January 1, 1970 (Vol. , No. )
Taralyn Tan Ph.D. Curriculum Fellow Harvard Medical
Don’t you people know that we are facing medical perils with potentially dastardly consequences? Didn’t you see it on TV? Didn’t you read about it in the paper? Didn’t you…stop to think for a minute and step back from the media manipulations???? With the competitive dispersion of information between different cable channels, publishers, and cyberspace comes the temptation for (and indulgence in) hyperbole. The “news” as an all-encompassing entity becomes a boxing ring, with different sources duking it out for the title of “best story” or “most compelling broadcast.” Such is the case today with the topics of vaccine safety and global pandemics.
In one corner, we have the HPV vaccine. Despite years of clinical trials and follow-up studies, we still see those pesky stories on the nightly news: “Just how safe is the vaccine, really?” “Mothers won’t vaccinate – you wouldn’t put your daughter in danger, would you?” These stories do little more than undermine the scientific method put in place to test vaccines and breed an irrational paranoia about vaccinations among the general public.
In the other corner, we have “2009 H1N1” (the virus formerly known as “Novel H1N1,” and formerly before that, the ominous “Swine Flu”). While broadcasting the “You’re a bad parent if you get your daughter vaccinated against HPV” stories, media outlets are simultaneously telling the general public that 2009 H1N1 massive death tolls are imminent, and that it is of great necessity to immunize as a many people as possible against this novel virus in the coming months. Thus, these reports deliver the one-two punch of 1) panicking the population over an exaggerated threat and 2) not exactly relieving the vaccine-paranoia of some people by fast-tracking the newly developed vaccine.
With both sides swinging, the general public is caught in the crossfire. Teetering on the seesaw between “vaccines are evil” and “Swine flu will kill us all – we must vaccinate immediately”, it is only a matter of time before people are thrown to one side or the other. To those of you who have already done so, I hope to bring you back to equilibrium.
So, you’re willing to subject your daughter to HPV and cervical cancer, rather than risk the vaccination that has withstood the test of the CDC, FDA, and years of clinical trials? Have you also forgotten about Polio? This pernicious nervous system-invading virus was completely eradicated in this country and many others due to the vaccination campaign against it. Bottom line: there is no need to fear well-tested vaccines, and the media should do its part to ameliorate the toxic attitude towards vaccinations, rather than provide seeds-of-doubt stories and paranoid testimonials.
On the other side of the seesaw, if you’ve already stocked your emergency H1N1 shelter with water and canned food…just stop. Yes, the world was introduced to this novel flu strain this past spring, and yes, it does seem to infect a younger population than our traditional “seasonal flu.” But is 2009 H1N1 really as bad as it has been sensationalized to be? From April 15 to July 24, 2009, the CDC reported individual cases of the novel H1N1 infection in the US. The results? Just under 44,000 confirmed and probable cases, about 5,000 hospitalizations, and 302 deaths. It sounds scary until you compare the CDC statistics for seasonal flu (something you rarely see in news reports). On average, the annual seasonal flu statistics in the US read as such: 5-20% of the population contracts the flu, more than 200,000 people are hospitalized from flu-related complications, and approximately 36,000 people die from flu-related causes. Even extrapolated to encompass an entire year, the 2009 H1N1 data don’t come close to these numbers. As for mortality rate, 2009 H1N1 has the edge (0.6% versus the seasonal flu’s 0.06-0.2%), although a larger H1N1 sample size would be preferred.
Additionally, there is new panic over the fact that the WHO has categorized 2009 H1N1 as a “phase 6 pandemic.” Of course, most stories don’t define what this entails, probably because “sustained community outbreaks in two or more countries in one WHO region, as well as outbreaks in at least one other country in another WHO region” doesn’t have the same headline appeal as “PANDEMIC!” Many people also fail to realize that prevalence is not synonymous with severity/mortality, and that the WHO has only characterized the 2009 H1N1 pandemic as “moderate.” This means most people recover without medical intervention and national levels of severe illness are by-and-large similar to levels seen during seasonal flu periods.
So maybe 2009 H1N1 isn’t the Biosafety Level 4 threat that the media would have us believe. Yet, panic tactics have been instrumental in the outpour of money and resources towards the development and soon-to-come distribution of the 2009 H1N1 vaccine. (Just hurry up with those clinical tests, folks, because we need this NOW!) Now, I’m certainly not trying to be a fearmonger regarding the new H1N1 vaccine – using tried-and-true flu vaccine development methods, I’m sure that scientists have gotten it right. However, I do think that between vaccine paranoia and fear-induced vaccination enthusiasm, there must exist a middle ground of reasonable caution.
In due course, vaccines should pass clinical trials – including follow-ups on patients months or years later – with flying colors. After that point, people would be erroneous to suspect some health agency conspiracy to get the nation’s children sick with diabolical vaccines. On the other hand, please don’t shove the new H1N1 down my throat, shrouded in a lozenge of medical hyperbole and dire consequences if I don’t get vaccinated the day after clinical trials are completed. Respect due course – take the time to test and perfect the dosage, the number of vaccinations needed, the interactions with the seasonal flu vaccine, and then get back to me. Give the H1N1 vaccine the same treatment as all of those great vaccines that came before it. In the meantime, I guess I’ll take my chances with the evil Swine Flu.