of flu cases as supposedly demonstrating the ineffectiveness of vaccines, and will yelp about any unexplained deaths as “proof” that flu vaccine caused them, ignoring the vastly greater number of deaths that are demonstrably due to influenza.

18

As I said earlier, of course you can come up with calculations for incidents per thousand after the fact. Of course you can have information about effects after the Ford-era vaccine was administered.

What you can’t have is good information before the fact for a new vaccine based on a different strain of flu. You can’t even know what the effects will be, let alone how many people will suffer from them.

If you or NeverSayDice say these numbers existed for previous new vaccines ahead of time, all you have to do is find them and give the cites. Right now all we know is that the testing did not show any reason not to proceed - just as was true before that swine flu vaccine, BTW. That tells us nothing about potential effects that the testing did not reveal.

To be more premise, the paper that footnotes that statistic actually says that 0.7 cases are reported per 1,000,000 vaccinations. Reported after is not the same as caused by. Nor is the full paper available to me online so I can’t say how much variation is built into that average. That still doesn’t mean that the CDC knows that the new vaccine will cause 0.7 cases per million but isn’t revealing the truth to the public. The CDC doesn’t know anything of the sort.

19

This is the opposite of how GQ works. If the OP already had the numbers, why would he ask for them? don’t ask seems to have the right attitude about this forum, he’s being helpful instead of arguing that it’s stupid to ask for data. Francis Vaughan on the other hand seems to be sure that tests have been done but they mean nothing, that we have to wait until it’s too late to see any numbers at all. I’m sure that can’t be right. Just because the smaller test is not 100% predictive of the largest test doesn’t mean they didn’t collect numbers. The standard for all such tests is the placebo, so “proving causation” is not exactly a mystery. If you inject a thousand people and the two groups have statistically the same outcome, your serum was a dud. If one placebo user dies and ten of the serum users die, then it’s not approved. In between, there are numbers, the “calculated” part of calculated risk. Somebody did the calculation and knows the numbers the trial produced. The only question is where to look for it. I suspect a direct call to the CDC would produce it.