According to data released by the Centers for Disease Control & Prevention, in the week that ended last Saturday, 11 more children died from the H1N1 influenza virus. In a typical flu season, between 46 and 88 children die. 86 children have died since April (with 43 of those deaths happening over just the last 47 days), and we're just getting into the main run of flu season. Swine flu is now widespread in 41 states, up from 37 last week, and the other 9 states have regional or local cases. 6.1% of all doctor's visits are for influenza-like symptoms.
To make a bad situation worse, the CDC reported H1N1 vaccine production has fallen short of projections. Expectations for 40 million doses of vaccine by the end of October is going to be more like 28 to 30 million since growing the virus in eggs has not yielded as much antigen as normally produced with the seasonal flu.
Of course, to make a worse situation stupider is the hysteria being spread by the anti-vaccination crowd & their sympathizers in the media.
A new Pew Poll has found the public divided on whether they would get the H1N1 vaccine (47-47). The public is also divided on whether the press is correctly presenting the danger of swine flu or hyping the story (46% saying the press reports are about right, 43% saying it's overstated). The Pew Poll also noticed a partisan divide in the numbers.
60 percent of Democratic respondents said that they would get the vaccine and 34 percent said they would not. Conversely, only 41 percent of Republicans said they would take the vaccine while 54 percent said that they would not. (Warning for Democrats: Independents have the same 41-54 split.)
Perhaps not surprisingly, Democrats and Republicans also had starkly different views of how the press is handling the H1N1 story: 53 percent of Democrats think the media has presented the story "about right," while 35 percent think the danger has been overstated. The numbers are practically flipped for Republicans, with 41 percent thinking the media's gotten it right and 54 percent saying the danger was overstated. (Independents are OK with the media's handling of the story by a 44-42 edge, and overall respondents think the press has done a good job by 46-43 percent.)
That said there's room here for sociological discussion of the GOP as anti-intellectual/anti-science/anti-government—the party of truthiness. Add this one to the anecdote pile.
While scary enough as it is, the Republican number is not surprising since a significant number of their ranks are listening to the anti-government bullshit of
Rush Limbaugh & Glenn Beck.
However, the numbers for Independents are surprising as well as the fact a third of Democrats seem to buy into the bullshit as well. You have people like Bill Maher continuing to dispense nonsense on his show.
I'll get to the aluminum & mercury claims made by Maher in a second, but really? Insect repellent?
From Orac over at ScienceBlogs' Respectful Insolence:
I will admit that the "insect repellent" gambit is a new one on me. I looked at the CDC list of vaccine ingredients and couldn't find anything resembling a pesticide or insect repellant chemical. I may not know enough to have identified it; so I did a bit of digging. Guess where I found this one? Really, take a guess? Surprise, surprise! I found it on the uber conspiracy website Rense.com, which complains about the adjuvant MF59, stating that it is made up of Tween 80, squalene, and Span85, about the last of which it says:
Span85: Patented by the now defunct Chiron (bought by Novartis). Its chemical name is Sorbitan Trioleate. It is an oily liquid used in medicine, textiles, cosmetics, and paints as an emulsifier, anti-rust agent, and thickener. [Some factories in China specialize only in manufacturing Tween 80 and Span 85.] According to the Pesticide Action Network North America [PANNA], this chemical is used as a pesticide. It is also used as an adjuvant and is "toxic to humans, including carcinogenicity, reproductive and developmental toxicity, neurotoxicity, and acute toxicity."(16)
This is just plain silly, because, as revere has pointed out, the H1N1 vaccines used in the U.S. have no adjuvant, MF-59, squalene, or otherwise... Again, remember that the dose makes the poison. As is the case for aluminum, there is no good evidence that squalene or MF59 is harmful at the doses used in vaccines and plenty of evidence that it is safe. It's also possible Maher may have meant polyoxyethylene sorbitan, which is sometimes be used in an insect repellents. Whatever the case, it's nothing more than using scary chemical names.
Overall, Pew's poll numbers mesh with an earlier poll that found a
third of the parents in this country say they will refuse to vaccinate their children against a possibly lethal virus. With anything concerning children, a "
little bit of information" can sometimes be a dangerous thing, and it doesn't take much to cloudy the waters & scare people. While having websites like WebMD can be a helpful resource, for some parents it can also be problematic if their imagination gets the better of them. Also, along with the legitimate medical resources, are those peddling pseudoscience.
