I'm going on about vaccines again!
Nov. 19th, 2009 11:30 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
blamebramptonI had my H1N1 vaccine this morning. No side effects so far, and it didn't even hurt! I far prefer flu vaccines to tetanus!
But the most exciting thing for me was reading the government information leaflet -- it's really good! Along with a section explaining that Panvax is not a live vaccine, so it's perfectly safe for foetuses (H1N1 influenza disproportionately causes miscarriage and serious maternal illness), it had a section addressing Guillain-Barré syndrome (GBS). GBS is a serious neurological syndrome that unexpectedly affected about 500 people in New Jersey after a mass vaccination programme in the US in 1976. Since then, there has not been another proven connection between flu vaccines and GBS, and the research done on the event suggests that it was probably a single batch infected with campylobacter, a known precursor to GBS (and a REALLY horrible stomach illness, trust me!)
Since 1976, although GBS has been raised as a concern by people who are not in favour of mass vaccination, there has not been any proof of a subsequent link between GBS rates and flu vaccination. Nevertheless, because governments and scientists generally err on the side of caution, a risk of 1 additional case of GBS per million vaccinations is given, and is stated on the Australian information sheet. Something aside from campylobacter that is known to cause GBS is influenza, and, as the info sheet says: "you are four to seven times more likely to contract GBS after an attack of the actual influenza than after the vaccination".
In actual fact, the risk of GBS from influenza seems to be more in the realm of forty times more likely, as rates are around 4 to 7 per 100,000 cases of influenza.
However, reading that paragraph in the surgery, I gave a little cheer. FINALLY a statement of risk that contextualises it sanely!
Why does this matter? Because people are being told by bad media reports and social networking scares that flu vaccine is not safe, that it contains chemicals that are known to cause harm and that it is not tested. In fact, H1N1 vaccines around the world are being made by the same companies that make seasonal flu vaccines, using the exact same methods. Flu vaccines save tens, if not hundreds, of thousands of lives every year, with excellent safety records. Most, like Panvax, contain no live vaccine -- people who are allergic to eggs are offered a version with live vaccine in many places, including the US, as it is safer for them.
H1N1, on the other hand, is not a safe nor mild disease. It has had a very serious impact on people between 20 and 50, who are normally minimally affected by seasonal flus. In fact, the death toll for old people, the usual flu victims, is statistically low for H1N1. And the people aged 20-50 being affected are not the usual immune-compromised set, either, but both the healthy and those whose only health issue is being overweight. If you're up for it, check out this excellent article from New Scientist on swine flu myths and how they are endangering people's health.
Having seen the incredible impact of H1N1 on the health system in Australia last year -- a warm country in which flu is not as dangerous as it is in cold countries -- I had no hesitation in getting the jab. Well, aside from my usual disorganisation delay ... Fourteen hours later, not even localised swelling. And if you're in Australia and have a Medicare card, it's free! Obviously, talk to your doctor and read the info from your health authorities if you have concerns.
You can read the Australian info sheet as a PDF, downloaded from here, it's available in several languages in the vaccination information sheet category down at the bottom right.
But the most exciting thing for me was reading the government information leaflet -- it's really good! Along with a section explaining that Panvax is not a live vaccine, so it's perfectly safe for foetuses (H1N1 influenza disproportionately causes miscarriage and serious maternal illness), it had a section addressing Guillain-Barré syndrome (GBS). GBS is a serious neurological syndrome that unexpectedly affected about 500 people in New Jersey after a mass vaccination programme in the US in 1976. Since then, there has not been another proven connection between flu vaccines and GBS, and the research done on the event suggests that it was probably a single batch infected with campylobacter, a known precursor to GBS (and a REALLY horrible stomach illness, trust me!)
Since 1976, although GBS has been raised as a concern by people who are not in favour of mass vaccination, there has not been any proof of a subsequent link between GBS rates and flu vaccination. Nevertheless, because governments and scientists generally err on the side of caution, a risk of 1 additional case of GBS per million vaccinations is given, and is stated on the Australian information sheet. Something aside from campylobacter that is known to cause GBS is influenza, and, as the info sheet says: "you are four to seven times more likely to contract GBS after an attack of the actual influenza than after the vaccination".
