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Why some people will say no to the H1N1 vaccine

Although reports from the state health department indicate that the most recent wave of H1N1-related illnesses may be cresting, no one knows for certain when the H1N1 vaccine will be produced in sufficient quantities to be available to most people. But when it finally does arrive, a recent McClatchy-Ipsos poll suggests, many Americans won't take advantage of the vaccine.

The poll found that 47 percent of Americans reported they weren't "at all likely" or weren't "very likely" to get vaccinated.
 
Doug Schultz, a spokesperson for the Minnesota Department of Health, says that number's a little higher than some of the poll numbers he's seen, which suggest that 30 to 40 percent of people will say "no thank you" to the H1 N1 vaccine. But he noted that these kinds of polls are often hard to interpret for a variety of reasons, and that it's difficult to predict public demand for a vaccine.


"It really depends on a lot of things: how they perceive the supply, if they perceive that there's going to be a lot of disease or not, and how they perceive their risk," Schultz explained.

It's easy to understand that one's willingness to be vaccinated would be proportionate to the perceived threat, but it's been difficult for many to gauge how threatening this pandemic virus really is. Certainly the possibility of getting infected with H1N1 is very high, with the number of cases nationally and globally already being far in excess of any typical flu season.
 
But is the H1N1 virus more virulent, more deadly than the standard seasonal virus? According to the U.S. Centers for Disease Control and Prevention, seasonal influenza kills about 36,000 Americans every year. Despite widespread flu activity, as of now, there have been 3,900 H1N1-related deaths in the United States.
 
Comparing those two numbers (and conceding that the flu season is hardly over), why is it that H1N1 feels so much more virulent? Yes, the sheer volume of H1N1 infections has been taxing and in some cases overwhelming to our health care system. But it may not be the number of people who are dying, but rather who those people are that's the most disturbing.
 
With seasonal influenza, over 90 percent of deaths and about 60 percent of hospitalizations occur in people older than 65. But that's not been the case at all with H1N1. Because many older folks have immunity against the novel virus from exposure to similar flu viruses in their youth, the elderly have been relatively spared, and the most serious H1N1 infections have primarily involved pregnant women, healthy young people from birth through age 24, adults 25 to 64 with underlying medical conditions, and children under 5 years of age, particularly if they have a high risk medical condition.
 
No life is more valuable than another, but an octogenarian passing away in the nursing home won't make the evening news, and the death of a pregnant woman certainly will. The death of a healthy 17-year-old just feels more tragic, and it understandably generates the kind of worry that would make for vaccination lines of unprecedented length. The results of the McClatchy-Ipsos poll—nearly half the country saying they don't plan on getting vaccinated—seem to argue against that, but conversely, the H1N1 threat led to an early season run on this year's seasonal influenza vaccination. "That's because people perceived there might be a scarcity," Schultz explained, "so it's like 'Get it now before it's all gone.'"
 
Whatever one's personal perception of the H1N1 threat is, there seems to be several factors at work for those who won't be getting in line for the H1N1 vaccine.
 
'Because H1 N1 is a new virus, no one really knows how the vaccine will act'

Yes, it's true that H1 N1 is a new strain of the influenza virus, but every year the standard flu vaccine is updated to contain the most active strains from the previous year's flu season, plus any newly identified strains. So yes, H1N1 is a novel strain of virus, but beyond that, everything is just standard procedure: the vaccine is produced in the same (antiquated and slow) manner, with the same protocols and safety measures.
 
There's also some public sense that for the sake of immediacy, the H1N1 vaccine has been slapped together and hurried through. That certainly isn't the case, but if the vaccine were indeed being fast-tracked, then why in the world is it taking so long?
 
Understand that early trials and ongoing analysis of the vaccine show it to be safe and effective.
 
'What about the problem with the swine flu vaccine in the mid-1970s? Couldn't that happen again?'

In 1976, a swine flu variant capable of infecting humans was identified, and a vaccine developed against the virus carried a 1 in 100,000 risk of getting a rare but potentially serious neurological disorder called Guillain-Barré syndrome (GBS). That risk was slightly higher than what is seen in the general population, where the most common trigger for GBS is an infection from food contaminated with a bacteria called Campylobacter jejuni. Infectious mononucleosis ("mono") can rarely be a trigger as well.
 
