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Tuesday, September 25, 2012

The Swine Flu Is Coming (again)

Tell us what you think. Are you going to get the Swine Flu shot or a regular flu shot or both? Neither?

By: Dr. Stephen G Chaney

We are again hearing reports of a possible swine flu pandemic. At this point several cases of swine flu have been reported. The individuals who came down with swine flu all had direct contact with pigs, and all of the cases have been mild so far.

However, we are being urged to get swine flu shots, and some of you have been asking my opinion. With that in mind, I am repeating the column I wrote several years ago at the height of the last swine flu epidemic.

“The swine flu vaccine will be available soon and many of you are asking me three questions:
Is it safe? Is it effective? Should I get swine flu shots?

There is a lot of hype on both sides of the issue, so let me give you some straight talk about safety and effectiveness so that you can use to make up your own mind about whether you want to get a swine flu shot.

Let’s talk about safety first.

You may have heard reports that both the British Health Protection Agency and the US Centers For Disease control have sent out letters to neurologists in Britain and the US asking them to look out for an increase in a brain disorder called Guillian-Barre Syndrome – and to notify their respective governments of all cases of this disease that they diagnose in patients that have received the swine flu shot.

Just in case you are not intimately acquainted with Guillian-Barre Syndrome, it is a disease that attacks the lining of the nerves, leaving them unable to transmit signals to the muscles. This can cause partial paralysis and, if it affects the lungs, can be fatal.

Now that sounds downright scary. But let me tell you the rest of the story. The concern of the British and US governments is based solely on the fact that a similar swine flu vaccine killed more people than it helped in the US in 1976.

Shortly after swine flu vaccinations started in 1976 people started coming down with Guillian-Barre Syndrome. By the time vaccinations were halted 10 weeks later, 500 people had developed the disease and 25 people had died – more than were killed by the virus itself.
It was estimated that one in 80,000 people who were given that swine flu shot developed Guillian-Barre Syndrome, compared to the one in a million who develop the disease when given most seasonal flu shots.

However, I want to emphasize that there is no direct evidence that the current swine flu shot increases the risk of Guillian-Barre Syndrome more than the regular seasonal flu shots.
The British and US governments simply view their warning letters to neurologists as a reasonable precaution under the circumstances.

In short, the risk of developing Guillian-Barre Syndrome or some other serious complication (miscarriages and sudden death are the other complications of most flu vaccines) from the swine flu shot is probably very, very small. It may be no greater than the one in a million chance of developing the disease that is associated with most flu vaccines – but it is not zero.

Now let’s turn to the issue of effectiveness.

There are several things that you should know about the effectiveness of the swine flu shot.
In the first place, there has been an active debate in the scientific community as to whether one shot or two shots will be required to give adequate protection against the swine flu.

Some scientists still think that two shots would be the better option. However, stocks of swine flu vaccine are limited so the recommendation is probably going to be for one shot so that as many people can be immunized as possible.

Secondly, you should know that the swine flu vaccine offers no protection against the seasonal flu and vice versa. Since both strains of flu will be around this fall & winter you need to be vaccinated against both if you really want to avoid the flu.

Finally, there is an interesting age distribution in regard to the susceptibility to the swine flu. It turns out that it is the young people who are most susceptible to the swine flu.

Those of us who are over 50 were apparently exposed to something similar to the current swine flu virus in the past, so we have some residual immunity.

That’s important because it turns out that the swine flu virus is no more deadly than the usual seasonal flu virus. What that means is that the age group that is most susceptible to the swine flu is also the age group for which the swine flu is most likely to be merely a 3 to 5 day inconvenience.

However, there are people for whom the swine flu, or any other type of flu, can be deadly. The people at highest risk are young children, pregnant women, the elderly, people with compromised immune systems, and people with pre-existing diseases like diabetes.

And here’s the interesting part. These are also the people for whom the flu shot is not very effective. The best way to protect these people is to immunize everybody else so that they never get exposed.

The bottom line is that most immunizations make great sense from a public health perspective to protect high risk individuals, which is why they are so strongly supported by the medical community.

However, for healthy individuals with strong immune systems and no pre-existing diseases the risk-benefit ratios are a not so clear cut. Sometimes the risks can outweigh the benefits.

That brings me to the last question – should you get a swine flu shot?

If you are a healthy individual that is a very personal decision, and I won’t presume to make it for you. I’ve just given you some facts that you may not have known about to ponder as you make that decision.

For people who are at risk for developing severe complications from the swine flu itself (young children, pregnant women, the elderly, people with compromised immune systems, and people with pre-existing diseases like diabetes) this is a decision that you should make in consultation with your physician.”

To Your Health! 
Dr. Stephen G Chaney

About the Author:
Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He currently holds the rank of Professor at a major university where runs an active cancer research program and has published over 100 scientific articles and reviews in peer-reviewed scientific journals.

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