What they did:
At the time of vaccination, vaccinees were instructed to report any adverse event to physicians or vaccination providers. […] Adverse events that were fatal or that resulted in disability and clusters of events (i.e., notably high numbers of similar adverse events related to a certain vaccine) were required to be reported within 2 hours after their occurrence […] and the Guillain–Barré syndrome occurring within 3 months after vaccination. […]
The rate of reported adverse events was calculated by dividing the number of vaccinees who reported having an event by the number of vaccine doses administered. The cumulative rate of reported adverse events was calculated by dividing the number of vaccinees who reported having an event by the number of vaccine doses administered from the beginning of the first week to the end of each week.
What they found:
Between September 21, 2009, and March 21, 2010, a total of 89.6 million doses of the H1N1 vaccine were administered, and 8067 vaccinees reported having an adverse event. The overall rate of reported adverse events was 90.0 per 1 million vaccine doses, with the weekly cumulative rate ranging from 90.0 to 265.0 per 1 million doses […] Of the 8067 vaccinees with an adverse event, 6552 (81.2%; rate per 1 million doses, 73.1) had events classified as vaccine reactions […] 5469 of the vaccinees with a vaccine reaction (67.8% of the 8067 with adverse events; rate per 1 million doses, 61.0) had common, minor reactions (typical local and systemic reactions), and the remaining 1083 vaccinees with a vaccine reaction (13.4% of all with adverse events; rate per 1 million doses, 12.1) had rare, more serious reactions.
A total of 29 vaccinees with more serious vaccine reactions (0.4% of all those with adverse events; rate per 1 million doses, 0.3) had neurologic reactions, including 8 cases with Guillain–Barré syndrome. [The reported rate of Guillain–Barré syndrome per 1 million doses was 0.1]
According to the Chinese Acute Flaccid Paralysis Surveillance System, during the H1N1 vaccination campaign, from September 2009 to March 2010, the monthly average number of reported cases of the Guillain–Barré syndrome among children under 15 years of age was 74 (range, 37 to 109; incidence, 1.9 cases per 1 million persons; 95% confidence interval [CI], 1.5 to 2.4). The number was higher in the previous corresponding interval, September 2008 to March 2009, during which there were 105 cases (range, 81 to 138; incidence, 2.7 per 1 million; 95% CI, 2.2 to 3.3)
What this means:
During our surveillance period, 11 cases of the Guillain–Barré syndrome were reported, 3 of them in patients under 15 years of age, with a rate of 0.1 cases per 1 million doses. This rate is lower than the baseline incidence rate of 1.9 cases per 1 million population among children under 15 years of age in China, according to the Acute Flaccid Paralysis Surveillance System during the same period; our H1N1 vaccination campaign was not associated with an increase in cases of acute flaccid paralysis or the Guillain–Barré syndrome. [Italics mine.]
The authors concluded that H1N1 vaccine has a reasonable safety profile, and there is no evidence that the vaccine is associated with an increased risk of the Guillain–Barré syndrome.
Media reporting of vaccination and Guillain–Barré syndrome
In October 2010, the Daily Mail published an article on the seasonal flu vaccine containing the H1N1 (swine flu) strain. While it seems that swine flu itself is more likely to cause Guillain–Barré syndrome than the vaccine is, the Mail saw fit to bring up the possibility of an association between GBS and the flu vaccine – without mentioning that rather important point. Back in 2009, the same MailOnline journalist wrote another article about swine flu and vaccination.
Ben Goldacre seems to think that, given their previous interest in vaccination and Guillain–Barré syndrome, the media might have been sufficiently interested in this research to publish a news story about it (Last year the newspapers were filled with people talking about the risk of Guillain Barre Syndrome with flu vaccine, and demanding “more research”). That seems, on the face of it, to be a reasonable expectation – but I think that the media would prefer not to publish stories about vaccination being safe as it doesn’t fit with the line that they’ve previously taken on this important public health initiative. A comment from Matt on Ben Goldacre’s blogpost provides a plausible reason for the lack of interest in this research:
It’s ‘no news’. This study won’t scare anyone and won’t sell newspapers so it’s ignored in the wider media.
It’ll be ignored in future too when the next vaccine scare starts!
That’s what the newspapers really care about – not truth, not newsworthiness, but money. And Matt could yet be proved correct regarding future reporting. If you do see a future newspaper article scaremongering about vaccination and Guillain–Barré syndrome, then you might like to use this handy link: Make a complaint to the PCC.
The media’s track record
This isn’t the first time the media has refrained from writing about something that didn’t fit their narrative or wasn’t deemed to be the sort of story that would sell papers.
In 2010, I wrote a similar blogpost on the safety of the MMR vaccine:
Unpublished research of unknown quality that purports to show a link between vaccination and autism is seized on and promoted by the press (for example, the work of Krigsman). Published research that finds no link is ignored.
The British media had decided not to write about a paper that found evidence against the association of autism with either MMR or a single measles vaccine. This was something I would have thought that a responsible media would have written about. Then again, a responsible media wouldn’t have been so heavily involved in the MMR hoax to begin with.
Back in 2008, there was another story that didn’t quite make it into the pages of our newspapers: people with serious mental illnesses are committing fewer murders than ever before, by a truly enormous margin.
If research suggests that the MMR and flu vaccines are safe or that we’re not all going to be murdered in our beds by people with serious mental illnesses, then the media seem not to want to hear about it (they certainly don’t want us to hear about it). It looks like the mainstream media in this country have decided that (a) the only thing that matters is how many papers they can sell and (b) fear sells.