Influenza: marketing vaccine by marketing disease

syringeIn a recent feature article published in the British Medical Journal, Peter Doshi discusses the marketing of influenza vaccine by marketing disease.

Here are some excerpts from the article:

Promotion of influenza vaccines is one of the most visible and aggressive public health policies today…Closer examination of influenza vaccine policies shows that although proponents employ the rhetoric of science, the studies underlying the policy are often of low quality, and do not substantiate officials’ claims. The vaccine might be less beneficial and less safe than has been claimed, and the threat of influenza appears overstated…

Selling sickness: what’s in a name?…Could influenza—a disease known for centuries, well defined in terms of its etiology, diagnosis, and prognosis—be yet one more case of disease mongering? I think it is. But unlike most stories of selling sickness, here the salesmen are public health officials, worried little about which brand of vaccine you get so long as they can convince you to take influenza seriously.

Marketing influenza vaccines thus involves marketing influenza as a threat of great proportions. The CDC’s website explains that “Flu seasons are unpredictable and can be severe,” citing a death toll of “3000 to a high of about 49 000 people.” However, a far less volatile and more reassuring picture of influenza seems likely if one considers that recorded deaths from influenza declined sharply over the middle of the 20th century, at least in the United States, all before the great expansion of vaccination campaigns in the 2000s, and despite three so-called “pandemics”

But perhaps the cleverest aspect of the influenza marketing strategy surrounds the claim that “flu” and “influenza” are the same. The distinction seems subtle, and purely semantic. But general lack of awareness of the difference might be the primary reason few people realize that even the ideal influenza vaccine, matched perfectly to circulating strains of wild influenza and capable of stopping all influenza viruses, can only deal with a small part of the “flu” problem because most “flu” appears to have nothing to do with influenza. Every year, hundreds of thousands of respiratory specimens are tested across the US. Of those tested, on average 16% are found to be influenza positive.

All influenza is “flu,” but only one in six “flus” might be influenza. It’s no wonder so many people feel that “flu shots” don’t work: for most flus, they can’t.

Read the entire article via this link:

Reference: Doshi, P. Influenza: marketing vaccine by marketing disease. BMJ 2013;346:f3037