Do You Really Need a Flu Shot? Don’t Ask NPR!

Introduction

On December 20, 2019, NPR published an article by Tara Haelle purporting to provide information to help people decide whether they should get the influenza vaccine annually. Instead of empowering readers with the knowledge they need to meaningfully exercise their right to informed consent, however, the article presents misleading and outright false information intended to persuade people to comply with the flu shot recommendations of the Centers for Disease Control and Prevention (CDC).

The NPR article was originally titled “Do You Really Need A Flu Shot? Here’s How To Decide” and has since been updated to read “Here’s Why You Really Need A Flu Shot”. Its central message is that everyone should comply with the CDC’s recommendation, which is that everyone aged six months and up, including pregnant women, should get a flu shot every year.

The goal of advocating public vaccine policy, however, is incompatible with the alternative goal of objectively providing people with the knowledge they need to make their own informed choice. The transparent purpose of this NPR article is not to educate but to advocate, including by demonstrably misinforming readers about what science tells us about the safety and effectiveness of influenza vaccines.

In short, as is typical for mainstream media reporting on anything related to vaccines, this NPR article is not journalism but propaganda.

Misrepresenting the Science on the Flu Shot’s Effectiveness

The first core message that Haelle delivers to her readers is that getting a flu shot guarantees a benefit. She tells her readers that it’s “never too late to benefit from a flu shot, even into December and January”.

She cites effectiveness estimates that aren’t particularly impressive. Last flu season, it “hovered around 44 percent overall; it was about 59 percent effective for young children and just 16 in adults over 65.” She then adds, “But even that low number for older adults elides how much death and disability the vaccine prevented.” In older adults, she states, “the flu shot prevents the loss of quality of life that can result from influenza complications”.

She goes on to explain how the influenza virus is “a master of adaptation” and so is “frequently a few steps ahead of scientists”, including those at the World Health Organization (WHO) who make an educated guess each year about which strains of the virus are most likely to be circulating. Each season’s flu shot is different. This year’s quadrivalent vaccine contains “two influenza A strains (an H1N1 strain and an H3N2) and two B strains. The two B strains are the same as last year’s formulation, but this year’s H1N1 and H3N2 vaccine strains are different from last year, based on recommendations from the World Health Organization.”

Tacitly acknowledging that the effectiveness estimates she cites are unimpressive, Haelle asserts that “any protection is better than none”.

However, it is simply not true that getting a flu shot guarantees that you’ll receive a protective benefit, and it is not true that without vaccination your immune system can offer no defense against influenza.

In fact, last season’s flu shot provides a useful illustration of a lack of benefit. As Mike Stobbe reported for the Associated Press (AP) on June 27, 2019, the vaccine was ineffective against the strain of influenza that was circulating most widely toward the end of the flu season. As the AP article’s lead paragraph states, “The flu vaccine turned out to be a big disappointment again.” The “again” is because the flu shot is often highly ineffective due in large part to a mismatch between the strains included in the vaccine and those that are circulating among the population.

The estimate at that time was that the vaccine’s overall effectiveness was down to just 29 percent because the strain of H3N2 circulating was a mismatch to the strain included in the vaccine. As Stobbe reported, the shot “was virtually worthless during a second wave driven by a tougher strain, at just 9%.” The CDC acknowledged that the vaccine offered “no significant protection” against that strain.

In fact, the CDC’s own preliminary estimates indicated that people who’d gotten the flu shot may have actually had an increased risk of infection with the circulating strain of H3N2. The 9 percent effectiveness cited by the AP referred to the estimate for all H3N2 strains from one of the networks the CDC uses for this purpose. Results from a second network showed an effectiveness of 13 percent. Results from a third network, however, showed a vaccine effectiveness against H3N2 strains of negative 43 percent.

The CDC’s interpretation of these conflicting results was that the three networks combined “identified no vaccine protection against predominant H3N2 virus this season”. There was “No significant protection against H3N2 illnesses likely due to emergence of antigenically different A(H3N2) clade 3C.3a”.

