Swine flu: pandemic or panic?

Public health officials are gearing up for a mass swine flu (H1N1) immunization campaign, first targeting children, pregnant women, and medical workers.

The U.S. government has purchased 195 million doses of swine flu vaccine, and contracted for 120 million doses of adjuvants to stretch the vaccine supply. The production process in eggs is yielding two to four times less viral antigen from H1N1 flu than from seasonal strains.

Is this necessary to prevent a replay of the 1918 influenza epidemic, with up to 350 million deaths worldwide instead of 50–100 million? Or is it 1976 all over again, when swine flu immunizations had to be terminated because the dreaded epidemic failed to occur, but thousands suffered adverse reactions, including Guillain-Barré syndrome, from the shots?

HHS Secretary Kathleen Sebelius has taken the precaution of immunizing both government officials and vaccine manufacturers from lawsuits like those filed in 1976, by invoking the 2006 Public Readiness and Emergency Preparedness Act (PREPA). The state of Maine, by declaring a statewide civil emergency, also protects schools and medical personnel from liability claims.

In Australia, the vaccine rollout has been delayed by the government’s refusal to underwrite physicians’ liability. A spokeswoman for the Medical Indemnity Protection Service said the company would cover doctors, but they needed to “appropriately advise patients that the vaccine is untested and may have [currently] unknown consequences…. We do not know the risk [or] benefit of the vaccine versus contracting the disease” (Julie Robotham, Sydney Morning Herald 8/28/09).

This statement highlights the fact that testing has been extremely limited, and only very short-term—only 5 days in the UK (Sunday Times 7/12/09). Officials are relying on the fact that the vaccine is “not radically different” from seasonal flu vaccine. The use of adjuvanted vaccine is different, however. As aluminum adjuvants may not be sufficiently immunogenic, oil-in-water adjuvants are being tried. Novartis’s M59 adjuvant, squalene, is especially controversial.

A compound normally found in the human body—and throughout the nervous system and brain, squalene could hypothetically induce a destructive autoimmune response if injected. Some consider it instrumental in causing Gulf War syndrome. Novartis claims that squalene is poorly immunogenic; that its use in influenza vaccines in Europe and other areas has been well tolerated; and that normal individuals not immunized with squalene-containing vaccines may also have anti-squalene antibodies (Del Guidice G et al. Clin Vaccine Immunol 2006;13:1010-1013). Injected squalene has induced chronic rheumatoid-like arthritis in susceptible strains of rats (Carlson BC et al. Am J Pathol 2000;156:2057-2065).

The effects of the new vaccine on pregnancy outcome or long-term effects on the fetus cannot be known. Concerns are being raised that human papillomavirus vaccine may be associated with an increased miscarriage rate in women who received it less than 3 months before conceiving, an unanticipated consequence (NY Times 9/4/09).

Circulating in cyberspace are apocalyptic concerns about devastation either from an influenza pandemic, or from mass forced vaccination. The following statements appear to be verifiably true:

  • We are living in a pandemic era that began in 1918 or before. There is always the possibility of the emergence of a highly pathogenic strain to which the population has no prior immunity. We are in a level 6 pandemic now, according to the World Health Organization’s new definition, which includes worldwide spread but no longer requires high morbidity or mortality. Instead of the feared, severe avian H5N1 strain, the H1N1 swine flu, which is so far less severe than usual seasonal flu, predominates.
  • Both the effectiveness and safety of influenza vaccines have been questioned. Extensive, long-term testing, and availability in time to mitigate a 1918-type pandemic, are mutually exclusive objectives.
  • There is widespread mistrust of the UN’s WHO, governmental agencies, and pharmaceutical manufacturers. There are huge amounts of money at stake, and serious conflicts of interest at the highest levels. There is much secretiveness. For example, the military is accused of covering up serious adverse effects of experimental vaccines used on troops (WLTV.com 5/7/07).
  • As Robert England, M.D., Director of the Maricopa County (Arizona) Department of Health, told the Arizona Medical Association, “we have scary powers” in the event of a declared emergency. Laws are on the books permitting use of the military to forcibly vaccinate, relocate, and quarantine Americans in an emergency.

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12 thoughts on “Swine flu: pandemic or panic?

  1. “Laws are on the books permitting use of the military to forcibly vaccinate, relocate, and quarantine Americans in an emergency. ”

    This too sounds like a voice of panic, albeit in a different direction. The Army coming to round up citizens and forcibly relocating them?

