Influenza

It is believed that influenza kills more people than all the other vaccine-preventable diseases combined. Therefore, theoretically, if there is any point at all to get vaccinated, it should be against the flu.

There are three types of flu viruses: A, B and C.
Type A influenza has subtypes that are determined by the surface antigens hemagglutinin (H) and neuraminidase (N). There are in total 18 hemagglutinin antigens, and 9 neuraminidase antigens, but what matters to the humans are three types of hemagglutinin (H1, H2, and H3), which have a role in virus attachment to cells. Two types of neuraminidase (N1 and N2) have a role in virus penetration into cells.
Influenza C is rarely reported as a cause of human illness, probably because most cases are subclinical. It has not been associated with epidemic disease; it is not contained in the flu vaccine.
Influenza B generally causes milder disease than type A.
A flu vaccine usually contains one strain of each of the virus types: A(H1N1), A(H3N2) and B. Quadrivalent flu vaccines, containing an additional strain of type B virus, became available in 2013.
Live intranasal flu vaccines became available in 2003.
Seasonal vaccines 2017/18 contain following strains: A/Hong Kong/4801/2014(H3N2), A/Michigan/45/2015(H1N1)pdm09, and B/Brisbane/60/2008. Quadrivalent vaccine also contains the strain B/Phuket/3073/2013.
A/Hong Kong/4801/2014(H3N2) means 4801-st type A flu strain, identified in Hong Kong in 2014. Virus strains in vaccines are not changed every year, and three out of these four strains remained the same from the previous season.

The virus for a vaccine is grown in fertilized chicken eggs. Some vaccines are grown on kidney cells of dogs. Thiomersal (mercury preservative in vaccines) is no longer used in childrens’ vaccines, however it remains in the flu vaccine (in the multidose ampoules). The vaccine also usually contains polysorbate 80.
Twice a year WHO decides which strains should be included into a vaccine. Strains that multiply well in eggs are usually chosen. In the process of growing the viruses mutate, that’s why the strain chosen by WHO does not always correspond to the strain in the vaccine. Each egg produces approximately one dose of vaccine, thus the vaccine manufacturer uses a million of fertilized eggs per day.

Vaccine effectiveness against virus strain A(H3N2) for 2016/17 season among hospitalized elderly people was 17%. Among those who also received vaccination the previous season, the vaccine effectiveness was -2% (negative).
Authors expect that next season it will not be particularly effective either, due to the fact that the virus strain used in the vaccine 2017/18 - A(H3N2) – remained unchanged.

The article explains why the vaccine for 2016/17 season was not effective (virus growing in eggs and mutating).

How to calculate the effectiveness of a vaccine? All means are used. In observatory studies (which are the majority), all hospitalized patients presenting symptoms of acute respiratory infection (ARI) are tested for influenza. However, these tests take into account only the strains contained in the vaccine. Vaccine effectiveness is calculated according to the formula VE = 1-OR = 1 - Oi/Oni, where Oi is a ratio of vaccinated to unvaccinated among the flu patients, and Oni – ratio of vaccinated to unvaccinated among patients with other respiratory symptoms, but not flu. In other words, vaccine effectiveness is usually measured only among hospitalized patients, or among already ill, which obviously does not give an adequate evaluation of its effectiveness. In the previous research, for example, the median age of the hospitalized patients was 80 years old, and 94% of them were suffering from another disease which predisposed them to ARI. As the virus strains change each year – just like the flu vaccines – its effectiveness is impossible to access before the flu season begins, therefore it’s accessed at the end of the season.

During the season 2014/15 effectiveness of the vaccine against flu type A(H3N2) in Canada was estimated at 53% for those who got vaccinated that year. Among those who had been vaccinated the previous year, the effectiveness was negative -32%. Among those who were vaccinated third year in a row, the vaccine effectiveness was negative -54%. The average vaccine effectiveness was -17% (negative).

Influenza type A(H3N2) vaccine effectiveness during 2004-2013 was 65% for those who got vaccinated that season. In those who are vaccinated frequently, the effectiveness was 24%. The effectiveness of type B flu virus was 75% for those vaccinated that season, and 48% for those who are vaccinated frequently.

Influenza vaccine effectiveness during 2010/11 season among those who were vaccinated two years in a row was negative: -45%. Among those who were vaccinated only one season, the effectiveness was 62%; among those, who got infected at home: -51%. Among adults, who got infected at home, the effectiveness was -283%.

Influenza vaccine effectiveness during the 2012/13 season was 48% for adults and -4% for children younger than 9 years old.

Analysis of the influenza vaccine effectiveness for pregnant women in 1997-2002. The vaccine did not have any impact on influenza prevention.

According to observational studies, flu vaccination in elderly reduces mortality among elderly people by 50%.
Flu vaccination coverage among elderly increased from 15-20% in 1970-s to 65% в 2001. Unexpectedly, estimates of influenza-related mortality in this age group also increased during this period. Because fewer than 10% of all winter deaths were attributable to influenza in any season, the conclusion is that observational studies substantially overestimate vaccination benefit.

