Ignore the cranks who decry the swine flu vaccine – protecting vulnerable service users must come first
As I type this column I can still feel a slight ache in my left shoulder where I had the swine flu vaccine yesterday. Though I believe that the scale of the pandemic and the threat it poses to public health have been exaggerated, I was happy to have the jab – and I would advise others in primary health and social care to do the same. The vaccine is likely to provide some protection against the flu virus and this in turn may protect vulnerable people with whom we come into contact.
It is unfortunate that legitimate scepticism about the scaremongering around swine flu has come to focus on the vaccine, which is only a slightly modified version of the familiar seasonal flu vaccine. The swine flu vaccine is likely to be as effective as this vaccine (which is to say that it offers a degree of protection against one of the viruses that may cause respiratory infections during the winter) and it is no more likely to cause serious adverse effects (which are rare with these widely-used vaccines).
It is true that there have been only limited trials of the efficacy and safety of the swine flu vaccine – but that is the price we pay for the rapidity of its development (a considerable technological achievement). The risks of swine flu are significantly increased in pregnancy – and there is no reason why pregnant women should fear adverse effects of this vaccine (the seasonal flu vaccine has been widely used in pregnancy).
Yet the anti-vaccine campaigners are already in full cry. These groups of disaffected scientists, cranks and conspiracy theorists are now trying to revive old vaccine scares in relation to swine flu. One issue is the use in one of the vaccines available in the UK (Pandemrix) of the mercury-based preservative thiomersal, which has been linked to autism by US campaigners. Though this association has been universally discredited, it is still advanced by the promoters of junk science and quack therapies who flourish around autism parent campaigns.
Another issue is the use of squalene, a naturally-occurring substance commercially extracted from fish oil, to enhance the effectiveness of the vaccine in provoking an immunological response. Though squalene was blamed for causing the Gulf War syndrome reported by veterans of the invasion of Kuwait in 1990-91, subsequent investigations revealed that it was not included in the vaccines given to combatants. It has, however, been included in seasonal flu vaccines given to more than 20 million people in Europe since 1997 and has not been linked to any adverse reaction.
Healthcare workers have already seen the first wave of swine flu cases (and they have noticed that the forecast second wave is stubbornly refusing to appear). We know that, in most cases, this is a fairly mild illness, often milder than seasonal flu, and we have seen that the doomsday scenarios projected in recent months have already been falsified by events.
We are also well aware of the ways in which reports of the numbers of cases of swine flu have been inflated by unreliable helpline telephone diagnoses. And we have been appalled at the politically-motivated distribution of vast quantities of the marginally effective Tamiflu to many people with mild symptoms.
Most people are not convinced by the publicity given to a small number of extreme cases that these confirm a significant risk to the wider population. Refusing the swine flu vaccine is set to become a gesture of defiance over the conduct of the pandemic scare among health workers and, more widely, an expression of public cynicism and distrust of the government.
Michael Fitzpatrick is a GP who practises in Hackney, east London
This article is published in the 26 November 2009 edition of Community Care magazine under the headline Despite the scaremongering, a swine flu jab is worthwhile