How CDC uses fear to increase demand for flu shots
How CDC uses fear to increase demand for flu shots
- The facts:
The CDC continues to use fear of hospitalization and death to increase the demand for flu vaccines. His "Recipe" calls for encouraging medical experts and public health authorities to "declare concern and alarm."
- Reflect on:
Is the flu vaccine necessary? It is becoming difficult to trust health professionals about this, especially since their knowledge about vaccines is not up to par. Independent research could be more effective. It's okay to question vaccines.
The CDC states that its recommendation that all people over six months or more should be vaccinated against the flu annually is firmly grounded in science. The mainstream media reinforces this characterization by misinforming the public about what science says.
A New York Times Article early this year, for example, in order. persuade readers to follow the recommendation of the CDC, cited the reviews of the scientific literature of the prestigious Cochrane Collaboration to support its characterization of influenza vaccine as effective and safe. the Times He said that science showed that the vaccine represented "a great reward for public health" and that the damage caused by the vaccine was "almost non-existent."
What the Cochrane researchers actually concluded, however, was that their findings "seem discourage the use of influenza vaccination in healthy adults as a routine public health measure "(emphasis added). In addition, given the known serious damages associated with specific flu vaccines and the CDC's recommendation that babies up to six months be vaccinated against the flu despite an alarming alarm. absence of safety studies for children under two years of age, "large-scale studies are urgently needed to evaluate important results and to directly compare types of vaccines."
The CDC also recommends the vaccine for pregnant women despite the total absence of randomized controlled trials that assess the safety of this practice for both the pregnant mother and the fetus. (This is all the more worrisome since multiple-dose vials of the inactivated influenza vaccine contain mercury, a known neurotoxin that can cross placental and blood-brain barriers and accumulate in the brain).
The Cochrane researchers also found "no evidence" to support the CDC's assumptions that the vaccine reduces the transmission of the virus or the risk of life-threatening complications:The two main justifications claimed by the CDC to support its recommendation..
However, the CDC promotes the influenza vaccine by stating that it prevents large numbers of hospitalizations and deaths from the flu. To reinforce their message that everyone should get an annual flu shot, the CDC claims that hundreds of thousands of people are hospitalized and tens of thousands die each year from the flu. These numbers are usually transmitted by the mainstream media as if they were representative of known cases of influenza. The aforementioned New York Times The article, for example, objectively stated that, of the 9 million to 36 million people that the CDC estimates to get the flu each year, "between 140,000 and 710,000 of them require hospitalization, and between 12,000 and 56,000 die every year. . "
... The average number of deaths each year for which the cause is actually attributed to death certificates to the influenza virus is just over 1000.
On Sept. 27, the CDC issued the complaint at a press conference that 80,000 people died from the flu during the 2017-2018 flu season, and the media repeated this number as fact.
What is not being communicated to the public is that the CDC numbers do not do not Represent known cases of influenza. They do not come directly from surveillance data, but rather are rather controversial estimates based on controversial mathematical models that can greatly overestimate numbers.
To put the matter in perspective, the average number of deaths each year for which the cause is actually attributed to death certificates to the influenza virus is little more than 1,000.
The consequence of the parrots of the CDC media as if they were not controversial is that the public is habitually misinformed about the impact of influenza on society and the apparent benefits of the vaccine. Obviously, this is how the CDC wants it, since the agency has also described a public relations strategy to use fear marketing to increase the demand for flu vaccines.
In other words, the CDC considers that it is a problem that people are increasingly doing their own research and are becoming more adept at educating themselves about health issues.
The CDC's "problem" of "Growing in health education"
Before analyzing some of the problems with the CDC estimates, it is useful to examine the agency's mindset regarding how CDC officials consider their role in society. On June 17, 2004, the director of media relations at the CDC presented an instructive summary of this mentality in a workshop for the Institute of Medicine (IOM).
