Much ado about swine flu

Distribution of the H1N1 flu vaccine began yesterday amidst a swirl of fanfare and controversy. This vaccine, which specifically targets the dreaded "swine flu," is taken in conjunction with a seasonal flu shot. I'm not big on fad vaccinations; I eluded SARS and the avian flu and I'm similarly unconcerned about a sudden outbreak of bubonic plague or the Vidiian Phage. I even survived twelve years of grade school without a "cooties shot." So ordinarily I wouldn't be paying much attention to the raging brouhaha. The wrinkle is that New York has become the first--and so far the only--state in the country to make the H1N1 vaccine mandatory for all healthcare workers.

My principal concern is that the vaccine has not been adequately tested. No one really knows if the vaccine works or if it is safe. As one classmate, a former combat medic, put it, "They haven't even tested it on the Army yet, and they test everything on us." There was a swine flu vaccine in the 1970's, but problems arose when people began dying from it. Presumably that shortcoming has been corrected with this new batch of vaccines, but new ones have arisen to take its place. The nephew of one of my lab instructors received the new vaccine and promptly developed Herpes zoster (which is distinct from but related to the venereal disease).

The outbreak of Spanish Influenza in 1918 killed upwards of 50-100 million people. One of the major contributing factors to this astronomically high death toll was a lack of appropriate public health response. Nearly a century later, epidemiological knowledge has progressed by leaps and bounds and proactivity is a major weapon in the public health officer's mitigation arsenal. Mass-producing a vaccine with which to protect the population is a responsible and sound decision.

I fear, however, that overzealousness has led to undue haste in the development and approval of this vaccine. No doubt the scientists working on the vaccine were under tremendous pressure to have the final product ready to go in time for "flu season," and the vaccine approval personnel were similarly motivated to put a product on the market. I find it impossible to believe that the H1N1 vaccine was developed and tested with the rigor, longevity and a scrutiny that a less "important" product would have received. (The volume of drug recalls in recent months has also shaken my faith in the entire approval process, but that's a different story.)

If I had a choice, I would not receive the H1N1 vaccine and I disagree with New York State's decision to make vaccination mandatory. The vaccine is available in all fifty states, but the other forty nine are leaving the decision to the individual providers. Surely the Department of Health must realize they're missing something everybody else can see? Nevertheless, I am an EMT and EMTs have to receive the H1N1 vaccine. So bring it on. But please hold the Herpes.