From the New York Times:
Web sites, Twitter feeds, talk radio and even elevator chatter are awash with skeptics criticizing the vaccine, largely with no factual or scientific basis. The most common complaint is that the vaccine has been newly formed and quickly distributed without the benefit of clinical trials; in fact, the swine flu vaccine was made using the same techniques as seasonal flu shots over the last two decades, and a small number of clinical trials were conducted this year to determine the adequate dose... Further, vitamin vendors — who in some cases operate blogs, with postings by people who claim to be doctors finding fault with vaccines — are reporting an increase in sales related to swine flu. Michael Angelo, chief research and information officer for eVitamins.com, said sales in September for flu-related products had tripled from last September. The company, he said, has sold 17,565 vitamins that it says protects against the H1N1 virus.
Some anti-vaccine groups are also highly organized and quick to respond to openings to promote their message. For instance, this week, an 8-year-old boy from Long Island died roughly a week after receiving a seasonal flu vaccine, though officials from the New York State Department of Health denied a connection.
Almost instantly, on a memorial page on Newsday’s Web site for the boy, Sean Weisse, a message from an anti-vaccine advocacy group appeared: “We are so sorry to hear about Sean. My understanding, and forgive me if I’m wrong, is that this was a vaccine-related injury. If so, we would like to help you. Best regards, Stan Kurtz, Generation Rescue, Jim Carrey and Jenny McCarthy’s Organization.”
To show how elements of the media can give anti-vax loons a seat at the table, just look at the
HPV (
Human Papillomavirus) vaccine. As of 2007, the
Human Papillomavirus was thought to be responsible for 11,000 cases of cervical cancer in women & 4,000 deaths in the United States each year. Worldwide, the numbers are 500,000 cases with 250,000 deaths per year. The FDA just
approved a second vaccine, Cervarix.
However, the first vaccine, Gardasil, has been a target of anti-vaccination activists using some of the same arguments used against the H1N1 & MMR vaccines. And the media, in search of headlines that can sell newspapers, have been happy to oblige them with a soapbox.
Not only is the headline untrue, according to Bad Science, the Sunday Express' story is a case where "every single assertion made on someone else’s behalf is false." Over at the Information is Beautiful blog, they decided too look at how safe the HPV vaccine is, and created a nice graphic to represent the risk involved.
So I thought I might look at some of the most common claims/myths used against the H1N1 vaccine, and vaccines in general, to see what happens when they're confronted by reality.
Claim 1: "The swine flu is simply another flu. It is not unusually deadly."
From Science-Based Medicine:
“Not unusually deadly.” Oh good, then we can expect only ~36,000 people to die from it this year! Why does that number not reassure me?
Let’s see, it circulated during the Summer, when flu doesn’t circulate, is uncommon in the elderly, is disproportionately infecting and hospitalizing younger people, it has a much higher incidence of ARDS requiring mechanical ventilation and heart-lung bypass (ECMO) than its seasonal counterpart (Australia reported 68 cases requiring ECMO vs. 4 the prior year), and it has a population which under the age of 60 is nearly 100% susceptible.
Yep, sounds like any old flu to me.
Claim 2: "The H1N1 vaccine is a new vaccine, and there wasn't enough time to test its safety."
From an OP-ED by Paul A. Offit, the chief of the infectious diseases division of the Children’s Hospital of Philadelphia.
The H1N1 virus revealed itself too late for it to be included in this year’s seasonal flu vaccine. But the H1N1-specific vaccine was manufactured in the same way as the regular vaccine: The shot form is made by growing the virus in hen’s eggs, purifying it and then treating it with a chemical that inactivates it. This technology has been used to make influenza vaccines for 60 years, and it has an excellent safety record. The nasal spray form is made by adapting the virus to temperatures below those typically found in the body. This allows it to reproduce in the relatively cool lining of the nose, but not in the lungs where it could cause harm. This technology has been used safely for more than 30 years. FluMist, a seasonal flu vaccine used since 2003, is made the same way.
The H1N1 vaccine has already been given to thousands of volunteers to determine whether it could protect them from the virus and to make sure that it caused no adverse reactions. Only then did the Food and Drug Administration license it.
Claim 3: "Dangerous adjuvants are in vaccines."
For some vaccines, substances called adjuvants are added to increase immune system response & spread a smaller quantity of antigen over more doses.
For one thing, the H1N1 vaccine doesn't have any. Secondly, even if there were aluminum salts or squalene in the bloody thing, that wouldn't be a reason to fear it. There is no evidence aluminum-containing vaccines are a serious health risk or justify changes to immunization practice. Aluminum salts have been used as adjuvants for about 80 years, and there's much more aluminum in breast milk & infant formula than there is in the vaccines.
During the first 6 months of life, infants could receive about 4 milligrams of aluminum from vaccines. That’s not very much: a milligram is one-thousandth of a gram and a gram is the weight of one-fifth of a teaspoon of water. During the same period, babies will also receive about 10 milligrams of aluminum in breast milk, about 40 milligrams in infant formula, or about 120 milligrams in soy-based formula.