In its presentation, the CDC outlined a ""Recipe" to promote public interest and high demand for vaccines"He called for encouraging medical experts and public health authorities to" express concern and alarm "about" and predict terrible results "from the flu season.To inspire the necessary fear, the CDC recommended describing each season as "very severe", "more severe than last year or last" and "mortal".
A problem for CDC is the accurate view among healthy adults that they are not at high risk for serious complications from the flu. As noted in the presentation, "achieving consensus for 'fiat' is difficult," which means that just because the CDC makes the recommendation does not mean that people will actually follow it. Therefore, it was necessary to cause "worry, anxiety and worry" among healthy young adults who consider the flu as an inconvenience rather than something they fear terribly.
The biggest puzzle for the CDC is the proliferation of information available to the public on the Internet. As the CDC stated bluntly, "health literacy is a growing problem."
In other words, the CDC considers it a problem that people are doing more and more their own research and more and more adepts to educating themselves on issues related to health. Y, as we have already seenThe CDC has very good reasons to worry about people doing their own research on what science really tells us about vaccines.
An important way in which the CDC inspires the necessary fear is, of course, with their estimates of the number of people who are hospitalized or die each year because of the flu.
... many if not plus people diagnosed with "the flu" He may not have actually been infected with the influenza virus at all., given the large number of other viruses that cause the same symptoms and the general lack of laboratory confirmation.
Problems with the CDC's estimates of annual flu deaths
Among the relevant facts that are routinely do not When the CDC numbers are cited by the public, they are relayed to the public is that only 7% to 15% of what is called "influenza-like illnesses" are actually caused by influenza viruses. In fact, there are more than 200 known viruses that cause influenza-like illness, and laboratory tests are required to determine if a disease was actually caused by the influenza virus.what is usually not done.
In addition, as the authors of a Cochrane Review 2010 In the best of cases, vaccines can only be effective against influenza A and B, which represent approximately 10% of all circulating viruses "that are known to cause flu-like symptoms. (That's the same review, by the way, that the Times mischaracterized by having discovered that the vaccine is "a great reward for public health".
While the CDC now uses a distance of numbers to describe the annual deaths attributed to influenza, used to claim that on average "Around 36,000 people a year in the United States die from influenza." The CDC switched to using a range in response to criticism that the average was misleading because there is great variability from year to year and from decade to decade. And while the change to the range addressed that criticism, other serious problems remain.
One of the main problems with "the much publicized figure of 36,000," as Peter Doshi observed in a 2005 BMJ Article, was that "it is not an estimate of annual deaths from influenza, as widely reported in the scientific and secular press, but an estimate (generated by a model) of influenzaassociated death."
Of course, as the media routinely reminds us when it comes to vaccines and autism (but seems to forget that it is the CDC flu numbers), the temporary association does not necessarily mean causality. The fact that someone dies after an influenza infection does not mean it was the flu that killed him. And, in addition, many if not. plus People diagnosed with "the flu". He may not have actually been infected with the influenza virus at all., given the large number of other viruses that cause the same symptoms and the general lack of laboratory confirmation.
The number of "36,000" came from a 2003 CDC study published in JAMA this acknowledged the difficulty of estimating deaths attributable to influenza, given that most cases are not confirmed by the laboratory. However, instead of recognizing the likelihood that a substantial percentage of the reported cases actually had nothing to do with the influenza virus, the CDC researchers treated it as if only meant that deaths related to influenza should be significantly higher than the numbers reported.
The study authors noted that seasonal influenza is "associated with an increase in hospitalizations and mortality in many diagnoses," including pneumonia, and assumed that many cases attributed to other diseases were actually caused by influenza. Therefore, they developed a mathematical model to estimate the number using as a starting point everyone "Respiratory and circulatory" deaths, which include everyone Deaths due to "pneumonia and influenza".
In your already mentioned BMJ article, Peter Doshi reasonably asked: "Are the numbers of deaths from influenza in the US More public relations than science?"
