Swine Flu Vaccine
There are several reasons I will not be getting an H1N1 [wikipedia] vaccine:
- Adjuvant content;
- Mercury content;
- Lawsuit indemnity to GSK from the Federal Government;
- Limited clinical trials;
- and Swine Flu isn't as bad as normal flu
Adjuvants are extra not-virus chemicals added to vaccines to increase immune response. They've never been approved for use before in the US or Canada as far as I can determine. GSK is using "AS03", a proprietary Squalene drivitive. The European Union recently approved the use of GSK's vaccine ("Pandemerix," isn't that cute?) upon which Canada's decision rests (although we're using a different one, called Arepanrix). The EU decision is only for official pandemics (although the WHO recently "lowered" their standards for this; they now just look at how fast things spread). [GSK Pandemirx press release]. Pregnant women will received a non-adjuvent version of the vaccine; children from 6 months to 10 years will receive two half-doses of adjuvent-containing vaccine [details, government decision order]. The decisions are based on preliminary clincal testing of a "mock up" vaccine based on H5N1. The US swine flu vaccine does not contain adjuvants, although there is some talk of using them (e.g.).
There are conflicting reports indicating that Thimerosal (a mercurcy-containing compound) is used as a preservative. Although Pandemerix does not use this (it uses Polysorbate-80 instead), the Canadian version (Arepanrix) does use themiorsal as well as Polysorbate-80 [press release]. Thimerosal is also still used in seasonal flu shots. Bear in mind of course, that the amount is indeed small (allegedly about what is in a tin of Tuna these days). Nonetheless, I'd like to limit my mercury exposure.
Lawsuit indemnity is provided to GSK by the federal government [TorontoStar]; they cannot be sued for problems related to the swine flu rollout. I believe this is likely related to my other point, that limited clinical trials have been done (partly, of course, by the "necessity" that the vaccine development has been rushed). There are widespread clinical trials going on right now, but their results won't be known until well after we inject everyone (who wants it) in Canada. Until now, pretty limited testing has been done. This is of special concern to me since adjuvants have not been well-tested or widely used (yet) in North America. From GSK's press release:
GSK supports the WHO's call for post-marketing surveillance of the "highest possible quality" to ensure extensive safety evaluation of all pandemic vaccines. When governments commence vaccination programmes, GSK will collect information on the safety of the vaccine while it is being used. In addition, the Company will undertake a large 9000 people post-marketing safety and effectiveness study.
Free clinical trials! ...and free experimentation with adjuvants. Evenback in July it was known that, ``Public Health Agency of Canada officials acknowledged last week there won't be time for a swine flu vaccine to go through standard safety testing before immunizations begin in autumn.'' If H1N1 were extremely fatal, it would be awsome that we can develop and deploy a vaccine so quickly (and I'd probably be lining up today), howver:
Swine Flu isn't that bad and in fact has a death rate at or below "normal" seasonal influenzas (it is about half as deadly by some reports, about the same by others). For example, several news reports available various places quote something like, ``New estimates suggest that the death rate compares to a moderate year of seasonal influenza, said Dr Marc Lipsitch of Harvard University.''. On top of that, they quote the same doctor as saying, ``It's mildest in kids. That's one of the really good pieces of news in this pandemic''. So lets not panic.
Rather than call Canada's swine flu vaccine program the biggest vaccination program ever, I prefer to think of it as the biggest clinical trial ever run. I won't be participating. Don't get me wrong, I am not a rabid anti-vaccination fanatic; I have several vaccinations and my son will be getting several as well. However, he won't be getting this one (and in fact he can't, as he's under 6 months old and it's not approved for kids that young).
You may also be interested in the CDC's weekly flu report.
Additionally, I very much suspect that swine flu numbers will get inflated merely by the hype; people are far, far more likely to go to the doctor if they get the flu this year. Calgary seems to be no longer even testing; my siser-in-law Rossane was told she has H1N1 and was prescribed Tamiflu although they did not do a swab "because the labs are overwhelmed", so she'll be a "swine flu" statistic even though she may just have "regular" flu (certainly better safe than sorry, going-to-work-and-infecting-people-wise of course!).