All babies are either breast-fed or bottle-fed. Because both breast milk and infant formula contain aluminum, all babies have small quantities of aluminum in their bloodstreams all the time. The amount is very small: about 5 nanograms (billionths of a gram) per milliliter of blood (about one-fifth of a teaspoon). Indeed, the quantity of aluminum in vaccines is so small that even after an injection of vaccines, the amount of aluminum in a baby’s blood does not detectably change. In contrast, the amount of aluminum in the bloodstreams of people who suffer health problems from aluminum is at least 100 times greater than the amount found in the bloodstreams of healthy people.
As for
Squalene, it's an organic compound that's manufactured by our livers, and circulated in our bloodstreams.
From the World Health Organization:
What is known about the safety of squalene in vaccines?
- Twenty two million doses of Chiron's influenza vaccine (FLUAD) have been administered safely since 1997. This vaccine contains about 10mg of squalene per dose. No severe adverse events have been associated with the vaccine. Some mild local reactogenicity has been observed.
- Clinical studies on squalene-containing vaccines have been done in infants and neonates without evidence of safety concerns.
Why do some people think squalene in vaccines carries a risk?
- A few people have tried to link the health problems of Gulf War veterans to the possible presence of squalene in the vaccines these soldiers received.
- One published report suggested that some veterans who received anthrax vaccines developed anti-squalene antibodies and these antibodies caused disabilities.
- 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.
Four independent civilian panels considered allegations related to squalene and anti-squalene antibodies, and
concluded that the study which alleged an association "
contains shortcomings, some serious, that combine to invalidate the authors’ conclusions."
Claim 4: "A flu vaccine can give you the flu... or worse."
The H1N1 vaccine comes in two forms; inactivated & live attenuated. It is impossible for the inactivated form of the vaccine to cause infection since the virus particles are dead. The live attenuated form used for the Monovalent Nasal-Spray Flu Vaccine ("FluMist"), contains weakened H1N1 virus. The risk of infection is extremely small from the nasal spray, and there are guidelines from the CDC on who should & shouldn't get the live attenuated form.
When you hear stories about how someone has come down with the Flu after getting a Flu shot, they more than likely were exposed to the Flu before being vaccinated. It takes two weeks for a person's body to build up immunity to the virus after being vaccinated, so if you were infected before you got the shot, you can still get sick.
One of the big arguments made by those against H1N1 vaccination is the risk of Guillain-Barré syndrome (a rare disorder in which a person’s own immune system damages the nerve cells, causing muscle weakness and sometimes paralysis), which was claimed to be a side-effect of the 1976 vaccine. While the CDC is monitoring this year's vaccine for any anomalies, it's important to keep in mind that the 1976 incidence of Guillain-Barré was barely higher than the normal rate, and you would still have a better chance of dying from a lightning strike, an airplane crash, or falling down than contracting Guillain-Barré.
From the CDC:
In 1976, there was a small risk of GBS following influenza (swine flu) vaccination (approximately 1 additional case per 100,000 people who received the swine flu vaccine). That number of GBS cases was slightly higher than the background rate for GBS. Since then, numerous studies have been done to evaluate if other flu vaccines were associated with GBS. In most studies, no association was found, but two studies suggested that approximately 1 additional person out of 1 million vaccinated people may be at risk for GBS associated with the seasonal influenza vaccine. It is important to keep in mind that severe illness and possible death can be associated with influenza, and vaccination is the best way to prevent influenza infection and its complications.
And of course, there is "
post hoc ergo propter hoc." In the week after getting a vaccine, there are a fair amount of people that will be in car accidents. However, no logical person is going to argue that vaccines cause car accidents.
Claim 5: "The H1N1 vaccine & other vaccines contain the mercury-based preservative Thimerosal, which contributes to the development of autism and other brain development disorders."
This is a biggie, since it was a prime suspect of those linking vaccines to autism. Thimerosal is a mercury-containing organic compound (an organomercurial). Since the 1930s, it has been widely used as a preservative in a number of biological and drug products, including many vaccines, to help prevent potentially life threatening contamination with harmful microbes. When people hear "mercury," the gears inside the brain's imagination machine start turning. However, thimerosal is a derivative of ethylmercury, not methylmercury. They are different chemical entities.
Expert consultation and data presented to the Global Advisory Committee on Vaccine Safety (GACVS) indicate that the pharmacokinetic profile of ethyl mercury is substantially different from that of methyl mercury. The half-life of ethyl mercury is short (less than one week) compared to methyl mercury (1.5 months) making exposure to ethyl mercury in blood comparatively brief. Further, ethyl mercury is actively excreted via the gut unlike methyl mercury that accumulates in the body.
