Non-Vax Nonsense

Mothering magazine, once a monthly printed periodical, is now an Internet-only resource for “attachment” or “gentle” methods of parenting (see this great article from Science of Mom that neatly sums up the problems with parenting-style labels). While I’ve occasionally found some useful nuggets among the articles published at, I’m distressed by the complete failure of the editors to acknowledge any of the multitude of scientific studies supporting the benefits and safety of vaccines. In fact, is a bastion of anti-vaccination nonsense, as exemplified by a recent article by Jennifer Margulis, entitled “Pregnancy and the Flu Shot.”

The article is quite long, so this will be Part 1 of a two-part rebuttal. Part 2 is here.

Margulis’ article begins with an anecdotal account of a pregnant woman who was advised by her healthcare practitioner to get a flu shot. Anecdotal accounts — stories, whether fictitious or factual — have no place in scientific decision-making or logical analysis. This is because a single person’s experience may or may not be representative of what usually happens, and there are a number of logical fallacies that can warp our perception of events (see “Why Experience Is Not Evidence.”) In any case, even if we allow the inappropriate use of the anecdote in the flu shot article, it’s completely irrelevant. The pregnant woman in question gets her flu shot, goes on vacation, and within 12 hours, begins to experience flu-like symptoms. “Flu-like” symptoms are caused by many, MANY illnesses, which run the gamut from the common cold to early HIV infection. Thus, citing “flu-like” symptoms is in no way evidence of having the flu. The article goes on to note that the woman felt ill for two and a half weeks, and eventually called her healthcare practitioner, at which point she was diagnosed with bronchitis. The author suggests that the flu shot caused the two-week illness (bronchitis), but this based upon a number of misconceptions.

First, the flu shot simply can’t cause the flu. Why? Because the flu shot contains killed virus (that is to say, not just dead virus, but virus that has been chopped up into little tiny bits). You can no more get “attacked” and sickened by the influenza virus particles in a flu shot than you can get attacked and pecked by the carcass of your chicken dinner. That many people get “flu-like” symptoms after a flu shot is not evidence that the shot causes flu. Flu-like symptoms, which include headache, perhaps mild fever or chills, achiness, and the like, are the result of activation of the immune system. This is the reason they’re shared by so many illnesses; as the immune system revs up to fight off an invading pathogen (an organism that can cause disease), it releases a variety of chemicals, including histamine. The responses to these chemicals assist in the pathogen-fighting process. For instance, the immune system dials up your body temperature, resulting in a fever (and perhaps concomitant headache and achiness). The increased temperature makes it harder for the invading virus or bacteria to reproduce. Further, immune system chemicals that help to call white blood cells to the site of an invasion lead to swelling (such as that which you experience at the site of a vaccination). Bottom line, while not everyone feels flu-like symptoms after a flu shot, many people do, and it means only that the shot is working; it’s causing your immune system to respond and to develop the ability to fight off the flu.

The second problem with the anecdote in Margulis’ article is that it falls victim to the post hoc ergo proctor hoc fallacy, assuming that because the woman in the story got sick after her flu shot, the illness was because of the flu shot. If you get a flu shot and then get in a car accident, win the lottery, or get hit by a meteor, common sense tells you that the second event wasn’t caused by the first, because there is no rational link between the two events. Because the body’s immune system is a complex and (to many people) mysterious thing, it seems rational to connect the event “flu shot” with the subsequent event “illness” in a causal manner. However, no scientist or medical practitioner with an understanding of the immune system would see these events as any more connected than the events in the facetious example of getting a flu shot and winning the lottery.

The article goes on to quote a number of medical practitioners, all of whom recommend (as do the CDC and the American College of Obstetrics and Gynecology) that pregnant women get the flu shot. Reasons include that pregnant women have suppressed immune systems relative to non-pregnant women (which helps to prevent attacking the developing fetus), and that some of the complications of the flu — which include secondary bacterial infection, pneumonia, and dehydration — can be particularly serious to pregnant women and their fetuses.