More than 90% influenza mortality falls on elderly above 70 years old. However, there are no randomized studies proving that influenza vaccination in elderly reduces their mortality. Some research show that the flu vaccine prevents mortality before the flu season starts, which demonstrates data selection bias. Such flawed studies, nevertheless, still get published in prestigious medical journals.

This paper presents the relevant literature and examines the evidence for patient benefit from healthcare worker vaccination. Published research shows that personal benefit from vaccinating healthy nonelderly adults is small and there is no evidence that it is any different for HCWs.
The studies aiming to prove the widespread belief that healthcare worker vaccination decreases patient morbidity and mortality are heavily flawed and the recommendations for vaccination biased. No reliable published evidence shows that healthcare workers' vaccination has substantial benefit for their patients—not in reducing patient morbidity or mortality and not even in increasing patient vaccination rates.
The arguments for uniform healthcare worker influenza vaccination are not supported by existing literature. The decision whether to get vaccinated should, except possibly in extreme situations, be that of the individual healthcare worker, without legal, institutional, or peer coercion.

Analysis of four randomized studies of the benefits of the HCWs influenza vaccination for the patients.
According to the above mentioned studies, vaccination of eight HCWs may save the life of one patient. Therefore, the generalized flu vaccination of HCWs should save 687 000 lives per year in the US, i.e. more people than there were deaths from the flu epidemic in 1918. There follows an explanation of how the authors manipulate the statistics in order to arrive to such extravagant results. More realistic calculations based on actual patient data instead shows that at least 6000 to 32,000 hospital workers would need to be vaccinated before a single patient death could potentially be averted.
Moreover, according to these studies, it appears that 90% of patients die of flu without having shown any respiratory symptoms and that flu vaccination saves more lives than the number of people who contracted the disease.
Authors conclude that current scientific data are inadequate to support the ethical implementation of enforced HCW influenza vaccination to reduce patients’ risk, and that the resources may well be better used on more evidence-based efforts.

Influenza outbreak on a military ship, where 99% were vaccinated (25 out of 102 soldiers). The virus strain identified was the same as in the vaccine received by the crew. All the infected soldiers received antiviral medication.
Another outbreak of influenza among fully vaccinated soldiers: [1], [2].

Research over the course of 8 seasons (1999-2007) shows a threefold increased risk of hospitalization in subjects who did get the trivalent inactivated flu vaccine, vs. unvaccinated subjects.
During these 8 seasons strain A(H3N2) was wrongly guessed 5 times; strain A(H1N1) and B – 4 times.

In a randomized placebo controlled trial, over the course of 9 months following the inactivated influenza vaccination, the risk of flu-unrelated diseases was 4,4 times higher among the vaccinated subjects than among non-vaccinated ones.

During the 13 weeks after vaccination, the influenza-like illness was by 60% more common in vaccinated children than in the unvaccinated. The risk of influenza infection was equal in both groups.

A randomized double blind placebo-controlled research to establish the cost-effectiveness of flu vaccination.
During the first year of the research the vaccine and predominant circulating viruses were badly matched, resulting in negative efficacy of the vaccine. The vaccinated lost 45% more workdays than non-vaccinated and visited physicians 378% more frequently.
During the second year of the research the vaccine and the virus were better matched; the non-vaccinated lost 32% more workdays than the vaccinated, and visited physicians 47% more frequently.
Both seasons resulted in societal costs. During the first year, this cost was $11.17 per person; during the second year - $31.4 per person. Authors conclude that vaccination may not provide overall economic benefits in most years.

A study designed to establish the influence of flu vaccination on immune response to influenza in households and communities.
In all, 47% of students in intervention schools received live attenuated influenza vaccine. As compared with control-school households, intervention-school households had significantly fewer influenza-like symptoms and outcomes during the recall week. Paradoxically, intervention-school households (both children and adults) had higher rates of hospitalization than did control-school households. However, there was no difference in the overall hospitalization rates for children or adults in households with vaccinated children, as compared with those with unvaccinated children, regardless of study-group assignment. Rates of school absenteeism for any cause (based on school records) were not significantly different between intervention and control schools.

People who have received flu vaccine two seasons in a row exhale 6.3 times more virus particles than the unvaccinated.
Sneezing was rare, and sneezing and coughing were not necessary for infectious aerosol generation.

Influenza vaccination did not reduce the risk of subsequent hospital admission among patients with vaccine failure. These findings do not support the hypothesis that vaccination mitigates influenza illness severity.

Many people believe that flu vaccination may cause flu. Authors conducted the present investigation in order to disprove this belief. Their discoveries are below.
The hazard of influenza in individuals during the 14-day post-vaccination period was similar to unvaccinated individuals during the same period.
The hazard of non-influenza respiratory pathogens during the same period was higher by 71% in vaccinated children.

Cochrane systematic review of the effectiveness of flu vaccine for children.
For children older than two years of age the efficacy of live vaccine was 33%, of inactivated one – 36%.
Inactivated vaccines in children under 2 years old are not significantly more efficacious than placebo.
There exists no evidence that the flu vaccine reduces mortality, hospitalization, serious post-flu complications or flu infection.
Authors were surprised to find only one study of inactivated vaccine in children under two years, conducted in 1976 and including 35 children. Authors consider it to be strange that the vaccination in children is recommended as a public health policy, although there are virtually no safety studies on the subject.
On the subject of live flu vaccine the authors found 10 industry-funded safety studies. However, they were unable to analyze the data presented in these studies, because the manufacturer refused to provide full information on side effects.
Authors note that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies.

