Flu and Measles Vaccines…A Few Thoughts
Yesterday, the FDA cancelled its meeting to determine the strains of flu that will be in the 2025-6 flu vaccine.
What traditionally happens is that at this meeting everyone agrees on what needs to be in the vaccine, the manufacturers take about six months to develop the vaccine, and then they come back to FDA showing that they have included those strains in order for the new vaccine to be legally marketed.
The vaccines aren’t always a good match for the strain that is infecting people. In fact, this year it’s not so great. However, even if the predictions don’t match up with the reality, there is a crossover effect that moderates flu symptoms, keeping people out of the hospital or doctor’s office. And certainly, it prevents many deaths.
Without this meeting, we may not have updated flu vaccines in the fall.
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Twenty-five years ago, the CDC declared the US free of measles. This week, the first child in a decade died from measles as part of one of the largest outbreaks of measles in modern history. Since the vaccine was introduced, measles infections have dropped significantly, from almost 500,000 infected per year to at most a few hundred (however in the late 80s/early 90s, when the second measles vaccine dose was recommended, infections were above 25,000 – still, that’s 5% of the number of infections before vaccination).
In 1998, a study, now widely debunked, claimed that the MMR vaccine (which includes measles) led to higher rates of autism in children. The study was of 12 children with autism, so not large enough to actually call for a change in public health practice, but the doctor who published study publicly called for halting use of the MMR. It took a few years, but one journalist uncovered the scheme that included paying the doctor to make claims against the MMR.
The Secretary of HHS recently said that a measles outbreak is not unusual. But this one clearly is. Only five of the 124 people infected (most of them children) were vaccinated.
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Vaccines are one of the greatest public health achievements in history. And, in case you care about the economic effects rather than health effects, vaccines have been astoundingly helpful:
Vaccination for the 1994–2023 birth cohorts will potentially avert $780 billion in direct costs and $2.9 trillion in societal costs by preventing illnesses and deaths. After accounting for $240 billion in direct costs and $268 billion in societal costs of routine childhood immunization, the net savings for routine childhood immunization from the payer and societal perspectives were $540 billion and $2.7 trillion, respectively. The payer and societal benefit-cost ratios for routine childhood immunizations were 3.3 and 10.9, respectively.
We are in an environment where parents far too often opt their children out of routine vaccines, where pockets of the population are unvaccinated and herd immunity is impossible.
Without effective and widespread vaccinations, we are all at risk.