Though the link between 1976 swine flu vaccine and Guillain-Barre Syndrome is real, as often happens with history, the risk of one leading to the other has become mythic and exaggerated. According to the CDC, numerous studies with yearly flu vaccines given since 1976 have shown no association with GBS, with the exception of two studies which suggested that approximately 1 additional person out of 1 million vaccinated against seasonal influenza people may be at risk for GBS.

Driving being the risk it is, you're probably putting yourself more in more danger by popping out to the local store for a gallon of milk than by getting the flu vaccine. In any case, the CDC and the FDA are well aware of this perceived threat, and intensive monitoring of those who have received the H1N1 vaccine has shown no such risk.

But what about mercury? Doesn't the flu vaccine contain mercury?

The subject in question is thimerosal, a mercury-containing preservative that's added to multi-dose vials to prevent contamination with bacteria and fungi. A limited number of thimerosal-free single-dose vials have been available to pregnant women, but not to the rest of us.

One shot of a standard, injectable flu vaccine contains about 25 mcg of mercury. Desperately trying to put that number into perspective, I set out to quantify it in terms of our state's most recognizable currency: the walleye. Even here in the land of sky blue waters, all fish contain mercury — some more, some less, depending on the age and size of the fish and where it is perched on the fishy food chain.

The Minnesota Department of Health recommends we eat walleye just once a week to limit our mercury exposure. And when I read on an immunization website that most commercial fish contain an average of 23 micrograms of mercury per 8 ounces of fish, I thought I had my sensationalist headline: "Walleye can't save your life, but H1N1 vaccine can!"

Not so fast, says Pat McCann, a researcher of the health effects of environmental mercury for the Minnesota Department of Health.

"The mercury that's in fish is methyl mercury, and the mercury that's in thimerasol is ethyl mercury," McCann explained. "So we really try to stay away from making the comparison between getting the flu shot and eating a meal of fish, because it's not really a direct comparison as far as the dose you get. Mercury isn't just mercury. It has different forms and the form makes a difference as far as toxicity."

OK, so my walleye-to-vaccine mercury comparison "spit the hook," as they say. That's just as well, because the CDC would argue that the comparison is not only imbalanced but also moot. The CDC website states: "The most recent and rigorous scientific research does not support the hypothesis that thimerosal-containing vaccines are harmful." Nevertheless, with thimerosal taking on arsenic qualities in the public eye, the FDA and the CDC took the unusual step of ignoring the science and pulling the preservative (except in trace amounts in some cases) out of all vaccines for children under the age of 6. The CDC describes this move as a "precautionary step," which is a pragmatic way of saying that a vaccine can't prevent anything when it's lying on the shelf. Hurdles, real or imagined, must be removed.

'I already had H1N1: Why would I need to get vaccinated?'

Perhaps the best reason to not get vaccinated against the H1N1 virus is as simple as, "No thank you, I had the real thing." Indeed, an actual infection with a particular contagion is a more potent stimulator of our immune system than a vaccine is. So if you've already been infected with H1N1, why bother with the shot in the arm? 
 
According to Schultz, the MDH is following CDC guidance on this issue. "Unless you've had a culture-confirmed case of H1N1 — which basically would mean anybody hospitalized with H1N1 — you don't really know for sure whether you've had H1N1," Schultz noted. "And so it would make sense to get the vaccine, because the vaccine is safe, and then you would know that you're protected."
 
"Obviously, we recognize that some people will naturally assume that they have had H1N1. If their symptoms were very characteristically influenza, and if they had it during the peak, there's a good chance they had H1N1," Schultz reasoned.

But without confirmatory testing, one can't be absolutely sure. "Our advice is to be safe," Schultz said, "and the best bet is to get the vaccine."
 
When it arrives. Whenever that is.

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Comments (14)

"why is it that H1N1 feels so much more virulent"

One word, media.

In the paragraph that discussed the inappropriateness of comparing ethyl mercury to methyl mercury, right after the sentence "It has different forms and the form makes a difference as far as toxicity," I was expecting to find out which was more toxic, but I was left hanging.

We're only hearing the side of the vaccine promoters here.
The mercury-based preservative thimerosal doesn't represent the same danger as a eating a piece of fish; it's far worse.
Dr. Thomas Burbacher at the U of WA has done the research that show's it's more toxic to the brain than methyl mercury.
Thimerosal was never tested or approved by the FDA. The drug company Eli Lilly invented it and they said it was safe.
The government just went along with their claim. The government has lots and lots of pharma-funded population studies showing
it's safe but I've never seen a toxicologist backing them up.