Cochrane sistematic review of the effectiveness of flu vaccine for adults (90 studies). Less than 10% of the studies were of good quality.
Influenza vaccines have a very modest effect on reducing influenza symptoms and working days lost in the general population, including pregnant women. The overall effectiveness of parenteral inactivated vaccine against influenza-like illness is limited, corresponding to a number needed to vaccinate of 40. The overall efficacy of inactivated vaccines in preventing confirmed influenza has a needed to vaccinate of 71.
Influenza vaccines have a very modest effect in reducing influenza symptoms and working days lost in the general population, including pregnant women.
Number needed to vaccinate of 92 in pregnant women to prevent a single case of influenza-like illness, and of 27 to prevent a single case of influenza-like illness in newborns. No evidence of association between influenza vaccination and serious adverse events was found in the comparative studies considered in the review.
While it exists over 200 viruses capable to cause influenza-like symptoms, it is impossible to distinguish between them without laboratory analysis. Influenza viruses of types A and B constitute around 10% of these viruses.

Cochrane systematic review of the effectiveness of influenza vaccines for the elderly included 75 studies. All the studies were of so low quality that the authors could not conclude anything.
Here it is reported that in the elderly after vaccination produced 41-76% less antibodies than the young.
Here it is reported that in the elderly who take statins, 38-67% less antibodies are produced than those who do not take them.

Cochrane systematic review of influenza vaccine effectiveness for the medical personnel working with elderly people.
The review findings have not identified conclusive evidence of benefit of healthcare workers vaccination programs on outcomes of laboratory-proven influenza, its complications or mortality in people over the age of 60 who live in care institutions.

Cochrane systematic review of 259 studies of influenza vaccines. 70% of studies were of poor quality and overly optimistic in their conclusions.
Only in 18% of the studies the data presented in the studies supported its conclusions. Let that think in. In 82% of studies the data did not support the conclusions.
In better quality studies the data supported the conclusions 16 times more often. These studies conclude that the vaccines are efficient 25 times less often. Government-funded studies conclude that the vaccines are efficient half the times.
Industry-funded studies are more often printed in prestigious medical journals (those with the highest journal impact factor), regardless of the quality of the study or the quantity of residents.

Infection with influenza type A virus increases the immune response to other, potentially more dangerous virus strains. This is called heterosubtypic immunity. Vaccination has the opposite effect.
Mice were vaccinated against seasonal influenza, then infected with pandemic avian influenza. The vaccinated mice died, unvaccinated mice survived.
The authors conclude that in the light of the pandemic threat caused by highly pathogenic avian influenza, vaccinating all healthy children against seasonal influenza may cause serious health issues for them. [1].

Some mice were infected with human influenza virus 4 weeks prior to a lethal infection with highly pathogenic avian influenza. Other mice were only infected with the avian flu. Mice which received the human virus infection showed a much higher survival rate compared to those which only got infected with the avian flu. [1], [2].

An individual’s first influenza virus infection at early age confers lifelong protection against severe disease from novel and potentially more dangerous virus subtypes in adult age.

Due to influenza virus’ continual mutation, the immune system reacting to it is subject to the “original antigenic sin”. Humans, upon infection with a novel influenza virus strain, produce antibodies against older viral strains at the expense of responses with novel, protective antibodies. This exacerbates the severity of the current infection.

Vaccine effectiveness does not monotonically decrease with the antigenic distance between the vaccine strains and the circulating strains. The minimal vaccine effectiveness falls at this intermediate antigenic distance between the vaccine and circulating strains. Since the vaccine effectiveness at this intermediate antigenic distance between the vaccine and circulating strains is lower than the effectiveness at a larger antigenic distance in unvaccinated people, original antigenic sin could make vaccinated people more susceptible to the virus than those who are unvaccinated.
This phenomenon possibly explains why during the years when the vaccine strain was not guessed, correctly the resulting vaccine was not only of little use but in fact exacerbated the severity of the disease. Vaccine strain is correctly determined in less than 50% of cases.

If vaccination confers partial or imperfect immunity, a highly immune or vaccinated population can pressure the virus population to evolve more quickly than usual. It has already been documented in an avian flu lineage in vaccinated chickens. The overall rate of virus mutation was almost twice as high in the vaccinated chickens compared to the unvaccinated chickens. The authors conclude that during the vaccination seasons we should expect virus mutations and increase their monitoring.

Seasonal influenza vaccination increased the risk of swine flu infection by 2.5 times among children in Canada in 2009. These results were confirmed in five other studies. More: [1].

In a ferret study part of the animals received a 2008-09 influenza vaccine and then infected with swine influenza; the other part received a placebo injection. As shown by to subsequent observations, the vaccinated ferrets suffered a more severe disease compared to the unvaccinated ferrets.

