How Effective is the Influenza Vaccine? How About Tamiflu?

One of the greatest concepts I have run across since I finished school is the Number Needed to Treat (abbreviated NNT). NNT was never taught back when I went to medical school (we had barely given up The Four Humors!). Instead, we were taught “the p-value.” Does anyone else remember the p-value? The p-value of a study, it turns out, is a relatively poor measure of study validity, partly because it implies an “all-or-nothing” kind of understanding of studies: either the study is “valid” (meaning a p-value of >95%) or it is not. Either the treatment being studied works or it does not. And if a treatment works, it must work for all people.

Of course, in real life, this is not the case. No drug is universally good or bad. All drugs help some people, harm some people (with adverse side effects) and make no difference one way or another in some people. These numbers can be derived from any study’s data. There is even a fabulous website devoted to this where you can look up the NNT and its corollary, the Number Needed to Harm (NNH) for all sorts of drugs and treatments (found here).

Since it is influenza season and time for us to get our flu shots (I got mine yesterday), I thought it would be a great time to see how beneficial the flu vaccine is.  What is the NNT for the flu vaccine?  And while we are at it, why don’t we also look at the data on oseltamivir (Tamiflu) while we’re at it?

Influenza Ward, Great Pandemic 1919

Influenza Ward, Great Pandemic 1919

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What’s That Skin Lesion? Plus updates.

Before we get to the cool skin lesion quiz, first a couple of updates!

Get your flu shot!

Robin, at the Ada County Jail in Boise, should get her flu shot!

Influenza shots are here.  Be sure to get yours.  I didn’t get my flu shot last year and subsequently came down with true influenza–NOT a fun experience.  I wrote about that experience here: Should the Flu Vaccine Be Mandatory?  Influenza is way worse than the shot. Continue reading

Should the Flu Vaccine be Mandatory?

Recovering at home with Ed the dog.

So I caught the flu last week and I have been pretty miserably sick for going on 7 days; fever, achy, cough.  Also cranky, peevish, and insufferable.  My hair hurts!  Is that even possible?

I usually get a flu shot, but I didn’t get one this year.  Why not?  I just didn’t get around to it.  It would have been easy.  All I had to do is ask one of the nurses to give me one back in the fall when we were doing them.  Duh.

The CDC announced the official onset of influenza season a couple of weeks ago.  Flu season is extraordinarily late, probably due to the mild winter most of us (me included) have experienced this year.

Coincidentally, around the same time as this announcement (and before I myself caught the dreaded bug), I ran across a couple of thought-provoking articles dealing with the flu that are relevant to our institutionalized patients. Continue reading