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Doctors question CDC flu statistics
By KELLY O'MEARA
Special to The Journal

Americans are scared. From coast to coast, young and old have stood in lines, signed up for lotteries and even crossed national borders with the hope of getting a shot at this year's limited supply of the influenza vaccine.

The credit for the mass hysteria that has swept the nation in the last two months should be given to federal health officials, who, through ongoing public relations campaigns that easily rival those of corporate America's top-selling products, have successfully convinced the public that without the vaccine tens of thousands, or worse, might die.

In fact, the Centers for Disease Control and Prevention has told the public that influenza is the most frequent cause of death from vaccine-preventable disease in this country and that from 1990 through 1998, an average of 36,000 flu-related pulmonary and circulatory deaths occurred each season in the United States.

Alan Clark, a family physician in Atlanta, specializing in emergency medicine argues that those "deaths" cannot be confirmed.

"The CDC cannot show anyone in any year where there were 36,000 actual deaths due to influenza," he said. "I think the vaccine is not working, and even if they do get the right strain of virus the chances of it being helpful is maybe 60 to 80 percent in a healthy adult, less than 50 or 60 with health problems - and I mean maybe. The only thing the vaccine is effective for is making money for the vaccine manufacturers."

Even CDC officials reluctantly admit the deaths are not "real" numbers, but only estimates. CDC spokesman Von Roebuck said the CDC uses indirect modeling methods to estimate the numbers of deaths associated with influenza, an approach that has been used for 40 years. Using this approach, the CDC estimates that about 36,000 influenza-associated deaths occur annually in the United States, he said.

This estimate is obtained by using the models to analyze the National Center for Health Statistics, NCHS, for underlying respiratory and circulatory deaths. The estimated 36,000 deaths from influenza represents about 3 percent of about 1.1 million underlying respiratory and circulatory deaths that occur during the year.

However, what the CDC fails to tell the public is that it has no idea how many people who died from underlying respiratory and circulatory problems actually had the influenza infection. In other words, the CDC doesn't know if a person who died of pneumonia also had the flu, because those statistics are not collected. The one fact that CDC can state for certain is this: The greatest number of influenza deaths recorded since 1979 were 3,006 in 1981. Still, most physicians eagerly will admit that the influenza virus is nothing to, well, sneeze at, and that history well documents the bug's lethality.

But is the influenza scare justified? To answer that question, The Journal decided to take a hard look at the CDC's historical data and last year's flu season as a good place to start.

Recall that public health officials announced that the 2003 flu season not only began earlier than normal but that the strain of influenza circulating in North America did not match the strain formulated in the vaccine. Early in the 2003-2004 flu season, the CDC advised that although a vaccine had been developed with the wrong strain of virus it, nevertheless, "may provide some protection or lessen the symptoms," and continued to encourage worried Americans to be vaccinated.

However, after analyzing 2003 data this year, the CDC acknowledged that the 2003-2004 influenza vaccine had "no or low effectiveness against ILI (influenza-like illness)." In other words, last year's shot didn't work.

Mark Geier, a Silver Spring physician and president of the Genetic Centers of America along with his son, David Geier, a Maryland consultant on vaccine issues, argue that the "no or low effectiveness" statement by the CDC is misleading.

"What the CDC looked at in its study of the 2003-2004 season were people who received the vaccine versus those who did not receive the vaccine and they followed these people for weeks to months," explained David Geier.

"What was demonstrated was that last year's vaccine did not prevent any influenza-like illness - it had no statistical efficacy against the influenza infection." "Anyone can look at the CDC data and see that there is no statistical difference between those who received the vaccine and those who did not," David Geier said.

The data can be found at the CDC Web site, www.cdc.gov, under the report titled Preliminary Assessment of the Effectiveness of the 2003-2004 Inactivated Influenza Vaccine Colorado, Dec. 2003.

The data shows that vaccine efficacy runs from -0.14 to 0.33. "The zero means that statistically it is not different from zero and has no efficacy," David Geier said. "In other words last year's vaccine made no difference in the rate of developing influenza-like illness," David Geier said. "The CDC says it had "no or low effectiveness," but that's just the CDC's spin that maybe one person was helped but they can't find them."

The Geiers also point to additional historical CDC data to further question not only whether the influenza vaccine is effective in any given year, but also raise questions about the reported 36,000 estimated deaths associated with the influenza virus.

"What is most disturbing is that the CDC's own data posted at the CDC's National Center for Health Statistics show that the influenza vaccines do not work," adds Mark Geier. "What we see (from the CDC data) is that in the late 1970s between 10 and 15 million doses of influenza vaccine were given to high-risk people, and by 2001-2002 nearly 80 million doses were distributed.

Despite the enormous increase in the number of people receiving the influenza vaccine and the CDC's public relations campaign to sell the vaccine, there has not been a decrease in the population rate of influenza deaths or influenza illnesses." In response to Mark Geier's claim that the "vaccines do not work," CDC spokesman Roebuck explained that "the studies looking at trends in mortality over time cannot address the effectiveness of the vaccination program since influenza vaccine information is not linked to death certificates or hospital data.

One explanation for not seeing a decline in influenza-related hospitalizations and deaths is the aging population, particularly persons 85 years and older. In addition, A (H3N2) viruses have predominated in more recent seasons."

"This response is ridiculous," countered Mark Geier. "The rules in science and medicine are that the vaccine manufacturers have to demonstrate efficacy - now we have to demonstrate that it isn't efficacious. What the CDC is saying is 'well, the data don't show that it's efficacious, but the numbers aren't good enough so we're going to keep giving it.' That's not how this is supposed to work.

They have to prove that the vaccine is working, and the CDC has no proof." "Furthermore," explained Mark Geier, "the CDC reports that roughly 100 children die from influenza each year, but the data show that there really are between five and 15 deaths in any given year. The CDC also touts the estimated 36,000 yearly deaths due to the influenza virus. All anyone has to do is look at the CDC's own data to see that in reality it is maybe 1,000 deaths."

Mark Geier is referring to the data made available by the CDC's National Center for Health Statistics which show, for example, the actual number of deaths due to influenza in 1979 were 604. The highest number of deaths recorded occurred in 1981 with a total of 3,006.These data include all age groups.

"The argument by the CDC that the vaccine is stopping these deaths doesn't hold up because with the increase of the vaccine over the years one would expect to see the number of deaths going down," Dr. Geier said. "We don't see a decrease. There is very little, if any, trend in these numbers and the point is there aren't a whole lot of deaths to be prevented."

"Given the CDC's data," concludes Mark Geier, "no one should be standing in a line thinking 'Oh God, if I get the vaccine I'm going to live and if I don't get the vaccine I'm going to die, because it appears that it just doesn't make much difference whether you get the vaccine or not."

Kelly O'Meara is a veteran investigative reporter who holds journalistic awards for articles in the medical field.

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