In actual fact, the risk of GBS from influenza seems to be more in the realm of forty times more likely, as rates are around 4 to 7 per 100,000 cases of influenza.
However, reading that paragraph in the surgery, I gave a little cheer. FINALLY a statement of risk that contextualises it sanely!
Why does this matter? Because people are being told by bad media reports and social networking scares that flu vaccine is not safe, that it contains chemicals that are known to cause harm and that it is not tested. In fact, H1N1 vaccines around the world are being made by the same companies that make seasonal flu vaccines, using the exact same methods. Flu vaccines save tens, if not hundreds, of thousands of lives every year, with excellent safety records. Most, like Panvax, contain no live vaccine -- people who are allergic to eggs are offered a version with live vaccine in many places, including the US, as it is safer for them.
H1N1, on the other hand, is not a safe nor mild disease. It has had a very serious impact on people between 20 and 50, who are normally minimally affected by seasonal flus. In fact, the death toll for old people, the usual flu victims, is statistically low for H1N1. And the people aged 20-50 being affected are not the usual immune-compromised set, either, but both the healthy and those whose only health issue is being overweight. If you're up for it, check out this excellent article from New Scientist on swine flu myths and how they are endangering people's health.
Having seen the incredible impact of H1N1 on the health system in Australia last year -- a warm country in which flu is not as dangerous as it is in cold countries -- I had no hesitation in getting the jab. Well, aside from my usual disorganisation delay ... Fourteen hours later, not even localised swelling. And if you're in Australia and have a Medicare card, it's free! Obviously, talk to your doctor and read the info from your health authorities if you have concerns.
You can read the Australian info sheet as a PDF, downloaded from here, it's available in several languages in the vaccination information sheet category down at the bottom right.
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no subject
Date: 2009-11-19 12:58 pm (UTC)no subject
Date: 2009-11-19 01:03 pm (UTC)It may be worth your while protesting the decision with your local authority, given the clear indication that overweight is a serious risk factor. At the very least, they might give you one to shut you up ;-)
And I am about to email you!
no subject
Date: 2009-11-19 03:23 pm (UTC):((((
They just opened our clinics to 'all ages' yesterday (from high-risk only). DH and the boys went (I'm still a bit too sick, so I remained home, also not cool to go to the clinic and infect people with H1N1 while they wait for the vaccine).
Fevers all and crankiness around around! but at least they are done.
no subject
Date: 2009-11-19 03:26 pm (UTC)"also not cool to go to the clinic and infect people with H1N1 while they wait for the vaccine" -- It would be kind of funny, though, wouldn't it? In a sort of evil way?
You and your family are due a long stretch of being well. *nods*
no subject
Date: 2009-11-19 03:34 pm (UTC)From what I have read, the programmes in the UK will be opened up once more vaccine is available. Not as sure on the US, but I think it is the same.
no subject
Date: 2009-11-19 01:00 pm (UTC)no subject
Date: 2009-11-19 01:05 pm (UTC)Since typing the above, I have accidentally bumped my arm with the injection site FIVE TIMES. I think that I am subconsciously testing my assertions ;-) Still doesn't hurt!
no subject
Date: 2009-11-19 01:15 pm (UTC)no subject
Date: 2009-11-19 01:16 pm (UTC)no subject
Date: 2009-11-19 02:28 pm (UTC)YES! It's just like the seasonal vaccine that's offered every year, people. Nothing mysterious about it.
I received it as I'm nursing infants under 6 mo. It's still not widely available here. Oh, and by the way, no side effects for me - not even a sore arm. Not a huge deal.
no subject
Date: 2009-11-19 02:33 pm (UTC)Of course, one of the doctors who I rang to see if they could fit me in for a shot this week airily assured me that one week would be adequate to develop immunity, which suggests that a lot of doctors don't keep up with the literature ...
