Author: Rebecca Cuneo Keenan

The H1N1 flu vaccine became available in Canada as of this Monday and health workers across the country are scrambling to administer the shots as widely and efficiently as possible. So far, there have been nearly 5000 deaths worldwide due to swine flu (H1N1) and overflowing clinics and long waits are a reality for the time being.

What I have been hearing, however,  is a far cry from eager anticipation of a life-saving medicine. I have been hearing cynical, suspicious critiques of the very governmental agencies and people who have been working around the clock to get the vaccine out in time for this year’s flu season. I have been hearing worry and concern about the safety of the vaccine. People are confused and don’t know what to believe.

There is a general climate of distrust when it comes to vaccines, I think, due to the highly publicized (and bogus) theory that childhood vaccinations are linked to rising autism rates. (See here how it impacts parents’ decisions regarding H1N1.) Much has been made of the rush to get these vaccines out and of the presence of thimerosal and an adjuvant in the vaccine. I have argued before that standard vaccines are safe and necessary and will now argue in favour of the H1N1 flu vaccine. You should absolutely get vaccinated and I’ll tell you why.

“But it’s just the flu.”

• Actually, the World Health Organization (WHO) states on its web site that: “This is a new influenza A(H1N1) virus that has never before circulated among humans. This virus is not related to previous or current human seasonal influenza viruses.” We do not, therefore, have any natural immunity to this virus.
• It is highly contagious and remains so even after the illness seems to have passed. The virus has been found present even 13 days after the onset of fever. (Globe and Mail)
• Most cases thus far have been mild and most healthy adults should be able to fight it off on their own. We think. Health Canada states on its web site that: “The H1N1 flu virus has caused primarily mild illness in Canada, but Canadians need to be prepared to respond to a potentially more severe form of the virus that may emerge this fall.”
• There has been an increase in mortality rates for healthy young adults and especially pregnant women when compared with other seasonal flus.
• The current issue of Atlantic Monthly has an article about this vaccine,  “Shots in the Dark,” that says:  “Whether this season’s swine flu turns out to be deadly or mild, most experts agree that it’s only a matter of time before we’re hit by a truly devastating flu pandemic—one that might kill more people worldwide than have died of the plague and aids combined.” This might not be it. But then again it might.
• Health Canada was concerned enough to purchase enough vaccine for everyone in Canada who wants it. They don’t do that every year.
• Barack Obama has declared the virus to be a national emergency. Again, not the normal response to “just the flu.”
• The Spanish Flu was also just the flu. It was a world-wide pandemic that seemed to target otherwise young and healthy adults and killed anywhere from 50 million to 100 million people from 1918 – 1920, seven times the casualty rate of WWI.

“But the vaccines contain mercury which is a known toxin.”

• It is true that the H1N1 vaccine available in Canada contains thimerosal, a form of mercury, that serves to preserve and stabilize the vaccine.
• This form of mercury is considered perfectly safe in low doses. Health Canada says: “The amount in the H1N1 adjuvanted flu vaccine is much less than the daily limit recommended for environmental exposure to mercury.  For example, there is significantly less mercury in the vaccine than you would find in a can of tuna fish.”
• Even the unadjuvanted vaccine which contains 10 times as much thimerosal is well within the safe range.
• Remember, the vaccine is administered once. Even in cases with relatively low levels of mercury (but still much higher than those in the vaccine) it is chronic exposure that causes adverse reactions.

“What about the adjuvant vs unadjuvanted vaccines? Why do pregnant women get a safer one than the rest of us?”

• The adjuvant that is added to the majority of vaccines serves to boost our immune systems and accelerate the effectiveness of the vaccine. “The adjuvant in Canada’s H1N1 flu vaccine is made up of natural ingredients such as water, squalene oil and vitamin E. An unadjuvanted vaccine has no “booster” element.” (Health Canada)
• The adjuvant actually makes the vaccine more effective and is recommended against this strain of flu. The same adjuvant has been used for years in the regular flu shot and is not new.
• In the absence of any studies of the adjuvant on pregnant women specifically, the government has ordered just enough unadjuvanted vaccines to administer to expecting mothers just to be safe. In fact, the threat of swine flu to pregnant women is such that they should go ahead and use the adjuvanted version if it is the only one available.

