Wednesday, October 28, 2009

Just da facts, Ma'am

I know I have been largely absent lately, and when I do show up I seem to be toting an agenda, but hey – it’s my blog so lump it.

There has been quite the lively debate on this continent lately about the H1N1 virus, specifically regarding the ol’ chestnut of whether or not to vaccinate. I am a largely suspicious person. I don’t just blindly take at face value what the medical community tells me. I learned that lesson when I helped my father die of cancer three years ago. If I didn’t ask the right questions or push for a real answer or make them show me the fucking DATA, they were perfectly happy to just let him croak because they needed the bed for the next poor sop they were keen to ignore. It’s not like I THINK they are out to get me, I KNOW they are out to get me.

Luckily for me, I have Politika. She is a masters degree educated research epidemiologist (gnarly contagious disease enthusiast) who has spent the last 10 years researching infectious disease, specifically influenza. Besides the impressive credentials, I have known Politika for 20 years, and she is nothing if not a critical thinker. Putting the science stuff away for a second, she is also a tree-huggin’ organic food eating vegetarian who doesn’t let her kids watch violent cartoons (raising a kid without hotdogs or batman seems just plain wrong to me, but whateva). Let me put it this way – when I was pregnant the second I went into labour I drove immediately to the hospital and ordered a double epidural on the rocks with a twist of morphine. Politika delivered her babies in her living room with a midwife. Then they all ate a tofu salad and started folding cloth diapers made out of hemp. She is far from a ‘western medicine’ flag waver.

Politika strongly believes I should get my whole family vaccinated.

We all have been bombarded with information, some true and some not on this issue. We’ve all heard the stories or watched a you tube video about people having bad reactions to vaccines or getting really sick from them or even dying. Has that happened? Probably. But I look at it this way – not getting immunized is like refusing to wear a seatbelt because you once heard a story about a car wreck where someone died because they were trapped by a seatbelt that wouldn’t release. Has that happened too? Probably. But I think we can all agree that the risk of dying because you’re NOT wearing a seatbelt is WAY higher than the risk of dying because you ARE wearing a seatbelt if you happen to crash. There is a chance that you could go your whole life without ever having a car accident. You might get into a few fender benders and live to tell the tale about how you don’t wear a seatbelt and still just walked away when some asshole rear-ended you. Or, you could roll your car when it was raining one night and die because you went flying through the windshield. Smell what I’m steppin’ in?

Therefore – I urge you to read the below. Politika has written this. This is factual information from a trustworthy source. This source is not trying make money, or pass a health care bill or kill your grandma. It’s long and sciencey, but this disease could kill you and your children, so it’s important you have the correct facts when making a decision.

H1N1 Vaccine Information - The vaccine is an adjuvanted inactivated influenza vaccine. The adjuvant basically gives the immune system a 'boost', which means that the vaccine itself can use less antigen (the influenza part). So whereas a normal, seasonal influenza vaccine shot contains 15ug (micrograms) of antigen per strain, this vaccine uses only 3.8ug of antigen. The antigen is an inactivated virus; the virus has been killed, then smashed into tiny pieces (the myth that you can get influenza from the vaccine is like expecting to get an egg from ground chicken).
The adjuvant is called AS03. It's a squalene-based adjuvant; squalene is a naturally-occuring oil, it's mixed with water and tocopherol (vitamin E). We are not entirely sure why adjuvants work, only that they do. The research indicates that with this adjuvant, it works only if it is delivered in the same area as the vaccine. Ie, if you were given the antigen in one arm and the adjuvant in another, the adjuvant wouldn't have the desired effect. This speaks to the fact that it is not a systemic reaction, but is more of a local reaction (which should allay any concerns that it's going to wreak havoc in other parts of the body or with other body systems).
The vaccine comes in multi-dose vials, which means that it does have thimerosal as a preservative. Thimerosal is considered the best preservative we have when it comes to vaccines. The amount is very small (5ug thimerosal per dose). It is a mercury derivative (2.5ug mercury per dose), but it is worth pointing out that (a) the amount of mercury is less than what you'd get in a tuna sandwich, and (b) it's ethyl mercurcy - which is metabolized quickly by the body (half-life of <1>
There has been much attempt to determine whether thimerosal causes any neurological damage (eg, autism), and there have been NO studies that have found any link. The authors of the one study that started all the concern, because it did find a link, have since recanted and have acknowledged that they should never have drawn the conclusions they did from the data they had. Thimerosal is considered safe by all public health bodies that have examined it (including the WHO, CDC Atlanta, Health Canada, EMEA in Europe, etc.), and they have all examined it thoroughly. The adjuvant, while relatively new, has been part of a research program for a few years now. Over 40,000 people have been exposed to it in clinical trials, and the safety profile is considered acceptable (which, in science-speak, means there are no safety concerns).
People may find that they experience slightly more injection-site pain than with other vaccinations, maybe even a bit more fever/feeling a bit lousy for a day, but this is to be expected, because of the 'boost' being given. We are trying to induce a stronger immune response. These side effects are WAY more mild than even mild influenza infection. The potential bad systemic side effects (serious infection-site swelling, high fevers, anaphylactic reactions, etc., etc.) seem to be no different from with any other vaccine, which are extremely minimal. The occurence of very rare side effects won't be known for sure until mass vaccinations are happening (e.g., Guillan-Barre Syndrome, which is a concern because of the experience in 1977, has a background rate of 1/million, which means that we won't know if the vaccine causes more until a million or more people have been immunized. That being said, among the 40,000+ people, there is so far no indication that any such severe side effects are going to be a problem).
The effectiveness of this vaccine so far seems to be in the high-90% range, compared to 70-90% for seasonal influenza vaccine.

Dem da facts, Jack.