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Legacy of 'junk science' affecting vaccine uptake

Fergus Walsh | 08:55 UK time, Friday, 11 December 2009

New figures from the Department of Health in England suggest that 2.3 million people in the priority groups have now been immunised against H1N1 swine flu.

That includes 81,000 pregnant women. 308,000 front-line health workers have been given the jab, compared to 124,000 last year for seasonal flu.

A look at the priority groups suggests a lot of people are still to be immunised, or will not bother to have the jab.

There are 9.5 million people in priority groups for the jab in England and 2 million front-line health care workers.

Health officials say they are encouraged by the uptake, but the Chief Medical Officer for England, Sir Liam Donaldson said it would have been higher but for two factors:

"The uptake had been influenced by the disgraceful junk science that was thrown at the MMR jab. The legacy of that is potentially putting lives at risk."

And he said the lack of a "fear factor" was another important element.

He contrasted the introduction of the swine flu jab with another vaccine against a strain of meningitis, introduced in 1999. "Take Meningitis C", he said:

"Parents were terrified of the disease and where there is a big public fear factor you will get a high uptake. Most people don't think swine flu is a big risk. But there is no need to expose yourself to. We don't force people to have vaccines in this country. It's not compulsory (unlike in the USA where you have to be immunised before going to school). If you are in an at risk group and you choose not to have the vaccine, then that is up to you."

Remember that the UK has provisional orders for up to 132 million doses of swine flu vaccine (based on the expectation that two doses would be needed).

Clearly we aren't going to need all of those, and the Department is not saying whether they have to buy them, or whether there is an opt-out clause (all such contract details are confidential).

But it begs the question as to whether any other groups will be offered the jab in the New Year. I think it unlikely, given that the H1N1 swine flu virus is likely to be incorporated into the seasonal flu jab for next winter.

Sir Liam Donaldson said "the next policy decision would be to see whether the swine flu vaccine should be made available to anyone", but he made it clear that this was not something that was being considered for now.

One vaccine enough for children

In case you missed it, the advice from the Department of Health is that one dose of vaccine is sufficient for the under-fives. So that means people of all ages need just one jab (unless they are immuno-compromised).

This is the result of new analysis from the European regulator, the EMEA, which warned that young children may experience fever after their second dose of Pandemrix (the main swine flu vaccine) and that the first dose triggered a good immune response.

More local deals are being struck between doctors and NHS managers over immunisation plans for children. GPs across London have signed up to a deal to ensure children between six months and under five get the jab via their local surgery. Other deals around the UK are said to be imminent.

Swine flu cases decreasing

Swine flu cases are decreasing across the UK.
England - estimated 11,000 new cases this week (22,000 last week)
Scotland - estimated 8,900 cases (12,300 last week)
Northern Ireland and Wales - cases continuing to fall

Deaths from H1N1 swine flu

191 England
13 Northern Ireland
54 Scotland
25 Wales

The estimated cumulative number of cases of swine flu in England is 795,000 (range 380,000 - 1,670,000) but the Health Protection Agency has estimated one in five schoolchildren has been infected, so this figure may be revised upwards at some point.

Whatever the figure, swine flu remains a mild illness for the vast majority. Nonetheless there were more than 600 people in hospital in England with suspected swine flu on 9 December and 133 were in intensive care.

Influenza-like illness England and Wales

As ever this is very good at showing trends and if you follow the bold red line you'll see that H1N1 swine flu cases are continuing to dip and are no way near as high as they were in July. All very reassuring.

Table showing history of long-term health conditions

I thought I'd show you this as it lists all the health conditions suffered by patients who died from H1N1 swine flu in England. You can see that asthma, COPD (chronic obstructive pulmonary disease) high blood pressure, diabetes, kidney disease and diabetes are all major risk factors.

The figures in brackets list the number of patients who had only that single health problem - clearly many had numerous ailments. Of those who died only one in four had received antiviral within the first 48 hours of symptoms.

Useful resources:

Detailed UK weekly epidemiology update
Swine flu figures for Northern Ireland
Swine flu figures for Scotland
Swine flu figures for Wales

PS: I told you last week that my son Hugo had suspected swine flu. Within 48 hours I'd been sent a swab kit from the HPA and I dutifully sent it back. Well, there was a letter waiting for me at home last night with the result. It was positive for the swine influenza virus, so he definitely had it.

I was delighted; that might sound odd, but after seeing him poorly, and giving him Tamiflu, I'm pleased that I can tick H1N1 off the list of winter viruses that he might have to contend with. I must take my hat off to the HPA for such a speedy test result. Hugo went back to school this week, sang in the carol concert and is much better. Thanks again for all your kind comments.

Comments

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  • 1. At 09:30am on 11 Dec 2009, littleworkingmum wrote:

    Thank you Fergus you always seem to have the most factual and up to date news. My GP has in fact just rang me this morning to cancel my daughters second Pandemrix jab as they had been notified not to carry on giving the second jab. This was news to me until I read your latest blog a few minutes ago.

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  • 2. At 09:34am on 11 Dec 2009, Diabloandco wrote:

    Could you remind Liam Donaldson of the " junk science " that gave us Thalidomide? Thanks!

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  • 3. At 09:41am on 11 Dec 2009, pentlandbiker wrote:

    Its all very well to complain about junk science but FiveLive banged on about MMR for months, giving publicity to the junk. There is no requiremnt to show 'balance' when one side is just crazy. The BBC share the blame for the current situation. This is one time when it is appropriate to shoot the messenger!

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  • 4. At 09:43am on 11 Dec 2009, pentlandbiker wrote:

    Good Grief! More irrelevant stuff about Thalidomide. Its never been out of use. It is still the main treatment for leprosy and is in trials for all manner of cancers.

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  • 5. At 09:49am on 11 Dec 2009, FrankyB wrote:

    Thanks Fergus - it's very interesting to see the table of underlying conditions that are so often mentioned in passing but never elaborated on.

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  • 6. At 09:57am on 11 Dec 2009, Cate wrote:

    Take up of the jab for groups with health problems would be higher if GPs surgeries were more accomodating on appointment times. My husband has asthma but our surgery only offers jabs between 9-12 in the morning, He is a teacher and can't just take time off. They assumed that all those with health problems would not be working which is daft many do work with conditions like asthma or diabetes and many women who are in the first 7 months of pregnancy will work too. He did get a jab in the end but silly appointment systems don't help.

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  • 7. At 10:06am on 11 Dec 2009, angelscomeinthrees wrote:

    Donaldson is a bit out of date - it isn't so much MMR as the vast amount of stuff on the net that is putting people - particularly parents - off the vaccine. I know people who've given their kids the MMR who are refusing the sf vaccine and I also know people who have the seasonal flu vaccine who don't want the sf one. On this blog we've seen everything from squalene being linked to Gulf War Syndrome to the vaccine being contaminated on the orders of Obama to control world population, and logically there is a whole load of other stuff out there. Maybe if the DoH or even Fergus had adressed some of the flakier concerns (esp over squalene) the take-up would be higher. As it is we are left with the suspicion we are being frightened into getting a vaccine that we don't need.

    I am concerned that healthy adults won't be offered the sf vaccine if we want it. Presumably private clinics will buy up the surplus. I don't get the seasonal flu vaccine as of right so it looks like either way I'm going to need to pay if I want it, and my dh, who has hypertension.

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  • 8. At 10:09am on 11 Dec 2009, crispy wrote:

    So the fact that we don't even know that Tamiflu works is irrelevant?

    "A major review of what data there is in the public domain has found no evidence Tamiflu can prevent healthy people with flu from suffering complications such as pneumonia"
    (http://www.guardian.co.uk/world/2009/dec/08/tamiflu-swine-flu-roche)

    "Sir Liam Donaldson, England's chief medical officer, has noted that doctors have little idea how effective oseltamivir antiviral tablets would actually be during a pandemic."
    (http://www.bmj.com/cgi/content/full/331/7527/1277)

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  • 9. At 10:23am on 11 Dec 2009, angelscomeinthrees wrote:

    I agree with you, Poodle. We have dished out tamiflu for free, at huge expense, to everyone who could claim to tick a few boxes and we still aren't certain if it helps or not (although there is some evidence that it is, it isn't conclusive).

    Now we are told that we won't be getting the vaccine, at least not on the State, presumably because of cost. Even though we know it saves lives, and even though we know that sf can kill the young and healthy so targetting those with ULHC is only the first part of the solution.

    What a shambles.

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  • 10. At 10:24am on 11 Dec 2009, unbrokenman wrote:

    Is it possible that uptake of the jab has been limited by its availability ?

    One of my children was designated as being in the priority group. We were given less than a week's notice of a one-hour slot when he could receive the vaccine. He was then told that he needed a second jab, which (again) we were given less than a week's notice of the appointment.

    When I queried why such little notice was being given, they told me that they had no visibility of when they would receive the vaccines from the supplier, and so couldn't make appointments until then.

