Re: Swine Flu 1976 & Propaganda
I wonder if the vaccine makers have made changes to prevent the dangerous side effects seen in 1976. I'm especially concerned over the fact that the vaccine is being prepared on an expedited schedule.
There was no way that the makers of the 1976 H1N1 vaccine could have known that it would result in the very rare and severe neurological adverse event of GB. The same will be true with the novel H1N1 vaccine when it is available this fall.
Why, while there were 500 cases counted of GB in the US among the 39,000,000 people who were vaccinated, this represents a very small number of cases. 500/39 MM = 1.3 cases in every 100,000 people vaccinated.
If we had the usual time to test both the efficacy and safety of the 1976 or coming novel H1N1 vaccine it would require several months at a minimum and be conducted in less than 10,000 people. Given the very low incidence of the GB events, there would have been only a 1 in 10 chance of seeing even a single case of GB in these studies if done in 1976 prior to the vaccines release. So, there was a 90% chance that even if that vaccine or indeed the new novel H1N1 vaccine were fully tested according to standing US FDA protocols, GB would not have been detected.
What is important to bear in mind about this issue is the risk vs benefit of the use of an efficacious vaccine for the person given it. For instance, the 1976 H1N1 pandemic did not develop because there was sufficient heard immunity present among those aged 20 and over to keep the transmission rate among the population low. What's more, vaccinating another 39,000,000 people in the US extended herd immunity considerably further especially to the extent those receiving it were under age 20 for which the 1976 strain was a new virus. The US population was 150,000,000 at that time so the vaccine program reached 26% of all living Americans.
The combination of the 26% of the pop vaccinated in 1976 together with the herd immunity due to natural H1N1 infections occurring prior to 1957 can easily be expected to have pushed the percentage of the pop with some form of immunity to the magic >50% level where pandemics can not tread well.
We had no pandemic in 1976 and and the US CDC and drug makers took the hit. But in retrospect it is very possible that if they did not take the expedited action they did, we could have had one. We will never know who lived as a result of the 1976 flu vaccine. We do know who died and made disabled from it and that's the rub.
There are no free lunches any where including in medicine. There will be unexpected as well as expected adverse reactions to the novel flu vaccine, of this we can be certain. What else is certain though, IMO that if the novel strain becomes really ugly and it could, those accepting the vaccine will be much better off than those rejecting it.
A good example is the MMR vaccine for measles mumps and rubella. We know from years of experience with naturally occurring measles 1 in 1000 kids will die from it or have terrible and permanent disabilities including brain damage from measles cerebritis. Regrettably, those vaccinated for measles have these same reactions but the rate is 1 in 1,000,000. For the 1 in a million with these terrible side effects of vaccination and their families and friends this is a great tragedy. But consider the 999 children in a million kids and their families who were spared these awful consequences of the natural measles.
The risk vs benefit calculation is pretty clear here. For every million kids given the vaccine, 1 will suffer instead of 1000. While not great, that is, IMO the kind of trade off that makes great sense and is one that is both ethical and moral. That does not make it acceptable for the 1 who gets the side effect and medical researchers are working on ways to try and reduce its rate further but this has proven to be very tough.
As stated, there is no free lunch and there are always risks with drugs and vaccines. What is the key though is not to focus on the 1 in 100,000 or 1 in 1,000,000 who have to pay the lunch bill for all the rest. What is important to also consider is in the case of measles for instance, the 999 kids that did not.
Grattan Woodson, MD