Of course, not all respiratory and circulatory deaths are caused by the influenza virus. However, the CDC try this number as "an upper limit", although it was possible that 100% of all respiratory and circulatory deaths that occurred in a given flu season were caused by influenza. The CDC also treats the total number of deaths from pneumonia and influenza as "a lower limit for deaths associated with influenza." The cdc state on its website that reported deaths from pneumonia and influenza "represents only a fraction of the total number of deaths from influenza" -As if all pneumonia deaths were caused by the flu.!
The CDC certainly knows better. In fact, at the same time, the CDC recognizes contradictorily that do not all deaths from pneumonia and influenza are related to influenza; that has estimatedthat in an average year, 2.1% of all respiratory and circulatory deaths and 8.5% of all deaths from pneumonia and influenza are associated with influenza.
So how can the CDC maintain both (a) that 8.5% of deaths from pneumonia and influenza are related to influenza, and (b) that the combined total of all deaths from pneumonia and influenza represents only one fraction of deaths caused by the flu? How can both of them be true?
The answer is that the CDC simply assume that deaths associated with influenza are so poorly reported within the broader category of deaths encoded in "respiratory and circulatory" that dwarf all people coded in "pneumonia and influenza."
In your already mentioned BMJ article, Peter Doshi reasonably asked: "Are the numbers of deaths in the flu in the US? UU More RP than in science? "As he said," the data on deaths from influenza in the US. UU They are a disaster". indistinctly. In addition, there are important statistical incompatibilities between official estimates and national vital statistics data. To aggravate these problems, fear must be commercialized: a communication strategy of the CDC in which medical experts "predict terrible results" during flu seasons. "
Leaving aside pneumonia and observing only deaths associated with influenza from 1979 to 2002, the annual average according to NCHS data was only 1,348.
To illustrate the problem, Doshi noted that by 2001, the total number of pneumonia and influenza deaths reported was 62,034. However, of those, Less than half of one percent was attributed to influenza. In addition, of the mere 257 cases attributed to influenza, only 7% were confirmed by laboratory. That's just 18 confirmed laboratory cases of influenza in 62,034 deaths from pneumonia and influenza, or just 0.03%, according to the National Center for Health Statistics (NCHS) of the CDC.
Leaving aside pneumonia and observing only deaths associated with influenza from 1979 to 2002, the annual average according to NCHS data was only 1,348.
The CDC's mortality estimates would be compatible with the NCHS data, Doshi argued, "if about half of the deaths classified by the NCHS as pneumonia were actually secondary pneumonias initiated by the flu." However, the NCHS criteria clearly indicated otherwise. Mortality statistics are based solely on the underlying cause of death ... defined by WHO as "the disease or injury that initiated the series of events that led directly to death."
The CDC researchers who were the authors of the 2003 study. admitted that underlying code of the cause of death "represents the disease or injury that initiated the chain of morbid events that led directly to death"; however, they combined pneumonia deaths with influenza deaths in their model anyway.
At the time Doshi was writing, the CDC publicly stated that each year "around 36,000 [Americans] to die of influenza ", and as seen with the example of New York TimesThe range of numbers is also presented as if it were representative of known cases of deaths caused by influenza. However, the lead author of that same CDC study, William Thompson, of the CDC's National Immunization Program, acknowledged that the number represented rather "a statistical association" that does not necessarily mean causality. In Thompson's own words, "Based on modeling, think It is associated I do not know what we would say is the underlying cause of death.." (Emphasis added.)
Of course, the CDC. make they say it is the underlying cause of death in their false public relations message. As noted by Doshi, Thompson's acknowledgment is "incompatible" with the CDC's "misrepresentation" of his estimates of deaths from influenza. The CDC, Doshi noted, was "working in the interest of manufacturers when conducting campaigns to increase flu vaccination," based on estimates that are "statistically biased," even when "arbitrarily linking influenza with pneumonia."
