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