The CDC does not advertise high effectiveness. This seems to be a strawman you are knocking down. If you administer a fairly ineffective vaccine, you will still save hundreds of lives. With a very effective vaccine, you'd save even more.
If you read the Atlantic article, the CDC believes vaccines to be so effective in the elderly that it would be immoral to do a randomized controlled trial.
The single best way to protect against the flu is to get vaccinated each year.
More frequently washing your hands is more effective against influenza then vaccination.
The purpose of vaccination is not necessarily to save lives- it is most often given to healthy individuals who are not at any kind of risk of death- it is so they can avoid getting sick.
The life-saving claims for the elderly simply haven't been scientifically demonstrated, as the Cochrane review referenced by the Atlantic article points out- studies are below:
Your point is good, and I don't see it as a rebuttal of mine. In particular, a vaccine can be both mildly effective AND, yet, so much more effective than placebo that to perform an RCT is immoral.
The above referenced studies point out that the influenza vaccine has not been proven to be more effective than placebo in the elderly, which is one of the groups that CDC thinks it would be immoral to give a placebo.
Can you clarify which "above referenced studies" you are talking about? From the same site that you pointed me to (CDC), I find this page http://www.cdc.gov/flu/about/qa/vaccineeffect.htm stating "How effective is the seasonal flu vaccine in the elderly? ... the seasonal flu shot is 30%-70% effective in preventing hospitalization for pneumonia (a lung infection) and influenza ... In past studies among elderly nursing home residents, the seasonal flu shot was most effective in preventing severe illness and complications that may follow flu (like pneumonia), and deaths related to the flu. In this population, the shot can be 50%-60% effective in preventing hospitalization or pneumonia, and 80% effective in preventing death from the flu."
Now, that is not a study itself, but a summary of prior studies. If you think the CDC has formed an improper conclusion, that's fine.
The summary: "In long-term care facilities, where vaccination is most effective against complications, the aims of the vaccination campaign are fulfilled, at least in part. However, according to reliable evidence the usefulness of vaccines in the community is modest. The apparent high effectiveness of the vaccines in preventing death from all causes may reflect a baseline imbalance in health status and other systematic differences in the two groups of participants."
In other words, like I said, the vaccine doesn't work all that well - but despite its relatively modest effectiveness, it is still of great importance in the very age group that you singled out as not receiving benefit.
The last sentence of that Cochrane review summary points out that no randomized controlled trials have been done, and that the benefit to the elderly may reflect the lack of randomization. The second doi study cited is a study to look at that selection bias, and actually found that the entirety of the protective effect could be due to the bias. This makes it difficult to conclude that the influenza vaccine has any effectiveness in the elderly.
