Wednesday, 14 October 2009

So, will that swine flu vaccine give my kid mumps or what?

Posted by: Dr. Thunder.

I've just had my umpteenth conversation with a concerned parent about the swine flu vaccine. I'm starting to sound like a broken record now.
Parents have every right to ask questions, when we consider what's been in the media, regarding this jab. It's a minefield of information, and it's difficult enough for those of us who work in healthcare to get our heads around it.

I get asked a lot of questions about this vaccine. Some sensible. Some truly bizarre. I've had the crackpot conversations already, with the truly paranoid. We discussed mandatory vaccinations, and the big pharma conspiracies.

"This vaccine has been made to give us all swine flu"

"This vaccine has been made to stimulate the world economy"

"I've heard this virus was released accidentally from an American army lab, and they're trying to wipe it out, so unfriendly countries dn't get their hands on it".

These people must live truly terrifying lives, if they're so convinced that government is out to get them.

At the normal-ish end of the paranoid spectrum, I've had some unusual questions. But nothing prepared me yesterday for a previously sensible parent asking me, in hushed tones, whether I thought there was a risk of Anthrax from this vaccine!!!!!!!!

Jesus H Christ!

"It's just that I read it on a website".

I tried to keep it calm. But I'm sure my face cracked a little, as the laughter tried to escape. I reassured Harvey's dad, and he was accepting of my explanation.

Having said that, the concerns expressed to me have been, by and large, fairly reasonable. And those that are a bit crazy, have generally come from respectable looking websites, which are essentially conspiracy theory sites, or are peddling alternative meds. There is something ironic about these people claiming a big pharma conspiracy on hand, and trying to sell you expensive vitamin D "anti-flu" tablets at extortionate prices on the other

I feel I should put up a list of the common concerns here, and make an attempt to address them. Cleverer people than me might want to add some extra info too.

1) This vaccine was rushed through the safety checking process: There's no doubt that the swine flu vaccine was made quickly. If there was a new vaccine on the market. it would take years to reach the market. But the swine flu jab isn't really new.
Every year, we have different strains of flu circulating. We usually detect these many months in advance, and make a vaccine against them. The way we do this is by taking a vaccine mixture that is shown to be safe, and adding in the virus particle that is circulating this year. The virus particle is the bit that immunises you against a specific strain of flu. It is a part of the surface of the virus that your body will recognise. It is not live virus. This year one of the strains of flu is swine flu. We didn't know about it early enough to include it in the yearly flu vaccine, so we've had to make a new one. But it's almost identical to the seasonal flu vaccine that people get every year. It is very likely to be included in the normal flu vaccine next year.

2) I don't need it as I don't have an underlying medical illness: Depending on the country we look at, we're seeing 30-50% of swine flu deaths and admissions to ICU in groups with no risk factors. Plus, vaccines are not designed to protect individuals. They're designed to protect communities. If you don't catch it, you can't pass it onto a baby, or someone else who will be less able to fight it.

3) I read about it making people sick in 1976: There was swine flu in the USA in 1976, and there was a vaccination programme. About 40 million people were vaccinated, and 25 died from Guillain-Barre syndrome. This is true. But when you look closely at the figures, there were about 1 case per million people more than would have been expected in a normal year. That's still high, but it's not a huge risk. No cause has ever been found for these cases. But vaccines weren't as pure as they are now, and this is thought to have been a contributory factor.
Bear in mind, though, a good chunk of those people would survie today, as GBS is better treated. Also remember that influenza infection is a big cause of GBS.

4) This is only a mild disease: True. In most cases. 1 in 200 people who get swine flu end up in hospital. A third of these end up in ICU. Usually for about 2 weeks. 1 in 1000 patients die from it. Though in some countries this figure is much higher. If 1 million people catch swine flu in Ireland, that's 1,000 deaths we're facing, and about 5,000 hospitalisatoins. That will wreak havoc on an overstretched health service this winter.

Everyone has their own choice to make. It's not for me to tell anyone what to do. But, whatever your decision, make it based on facts. Speak to your doctor or nurse. Don't look at the quack websites.

I had mine the other day. Had a bit of nausea the next day. But otherwise I was fine.

Feel free to comment. Feel free to disagree. But please don't scaremonger.

Dr. Thunder.


  1. This is a really good, sensible post. There really needs to be more like it, the tinfoil hat brigade are having a field day with swine 'flu, and it may cause unnecessary suffering for those who end up infected as a result of uninformed scaremongering.

  2. Good to hear you're tackling the vaccine misinformation out on the front line, Doc.

    For info, UK blogger DeeTee, who is an infectious disease consultant, has done a series of posts on swine flu, including one tackling the Guillian-Barre risk issue in detail here.

    The other place I look for swine flu info is the American public health blog Effect Measure.

  3. Thanks Dr Aust!

    Good to see some others fighting the corner!

    It's been a long time since I've seen such an orchestrated campaign of misinformation.

    It's a shame that, for some people, they think looking at a conspiracy theories website = informed decision making.

  4. Slightly off-topic, swine flu vaccination for sprogs in the UK is on hold because of a ridiculous dispute between the GPs and the Govt.

    While the GPs may have a case where surgeries are really stretched, it is a terrible time to be picking this sort of fight - I see it as exactly analogous to, say, asking for a 3% pay rise when the country is deep in the shit financially. You MAY be able to justify the stance somehow, but in terms of: (i) the greater good; and (ii) how the public perceive you, it is a complete and utter gun-foot incident.

    To give you an example of what a balls-up it has been, Mrs Dr Aust went along to get a jab (as she is in a priority group) and took our 5 yr old who had a first shot. The baby didn't get one as he had a cold, told to bring him back.

    Lo and behold, when she took the kids back 2 wks later, the GP said "Oh no, we're not doing kids 5 and under now, no clinical need". He wouldn't even give the 5 yr old the second shot! Mrs Dr Aust was absolutely incandescent. I think "doctor solidarity" is the only thing that stopped her making an official complaint.

    It is hard not to feel that what was really behind it was the dispute over payment.

  5. Bet the patient's "anthrax" was linked to the fact someone in the media (not sure who now) nicknamed piggy flu "hamthrax".
    I liked your corner about the vaccine not being for individuals but for the herd immunity. I still don't get a jab for either flu despite being the only non-risk member of my family (2x asthma and not a lot of left-over lung and what there is is rather fibrosed due to radiotherapy after the rest was removed) - and they all count twice as they're all NHS front-line staff! I just avoid people as much as possible during the flu season!

  6. The Swine Flu (H1N1) virus is on the minds of many of us these days. Whether you have small children or elderly people around you may want to take some precautions to keep you and your family safe.

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