This week on my regular spot on the Paul Murray show on 6PR we spoke about flu vaccinations. Last year there were significant problems with a number of children having febrile convulsions after the vaccine leading to a withdrawal of use in children under five.

This year there are six vaccines licensed for use in Australia with only two licensed for use in children under five.  All six have the same three strains of flu virus.  A good question would be what are the differences between them?

Unless you have been on mars for most of the last two years you would have heard about the H1N1 virus also known as swine flu. In response to the perceived “killer” virus, governments around the world ordered mass dosages of a vaccine against the virus in a bid to save the populace from the terror of flu and countless deaths.

As things turned out there was no “plague” and the last two flu seasons have been mild. In Australia less than one in five people took up the free vaccine. Yet there is a continued push to vaccinate people against the flu.

Through all this though there has not been any questioning of the basic assumption that giving people a flu vaccine protects them from flu and that in turn, they and society benefit.

Many countries run annual flu vaccination programs for those over 65. There is not actually any evidence to show that this does any good! The well-respected Cochrane collaboration released a report, which looked at 75 studies over a 40-year period. The conclusion was that “The available evidence is of poor quality and provides no guidance regarding the safety, efficacy or effectiveness of influenza vaccines in people aged 65 years or older”.

In simple terms after 40 years we do not know if giving people over 65 a flu vaccine, does any good or any harm.  After 40 years and 75 studies on a commonplace medical procedure you would expect evidence of benefit to be apparent.

People with a competent immune system are able to deal with the flu and other viruses. For the vast, vast majority the flu is an illness, which lasts a week and then goes. Each year there are deaths associated with flu but most of these are in people with other underlying health problems. There will be a small number of people who succumb to an overwhelming infection for reasons we will never know.

It has also emerged that people who had regular flu shots were more prone to swine flu. This is because if you get flu the immune system emerges stronger and you have broader protection in subsequent years. In mass vaccinating otherwise health adults and children we may be doing more harm than good.

Any questioning of any vaccine program is met with howls of being “anti vaccination”. The assumption is that because it involves vaccination it must be good, is not a scientific position but one of faith. It is exactly the type of criticism that is leveled at those opposed to vaccines by health authorities. Unfortunately “debates” over vaccination generate heat and no light as positions are entrenched and facts are of little interest.

With pharmaceuticals those, which are shown to be not useful, go out of use. It is not deemed that it must be good because it is a drug. Medical procedures too, become superseded. There is no reason the same logic should not apply to vaccination. Those, like tetanus, which are shown to be useful, should be continued. Those where there is not shown to be benefit should not.

The bottom line is that this matters. Governments spend large sums of money on vaccine programs. There is in many instances some compulsion about being vaccinated and penalties for not doing so. This does not occur with any other area of medicine. Assessments made on the basis of facts, not pre conceived notions, faith in vaccines, or opposition to vaccines, is what is needed. Those, which are shown to have benefits outweighing risks, are worth doing. Those where this is not the case, are not worth continuing.

There are serious questions about the need for mass flu vaccination in people who do not have specific susceptibility or other underling medical problems, which the flu could worsen. We are no wiser as to why there were so many problems with the vaccine last year and the strains in this year’s vaccine are the same. What if we get more febrile convulsions in children who receive the flu vaccine?

Nobody was accountable last year. Nobody has been accountable for the waste of money and hysteria whipped up over swine flu. To the authorities it is business as usual and please do not ask awkward questions.

Vaccination is a medical and public health issue. It is not a sacred cow. Programs need to be assessed, criticized and changed or stopped if not found to be of benefit. Justification on the basis that vaccination, of itself, is good is no better an argument than vaccination, of itself, is bad.