H1N1 vaccine makers & The WHO are being Investigated

I heard recently from the news that the second wave of H1N1 has been declared over in Canada. To be honest, we haven't seen too many concerned patients clamouring for H1N1 treatments or for information regarding the vaccine since the initial scare. The Canadian government had ordered enough vaccines for every single Canadian. As a result of the low vaccination rates, I believe we ended up donating much of the vaccines to other countries.

I haven't had to answer an H1N1 question for so long, but two interesting notes came to my attention this week.

1) A patient here at the clinic (who reads European & Russian newspapers) informed us that there were big investigations getting started in Europe regarding the involvement of the pharmaceutical industry's reach and their ability to influence the World Health Organization. That sounded far-fetched to me (as I'm not one to believe in conspiracy theories). But it appears that an inquiry is being launched. This is news that has yet to appear here in North America. You can read more about this here.

2) Apparently pregnant women in Hong Kong have stopped getting the H1N1 vaccine. This has happened as news of 3 fetal deaths occurring in the last month after women received the H1N1 shot. I believe that at least one of these women had an underlying complication.

Frankly, I don't know enough about what's happening in Asian or Europe to make a well-informed commentary, but for those of you who would like to do further research, send me an email or links for what you find and I'll try to post relevant information for our readers.

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

Update: H1N1 & Flu Vaccinations - should we or shouldn't we? Pros & Cons

In light of the recent death of a 13 year old boy in Toronto, I've gotten a lot of questions about whether we should vaccinate. Should we vaccinate for H1N1? Seasonal flu shots?

The public is looking for answers and unfortunately I cannot make that decision for you. I do understand your frustration though with so many conflicting points of views, what is one to think. There are possible pros and cons (some theoretical & some not) for getting the vaccine(s) and for not getting the vaccine(s). Parents and individuals need to sift through this information and be at peace with the decision that they make.

Hopefully I can shed some light on this topic.

Dual flu & H1N1 vaccinations:
Ontario and a few other provinces have decided to separate the two and in Ontario, public health officials have decided to delay the seasonal flu vaccine in light of some preliminary (Cdn) data showing that those who received the seasonal flu shot last year had an increased risk of contracting H1N1. In addition, the seasonal flu does not usually lead to fatalities in healthy adults and the young.

Pros & Cons of H1N1 vaccinations:

PROS

• H1N1 can affect certain segments of the population more severely than the seasonal flu (ie. pregnant women, young children). The elderly and immunocompromised individuals have always been at greater risk of complications from the seasonal flu virus.
• Technically, this vaccine should be more effective than the seasonal flu shot because there is no guess work involved as to which strains should be used. In the past few years, the seasonal flu shot has been largely ineffective. To be fair, the "gold standard" of evidence-based double-blind placebo control trial studies, that are often lacking from natural therapies (and thus used by many to dissuade people from using natural medicine), are not really used to test flu vaccines. If you go to the CBC article that I have linked below, you can read about what Dr. Jim Wright from the University of British Columbia has to say about this.
  

CONS

• Preservatives/adjuvants (ie. thimerosol, squalene) are in the vaccines being given out. Only pregnant women are being given adjuvant-free vaccines. There is debate about whether these pose any risk.
  
• Some people believe that the H1N1 vaccines were rushed to production and not enough research has been done on them. However, to be fair, the same process used to create seasonal flu shots were used for the H1N1 vaccines so if you have/don't have concerns about the seasonal flu shot, then those same arguments for or against still hold for the H1N1 vaccine.
• One con in general regarding vaccines (1 in one million) is the risk of contracting Guillain-Barre Syndrome (GBS), where certain neurological symptoms appear.
• People with egg allergies should not get the flu shot
• This vaccine is not recommended for children less than 6 months old
  
• Many believe that the swine flu risks have been exaggerated and the statistics seem to indicate that so far. In fact, the World Health Organization (WHO) states that 250 000 - 500 000 people die every year from influenza (seasonal) vs. 5000 deaths this year to H1N1. CBS recently ran a story stating that "the swine flu cases were seriously overestimated." Most people who do get the swine flu will recover. Unfortunately, we are in an age of constant media where we see the worst case scenarios all the time. Having said that, even though the risks are low these worst-case scenarios are present. The CBC recently ran two worst-case scenario stories: 1) the death of the 13 year old boy 2) a gentleman who got GBS from the flu shot and has had complications with his health ever since.

Many families are split on this topic. Dr. Oz (who has somehow become the guru of complementary medicine) has stated that he will vaccinate himself, whereas his wife has refused the vaccination for herself and their children. In the end, you need to make a decision that you are comfortable with and can live with.

Other things to Note

Statistics seem to indicate that many people born before 1957 already have immunity to the H1N1 swine flu as scientists hypothesize that the kind of flu that infected individuals before this date was more like the swine flu. The H1N1 virus was the culprit in the 1918 flu pandemic and continued to circulate in the population til 1957, when an H2N2 virus displaced it as the dominant virus.

Health Canada's full description of the H1N1 vaccine by GlaxoSmithKline can be found here. This is a must read if you want to form your own opinions. It's pretty frank and quite thorough. Hope you like science!