Margulis then downplays the seriousness of influenza, a common tactic in anti-vaccination rhetoric. Influenza is not, as Margulis claims, “…like a severe cold.” Instead, it’s characterized by extremely rapid onset, high fever, chills, and weakness. One of the problems is that in common parlance, we use “the flu” nonspecifically, and most often in reference to mild, cold-like viral infection. Very rarely is what we call “the flu” actually influenza. Margulis references Dr. Robert Sears, author of The Vaccine Book, who claims that the public has a “misperception” regarding the severity of influenza because the CDC combines influenza deaths with pneumonia deaths for reporting purposes, which makes it impossible to obtain an accurate influenza death toll. Here, both Margulis and Dr. Sears are either confusing or misrepresenting the medicine, however, as pneumonia is a common complication of influenza, and is the complication responsible for most of the influenza-related deaths.

Margulis goes on to state, correctly, that there are very few total cases of influenza resulting in death among pregnant women. I think few healthcare practitioners would argue that the primary reason to get the flu shot is to prevent death, however. Despite the fact that influenza can be fatal, it very rarely is. Still, the complications associated with the flu (dehydration, for instance) have much more serious ramifications in pregnant women. Margulis then cites two physicians (Ayoub and Yazbak) who, after reviewing the literature, published a paper in which they stated that influenza isn’t a threat to a normal pregnancy. However, this paper can’t be taken as any sort of authoritative source, since it was published in the Journal of American Physicians and Surgeons, a publication so questionable and fringe that it isn’t recognized by PubMed (a database of the National Library of Medicine and National Institutes of Health). Articles published in this laughable journal include one asserting that HIV doesn’t cause AIDS, one suggesting that there is a link between abortion and breast cancer, and one that claims global warming is not human-caused, and will actually be beneficial. There is an excellent and complete critique of the organization behind the Journal of American Physicians and Surgeons at the Neurodiversity Weblog, and of the journal itself at Science-Based Medicine.

In contrast to the pseudo-science cited by Margulis, the true scientific literature paints a different picture of the risk of influenza in pregnant women. The CDC points out that not only is influenza more serious in pregnant than in non-pregnant women, it can also cause pregnancy-related complications including preterm labor. A study published in the highly regarded medical journal The Lancet determined that pregnant women appear to be more susceptible to the particularly serious H1N1 (“swine flu”) (Jamieson et al). Another study, again in a very well respected publication, showed that influenza is not uncommon in second- and third-trimester pregnant women, and that while it isn’t transmitted to the fetus, it nevertheless increases the risk of pregnancy-related complications (Reader et al).

Margulis’ article continues with accusation that the influenza vaccine isn’t effective, and, in fact, is dangerous, but the science suggests otherwise. I’ll address these issues in part 2 of this post.


Science Bottom Line:* Influenza is more severe in pregnant women than in non-pregnant women, and pregnant women are more susceptible to influenza that non-pregnant women. Complications associated with influenza during pregnancy extend beyond those normally associated with the flu to include pregnancy-related complications. Influenza presents a serious risk to pregnant women.


Did you get the flu shot while you were pregnant?



Jamieson et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009 Aug 8;374(9688):451-8. Epub 2009 Jul 28.

Reader et al. Influenza virus infection in the second and third trimesters of pregnancy: a clinical and seroepidemiological study. BJOG. 2000 Oct;107(10):1282-9.


5 Comments (+add yours?)

  1. Leslie T
    Jan 04, 2012 @ 17:25:00

    Yes I did and will every year


  2. Ashley @ C is for Cockerham
    Jan 04, 2012 @ 20:47:50

    I get a flu shot every year and did while I was pregnant as well. Thanks, as always, for a thorough and readable analysis. Looking forward to Part 2!


  3. Trackback: More Non-Vax Nonsense |
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  5. Trackback: Should we bother getting the flu shot (or nasal mist)? | Thinking it out

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