    One could query how effective the surgery is being in administering this, but that would be a separate debate. It strikes me that this type of administration (whether appropriate or not) as a response to lack of availability of the vaccine could well be deterring people who are in two minds as to whether or not to have the jab.

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  • 11. At 10:25am on 11 Dec 2009, ThoughtCrime wrote:

    It's easy to point fingers at the so-called "junk science" behind MMR but that does nothing to ease the burden on families whose children did develop autism immediately after getting the vaccine.

    It's also easy to hide behind all sorts of clever weasel words, but given the state of fear of the vaccine in the nation what could have done more to overrule objections than the production of proof that Leo Blair had received the vaccine? At a stroke Tony Blair could have demonstrated to the nation that, even with the privileged information he had as PM, he was still willing to give it to his own child. What better demonstration that there's nothing being hidden?

    Instead we had weasel words, removal of choice and attempts to coerce people into having what was feared. Which in turn fuelled the fear that there was some kind of coverup.

    Science or no science, for someone who knew the public mood the way Blair did the fact he missed that opportunity suggests to me that Leo didn't have the MMR, which leads me to wonder why not. And I'm obviously not the only one.

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  • 12. At 10:26am on 11 Dec 2009, joandunne wrote:

    Very good post, Fergus. I found the chart listing the health conditions of those who died particularly interesting, it is something I have wondered about. I'm glad Hugo is better and also that he has had sf and that is one worry out of the way. To know is, as you say, a wonderful. HPA - why couldn't all those diagnosed with sf (by the doctor or by the helpline) have a swab kit? I WISH I knew. The comfort would be immeasurable. Ah well...
    Angels, sorry you're knee-deep in vomit. I too would queue over-night for a vaccine against norovirus. Hope it all clears up soon.)

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  • 13. At 10:28am on 11 Dec 2009, EmilyD wrote:


    The hysteria over MMR has not only affected public uptake of the swine flu vaccine, but also of many other vital vaccinations.
    My 5-week old daughter contracted whooping cough, just a few weeks before she was due to receive her mandatory vaccination against it. Whooping cough can be fatal in the under-ones, we were hospitalised but luckily got away lightly.
    Highly infectious diseases like whooping cough had been virtually eradicated until the MMR hullabaloo put many parents off vaccinating their children against anything - not just measles, mumps and rubella.
    These diseases are now on the increase. Vaccinations do not exist only to protect the individual, but to protect other vulnerable members of the community - young babies, the elderly and those with compromised immune systems.

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  • 14. At 10:30am on 11 Dec 2009, dmcblue wrote:

    unfortunately the media, some worse than others (stand up the daily mail) much prefer a scare story, no matter how implausible or scientifically rubbish it is, to the facts - real science is often boring and as much papers aren't interested, someone comes out with a theory that scares people and its news even if its rubbish and unfortunately many people will believe it

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  • 15. At 10:33am on 11 Dec 2009, angelscomeinthrees wrote:

    Fergus, thanks for your update on Hugo, I too would be delighted to know I could tick sf off for our kids so your comments do not sound odd at all. I am really surprised that the swab test was so efficient as I'd heard that they weren't unless used very soon after the onset of symptoms. So glad Hugo was able to sing for his proud dad :-)

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  • 16. At 10:39am on 11 Dec 2009, angelscomeinthrees wrote:

    Thanks, Joan - mercifully the bug seems short-lived this time, both girls drinking okay, eldest eating and younger on the sniff for breakfast and no temps. Not so sure about dh though. Am hoping against hope that the sicky/temp/dizzy spell I had on Tuesday was my lot because we have a busy weekend planned and I would hate to cancel it. My eldest is having a fundraising stall at the village market tomorrow in memory of her friend who died when they were little, we've got loads of decorations and Christmassy things to sell and I'd hate for her to miss it. Yes, the inventor of the norovirus vaccine should be given the Nobel prize, a knighthood and should win the X Factor. Queue through the night? I'd remortgage the house to pay for it if I had to!

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  • 17. At 10:46am on 11 Dec 2009, angelscomeinthrees wrote:

    Aardvark, Blair was just exercising his personal right to both refuse the vaccine and his privacy - yes, I know he didn't always when it suited him. I hope that MMR/autism hasn't affected you personally. I knew someone who had a child affected by autism and she was convinced that the MMR can trigger autism in a few susceptible individuals and that it should be possible to identify who those individuals are and avoid giving them the vaccine. I also know a doctor who has a friend who worked with Andrew Wakefield and he is described as being 100% comitted and believing in what he was doing, even though his methods are now totally discredited.

    None of this changed my decision to get my children vaccnated, all three have had the MMR because I decided they were more at risk from measles than the vaccine. My friend's son dying made a huge impact on my attitude towards vaccination and now I am very grateful for the chance to safeguard my children.

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  • 18. At 10:49am on 11 Dec 2009, ThoughtCrime wrote:

    One other thought on the implications of having a vaccine to protect society. Society expects us to have these vaccines but that same society leaves us to rot if we are one of the people who suffers severe side-effects from it.

    Why would I put my child through something that has potential side-effects I consider an unacceptable risk to protect a society that will turn its back on me in a heartbeat if my child is affected? I've seen first-hand the lengths some parents have had to go to to look after a child apparently severely damaged by a vaccine and they got no help whatsoever from society.

    We can't have it both ways - if we bleat about protecting society than society also has to provide for those who pay a very high price for that protection.

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  • 19. At 11:00am on 11 Dec 2009, angelscomeinthrees wrote:

    Aardvark, provision for autism in this country is woeful whatever the cause.

    Emily - there is a vaccine-resistant strain of whooping cough that has been circulating for a few years'. I'm so sorry to hear about your baby being unwell, and I'm glad she's recovered well, I know that woudl have been very scary for you.

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  • 20. At 11:05am on 11 Dec 2009, Peter_Sym wrote:

    I find it wonderfully hypocrital of the BBC to mention 'junk science causing a fear of vaccines' just months after running the libellous 'girl dies after cervical cancer jab'

    post #2 mentions thalidomide. Can anyone think of a similar pharmaceutical cock-up thats happened in my lifetime (I'm 32)? The Thalidomide scandal happened because the drug was only tested on rats. If it had been tested on rabbits or guinea pigs or primates as well the birth defects would have been picked up. This sort of multi-species testing is now mandatory precisely because of Thalidomide and is why companies such as Hungtingdon Life Sciences use so many animals.

    Its also the reason why the swine flu vaccine has taken so long to reach the clinics. Its been tested, then tested, then tested again for the simple reason that another thalidomide means bankrupcy for the company producing it. The pharm industry is always accused of putting money first, but in this case fear of being sued ensures no one dares put out anything they're not 100% sure is safe.

    Incidentally we don't routinely 'force' vaccines on people but when I served in the army I was ordered to get a tetanus jab. It wasn't a choice. Likewise not taking certain drugs (mainly malaria pills) is a court martial offence. I used to be routinely woken up in the middle of the night whenever a transplant had gone wrong at the local hospital. As all soldiers know their own blood groups we were a good source of the red stuff. Again I was never actually asked if I minded......

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  • 21. At 11:10am on 11 Dec 2009, dmcblue wrote:

    you see aardvark thats where you're argument falls on its rear end, you've already started from the position that the vaccine is harmful and harms people therefore why should i have it?

    if you start from that position before the science then you're in trouble, thats partly where wakefield fell down, he'd decided the results of his 'study' before he'd done it and that just isn't acceptable in scienctific methods

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  • 22. At 11:12am on 11 Dec 2009, Peter_Sym wrote:

    #18 Screw society. The reason you should give your child the MMR jab is because the chances of your child dying or being left seriously brain damaged by measles or mumps (or in later life passing rubella onto their own unborn kid and causing birth defects) is far higher than the chance of getting autism.

    If a vaccine has a 1 in 100,000 chance of killing you and the disease a 1 in 1000 chance of killing you then its 100 times safer to take the vaccine than chance the disease. Its simple risk management.

    In any case there is ZERO proof that MMR causes autism. Andrew Wakefield was being paid by solicitors to find evidence to back up their lawsuits against the manufacturer. If a scientist in the pay of a tobacco company 'proved' that smoking was good for you would you believe it? Like hell you would. Rates of proper autism are approx the same as they were before MMR came out. If you've ever seen a REAL autistic kid they barely speak at all and live in their own little world. 'Autism' is the new ADHD or Dsylexia. An awful lot of kids with very little wrong with them are being labelled as 'autistic' which does a great diservice to those who really have the syndrome.

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  • 23. At 11:13am on 11 Dec 2009, angelscomeinthrees wrote:

    Aardvark, I don't know anyone who disputes the safety of the rubella vaccine, yet people who refuse it for their children could be said to be 'turning their backs' on the most vulnerable - unborn children.

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  • 24. At 11:17am on 11 Dec 2009, ThoughtCrime wrote:

    #22, if only the stats were as simple as you made out. If there was a 100% chance of getting the disease without the vaccine you'd be right.