Haelle does not provide a source for where she obtained the estimates she presents, but it was evidently the CDC. Presently, the CDC webpage providing information about the effectiveness of the flu shot’s effectiveness for the 2018 – 2019 flu season cites a study published in the Journal of Infectious Diseases on October 30, 2019. But the data from that study does not show an overall vaccine effectiveness of 44 percent, as Haelle claims. That number rather refers to the shot’s effectiveness specifically against the 2009 pandemic H1N1 strain of influenza. The overall vaccine effectiveness was far lower, at just 29 percent.

Haelle makes a similar mistake with her claim that estimated effectiveness among children was 59 percent. Once again, that refers to effectiveness against the included H1N1 strain for children aged six months to eight years. The overall effectiveness for that age group against any strain was lower, at 48 percent.

Likewise, contrary to her claim of 16 percent overall effectiveness for adults over age 65, the actual estimate for that age group was only 12 percent.

Overall effectiveness of the vaccine against the emergent H3N2 strain was just 5 percent.

Moreover, as the study authors pointed out that, while the results did not reach statistical significance, the age-specific estimates against the emergent H3N2 strain were negative for adults aged 18 to 64 years, indicating “higher odds of influenza among vaccinated compared with unvaccinated” patients.

In other words, while possibly due to chance, the data suggest that adults who got the flu shot last season were at an increased risk of infection with the emergent H3N2 strain.

As the study authors remarked, “The evasion of immunity through rapid evolution and accumulation of changes in major surface proteins of the A(H3N2) virus is a challenge for influenza vaccine strain selection and production.” The data suggest that “vaccination did not significantly reduce medically attended influenza illness due to A(H3N2) virus infection.”

Misreporting the numbers and ignoring the data indicating negative effectiveness of the vaccine against the emergent H3N2 strain aren’t the only problems with Haelle’s suggestion that getting a flu shot guarantees at least some benefit.

For starters, there are at least 200 known viruses that cause what are broadly termed “influenza-like illnesses”. Frequently, what doctors diagnose as “the flu” isn’t caused by the influenza virus at all, but by some other virus that the vaccine offers no protection against. (The only way to confirm influenza infection is with laboratory testing, which isn’t usually done.)

While the vaccine is designed to offer some protection against some strains of influenza A and B, all types of these strains represent only about 10 percent of circulating viruses known to cause flu-like symptoms.

Furthermore, according to a CDC study published in the journal Vaccine, only about 8 percent of the US population on average is infected with influenza during any given year.

Far from conferring at least some benefit for everyone, a systematic review of the medical literature published in February 2018 found that “71 healthy adults need to be vaccinated to prevent one of them experiencing influenza”.

To put it another way, most people who get a flu shot are placing themselves at risk of harm from the vaccine despite the unlikelihood that it will confer a benefit. (The only adverse events Haelle acknowledges are “headache, nausea, low fever or similar symptoms” that resemble those caused by the virus itself. She otherwise insists on the safety of the vaccine, which we’ll come to.)

In addition to the vaccine’s “modest” impact, according to that review, “the effects of inactivated vaccines on working days lost or serious complications” remains “uncertain”.

A prior systematic review had found “no evidence that they affect complications, such as pneumonia, or transmission.”

Its authors also warned that the findings of a modest protective effect must be interpreted in light of the inclusion of studies funded by the pharmaceutical industry because, unsurprisingly, studies have shown that industry funding tends to bias results in favor of product under study.

That prior review, published in 2010, also specifically criticized the CDC for deliberately misrepresenting the science in order to support its flu shot recommendations.

Instructively, it is the routine habit of journalists to turn to the CDC for their information about flu shots, which they then relay to readers as though credible despite the fact that the CDC has been shown to misrepresent the science in pursuit of its public policy goals.

Misrepresenting the Science on Vaccination of the Elderly

Similarly contrary to NPR’s characterization of the flu shot as guaranteeing at least some benefit to every individual who receives it, a 2018 systematic review of vaccination to prevent influenza in the elderly found that 30 people aged 65 or older need to be vaccinated to prevent a single case of influenza.

The researchers also qualified that result by rating the quality of evidence as “low” and “limited by biases in the design or conduct of the studies.” They also cautioned that the data did now allow them to determine the effect of vaccination on mortality or pneumonia, which is a potentially deadly complication of influenza infection.

Contrary to Haelle’s implicit claim that science supports the CDC’s recommendation because it has proven that the vaccine reduces the risk of complications in the elderly, the review authors concluded that “The available evidence relating to complications is of poor quality, insufficient, or old and provides no clear guidance for public health regarding the safety, efficacy, or effectiveness of influenza vaccines for people aged 65 years or older.”