Previously vaccinated soldiers contracted swine flu much more often than the unvaccinated.

Piglets vaccinated from one strain of influenza showed significantly more complications when they were infected with swine flu. The antibodies from the vaccine helped the new flu strain penetrate the lungs.

Vaccination against influenza inhibits the production of cytotoxic T-lymphocytes in children, that is, makes them more susceptible to infections.

Vaccination against influenza during pregnancy increases the risk of miscarriage in the next 28 days by 2 times.
Among women who received an influenza vaccine in the previous influenza season, the risk of miscarriage was 7.7 times higher.

A Vaccine Adverse Event Reporting System (VAERS) study.
During a two-vaccine 2009-10 season, when pregnant women were vaccinated against common flu and swine flu, the risk of fetal losses was 11 times higher than during the 2008-09 season, and 6 times higher than during the 2010-11 season.
Three studies are usually used to prove the flu vaccine safety for pregnant women.
First study involved 56, second – 180 women. Both these studies used ‘no Thimerosal’ vaccines.
A third study was conducted among 2291 pregnant women but fetal losses were not included in the analysis.
It is thought that vaccines may cause a fetal loss in 1.9 cases per million of vaccinated women. However this data does not take into consideration that VAERS registers only an insignificant number of vaccine side effects.

Influenza vaccine causes inflammatory reaction in pregnant women. This reaction is significantly weaker than that caused by the virus itself; however it may increase the risk of adverse outcomes.
11.3% of pregnant women were vaccinated during the 2008-09 season. However, during the double-vaccine season of 2009-10, 50.7% of pregnant women were vaccinated against seasonal flu and 47.7% against swine flu.

A study of 197 000 children born between 2000 and 2010. 1.6% of children were diagnosed with autism spectrum disorder (1 out of 63).
Influenza vaccine administered to pregnant women during the first trimester of pregnancy increased the risk of autism by 20%. However, after adjusting for multiple testing (Bonferroni correction) p-value becomes 0.1 and authors conclude that there is 10% likelihood that this is merely a chance correlation.

In 1990-2005, VAERS recorded 1000 cases of Guillain-Barre syndrome after vaccination, 63% of them were after influenza vaccination.

Risk of narcolepsy in vaccinated against swine flu in 2009 was increased by 17 times. In another study the risk was increased 4-9 times. Third study showed 14-16 times narcolepsy risk increase.
A similar Swedish study found increased psychiatric comorbidity in children and adolescents with narcolepsy.
A possible explanation of this phenomenon may be that the human antibodies to nucleoprotein cross-react with human hypocretin receptor. [1]

Influenza vaccine causes platelet activation and may potentially cause cardiovascular events.

Live influenza vaccine may in certain circumstances mutate into a pathogenic virus.

Influenza vaccine may occasionally cause vasiculitis and neurological complications.
Live influenza vaccine significantly increases colonization of pneumococcus and staphylococcus in mice.
Live influenza vaccine also increases colonization of pneumococus within the middle ear in mice, which may increase the risk of otitis media.
Inactivated intranasal influenza vaccine, used in Switzerland, increased the risk of facial palsy by 84 times.

The CDC states that about 36 000 Americans die from flu. However they also include pneumonia-related deaths into this statistics, although pneumonia is not always caused by flu. For example, antacids increase the risk of pneumonia, but for some reason they are not included into this statistics.
According to the National Center for Health Statistics (which is part of CDC), flu causes an average of 1348 deaths yearly.
Prior to 2003 CDC stated that annual death toll due to flu is 20,000. Then article was published in JAMA which increased this number by 80% based on statistical model, although flu-related mortality in the 90's was 30% lower than in the 80's.
“In 2003 the demand for flu vaccines was low, the vaccine-producing companies were not receiving orders even in December” said Dr. Nowak from CDC on NPR, - "therefore we decided to encourage people to get vaccinated".

Here is an example of mortality data from CDC for 2014. 55,227 people died from influenza and pneumonia. But only 4,605 of them died from influenza, the rest died from pneumonia. Still, not all of these 4,605 really died of influenza, because the laboratory analysis of the virus is fairly uncommon. Nevertheless, CDC adds up cases of lab-confirmed influenza (J09-J10) and of suspected influenza (J11), despite the fact that only a fraction of acute respiratory illnesses are caused by influenza viruses.

This presentation, prepared by Dr. Nowak, CDC PR director, explains precisely how the media and medical experts should scare the population to increase vaccine coverage. You also get to learn what CDC thinks of you. It believes that an atmosphere of anxiety and fear should be created, particularly among people who are not vaccinated yearly. It makes for an interesting read, indeed highly recommended, only 17 slides. Here’s a spoiler quote: “Health literacy is a growing problem".

Homeland Security expects the next pandemic flu to kill 6-56 times more Americans than common seasonal flu. WHO is more conservative and expects that pandemic flu could claim 4-30 times more lives than common seasonal flu.
However, except 1918, every following flu pandemic was less lethal than the preceding one. Moreover, mortality during the flu pandemics (1957/58, 1968/9) was not much different from that during season flu.
NIH analyzed data from 30 flu seasons and could not correlate increasing vaccination coverage after 1980 with declining mortality rates in any age group. CDC states that flu-related mortality increased by 67% in the 90's, whereas in reality it decreased by 38%.