    But let's say there's a 1 in 100,000 chance of dying from the vaccine (assuming no other side-effects are possible), a 1 in 100 chance of getting the disease without the vaccine and a 1 in 1000 chance of dying from the disease (again, assuming the disease has no other effects). Now there's roughly a 1 in 100,000 of dying whichever way you turn.

    And I wasn't talking about proof that MMR causes autism. I simply observed that if it was as safe as we're being told, why didn't the Blairs simply demonstrate that Leo had had the vaccine? They can bleat about privacy all they want but just imagine how much objection it would have blocked. What better advert that something is safe than the Prime Minister considering it good enough for his own family?

    The point about society is because of the number of people who think everybody should have vaccines to protect society even if they don't want to protect themselves. But on your sentiment I agree, since society would turn its back on me in a heartbeat I feel no requirement to vaccinate for the benefit of society.

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  • 25. At 11:17am on 11 Dec 2009, billtils wrote:

    Maybe some of us were more moved by concern about the overstated junk media biopanic coverage and worked out for ourselves that it was not supported by the scientific facts available. Maybe some of us worked out it was not the end of the world (and of course were totally underwhelmed by chief medical officer Sir Liam Donaldson announcement that it was less lethal than feared). Maybe some of us have a strong awareness of the value of immunization but prefer to keep it for use in circumstances that matter, and rely on sensible behaviours to keep swine flu at bay - just as we do for the common cold and good old (highly mutative) flu.

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  • 26. At 11:19am on 11 Dec 2009, ThoughtCrime wrote:

    #21, I don't think anybody is assuming vaccines are harmful. But we know that just about every medicine known to mankind has potential side effects. If you read the blurb that comes with medicines it lists known side effects, and they usually range from relatively trivial things to conditions worse than what the drugs are supposed to treat.

    So the question isn't "is the vaccine harmful?" - the question is whether the risk of the side effects is worth the benefit of the vaccine. And that's a matter of individual attitudes to risk, it's not something that can be answered with a simple "yes" or "no" response

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  • 27. At 11:21am on 11 Dec 2009, dmcblue wrote:

    i don't give a toss what blair does or doesn't do with his son, how is that relevant? Blair is no scientist and has no clue whether anythings safe or not so his opinion is meaningless.

    If all the doctors were refusing a drug/vaccine that would be more significant not a politician!

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  • 28. At 11:26am on 11 Dec 2009, angelscomeinthrees wrote:

    Aardvark, Blair is no more a scientist than I am. It wasn't that he had some inside info that we aren't party to, it's that his decision was not to vaccinate (assuming that is what he did). Remember Cherie and her electromagnetic pendants and rebirthing ceremonies? Not all that surprising that they may be anti-vaccine, it's part of the same outlook on life.

    Not vaccinating doesn't put 'society' at risk. It puts the unborn, small babies, the very young, the people too sick to be vaccinated, those undergoing chemo. The State turns it back on those who lose their children too, I've seen it, but society - including total starngers - do not. You are confusing the State with society.

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  • 29. At 11:34am on 11 Dec 2009, angelscomeinthrees wrote:

    Aardvark, my GP was totally honest with me and said that some children are damaged by vaccines, although not specifically autism. So I do not regard vaccination as totally safe. However, my GP also pointed out that my children are far more at risk during the car journey to the surgery. How many of us stop and weigh up the odds before taking a car journey or walking down the street, or going swimming?

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  • 30. At 12:10pm on 11 Dec 2009, Jen wrote:

    Fergus-so pleased Hugo is well recovered - he obviously managed to avoid any long term breathing difficulties from SF complications.

    I still have difficulties getting enough breath to sing, as does my friend who had SF 2 months ago. We were discussing this very thing yesterday. It's worrying because she has the lead in the panto and as a professional singer she is very worried about how long she will be like this. She is certain the Tamiflu helped shorten the duration of her illness, but didn't get antibiotics. I am convinced now that I had SF as my symptoms were exactly the same as hers. I also made a mistake thinking my temp wasn't high enough as I forgot that my normal temp is 1 degree F lower than the accepted normal. After reading about the NY autopsy study I'm wondering if there is a long term deeper lung damage which will take time to repair hence the ongoing breathing difficulties when singing.

    It's great to see the long term conditions info, Fergus. It's been something we have wondered about on here for some time and it shows how important vaccination is for these people. My arm still has that sore lump but it is getting smaller-by contrast my Mum hasn't had any problems. She has all her flu shots every year and I don't (will after this though!) so maybe her body is better at dealing with such things. I absolutely believe that vaccination for anything is by far more preferable than seeing my child suffer. I just wish they'd develop an effective vaccine against Chicken Pox after my kids and me were so rough with it!

    Re MMR-when mine were small the vaccination age was 3 yrs old and it was done on its own. Whilst all the childhood illnesses are nasty and indeed fatal in some cases, I was horrified when they made the age younger and younger. I've always found the supposed link between MMR and Autism strange-there may be no medical evidence for it, but the cases of it do seem to be higher and suggest more than just coincidence. My niece became Autistic after her jab, whereas my nephew didn't. Who really knows?

    I just think the MMR furore and uncertainty around the link between GWS and multiple vaccinations has led people to question any vaccine. But honestly, the SF vaccine is a FLU vaccine, no different from seasonal flu jabs. I'm glad I had it (just in case!), though I fully understand why some people have reservations. Yet I wonder if more people would grab the chance for a vaccination had SF been more dangerous? Frankly, if the answer to that is yes, then there is no valid reason to say no, surely?

    I really think the media worldwide need to take responsibility for their scaremongering. So many people see something written on paper or on the Internet and believe every word. The media's thirst for headlines to sell papers is disgusting-
    they give the impression that what they say is fact, when it is actually unfounded rumour. Perhaps they should be made to quote their sources when reporting on such things?

    Whilst vaccination is a matter of choice for anyone, if a child dies because a vaccination was refused by a parent, the media needs to bear some responsibility too.

    Some sort of positive message needs to be out there if the government want a greater vaccine take up.

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  • 31. At 12:19pm on 11 Dec 2009, Peter_Sym wrote:

    Aardvark. I more or less agree with you. If you go back a few weeks you'll find I even posted a link to the blurb GSK provide with their flu vaccine stating the rough odds of each side effect. You seem capable of doing the sums so my advice stands... balance the risk.

    However turning one of your previous arguments on its head: if society provides at no direct cost to you a proven safe and effective vaccine which you then choose not to use why should society then pay hundreds of thousands to treat you and support your disability when you get badly damaged by the disease the vaccine would probably prevent? It can be looked at two ways.

    I do agree with you RE Blair. That did a lot of harm. I trust Blair as far as I could throw him and his wife less than that so it came across as if he wasn't prepared to risk it. In our paranoid world this sort of behaviour is the last thing we need from our leaders.

    A few people DO die and more suffer serious side effects from vaccines. As you say 'any medicine with no side effects is simply a placebo' however more people die from eating peanuts so the risk should be put into context. Likewise the fact that there's 4 times as much mercury in a tin of tuna or a salmon steak (and worse its often organic compounds of mercury) compared to a vaccine (containing a very inert compound of mercurcy... and many vaccines have none at all) should be put into context too.

    #30. Why do you say 'the cases of it do seem to be higher and suggest more than just coincidence' when its been statistically shown to be anything but:
    http://news.bbc.co.uk/1/hi/health/8268302.stm
    Its maybe a perfect case of 'everybody knows' syndrome.

    The simple truth is that 20 years ago almost no-one had even heard of autism. I'd suggest 'Rain Man' started the public awareness of it. I've worked with PROPER autistic kids (a long term girlfriend worked for Mencap and used to take me along as muscle to help move climbing frames etc) and they have almost no vocabulary, no social interaction and can litterally spend hours spinning the wheels on a toy train. Most 'autistic' cases diagnoses now are mild-aspergers syndrome. Not so different from people with obssessive compulsive disorder. That covers me and I'd suggest many other scientists. Its our slightly weird fascination with small detail and repetitive way of doing things that makes us good at our job.

    Whats most important to remember is that autism is normally diagnosed at about age two. Before that most kids lack the social skills for any abnormality to be noticed. Also with more GP's and parents aware of autism what 20 years ago would be written off as 'odd kid' now gets a diagnosis and label.

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  • 32. At 12:25pm on 11 Dec 2009, angelscomeinthrees wrote:

    PeterSym, what Blair did or didn't do only matters if you rate the man's judgement in any way. I don't, and it staggers me that other people do.

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  • 33. At 12:37pm on 11 Dec 2009, SShark32 wrote:

    The coverage of the girl who died after a cervical cancer jab was an absolute disgrace. I accept that, in some warped way, you can see it as a news story but it's amazing how a load of bull can be front page news then the later accurate story is hidden away.

    The internet has a lot to answer for too. Before my wife had the vaccine I carried out an agonising search of the internet and you eventually realise that no official source had anything negative to say about the vaccine, it was just rumours and scare stories on blogs and the websites of individuals.

    Clearly there is an unknown with taking any form of medicine - in an ideal world it would probably be better not to ingest/be injected with any chemical - but some of the crazy theories are ridiculous.