Eighty percent of the regular flu shot has toxic mercury. The H1N1 vaccine will only add to the mercury load. With the annual flu vaccine a child from 6 months to age three receiving a flu vaccine gets 12.5 mcg of mercury. This amount of mercury can be processed only by someone weighing 275 pounds according to the EPA. One month later, another 12.5 booster is recommended. Older children receive the adult vaccine with 25 mcg of mercury. That much mercury is meant for someone weighing 550 pounds according to the EPA. The trials supposedly show the H1N1 vaccine to be safe, yet THE TRIAL VACCINES WERE WITHOUT THIMEROSAL!

Finally, according to the package inserts, the manufacturers of the flu vaccine DO NOT RECOMMEND THEM FOR PREGNANT WOMEN. So why do doctors?
http://www.safeminds.org/about/documents/SM%20Flu%20Brochure%202009-2010...

Anne Dachel
Age of Autism http://www.ageofautism.com/

The H1N1 flu vaccine has not been tested in pregnant women who were followed long enough to see whether harm was caused to their fetus. None of the flu vaccines have had clinical studies to determine whether offspring of women who were pregnant when they received a flu vaccine are harmed. (The CDC lists only one such study, but that study was in the 1960s and looking only for malignancies). The package inserts on all of the flu vaccines give the caution that it is not known whether it is safe for pregnant women.

In addition, the flu vaccines are never tested on people who have underlying health issues - those folks are screened out from the clinical studies and all test subjects are healthy. So it is not known whether it is safe for people with immune system problems such as asthma, lupus, etc, to receive the vaccine.

But a 2009 study from the Mayo Clinic on children receiving the flu vaccine found that those receiving the vaccine were three times more likely to be hospitalized that year for influenza-like illnesses than those children who did not receive the flu vaccine. And among those children with asthma, the discrepancy was even higher.

Every time the subject of mercury in vaccines comes up there is a comparison between fish and vaccines. The mercury in fish is injested through the digestive system, where it may or may NOT be absorbed into the body.
The mercury in vaccines is injected directly into the blood stream without a chance of any of it passing through.
If you were to see a vial of Thimerosal, it would have a poison label on the side, complete with skull and crossbones.
And what about children? Most children under two or three years old don't eat fish.

How can a medical professional even suggest injecting one of the most lethal elements on earth into a human body?
Doctor's still adhere to the Hippocratic Oath, don't they?
The oath reads in part;
I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan.

#1, H1N1 is more virulent for younger age groups and less virulent for older age groups. That's a statistical measure. Unusually, it has been affecting younger people disproportionality to older people, who are thought to have been previously exposed to a similar strain of influenza. Virulence is a combination of the genetics of the virus, genetics of the humans in a population, and previous exposure. Virus genes are recombining and shifting all the time, so we cannot predict what will happen next year or the year after. (The human genetic makeup is also shifting, but many more decades instead of hours per generation.) After enough people are exposed to or vaccinated for H1N1, its current genetic configuration will become generally "less virulent."

#3, I checked Dr. Burbacher's original paper on ethylmercury. "More toxic to the brain" was not the conclusion of the study. His lab demonstrated in primate studies that while ethylmercury was excreted from the bloodstream more quickly than methylmercury, for the same dosage, a larger fraction remained in the brains of the macaque monkeys, where it was converted to potentially harmful inorganic compounds. The study drew no conclusions about the relative toxicity of the two mercury compounds. The conclusion of the study was that because the two compounds are taken up differently, methylmercury was likely an unsuitable benchmark for evaluating the less-understood ethylmercury toxicity (Wikipedia.org has a nontechnical summary as well as a link to the original paper--search for Thomas Burbacher). I don't question the merit of your advocacy, but scientists (at least) listen better when scientific data isn't stretched to fit the thesis.

It makes absolutely no sense to inject Thimerosal, a known neurotoxin, into children and pregnant women.

First, mercury kills brain cells. See http://www.mindfully.org/Health/Mercurcy-Exposure-Nerves.htm and http://www.youtube.com/watch?v=lCzT1yuau_4 .

Second, The USEPA limits are 0.1 microgram per kg body weight per day. This means that a child receiving a flu shot would have to weigh 550 pounds not to exceed the EPA guideline for that day.

