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Refuting the anti-vax anti-flu shot copy’n’paste

Copy n pasted…

Right of the bat, we know this anti-vaxxer is a winner. They couldn’t come up with a response to what you said, so they’re going to copy and paste this off their anti-vax cult page.

Me: “May I please have the package insert for the flu vaccine?”

Rite-Aid Pharmacist: “Why?”

Me: “So I can read it.”

P: “Which one?”

Me: “The one advertised with the little banners on every aisle.”

Any pharmacy giving flu shots has several variations. So the fact that they advertise “flu shot” in every aisle doesn’t mean that they have one kind.

P: “I will print you the information sheet.”

Me: “No, that’s not the same thing.”

Additionally, every patient who receives a vaccine will get a vaccine information sheet (VIS). These sheets give important information about risks and benefits of the specific vaccine. They are formatted to about a 10th-grade reading level, ensuring that most people can read and understand them.

These differ from the vaccine insert in several ways. First, the vaccine insert was written with legality in mind. So they list any adverse event that was temporally correlated with a vaccine. The VIS only lists adverse effects that have actually been proven to be caused by the vaccine. This is back to that whole correlation does not equal causation argument.

The VIS is more useful to patients because it gives you relevant medical information, instead of legal information. But the vaccine insert is still available online.

P: “What do you want to know? I can tell you.”

Me: “I would just like to read the whole thing before I consider getting one…side effects, contraindications, effectiveness, ingredients like mercury.”

P: “I don’t think I have any. Let mey check. (checks) Sorry, I can’t give you one until the box is empty, because it has to stay in the box. And there isn’t any thimerisol in the single dose flu shot any more. I can print you the information sheet.”

Remember that this is a pharmacist who has other patients and other things going on. The fact that you didn’t look up the vaccine insert before arriving really isn’t their problem. The fact that they don’t have an empty box lying around isn’t either.

Pharmacy co-worker with big smile at me: “Hi, I found one.” (hands insert to P, hands to me).

Good for you sweetie, someone saved you the trouble of using google.

***

Here are some things in the insert not on the store’s sheet:

It is too bad that she still doesn’t understand that different variations of the flu vaccine exist, but from scrolling down into her post, she is talking about Fluvarian. I did a bit of googling myself (this post was created without harassing any pharmacists) and found both the vaccine insert and the VIS. Let’s see if what she finds is real and if it actually matters.

1. The single dose vial contains mercury at ≤1mcg (This is called a “trace amount” by the industry.) (The multi-vial contains 25 mcg.)

What does the insert say?

Question 1
Screen capture from page 8 of the vaccine insert

Let’s discuss the units here. mcg… what is that? It is a microgram. That means that it is 1/1,000,000 of a gram. Let’s also remember that the vaccine insert is not written for general patient comprehension (unlike the VIS), so it fails to point out that the mercury in Thimerosal is not the same as the mercury in a thermometer.

elemental-mercury-methylmercury-ethylmercury-completely-different-chemicals

Remember that Thimerosal is not just mercury. It was repeatedly proven safe, but due to patient fears was removed from most vaccines.

Also notice that the insert says that the thimerosal is removed, but trace amounts may remain. This is that legal jargon again. Even though their system is great at removing something, if they tell you it was there at one point, you can’t sue them. Even though that something is totally harmless.

So onto the next part, is this not mentioned in the VIS (as our trusty author claims)?

question 1a

Nope totally mentioned. Again, the VIS is written so that everyone can understand it. The relevant information here is that some vaccines have a bit of this, it isn’t harmful, but you can request one without anyways.

2. People with egg allergies are contraindicated.

Question 2
Found on page 2 of the insert

She is right- people the insert directs providers not to give this vaccine to someone with a severe egg allergy.

But what does the VIS say?

Question 2a

The same dang thing.

3. “Safety and effectiveness have not been established in pregnant women, nursing mothers and children under four. There are no adequate and well-controlled studies in pregnant women. This vaccine should be used during pregnancy only if clearly needed. It is not known whether fluvarin is excreted in human milk.”

Question 3
Found on page 1 of the insert

Keep in mind that according to the CDC, “Flu is more likely to cause severe illness in pregnant women than in women who are not pregnant. Changes in the immune system, heart, and lungs during pregnancy make pregnant women (and women up to two weeks postpartum) more prone to severe illness from flu, including illness resulting in hospitalization.”

While the vaccine manufacturer did not test the safety of Fluvarian in pregnant women, academia did. Here, and here, and here, and here, and here, and here, and here. Anti-vaxxers always complain that the flu shot is only tested by drug companies. Well here are 7 independent studies proving the safety of this vaccine in pregnant women. The vaccine insert only covers what has been done by the company, not the overall field of science. But what about the VIS?

Question 3a

Because the VIS is compiled based on all available information, it gives you the clinically relevant part. That the flu is more dangerous for pregnant women.

4. “Fluvarin has not been evaluated for carcinogenic or mutagenic potential, or for impairment of fertility.”