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  • 34. At 12:40pm on 11 Dec 2009, Peter_Sym wrote:

    #32. God help me I voted for the man twice.......... the problem is that the guy is percieved (probably rightly) as a snake & I suspect a lot of people must have wondered what he knew that he wasn't telling us. It wasn't so much whether Leo had, or didn't have the jab but the constant evasive behaviour over the issue that looked really bad.

    Going off on a total tangent his judgement is spot on when it comes to self-benefit. Look at the human rights act and how many millions his human rights lawyer wife makes from it. He bailed out of Number 10 about a month before the credit crunch leaving Brown to take the flak, got himself a few million working for a bank and damn near got himself the job of supreme leader of Europe for life.

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  • 35. At 12:43pm on 11 Dec 2009, Peter_Sym wrote:

    #33. Self diagnosis on the internet is deadly. Enter 'headache' and rather than being told to take two asprin I bet you'll find 'brain tumour' in the top 5 google hits. My father is a cancer surgeon and has a remarkable amount of clinic time wasted with people bringing in nonsense they've found on the internet. With his workload its immensely frustrating to have to explain to someone that the combination chemo and radiotherapy is better for them than some herbal tablet they've bought from a spam e-mail. The guy's I work with have had massive problems with Leaukemia patients taking echanacia... that DOES boost your white cell count which is the last thing you need when the whole point of the chemo is to kill off the cancerous white cells in your blood. The echanacia seriously affects the chemo.

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  • 36. At 12:56pm on 11 Dec 2009, Lurkingmumoftwo wrote:

    Just another thought about why there is poor uptake within the priority groups. I think many on here have mentioned how they had to be proactive in contacting the surgery to get their jab and my younger sister's experience confirms this. She is the sole carer for her husband who has just undergone major surgery and so, for this reason, she is in the priority group. She had to ask for the jab and is booked in for next week; I wonder how many other people who are eligible have slipped through the net in this way. I am guessing in my sister's case it is lack of communication between the hospital were her husband had surgery and her GP surgery.

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  • 37. At 12:58pm on 11 Dec 2009, Lurkingmumoftwo wrote:

    On a different subject; has anyone found the detailed HPA report for this week yet?

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  • 38. At 1:02pm on 11 Dec 2009, Lurkingmumoftwo wrote:

    Forgot to say; really pleased that Hugo has recovered so well Fergus and that his swab test was positive. I can also understand the relief you must feel at that news. As Angels said though, I also thought that the swab test had to be done within 48hours so a little confused.

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  • 39. At 1:10pm on 11 Dec 2009, TCMM wrote:

    I think the big problem here is the specificity of the advice that the government provided to the general public.

    I should clarify that science is not infallible (eg. Thalidomide) and I accept that but it should also be recognised that science is the best mechanism we have to evaluate what is and what is not safe - and will more often than not provide the correct answer, or at least the very best answer possible given the information available. Personally, disregarding any debate re. the severity of the consequences, I would feel worse if I ignored scientific advice and was wrong than if I accepted it and the advice was flawed.

    Where I think we were let down in the UK is that we were not given sufficient credit to be able to understand the issues so, to use pregnant women as an example, the government advice was simple:

    - Both Pandemrix and Cevalpam have been approved by various agencies as safe for pregnant women.
    - If you are allergic to eggs, take the Cevalpam option.
    - Pregnant women should have the vaccination.

    The problem is it didn't answer any of the specific questions that people had been scared by following their internet research:

    - Is the preservative used in the vaccine safe?
    - Is the adjuvant used in the vaccine safe?
    - How (other than containing different antigens) is the swine flu jab different from the seasonal flu jab?
    - Has the vaccine been tested on pregnant women?

    Clearly, people need explanations and not yes / no answers to these questions and in my opinion, when you compare the official advice passed out by the UK Agencies to (eg) Health Canada, the UK came a clear second best.

    I think the problem is that a lot of people lost faith in either science (following BSE, Thalidomide, etc) and the government (various reasons) so needed more than just a "yes it's safe" to convince them.

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  • 40. At 1:38pm on 11 Dec 2009, Peter_Sym wrote:

    #39. How long is the human gestation period? It would take a minimum of 9 months to test a vaccine on pregnant women and get results which would mean that the swine flu vaccine might just have been approved as safe in the middle of next year.

    That also ignores the ethical issue of testing drugs on pregnant women. For obvious reasons safety tests are normally carried out on adult males who volunteer. Anything else would be in breach of the Nuremberg protocols.

    Regarding your other questions, its basically the same vaccine as for seasonal flu just (as you say) with a slightly different antigen, the adjuvant and the preservatives are exactly the same as used in dozens of other vaccines. They're 'safe' according to the best UK, EU and US Federal tests. That should almost go without saying. Anyone putting a drug that didn't meet these criteria into the public would go to jail. It precisely because of Thalidomide that we now test on multiple animal species and for much longer.... this is the main reason that supplies of the vaccine have been delayed.

    I'm not sure how 'science' is to blame for BSE either. It wasn't me or my colleages suggesting that feeding cows ground up sheep was a good idea. Fortunately (and as with swine flu) it would seem that we got lucky there and haven't had an epidemic. The fact that most of us are alive today is because of science. Fancy smallpox? The reason thats gone is us vaccine manufacturers. Polio? Diptheria? all gone because of the jabs.

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  • 41. At 2:05pm on 11 Dec 2009, Peter_Sym wrote:

    Would anyone like to contract these diseases?

    * Amyotrophic lateral sclerosis
    * Aphthous ulcer
    * Behcet's syndrome
    * Brain cancer
    * Breast cancer
    * Cachexia
    * Colorectal cancer
    * Congestive heart failure
    * Crohn's disease
    * Diarrhoea
    * Fibrodysplasia ossificans progressiva
    * Graft-versus-host disease
    * Haematological malignancies
    * HIV infections
    * Hodgkin's disease
    * Kaposi's sarcoma
    * Leukaemia
    * Macular degeneration
    * Malignant melanoma
    * Mycobacterium avium complex infections
    * Myelodysplastic syndromes
    * Myelofibrosis
    * Myeloid leukaemia
    * Non-Hodgkin's lymphoma
    * Non-small cell lung cancer
    * Ovarian cancer
    * Pain
    * Prostate cancer
    * Prurigo nodularis
    * Renal cancer
    * Rheumatoid arthritis
    * Small cell lung cancer
    * Systemic lupus erythematosus
    * Thyroid cancer
    * Tuberculosis

    Guess which drug is being tested as a treatment for all of them?

    Thalidomide.

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  • 42. At 2:07pm on 11 Dec 2009, TCMM wrote:

    #40. I think you're missing the point here. I am completely in favour of science and my own background is in Biology. The point I am making is not that we had inadequate science to support the roll out of the vaccine, far from it. The point I am making is that science as a whole needs to be able to communicate better with and win the trust of the General Public.

    Whether you like it or not, the questions I listed in my previous post are the questions people are asking and the type of response you posted illustrates my point about communication very well.

    I am well aware of the constraints of testing a swine flu vaccine on pregnant women but the type of response to that question that I would prefer to have seen would have gone along the lines of:

    Whilst the swine flu vaccine has not been tested on pregnant women, a number of key health workers were vaccinated earlier in the year and, to date, there have been no discernable complications for the pregnant women within that group. Furthermore, the preservatives and adjuvants contained in the swine flu vaccine are the same as those used in the seasonal flu vaccine, which has routinely been used on pregnant women throughout Europe without problem...etc, etc.

    In terms of the other questions, I don't think there's too much point going into details but I think people would have valued explanations of what adjuvants were, the production benefits they yield, the improved efficiency of the resulting vaccine and something along the lines that as a pregnant woman, the risks of complications are higher than in less vulnerable groups and therefore the potential cost of catching swine flu is greater and consequently, it is even more important to have the vaccine.

    I agree with you that science is not the culprit in BSE and also that the public perception of GM foods for example is wildly off the mark. The point is though that these perceptions exist and in order to correct them, science needs to engage better with its audience.

    I hope I have made my point better this time around - it seems I am not a shining example of good communication either!

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  • 43. At 2:27pm on 11 Dec 2009, Peter_Sym wrote:

    #42. Ahh. Understood. The fact that you knew what an adjuvant was should have been the clue.

    Take MMR.... the public simply don't believe what you tell them. That is largely the fault of the media (and I include internet conspiracy sites as media). Even this blog shows how many people link MMR & Autism even though no link exists.

    The other problem with a huge chunk of the public is that explaining whats in a vaccine is like explaining how a TV set works to someone who has no concept of electricity. This is a huge problem in the UK in general. Science teaching is inadequate and getting worse.

