Correcting the record on swine flu vaccination stories

Maryann Napoli from the Center for Medical Consumers in New York recently interviewed Dr Tom Jefferson, a medically trained epidemiologist who has long experience as a reviewer for the Cochrane Collaboration, for this story titled “why the swine flu virus is not a major threat”.

A previous Croakey post linked to this interview, as well as to other articles related to Dr Jefferson, including a systematic review he and others published in the British Medical Journal recently.

I then asked them each to write about swine flu vaccination for the Crikey bulletin, to examine some of the issues involved. Their articles were not written as part of a debate about the merits of vaccination, although this is how they were inadvertently headlined during the Crikey production process.

I would like to put it on the public record that both authors object to their articles being headlined this way and being framed as part of a debate when they were not written for this purpose.

Their articles follow below.

Maryann Napoli, of the Center for Medical Consumers in New York writes:

“How do we know whether the H1N1 [swine flu] vaccines actually work?  How do we know they’re safe for children, pregnant women and elderly people?  These are the most basic questions consumer advocates and medical journalists usually want answered where it concerns new prescription drugs.

And yet when it comes to new vaccines, that justifiable skepticism is often suspended.  What we get instead is an uncritical version of the classic public health position: Vaccines have saved millions of lives worldwide; therefore all vaccines are good. Vaccines are a major public health triumph and any risks are far outweighed by benefits.

That was made depressingly clear three years ago in the US when Gardasil, Merck’s Human Papillomavirus vaccine, came on the market. Yes, we got a lot of excellent reporting about Merck’s appalling marketing tactics but little about the science behind this vaccination recommended to all girls, age 9 and up.

I recently asked the question about H1N1 vaccine effectiveness of the world’s leading authority on the quality of the evidence supporting influenza vaccines, Dr Tom Jefferson, a medically trained epidemiologist who has been a reviewer for the Cochrane Collaboration for many years.

His answers weren’t reassuring, and there isn’t much to say about safety because the one published study looked only at antigens 21 days after the vaccination.

As for those flu-related death stats meant to hasten flu-shot compliance, they haven’t seemed remotely trustworthy ever since a 2005 study concluded that an accurate assessment of flu-related deaths is virtually impossible because few cases are confirmed with blood tests. And the viral infection is usually cleared from the body before the appearance of complications that cause death.

Things are calm here in New York City (flu-wise, that is). The mayor says he won’t close public schools in the event of another swine flu outbreak, except as a last resort (there were at least five swine flu deaths last winter in NYC).

But perhaps the two-pig cartoon currently making the rounds is a sign of what’s going on elsewhere in the country. It shows a small pig marked, “Swine Flu” side-by-side with a giant pig marked “Swine Flu Hysteria.”

By the end of October, all we need will be a news flash about the death of one child, and people, young and old, will be lining up in droves for the vaccine.

Here’s something that might give them pause: In the wake of the 9/11 tragedy, the U.S. Congress, which is bought and paid for by PHARMA, passed a federal law that allows vaccine companies to be protected from liability if anyone gets hurt.

Authorities need only declare a public health emergency for the protection to go into effect.  Like most Americans I would probably be blissfully unaware of this law were it not for one independent vaccine safety organization, the National Vaccine Information Center.”

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Dr Tom Jefferson, of the Cochrane Collaboration’s Acute Respiratory Infections Group, writes:

“As winter turns to antipodean spring, the scientific community downunder have a duty to inform their northern counterparts about the ebbing of the current “pandemic”.

The information needs to be as accurate and as comprehensive as possible, but most of all it needs to be free of spin and shroud waving. Both of them have featured prominently in scientific and lay media coverage of the “pandemic” and have obscured reality, like a smokescreen.

Here is what we need to know:

1.    What are the estimates of the incidence and impact of influenza-like illness (ILI) in Oz/Kiwiland since early 2009?
2.    How do these compare with previous years?
3.    What is the estimated slice of ILIs and complications caused by influenza A&B and influenza A/H1N1 since early 2009?
4.    What is the estimate of the co-circulation of other agents?
5.    Can you give us full details of deaths coded as caused by H1N1 including, setting, comorbidites and coinfections?
6.    Can you do the same for all serious cases who survived?
7.    Do you have evidence from seroprevalence surveys of when H1N1 first appeared dowunder?
8.    What does your pharmacosurveillance tell you about harms from the use of antivirals?
9.    Are still serious about mass vaccinating now the epidemic is past?
10.   If so, why?

I know it is a lot to ask for, but we need the information to break the smokescreen and in any case if your public health is as good as we hear it is, you will be able to get the information relatively quickly and in an unbiased manner.”