Dr Crippen On Swine Flu Vaccination

September 9, 2009 at 6:50 pm (Miscellaneous) (, , , , )

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.

Here goes.

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.

More

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.

17 Comments

  1. Swine Flu Britain said,

    China is to become the first country in the world to start a mass swine flu vaccination programme but would you have a swine flu vaccine if offered? Vote Here

  2. Twitter Trackbacks for Dr Crippen On Swine Flu Vaccination « Stuff And Nonsense [jdc325.wordpress.com] on Topsy.com said,

    […] Dr Crippen On Swine Flu Vaccination « Stuff And Nonsense jdc325.wordpress.com/2009/09/09/dr-crippen-on-swine-flu-vaccination – view page – cached #RSS 2.0 Stuff And Nonsense » Dr Crippen On Swine Flu Vaccination Comments Feed Stuff And Nonsense Better Blogs Daily Mail Recommend Food In Pill Form — From the page […]

  3. zeno said,

    In answer to ‘Swine Flu Britain’: Yes.

  4. jdc325 said,

    Some comments others have made elsewhere:

    1: “the evidence on the 1976 GBS problems is, in any case, rather equivocal”
    2: “this is also odd “if the virus mutates to a more virulent form, the immunisation may not work”; there is no necessary connection between a mutation that renders the vaccine less effective & a mutation that makes the virus more virulent.”
    3: “Let’s see, use of a dodgy survey as though it’s the word of god? check.
    Attack on something the government is saying, possibly because it’s coming from the government and suggesting that this government is endangering health oin order to seem competent, almost in a paranoid conspiracy way? Check.
    Largely irrelevant historical comparisson? Check.
    Not understanding modern medicine or any of the rationale behind why things are proposed, but having a strident view against them? Check.
    Taking a call for vigilance over a potential complication as proof that it’s a problem? Check.”
    4: “There are genuine questions here – unfortunately the Crippen article doesn’t really address them properly.”

    Comments 5, 6, & 7 begin with paraphrases of some of Crippen’s arguments (in single quotation marks).
    5: ‘The disease is mild/there may never be a second wave.’
    “It is mild, in the majority of people, but as the Australian and American evidence has shown, it is disproportionately severe in at risk groups and has a high attack rate in the young.”
    6: ‘The virus may mutate into another form, and the vaccine might be ineffective.’
    “Lots of speculative if and buts there … There is little likelihood of any reassortment happening with the current H1N1 virus, and there is absolutely no reason to think the vaccine will fail to work. It won’t be 100% protective, but if it is even 60% or 70% effective at preventing swine flu this will be a major help in averting problems during a second wave.”
    7: ‘The vaccine has been rushed into production/is untested/you question the evidence base for safety.’
    “The time frame for production has been 4-5 months; the same as for seasonal vaccines. The vaccine has actually been tested more rigorously than usual flu vaccines, and is undergoing efficacy testing as well as closer monitoring for side effects. It is a monovalent vaccine, as opposed to the usual trivalent vaccines, and there is no reason on earth to suppose there will be a higher rate of reactions than seen with seasonal vaccines.”

    The comments above may be abridged. You can also see discussion of Crippen’s article in the comment section on his blog: here (I recommend the comment by Fiona Wallace) and on the Bad Science forum: here.

  5. dt said,

    Thanks jdc. As Crippen hasn’t returned to Badscience I followed him to his blog. Hope he responds.

  6. jdc325 said,

    Note: Dr Crippen has responded to DT on the Lay Science post I link to in my post. His response seems to boil down to ‘lots of doctors don’t want the jab and I don’t trust the government’ (I’m paraphrasing) – so still not a measured consideration of the evidence, just something that looks rather like conspiracy theory rambling about the behaviour of government and an appeal to popularity.