This again highlights the problem with relying on the CDC as a source of information. To support its flu shot recommendation for the elderly, the CDC has a history of citing studies that are simply not credible. The agency has cited a meta-analysis of observational studies finding that vaccination is associated with a reduction in flu-season deaths from any cause among the elderly by an unbelievable 50 percent.

Researchers from the National Institutes of Health (NIH), however, observed in a 2005 study in Archives of Internal Medicine that, as the vaccination rate for elderly Americans increased dramatically throughout the 1980s and 1990s, influenza mortality and hospitalization rates also significantly increased.

The NIH researchers found that, over the course of 33 flu seasons, influenza-related deaths were on average only about 5 percent and never more than 10 percent of the total number of winter deaths among the elderly. The obvious question was how it could be possible for the flu shot to reduce wintertime deaths from any cause by half when only 5 percent of deaths on average could be attributed to influenza.

Observational studies are prone to selection biases due to the inability of researchers to control for innumerable potentially confounding variables. That’s why the randomized, placebo-controlled clinical trial is considered the gold standard for studies of safety and effectiveness. Yet, as the NIH researchers also observed, no such trials had ever been done to determine the flu shot’s effect on elderly mortality.

In light of this, the NIH researchers examined the methodologies of the observational studies the CDC was relying upon and identified a selection bias sometimes known as a “healthy user” bias. Specifically, it wasn’t that vaccinated individuals were less likely to die, but that frail elderly people who were more likely to die during the coming winter were less likely to get a flu shot.

A study published in the International Journal of Epidemiology in 2006 found that the magnitude of this healthy user bias was “sufficient to account entirely for the associations observed”. In other words, the observational studies presented no credible evidence that vaccinating elderly people works to reduce influenza-related deaths.

Instructively, Haelle cites no published studies to support her claim that vaccination of the elderly prevents “much death and disability”. Instead, without disclosing her source’s inherent conflicts of interest, she cites Dr. LJ Tan, chief strategy officer for the Immunization Action Coalition (IAC), an organization funded in part by the CDC and whose stated mission is “to increase immunization rates”.

The IAC is also funded by pharmaceutical companies such as Merk. Influenza vaccine manufacturers that have funded the IAC during 2019 include GlaxoSmithKline, Sanofi Pasteur, and Seqirus.

Ignoring Science Indicating That Getting an Annual Flu Shot Can Increase the Risk of Illness

Another important point to keep in mind is that the estimates of vaccine effectiveness that are typically presented to the public consider only a single flu season. Relatively few studies have been done examining the safety and effectiveness of repeatedly getting a flu shot year after year. And what we know from such studies also does not reflect too well on the vaccine.

As reported in the journal PLoS Medicine in April 2010, four studies in Canada had found that receipt of the seasonal flu shot for the 2008 – 2009 flu season was associated with an increased risk of illness due to the pandemic A(H1N1) “swine flu” virus that had emerged. Researchers hypothesized that this was because repeated annual vaccination “effectively blocks the more robust, complex, and cross-protective immunity afforded by prior infection.”

In other words, the immunity acquired from natural infection with influenza not only protects the host against that particular strain, but other strains of influenza, as well, whereas the vaccine does not confer that benefit.

A study published in 2011 in the Journal of Virology confirmed that annual influenza vaccination indeed hampers the development of cross-protective immunity. Specifically, whereas the vaccine is designed to stimulate a strong antibody response, or humoral immunity, cell-mediated immunity is also important for protection from influenza. Natural infection confers both humoral and a robust cell-mediated immunity, whereas getting the flu shot each year “prevented the development” of the cross-protective cellular immunity “otherwise induced by infection.”

In the words of the study’s authors, repeated annual vaccination “may render young children who have not previously been infected with an influenza virus more susceptible to infection with a pandemic influenza virus of a novel subtype.”

A study published in August 2019 in the Journal of Infectious Diseases also confirmed that any protective effects from repeated annual vaccination come at the opportunity cost of blunting the cross-protective cell-mediated immune response to influenza infection.