For majority of population the influenza vaccine is quite useless, because the majority does not get sick with influenza. Only 7% of the acute respiratory illnesses are caused by flu viruses.
Studies quoted by CDC are subject to ‘healthy user bias’, meaning that the healthy people are vaccinated more often than sick ones.
In 2009 Australia stopped the country-wide vaccination program after it has been discovered that one out of 110 vaccinated children suffered from febrile convulsions. The assumption that safety of previously administered flu vaccines proves safety of future ones is unfounded.

Promotion of influenza vaccines is one of the most visible and aggressive public health policies today. Twenty years ago, in 1990, 32 million doses of influenza vaccine were available in the United States. Today around 135 million doses of influenza vaccine annually enter the US market. This enormous growth has not been fueled by popular demand but instead by a public health campaign that delivers a straightforward message: influenza is a serious disease, we are all at risk of complications from influenza, the flu shot is virtually risk free, and vaccination saves lives. Through this lens, the lack of influenza vaccine availability for all 315 million US citizens seems to border on the unethical. Yet across the country, mandatory influenza vaccination policies have cropped up, particularly in healthcare facilities, precisely because not everyone wants the vaccination, and compulsion appears the only way to achieve high vaccination rates.
In 1960-s CDC recommended vaccination only for elderly people (from 65 years old);
1984 – the introduction of medical personnel vaccination;
1987 – vaccination of those who share household with elderly people;
1997 – vaccination of pregnant women in 2nd and 3rd trimester of pregnancy;
2000 – vaccination of people older than 50 years old;
2004 – vaccination of pregnant women during the 1st trimester of pregnancy, as well as children from 6 months to two years old and all who come in contact with them;
2006 – vaccination of children up to 5 years old and all who come in contact with them;
2008 – vaccination of all children up to 18 years old;
2010 – total vaccination of all population with the exception of babies younger than 6 months old.
Based on a single observation study (financed by CDC) CDC made the statement that flu vaccine reduces mortality by 48%. If this should be true than flu vaccines could save more lives than any medicine registered on our planet. If influenza is responsible for a mere 5% of winter mortality, the flu vaccine cannot prevent half of all life losses.
If observational studies are not to be believed, what evidence is there that vaccines reduce mortality among elderly people? Practically none. Only one randomized study among elderly people was conducted 20 years ago, and it did not show that flu vaccines help to reduce mortality. In other words, the flu vaccine is being recommended regardless of total absence of clinical studies showing its effectiveness. This recommendations is based solely on the presence of antibodies, however there is no proof that these antibodies lead to reduced morbidity. And since to date the flu vaccine is recommended to everyone, it should seem unethical to conduct randomized studies at this point.

In 1999, after the avian flu outbreak in Hong Kong, WHO started preparations for influenza pandemic. 10 years later, on June 11, 2009, Margaret Chan, the director general of the World Health Organization, announced to the world’s media that world is now at the start of the 2009 influenza pandemic. Governments that took advice from WHO have spent billions of dollars’ worth of antivirus vaccines oseltamivir (Tamiflu) and zanamivir (Relenza). One year later — and these vaccines lay stockpiled unused in warehouses around the world, whilst governments were unwinding their vaccine contracts. Scientists who were helping WHO to put together vaccination recommendations were employed by pharmaceutical companies - a conflict of interest which was kept carefully under wraps. This is how the vaccine-producing pharmaceutical companies were using WHO to pass recommendations to governments to stock on vaccine supplies, as they would be in short supply once the flu pandemic sets in. WHO keeps secret the member list of its Committee for Emergency Situations. Dr. Margaret Chan refused to comment on the conflict of interest issue. A few months prior to announcing the pandemic WHO changed the criteria used to determine whether pandemic is indeed taking place, as it was no longer deemed necessary to assess morbidity and mortality.
WHO did not have any scientific foundations to conclude that 2 billion people would be infected with swine flu. Moreover, WHO did not change this estimation even after the flu season was over in Australia and New Zealand, where only 1-2 people out of 1000 got ill. Vaccine safety and efficacy information was equally scarce.
FDA was reluctant to license Relenza due to the fact that it did not show more efficacy than placebo. However, the license was finally given, ostensibly to put in the market at least something for the event of pandemic.
There are more interesting facts in the article. BMJ, one of the leading medical journals, is conducting a journalist investigation and writes openly about total corruption within WHO. Should you have any more doubts that WHO is a deeply corrupt organization, this article will dispel them.

Systematic reviews show that flu vaccination is next to useless. Most of the studies are of low quality with safety almost never thoroughly analyzed. Vaccination programs need to be reviewed.
These are the thoughts expressed by the head of vaccination department at Cochrane. The very same one who believes that despite the absence of proof of the safety of aluminum it is not worthwhile to continue the aluminum safety studies. Because of his views he was ostracized by his colleagues and he had to lunch alone during a pandemic preparation conference.