    Dr Crippen has made no real attempt to provide useful evidence or information and has not even responded to this post, or to comments on his own blog. I’m disappointed that he saw fit to submit an article to the Guardian that was light on information and evidence, but heavy on speculation. I am also disappointed that he has not adequately answered relevant points others have brought up and seems to be unwilling to engage with criticism of his article.
    A further source of disappointment is his repeated complaint of being subjected to vitriol, bad language, and abuse: (“I have been subjected to foul mouthed abuse on the Badscience column. It was the kind of monomaniacal abuse I expect from JABS”; “What a load of vitriol, bad language, lack of understanding and uninformed comment”). There is a single comment on the Bad Science forum that I would say had an unnecessarily foul-mouthed conclusion – on the basis of a single comment, Crippen alleges “a load of vitriol, bad language…”. I feel that this is a misrepresentation of the forum. I also note that Crippen himself can be robust on occasion and is a fan of the Devil’s Kitchen blog (the author of Devil’s Kitchen is not known for mincing their words). It is odd that Crippen is so sensitive to a single rude comment that it has coloured his view of an entire thread – and slightly odd that he seems to be so sensitive to criticism aimed at himself while often being, shall we say “less than delicate” in his own comments.

  7. SP said,

    This is rubbish. You are accusing Dr Crippen of not using evidence but you haven’t posted any evidence that this swine flu vaccine (which is NEW) will be safe or that it will even work! Instead of bashing Dr Crippen for his honest views why don’t you look into WHY the US government are making pharma companies immune from lawsuits and WHY the UK gov is warning about neurological problems??

  8. Fiona Wallace said,

    Thanks for the kind words. about my comment.

    I too was more than a little startled at John’s bizarre stand on the flu vaccine, and he hasn’t, as yet, answered my question as to whether he recommends the standard yearly flu vaccination for his patients.

    All very weird and anti-science. The damage these sorts of articles do to the vaccination schedule and public health is incalculable.

  9. Fiona Wallace said,

    SP –

    If you go to Crippen’s blog, you’ll find a commenter there providing the evidence that answers your question about vaccine efficacy.

    The governments are providing indemnity because in this insane, anti-science world that we live in, companies are getting incresingly wary of producing vaccines because of the amount of time and money they have to spend fighting insane, fact-free claims against them.

    BUt you won’t listen to any of the evidence because you are clearly already closed to it.

  10. Neuroskeptic said,

    “why don’t you look into WHY the US government are making pharma companies immune from lawsuits”

    Because they would look pretty stupid if pharma failed to produce a vaccine in time to prevent an epidemic, merely because that they spent ages testing it to avoid the possibility of lawsuits. This is basically saying to pharma “We really want this vaccine, like, now please”.

    “and WHY the UK gov is warning about neurological problems??”

    Because of the history of GBS with one particular flu vaccine in 1976. It makes sense to be alert for GBS – but this does not mean that it will happen.

    I hope that answers your questions – I’ll see you in the line to get vaccinated SP!

  11. LeeT said,

    Unlike you I don’t like or respect Dr Crippen. He is often rather unpleasant about those he disagrees with.

    However, on this occasion I sympathise with what he is saying. Has the vaccine been properly tested in clinical tested? From what I recall – I’ll see if I can find the link – many don’t seem to think it has. Is there not a danger of embarking on a vaccination programme just to be seen to be doing something?

  12. jdc325 said,

    Apparently: “The time frame for production has been 4-5 months; the same as for seasonal vaccines. The vaccine has actually been tested more rigorously than usual flu vaccines, and is undergoing efficacy testing as well as closer monitoring for side effects. It is a monovalent vaccine, as opposed to the usual trivalent vaccines, and there is no reason on earth to suppose there will be a higher rate of reactions than seen with seasonal vaccines.” (Quote from an infectious diseases specialist.)
    Link to NHS page: quality control and preparedness “will be based on the processes and policies for seasonal vaccines and usually subject to testing by the National Control Laboratory”. The WHO: here notes that “regulatory procedures in place for the licensing of pandemic vaccines, including procedures for expediting regulatory approval, are rigorous and do not compromise safety or quality controls”.
    While I am not confident that the government always make decisions based on the available evidence (far from it), it seems to me from what I have read so far that exposing oneself to the swine flu vaccine is preferable to exposing oneself to swine flu. Concerns raised so far seem to centre on the issue of neurological problems caused by vaccination, but the risk of these problems seems to be greater from swine flu than from vaccination against the disease.