A CDC-funded study published in Clinical Infectious Diseases in 2014 looked at data over five flu seasons and found that the more that people got the flu shot year after year, the less effective the vaccine was at preventing the recent season’s dominant H3N2 strain. The authors hypothesized that this was due to a phenomenon known as “original antigenic sin”, which is the idea that the immune system’s subsequent response to influenza viruses is influenced by the response to an earlier first exposure. Essentially, the immune system remembers the original antigen exposure and puts out a rapid defense against that particular strain at the opportunity cost of failing to develop a less rapid but more appropriate response the currently infecting strain.

Curiously, the CDC researchers didn’t include in their study people who had not received any flu shots during any of those five years, to see how well unvaccinated people did against the H2N2 virus compared with those who’d been vaccinated for one or more consecutive years. Evidently, that is a question the CDC did not wish to discover the answer to.

Apart from failing to consider the effects of repeated annual vaccination, most studies also don’t consider non-specific effects of the flu shot, meaning outcomes other than the vaccine’s effect on the risk of influenza infection. One exception is a randomized, placebo-controlled study published in the journal Clinical Infectious Diseases in 2012, which found that there was “no statistically significant difference in the risk of confirmed seasonal influenza infection” between children who’d gotten a flu shot and children who hadn’t. This was true even though vaccinated children demonstrated high levels of antibodies. (For further discussion of how antibodies are neither always sufficient nor even necessary for the development of immunity, see here.)

Furthermore, the study authors found that vaccinated children had an increased risk of non-influenza infections during the nine months following vaccination, including from rhinoviruses, coxsackie viruses, and echoviruses. Whatever possible benefit the vaccine might offer in terms of protection against seasonal influenza, the authors concluded, “was offset by an increased risk of other respiratory virus infection.”

In other words, their findings indicated that the influenza vaccine produced no significant benefit, only significant detriment to the functioning of children’s immune systems.

Misrepresenting the Science on the Safety of Vaccinating Pregnant Women

No less concerning is how Haelle also advises pregnant women to get a flu shot. She asserts that the flu shot is “not only safe for pregnant mothers” but “also linked to a lower risk of miscarriage and stillbirth.”

To support her assertion that this practice is “safe”, she cites a CDC-funded observational study that considered only certain outcomes for the mother within 42 days of receiving a flu shot and did not consider any birth or developmental outcomes. To support her claim that vaccination is associated with a reduced risk of fetal death, she cites an observational study of women in Norway who’d received a flu shot during pregnancy during the 2009 – 2010 pandemic influenza A(H1N1) flu season. Importantly, the recommendation in Norway was that pregnant women receive the vaccine during the second or third trimester only, whereas the CDC has since 2004 recommended the flu shot for pregnant women even during the first trimester.

Insightfully, the authors of the Norway study acknowledged that “safety data” for the use of the influenza vaccine pregnant women had received “were lacking at the time of the pandemic” and that, instead, public health officials supported their claim that it was “safe for use during pregnancy” based on “studies in animals”.

Their own study was prompted by reports of fetal losses after vaccination that had “raised public concern about the safety of vaccination during pregnancy.” They acknowledged that one limitation of their observational study was the risk of selection bias, such as the possibility that women with a history of previous fetal death might be less likely to accept vaccination.

While they found that infection with the pandemic H1N1 influenza virus was associated with an increased risk of fetal death and that vaccination was associated with a reduced risk of an influenza diagnosis, their finding of a reduced risk of fetal death with vaccination was not statistically significant.

But that is not the only reason why Haelle’s claim is highly misleading. She could just as well have also accurately written that vaccination during pregnancy has been linked with an increased risk of miscarriage.

Several months after that Norway study was published, a study by former CDC researcher Gary S. Goldman was published in Human & Experimental Toxicology in which he looked at US population data from the Vaccine Adverse Event Reporting System (VAERS) and found that women who’d received both the seasonal and the pandemic H1N1 flu shot during the 2008 – 2009 flu season had a significantly higher risk of having a miscarriage.

CDC researchers also followed up with their own study, which was published in the journal Vaccine in 2017. Their study looked specifically at vaccination during the first trimester since, as they understatedly acknowledged, “evidence of safety in early pregnancy is limited”. Their data also showed that vaccination was associated with an increased risk of miscarriage.