... otherwise, there are significant limitations of the CDC models that may result in the false attribution of influenza deaths.
More "Limitations" of the CDC Models
While the media present the CDC numbers as if they were not controversial, in fact there is a "substantial controversy" surrounding estimates of deaths from influenza, such as a 2005 report. study published in the American Journal of Epidemiology famous. One problem is that the CDC models use virus monitoring data that "has not been made available in the public domain," which means that their results are not reproducible. (Like the magazine Cell remember, "The reproducibility of science" is "a key element of credibility". And, otherwise, there are "significant limitations" of the CDC models that may result in a "false attribution of influenza deaths."
To illustrate, when Peter Doshi requested access To the circulation data of the virus, the CDC refused to allow it unless it granted the co-authorship of the study that was being carried out, which Doshi rejected in an appropriate way.
While the confirmed number of infant deaths related to H1N1 was 371, the claimed number of CDC was 1,271 or more.
At Review of New York booksHelen epstein has He pointed out how the terrible warnings of the CDC about the "swine flu" of the 2009 H1N1 flu were never fulfilled, as well as how "Some experts argue that the CDC estimates are studying overestimate mortality from influenza, particularly among children." While the confirmed number of infant deaths related to H1N1 was 371, the claimed number of CDC was 1,271 or more. To get to their number, the CDC used a multiplier based on certain assumptions. One assumption is that some cases are lost because laboratory confirmation was not sought or because the children were not in a hospital when they died and, therefore, were not examined. Another is that a certain percentage of the test results will be false negatives.
However, Epstein noted that "in accordance with CDC guidelines at that time," any hospitalized child with symptoms of severe influenza should have been screened for H1N1. In addition, "deaths in children from infectious diseases are rare in the US. UU., And even those who did not die in hospitals almost certainly would have undergone an autopsy (and H1N1 was analyzed) .... In addition, the test is accurate and few cases would have been lost. Because large numbers of actual cases of infant deaths from H1N1 in the US are unlikely to be detected. UU., The count confirmed in the laboratory (371) is probably much closer to the modeled numbers ... which in any case are impossible to verify ".
As already indicated, another assumption made by the CDC is that the excess mortality in winter is mainly due to influenza. A 2009 Board Article described this is among a series of "potential failures" that make flu deaths reported by the CDC the "least bad" estimate. Referring to previous methods that associated deaths from influenza with deaths during the winter of everyone Causes, the article noted that he risked blaming the flu for deaths caused by traffic accidents caused by icy roads. And while the updated method presented in the 2003 CDC study excluded such unjustly related causes of death, the related problems continue.
As mentioned above. American Journal of Epidemiology study famous, the updated method "reduces, but does not eliminate, the potential for spurious correlation and the false attribution of deaths to influenza". In addition, "Methods based on a seasonal pattern start from the assumption that influenza is the main source of excess death in the winter." Therefore, the CDC models are still "in danger of being confused by other seasonal factors". The authors also stated that they could not conclude from their own study "that influenza is a more important cause of winter mortality on an annual time scale than in cold weather. "
Once the CDC has its Dear hospitalization rate, then multiply that amount by the proportion of deaths to hospitalizations to reach their estimated mortality rate. Therefore, any overestimation of the hospitalization rate is also complicated in its estimated mortality rate.
As a 2002 BMJ study "Cold weather alone causes noticeable short-term increases in mortality, mainly from thrombosis and respiratory disease. Non-thermal seasonal factors, such as diet, can also affect mortality. "(Emphasis added.) The study estimated that of the annual deaths in excess of winter, only" 2.4% was due to influenza directly or indirectly. " that "with influenza causing such a small proportion of excess deaths in winter, measures to reduce cold stress offer the best opportunities to reduce current levels of mortality in winter."