And YAY AMBER! *SENDS HUGS!*
H1N1 vaccines
Date: 2009-11-19 03:43 pm (UTC)You may find this article on historical flu outbreaks and the role mass vaccinations had in their spread interesting: http://content.nejm.org/cgi/content/full/NEJMra0904322
And here's the Arzneimitteltelegramm for doctors and health care workers with information about why flu mass vaccinations are not necessary and potentially harmful in Germany. Unfortunately it's only in German (I include it in this post only for the German-speaking of your flist, Brammers, in case they are interested.)
I don't want to get into a huge discussion about vaccination - I am no expert and could not argue on a medical level. My comment is only meant to convey that there are other opinions out there.
Re: H1N1 vaccines
Date: 2009-11-19 04:06 pm (UTC)Was that first link to the correct paper? If it is, I would strongly disagree with your conclusion on what it shows: the Fort Dix incident was an extremely special case and, as the paper's conclusion says, the H1N1 release came from a research laboratory, not from the vaccination programme. That vaccination programme had its own issues, due to limited contamination according to the best sources available, but that is a separate issue.
Re: H1N1 vaccines
Date: 2009-11-20 12:39 pm (UTC)Fact: Influenza leads to TENS OF MILLIONS of lost work days world wide every year.
Fact: Vaccination prevents influenza infection. THIS IS UNDISPUTABLE.
Fact: Mass vaccination reduces disease spread through a population, a state known as "herd immunity." (Flu vaccine has NEVER had sufficient penetration to achieve this... but herd immunity is how smallpox was eradicated.)
Fact: No one has ever proven (or even generated a statistical trend suggesting) a link between vaccination and any other condition. Every single time, either no association could be found, or another agent (i.e. Campylobacter in the GBS case in 1976) has been identified.
Opposing vaccinations is fearmongering based on bad (or no) science. It is contrary to the most basic principles of public health.
Re: H1N1 vaccines
Date: 2009-11-20 12:50 pm (UTC)Fact is: in Germany health care officials and doctors talk more about "panicmongering" than the supposed deaths that could be avoided with mass vaccinations.
I am stepping away from this now.
Re: H1N1 vaccines
Date: 2009-11-20 01:26 pm (UTC)'Alternative' medicine has a strong tradition in Germany, with the country's medical tradition having its roots in public health and quasi-moral injunctions concerning hygiene. This was a fabulous step to take in the 19th century and has produced more good than bad overall.
Out of this democratisation of health came movements like homeopathy, which was but the first of the big CAM approaches to reach a mass audience in Germany.
Now I think that the science of homeopathy is bollocks, but treatment by a homeopath can be very successful, for all the same reasons that the original public health focus of modern German medicine saw dramatic improvements in the German populace: it puts a focus on wellbeing and deals with many minor issues through the concern shown by practitioners to patients, and by the time and ritual of being concerned with the patient's health (most conditions being self-healing).
CAM models fall down when looked to as a focus for acute and serious conditions, such as menigicoccal or cancer, but the German approach on the whole does not see an either/or situation there and has a strong reliance on using contemporary medicine with CAM adjuncts for wellbeing, or, eventually, for palliative care if needed.
All of this means that the debate in Germany is one in which the population is actively involved and where a lot of medical professionals are as focussed on what could be seen as 'healer' modes of thought as on 'science' modes (a dear friend, when studying for her MBBS, described her career as 'part science, part art, part village priest', which I think is very accurate). This sees less emphasis placed on bare hard science and statistics, and more placed on broad concerns regarding a well population.
While I disagree with this approach for issues such as vaccination in which herd immunities are important and the specific issues raised against them are not strong, overall, the German approach is quite successful when looked at in terms of key indicators including life expectancy, satisfaction, overall health and so on.
A world based on science would be more to my taste, but I am also very prepared to admit that such a world would leave itself open to significant problems, too, as history has shown several times. So while I disagree with the German approach on this issue, I do think that it has a lot to recommend it as a way of delivering health care to a populace.
