“Alternatives” to the flu vaccine are no alternative at all

Once again, it’s influenza season. The vaccine clinics are open, and the hysterical posts about the vaccine’s danger are appearing in social media. There’s familiarity to all of this, but also a big new change – at least in Canada, where I am. Pharmacists can now administer the vaccine. And it’s completely free to anyone in Ontario (where I am), so the barriers to obtaining the vaccine are pretty much eliminated. There’s no longer a need to drag your kids to their family doctor or line up at a public health clinic. Anyone can walk into a pharmacy, show their health card, and walk out minutes later, vaccinated. It’s another enabling change that may help improve immunization rates, as uptake rates in the population remain modest.

This year’s flu season is (as of week 47) fairly quiet. Google Flu trends suggests a fairly typical picture, nothing like what we saw in 2009/10, the year of H1N1. My city’s influenza tracker reports only a dozen cases so far this season. Many of us will get our flu shot, continue with our lives, and not think about the flu until next season’s announcements. That’s the hope, anyway. Influenza can kill, and in its more virulent forms, is devastatingly deadly. The worst case scenario (so far) is almost unimaginable today. In 1918/19 an influenza pandemic killed 50 million people worldwide (5% of the population). So among public health professionals, that worry about the next wave is always present. Much has been written at this blog and at Science-Based Medicine on the efficacy and safety of the flu vaccine. In short, the vaccine is effective for both individual and population-level protection, but only modestly so, and its effectiveness varies based on its match with circulating strains. And despite widespread use for decades, there are frustrating limitations with the current vaccine beyond efficacy, including the need to repeat the shot annually. Donald Rumsfeld once said, “You go to war with the army you have—not the army you might want or wish to have at a later time.” The quote is relevant to influenza. The flu vaccine is not a perfect vaccine, but it does offer protection – if not directly to you, then indirectly to those at greater risk of infection. Hospitals and health facilities have been criticized for demanding health professionals either get the vaccine or wear a mask – and the arguments against vaccination are losing. But even the strongest advocates of influenza vaccine will acknowledge its limitations, which perhaps contributes to the understandable perception that there is more that could be done- beyond reasonable and effective precautions like handwashing and hygiene.

Weekend Reading

Winter has now fully descended across most of Canada, giving views like the the one above. Here are some links of interest to SBP readers:

Oil of Oregano – No substitute for the pertussis vaccine

Oil of Oregano-Today’s Snake Oil

One of the terms that you’ll see used to describe health quackery, scams and pseudoscience is “snake oil”. Snake oil was a real product, sold in the early 19th century as a cure-all elixer in the “patent medicine” era. Popularized in movies, the snake-oil salesman would pull into town, and start the hard sell for his product that was promised to CURE everything from aches and pains to sore throats and dislocations. The original products apparently did contain snake, but soon other products appeared on the market that didn’t even contain any snake – they were an assortment of ingredients concocted to smell medicinal and seem medicinal, but had no therapeutic effects. These small-town sideshows would hype the products and try to sell as much as possible. In 1905 an article in Colliers exposed the patent medicine industry for what it was – health fraud. The Pure Food and Drugs Act (in the USA) followed, and eventually, modern drug regulations emerged as we know them today.

Case closed? Not quite. As a consequence of regulators worldwide implementing lower regulatory standards for supplements and natural health products, snake oil is back on the shelves. I highlighted this recently when I somewhat facetiously asked Is there anything the Natural Health Products Directorate Won’t Approve? After all, when sugar pills are approved as an insect repellant, how much more ludicrous can you get? But I was proved wrong, when Dianne Sousa pointed out that Health Canada has also approved homeopathic rabbit anus as “safe and effective”.

Super Cold-Treatment Reference Spectacular!

I was recently the guest of Desiree Schell on Skeptically Speaking, where we spent an hour discussing the prevention and treatment of the common cold. Here are some of the references and sources I cited or referred to during the discussion. So read along as you listen to the podcast.

Oil of Oregano: Rebottled

Go check out my post today on oil of oregano at Science-Based Medicine. It’s an update (no new evidence, sadly) of a popular older post from this blog.

Got Lice? Use Science, Not Placebos

With the return to school earlier this month, we’re in prime lice season. I was recently forwarded a copy of a Toronto public school’s communication on head lice. Here’s an excerpt:

Oil & vinegar lice treatments do not kill live (unhatched) nits & have to be hand picked. It must be repeated daily until no nits (eggs) are found. Both light (hatched) and unhatched nits must be removed by hand (lice combs won’t pull all nits), and the hair needs to be checked daily for new nits.  As much as no-one wants to put chemicals in their child’s hair, in severe cases it might be advisable. Medicated shampoos and cream rinses have a residual effect, but daily nit picking is required. As well a second treatment with the same treatment in a week is required. Homeopathic treatments are available, but eggs must be picked daily. Teatree oil, as a shampoo or oil (massaged in the scalp) is said to be a preventative. However, if you already have nits or lice, it will not kill or remove them. Remember: One nit left on the hair will keep the cycle going.

This paragraph is so full of inaccurate information, it’s astonishing.  First a bit of background, then let’s examine the evidence supporting this school’s advice.