I found this CBC article to be pretty informative. Dr. Jim Wright at the University of British Columbia makes an interesting point.

If you want to read about the "anti-vaccine" side, you will want to read Dr. Tom Jefferson, MD interview.

A list of vaccine clinics in Peel Region & Toronto. You can even check wait times. If you're not in one of the at risk groups, please let pregnant women, health care workers, the elderly and parents with kids go first. There's nothing worse than seeing a pregnant lady or an elderly person waiting in line for 4-6 hrs with no place to rest.

Naturopathic Perspective

There are many people who consider themselves healthy because they have no overt signs & symptoms of disease. But I often tell my patients that health is more than the absence of disease. A person who isn't sleeping properly or has a poor diet and is under constant stress is not in a healthy state of being. If you fall in this category, you are definitely putting yourself at greater risk of contracting the flu. Make sure that you're doing everything you can to optimize your health. Naturopathic doctors can certainly help you with this and have many tools to help you should you fall ill.

Important Warning Signs you should be Aware of

The U.S. Centers for Disease Control says patients showing these symptoms should seek medical care immediately.

CHILDREN: Fast or troubled breathing; skin turning bluish; not drinking enough fluids; being unusually hard to wake up or not interacting; being so irritable that the child doesn't want to be held, flu-like symptoms improve but then return with fever and worse cough; fever with a rash.

ADULTS: Difficulty breathing or shortness of breath; pain or pressure in the chest or abdomen; severe or persistent vomiting; sudden dizziness; confusion.

Know the Difference between a Cold and H1N1 Flu Symptoms

Symptom	Cold	H1N1 Flu
Fever	Fever is rare with a cold.	Fever is usually present with the flu in up to 80% of all flu cases. A temperature of 100°F or higher for 3 to 4 days is associated with the H1N1 flu.
Coughing	A hacking, productive (mucus- producing) cough is often present with a cold.	A non-productive (non-mucus producing) cough is usually present with the H1N1 flu (sometimes referred to as dry cough).
Aches	Slight body aches and pains can be part of a cold.	Severe aches and pains are common with the H1N1 flu.
Stuffy Nose	Stuffy nose is commonly present with a cold and typically resolves spontaneously within a week.	Stuffy nose is not commonly present with the H1N1 flu.
Chills	Chills are uncommon with a cold.	60% of people who have the H1N1 flu experience chills.
Tiredness	Tiredness is fairly mild with a cold.	Tiredness is moderate to severe with the H1N1 flu.
Sneezing	Sneezing is commonly present with a cold.	Sneezing is not common with the H1N1 flu.
Sudden Symptoms	Cold symptoms tend to develop over a few days.	The H1N1 flu has a rapid onset within 3-6 hours. The flu hits hard and includes sudden symptoms like high fever, aches and pains.
Headache	A headache is fairly uncommon with a cold.	A headache is very common with the H1N1 flu, present in 80% of flu cases.
Nausea, Vomiting, Diarrhea	Nausea, vomiting and diarrhea are fairly uncommon with a cold	Nausea, vomiting and diarrhea are sometimes present in H1N1 flu.
Chest Discomfort	Chest discomfort is mild to moderate with a cold.	Chest discomfort is often severe with the H1N1 flu.

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

What we know about the cervical cancer vaccine (Gardasil) - 2 years later

The US Centers for Disease Control & the CBC have new updates about the controversial cervical cancer vaccine Gardasil. At the time of widespread implementation by public health authorities, many health care practitioners voiced concerns about the rush to vaccinate young girls as they felt that there was too little data to warrant such a move. Two years worth of data have now been collected and the data looks promising. Of course, we'll know more when even longer time horizons are gathered and analyzed. In science and medicine, I've found that a clear picture for adverse effects and safety develops when you look at long term data. Also, the public should know that adverse reporting of vaccines & drugs is done on a voluntary basis. There is no system in place to actually follow-up with patients after they have received a vaccine or started on a new drug regiment. It is usually at the discretion of a health care practitioner to report to the ministry of health any side effects which they may have spotted. Therefore, as a caveat, such data does not give us a complete picture.

Nonetheless, I would say from a public health perspective that the number of adverse reactions reported is minimal, unless of course you're one of those people who incurred a severe reaction from this vaccine.

In the US, 2.2 million doses of Gardasil was distributed in 2006 and 11.3 million in 2007. In all, 7802 adverse events were reported between June 2006 and April 2008. Seven percent of those who reported adverse events had serious side effects - the worse being 31 reported cases of Guillain Barre Syndrome, a condition that usually results in temporary paralysis and is often triggered by a vaccine injection. Fifteen deaths were reported to the FDA, and ten were confirmed. However, the CDC says none of the ten were linked to the vaccine. The seven percent of serious side effects is apparently half the average of what is normally seen with vaccines. Of course, over the long term, these statistics can change, but the results are promising thus far.

Gardasil was designed to protect women from four strains of Human Papillomavirus - types 6, 11, 16 & 18 - which are responsible for 70% of cervical cancer cases. HPV is transmitted through sexual contact and is reported to infect up to half of all sexually active women between 18 and 22. Cervical cancer is the second most common type of cancer for young women.