Jun 6, 2010

I am really not a member of the Flat Earth Society

Don't you hate feeling like a flat-earther? You know that uncomfortable feeling that you may be out of step with intelligent and rational society, when you're not wholly on-side with prevailing beliefs. (Hello, global warming...I do believe - sort of - with some aspects - but the stridency of the movement and the labelling of any dissent as from "climate change deniers" does not sit well with me). Anyway, this is about vaccines.
Now, I am pro-vaccines. No question. I get impatient with people who forget about the horrible sicknesses children used to get and the numbers that died from these diseases in the past, in an age (fairly recent!) when the spectre of losing a child from illness was very real. It is wonderful that we live in an age where our worrying minds can relax about child mortality and can use those worry-neurons for fretting about social, educational and parenting issues instead. Once upon a time these aspects were neglected because people's focus was more solidly on keeping their children alive. So yes, there IS such a thing as progress. (I loved my Popper philosophy at uni, and it is useful not to be blinded by an overly-credible belief in forward progress at all times....but still).

Anyway, about the flu vaccine. I am not going to talk much about swine flu, because despite reading a lot about it and giving it some thought, I just am not sure. Who knows?? (Answer: no one, until some more time passes).

Something happened in Australia in recent months which is very worrying. A number of little children who had had the seasonal flu vaccine got bad fevers and convulsions, and a two-year-old died. This was a shock. I have to admit without giving it any thought I had believed the seasonal flu vaccine to be completely safe and proven so over many years. Though I haven't done it, I would not have been too worried getting my kids vaccinated against seasonal flu.
Following more adverse reactions in multiple states, it has now been recommended the seasonal flu vaccine not be given to children younger than 5, until the cause of the problem can be proven and the vaccine changed if warranted.

So that was one thing. Another worrying thing happened a couple of weeks ago. I heard a medical expert on a radio news program talking about this, and he said that when they looked more closely at the data of the children with adverse reactions, they found that these reactions were in fact not unusual. The problem it seems, is with the tracking of results after clinical vaccination trials. Here is something I didn't know: in a vaccine trial, the participants are not tracked for adverse reactions. Instead, adverse reactions are measured from statistics as people present at hospitals. This was news to me and I was shocked!
Then I did some more reading. The reason is due to the sample size of the test population. As adverse reactions are very rare, there are never enough people participating in a trial to properly measure adverse reactions, or to seperate problems from things due to other causes from those due to the vaccine. So they also cannot categorise all the adverse reactions and their probability. These things are only truly known once the vaccine is rolled out to millions of people.
This is explained on the website of the US Centres for Disease Control and Prevention which you can read here:

It also explains something else I could not understand.
Even after all these horrifying reactions among children to the "normal", "safe" seasonal flu vaccine, governments and doctors insisted the new swine flu vaccine was safe for children under 5.
How could this be? The cause of the problems with the seasonal flu vaccine is still not known. The seasonal flu vaccine has been used for years; the swine flu vaccine is about a year old and still not widely taken up. Didn't make sense.

Here are the elements of the answer as far as I can make out:
- the swine flu vaccine is known to be safe for children under 5, because there were extensive trials done testing dosages on children under 5 (I remember when this was going on - I was interested that people participated in these trials. I love and believe in science but unless there were rabid pigs breaking down my door and the people being quarantined with swine flu had symptoms worse than the sniffles they seemed to have, don't think I would enter my kids in tests for a new vaccine against a new disease. On the other hand I knew this was probably ignorant).

- something else I didn't know. The seasonal flu vaccine is not exactly a vaccine that has been in use for years because every year it is different! because flu strains differ every year. Didn't quite know this I don't think!

- however, the seasonal flu vaccine "base" is well tested and known to be safe (though all vaccines will have small numbers of people react adversely).

So you put all that together and conclude that most probably the swine flu vaccine is perfectly safe (for most) and the seasonal flu vaccine usually is too but possibly not ever safe for children under 5, OR there may be something more likely to cause adverse reactions in little kids in this year's batch.

Another point in passing -
I had wondered before how it could be possible that a vaccine was developed for swine flu so quickly and still be safe - but I have read something that explained that; to simplify it lots, basically they have had a lot of practice developing vaccines over the years and these days can roll out new ones very quickly as they just have to add the new ingredient to the base recipe.

I still have a slight question though, if adverse reactions are not individually tracked during trials, and if this batch of seasonal flu vaccine caught everyone by surprise with the child reactions but later data analysis has found the pattern "not unusual", then how can they be REALLY sure the swine flu vaccine is safe for little kids? Were the trials done differently?

Some quick comments lest anyone actually read this and think any of it irresponsible. First, I do NOT believe there is any kind of conspiracy by government and Big Pharma to roll out unsafe vaccines. I do not think there is a conspiracy by the Australian government to offload its swine flu vaccine stockpiles to get their money back or save face over the criticism it was over the top with its swine flu pandemic response plan. (No wait - actually I do kind of believe this one! Simple economics mean it must at least be a TINY bit of a factor... ;-) ! )
I believe the swine flu vaccine is (most probably) safe. I definitely believe in vaccinations for children, and I don't believe that vaccines cause autism.

But I do think - to my shock and disappointment - there have probably always been risks for children under 5 from the flu vaccine, which we have not been educated enough about. It's heartbreaking, the trust that all the parents had, who routinely vaccinated their kids with the flu shot this year. And it's a real shame, if this spurs on more parents to decide not to vaccinate their kids against the other stuff.

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