Re: H1N1 vaccines
Date: 2009-11-20 02:06 pm (UTC)(NB: Having just recalled that you are not American, I will point out that the parenthetical insertion in the last sentence is not intended to be condescending, but rather a humorous reference to an American Public Television children's show called Mister Rogers' Neighborhood. The "Can you say... I knew you could" construction was one of Fred Rogers' trademark verbal tics.)
Re: H1N1 vaccines
Date: 2009-11-20 02:32 pm (UTC)At the heart of the matter these days is the fact very few people have seen the devastation that can be wrought by diseases including measles, polio and so on. With very little history taught these days, and even less history of science or medicine, it is incredibly easy to forget.
Additionally, science and health are very badly reported by most journalists, but also very badly communicated to those journos by many universities and medical professionals. So something such as GBS is reported as being an increased risk of vaccination, but not in context of being a debated increase, nor of being a substantial lowering of risk compared to influenza.
One of the most common furphies I have heard regarding H1N1 is that it only affects the old and weak. I even photocopied graphs for my workmates on a best-selling magazine -- with health pages -- that showed the atypical distribution of serious and fatal cases in Australia and the US, which they looked at, and then in several cases said 'Yeah, but ...'
It works the other way, too. My passion for vaccination (and prophylactic treatment) was formed entirely from experience: a childhood friend died of measles, then in India and especially in Mozambique and Tanzania, I saw astonishing illness caused by pathogens that were unknown back in my developed-world home. I also caught a malaria-like fever and was seriously ill in Mozambique because my father was a dreadful hippy when it came to things like preventative measures. (I was fine, and in the small hospital I was sent to became a minor celebrity for being the very whitest person they had seen in years; deserved, I was ridiculously pale in those days.)
Re: H1N1 vaccines
Date: 2009-11-20 08:01 pm (UTC)To once again reference that unforgettable sentiment of George Santayana (which no one ever quotes precisely correctly, but the sense is what matters here anyway): those who fail to remember their history are doomed to repeat it.
You are clearly "in the know," but it bears repeating: H1N1 is worrisome particularly BECAUSE it does NOT only target the young, old, and infirm; deaths have been fairly uniformly distributed across all age groups, which is VERY atypical of flu.
I am a general internist; prophylactic/preventative care is what we're supposed to DO.
I need a "doctor" icon for occasions when I am pontificating on subjects medical. In the meantime, have a Doctor icon.
Re: H1N1 vaccines
Date: 2009-11-21 01:04 am (UTC)Actually, I am not sure if this is true, the New Scientist and Australian Dept of Health and Ageing have both reported unusually low incidences in the v young and elderly, with completely disproportionate cases among the 'prime of life' population.
Which is why I keep banging on about it, as you note, preventative care is important on this one.
Re: H1N1 vaccines
Date: 2009-11-21 01:11 am (UTC)Re: H1N1 vaccines
Date: 2009-11-21 01:20 am (UTC)Re: H1N1 vaccines
Date: 2009-11-21 01:23 am (UTC)You are probably aware that I am working on my Masters in Public Health degree in Health Policy and Management; clearly, I AM a crazy person.
Re: H1N1 vaccines
Date: 2009-11-21 01:36 am (UTC)How do you mandate reporting in a population that has statistically high under-use of medical resources due to un- or under-insurance? I'd be seriously interested to know if there are secondary means of information gathering, such as pharmacists.
Re: H1N1 vaccines
Date: 2009-11-21 01:47 am (UTC)no subject
Date: 2009-11-19 06:43 pm (UTC)I just thought you may be interested about the following documentary. It is about the story about the creation of the polio vaccine. Extremely interesting and at the same time a testimony about the importance of mass vaccination.
http://www.pbs.org/wgbh/americanexperience/polio/
Have a good day!
no subject
Date: 2009-11-19 09:21 pm (UTC)Back in the developed world, I had a childhood friend die of measles, an adult friend of meningicoccal, and recently an American acquaintance of H1N1. The first two were easily preventable, and the last would have been had she been luckier with her timing.