In 2002 CDC started encouraging vaccination of children between 6 months and 2 years old; in 2004 encouragement turned into strong recommendation. From that point on a child receive two vaccines during the first year of his life. In 2009 children received additional vaccine against swine flu. Below is the graph of flu-related mortality of children aged 5 years old in 1994-2014.

In 2010 the recommendation covered everyone older than 6 months old. Below is the graph of flu-related mortality of all age groups in 1996-2014.
To put things into perspective, every year over 3000 people in the US die from malnutrition, 7000 - from C.difficile infection, 40,000 – from poisoning, 30,000 – from alcohol, 50,000 – from drugs, 40,000 – suicides, 80,000 – from diabetes, 90,000 – from Alzheimer and 200,000-400,000 from medical errors.

According to VAERS, more than 960 people died after a flu vaccine since 2000, and almost 3000 became disabled. Considering, that VAERS registers only 1-2% of serious side effects, it is plausible that the flu vaccine took lives of more people than the flu inself.

Despite claims made by observational studies that vaccination reduces all-cause winter mortality by approximately 50%, increased vaccine coverage did not result in the reduction of either flu-related mortality or all-causes winter mortality.

Subjects who reported a history of infectious diseases (e.g., colds, flu) showed a 30% reduction in risk of glioma (brain tumor) development.

Biased, poor-quality, mostly unpublished evidence suggests that oseltamivir and zanamivir shorten the duration of influenza symptoms by 0.6 to 0.7 of a day. Pneumonia and hospitalizations are not decreased.
Oseltamivir sales are more than $18 billion. Most have not been used. These products are not recommended if symptoms have lasted longer than 48 hours.

An interesting BMJ investigation, relating how Cochrane was trying to get access to Tamiflu clinical research.
In 2009 a Japanese pediatrician asked Cochrane why their systematic review is based on unpublished manufacturer data and not on their own analysis. Cochrane had to answer within 6 months and they were trying for a long time to get the baseline data from the manufacturer. They never got it.
As a result, Cohrane decided to change their methodology of systematic reviews.

Another interesting article on Tamiflu. How it happened that despite the absence of scientific proof of safety and efficacy of this drug WHO, FDA, CDC and EMA (European analogue of FDA) issued recommendations for its use in treatment and prophylaxis of influenza, and it's stockpiling as a measure to tide over the potential pandemic. More here [1], [2].
Mortality risk 12 hours after taking Tamiflu is 1.9 times higher than after taking Relenza, and risk of complications is 5.9 times higher.

A systematic review and meta-analysis of the use of antipyretic drugs during influenza on mortality. Randomized and placebo-controlled studies in humans have not been conducted, eight animal studies (mice and chickens) have been found.
Antipyretics (aspirin, paracetamol, diclofenac) taken during flu increased mortality by 34%.
Paracetamol and Ibuprofen are recommended for adults and children as antipyretics during flu, despite the absence of scientific evidence of their effectiveness and safety. Furthermore, there is evidence showing that fever occurring during a disease increases survival chances and that using antipyretics may result in an unfavorable outcome. In non-human mammals, antipyretic treatment increases the risk of mortality due to different bacterial, viral and parasitic infections. There is also evidence from animal models that antipyretics may impair the response in bacterial pneumonia which may complicate influenza illness.
Similar to influenza virus, many strains of pneumococcus are temperature-sensitive and die when the temperature is between 40–41°C. In mice, treatment with aspirin to treat pneumococcal infection increased mortality rates two to three-fold.

Probiotics show efficacy protecting mice infected with flu. More here: [1], [2], [3], [4], [5], [6].
Probiotics are also effective in elevating seroconversion of influenza vaccines.

Probiotics protect children from influenza as well.

Probiotics reduce cough incidence by 41-62%, rhinorrhea incidence by 28-58%, fever incidence by 53-72%. Children receiving probiotics had significant reductions in days absent from group child care, by 27-31%, and antibiotic use incidence was reduced by 68-84% compared to placebo.

Cochrane systematic review. Respiratory virus spread can be prevented by hygienic measures, such as handwashing, especially around younger children. Surgical masks and gloves are also quite effective.

Cochrane systematic review of the effect of garlic on common cold. Authors identified only one trial meeting the selection criteria. Taking garlic supplements daily reduced risk of common cold threefold.

A small, randomized, double-blind, placebo-controlled trial of treatment of influenza with elderberry extract.
Elderberry extract shortened the duration of influenza by 4 days compared to placebo. [1], [2], [3], [4].
For comparison, Tamiflu shortens influenza by 17 hours, at the same time increasing the risk of psychiatric complications and renal insufficiency. However, governments spend millions of dollars to stock up on Tamiflu, and nobody is stocking up on elderberry.

Megadoses of vitamin C (1g every hour during 6 hours, then thrice a day) administered before or after the appearance of cold and flu symptoms relieved and prevented the symptoms by 85%.

Study showing a strong evidence that large doses of zinc (over 75 mg) contribute to reduction of the duration of common cold.
Red ginseng, green tea, propolisiodine and honeysuckle also have anti-influenza properties.

