Tuesday, November 03, 2009

H1N1 Vaccinations: Some Thoughts from an ICU Nurse-Comrade

Received this email from Scott Weinstein, a friend of mine who is an ICU nurse, and thought it worth sharing for the light (as opposed to just heat) that it shines on the question of the H1N1 vaccine:

This mail is unsolicited, so you may trash it or read it. I am NOT a flu expert, so take my thoughts with skepticism, which you should do with any health advice from someone who is not well educated in the subject. I am an intensive care RN and have been studying on my own the flu and vaccination debate for a month now, and want to share my thoughts that may tamper the emotions and claims on the debate. This month at work on my ICU, two patients had H1N1. Both had other high risk factors. The elderly lady did fine. The 23 year old died. That is not statistically significant, but It forced me to examine this flu more seriously than I have with previous flues.

I am agnostic on the issue, except that my bullshit meter has been in the red-zone for a while, and I desire a more cold-blooded analysis and less dogma.

There are three major problems with the H1N1 flu and vaccination program.
  1. People are getting hysterical that there is not enough vaccines to go around.
  2. People are getting hysterical that the the vaccines are more deadly than the flu.
  3. Accurate information seems harder to access than sensational information.
Not surprisingly, there media has sensationalized the problem, and there is a strong odor of conspiracy-theory.

In the middle are those of us who are confused.

People like me in the health care field have to deal with a lot of complexity and unknowns, in a short amount of time, with potentially deadly results.

The US public health agency, the Center for Disease Control CDC is poor when it comes to releasing easy to understand statistics, but they are issuing advice and guidelines, and seem to have the most information compiled from scientists and medical professionals around the U.S. on the subject. I quote them because it is easy, and they have a lot of public health stats. Should we trust them? Well, they are the government, but they are not the people who vote for war, or gave the job of fixing the economy to the bankers who ruined it for the rest of us.

There are four questions that we need to know

1. Who are at most risk of serious illness or death from the H1N1 flu?
We know it is people who are: pregnant, immunocompromised, have asthma, cardiovascular disease, arthritis, diabetes, or obese.. Healthy people with good immune systems are obviously less at risk for the flu, (or any other illness). Except healthy pregnant women and healthy kids are more at risk for serious H1N1 complications than with the regular seasonal flu.

These last three questions wont be known until later, or until after this flu season is over.

2. What percentage of UN-VACCINATED people will get seriously ill or die from the H1N1 flu?
3. What percentage of VACCINATED people will get seriously ill or die from the H1N1 flu?
4. What percentage of VACCINATED people will get seriously ill or die from the H1N1 vaccine?

"CDC estimated that about 36,000 people died of seasonal flu-related causes each year, on average, during the 1990s in the United States."

They report that the seasonal flu vaccine is about 30-90% effective (depending on your other risk factors) in preventing serious illness and death. But they don't have current stats on H1N1 because the vaccination program just got started.

In the worst year for serious illness and deaths from a flu vaccine, 1976, 532 vaccinated people for H1N1 out of 40 million, got Guillain-Barré Syndrome (GBS) in the US. 32 died. Only 13 people contracted and one person died from the H1N1 flu! The U.S. shut down the vaccination program and paid out $millions to the GBS victims.

As of Oct. 24, the CDC reports there are 114 confirmed pediatric deaths in the U.S. from H1N1 and (this web page may be updated weekly). Ignoring the H1N1 effects from April through August, the CDC reports from August 30th - October 24th, 530 flu deaths, and 2,916 pneumonia and flu syndrome-based deaths. The flu is H1N1.

The U.S. H1N1 vaccines do not contain adjuvants like aluminum, for political reasons. Adjuvants supposedly make the vaccine more effective. The Canadian and European vaccines do. A very small study inspired by neuro problems of American Gulf War soldiers, injected the common aluminum hydroxide and the sqalene adjuvants in about 43 mice. It found that aluminum hydroxide adjuvant increased the risk of neuodamage by up to 23% (1). The number of mice tested is way too small to draw a conclusion, other than this might warrant a much larger study. It is also a perfect example against killing animals for studies like these: Why not study people who got the adjuvants? That should be easy because millions do each year. So we could look at a large sample of people who got flu vaccines with the adjuvants, and a large sample of people who got the flu vaccine without adjuvants, and a large sample of people who didn't get a vaccine or adjuvants and see if any group has more neuro deficits or damage. I know, people will say the study would be flawed because Americans didn't get the adjuvants, and so many are brain damaged anyway, but we can control for that.

There have been studies to figure out what part of the vaccine caused GBS in 1976. They are inconclusive according to the CDC. Could it have been the adjuvants, the preparation, the medium, the killed virus or the attenuated virus? Anyway, they predict the new H1N1 vaccine in the US will be a lot safer. Will it be? I can't say for sure, but I assume that the public health experts do NOT want to get burned again by issuing a deadly vaccine. Not only will it cost them their jobs, but it will seriously destroy any confidence the public has in public health efforts.

Lots of problematic internet articles pass my way to prove that the vaccines are harmful. First I look to see if the article is based on statistical research of a good sample size, or is it based on anecdotes, stories or individual examples. I would never base a serious decision solely on anecdotal 'evidence'. I would never solely base a decision only from any person, doctor or pharmaceutical corporation that stood to profit by me following their advice. Although I have serious criticisms of the western medical-industrial-complex, many natural or alternative health practitioners are as unscrupulous, greedy or dogmatic as the Western medical industry they criticize. Dogma is an incurable epidemic I fear.

One interesting source of science geek news and views on the flu & epidemiology is: http://scienceblogs.com/effectmeasure/

There is one troubling aspect of the H1N1 virus that reminds me of the HIV virus. The HIV virus causes AIDS by hijacking the person's immune system, and turning it against them. With H1N1, we are reading about a hypothesis that the reason young healthy people are getting sicker and sometimes dying at a higher rate than they would for the regular seasonal flu, is that much of the lung damage in life-threatening flu infections is caused by a “cytokine storm,” the inflammatory overreaction of the body’s immune system to invasion by the virus that can happen with healthy people.

So, given the knowns and the unknowns, should someone get the flu vaccine?
I personally have never been vaccinated for the flu until I was forced to for H1N1 as a condition for keeping my job.

My simple answer is that if they fall in a high risk category, they should certainly consider it. If they are exposed to the public inside closed spaces and their sneezing and coughing, they should consider it.

Of course, people should wash their hands, cover their cough, and stay home if they have flu-like symptoms.

Finally, people should always pursue a healthy lifestyle and lessen their health risk factors, regardless what illness they are concerned about.

Best wishes and stay healthy!

Footnote (1): Aluminum hydroxide injections lead to motor deficits and motor
neuron degeneration
Christopher A. Shaw, Michael S. Petrik c
Contents lists available at ScienceDirect
Journal of Inorganic Biochemistry
journal homepage: www.elsevier.com/locate/jinorgbio

1 comment:

  1. GBS is also caused by viruses themselves. So, a portion of persons who don't vaccinate, and get the flu will also get GBS.

    Also, the less immunity we have, the more likely a flu will mutate into something quite virulent.

    Cost-benefit analysis.