Women who’d received a flu shot during the study period, from 2010 to 2012, had twice the risk of spontaneous abortion within 28 days of vaccination. For the 2010 – 2011 flu season, vaccinated women had a 3.7 times greater risk. Neither of those findings were statistically significant. However, they also found that women who’d received a flu shot and who’d also received the vaccine the prior season had a statistically significant 7.7 times higher risk of miscarriage.

The fact that Haelle relies on observational studies to support her claim that vaccination during pregnancy is “safe” is unsurprising since no randomized, placebo-controlled trials have ever been done in the US to determine the safety of vaccinating pregnant women.

In fact, the influenza vaccine manufacturers themselves point out the lack of safety studies in their own product package inserts. For example, GlaxoSmithKline’s Fluarix insert states explicitly that “Safety and effectiveness of FLUARIX have not been established in pregnant women or nursing mothers.” Similar warnings are included in other flu shot products licensed for use in the US. No influenza vaccines have been approved by the FDA specifically for use in pregnant women, which is an “off-label” use of these products.

The reason the manufacturers include the warning about the lack of adequate safety studies for pregnant women is to absolve themselves of liability for any harms that might arise from this off-label use of their products. While the US government has granted broad legal immunity to manufacturers of vaccines recommended by the CDC for routine use in children, which includes flu shots, there are two circumstances in which a pharmaceutical company can be sued for vaccine injury: if they fail to manufacture the vaccine according to specifications or if they fail to include adequate warnings in their package inserts.

Indeed, if flu shot manufacturers were to make the same claim on their inserts about the safety of vaccinating pregnant women that Tara Haelle makes in her NPR article and that the CDC makes in its public relations messaging, they could be sued for fraud. Hence their inclusion of the warning about the lack of studies demonstrating the safety of vaccinating pregnant women.

(For further discussion and documentation related to the practice of vaccinating pregnant women for influenza, see here.)

Feigning to Bust Myths about the Flu Shot While Propagating Misinformation

The fact that NPR is so grossly misinforming the public about the safety and effectiveness of the influenza vaccine is all the more hypocritical in light of the focus the article places on “Busting Myths” about it, as the article purports to do with its meta title, which is the title embedded into the page’s source code that is intended to appear in search engine results. The article meta description begins, “The Internet abounds with myths about the relative risks of flu and flu shots . . . .”

Attributing the assertion to “doctors”, Haelle claims that people too often “shy away from the shot because of some falsehoods or misconceptions they’ve heard about the flu vaccine.” She purports to identify “five of the most common myths about flu shots” and to present “a strong dose of science-based facts to dispel the fiction.” Yet while claiming to bust myths about the vaccine, she is herself guilty of propagating misinformation.

She presents the supposed “myths” in the form of questions and answers. We’ll address each in the order she presents them.

Can getting the flu shot make you sick?

The first of her rhetorical questions is “Can getting the flu vaccine give you the flu or make you sick?” Haelle asserts that “The flu shot can’t give you the flu.” She goes on to explain that it’s not a live virus vaccine, but instead contains viral components that have been “inactivated” so that they cannot cause the flu. At the same time, she acknowledges that “normal responses” to flu shots include flu-like symptoms, including headache, nausea, and fever.

The distinction, though, between symptoms caused by a live virus and those caused by an inactivated influenza vaccine may not be too meaningful for anyone suffering such adverse consequences of vaccination. Just as most doctors diagnose “the flu” based on its symptoms, so would most people likely consider themselves as having “the flu”—and certainly of being “sick”—if they got a headache and fever and started throwing up after getting a flu shot.

That aside, Haelle’s statement that the vaccine “can’t give you the flu” is misleading because it remains true, as we’ve already seen, that getting an annual flu shot has been associated with an increased risk of not only influenza but also non-influenza illnesses.

Her characterization is also misleading because flu-like symptoms aren’t the only adverse events associated with the influenza vaccine and certainly aren’t the most serious.

For example, influenza vaccines, and particularly the pandemic ones, have been associated with an increased risk of an autoimmune condition called Guillain-Barré syndrome (GBS), the symptoms of which can resemble paralytic polio.

