Why So Afraid of H1N1 Vaccine?

h1n1The H1N1 virus is full into its second wave all over the world. There has been a large increase over the last 2-3 weeks, including in China. There are some disturbing signs that this H1N1 virus is more dangerous to pregnant women and children than previously thought. With pregnant women, the risk of death from H1N1 is six times higher than the population, and health authorities are stressing that pregnant women get the vaccine. And as for children, already in the US 86 children have died from H1N1, again already a higher total number than we would usually see during the entire seasonal flu season.

And yet there are widespread reports of uncertainty about the H1N1 vaccine. Is there any data to support such fears? The quick answer is no, but let’s talk more about it…

Where’s The Data?

No vaccine is ever 100% safe, but so far this H1N1 vaccine is proving to be as safe as expected — which is to say, very safe. And why wouldn’t it? It is not a completely “new” vaccine, in the sense that it is made the same way as the seasonal flu vaccine, using a similar non-active fragment of the virus. So you would expect the same adverse effect profile.

As for chronic worries by some regarding thimerosal and adjuvants, those issues are moot here, as there are no adjuvants in the H1N1 vaccine nor is there any thimerosal in the single-use vaccines (there is thimerosal in some multi-use vials). Moreover, there continues to be no good evidence linking either thimerosal or adjuvants to increased illnesses.

As for real data on safety, within China, of the 300,000+ initial vaccine group, there are about 100 reported side effects, none serious. That’s considered an even lower side effect profile than the usual seasonal flu vaccine. An earlier report had stated that of the first 39,000 recipients, only 4 had side effects, all mild (muscle cramps and headaches, usually).

There are a lot of websites providing poor information, or latching on to alluring but clinically irrelevant case reports, so it’s best to stick with the most reliable news sources such as WebMD. You can also follow the most reliable tracking of adverse effects from the US CDC and the WHO websites; they have frequent H1N1 updates.

Does the Seasonal Flu Vaccine Help or Hurt H1N1?

You may have read some conflicting news sources over the last couple weeks regarding the seasonal flu vaccine and how it affects H1N1. First, there had been news from an as-yet unpublished Canadian study suggesting that persons vaccinated against seasonal flu were twice as likely to get swine flu. But then a study in Mexico reported the exact opposite finding — that the seasonal flu vaccine actually offers partial protection against H1N1 (here is that original article, published in BMJ). So, who to believe? Well, as this WebMD article discusses, both studies have their flaws, and the overall numbers from other countries still show that there is no cross-over protection to H1N1. And the recommendation remains for those at highest risk to get both seasonal and H1N1 vaccines this year.

Still Not Available in China…Except Schoolkids

Most parents know that the government is offering the H1N1 vaccine to all students over 3, including the expat schools. I personally think this is a great idea, and I hope that parents can assess the real data and say “yes” to vaccination. Unfortunately for us adults, there is as yet still no word as to when the local expat clinics in Beijing will receive the H1N1 vaccine, as the government is allocating these initial stocks. There will be very limited supply for months; even by December there may be enough for only 5% of China’s population. So, China is doing what every country is doing — prioritizing limited supplies for those most at risk. So, stay tuned, and as usual, always practice good prevention. And don’t forget that the seasonal flu vaccine is available now.

Meanwhile, the CDC has updated Q&A about H1N1 vaccine, as well as specific information for pregnant women. The WHO also has their latest update, which specifically mentions concerns that many younger healthy people are ending up in critical care; also, the highest risk patients remain children under 1 and pregnant women.

Summary…

There is no evidence so far that this H1N1 vaccine is causing any more adverse effects than the regular seasonal flu vaccine. Moreover, the flu season is heating up, and there are some disturbing trends that pregnant women and children under 1 are having more serious illnesses than expected — including death. So, please consider vaccinating your children this week in school, and as the rest of us wait for the H1N1 vaccine, it’s a good idea for those at highest risk to get the available seasonal flu vaccine now. And as we wait, keep up with your best preventive medicine habits!

Article: As Flu Vaccines Are Given, Myths Are Debunked – NYTimes.com.


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3 thoughts on “Why So Afraid of H1N1 Vaccine?”