    Generally though I think the point about pregnant women being at a higher risk is coming across well in the media but equally I've first hand experience of pregnant women behaving irrationally. My sister-in-law (who has a better science degree than me) stopped eating toast when pregnant (because of fear that carcinogens in the burnt bits would affect the baby) and spent a small fortune on bottled water rather than drink the tap water even though there's been more incidence of nasties from the plastic bottles contaminating the stuff than any toxins in tap water.... (its why Perrier isn't really around any more- if anyone is interested google Perrier Benzene crisis) . I really don't know what can be done to combat that. If a pregnant women won't take the advice of her own GP then who will she listen too?

    Remember too that my job is to make vaccines (therapeutic ones for people with advanced cancer, not preventative ones, but the technology has a lot of overlap). The people who's job it is to communicate with the public are the government, the NHS staff & the PR arm of Glaxo etc. There might be something to be said for us scientists trying to directly communicate with the public (I think I'm doing O.K so far!) but its a bit of an art. I've had a bit of teaching experience (two army instructors courses and ten years of supervising post grad students in the lab) but that probably puts me in a minority of 'white coats'

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  • 44. At 2:38pm on 11 Dec 2009, TCMM wrote:

    #42. "Science teaching is inadequate and getting worse."

    I hope then that I am not about to make it worse! I gave in my notice a couple of months ago so finish up here soon and am looking forward to starting a PGCE in September next year!

    Seriously though, I remember writing my dissertation and spending a long time trying to make it understandable to non scientists. Subsequently parts of it were published but every two syllable word had been replaced with three 5 syllable words! Sometimes I think things are made more complicated than they need to be.

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  • 45. At 2:50pm on 11 Dec 2009, SShark32 wrote:

    TCMM most (or maybe all) of those questions are answered on the NHS website. I know this as I read it a couple of weeks ago.

    I think paranoia is the main problem rather than lack of information. People read scare stories and rumours and then question whether they can trust the Government/NHS.

    The other issue is the inconsistency across the world. Eg USA doesnt use a vaccine with an adjuvant for anyone, some countries use Celvapan for pregnant women etc. So people then think "Well of Norway are doing this why arent we?" etc.

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  • 46. At 2:56pm on 11 Dec 2009, Peter_Sym wrote:

    #44 I was lucky in many respects in that I went to school in Scotland... their sylabus is a bit old fashioned but its closer to O level set up. It was remarkably easy to do all three science subjects as individual subjects and when you do 5 Highers rather than 3 A levels you can continue with Maths and English as well as Chemistry, Biology & Physics.

    I had some damn good science teachers too, and although it was a state school (and in a very nice area of Glasgow so comparitively underfunded compared to more deprived areas) it had plenty of lab space.

    My little Sister in contrast went to a very expensive fee paying school in England and could only do 'double science'

    Getting a balance between exactly what happens 'for real' and an adequate explanation thats understandable is tough. Just saying 'adjuvants make the vaccine work better' is inadequate but explaining exactly why requires so much technical language that even I have to read it twice. Worst of all there are plenty of things we don't entirely understand (which is why we have scientists after all!) but no-one wants to stand in front of the public and say 'we put this in the drug and it makes it work much better.... but we don't know why or how'. That really doesn't encourage confidence.

    Good luck with the PGCE... a lot of my colleagues have gone down the same route because of short term contracts in science. It seems to have worked out well for most of them.

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  • 47. At 3:04pm on 11 Dec 2009, TCMM wrote:

    When we searched the NHS web site (my wife was panicking about GBS, Gulf War Syndrome, miscarriage, etc) the only information we could find was "it is safe", "this agency or that agency has approved both for use on pregnant women", "pregnant women are at risk therefore should have the vaccine" - my wife finally consented and had her jab about four weeks ago, but largely as a result of the information she saw published on the Health Canada web site.

    I think paranoia is definitely a problem but by simply saying "it's not true" or "the science is unsound", we do the public a disservice. I think most people who do their research are capable of understanding the principles of vaccinations, adjuvants, preservatives, epidemiology, etc, etc if they are properly explained and I think it is a shame that, given we have the information available to us, it is either unpublished or made difficult to find. I believe the improved "swine flu and pregnancy" leaflet was actually published only after it was noted how low the take up rate of the vaccine was amongst pregnant women.

    I also agree that the worldwide inconsistency is a massive issue and a question that should have an official answer rather than allowing people to come up with their own conspiracy theories.

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  • 48. At 3:29pm on 11 Dec 2009, TCMM wrote:

    Thanks - will make a change from accountancy and banking and feels a little more worthwhile too!

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  • 49. At 3:41pm on 11 Dec 2009, Peter_Sym wrote:

    Hi TCMM. There's been a shift in the attitudes of the British public. 60 years ago we basically believed everything the doctors and politicians said. Now its gone too far the other way . A lot of it is journalists just desperate for their pulitzer trying to find watergates and thalidomides behind every story.

    'Safe' is an ambiguous term sadly. I've tried to be careful explaining things here but some people expect a medicine thats been 'safety tested' to be 100.00000% safe which obviously is impossible. I think the same logic has been used regarding pregnancy. For obvious reasons we can't test in pregnant humans so no-one will give absolute answers which can sound like there's something to hide.

    I had a look at your 'health canada' site. Its pretty good but one criticism I'd make is that by stressing that a non-adjuvanted vaccine is available it implies that adjuvants may not be safe. The normal adjuvants used here are aluminium salts or organic oils such as squalene. Squalene is actually produced by the human body as a precursor of cholestrol so its totally harmless. You already have far more in you than you'll get from the jab. Claims linking it to 'Gulf war syndrome' are ridiculous but google pulls up a lot of dangerous nonsense as top hits.

    The worldwide inconsistency is easy. GSK is a massive company but its doesn't have anything like a global monopoly (nor would that be desirable for obvious reasons). They're a British company (and employ over 100,000 Brits) so for perfectly good reasons our govt has used our money to buy a british vaccine rather than an effectively identical product from Novartis (Swiss). This also explains why the Swiss govt has limited distribution of the GSK vaccine in Switzerland and instead mostly gone for the Novartis. The USA have chosen to use a vaccine without an adjuvant because of fear that people's worries about adjuvants would reduce uptake. The downside is that you get a more expensive, less effective vaccine, but one with less theoretical safety concerns.

    If nothing else the fact that each country is basing its decisions on its own regulatory codes, financial concerns and cultural issues should act as a powerful argument against those claiming swine flu is man-made by the pharma industry or that we're all under the control of the new world order!

    Actually on the subject of clear, accurate and moderately technical communication this article from USAToday scores highly. The BBC should take note!
    http://www.usatoday.com/news/health/2009-08-23-swine-flu-qna_N.htm

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  • 50. At 3:46pm on 11 Dec 2009, angelscomeinthrees wrote:

    ~ 43 Peter, I don't know if you were referring to me re believing alink between MMR and autism. A GP at my practise told me a while back that there was some emerging research coming from the States to suggest that the MMR jab coudl be triggering autism in a very small number of children. The researchers were trying to discover what that was and if the trigger could have happened anyway. The person that I knew who had a child with autism also believed that the MMR had triggered an immune system response in her son - he went from being very responsive and alert to being totally non-communicative and double-incontinent. It seems plausible to me but I don't 'believe' it because it's not proven, and my kids have had the MMR.

    Terribly funny re your SIL. Been there, my first pregnancy I was paranoid about just about everything. I threw out all my toiletries that had chemicals in and bought 100% natural ones, but because I was also paranoid about herbs and essential oils I had to source base ones from a manufacturer! Everything had to be organic, additive free, even the paint used in our house. By the time I had my third baby four yrs later I was so knackered looking after a 4 yr old and a 2 yr old that I ate kitkats for breakfast.

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  • 51. At 3:49pm on 11 Dec 2009, angelscomeinthrees wrote:

    TCMM, I would like to have seen Fergsu look at Gulf War Syndrome and the rest, there were plenty of bloggers putting up links about this stuff with no direct response as to why it wasn't true.

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  • 52. At 4:05pm on 11 Dec 2009, Peter_Sym wrote:

    #50 I wasn't specifically refering to you but your story is the kind of thing I mean. In a law court it would be called 'hearsay'. I've heard the same story a remarkable amount of times that kids suddenly regress after getting the jab. From personal experience of autistic kids I noticed a few things: They're almost all male, a statistically implausible number of them look nordic.... blonde hair, blue eyes and they're quite lightly built attractive kids. To me that screams 'genetic'. Its conceivable that a vaccine could trigger something thats there already but it seems unlikely. The idea that measles virus is found in the bowels of these kids seems sensible but it also implies that the virus is the cause, not the vaccine.

    #51. The problem is that 'Gulf War Syndrome' was first reported after the US Civil war. Statistically soldiers die younger and are more likely to have mental health issues (see number of suicides among British and Argentine Falklands veterans) and often don't live very healthy livesm especially after leaving the services. Prolonged stress is the most likely explanation for ill effects, although there were a lot of nasty things drifting around the battlefields: burning nerve agents, rocket fuel from SCUDS and plumes of smoke from burning oil wells you could see from space etc.