The use of the pandemic H1N1 flu shot in Europe was associated with an increased risk of developing narcolepsy, a neurological disorder affecting the brain’s ability to control sleep-wake cycles, resulting in uncontrollable daytime sleepiness. This might have been due to some people having a genetic predisposition wherein the vaccine triggered an autoimmune response by stimulating the production of antibodies that also attacked a protein produced in the brain’s hypothalamus that regulates the sleep-wake cycle.

Another serious harm known to be associated with influenza vaccines in children is febrile convulsions.

So, the true answer to the question is yes, flu shots can make you sick, including by potentially increasing your risk of infection with an influenza strain the vaccine is not designed protect against.

Does the CDC overestimate annual flu deaths?

The second question she rhetorically asks is “Aren’t deaths from the flu exaggerated?” But she declines to answer this question altogether, instead asserting as “Fact” that “Deaths from influenza range from a few thousand to tens of thousands every U.S. flu season.” To support this assertion, she cites numbers from the CDC.

But this is the logical fallacy of begging the question since it is precisely the reliability of the CDC’s estimates that have long been questioned by scientific researchers!

There is in fact “substantial controversy” surrounding the CDC’s flu death estimates, to quote from a 2005 study published in the American Journal of Epidemiology. That study acknowledged “significant limitations” of the CDC’s models, including the danger of confounding by other seasonal factors, which could potentially result in “spurious attribution of deaths to influenza.”

To provide some perspective about the CDC’s claim that in an average year tens of thousands of people die from influenza, consider that the average number of deaths for which the primary underlying factor is attributed to the influenza virus on death certificates is little more than 1,000.

Nobody knows how many deaths influenza causes each year, so the CDC uses mathematical models to estimate the numbers. But its models are only as good as the assumptions built into them.

Moreover, the CDC’s models estimate the numbers of influenza-associated deaths, but just because a person dies following infection with influenza does not necessarily mean that the virus caused the death. CDC researcher William Thompson, who helped develop the models used to estimate flu deaths, acknowledged that the CDC’s numbers represent a presumed association and not necessarily causation. “Based on modelling,” Thompson has acknowledged, “we think it’s associated. I don’t know that we would say that it’s the underlying cause of death.”

Of course, that is precisely what Tara Haelle is doing when she falsely cites the CDC’s numbers as though representative of known deaths caused by the influenza virus. (For further discussion of the CDC’s controversial estimates, see here and here.)

So, the true answer to the question is nobody really knows how many people die each year because of influenza infection, and the CDC’s numbers are estimates that do not represent known cases of flu-caused deaths and may very well exaggerate the numbers.

Is mercury safe for pregnant women and fetuses?

The next question Haelle rhetorically asks is, “Don’t flu vaccines contain dangerous ingredients, such as mercury, formaldehyde and antifreeze?” While she rightly points out that they don’t contain antifreeze, she acknowledges that they do contain “trace amounts” of formaldehyde from the manufacturing process and, in multi-dose vials of the vaccine, a preservative called thimerosal that by weight is about half ethylmercury.

However, to convince NPR readers that the mercury in flu shots poses no risk, Haelle blatantly lies to her readers. “Unlike the methylmercury that can build up in the body, ethylmercury is made of larger molecules that a cannot enter the brain; they exit the body in about a week.” She adds that vaccines made with thimerosal “have been extensively studied and are safe”.

To support her claim that ethylmercury is quickly eliminated and cannot accumulate in the body, Haelle cites an information sheet from, once again, the industry-funded Immunization Action Coalition. But that source, while similarly characterizing thimerosal as safe, does not support the claim and nowhere says that ethylmercury cannot enter the brain and does not accumulate in the body.

Secondarily, she supports that claim by citing a study published in The Lancet in 2002 that found that ethylmercury from vaccines “seems to be eliminated from blood rapidly”.

Haelle’s claims about thimerosal echo those of the CDC, which similarly claims that ethylmercury from vaccines is “readily eliminated” and so “does not build up and reach harmful levels.”

But to demonstrate that NPR and the CDC are both blatantly lying to the public, all we have to do is examine the CDC’s own sources from the scientific literature.

One source cited by the CDC to support the claim is a 2004 report by the Institute of Medicine (IOM). But that report in fact described thimerosal as a “known neurotoxin” that “can injure the nervous system”. The IOM report also acknowledged that ethylmercury from vaccines “accumulates in the brain”.