Question 4a
Found on page 1 of the insert

The Skeptical Raptor addressed this better than I can, so I will just quote: “Nonclinical toxicology – this section describes the potential of carcinogenesis (causing cancer), mutagenesis (causing mutation) or impairment of fertility from the drug. This section has little applicability to vaccines, since they have no carcinogenic, mutagenic, or fertility effect, given that the level of the vaccine’s ingredients’ dosage falls far below the lower threshold of any dose-response test of these issues. The PI [package insert] may state some innocuous verbiage such as “no known information” meaning that in the 10-15 years of research and study, no evidence that the vaccine is carcinogenic or mutagenic.” 

For a great explanation of vaccine inserts, I invite you to go read the full post here.

In short, there is no scientifically viable method by which vaccines could cause these damages and no connection has ever been found. I would also point out that animal studies have been conducted and are mentioned in the insert (but of course not by our trusty author) that show that even at extremely high levels, vaccines do not cause any ill effects to reproduction or development of cancer.

 

Question 4
Found on page 7-8 of the insert (excuse the page break)

 

So why isn’t this mentioned in the VIS? Because there is no reason or data to believe that it is important.

5. “Antibody response is low in the geriatric population.”

Question 3
Found on page 1 of the insert

Lower. That is an important distinction. It is well established that the elderly do not have immune systems as strong as the young. This is why it is so important for this group to be vaccinated (as is mentioned in the VIS).

 

Question 5
Top found on page 8. Table found on page 13

 

Notice that in every single study, the geriatric population still had a 5 – 100 fold increase in antibodies to the flu. This means that the flu vaccine still worked in these populations.

This was a serious attempt by the author to mislead and lie. Or, the author wasn’t informed enough to know how to read the vaccine insert (which is why she was offered a VIS).

6. “Serious reactions, including anaphylactic shock, have been observed.”

Question 6
Found on page 3 of the insert

This study found 5 cases of anaphylaxis in 7,644,049 people given the flu shot. Your odds of having an anaphylactic reaction are 1:1,528,809. For comparison’s sake, your chances of drowning in the bathtub (as an adult) is 1:650,000. Your odds of dying in a train crash (population-wide, not just people who ride them daily) are 1:500,000. Your chance of being killed in car accident are 1:8,000. (Source)

Avoiding flu vaccines because of a 1:1,528,809 chance of something happening is crazy.

 

number of flu
source

On an average year, 5-20% of the population will get the flu. 200,000 people will be hospitalized, and 36,000 will die. Given these odds, in any given year you have a 1:1000 chances of dying from the flu. So the risk of not getting the vaccine is about 1,000 times higher than the risk of anaphylactic shock.

 

7. “There are no data to assess the concomitant administration of flu vaccine with other vaccines.”

Question 7
Found on page 7 of the insert

This is true. It is against guidelines to have a flu shot at the same time you get other shots, the exception being the pneumococcal, which has been proven safe and effective.

The fact that this is true doesn’t mean that it is useful. Doctors and practitioners are not giving these vaccines concurrently because they can’t. The only reason it is included on this list is that the author was too ignorant to know that. It isn’t in the VIS because it is against practitioner rules.

8. “The vaccine has been associated with an increased frequency of Guillain-Barre syndrome.”

Question 8
Found on page 7 of the insert

The insert shows that a single type of flu vaccine 40+ years ago increased rates of Guillain-Barre syndrome (GBS), no other flu vaccine has ever been shown to increase GBS, but based on temporal association alone, it is estimated to be less than 1 case per 1,000,000 doses. This is the same argument as the previous point- the risks of not vaccinating far outweigh the risks of vaccinating.

Is this information in the VIS? Yes indeed.

Question 8a

9. “In some studies, fluvarin protected up to 30% of subjects.”

This one is a bit trickier than the others. Here is the passage our author is referring to:

 

Question 9
Found on page 11 of the insert

 

But this passage refers specifically to geriatric patients. It also refers directly to patients with a sufficient immune response. If you’ll notice, there are an additional 60% with an extremely high response. 90% of elderly patients had good or excellent immune response with one shot.

This one was not in the VIS because the author was dead wrong.

So let’s review: 

This author claimed that they found 9 issues that will change your mind on vaccination that were in the insert but not in the VIS. In addressing these points I will assess them as an ethically important finding (meaning it could/should change your opinion on getting the vaccine), an ethically unimportant finding (meaning it may be true but will not affect getting the vaccine, and a scientifically invalid point (meaning that the author was simply wrong). I will also reference which were in the VIS (except for those that were scientifically invalid as we can’t expect the VIS to cover falsehoods).

  1. Not an ethically important finding and in the VIS
  2. Important ethical finding listed in the VIS
  3. Not an ethically important finding and in the VIS
  4. Not a scientifically valid point
  5. Not a scientifically valid point
  6. Not an ethically important finding and in the VIS
  7. Not a scientifically valid point
  8. Not an ethically important finding and in the VIS
  9. Not a scientifically valid point

So in conclusion: everthing in this chain letter is crap.

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