“Okay, but I’m not really at risk so why should I assume any risk from the vaccination, however minuscule?”

• This was my original position on the vaccine, admittedly. I don’t usually get the flu shot, I thought, and I have a strong immune system. Why bother?
• First, the risk is less than minuscule. The risk of any serious adverse affects (beyond soreness at the injection site and minor aches the day of) from the vaccine is infinitesimal, one in a million. Your odds of contracting the flu far outweigh the vanishingly small odds of a side effect from the vaccine.
• Second, even the regular flu just plain sucks and this swine flu is far worse. (Here’s a post by a woman whose entire family is just getting over swine flu.) So why not try to avoid having to take a week off work to nurse your entirely preventable illness?
• You probably know someone, or someone who knows someone, who is at risk. Do you really want to be responsible for spreading this flu?
• We are trying to prevent a full-scale pandemic and that means everybody should participate. At a 90% inoculation rate diseases are kept at bay. As soon as rates start to drop again the disease rears it’s head. (Flu shots are much less effective because only about a third of the population gets them and they are not always targeted at the right strain. We have the right strain this year.)
• There is a three to four per cent rate of inefficiency for most vaccines. So for every 100 people vaccinated three or four will still be susceptible to the illness. If nearly everyone is vaccinated, though, that doesn’t matter. What if someone you love is one of those three per cent?
• Not everybody can be vaccinated. Newborns, people with egg allergies, and anyone with a high fever are not eligible. Prominent blogger Catherine Connors has a toddler son, for example, with a serious respiratory infection that means he is not a candidate for the vaccination. His condition also makes him much more susceptible to serious complications should he contract H1N1. Anyone who cannot get vaccinated themselves is at the mercy of the general public to contain this virus.
• You are the general public. Each and every one of us should feel obliged to do everything in our power to eradicate this virus. All we need to do is get a shot. I know that x number of people die of all kinds of other things all the time — far more than will die of swine flu this year. But I don’t care. People are dying of this right now and we can all stop it.

Vanetia Warner was a healthy ten year old girl living in Cornwall, Ontario with no underlying medical problems whatsoever. She was admitted into hospital last weekend with the swine flu and then died.

Evan Frustaglio was a 13 year old hockey player from Toronto with no health problems at all. While at a hockey tournament in London he began to feel slightly ill. By Saturday his fever wasn’t being helped by over-the-counter medication and his parents brought him to a clinic on Sunday. He was sent home with nothing to worry about as his breathing was regular and the fever was being controlled. He got out of the bath on Monday and collapsed. He was pronounced dead at the hospital. [Update: From the Toronto Star: “Dr. David McKeown, Toronto’s medical officer of health, said Evan had “mild asthma,” something his father disputed.”Evan didn’t have asthma; he had been prescribed puffers a few years ago when he had a cold,” Frustaglio said.]

The truth is that we don’t know who the victims are going to be with this flu. This is a brand new strain that nobody has any natural immunity against. It isn’t just the flu.

We are lucky enough to live in an age where scientists are tracking these illnesses and identifying them and projecting what they will look like. And they are mostly right. Untold numbers of people do not have to die before a vaccine is found. The victims of the Spanish Flu should have been so lucky. Let’s be able to look back on this and laugh. Remember how worried we were? Turned out to be nothing.

Further reading:
Health Canada’s Vaccine Myths
World Health Organization’s Influenza A(H1N1) Frequently Asked Questions
Wired, “An Epidemic of Fear,” and the follow up, “H1N1 Flu Shot: 3 Major Fears Debunked” (highly recommended)
The Atlantic Monthly, “Does the Vaccine Matter?”

(Image courtesy of Zaldylmg on Flickr.)