Another source the CDC cites is a study by FDA researchers published in Pediatrics in 2001. But that study admitted that the CDC’s routine childhood vaccine schedule was exposing infants to cumulative levels of mercury that exceeded the safety guidelines of the Environmental Protection Agency (EPA). (This was why the decision was made in 1999 to phase out the use of thimerosal in most childhood vaccines.)

While attempting to offer reassurance that studies hadn’t proven neurodevelopmental harms from vaccines, the FDA researchers also acknowledged that “no controlled studies have been conducted to examine low-dose thimerosal toxicity in humans”. Furthermore, “similar toxicological profiles between ethylmercury and methylmercury suggest that neurotoxicity may also occur at low doses of thimerosal” (emphasis added). They therefore could not “exclude the possibility of subtle neurodevelopmental abnormalities for the cumulative exposure to thimerosal in vaccines”.

Another of the CDC’s sources is a study published in Environmental Health Perspectives in 2005. But that study confirmed that, while ethylmercury from vaccines is more rapidly eliminated from the blood than methylmercury, it can also cross the blood-brain barrier and accumulate in the brain. In fact, the study showed that the type of mercury in vaccines is more persistent in the brain than methylmercury. This is because ethylmercury, once inside the brain, breaks down to inorganic mercury (meaning it’s no longer bound to carbon atoms), which is less readily eliminated once inside the brain.

The authors of that study also observed that inorganic mercury in the brain has been “associated with a significant increase in the number of microglia in the brain” and that “‘an active neuroinflammatory process’ has been demonstrated in brains of autistic patients, including a marked activation of microglia.”

Instructively, the authors drew the conclusions that the government’s use of methylmercury toxicology as a reference for risk assessment from thimerosal exposure is scientifically invalid and that the use of mercury in vaccines represents a significant cause for concern.

Researchers from the NIH have also acknowledged that, while more readily eliminated from the blood, ethylmercury is persistent in tissues, the kidneys, and the brain.

In sum, Haelle’s claim that the mercury in multi-dose vials of influenza vaccines cannot enter the brain and does not accumulate in the body is not just deceptive but an outright lie.

Moving on, to support her claim that the safety of thimerosal has been “extensively studied”, Haelle cites a 2004 Pediatrics study that reviewed available studies related to the question of whether vaccines can cause autism. That review criticized studies supporting an association for having “significant design flaws that invalidate their conclusions.”

But we could stipulate that thimerosal-containing vaccines cannot cause autism and it would not logically follow that therefore they cannot cause other serious neurological harms or fetal death.

Furthermore, the same criticism the Pediatrics study made of studies supporting an association can also be made of the observational studies finding no association between thimerosal-containing vaccines and autism.

In fact, while the CDC claims that vaccines can’t cause autism, the 2004 IOM report it cites explicitly acknowledged that the hypothesis that vaccines can cause autism in genetically susceptible individuals “cannot be excluded” by observational studies. In fact, none of the studies examined by the IOM was designed to take into consideration the possibility of genetically susceptible subpopulations. This, the IOM further conceded, could explain why these studies had failed to find an association!

To support the claim that flu shots “are safe” even for pregnant women and infants as young as six months, Haelle also cites a study by FDA researchers published in Risk Analysis in 2013. But that study was based on a comparison of estimated levels of injected ethylmercury from annual influenza vaccination with the EPA’s safety guidelines for ingested methylmercury. Ironically, the FDA researchers cited the 2005 Environmental Health Perspectives study, describing it as “the most relevant study on which to base a comparative assessment of infant mercury assessment of infant mercury exposure or risk from thimerosal relative to MeHg [methylmercury].” Yet the FDA scientists ignored that prior study’s conclusion that judging the risks from injected ethylmercury based on comparison with what’s known about the toxicological properties of ingested methylmercury is not a scientifically valid practice!

No less ironically, while Haelle claims that ethylmercury cannot enter the brain, the Risk Analysis study she cites to support her argument acknowledges that it does.

So, the true answer to the question is no, it absolutely is not “safe”, in any meaningful sense of the word, to inject pregnant women and infants with a known neurotoxin that crosses both the placental and blood-brain barriers and accumulates in the brain. While the potential harms from this dangerous practice remain unknown because it hasn’t been well studied and symptoms of harm may not be noticeable until many years after vaccination, it is biologically plausible if not probable that neurodevelopmental harms do result. In accordance with the precautionary principle, anyone choosing to get a flu shot—and especially pregnant women and parents of young children—should opt for a thimerosal-free single-dose vial version of the vaccine to avoid the unnecessary exposure.

