September 7, 2009

H1N1 Swine Flu Panic! Where's the evidence for vaccination?

The "Swine Flu" is spreading quickly via mass media channels. Italy may close some schools over swine flu. A link to a Daily Mail article concerning a "leaked letter" in the UK written by neurologists concerned by an unacceptable post vaccination risk of Guillain-Barre Syndrome, is virally spreading through social websites such as Facebook.

Let's make it clear, CDC website states:

In 1976, a certain type of influenza (swine flu) vaccine was associated with Guillain-Barré Syndrome (GBS). Since then, flu vaccines have not been clearly linked to GBS. However, if there is a risk of GBS from current flu vaccines, it would be no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe influenza, which can be prevented by vaccination.

I am wondering what should be the process of making a real evidence based choice on vaccination. It's always a balance between risks and benefits. What are the real convincing data that should make everyone vaccinate for H1N1?
Since vaccine trials for the novel H1N1 flu are currently being conducted, probably this choice can't be based on any evidence at the moment.

What we know is that of 30 Aug 2009 in Europe for example there have been 46000 cases with at least 104 deaths (WHO september 4 - update 64).

Are there other valuable authoritative resources besides the following? (U.S. Department of Health & Human Services)

WHO's Pandemic (H1N1) 2009

I would really appreciate any suggestion on resources to further understand these issues.

Other interesting resources on H1N1 flu:

Dr. Ves posted this on twitter: Administering the H1N1 influenza vaccine in patients with suspected egg allergy - AAAAI (PDF)

Are there particular precautions for people who have a history of a positive prick test for egg (with many others allergens), but no clinical allergic symptom from eggs?

Shamsha Damani shamsha kindly suggested me ("Prepandemic" immunization for novel influenza viruses, "swine flu" vaccine, Guillain-Barré syndrome, and the detection of rare severe adverse events. Aug 1)

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