A particularly detailed and well-made article on influenza and H1N1 vaccination finds some success (deserved in my opinion) on the Internet and on Twitter. Here
If I totally agree on the vast majority of the principles and remarks made in this article, I have issued some reservations on Twitter.
So I explain…
I said above, this article is excellent on the principle, very detailed (too??), but in my opinion not necessarily within the reach of someone without medical knowledge (especially on how to make a decision based on the data in our Possession, nothing is ever white or black).
The first publication dates from mid-November, but I find no mention of studies showing the abnormal mortality of the virus in young populations without risk factor, just projections while the data are available. The update of 2 December does not make any case of data concerning the mutation observed on the virus which explains not only some of the abnormal mortality of the virus, but also the tropism of the virus for the bottom of our lungs (the alveoli) rather than the bronchi Usually (explaining why there is more hospitalization in resuscitation than normal). I regret not finding more clearly that this virus is capable of killing healthy young adults, which is clearly not the case for the seasonal flu virus. This is, in my opinion, essential information about this virus and its current evolution.
If I take the early December part about the reactions to vaccines in Canada. The information comes from Cyberpresse.ca (not very medical as a newspaper). I'm copying and pasting the part about the deaths:
On November 17, the Canadian authorities themselves counted nearly 200 deaths, as well as 36 cases of serious reactions to the 6.6 million of vaccinated persons (about one-fifth of the population). »
And there, honestly, I don't understand the sentence. We're talking about 200 dead after vaccination? But then, why talk about 36 cases of serious reactions (even if it is just that death is serious…)? I think 200 died after vaccination, we would have heard about it. So, parle-t'on of 200 deaths due to influenza, of which 36 cases of serious reactions, of the 6.6 million of vaccinated (not heard of death following vaccination)? This information is irrelevant and should not be used in my view as it concerns seem a single lot whose health professionals know that there are regular alerts on batches of drugs (such as on cheese, Chopped steaks….).
Concerning the English study quoted, I do a copy and paste of the part on the Pandemrix quoted in the article:
TWO reports of death following vaccination with Pandemrix have been carried over in the UK to date. In Both cases the patients had significant underlying medical conditions. There is no indication that the vaccine contributes to these deaths. »
Thus, there were two deaths after vaccination with Pandemrix in people with severe chronic diseases with no relationship between vaccination and deaths. In addition, there is no data on the amount of doses of Pandemrix administered, just the notion that Pandemrix is the vaccine that has brought back the most reports, as it is the most used in Britain. I refer you to a previous article on the occurrence of side effects after injection of sterile water to make the parallel with this assertion.
This part for me is therefore subject to bail. I am not in favour of anyone, but I just want to base my decisions on relevant elements. In any event, it would have been advisable to detail this data a little more if we wanted to use them.
With regard to information on too late vaccination, the epidemic being launched, some elements are also subject to caution. Indeed, during the last Pandemics (1918, 1957 and 1968), we systematically observed several waves from one year to the other with some particularities. Say that the first wave was in September and the second currently implying that there will be no waves in 2010 is not based on anything concrete. I could just say that there were mild temperatures in October and early November and then a resurgence of the virus as soon as the temperatures were more stringent. So on this point, the master Word is uncertainty.
Then the argument of "never or always" is a little incomprehensible to me. We are talking about an unknown virus like the one of 1968 that we have been dragging for 40 years. The natural history of influenza viruses strongly suggests that the current virus will be the seasonal influenza virus of the 30 or 40 years to come with naturally declinations. Above all, we will have (in any case, hopefully…) A virus probably banal, returning to "classical" mortality and groups at risk "classical". In this, vaccination today has all its meaning. Tomorrow will be another day…
All these remarks do not remove anything from the quality of the article I admit to having read a few weeks ago. It has a very great merit, it is to put everyone in front of the data in our possession. I only think that so much information requires medical training to be digested. A researcher, an epidemiologist will have a statistical view of the problems, it is different from a general practitioner who treats a person and not a percentage. That the mortality of the virus is 0.00001% or 40%, what matters to my patient is whether he is likely to be affected and eventually die (after all, we have 1 chance on 13 983 816 to have 6 good numbers in the lotto and yet there is no shortage of players). I had on the majority of articles published on my site tempted not to go too much in detail so precisely not to add to the confusion. But in this article, the conclusion annoys me. There is no single conclusion, and the patient should be sent back to his doctor to conclude. But it is the role of a health professional to steer the choice of the population to what it deems or not judicious to do in view of the results of the studies, in short to moisten a little the shirt. A phrase of the type "do what you want, but personally I will get vaccinated (or not for that matter)." "would have been welcome.