Third, as Maya et al. states, “Thimerosal … separates in the organism in ethylmercury and thiosalicylate, being a highly unstable chemical composition. Due to its great liposolubility, it can easily cross the blood-brain and placental barriers, exhibiting a short time of half-life in the blood. It can deposit itself in the central nervous system, where subsequently it is transformed into inorganic Hg, which accumulates in the human and animal brain, showing a half-life between 227 and 540 days.” See Maya et al, “Thimerosal and Children’s Neurodevelopmental Disorders” page 10 at http://www.safeminds.org/research/AnFacMedLima2006-67(3).pdf

Fourth, based on animal test data, elemental mercury in the brain results from Thimerosal injections.
Burbacher et al gave infant monkeys shots with Thimerosal--with the same mercury weight per body weight, on average, as received by human infants. This study reported that the percentage of elemental mercury that winds up in the brain is about five times higher from ethylmercury than from methymercury exposure. “A higher percentage of the total Hg in the brain was in the form of inorganic Hg for the thimerosal-exposed monkeys (34% vs. 7%).” And “The inorganic form of Hg was readily measurable in the brain of the thimerosal-exposed infants. The average concentration of inorganic Hg did not change across the 28 days of washout and was approximately 16 nanograms per milliliter.” See http://www.ehponline.org/members/2005/7712/7712.pdf

Finally, no one should give a child or pregnant woman a half cup of mercury hazardous waste liquid to drink. And yet there are 25 micrograms of mercury in each flu shot that uses Thimerosal as a preservative. And a half cup of water (4 ounces) with that much mercury has 0.2114 parts per million mercury and is considered a hazardous waste by the USEPA. http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?TITLE=40&PART=261&SE...

A large collection of Thimerosal toxicity studies has been amassed by mercury researcher Boyd E. Haley, PhD, former chemistry chair at the University of Kentucky.
http://www.iaomt.org/testfoundation/thimerosal.htm

Also see this 2006 study summary, "UC Davis Study Links Thimerosal With Immune System Dysfunction."
http://www.universityofcalifornia.edu/news/article/7973

For a constructive, forward-thinking public health policy statement, read "Vaccines, Thimerosal and Other Potential Environmental Causes of Autism" from the UC Davis M.I.N.D. Institute.
http://www.ucdmc.ucdavis.edu/mindinstitute/newsroom/vaccineposition.html

Currently the CDC's vaccine injury policy is denial, denial, denial, rather than study, treat, and prevent. Loss of trust is a vaccine consumer's logical response; hype and bullying must be replaced by ethics, compassion, and the precautionary principle over profits.

I appreciate all of the above comments, but time precludes a thorough response to what is obviously a complex and contentious issue. A few thoughts:

I am no fan of the myriad of, for lack of a better word, "unnatural"/concocted chemicals that have found there way into our bodies and our environment. The story of the chemical and pharmaceutical revolution has been told in rapturous tones, with little attention to the problems each has generated.

In 2004 the journal Pediatrics had a review of thimerosal and autism:
http://pediatrics.aappublications.org/cgi/content/abstract/114/3/793

Anyone dealing directly or indirectly with autism has my sincerest empathy. We should do whatever we can to find and eliminate whatever is causing it.

Regarding the 2004 the journal Pediatrics review of thimerosal and autism, the Burbacher et al 2005 study is not in it.

And the Pediatrics report (2004 review) is extremely misleading. For instance on page 801 it states “No standards exist for an ‘instantaneous,’ single-day dosage of ethylmercury delivered by intramuscular injection.” This statement is an (unintended) admission, by the authors of this report, of the thimerosal problem. No one has a clue as to a safe standard, using numeric criteria, for injecting it into children and pregnant women.

And the authors say “Removal of thimerosal as a preservative has resulted in the use of single-dose vials that are more expensive and increases the need for refrigerator space and other cold chain equipment.” This unbelievable! Mercury is regulated at a level 25 times lower than lead in USEPA hazardous waste standards. The number of nanograms of mercury per milliliter of brain tissue from vaccine injections should be Zero! See http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?TITLE=40&PART=261&SE...

Regarding the conclusion in the 2004 review “The evidence reviewed here indicates there is no
association between thimerosal-containing vaccines and NDDs, including autism.” That is just not true. The authors hope no one reads the references. In terms of discussing mercury injected into children and pregnant women the approach should always be "first, do no harm." Just don’t do it.