  13. James said,

    Neurological disorders? The soldiers who have said to have Gulf War syndrome were told,”it was all in their mind”. See the video, you decide http://countusout.wordpress.com/2009/09/16/swine-flus-vaccines-devastating-ingredient-squalene

  14. jdc325 said,

    There’s a rather interesting page on squalene here: Squalene Q&A. I see that your post is headlined “Swine Flu’s vaccine’s devastating ingredient – Squalene” and that you refer to Gulf War Syndrome. The page I link to points out that “It is now known that squalene was not added to the vaccines administered to these veterans, and technical deficiencies in the report suggesting an association have been published.” Unfortunately, the video on your page will not load for me at the moment (there’s a message about a technical fault that advises me to try later). I will try it later and see if the fault has cleared up.

    Thank you for commenting.

  15. BigHitDog said,

    I sit back and read this comments. The sad fact is our goverment,who we thought was put there to protect us,has gotten caught up in, like as well as alot of others, in the greed for one thing…..money. Unforturnately, you ,me and anyone else that take that vaccination put ourselves,our kids at risk for whatever Neurological distaster come from it. Some may sit back and say this guy is just talking nonsense.No. I recently was diagnose with “Transverse Myelitis” a rare neurological disorder after taking those “mandatory” flu shots for all Healthcare workers in NY back in Sept.09. The saddest thing of all is,after you go for tons of bloodwork,tests,MRI’s,CatScans,Spinal Taps,Neurological testing..you did all that asked of you and you ask them that one question” Did this come from the Vaccination shot i took?” They look at you like you spoke of a deadly sin. No one wants to acknowledge that you got it from the shot. All they say are things like”Anythings Possible”. After all your test come back negative for everything else and reasons you could have got this from…still no one wants to say it came from the Flu Shot.

  16. jdc325 said,

    Thank you for your comment Big Hit Dog. I’m not sure I agree with some of your assertions – e.g. that governments have been caught up in greed for money.

    As far as I am aware, though, it is possible for Transverse Myelitis to be caused by some vaccinations. I don’t know if flu vaccines have been proved to cause Transverse Myelitis, but it does seem that some other vaccines have been implicated in this condition:

    Researchers are uncertain of the exact causes of transverse myelitis. The inflammation that causes such extensive damage to nerve fibers of the spinal cord may result from viral infections, abnormal immune reactions, or insufficient blood flow through the blood vessels located in the spinal cord. Transverse myelitis also may occur as a complication of syphilis, measles, Lyme disease, and some vaccinations, including those for chickenpox and rabies. Cases in which a cause cannot be identified are called idiopathic.

    Transverse myelitis often develops following viral infections. Infectious agents suspected of causing transverse myelitis include varicella zoster (the virus that causes chickenpox and shingles), herpes simplex, cytomegalovirus, Epstein-Barr, influenza, echovirus, human immunodeficiency virus (HIV), hepatitis A, and rubella. Bacterial skin infections, middle-ear infections (otitis media), and Mycoplasma pneumoniae (bacterial pneumonia) have also been associated with the condition. National Institute of Neurological Disorders and Stroke.

    http://www.ncbi.nlm.nih.gov/pubmed/12636241 & http://www.ncbi.nlm.nih.gov/pubmed/8903080 are two of the six papers that are shown on a Pubmed search for “Transverse Myelitis flu vaccine”

    The patient with acute transverse myelitis described in the 1996 paper apparently had a complete long-term recovery of neurological function.

  17. Mail Article On Flu Vaccination « Stuff And Nonsense said,

    […] by the mainstream media might have something to do with that. For example articles written by Dr Crippen for The Guardian and Dr Halvorsen for The Times. I found this post useful: Swine Flu, Guillain […]

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