Tuesday, October 27, 2009

H1N1 Vaccines

H1N1 has begun its anticipated resurgence, sweeping through communities and spreading rapidly. There has been an incredible amount of misinformation being spread about the vaccine. Most of it is well intentioned, but horrendously uninformed. Unfortunately viruses are apathetic to good intentions but bad science; they cause illness and death anyways. I am going to be focusing on misunderstandings of the science. If you believe that H1N1 is a ploy by the government to institute massive depopulation no amount of evidence will change your mind. It is well beyond the scope of a blog post, it would require a textbook on critical thinking and maybe a bucket of ice water. Ironically sometimes the same individuals who claim it is a plan for massive depopulation also claim that H1N1 is relatively mild and you don't need the vaccine...
So that being said I will try to reach out for people who are skeptical about the vaccine and guide them in the right direction to find the legitimate sources that assess both effectiveness and the safety of the H1N1 flu vaccine.

I am also going to be greatly simplifying just about everything because I am not an expert and it would take a textbook to explain everything in great detail. I encourage you to use this as a starting point I may make errors (if I do please email me I will correct them).

There is only one reason I am writing this, it isn't to prove myself to anyone nor do I don't get a cheque from big pharma (although if you are from big pharma reading this call me I have lots and lots of student loans to repay). I am writing this because a preventable disease that can cause severe illness or death in healthy young individuals is spreading rapidly. Many people are uninformed about the facts due to an overload of misinformation, found primarily on the Internet. In short I want my friends, family and ultimately all of humanity to be as healthy as possible.

I am not a doctor, I am not here to give you health advice other than the recommendation to listen to medical science. First lets quickly go over how vaccines works, again this isn't my area of expertise and I am heavily quoting physicians and scientists. I will give my references at the end.

Vaccines are one of the miracles of modern science. Smallpox is estimated to have killed hundreds of millions of people in the 20th century alone. The population of the US and Canada in the approximately 75 years. More than the holocaust, both world wars, the Rwandan genocide, Pol Pot, Stalin, and Mao COMBINED. Guess how it was eradicated, not by eating healthy (which is a good thing too), not by homeopathy or herbal treatments but by vaccines. In two decades it was effectively eradicated, the last case occurred in 1978.

Vaccines work by injecting a small amount of something that resembles a microorganism into the bloodstream. It allows the immune system to recognize it as foreign and destroy it. The immune system has also evolved to keep a memory of previous microorganisms it has destroyed so that if they appear again they can be destroyed much more quickly and not cause infection. The flu vaccine contains dead flu viruses, which your body recognizes as foreign, eliminates them and remembers what the virus looks like. Because these viruses are dead they cannot cause the flu... ever. Very rarely people react poorly to vaccines and the flu vaccine is by no means 100 percent effective due to the variety of strains but the risks are dwarfed by the benefits. Getting the flu directly from the vaccine is analogous to someone dumping a corpse in your living room, your house getting robbed the next day and blaming it on the corpse. The problem is that all influenza strains are not the same and creating the vaccine in large quantities takes a long time ~6 months. So researchers have to make an educated guess on what flu strain will be prevalent in the flu season next year which brings us to H1N1 (Swine flu).

Influenza has the ability to exchange parts of its genetic code (RNA in this case) with other strains of influenza. That is precisely what happened. Sections of swine flu, avian flu and human flu combined creating something that most peoples immune system haven't seen before. That is the major concern and why so much attention has been focused on this pandemic. Most people have at least limited immunity to seasonal flu because their body has seen parts of the virus before. Influenza is constantly mutating, like any reproducing organism and a more deadly form of H1N1 could appear tomorrow.

Luckily our immune system is quite incredible and most people who get H1N1 suffer from basically a normal flu. The mortality rate looks so far to be approximately what you would expect from the yearly seasonal flu. So why worry about it? Because it causes serious illness young healthy people in far greater numbers than you would expect from the normal seasonal flu. Here is another important point: H1N1 appears to have almost a "split personality", either you are sick for a few days and get better or you have a very serious illness that requires hospitalization often in the ICU. This is where a lot of misinformation lies. I've heard it repeated ad nauseum that "its just like a normal flu why the big deal" and that is true in around 99 percent of the cases. In the remaining 1 percent, indiscriminate of age or prior health they develop a deadly illness. In the event of a pandemic where millions of people are getting sick 1 percent is a huge number.

So in order to combat this spread governments and pharmaceutical companies quickly threw together some sort of a vaccine that may protect you in an experimental new treatment that is untested and potentially worse than the virus right? Well no. It takes around nine months to make the flu vaccine, 3 months to figure out what strains to put in and 6 months to produce and deliver it. They are using the exact same tried and true methods of flu vaccinations except they were able to skip the first 3 months because they knew exactly what strain of influenza to use. They then started to produce the vaccine just like any other seasonal vaccine. So yes it was "rushed" it needed to be but it wasn't rushed on things like safety. If you are interested checkout this podcast from an infectious disease doctor. He covers it much better than I ever could.

Vaccines like any medical intervention have risks. Luckily the risk of getting serious complications from the vaccine is around 1 in a million, lottery odds. Your risk of getting serious complications from the flu is much higher. It is all about relative risk. It is also important to look at the common logical fallacy "post hoc, ergo proper hoc" (After therefore because of). If millions of people are getting vaccinated then it makes sense that some people, shortly after their vaccine will have a myriad of health problems purely by chance. Some will have heart attacks, some will have a stroke, some will develop "flu like symptoms" etc. completely unrelated to the vaccine, they would have developed it anyways. This is why careful studies are required to determine if a medical intervention is actually causing serious harm (which it can, thats why drugs get pulled off the market sometimes) or if it is just coincidental over a large population.

Bottom line. The vaccine is safe. H1N1 either produces a mild illness or a deadly one. If you have H1N1 right now you are probably going to be OK the chances of death are quite low. Statistically speaking however it can do a great deal of preventable damage. It appears to target young healthy people with serious illness much more often than the seasonal flu. By not getting the vaccine you are giving the virus the opportunity to spread and infect others.

Get the vaccine.

References:

http://www.cdc.gov/h1n1flu/updates/us/
http://www.theness.com/neurologicablog/?p=872#more-872
http://www.quackcast.com/spodcasts/files/podcast_33.mp3
http://www.sciencebasedmedicine.org/?p=2040
http://en.wikipedia.org/wiki/Influenza (Not exactly scholarly research but a good starting point and the references are good at the bottom)
http://www.phac-aspc.gc.ca/alert-alerte/h1n1/index-eng.php
http://www.ncbi.nlm.nih.gov/pubmed/