Please read David Kirby’s book Evidence of Harm and then read about the Simpsonwood Conference in 2000 and the vaccine risk cover-up by CDC staff members.

And then read Bernard et al, and Geier et al and simpsonwood transcripts (these are listed in reference section of the 2004 report).

“When I saw this, and I went back through the literature, I was actually stunned by what I saw because I thought it is plausible.” See page 161 of the Simpsonwood Transcript.

See the Simpsonwood transcripts at http://www.autismhelpforyou.com/HG%20IN%20VACCINES%20-%20Simpsonwood%20-... .

Finally, Dr. Bowron, thank you for your openness, kind words, and consideration of our children.

Here are three more links regarding the CDC staff thimerosal risk coverup of 2000.

http://www.putchildrenfirst.org/media/2.20.pdf (40kB)

http://www.putchildrenfirst.org/media/2.7.pdf (87kB)

http://www.putchildrenfirst.org/media/2.9.pdf (11.5 MB - with pages numbered)

Here are two quotes from the last link, the Simpsonwood conference of 2000.

“The number of dose related relationships are linear and statistically significant. You can play with this all you want. They are linear. They are statistically significant. The positive relationships are those that one might expect from the Faeroe Islands studies. They are also related to those data we do have on experimental animal data and similar to the neurodevelopmental tox data on other substances, so that I think you can't accept that this is out of the ordinary. It isn't out of the ordinary. The Seychelles Island studies, and somebody said the Faeroe Island studies both, were chronic exposures. We are not talking necessarily about chronic exposure. We are talking about a series of acute exposures and at one point in time that exposure is much greater on that one day than any of the Seychelles Islands.”

Page 207, Dr. Bill Weil, American Academy of Pediatrics, Committee on Environmental Health

“We have been privileged so far that given the sensitivity of information, we have been able to manage to keep it out of, let's say, less responsible hands, yet the nature of kind of proliferation and Xerox machines being what they are, the risk of that changes.” Page 256, Dr. Bob Chen, Chief of Vaccine Safety and Development at the National Immunization Program at CDC, at http://www.putchildrenfirst.org/media/2.9.pdf

The linear relationship that Dr. Weil was talking about is basically an approximate straight line relationship between Autism with Thimerosal dosage. Essentially, autism rates in this first group of children studied by the CDC in 2000 increased as the thimerosal dosage rates increased. The data was obtained with a Freedom of Information Act request and today a mathematical curve fitting tool in Microsoft Excel can be used to estimate the rate of the increase in terms of relative risk. Relative Risk is the chance of diagnosis at higher dosage divided by the chance at some lower reference dosage. In this case the reference dosage is estimated at 15.65 micrograms (and while parents have been pleading for 10 years to do a study with a zero reference dose of Thimerosal the CDC has refused).

The following results are from a linear regression for Autism versus Thimerosal dosage (straight line mathematical model using Microsoft excel) from the Verstraeten CDC report of February 29, 2000.

See graphs 3 and 16 at http://www.nomercury.org/science/documents/ThimerosalVSDstudy_2-29-00.pdf

Using an average reference dose (in this CDC report there was no zero reference dose in the data) of 15.65 micrograms of mercury, per page 21, gives the slope for graph 16.

Using an x intercept of 15.65 micrograms of Hg (average reference dose) for linear regression, the slope is 0.013 (RR)/(microgram Hg). The equation is Y = 1.00 + 0.013x - 0.2035, and R^2 (measure of statistical significance) equals 0.6821.

Y equals relative risk, and x equals micrograms of mercury injected using Thimerosal vaccine preservative with n (number of children in the study) > 50.

Similarly, the slope for Graph 3 is 0.0126 (RR)/(microgram Hg). The equation is y = 1.00 + 0.0126x - 0.2066, and the Correlation Coefficient squared (R^2) equals 0.4295.

Again, Y equals relative risk, and x equals micrograms of mercury injected using Thimerosal vaccine preservative with n > 50.

The CDC was never really able to explain away this relationship. They found another data for another totally different group of children which did not agree with this data and they called it neutral. But one half plus zero equals one half when it comes to finding risk. Thimerosal has not been proven safe. But the CDC states it backwards and upside down-sort of like trying to establish, decades ago, that there was no proof that smoking caused cancer. The reality is that the research has failed to "support the hypothesis that thimerosal-containing vaccines” are not harmful.