Each year, U.S. public health officials and their media partners renew the campaign to sell the entire country (including pregnant women, six-month-olds and fragile senior citizens) on the need for and benefits of flu vaccines. Ordinarily, to persuade the public that a given vaccine is beneficial, officials must show that it is effective—in other words, that it is able to “prevent outcomes of interest in the ‘real world.’” However, influenza vaccination’s infamous ineffectiveness makes this talking point a bit tricky. And when vaccination does not “significantly reduce medically attended influenza illness,” it is hard to avoid the conclusion that the vaccine has bombed. As public health experts are well aware, many factors can lessen influenza vaccine effectiveness (VE), including particular characteristics of vaccine recipients and the vaccinesthemselves. The scientific literature also points to serious wrinkles that underscore influenza vaccination’s inability to deliver meaningful benefits and its propensity to create new problems. For example, studies show that getting flu vaccines year after year reduces the level of vaccine protection available; flu-vaccinated individuals are also more susceptible to other strains of influenza and severe respiratory infections. Recent studies even suggest that childhood influenza vaccination can lead to larger epidemics and “an overall health loss.” A vaccine expert who recently admitted to knowing less about influenza today than a decade ago lamented, “It’s much more complicated than we thought.”

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