The CDC's own researchers recognize that their models are "subject to some limitations". In a 2009 study published in the American Journal of Public HealthThe CDC investigators admitted that "the deaths for which influenza is coded are simply counted as the underlying cause of death certificates" can carry both and underestimates the magnitude of mortality associated with influenza. "(Emphasis added.) However, they offered no comments on how, then, their models explain the likelihood that many reported cases of" flu "have nothing to do with the influenza virus, obviously this is because do not, as indicated by the CDC treatment of all influenza deaths more deaths due to pneumonia as a "lower limit".
For another illustration, given that it takes two or three years before data is available to estimate hospitalizations and deaths from influenza by the usual means, the CDC has also developed a method for making preliminary estimates for a given year "adjusting "the number of cases confirmed in the laboratory notified in selected surveillance areas throughout the country. The "80,000" figure claimed for deaths from the flu last season is only an estimate. The way the CDC "adjusts" the numbers is by multiplying the number of cases confirmed in the laboratory by a certain amount, apparently "to correct the insufficient report". To determine the multiplier, the CDC makes a series of assumptions to estimate (a) the probability of a hospitalized person any respiratory diseasewill be tested for influenza and (b) the probability that a person with influenza will be positive.
Warnings like that, however, are do not communicated to the general public by the CDC in their press releases or by the mainstream media so that people can make a true informed decide if it's worth the risk of getting a flu shot.
Once the CDC has your estimated hospitalization rate, multiply that amount by the ratio of deaths to hospitalizations to reach your estimated mortality rate. Therefore, any overestimation of the hospitalization rate is also complicated in its estimated mortality rate.
An obvious problem with this is the underlying assumption that the percentage of people who (a) are hospitalized for respiratory diseases Y Having the flu is the same as (b) the percentage of people hospitalized for respiratory illnesses are actually evaluated and give a positive result. This implies that the doctors are do not They are more likely to seek laboratory confirmation for people. who really have influenza of what they are for people whose respiratory symptoms are due to some other cause.
Assuming that doctors can do better than a pair of dice thrown when selecting patients with influenza, this implies that doctors are not more likely to order a laboratory test for patients. of those who suspect they have the flu of what they are for ordering a laboratory test for patients whose respiratory symptoms believe they are caused by something else.
The CDC assumption thus introduces a selection bias in its model that further questions the plausibility of its conclusions, since it is intended to result in overestimation. In a 2015 study published in More one In detailing this method, the CDC researchers acknowledged that, "if physicians were more likely to clinically recognize patients with influenza and select them for testing, we may have overestimated the magnitude of the lack of detection." And that, of course, would result in an overestimation of hospitalizations and deaths associated with influenza.
Warnings like that, however, are do not communicated to the general public by the CDC in their press releases or by the mainstream media so that people can make a true informed decide if it's worth the risk of getting a flu shot.
conclusion
In summary, to avoid underestimating hospitalizations and deaths associated with influenza, the CDC is based on models that, on the other hand, seem to overestimate numbers to a large extent due to the fallacious assumptions incorporated in them. These numbers are erroneously presented to the public by both public health officials and traditional media as if they were not controversial and representative of known cases of diseases caused by influenza and deaths from surveillance data. As a result, the public is very poorly informed about the disease burden of society due to the flu and the apparent benefit of the vaccine.
It is clear that the CDC does not consider that its mission is to educate the public in order to make an informed decision about vaccination. After all, that would be incompatible with his view that the increase in health literacy is a threat to your mission and an obstacle to overcome. On the other hand, a uninformed the population is perfectly aligned with the CDC's stated objective of using fear marketing to generate more demand for influenza vaccine products from the pharmaceutical industry.
This article is an adapted and expanded extract of the second part of the author's various exposition on the influenza vaccine. Sign up so that Jeremy's newsletter keeps updated with his work on vaccines and receives his free downloadable report, "5 horrifying facts about the FDA approval process for vaccines".
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