There are many hypotheses as to why seasonal colds are so widespread only during a certain season: low temperatures, dry air, crowding together indoor in the winter, travelling patterns, seasonality of ultraviolet (UV) radiation from the sun that might kill pathogens, circannual rhythms of hormones like the “dark hormone” melatonin, etc. Possibly, the seasonality of viruses and batteries is also partly responsible.
In this study the authors have studied the annual death numbers of influenza and pneumonia in Norway for the time period 1980-2000 and compared with UVB level and vitamin D level produced by it.
Influenza-related mortality is increased 2 months after reaching the minimum vitamin D level. This, however, may be caused by the fact that the disease usually starts weeks prior to the point of death, when the immune system is at the lowest.
The vitamin D level is maximal close to midsummer; the lowest vitamin D is found in February, and average level as low as 25 nmol/l have been observed among women avoiding direct sun exposure.
Norway is localized from 58 to 70 degrees north, vitamin D being synthesized in skin exclusively in the summer months. Generally, there is no distinct seasonal pattern in the tropics. At latitudes between 20 and 30 degrees north, clear winter seasons of influenza are found. This is at first sight surprising. However, at 25 degrees north the rate of vitamin D synthesis in human skin is about five times larger in late June than in late December.
It is common knowledge that vitamin D strengthens immune protection. [1]

Solar radiation triggers robust seasonal vitamin D production in the skin; vitamin D deficiency is common in the winter. The elderly only make about 25% of the vitamin D compared to 20-year-olds after exposure to the same amount of sunlight.
No vitamin D is made in the skin at latitude 52° N (the latitude of London) from about October to March because atmospheric ozone easily filters out UVB radiation. The average excess winter mortality in Great Britain alone is inversely related to hours of sunlight. Every additional hour of sunlight reduces mortality by 2·9%
People who received a live influenza vaccine in February experienced high fever twice as often as those vaccinated in June; the lowest rate of antibody formation is registered in summer. 40% of people vaccinated in December shed the virus, compared to 16% of those vaccinated in June.
There was no evidence of toxicity in young men taking 50 000 IU of vitamin D a day for 6 weeks (although such a dose would be toxic if taken over a longer period). A single dose of 600,000 МЕ taken via injection did not show any toxicity either.

A randomized, double-blind, placebo-controlled study of the effect of vitamin D on the incidence of influenza.
Influenza occurred 42% less in schoolchildren who received 1200 МЕ of vitamin D3 supplements daily.

Systematic review and meta-analysis of the effect of vitamin D on the incidence of acute respiratory disease. 5 randomized placebo-controlled trials were included. Vitamin D reduces the risk of influenza by 42% in children and by 35% in adults.

A similar review and meta-analysis (11 studies). Vitamin D reduces the risk of respiratory tract infections (RTI) by 36%. Small daily doses reduce the risk of RTI by 49%, whereas infrequent large doses of vitamin D are less efficient and reduce the risk of RTI only by 14%.

Among patients admitted to the hospital with pneumonia, mortality in those who had a vitamin D deficiency (less than 30 nmol/L) was 12.7 times higher than among those who had a vitamin level higher than 50 nmol/L.

Vitamin D level in newborns, hospitalized with acute lower respiratory infection, was significantly lower than that in healthy newborns (9.12 ng/mL vs 16.33 ng/mL).
Vitamin D level in mothers of the hospitalized newborns was also lower than that of the mothers of healthy newborns (13.38 ng/mL vs 22.79 ng/mL).
The authors observed a strong positive correlation between newborns' and mothers' level of vitamin D.

Authors measured the vitamin D level in the umbilical cord of 922 newborn. During the 3 months following birth the risk of respiratory tract infections in newborns with vitamin D level < 25 nmol/L was twice as high as that in newborns with vitamin D level > 75 nmol/L. Risk of wheezing in children with low vitamin D at birth was twice as high till they were 5 years old than that of newborns with high vitamin D at birth.

Newborns with vitamin D level in the umbilical cord below 50 nmol/L had severe lower respiratory tract infection during the first year of their lives 6.2 times more often than those whose vitamin D was above 75 nmol/L.
In western countries 40% of pregnant women and 50% newborns have vitamin D deficiency. This deficiency during pregnancy is associated with type 1 diabetes, multiple sclerosis, schizophrenia and respiratory tract infections in children.

Children with vitamin D level haiger than 22.5 nmol/l contracted severe acute lower respiratory infection (ALRI) 91% less frequently. Exclusive breastfeeding in the first 4 months of life reduced the risk of ALRI by 58%.

A prospective study of 14 thousand men and women living in the UK, lasting 13 years.
The level of vitamin D appears to be in inverse correlation with mortality. Among those whose vitamin D level was >90 nmol/L, mortality was 34% lower than among subjects with vitamin D <30 nmol/L.
Risk of death from cardiovascular diseases in these subjects was 38% lower, from cancer – 15% lower and from lower respiratory infections – 78% lower.

Young men with low level of vitamin D (<40 nmol/L) had acute respiratory tract infections 63% more often than young men with level of vitamin D >40 nmol/L.
Smokers had lower vitamin D than non-smokers. Young men who did physical exercise more than 5 hours per week had a higher vitamin D level.

