Dr Crippen of http://nhsblogdoc.blogspot.com/ has written a piece for the Guardian on swine flu vaccination. I was unimpressed. Given that (a) I argued not so long ago that we should criticise those we like and/or respect as well as those we do not, and (b) I have generally agreed with the thrust of previous posts that Dr Crippen has written (for example, on MMR vaccines or Dr John Briffa’s views), I thought that now would be a good time to practice what I preach.
Crippen asks why, if the US and UK governments are so confident in the vaccine, are they “making federal officials and vaccine makers immune from lawsuits related to any ill-effects from the vaccine” and “letters to neurologists asking them to be on the alert for neurological complications caused by the immunisation”. Well, regardless of the level of confidence the US government has in the vaccine it doesn’t seem completely unreasonable to me to provide immunity from lawsuits related to ill-effects from the vaccine (although I’m not sure it’s something I agree with). On the second point, it seems to me to be pefectly sensible to ask neurologists to be alert to neurological complications and I don’t think it is helpful to imply that a call for alertness over complications means that we have proof that the UK government expects these complications or that they are inevitable.
Regarding the neurological problems Dr Crippen alludes to, there is a post on Lay Science that looks at the link between influenza vaccination and an uncommon neurological disorder, Guillain-Barré Syndrome:
That GBS might be triggered by flu vaccine is possible; it certainly seems as though 33 years ago it may have done so with the vaccine produced at that time. Whether the current swine flu vaccine will do anything similar is questionable; flu vaccines produced since 1976 do not appear to have significantly raised the risks of GBS above the background noise level […] the most powerful argument in favour of continuing to have flu vaccine (thereby running a tiny, one or two in a million risk of GBS) is that flu itself is a relatively common cause of GBS, and would appear to cause it once in every 14,000 to 25,000 episodes of flu. Running the risks of a rare vaccine side effect is perfectly acceptable when the risks from not having the vaccine are much worse.
So, it is possible that Dr Crippen’s concerns about a swine flu vaccine and neurological problems such as GBS have some foundation – but it seems that swine flu itself is more likely to cause GBS than the vaccine is.
As I pointed out above, Dr Crippen has alluded to the behaviour of the US and UK governments in pondering the possible adverse effects of the swine flu vaccine. It seems to me that Crippen’s doubts about the swine flu vaccine are prompted as much by his distrust of government as by the evidence on vaccination. If that seems unkind, I would like to point out that the word ‘government’ is mentioned six times in the article – but no evidence supporting his position is cited. Crippen even asks the reader to consider their own experience of influenza vaccination (“You may have had one last year. Did it work?”), but does not refer to the evidence on efficacy of flu vaccination. This abstract, for example, states that “A review of the published literature shows that vaccination of children, healthy younger adults, the elderly, and both children and adults with high-risk medical conditions provides substantial benefits, although the types of benefits vary by age.” This one looks at “estimates of 4 measures of vaccine efficacy for live, attenuated and inactivated influenza vaccine”. I would have preferred to see an article on swine flu written by a doctor and published by the Guardian that dealt with the evidence regarding vaccination, rather than one inviting the reader to think of an anecdote.
It has come to my attention that searching Google for “squalene swine flu vaccine” or “swine flu vaccine toxins” brings up a number of results for unreliable websites, with little in the way of sensible advice. This is rather unfortunate. Articles such as this one by Dr Mercola should only be linked to if you are using “rel=nofollow” as per the instructions in this blog post by Malcolm Coles: http://tr.im/LinkHate.
What might be helpful would be some links to more reliable sources, for example the WHO on: squalene, the adjuvant found in swine flu vaccines. Or the NHS FAQ on swine flu, which includes a section on swine flu vaccines. The NHS site also contains links to ingredients contained in the swine flu vaccines, for those who may be worried about “swine flu vaccine toxins”. The adjuvant squalene, found in swine flu vaccines was never included as an ingredient in vaccines given to soldiers in the Gulf War, and therefore cannot possibly be responsible for Gulf War Syndrome. Here’s what the WHO has to say:
A link between the health problems of Gulf-War veterans and possible presence of squalene in vaccines received by these soldiers has been suggested. One published report has suggested that some army veterans who received anthrax vaccines developed anti-squalene antibodies and that these antibodies caused disabilities. However, squalene was not added to the vaccines administered to these veterans, nor was it used in the manufacturing process. Various papers have been published outlining the technical deficiencies in that original report.
I’ve now expanded on this point about squalene in a new post, on Swine Flu, Squalene, and Gulf War Syndrome.