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  • 53. At 4:11pm on 11 Dec 2009, Peter_Sym wrote:

    I should add in supplement to my response to #50 that I've heard the story about regressing kids constantly but its not born out by statistics. If everyone's friend of a friend had a kid do this we'd have millions of autistic kids, not a handful. It probably did happen in a few cases (and god knows why) but this story has been repeated and repeated so many times its responsible for the perception that autism is increasing when the truth is that it isn't. Living your life based on things that might be a problem (autism) while ignoring things that are a problem (measles) makes no sense. Its like choosing to remain in the office all weekend because I might get killed in a car crash going home.... not sensible.

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  • 54. At 4:16pm on 11 Dec 2009, TCMM wrote:

    #51. Me too but from the limited time and resource I have had available, my current understanding is that the researcher in question was operating on the premise that the vaccines in question were adjuvenated whereas subsequent investigation suggested that they did not in fact contain any adjuvant at all.

    GBS is the other one that annoys me - it's constantly cited on the web as a side effect of vaccines but from what little I have been able to gather, there is no solid research confirming that link although research does seem to suggest that you are about 7 times more likely to get it if you actually get the flu!

    I think it must be quite fun to be a science correspondent - I would love to be paid to find out the truth behind all these wild rumours!

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  • 55. At 4:22pm on 11 Dec 2009, TCMM wrote:

    #49. I agree entirely.

    Everyone wants certainty but sadly that's one thing that empirical science will never be able to offer but as I said earlier, it's still the best we've got and to my mind doesn't do a bad job.

    At the risk of inciting controversy, I have always considered science to be like a religion (at least it is for me in that I believe it but know I can never prove it 100%). I think the problem with both is misapplication and poor understanding - it's not science or religion that's wrong, it's the people (I like to think a minority) who abuse it!

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  • 56. At 4:32pm on 11 Dec 2009, angelscomeinthrees wrote:

    I don't know, Peter, as someone who has seen my own three kids I believe there is a possibility that some children regress after MMR, just because of what their parents describe. I also believe that some people imagine a regression. Interesting about a genetic link, presumably that could also pre-dispose some kind of trigger reaction. I should add that the person I knew was themselves a scientist. I agree that there is no increase in that very full-on type of autism though, if there is an MMR/autism trigger I would think it affects a very tiny proportion of children and should be identifiable. As for my personal philosophy, if you look above you'll see I agree with you - I don't do a risk assessment every time I walk down the street, or go on a car journey, both of which are vastly more risky than vaccination.

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  • 57. At 5:49pm on 11 Dec 2009, RisainCanada wrote:

    Fergus--wonderful news that Hugo had SF and you can cross it off your worry list.

    So much to comment on in the great discussion above. I agree that 'junk science' and especially conspiracy theorist sites have done a lot to put folks off getting jabs. But here's the problem. These sites rightly point out that some folks are harmed--seriously, perhaps even fatally--by vaccines. That is simply indisputable. And the problem is that for many countries and many illnesses now, the risks to the INDIVIDUAL of the illness do indeed seem to be outweighed by the risks of the vaccine. (I do NOT think this is the case with the SF vaccine, BTW). Take Measles. In Canada, measles has been pretty much eradicated--we have very rare outbreaks (usually among groups that do not vaccinate for religious reasons)--but its been ages since we've had fatalities. So when considering whether or not to get MMR, its not that the parents are necessarily being irrational: there are side effects to every medicine, and in this case, since the illness has all but disappeared, I can fully understand why folks choose not to vaccinate. But if everyone chose this, no doubt measles (and mumps and rubella) would make a comeback and we'd all be worse off. There's a sort of prisoner's dilmemma here, where everyone acting in their own rational self-interest makes all of us worse, as the illness(es) would come back and kill again. That said, it does need to be pointed out that many of the most publicized fears about MMR are based on 'junk science'. For an excellent overview of this topic, with links to oodles of studies from a wide variety of countries, google the article "Vaccines and Autism: A Tale of Shifting Hypotheses" by Gerber and Offit. (it's a pdf)

    So public health officials have a problem if they want to keep a high level of immunization up in a country. And I frankly think they need to change strategies. Gone are the days when simply telling us what to do is going to work--thank the internet for that. Some official sites are better than others; as someone mentioned, the Health Canada site has lots of info. But even there I have written to them suggesting they provide links to the studies they base their recommendations on, as many of us want to have a go at slogging through some of the original material ourselves.

    This has in general been my approach with SF and other vaccines: to deconstruct the arguments on both sides and look at original studies and evidence. Has the site (government or anti-vac) represented the study they've quoted accurately, or are they only mentioning the bits that agree with their desired conclusions and omitting others? No matter which side is doing this, this method is junk science! So on the anti-vac side you'll find references to studies showing that flu vaccines are effective only about 1/3 of the time...and no mention at all that those same studies say the vaccines efficacy rate is 60-80%, or that these studies say the vaccine is safe. On the government side, you'll find mention of the safe use of squalene-based adjuvants in flu vaccines in Europe, and no mention that the adjuvant used in the SF vaccine, though still squalene-based, is a different one (AS03 rather than MF59). Does either side overstate their case, or use the data illegitimately? (e.g. implying that adjuvanted vaccines are unsafe for pregnant women, when in fact there is NO data on adjuvanted flu vaccines for pregnant women? Lack of data does not imply data showing harm!) Do both sides give me all the info I need to make a decision? It's fine and well to discuss the risks of vaccines to pregnant women and their fetuses, but are their also studies looking at the risks of the illness (flu) to pregnant women and their fetuses? (answer: yes. There is evidence that people exposed in utero to flu have more difficulties later on than the general population).

    Two things I would like to see in all 'first world' countries are systems like VAERS in the States where both medical folks and the general public can report adverse events that happen after a vaccination (note I am NOT implying cause) to a database, so that we can compare rates of these events to 'background' rates in the general population. Folks miscarry, die, and develop auto-immune diseases at other times too. Second, in acknowledgment that vaccines do cause harm to the rare and unlucky few, but that it is in a country's interest to nonetheless maintain high immunization rates, I would like to see a compensation program for those adversely affected. There is a 'no-fault' system in Quebec, but not in Canada as a whole. Dr Kumanan Wilson, now Canada Research Chair in Public Health Policy of the University of Ottawa has a short and clear paper on this topic:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1877841/

    Lastly, let me recommend _The Vaccine Book_ by Dr. Robert Sears. It is the most balanced book I have found on vaccines, and one whose focus is on giving parents information (is the illness serious? common? otherwise treatable? what are the vaccine ingredients? side effects? etc.) needed to make vaccination decisions for their family. Though his writing is for the US audience, I found almost all of it applicable, and while he doesn't deny that adverse reactions have happened, he is no anti-vac doctor. He explicitly rejects some of the main anti-vac arguments, like that vaccines haven't mattered at all and reductions in illness is all due to better hygiene and clean water. And he includes some very helpful info, like that fact that is you wait til age 4 for MMR, your child will need only 1 shot to generate adequate immune response (rather than 1 at 12-18 months plus booster later), and that there are virtually no reports, from parents or doctors, of children 'regressing' after MMR at this age. With more and more parents refusing MMR in particular in my country (and no doubt elsewhere), this sort of info may help increase vaccination rates, particularly as Sears stresses that these illnesses are still quite common and serious elsewhere in the world, and only a airplane ride away.

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  • 58. At 6:26pm on 11 Dec 2009, RisainCanada wrote:

    Here's some responses, with references, to the recent Cochrane review questioning the use of Tamiflu and other antivirals:

    http://www.bmj.com/cgi/eletters/339/dec07_2/b5106#227197

    See especially the second response, "Effectiveness of neuraminidase inhibitors..."

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  • 59. At 9:44pm on 11 Dec 2009, Grey Animal wrote:

    I'm really glad to hear that Hugo is recovered, and I wish him, and the rest of your family, a wonderful Christmas!

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  • 60. At 10:12pm on 11 Dec 2009, Questionsaplenty2 wrote:

    Lurking - i think I found the detailed report from yesterday at last!

    http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1259152217308

    Hope i got the right one this time LOL

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  • 61. At 10:14pm on 11 Dec 2009, Questionsaplenty2 wrote:

    I must be less anxious about SF - I only checked this site once per day the last few days instead of about 20 when the fear factor was at it's worst!

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  • 62. At 10:49pm on 11 Dec 2009, angelscomeinthrees wrote:

    Questions - I've been here all day but that's just because I don't have any friends in RL ;-)

    Risa, I too have seen the studies that showed that flu can cause health problems in people who were exposed to it in vitrio, I had a stonking dose of flu when I was 7 mo pg with my son. I believe that the latest thinking is that it is taking paracetamol to deal with the symptoms that could be the cause. Not that that makes me feel any better as I was rattling with the things, but there we are.

