To Be or Not To Be H1N1 Vaccinated

Have you been thinking about getting the swine flu shot? Are you a skeptic? Well, perhaps you have reason to be. Here's what our guest blogger, Sam Li has to say: So I got to thinking about this H1N1 craze as my mother hands me one of those “reserve your place” coupons for tomorrow’s rounds of vaccines. It makes me wonder, should I ? The fact that mother-dearest insists on me getting it is because of, well, the big media scare. However, I never really felt compelled… nor do I feel it now. The only thing that actually acts as the driving force, or potentially, is the wrath of my mother coming down on me for not listening to what she said and of course, mommies know best for their “little” girls. Haha.

As I ponder how I am going to get myself out of getting the vaccine, let me come up with a rebuttle against this so-called “big bad pandemic” and bring out some facts of why maybe this might just be a passing case of a regular annual flu. No need for panic. Just wash hands, cough in your sleeve, and continue on out of harms way.

Let us get into the hardcore SCIENCE behind it all first in the form of regularly non-boring people language (I joke, I joke… I AM an immunologist myself). But seriously… under the microscope we go.

The “Test-Tube” Jargon

The threat we are dealing with is known as the “swine flu”, the “flu pandemic of 2009”, and more scientifically as “influenza A H1N1”. Influenza is a virus found in three forms: A, B, and C. However, type A is the only form known to cause epidemic illnesses. Influenza A is enveloped in a capsule, which contain a variety of proteins. Two of in particular are the hemagluttinin (the “H”), which acts as an anchor on its target cell, and the neuraminidase (the “N”), which is an enzyme responsible for the virus entry within the target cell resulting in the cell being infected. Within the influenza A family, there are approximately 16 subtypes of H, in which H1, H2 and H3 are known to infect humans, and 9 subtypes of N exist, where N1 and N2 target human cells. H1N1 is a virus that contains the subtype 1 of both H and N.

The “Pandemic”

A pandemic (according to our friend Wiki) is an infectious disease that infects and wipes out a population of a large region, eventually stretching out over the continent and, finally, taking on the whole world. Examples of these are smallpox and tuberculosis. However, the one we are most interested in for this topic, in which the entire scare has stemmed from, is comparing this new age H1N1 Swine Flu to the Spanish Flu of 1918.

The “Swine Flu” and the “Spanish Flu”

Spanish Flu pandemic, which first developed in mild waves in the spring time of 1917, ended up causing 40-50 million deaths world wide as it wiped out whole populations during the fall and winter season of 1918. In North America, it was estimated that 1 out of 4 people infected resulted in over 750 000 lives taken.Now, I could understand why people have been petrified over the Swine Flu of 2009 because it seems to be taking the same course as the Spanish Flu, which was slow and steady at first. The feeling that it would developed into a large massacre in a year is due to the fact that the pandemic of 1918 was also of the H1N1 form, hence added fear to the whole situation.

Nonetheless, there are still many reasons to believe that we really should take the level of panic down several notches. Looking at the numbers alone is enough to feel more secure. During the Swine Flu season, we have observed, world-wide, over 500 000 reported cases with an approximate 8000 casualties, which is clearly incomparable to the statistics pulled when the Spanish Flu plagued the earth. Also, we are in 2009 and not 1918. There are huge differences in medical knowledge and technology. There is a lot people did not know almost a century ago that we are very privileged to have today. We have anti-viral medications (namely Tamiflu and Relenza), which are more than potent to cure severe flu disease sufferers. When taken 48 hours after onset of symptoms, it not only clears the illness but controls the infected person to being contagious. There is another simple method to keep from transmitting the virus, which, believe it or not, was not very well documented and practiced back in the day. This is by simply following hygienic measures such as frequently washing your hands, using disinfectants for commonly accessed surfaces (table tops, door knobs, etc) and courtesy manners (sneezing and coughing in one’s sleeve, followed by disinfectants and washing hands) could act as a new age vaccine.

The “Influenza A H1N1 Vaccine”

There are great advances in the medical field pertaining to such infectious disease, especially in terms of safety issues and prevention methods. Now, because “prevention” is so important, as it is the best solution for the flu, it brings me to the topic of “vaccines”. It seems like I am back to square one, as I stare at the orange card marked “12 PM”. Forgive me for being so dramatic but… it feels like a death-sentence to me right now. I mean, is this really necessary ?

Of the various numbers of articles I have read on the topic, here are just a few pertinent pieces of information I found most intriguing, which I compiled re-iterating medical experts in the field against the use of the Influenza A H1N1 vaccine.

• There are healthcare practitioners who are advising their patients to not get the vaccine. We go to the doctors for medical advice, so if this does not make a strong statement, what does ? One reason for this is because there is a risk of developing Guillaine-Barre Syndrome when taking the vaccine, which is an autoimmune disease of the nervous system and leading cause of non-trauma inducing paralysis in the world.

• The official vaccine against influenze A H1N1 is ArepanrixTM H1N1 by the renown GlaxoSmithKline, which was authorized by Health Canada and the Public Health Agency of Canada was made available for sale in mid-October, is still undergoing numerous tests and clinical trials, in order to further evaluate its safety and efficacy. There are four distinct stages of a clinical trial. The first stage, namely Phase I, is to answer the question: “Is the vaccine safe?” After this, phase II to IV include: “Does it work?, Is it better than what we have now? What else does it do?”, all of which according to medical experts are only in the process of being reviewed as data is pending for analysis. In most cases, companies and researchers involved in the production of drugs for the use of health, on average require 5-10 years before their final product. After the WHO announced “Swine Flu” as a pandemic outbreak in mid-June 2009, ArepanrixTM H1N1 vaccine was given to the public only a short 4 months later. These facts as well as the ongoing tests for the safety of the drug has resulted in many skeptics, who refuse to be vaccinated, some of which are amongst our own healthcare practitioners, who are preaching against it.

• There are different categories found under the title of “high-risk groups”, such as pregnant women and healthcare/medical personelle. There have been reports that amongst those who fall under the “high-risk” category, there are less than 50% to date who are actually getting vaccinated. If more than half of the population, who are most likely to contract this virus, are withholding from getting immunized and the infection rates and death tolls are only increasing in mild increments, again, it stems a lot of disbelievers when it comes to the need for a vaccine.

In Conclusion (… Sorta?)

It has been said that there is a very fine line between safety and risk when it comes down to vaccines, particularly when it is a world-wide immunization motion. Questions have been flying between the risk of disease and the safety of the drug. The skeptics ponder the concept of the need to vaccinate whole populations to prevent for a pandemic that has yet to potentially arise in 6 months to a year from now with no clear, concrete proof. Don’t they stand with a case and point?

All to say, I sit here swimming in my thoughts of the pros and the cons, the “what I think”, the “what they think”, and of course, the “what mother thinks” as I stare down at my vaccination coupon while the clock keeps ticking. I guess, at the end of the day, it is up to you and yours to make an informed decision of what to do. It is your health, your safety, and your choice. So, take some time and look at the figures and see which side of the fence you’re on. The future will unfold itself but until then, today is ours’. Make it your own and do what’s right for you. Cheers!