Adults with vitamin D <38 ng/mL suffered from acute viral respiratory tract infections 2.7 times less, and the duration of the disease was 4.9 times less. Influenza vaccine did not affect the incidence of acute viral respiratory tract infections.

Some more studies on relation of vitamin D and influenza and other acute viral respiratory tract infections: [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18].

A very interesting review on epidemiology of influenza and vitamin D, well worth reading. It turns out that the numerous laboratory experiments failed to prove that a person with flu can infect a healthy person.

An association has been established between low levels of vitamin D and upper respiratory and enteric infections, pneumonia, otitis, Clostridium infections, vaginosis, urinary tract infections, sepsis, influenza, dengue, hepatitis B, hepatitis C, and HIV infections. Vitamin D is used in treatment of osteoporosis, rheumatoid arthritis and cancer.
Till mid 20th century, treatment of tuberculosis patients was restricted to sun exposure in sanatoria and fish oil. These two methods have one thing in common – vitamin D.

Tamiflu and Relenza are useless drugs which do more harm than good. The author writes that in nursing homes he has seen some of the patients and staff develop vomiting; some with serious diarrhea (also a known side effect); some with acute confusion, hallucinations, or delirium; and a number with worsening cognitive function. These medications should no longer be stockpiled or used. This would result in tremendous savings in health care dollars.
The Institute of Medicine recommendation for adults younger than 70 years of age is 600 IU of vitamin D daily, to achieve a level of 50 nmol/L in more than 97.5% of individuals. Regrettably, a statistical error has resulted in erroneous recommendations by the Institute of Medicine leading to this conclusion. In actual fact one needs to take 8800 IU of vitamin D to achieve this level in 97.5% of the population.
The author and his colleague have introduced vitamin D at doses that have achieved greater than 100 nmol/L in most of their patients for the past number of years, and they now see very few patients with the flu or influenza like illness. In those patients who do have influenza, they have treated them with the vitamin D hammer: a 1-time 50 000 IU dose of vitamin D3 or 10 000 IU 3 times daily for 2 to 3 days. The results are dramatic, with complete resolution of symptoms in 48 to 72 hours. The cost of vitamin D is about a penny for 1000 IU, so this treatment costs less than a dollar.

Some health-care workers may be hesitant to take a vaccine because it contains a mercury preservative-thimerosal - which can be harmful to their health. These health-care workers and patients should be tested and treated for vitamin D deficiency to prevent exacerbation of a respiratory infection.
Optimal vitamin D level is 50-75 ng/mL, and an optimal dose for grown-ups is 4000-5000 IU daily.

What follows from these articles is that there is a correlation between vitamin D level and susceptibility to infectious diseases. What does not follow is that administration of vitamin D is safe and effective. What does follow is that exposure to sunlight has health benefits.
- What is meant by vitamin D here is vitamin D3. You should choose the supplement carefully as not all of them equally harmless. Best solution is to supplement your vitamin D by being exposed to sunlight instead of taking supplements.
- My personal opinion is that taking a vitamin D in supplements as a preventive measure is, probably, a good idea for grownups and elderly, but I am not sure that it is so for children, especially for newborns.

Weston Price foundation articles about vitamin D: [1], [2].

An influenza virus is most easily transmitted at close contact (less than 1m). The virus survives the longest on stainless steel surfaces (several hours), on uneven surfaces it survives less than 15 min. A flu virus is 99% inactivated by hydrogen peroxide vapor (10 ppm) in 2,5 minutes.

Influenza virus A(H3N2) is accused in having caused deaths of hundreds of elderly Australians in 2017. This virus was contained in a vaccine, but managed to mutate in 4 months. [1].

New clinical trial of a respiratory syncytial virus (RSV) vaccine has started. Volunteers needed. There already was an attempt in the 1960s to develop such a vaccine, but it was unsuccessful. The vaccine did not protect against subsequent infection and caused a much greater frequency of severe disease, particularly in the youngest age group <6 months. Of 31 infants immunized with the vaccine, 25 required hospitalization following natural infection and two died. The existing vaccine was enhanced with aluminum, which gives the scientists hope that it will be more safe and effective.

It is believed that the 1918 pandemic was caused by an influenza virus. However, this is far from being an established fact. According to some studies, what resulted in a massive death toll in 1918 was caused by a bacterial agent, not a virus. Possibly, it was Streptococcus.

The high-case mortality during the 1918 flu pandemic may have been caused by aspirin, because physicians of the day prescribed in extremely high doses (8-31 g per day).

WHO, CDC and many other national public health advisory groups issue strong recommendations in favor of flu vaccination for pregnant and lactating women.
The majority of vaccines contain precautionary language which could discourage use in pregnant women and some include stronger language discouraging or contradicting use in pregnant or lactating women.
Authors conclude that regulators and manufacturers should regularly assess the language of pregnancy and lactation sections in product information for vaccines and include information from national public health advisory groups regarding use by pregnant or lactating women.

An interesting investigation into the swine flu vaccine of 1976. CDC knew that this flu vaccine may cause neurological complications but forgot to inform the population about this fact.