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  • 63. At 11:48pm on 11 Dec 2009, RisainCanada wrote:

    Angels, paracetamol could well be playing a role. But I've also seen a study following the cohort of folks born to mothers who had the 1918 flu, and I doubt paracetamol (known as acetaminophen--i.e. Tylenol--for anyone like me from this side of the Atlantic) would explain this. I'm not saying 'risks to the fetus from flu' carries the day re: flu shots for pregnant women, just that its one of the factors that should be considered, and on most of the anti-vac / conspiracy sites, you won't even see it questioned. More here for the interested:

    http://www.newscientist.com/article/mg20427293.200-flu-in-pregnancy-leaves-a-mean-legacy.html

    Oh, and for those complaining about norovirus--oy! do I sympathize! I got it when almost 8 months pregnant and dropped 8 1/2 pounds in about 24 hours. Was just on the verge of going to hospital to get re-hydrated with IV fluids when it passed and I was able to keep water down again.

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  • 64. At 09:49am on 12 Dec 2009, SShark32 wrote:

    Risain - if there's one thing that official sources over here havent used as an encouragement for pregnant women to get the vaccine, it's the health of the unborn baby.

    Because some pregnant women have been hospitalised and died the argument seems to have been a trade off between a) have a vaccine and protect the mother or b) dont have a vaccine and protect the unborn baby. Articles like the one you linked prove that not getting flu could be just as important for the unborn baby.

    I listened to an interview on a Canadian website recently - I think it's a GP/doctor who decided to start his own radio show - and he interviewed someone about the vaccine/adjuvants/mercury etc.

    I thought the interview was good as it brought it all down to the concept of risk levels:
    1) If you are pregnant and you get swine flu, there's only a very small chance that you will die and a small chance you'll be hospitalised - but there's always a chance...
    2) If you are pregnant and get the vaccine there is an even smaller chance that the vaccine will do any harm....but there's always a chance

    So, if you are living in a community where swine flu is around, it's better to have the vaccine as weighing up the risk factors for both decisions, that's the action which equals the lowest risk level.

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  • 65. At 11:21am on 12 Dec 2009, SkylineOnFire wrote:

    I'd be your friend angels! If you dont mind hanging out with a 20 year old guy that is!

    In other news, it's really irritating me reading all these media outlets complaining of the panic thrown up about swine flu, when they were the ones responsible for the entire panic. So hypocritical.

    And in even more other news, my girlfriends little brother (who has just started secondary school and was dreadfully ill with flu a month or so ago) had a blood test to check if he had antibodies to SF, yesterday. Seems the HPA are conducting randomized tests again to determine a percentage of cases in younger people. Il bet a lot of money that it was SF.

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  • 66. At 11:30am on 12 Dec 2009, candrews wrote:

    Fergus, I am delighted that your son is better and that you have had confirmation regarding your son's health status to put your mind at rest. I must say that it seems a little unfair that testing for the virus is status orientated! You are one of the fortunate few who will not have the massive dilemma of deciding whether or not to poison our child with a vaccine or face take the risk of "going it alone" with this virus and never being quite certain if they have had it or not. Of course I can go private and pay £150 to have the test. That would be £300 for my two!

    Both my children have had suspected swine flu. They have not taken Tamiflu and I was discreetly advised by my GP NOT to do so. They are making normal recovery BUT I still am not certain what or whether indeed they have had SF! Option to vaccinate still remains a dilemma even though they actually may not need it. Perhaps our government could have spent money on setting up testing facilities to confirm our health status, rather that a "waste of time" phone and internet helpline which dishes out Tamiflu with the symptoms of a mere common cold!

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  • 67. At 11:38am on 12 Dec 2009, SShark32 wrote:

    The media have a lot to answer for sometimes. There have been criticisms on this blog from people who question the need for the government to make planning assumptions about deaths and then allow them to be discussed in public. I dont share that concern - they have to plan and tell people what they are planning for.

    However, take the Evening Standard, at the start of the Swine Flu scare. I cant remember exactly what document they used, but I think they read the a London pandemic flu plan - one that's been available since prior to Swine Flu, and contains planning assumptions about excess deaths in various boroughs.

    "London Flu pandemic could kill 94,000" was the Standard's headline and it went on to describe how many people might die in each borough.

    There was probably nothing inaccurate about the figures they used (in that they were official planning assumptions) but they chose the timing and interpretation of the figures to create the most dramatic story. Is that reporting the news....I'm not sure?

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  • 68. At 1:33pm on 12 Dec 2009, angelscomeinthrees wrote:

    Lol, Skyline, I'd love to be your mate. :-)

    Sshark, there is another thing to consider with the vaccine and pregnant women. Having the vaccine doesn't just protect the mother from sf, it protects the baby as well. Obviously, if the mother dies early on in pregnancy then her baby will die too; later on it may be possible to save the baby, but the earlier a baby is delievered the higher the chances are that he or she won't make it or have health problems. Leaving aside the problems specific to sf, throwing a huge temp for any reason can trigger premature labour and any way you can protect against that has to be good. When I had flu I was initially hospitalised because they were worried that my labour would start and it was only later I needed rehydrating etc. So whilst it may be theoretically possible that a vaccine may harm an unborn baby, it is also true to say that the vaccine will protect it, too.

    We'll never agree on the Govt's presentation of the flu situation but I do agree 100% about the shocking media coverage. I tend not to read newspapers very much but when I do I am shocked at the tone of the reporting. I agree with Skyline, it's terribly hypocritical for them to start moaning about the panic about nothing when they certainly fuelled the panic to start with.

    Interesting, Risa, I had no idea it was possible to do such research around the 1918 pandemic, it was so long ago. Yuck re the norovirus, I don't know how you coped with that.

    Hats off to my eldest angel, she sat through the village market this morning looking distinctly pasty but raised £40 in her friend' memory.

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  • 69. At 3:46pm on 12 Dec 2009, joe hanson wrote:

    Read Jane Burgermeister's account on the flu case.com to give you an insight as to why people have shunned this vaccine. Real journalists would have reported on the revelation that transpired and would have brought it into mainstream for a thorough debate. If nothing else this would calm the publics fears. Nothing to do with MMR.More and more people are waking up to the big picture. They are doing there own research rather than rely on mainstream propaganda.

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  • 70. At 5:44pm on 12 Dec 2009, SkylineOnFire wrote:

    Joe Hanson. You really are going to try and reference that website? Really? Okay, time for a skyline special!

    1. Lets start this, by analyzing some of the stuff on this website, some of the articles it links to etc... Alright.

    http://www.theflucase.com/index.php?option=com_content&view=article&id=2243%3Athere-are-many-variants-to-the-h1n1-says-cfr1&catid=1%3Alatest-news&Itemid=64&lang=en

    Claims there are many variants of swine flu. This is just plain wrong. Firstly it seems to be pushing that every H1N1 strain is the same, and that every H1N1 strain is swine flu. Completely untrue obviously. They are different strains of H1N1, just like swine flu is a different strain. They have nothing to do with swine flu. Its baffling that they decided to put that up. What "makes this avian swine flu stand out" is the fact it is highly contagious, and spreading far quicker than any other strain of influenza. Jeez it doesnt take a rocket scientist to figure that one out does it now.... The other strains there arent pandemic material, hence why there is no major concern about them.

    Next one, lets see...

    http://www.theflucase.com/index.php?option=com_content&view=article&id=2240%3Aswedish-boy-aged-6-gets-qswine-fluq-from-vaccination&catid=1%3Alatest-news&Itemid=64&lang=en

    Swedish boy got swine flu from a vaccination. This site is precious. First off, vaccine is dead. There is no live virus to even infect you. It states he got flu symptoms 10 days after vaccination. Thats quite obviously a case of him catching SF before the vaccine provided its 90% immunity. Which can take 21 days. So he got the flu, before the vaccine protected him. How is this the same as "catching the flu from a vaccine" which is technically and medically and scientifically impossible.

    Next one.

    http://www.theflucase.com/index.php?option=com_content&view=article&id=2222%3A64-people-die-in-japan-after-getting-swine-flu-jab&catid=1%3Alatest-news&Itemid=64&lang=en

    64 people die in japan from swine flu vaccination. Really? I guess this site doesnt grasp the concept of, if you vaccinate a million people, and on average a few thousand of those people die every day and a few thousand are born every day, naturally. That some of those people vaccinated will die. It doesnt even matter that they had the vaccine. Its a simple case of statistics. I think even Fergus bless him went over this himself in one of his blog posts. This is basic stuff. If i stated now that 100 people who have drank orange juice brought from the tesco value range in the past few weeks, have died. It wouldnt mean it was because of the orange juice would it. This site is certainly something else.

    Next one.

    http://www.theflucase.com/index.php?option=com_content&view=article&id=2206%3Adamage-caused-by-swine-flu-jab-suppressed-in-usa&catid=1%3Alatest-news&Itemid=64&lang=en

    Thats a good one, lets reference an "anonymous" I.E made up email, but state we cant reveal any info about it. Genius. Well i received an email yesterday telling me id won a free "enlarger" and 10,000,000,000,000 from a Nigerian bank. Hows that eh!

