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Deaths during H1N1 vaccine campaign could be misinterpreted

Kathleen Blanchard's picture

According to a new study, medical events or deaths that occur during a flu vaccine campaign, like the current H1N1 program, might be easy for the public to misinterpret, undermining vaccination efforts. Public concern about deaths and adverse advents that happen daily, unrelated to flu vaccine, can prevent people from receiving immunizations, even if the cause is unrelated to the vaccine.

The authors of a publication in the Lancet included an international team of investigators led by Cincinnati Children's Hospital Medical Center concluded that the public could incorrectly associate unrelated health events with the H1N1 vaccine. Their findings, looking at past events, show interruptions in flu campaigns, associated with reports of deaths that would have been expected, and were not vaccine related.

According to Steven Black, M.D., lead author and a physician in the Center for Global Health and Division of Infectious Diseases at Cincinnati Children's, "Regardless of whether someone gets the vaccine, bad things happen to people every day and generally occur at fairly predictable rates. Identifying real safety concerns with new vaccines means we have to untangle actual safety signals from background medical events, which are those that would happen without vaccination."

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The paper cited four deaths that interrupted a seasonal flu vaccine campaign in Israel in 2006. News coverage about the deaths during the flu vaccine campaign received wide attention, undermining flu vaccination efforts. In that instance, all four deaths were related to underlying medical conditions. Based on the author’s analysis, there was no higher rate or unexpected deaths associated with flu vaccine.

The authors also site incidences of Guillian-Barre Syndrome cases that occurred during the swine flu vaccination campaign in 1976 and 1977. Since the syndrome is expected to occur in one out of every 100,000 people a year, the authors concluded Guillian-Barre Syndrome cases should be expected – with or without vaccines. Black says interpreting adverse events from H1N1 flu vaccine is important, but should be done "judiciously".

The authors write, "The reporting of even a fraction of such a large number of case as adverse events following immunization, with attendant media coverage, would likely give rise to high levels public concern, even though the occurrence of such cases was completely predictable and would have happened in the absence of a mass campaign."

Thus, the authors suggest that the public and news media exercise caution in interpreting deaths and adverse events during vaccine campaigns, so as not to sway the public from making informed decisions about receiving flu vaccines. The authors say …”people die or develop serious illnesses every day”, and the public is not good at evaluating vaccine risks. The message is that the public could misinterpret adverse health events that would otherwise be expected during flu vaccine campaigns, undermining vaccination efforts.