The flu

A colleague recently wrote me that he had read my post on the flu vaccine and GBS, and his son had had GBS at age 3.

I am sorry that his son had GBS. It is not a fun condition, and it must be horrifying to see in one's own child. But as a medical professional, and as a public health professional, I have to be very careful not to confuse one patient's experience with what is likely to happen to all, most, or even many patients.

My point on flu vaccine and GBS is that, although there is the possibility of GBS from getting the vaccine, not getting the vaccine leaves people liable to influenza - so the question is, which possibility is greater, and which condition is worse? WHO states that on 1 million vaccinations, 1 case of GBS will result. Last year, (as of 1 July 2008) the US population was 304,059,724(1) - if we had vaccinated everyone, that would translate into 304 cases of GBS; with a fatality rate of 6% (the larger end of the estimate from the CDC, as discussed in the previous post) that would yield 18 deaths total.

On the influenza side, for the 2007 - 2008 season, 88 "Influenza-Associated" pediatric deaths occurred. That's pediatric deaths only - not counting the deaths in young adults, middle aged adults, and the elderly. And this is death from seasonal flu only, not swine flu (also known as H1N1)(2)

So, looking at these numbers, we have 18 vaccination deaths in the entire population, if we vaccinated everyone; or 88 deaths in the pediatric population from the flu itself, plus additional deaths in the adult populations.

I'd rather go with the vaccination.

[Edited 25 October 2009]

Previous post: The flu vaccine and GBS
SOURCE:
(1) http://www.census.gov/popest/states/tables/NST-EST2008-01.xls
(2) http://www.cdc.gov/flu/weekly/weeklyarchives2008-2009/weekly32.htm