Does public vaccine policy profit the pharmaceutical industry?

The fourth question Haelle rhetorically asks is whether pregnant women should avoid getting the flu shot, which we’ve already been over, so we’ll skip to the fifth.

Her fifth and final question is “Don’t pharmaceutical companies make a massive profit from flu vaccines?” Humorously, the answer to her question depends entirely upon how one defines “massive”. She acknowledges that influenza vaccines produced an estimated revenue of $2.2 billion in 2018, putting that into some perspective by also citing the figure of $1.2 trillion in total pharmaceutical industry revenue.

“If pharmaceutical companies didn’t make a profit off vaccines, they likely wouldn’t manufacture them,” Haelle also argues. But while the profit motive in and of itself isn’t problematic, her argument ignores the fact that the US federal government has granted influenza vaccine manufacturers legal immunity, while state governments mandate their use in children. She ignores the fact that, were it not for this government intervention into the marketplace, pharmaceutical companies might well not profit off this or other vaccines. Indeed, it was precisely because vaccine injury lawsuits were putting manufacturers out of business—which in turn threatened the public policy goals of government health officials—that the US Congress passed the law in 1986 granting broad legal immunity to the pharmaceutical industry.

Haelle closes by arguing that, even if you don’t get a flu shot for yourself, you should do it to protect others. She implies that the vaccine confers herd immunity by claiming that getting a flu shot will also help protect vulnerable people around you from influenza infection.

However, the 2018 systematic review of vaccination to prevent influenza in healthy adults pointed out that the prior 2010 review had found “no evidence” that flu shots “affect complications, such as pneumonia, or transmission” (emphasis added). That prior finding was not altered in the updated review by researchers from Cochrane, an international organization specializing in this type of study, which also known as a meta-analysis. In a commentary published at the same time as the updated review, leading Cochrane researchers pointed out that there remains “little evidence on prevention of complications, transmission, or time off work” (emphasis added).

A study published in January 2018 in PNAS, the journal of the Proceedings of the National Academy of Sciences, found that people who’d gotten a flu shot two years in a row actually shed over six times as much aerosolized virus in their breath than people who’d skipped the shot both years. While calling for further studies to confirm their results, they remarked that “this observation, together with recent literature suggesting reduced protection with annual vaccination, would have implications for influenza vaccination recommendations and policies.”

One would certainly hope so, but, then, neither the government nor mainstream media outlets like NPR seem to have much interest in critically and objectively reevaluating existing public vaccine policies in light of scientific advancements in our knowledge about the immune system and the effects of vaccination.

Conclusion

The hypocrisy of Tara Haelle’s NPR article is staggering. While purporting to debunk “myths” that lead people to avoid getting a flu shot, she grossly deceives NPR’s readers on practically every count, including by blatantly lying that the mercury from flu shots can’t enter or accumulate in the brain.

Her intent is palpably not to properly inform people so that they may conduct their own individual risk-benefit analysis and determine for themselves whether getting an annual flu shot is the right choice for them or their loved ones. Her transparent purpose is rather to manufacture consent for the CDC’s influenza vaccine recommendations—and if the goal of creating more demand for the pharmaceutical industry’s flu shot products requires grossly misinforming the public about the science, so be it.

As far as NPR would have its readers believe, there is simply no reasonable basis for anyone to choose not to get a flu shot. But that is ludicrous. There are innumerable legitimate and science-based reasons why individuals might choose not to comply with the CDC’s recommendations.

Of course, it’s useful to remember that when NPR, the New York Times, the Washington Post, and other mainstream media outlets systematically deceive the public about the safety and effectiveness of the influenza vaccine, they are simply following the example set by the CDC.

Postscript

Prior to writing this article, I confronted Tara Haelle on Twitter about a few of her deceptions (see here and here). Here was her dismissive response:

I will leave it to you, dear reader, to examine the scientific evidence for yourself and determine which one of us is demonstrating willful ignorance and dishonesty.

Update, December 28, 2019: Tara Haelle has continued to refuse to correct her misinformation in her NPR article: