Sunday, October 11, 2009

The H1N1 Vaccine is here…What is an Acceptable Risk?

I’m going to define my era a little here by saying that this is not the first “swine flu” alarm we’ve had in my lifetime. Back in 1976, the first “swine flu” scare held the country in its grip. There was panic over the lack of a vaccine, and much like today, companies scrambled to jury-rig together something that was supposed to protect the public against this inveterate killing machine.

Hundreds of thousands received the shots. It was particularly recommended for pregnant women and those with chronic illnesses and the elderly. Emergency shot administration locations were set up all over the country. I actually volunteered to help at one of those sites. Obviously pregnant with my first child, one of the other volunteers asked me if I had received my shot.

“No I haven’t,” I replied.

“Why not?” she asked.

“Because I’m pregnant, not stupid. Not even an aspirin crosses these lips while I’m in this condition, and from everything I’ve read, this vaccine has not been around long enough to test for long-term effects.”

Even in my early 20’s, I was cognizant enough of what was going on to realize that not enough testing had been done.

That version of swine flu did kill some people, but it was never the pandemic they all warned us about. There was a huge backlash from doling out vaccine that wasn’t sufficiently tested, a hoopla about vaccinating low-income areas first (to test it for the rest of society), and there were some unexpected effects as well, but there are always unexpected effects from most new medications.

Flash forward 33 years. Here it is again. I am speaking to you not as a doctor or nurse or public health official. I am giving my personal opinion as someone with a long medical industry background and many years in pharmaceutical research. I will not be getting the H1N1 shot. I will get the normal flu shot offered at my place of employment.

I will also be requesting the pneumonia shot from my primary physician. Generally speaking, it is the pneumonia complication of the flu that kills.

Anyone in my general age range, from 40 up, has already been exposed to a similar strain of this flu and should have some residual antibodies to fight it. Would I give this new vaccine to my teens and kids? In spite of the lack of testing, I probably would. The younger age groups have not had the exposure of the older generations. And testing has come quite a long way in the last 33 years.

I’m not saying that it’s safe. I’m saying that there is a component of risk, and you have to consider that risk before you take the vaccine. As with all new medications, there are unexpected side effects, including allergies to the medication itself or to the vehicle the medication is mixed with so that it can be administered.

I’m sure that the parent of any child or teen who has died from swine flu would consider the risk of taking the relatively under-tested vaccine to be an acceptable one.

So, the question is, what will you consider to be an acceptable risk?