DOH must be prepared for vaccine problems
By Liu Pei-pai 劉培æŸÂ
Tuesday, Sep 01, 2009, Page 8
Department of Health (DOH) Minister Yaung Chih-liang (楊志良) said recently that we cannot directly link death after treatment with the vaccine for A(H1N1) influenza to the vaccine itself and that further studies are needed.
Since this involves the risks posed by vaccinations, the ministry should explain the risks to the public and take proper precautions.
Earlier last month, a New York Times editorial said the US government took a series of steps to prepare for a potential A(H1N1) pandemic. Public officials were instructed to stockpile antiviral drugs. When a swine flu case emerged in April, diagnostic kits to detect the virus were created for use nationwide and domestic companies were enrolled to make the vaccine.
In addition, the government signed contracts with several farmers in Pennsylvania and requisitioned their eggs to grow flu vaccine.
By the middle of next month, the US will have at least 80 million doses ready for a mass immunization program. It seems everything has proceeded smoothly and is under control.
However, the weakest link in this chain of preparations is the federal bureaucracy’s head-in-the-sand attitude toward explaining the risks of the vaccination program to the public, which may cause all those efforts to come to naught.
In Taiwan, this is reflected in the DOH’s torpor in informing the public of any risks posed by flu vaccine, despite repeated assurances that domestically produced flu vaccines are safe and effective.
Some risks posed by treatment with the flu vaccine are predictable.
The real controversy, however, will not appear until after the health authorities begin administering flu vaccinations on a large scale this fall and winter.
The DOH will issue 10 million doses of the vaccine, three times the number of people receiving seasonal influenza vaccines in previous years.
That being the case, the probabilities of side effects caused by the vaccine will increase significantly.
In 1976, one in 100,000 people in the US who received the H1N1 flu vaccine suffered from side effects, developing Guillain-Barre syndrome — a crippling nerve disorder that caused many deaths. Some academics argue that it might have been related to the antigen in vaccines or toxins in contaminated germs during the manufacturing process.
Will similar reactions be seen in Taiwan following the implementation of a mass vaccination program?
Statistically speaking, it is inevitable that some of the nearly 1 million people receiving vaccines this fall will become ill or die.
If anyone happens to get ill or die after being vaccinated, it will likely be the result of underlying health problems, although the vaccine will often be blamed.
For example, pregnant women infected with swine flu are four times more likely to become severely ill or die than ordinary people.
But statistics show that about one in seven pregnancies ends in a miscarriage. Thus, after pregnant women get the vaccine, a miscarriage may coincidentally happen. Some will likely attribute it to the vaccine.
Now that the DOH has given pregnant women priority for the future flu vaccine program, a major controversy could ensue.
If this were to happen, it would certainly turn into a political storm.
Public health officials should be prepared.
Liu Pei-pai is a former director of the Taiwan Animal Health Research Institute.
TRANSLATED BY TED YANG