On Swine Flu Vaccination

On Swine Flu Vaccination Dr. Michael Raucci

There seems to be quite a bit of false perceptions, misunderstandings, and misleading propaganda circulating in the United States regarding the swine flu vaccination. To start off, I plan to be vaccinated and plan to have my children vaccinated against the H1N1 swine flu. We have already been vaccinated against the seasonal flu.

Why? There are a lot of factors that go into making every medical decision. They include: religious beliefs, medical history, state of mind, quality of life, diagnosis, treatment options, personal desires and probabilities. The most important of these to consider is probabilities, but it is also the least understood and the least utilized by the average person. Probability refers to the odds or the percentages. What is the likelihood of contracting a disease or disorder, what is the likelihood of different outcomes of that disease or disorder, and what is the success or failure rate of various treatments.

While it sounds insensitive and inappropriate, healthcare is a lot like gambling. If you already have a disease and you must decide on whether to embark on a particular treatment, you should want to know the probability that the treatment will work, the probability of various side effects, and the probability of iatrogenic complications such as death. If you have a mild, intermittently symptomatic gout, you might opt not to take the medication, allopurinal, for it, because of the high incidence of liver problems associated with long term use. You might instead choose to simply limit the purines in your diet. Conversely, if you have pancreatic cancer with only a 5% chance of surviving 2 years you might choose treatments with high complication rates such as the Whipple Procedure. In essence, you are gambling. In fact, when a patient asks me when I think they should have surgery, my response is when the potential benefits of the surgery outweigh the risks. Essentially, when the odds are in their favor. It is similar to the decision process someone undertakes when determining whether or not to take another card in blackjack. If you are sitting on eleven, it’s a no brainer, but if you have 16 or 17 the decision becomes more difficult.

Getting back to flu shots, the seasonal flu typically kills about 40,000 Americans each year with a relatively low communicability potential because of latent immunity through the population. Most of those who die have immune system compromise of some sort. Complications from the seasonal flu shot is nearly zero. The current H1N1 swine flu virus, a combination of genetic material from humans, birds and pigs, is new to the human population and could have a communicability rate as high as 90%. With an infection rate this high and extrapolating from seasonal flu mortality rates, the death toll from the swine flu could easily be hundreds of thousands of people in the United States alone, despite its typically mild symptoms.

In 1918, a swine flu outbreak occurred with relatively mild symptoms and low mortality in the Spring. When it resurged in the Fall and Winter of the same year a mutated form killed 60 million people. Mutation of the current H1N1 virus to a more virulent form remains a possibility. At this point, approximately 40 million people have received the H1N1 vaccination with no serious side effects. It is manufactured in exactly the same way as the seasonal flu vaccine which also carries a low side effects rate. If the H1N1 virus were to mutate it could produce death rates equivalent to or exceeding the 1918 rates in the un-vaccinated.

The odds of someone contracting the H1N1 swine flu are high. In its current form, the odds are that those infected will suffer and be unproductive for one week at a cost of billions to the economy. A small percentage will suffer grievous outcomes including death. The H1N1 vaccination appears to carry no serious side effects unless someone is allergic to components of the vaccine (Most of those people are aware of their allergies and they represent a small percentage of the population).

Based on this it seems to me that the with a high infection rate, the possibility of grievous outcome, the likelihood of loss of wages, and a substantially low complication rate for the vaccine it is mathematically favorable to receive the H1N1 vaccination.

Recently, someone insisted to me that getting the seasonal flu shot would give them partial protection from the swine flu. This is absolutely false and is equivalent to someone saying that getting the measles shot protects them from chicken pox. I have also heard people, conspiracy theorists, state that the vaccination is designed to kill and depopulate parts of the globe. You’ve got to be kidding me. Finally, some people believe that vaccinations cause autism. To date there is nothing but anecdotal evidence of such and repeated inquiries have shown this to be false. Vaccinations overall have been an overwhelming success story. Where do you think polio, measles, mumps, rubella, and pertussis have gone. Did they go away on their own. No, they were eradicated by vaccination programs, saving millions of lives in the process. In areas where vaccination has not been employed, these diseases continue to infect, maim, and kill people. Some people have chosen not to have their own children immunized against the above mentioned diseases and then point to them and say, “See, they didn’t get it.” This is called herd immunity. They don’t get the disease because the rest of us got the vaccination thereby reducing the points of transmission. A certain amount of skepticism towards the medical establishment is healthy, especially given its links to the profit driven pharmaceutical industry, but by and large their goals are to care for and heal those in need.

Swine flu and seasonal flu vaccination is not mandated, it is a choice. It is crucial that individuals collect the information, particularly scientific data, and make an informed decision based on facts. Individual anecdotal stories and cries of conspiracy might perk our interest but they should not be part of the decision making process.