  1. This is a good post, but I worry that it’s preaching to the chior and isn’t pursuading the anti-vaccine crowd enough. And meanwhile, H1N1 virus is killing people. I am perplexed as to why some members of the Beijing Organic Consumers Association keep posting frightful warnings and stories about the vaccine. For example, just yesterday, someone posted that women who’ve just had the vaccine are reporting miscarriages. Well, hello! Miscarriages are extremely common in the early weeks of pregnancy, and just because someone has the vaccine followed by a miscarriage does not suggest causation, not even in the least. It would seem obvious, but maybe it isn’t. I guess it’s normal that when someone has a miscarriage, they worry about what they might have recently done to cause it, even throwing suspicion on the vaccine. Oh well, there’s my little rant. I hope you’ll keep sending this message forward, and that more people will study statistics and critical thinking.

    1. “Little rants” are encouraged here! I agree about the H1N1 seriousness — for high-risk groups. But overall, I don’t think my website readers are 100% pro-vaccine at all in terms of “preaching to the choir”. In fact I’d assume that half my readers still aren’t too sure. I can’t even convince my wife to get the vaccine! So I will keep trying to show people the evidence. As for BOCA, I do agree that their intended goal of providing organic information and discussion is many times overwhelmed by anti-vaccine and other posts, which really have no place on an organics blog. Certainly their mission statement is compromised by such posts. That’s why I left that group and now only read Beijingcafe.

  2. Just so that you know, this story is not from some fringe anti vaccine group.

    It was data presented at a talk given by Eileen Dannemann, Director, National Coalition of Organized Women (NCOW) Speech, most recent presentation was Friday, September 3, 2010. She presented data in September from two different sources demonstrating that the 2009/10 H1N1 vaccines adverse reaction. She analyzed the data from two sources, and asserts there are as many as 3,587 cases of stillbirth and miscarriage (U.S. figures alone) directly following the vaccine, and 30 maternal deaths (that is the CDC figure, not disputed).
    http://preventdisease.com/news/10/091410_H1N1_mis… discusses the method and statistical modelling they used.

    and a google search for h1n1 vaccine miscarriage month pregnancy will give you lots and lots of firsthand accounts of woman miscarrying afterwards…and very many of these are NOT in the first trimester, either. googling for h1n1 vaccine miscarriage "month of pregnancy" will get you more targeted accounts. 9th month. 6th month. Earlier, it's true, people might not even register that it's a vaccine reaction. With a baby further along, and miscarriage within days or weeks…you just know it might be the vaccine.

    This vaccine was untested in pregnant women.

    They have now put the H1n1 strain into the seasonal Flu vaccine as one of the 3 strains. VAXIGRIP, AGRIPPAL and FLUARIX are the three locally available brands that I know of. The ingredient list is incredibly disturbing.

    VAXIGRIP contains octocynol-9 (marketed as a spermicide in the U.S. for years), neomycin (an antibiotic with a side effect profile of its own) and formaldehyde (a known carcinogen according to the The International Agency for Research on Cancer -IARC)

    AGRIPPAL contains Polysorbate-80, linked to infertility in laboratory animals and CTAB Cetyl trimethylammonium bromide from the msds here &lt ;http://www.fastiddna.com/documents/MSDSFoodDNAKitCTAB.aspx> "Toxic (USA) Harmful (EU)" yet "To the best of our knowledge, the chemical, physical, and toxicological properties have not been thoroughly investigated." There is no study data on mutagenic or carcinogenic qualities of this "toxic" substance. Babies from 6 months of age are recommended to receive this.

    FLUARIX contains both Octoxynol-10 (Triton X-100), Polysorbate-80 once again, and along with two antibiotics which also carry risk profiles, also formaldehyde once again

    Each of the package inserts for the influenza vaccine state a long list of potential systemic and neurological reactions which have been seen to occur.

    They have not been evaluated for mutagenicity, reproductive effects, or carcinogenicity or for adverse events in pregnancy.

    IMO Caution is warranted, with these particular chemicals.

    Materials Safety Data Sheets are freely available, as are the package inserts (Vaxigrip is called simply Split Virion BP by Sanofi-Pasteur at http://www.medicines.org.uk/EMC/ as it is marketed under several names worldwide. Agrippal is there at EMC as well, and the Fluarix package insert is available here http://www.fda.gov/BiologicsBloodVaccines/Vaccine… . For the EMC products make sure you view the SPC summary Product Characteristics AND the PIL Patient Information Leaflet as information can and does differ somewhat).

    Liora

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