Some truth about the new swine flu vaccine
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Yesterday at 5:36pm
From: Mark Crispin Miller
To:
newsfromunderground@googlegroups.comSent: Fri, 9 Oct 2009 09:27:00 -0400
Subject: [MCM] Some truth about the new swine flu vaccine
According to the CDC and, therefore, the MSM (especially the New York Times), the new
swine flu vaccine has now been thoroughly tested, and is "good to go," so there is no good
reason not to get your shot.
In fact, there are good reasons to be wary of this new vaccine. People need to make their
own decisions on this matter, but such decisions ought to be informed by sober independent
experts, not (on the one hand) by a state bureacracy tied closely to Big Pharma, and not
(on the other hand) by random screeds in cyberspace.
Dr. Meryl Nass is such an expert. Here, then, is what she has to say about it, posted on her
blog today:
Why Am I Concerned about Safety of Swine Flu Vaccines?
Friday, October 9, 2009
http://anthraxvaccine.blogspot.com/2009 ... ty-of.htmlMy friend Mark Crispin Miller has urged me to be more specific about why I am concerned about the safety of swine flu vaccines in the US. In a nutshell:
1. Newness
I am always concerned about new drugs and vaccines. A former FDA Commissioner, Dr. Jane Henney, once said she did not use drugs during the first year they were on the market, and advised others to likewise avoid them. The reason is that some drugs and vaccines caused serious side effects that were not picked up, or not considered enough of a concern, during initial clinical trials. Rotashield vaccine is a good example: intussusception (causing bowel obstruction) did occur in prelicensure trials, yet a million babies received this vaccine before it was taken off the market in 1999. Rotashield caused 22 times the expected rate of intussusception in infants... which was nonetheless overlooked in the first months of usage.
Pre-licensure trials typically involve about 1,000 subjects for short periods of time.
2. The Currently Available Evidence is Thin
There are few published studies of swine flu vaccine. The Greenberg et al. study from Australia (Response after one dose of a monovalent influenza A H1N1 2009 vaccine--preliminary report; NEJM 2009; epub Sept. 10) is a relatively high quality study. How was vaccine safety evaluated? By using a diary card for 7 days post-vaccination. The 240 subjects returned on day 21 for a blood draw, and presumably some data were collected then, but it is not clear from the published report what safety information was obtained after 7 days. Local symptoms like a sore arm were reported by 46% of subjects, and systemic symptoms such as headache, muscle aches or malaise were reported by 45%. Subjects were healthy adults aged 18-64.
The authors stated, "No deaths, serious adverse events or adverse events of special interest were reported." The investigators did specifically query subjects about several neurologic and immunologic events, including Guillain Barre Syndrome. However, it is unclear how actively other adverse events were sought, if at all, after the initial seven days post-vaccination.
The authors acknowledge that, "The full safety profile of the H1N1 vaccine has not yet been elucidated. Population-based postlicensure surveillance will be required for all H1N1 vaccines, especially to assess rare outcomes, such as the Guillain-Barre Syndrome." And they point out that they studied a population of healthy adults, and "trials need to be conducted in other populations that may have different responses to the vaccine, such as the elderly, children, and those with impaired immunity."
What concerns me are the later side effects that will not be collected, or not attributed to the vaccine due to lack of "biological plausibility." Since there do not exist reliable scientific criteria for assigning causality to vaccine adverse events, those the vaccine causes are likely to be dismissed as coincidental. An example is the drug Chantix, used to help people quit smoking. It often causes a variety of paychiatric side effects including suicide, even after the drug has been stopped. It took years after licensure to figure this out. The brief periods of active surveillance in vaccine research seem grossly inadequate to me.
3. The Liability Waiver... blanket immunity in the absence of willful misconduct
As I've noted previously, manufacturers can only be sued for damages if they are guilty of willful misconduct. As long as they don't know about safety problems, they cannot be held liable for them. This thoughtless language may induce manufacturers to perform minimal safety testing in order to avoid potential liability. Don't you think corporate attorneys have so advised their clients?
4. When the program isn't transparent, the result is lack of trust.
I expect the government supplying swine flu vaccines to advise recipients honestly about them. Live flu vaccines have very low efficacy in adults, compared to injected subunit vaccines. How attractive would a nasal vaccine that was only 29% effective at preventing influenza be to you, when the injected vaccine had 72% efficacy? Yet this is what Monto et al. recently reported in the NEJM about last year's seasonal vaccine. It makes you wonder why live flu vaccines are even licensed for adults. And how good are they in children? Better--but the data are limited.
Some hospitals are refusing live nasal vaccines for employees. That is wise: they are concerned the live viruses could be transmissible to patients, especially those with impaired immunity. They should also be concerned about efficacy.
Schools offering these vaccines don't seem to be aware of these potential problems. We need to know what the effectiveness of a vaccine is before being vaccinated. If the benefit is low, being vaccinated is probably not worth the (unknown) risk.
5. Benefit and risk should be compared
Yes, there are serious swine flu illnesses and deaths in a young, healthy population. But how frequent are they? How good is the vaccine at protecting against them? The very best flu vaccines are about 70% protective against catching the disease, which is the measure you are interested in. Most studies measure the rise in antibody levels, which may not reflect actual protection.
During 4 weeks in September there were 182 confirmed influenza deaths in the US. Though not a small number, it is not a big number either compared to seasonal flu. Cities (like Boston and New York) that had a lot of swine flu cases in the spring are having few now, suggesting a large enough number of people (perhaps 50% or more to induce this effect) had subclinical infections then to generate herd immunity. It is likely many will be vaccinated who are already immune. In the Australian trial, 31.7% of vaccine recipients were later found to have had antibodies against swine flu before they were vaccinated, even though they had no symptoms of disease.
If you have a neuromuscular disorder or lung disorder, you are at higher risk of a serious outcome from flu. Thus your benefit from vaccination is greater.
The benefit should be balanced against the risk, but we don't know the risk yet. I do my best to balance the known risks and benefits as I advise people regarding vaccination, and I hope readers of this blog do also.