    Why denounce one kind of panic and embrace another?

  2. Mirabile dictu! It takes BIG PHARMA about 11 years and two large FDA-approved drug trials (about a billion dollars in Research and Development costs) before it is allowed to market one pharmaceutical drug. But the vaccination against H1N1 has been fast-tracked at Warp speed to combat a disease that may not even happen. And nobody even knows if and what are going to be the side effects.

    And it’s not a schizophrenic stretch of the mind to imagine that some type of biomedical implant with GPS potential could be slipped in either in this vaccine or during some other world class emergency that under the auspices of emercency martial law could be forcibly injected into every person in this country merely at the whims of some Health Czar yet to be installed in our ever mushrooming bureaucracy. If we ever lose the right of private possession of firearms, the whole show is over.

  3. I agree. This whole scenario seems to be more hype than reality. The pharmaceutical industry certainly has a lot to gain. I’m still unconvinced that this will be the best thing for my patients, so I have not been recommending this to all of them.

  4. …some type of biomedical implant with GPS potential could be slipped in either in this vaccine or during some other world class emergency that under the auspices of emercency martial law could be forcibly injected into every person in this country merely at the whims of some Health Czar…

    A flu epidemic is “hype,” but this is reality? The CDC is emphasizing that there will not be enough H1N1 vaccine for everyone, but now we are all going to be forced to receive it?

    I am old enough to remember certain hippies in 1969 fearing that Ronald Reagan would put them all into concentration camps if he ever came to power. I have been reminded again and again of those times when I see people with posters equating Obama with Hitler and Stalin. Except they do not disappear into the concentration camps or the gulag! Nor did the fear-stricken hippies of yore.

    The annual flu vaccine is fast-tracked, and has never taken 11 years to prepare, by the very nature of the beast. The H1N1 vaccine is not the exception but the rule in this area.

    Physicians are being given information about the highest risk groups who have priority for the new vaccine so that they can give current information to their patients; no one is expected to recommend the vaccine for “all of them.”

    In the end, reason will prevail, but only if very determined individuals make it their business to see that it does.

  5. I find it of interest that no one over the age of 64 is to receive the vaccine when it is released. Health Care Rationing for the elderly is very clearly demonstrated by this fact. Do we want physicians and patients to work together in the best interests of the patients to control health care, or do we trust a government “elite” to control every aspect of medical “care.” I don’t think the government does care.

  6. Southern Hemisphere flu season is wrapping up. Argentina’s unionized healthcare workers (2800) reported 175 H1N1 cases (about 6%)with 6 deaths this season. (WSJ article 9/15/09)
    If 6% of my colleagues and hospital workforce get H1N1 and 3% of them die, I think that’s a concern. There were no vaccinations in Argentina so we do not know if there would have been any effectiveness of such a program.

  7. Seasonal flu vaccine for those over 65 is still recommended as usual. The H1N1 recommendations target groups at higher risk for disease and complications. Once the highest risk groups have been vaccinated, the use of vaccine can be extended to lower risk groups. Only 1% of confirmed cases of H1N1 have occurred in people over 65, and the 50 to 65 year old group has also had few infections. The CDC press release days that as the needs of the younger age groups are met, vaccination should be offered to those over the age of 65.

    The government doesn’t care? About whom? What does this mean? Does the aging baby boom generation care more about itself or about its children and grandchildren? I don’t get it. What has happened to us? I remember resenting it 40 years ago when we were described as the most self-indulgent generation in history, but now I have to wonder if that designation was not correct.

    One pertinent point: there is indeed insufficient information about the MF59 adjuvant’s safety. That is why rigorous surveillance is needed. The New England Journal studies suggest that the adjuvant reduces the amount of antigen needed for an immune response, meaning that more Americans can be protected with its use, and that “rationing” will be less necessary. Decision making under conditions of uncertainty is what doctors (and other humans) are faced with every day. Rare adverse effects could accrue quickly if surveillance is less than vigilant. We need to monitor carefully to make sure the CDC does its job.

    The US has made the decision to outsource vaccine production, a policy that has certain consequences. We have less flexibility and autonomy than would be ideal when it comes to flu vaccine production and distribution. Little blue pills for erectile dysfunction are bigger money-makers than flu vaccines. “BIG PHARMA” has elected to invest its resources for products that bring in a greater financial return. Drugs that you need once a year don’t qualify; those that you need regularly are a different matter.

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