I also passionately love antibiotics and sanitation. And I'll certainly make time to watch the doco, thank you for sharing it!
no subject
Date: 2009-11-19 08:04 pm (UTC)no subject
Date: 2009-11-20 01:27 pm (UTC)no subject
Date: 2009-11-21 01:43 am (UTC)I had the jab and it was painless and I've had no after effects. Yay! *remembers the sore arm for days after my last pneumonia shot*
I wonder if I'm so pro immunisation because I'm old enough to remember kids wearing callipers from polio and losing sight from measles. I also remember going with my parents when they had their routine (and compulsory?) chest X-rays back in the early 60's, though TB is a slightly different case.
no subject
Date: 2009-11-21 01:52 am (UTC)And HURRAH for pain-free shots. Panvax seems to be a bloody winner! Now watch me contract seasonal flu, which Aus has no vaccines for the current UK set ;-)
no subject
Date: 2009-11-19 09:19 pm (UTC)I'm still recovering from swine flu and I do not recommend that experience to anyone. It wasn't quite as bad as I thought it might be but having high fever for days made me really weak. I've getting pretty much all the infections for the last two years - and we're most certainly not amused.
no subject
Date: 2009-11-19 09:31 pm (UTC)Best wishes for getting well!
no subject
Date: 2009-11-19 09:39 pm (UTC)Haha! It's not funny...but yes it is...in a horrible way. We should probably all move to mountains.
no subject
Date: 2009-11-20 01:28 pm (UTC)no subject
Date: 2009-11-19 10:33 pm (UTC)I actually got put onto a yearly flu shot regime years ago when they thought I had leukaemia - that was a fun couple of weeks. Having one helps focus my system into actually doing what it's meant to do instead of all the faffing around it likes to get on with. Of course, since then I actually have had a proper diagnosis of what's wrong with my immune system. Joy!
Glad to see they're putting out some meaningful literature. I try not to read the brochures and the 'slight risk of' lists, because I'm prone to psychosomatic reactions. Sometimes less information is a good thing for my brain.
Thanks for spreading the good word, honey. *smooch*
ps. Will miss you. Have a BLAST!
*is determined not to get eaten by envy*
no subject
Date: 2009-11-20 12:48 am (UTC)I can understand that people are confused, though. As you said, there's a lot of misinformation going around about vaccines (I really hope people don't still believe those Autism myths, BTW). But you can get whiplash just trying to follow valid reports about treatment and nutrition--something's good one year and bad the next. I've been hearing a lot about antibacterial soap lately ... super strains and all that.
no subject
Date: 2009-11-20 02:09 am (UTC)I don't believe in Coincidence
Date: 2009-11-20 05:39 am (UTC)Thank you BlameBranton for posting this.
On my lunch hour, I went to get my allergy shots.
They had a limited supply of the H1N1 vaccine.
My Md allergist offered it to me.
I decided to take the H1N1 vaccine.
The shot, not the nasal vaccine.
I do not smoke, my deceased mother did, and I have
a hx. of bronchitis. I also work daily, very closely,
with the public. I am taking temperatures, blood
pressures, pulses, and pricking their fingers.
I consider myself a health care worker.
I do not work in a hospital or nursing home.
My work organization will not offer the H1N1 to
their people. I did get a regular flu shot from
my work organization the first week in October.
When I got home, there were 6 clinics offering the
H1N1 for free in my area.
There were 2000 vaccines and once they were gone,
they were gone. People, adults,
children, handicapped were lined up around blocks
or the length of buildings waiting to receive the
vaccine.
There is a shortage of the regular flu vaccine
and the H1N1 vaccine in our area.
I don't believe in coincidence.
I am glad I was able to receive the vaccine.
no subject
Date: 2009-11-20 12:32 pm (UTC)The flip side is, the diversion of vaccine manufacturing equipment to making H1N1 vaccine has led to a shortage of seasonal flu vaccine in the US this year.
no subject
Date: 2009-11-21 03:47 am (UTC)no subject
Date: 2009-11-21 11:07 pm (UTC)I agree that people should definitely look at what the side effects/ make sure it has been tested, but I think most vaccines are definitely worth it.
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