(Source)
To put this in perspective, a vaccination has less ethylmercury (
in the form of thimerosal) than the amount of methylmercury an adult/kid might possibly get from eating a tuna sandwich. The association between thimerosal in vaccines & autism has been a
failed hypothesis as study after study has shown no linkage.
From Clinical Infectious Diseases (CID):
Three ecological studies performed in 3 different countries compared the incidence of autism with thimerosal exposure from vaccines. In each case, the nationwide removal of thimerosal—which occurred in 1992 in Europe and in 2001 in the United States—allowed robust comparisons of vaccination with thimerosal‐containing and thimerosal‐free products, as follows:
1. In Sweden and Denmark, researchers found a relatively stable incidence of autism when thimerosal‐containing vaccines were in use (1980–1990), including years when children were exposed to as much as 200 μg of ethylmercury (concentrations similar to peak US exposures). However, in 1990, a steady increase in the incidence of autism began in both countries and continued through the end of the study period in 2000, despite the removal of thimerosal from vaccines in 1992.
2. In Denmark, researchers performed a study comparing the incidence of autism in children who had received 200 μg (1961–1970), 125 μg (1970–1992), or 0 μg of thimerosal (1992–2000) and again demonstrated no relationship between thimerosal exposure and autism.
3. In Quebec, researchers grouped 27,749 children from 55 schools by date of birth and estimated thimerosal exposure on the basis of the corresponding Ministry of Health vaccine schedules. School records were obtained to determine age‐specific rates of pervasive developmental disorder. Thimerosal exposure and pervasive developmental disorder diagnosis were found to be independent variables. Similar to previous analyses, the highest rates of pervasive developmental disorder were found in cohorts exposed to thimerosal‐free vaccines. The results were unchanged when both exposure and outcome definitions varied.
Four cohort studies that examined thimerosal exposure and autism have been performed, as follows:
1. In Denmark, researchers examined >1200 children with autism that was identified during 1990–1996, which comprised 3 million person‐years. They found that the risk of autism did not differ between children vaccinated with thimerosal‐containing vaccines and those vaccinated with thimerosal‐free vaccines or between children who received greater or lower quantities of thimerosal. They also found that the rates of autism increased after the removal of thimerosal from all vaccines.
2. In the United States, using the Vaccine Safety Data Link, researchers at the Centers for Disease Control and Prevention examined 140,887 US children born during 1991–1999, including >200 children with autism. The researchers found no relationship between receipt of thimerosal‐containing vaccines and autism.
3. In England, researchers prospectively followed 12,810 children for whom they had complete vaccination records who were born during 1991–1992, and they found no relationship between early thimerosal exposure and deleterious neurological or psychological outcomes.
4. In the United Kingdom, researchers evaluated the vaccination records of 100,572 children born during 1988–1997, using the General Practice Research Database, 104 of whom were affected with autism. No relationship between thimerosal exposure and autism diagnosis was observed.
From the
FDA:
In 2004, the Institutes Of Medicine's Immunization Safety Review Committee issued its final report, examining the hypothesis that vaccines, specifically the MMR vaccines and thimerosal containing vaccines, are causally associated with autism. In this report, the committee incorporated new epidemiological evidence from the U.S., Denmark, Sweden, and the United Kingdom, and studies of biologic mechanisms related to vaccines and autism since its report in 2001. The committee concluded that this body of evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism, and that hypotheses generated to date concerning a biological mechanism for such causality are theoretical only. Further, the committee stated that the benefits of vaccination are proven and the hypothesis of susceptible populations is presently speculative, and that widespread rejection of vaccines would lead to increases in incidences of serious infectious diseases like measles, whooping cough and Hib bacterial meningitis.
Claim 6: "There are too many vaccinations given to children. Too many, too soon."
While it's true there are more vaccines against specific viruses and bacteria on the routine schedule, the Vaccine load is actually much less than it once was.
Although the number of recommended childhood vaccines has increased during the past 30 years, with advances in protein chemistry and recombinant DNA technology, the immunologic load has actually decreased. The 14 vaccines given today contain less than 200 bacterial and viral proteins or polysaccharides, compared with more than 3000 of these immunological components in the 7 vaccines administered in 1980.
Studies of this hypothesis have found the evidence
lacking for "
vaccine overload."
While I'm sure I might have left some kook's theory out of the debunking, I'm sure at this hour someone is working on a new reason that will scare people into buying vitamins or homeopathic treatment (A.K.A. dihydrogen monoxide or water).