The Flu: What can we say about it as Oriental Medicine Practitioners?

Matthew Stuckey Every year, the Flu conversation comes up; and even as a student acupuncturist, I get asked about the Flu vaccines and its alternatives, as if I am some kind of authority. Though I know quite a bit about its alternatives, I realized that I dont always know how to talk about these alternatives to my patients or with doctors. I also realized that I didnt know much about the flu vaccine itself, other than not being interested in it and the usual vague fears about mercury, autism and being hesitant around aggressive marketing. I found that Im not alone in this position, and think it necessary to hash out what we can say about the flu vaccination with more information, but also what were allowed to say about it. This exploration is twofold; the politics of how we talk about treating or preventing the flu, and secondly, about the flu vaccine itself. CYA Cover your ass. A cautionary western mantra for many professionals in todays world of law and regulation. A Wikipedia definition of the CYA is as follows: professional and organizational practices that serve to protect oneself from legal and administrative penalties, criticism, or other punitive measures. Basically, protecting ones own rear-end from anyone after it. Dr. Andrew Weil, a famous and widely respected author and professor at the Tucson, AZ medical school experienced first-hand from the Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) what its like when you dont CYA, specifically in his case regarding the Flu Virus. But before telling his story, its important to understand what MDs and other healthcare professionals role officially looks like in this country. What are we legally allowed to say? MDs are no longer able to treat patients according to scientific literature the experiences of the physician, or the desires of the patient. MDs are required to treat patients according to what are called standards of care. These guidelines are not really guidelines at all, but are considered mandatory edicts by medical boards. Jerry Tennant, MD

Certainly as oriental medicine (OM) practitioners, we are educated in vast ways that MDs are not, and dont seem quite as limited in the tools that we use in treating disease. We have a variety of knowledge to use, and we also dont stand in as sensitive of a position as an MD in regards to liability just look at liability insurance costs. However, we do have to be careful making claims about both acupuncture and herbs. Acupuncture and herbs have not been officially approved to diagnose, mitigate, prevent, treat, or cure the Flu. Period. Dr. Weil was threatened with jail and fines for explaining the usage of dietary supplements and one of Chinese medicines major herbs, Huang Qi (Astragalus). Dr. Weils language about Astragalus was as follows; is used traditionally to ward off colds and flu and has been well studied for its antiviral and immunity-enhancing properties. This language had to go. So, what does prevent the Flu? For the FDA and FTC; the Flu vaccine. How well does it work? Ive often seen in the traditional medicine camp that we find it easy just to deny something like the flu vaccine without a lot of information or asking people who really know about. Michael T. Osterholm director of the Center for Infectious Disease Research and Policy, as well as its Center of Excellence for Influenza Research and Surveillance said, We have over-promoted and overhyped this vaccine, It does not protect as promoted. Its all a sales job: its all public relations. The Center for Infectious Disease Research and Policy at the University of Minnesota released a study in October 2012 that stated only modest protection for healthy young and middle-age adults, and little if any protection for those 65 and older, who are most likely to succumb to the illness or its complications. Moreover, the reports authors concluded, federal vaccination recommendations, which have expanded in recent years, are based on inadequate evidence and poorly executed studies. Note however that they did not say not to get the vaccine or thats its completely rubbish. Even Dr. Osterholm still recommends the vaccine, only now with a just sigh of confidence rather than his heavy promotion of the past, and only if people know the real facts about it.

What does modest protection mean with the Flu vaccine in the University of Minnesota article? Modest is the same language used when describing how well hand-washing works in preventing the transmission of the Flu as stated in a UCL Centre for Infectious Disease Epidemiology study done also in October 2012. See bibliography. A November 2012 New York Times article entitled Reassessing Flu Shots as the Season Draws Near summed up one of the most unbiased reviews available on the Flu; The Cochrane Collaboration, an international network of experts that evaluates medical research, concluded in a 2010 review that the vaccines decrease symptoms in healthy adults under 65 and save people about a half-day of work on average, but that they do not affect the number of people hospitalized and have minimal impact in seasons when vaccines and viruses are mismatched. We dont seem to be too convinced right now that the flu vaccine is all that great. The most deaths weve had in 30 years was the swine flu pandemic of 2009. While drug developers rush to create a vaccine for this particular strain, the usual shot will not do the trick. The potential for a swine flu is still lurking in shadows, and the regular flu shot is still one step behind. Even as of 2013, the United Nations is urging governments around the world to keep up their guard when it comes to the bird flu virus amid fears that continued outbreaks in Asia and the Middle East could lead to a fresh pandemic. Another case of the flu vaccine being of no use in major crisis. There are also some startling statistics about the inefficacy of the flu vaccine seen in the graphs on the following two pages put together by Dr. Obomsawin of the National Aboriginal Health Organization.

As we can see in Figure 26, early childhood deaths increased in this period of time regardless of the flu vaccine being introduced. Others have pointed to the vaccine contributing to the cause of death, but were not going to take that up here. We also must see however that the graph only shows a small period of time marking the trend that the creator wanted to see. Figure 11 shows a larger trend, again with real CDC statistics that pique our curiosity. Have we slowly become immune without being vaccinated? The other end of this graph would mainly show a swine and bird flu spike in deaths. So are these further proof against the flu vaccine? Not really, but they raise interesting questions and make us aware of trends we might not have known about. Do we really need to debate with more scientific articles and research about how we can help boost immunity to increase the likelihood of preventing the flu and therefore gain the recognition and respect from the medical mainstream? Some people will find this necessary, but at the same time, we cant forget that we also just know certain therapies work regardless of their recognition. What are we really trying to prove, and to whom? What about our patients? They usually come in and just want to be fixed. Our energies can be focused in that direction. Until an unlikely and devastating flu pandemic breaks out from chickens and pigs in the future, we probably dont need to be scrambling to get in line for the flu shot. While our patients, friends and family members consider the flu shot while at the grocery store, drug store, and watching TV, we can offer a sober viewpoint on the matter. We can explain the growing lack of confidence among researchers of the flu vaccine without throwing it out completely, because it probably works sometimes. We just dont know 100% either way and I think its ok to admit that. At the same time, you can CYA by being careful with the language you use about preventing the flu, and being cautious of selling" patients herbs or acupuncture. Well see how the politics around this popular vaccine continue to unfold as we carry on washing our hands and sipping herbal tea.

About the author: Matthew Stuckey began his exploration in traditional herbal medicines in northern Arizona. He completed an internship with the Herb Pharm in southern OR, and went on to become a certified herbalist from Vitalist School of Applied Herbology in Ashland, OR. He is now close to graduating with a degree in Oriental Medicine from World Medicine Institute in Honolulu, HI.

Bibliography -Healing is Voltage: The Handbook by Jerry Tenannt, MD, MD(H), MD(P) -Immunization Graphs: Natural Infectious Disease Declines; Immunization Effectiveness; and Immunization Dangers, Prepared by: Raymond Obomsawin Ph.D. , National Aboriginal Health Organization, October 2009 - Influenza Deaths: the hype vs. the evidence http://articles.mercola.com/sites/articles/archive/2012/10/03/hype-vs-evidenceof-influenza-deaths.aspx#_edn41 -Reassessing the Flus Shot as the Season Draws Near http://well.blogs.nytimes.com/2012/11/05/reassessing-flu-shots-as-the-seasondraws-near/ -Bird Flu pandemic http://news.bbc.co.uk/2/hi/health/4579777.stm -Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review http://www.ncbi.nlm.nih.gov/pubmed/23043518