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The NNT for Flu Shots

Dave Newman, MD
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30:03
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Flu vaccination works, but maybe not in ways that we think. Your patients will benefit, but it’s not a panacea. And it turns out that oral antivirals may be a more effective remedy for normal bowel patterns than influenza.

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Larry F., Dr -

Thank you ... Love the layout. Perhaps emrap could go the same way? Very helpful to see the evidence and hear the audio. Keep up the good work!

Tim L. -

Given the lack of evidence for antiviral use in influenza the CDC is pushing even more agressively saying that its use will save lives prevent complications, and hositializations .

Rob O., MD -

Hi Tim. The hard push for antivirals is strange, especially given the lack of quality evidence showing benefit. Questionable (at best) utility in outpatients and lack of RCT in inpatients makes one wonder why the recommendations to use them keep getting stronger.

mike p. -

what are you doing with pregnant women or children under 5? Are you treating them within 48 hours, no matter when onset of symptoms or giving prophylaxis to pregnant women with likely flu contact at home?

Rob O., MD -

Here is the response from David Newman...

Definitely not treating children with oseltamivir, as many of the worst reported adverse effects (psychosis, etc.) have been in children. Would also not treat a pregnant woman with NIs. Both of these approaches are contrary to what the CDC and many state DOHs are saying, however there is no compelling evidence to treat either one of these groups, and there are important known harms that I would not want to expose patients to.

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All Roads Lead to Cheese Fries Full episode audio for MD edition 220:38 min - 104 MB - M4AHippo Primary Care RAP August 2014 Written Summary 559 KB - PDF