    Next one.

    http://www.theflucase.com/index.php?option=com_content&view=article&id=2166%3Atwo-children-die-in-the-netherlands-after-swine-flu-shot&catid=1%3Alatest-news&Itemid=64&lang=en

    Mhm more deaths caused by the vaccine apparently. Yeah. Or the fact both kids had very severe underlying health conditions that meant they could die at any moment anyway. Rip to the kids, and shame on Jane BurgerMeister for posting this garbage. The vaccine is there to save people like them.

    Next one. My word this is easy.

    http://www.theflucase.com/index.php?option=com_content&view=article&id=2154%3Amuch-of-uk-population-exposed-to-germ-spraying-by-government&catid=1%3Alatest-news&Itemid=64&lang=en

    Much of UK population used as guinea pigs for MoD military testing. Sure. I know guys! Our post holds no fact or relevance to... Anything! So lets put it in a large font and use upper case for it all. That will get them to believe us yeah!



    Need i go on? Im happy to! Point of all this? The website is garbage. Its not "independent journalists" its "idiotic journalists" There is no facts for any of that. They dont even post up their sources! Its hilarious. Shall i make a site called... The Skyline on fire website? And post about how im the next best thing since sliced bread and that i can singlehandedly cure world hunger and aids in one flick of my gold plated wrist? No. Because its not true. Just like hers isnt. That was fun!

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  • 71. At 6:27pm on 12 Dec 2009, Tina wrote:

    SkylineOnFire

    I think that was a bit uncalled for. People belive what they want to believe, and read what they want to read. Trying to tell someone that what they are reading is a load of tosh isn't fair really is it?

    I used to be an avid poster on here, but stopped as I was getting shunned for NOT wanting the vaccine. I think we should stick to the original post (what fergus is saying) and not pick out indivduals!

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  • 72. At 6:44pm on 12 Dec 2009, SkylineOnFire wrote:

    Its called for when someone is referencing articles without sources, articles without any basis or fact whatsoever. Why should i not be allowed to show people how wrong the person, and their source is? Its not fair to teach someone that they are reading garbage? Well make sure we close schools, colleges and universities then, since teaching someone is uncalled for.

    Sorry but it just isnt and i refuse to let people on this site go to a site like that and take it as gospel without reading the actual *gasp* facts. You can not want the vaccine all you like, and you can believe what you like. Just as i am allowed and entitled, and morally obliged, to point out the severe discrepancies in this persons link to a site of a known.... idiot to be fair.

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  • 73. At 7:42pm on 12 Dec 2009, SShark32 wrote:

    I think Skyline is right to react to the flucase website, as it is pretty scary stuff and it's a shame worried people searching for information have to read that sort of material.

    The internet is an amazing place for us all to get information, but it's hard to separate the good stuff from the rubbish.

    If you're buying a new Mp3 player you can probably be quite objective about the sites you can trust and cant trust, but if you're health and the health of loved ones is involved it's easy to start wondering who to believe.

    I remember a few years back when my dad was dying of cancer, you start searching for information and inevitably find websites that claim incredible results for miracle cures and tell you that conventional medicine is useless as it's all controlled by big pharmaceutical companies.

    Read enough of it and you start feeling angry about the NHS and wondering whether buying some new herbal remedy or multivitamin is the way forward.

    I totally understand that issue like Iraq have made people question whether the authorities can always be trusted, but it's a sad state of affairs if we all become so cynical that we'll go to Google rather than listen to experienced Doctors and scientists.

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  • 74. At 7:58pm on 12 Dec 2009, angelscomeinthrees wrote:

    I agree with both Skyline and Sshark. One of the really frightening things about the Burgermeister style 'alternative' websites etc. is the number of people who fall for them without being able to think critically and actually make up their own minds rather than swallow it hook, line and sinker. It's no more independence of thought than that of my grandparents' generation had when they did everything that anyone in authority told them to.

    Of course you don't have to adopt the Govt. line or any accepted orthodoxy. But don't replace it with garbage.

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  • 75. At 8:02pm on 12 Dec 2009, SkylineOnFire wrote:

    Angels has it perfectly put there. Its showing zero amount of free thinking by buying into this junk without studying it and critiquing it independently. You are more of a "sucker" than the people who buy into the other way of thinking. For sure. Its a sad state of affairs when most "independent thinkers" listen to that drivel.

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  • 76. At 9:41pm on 12 Dec 2009, joe hanson wrote:

    Skyline on fire. That was quite a sustained attack there ! I agree some of the material lately is contentious and I don't pay as much attention as I once did. However, you missed one vital point...the reason Burgermeisters site came into existence was her contention that Baxter had released live bird flu with false labelling of vials which, if it had not been discovered by a Czech lab technician may have started a pandemic far worse than the swine flu.Further, the deaths related to the vaccine in Japan and Canada need to be publicly refuted, the reported plague cases in Ukraine needs to be verified or proven to be a lie... to name a few. Call me old fashioned but I think these facts (if they are) are worth knowing. You may or may not believe them and I don't know whether it is true or not but what I was trying to say earlier is that it is up to mainstream media to take these stories on and kill them straight away. Prove that is rubbish and the whole conspiracy falls. But nothing, no discussion on mainstream. Another good account is provided by a Spanish Nun (google 'Teresa Forcades') with a PhD in public health . Lets pretend she's nothing of the sort..a confidence trickster out to con us all. Even the most opinionated individual can't fail to recognise her questions are just and need answering. Check it out then you will know why I refer to the "big picture" and not just the vaccine itself.Her video stays well clear of conspiracy material but sets to question the role and motive of the WHO, the arrival of the virus and why pandemic definitions were changed. It's all a bit odd in my mind and I am entitled to think that until mainstream dares to take these people on and expalin why we are all so unnecessarily paranoid. If it's all tosh then destroy them in debate. One important thing Forcades suggests is that we never lose our capacity to question things...for every expert that says it's this there will be another one that say's it isn't. Journalists should be chomping at the bit to debate the "nonsense in conspiracy land" and rip these stories apart (particularly when they are impacting on a national directive)...but they aren't. Try and see why people have misgivings about this whole affair (and that it is multi-layered) rather than arrogantly assuming only you are right.

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  • 77. At 00:03am on 13 Dec 2009, dmcblue wrote:

    its the return of the nun again!

    as i pointed out in the previous topics, i've read this article and rather than independent questioning she just rehashes a few old conspiracy theories and then even more worrying makes up a scare on GBS when no such scare or evidence exists, i'd stick to seeing nuns in church rather than in scientific presentations after reading her

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  • 78. At 09:28am on 13 Dec 2009, SShark32 wrote:

    Joe - regarding your point on the media, rather than killing these rumours I think they would love them to be true.

    I think the media (some parts, not all) is desperate to paint a picture of chaos or incompetence or danger. If there was anything in the scare stories I'm sure they would love to write about how poison killer vaccines had harmed gulf war veterans or the swine flu vaccine was leading to lots of adverse reactions. They would love to uncover a conspiracy by dodgy politicians to make money with vaccines/medicines, in cahoots with GSK/Novartis/Roche etc etc.

    The fact that only lone sources (which I'm sure journalists like Fergus are aware of) are making big claims could be revealing?

    There's no point in complacency and blind faith in the Govt - people are bound to question new treatments/vaccines and we will never truly know how they will pan out until a few years down the line. But looking at the available scientific evidence before they were used and so far, everything seems fine as it has done in the past with the seasonal flu vaccine.

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  • 79. At 10:29am on 13 Dec 2009, sensiblegrannie wrote:

    I haven't paid a visit for a while but I thought I would just pop in for a quick look. So glad your son Hugo is ok Fergus. Regarding autism, I have worked with severely autistic children and I can assure you they are extremely well looked after by loving, dedicated teams of people. Autism is a spectrum disorder with a varying range of symptoms and degrees of severity. The most severe cases do not communicate easily, they do not speak but use and understand sign language (not sign language for the deaf) Those children with less severe symptoms of autism are able to fit in the normal school environment with some support. I think those of you who are blaming the vaccines aught to do more peer reviewed research.

    Now, guillain barre syndrome is a dilemma. This is an autoimmune disorder triggered by an infection of some sort or by vaccines. This disorder is continuously PAINFUL and appears to get worse and worse. The doctors do a blood test once you have complained about the pain to the doctors over and over again. The doctors will tell you it is muscle strain or arthritis. If you get it, you are stuck with it, and the cure is not readily available as it is a bit complicated to do. The syndrome should clear up by itself after a couple of years if you are lucky. If you are unlucky well... Anyway, check it out on a google search from a reliable peer reviewed paper. I am pretty sure my chap has developed it from his ordinary flu jabs and although he is able to get on with his day to day activities, he suffers from a lot of pain now.

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  • 80. At 1:55pm on 13 Dec 2009, angelscomeinthrees wrote:

    Grannie, I'm sorry to hear about your partner. I'd never heard of GBS being linked to seasonal flu vaccines.

    Re autism, I don't think anyone would dispute that the people who care for children with autism are extremely dedicated. I'd go further and say that most of society would want children with autism to get the best care possible. But the difficulty for families with autism is that getting that care in the fist place is so hard. Parents have to fight the State for every crumb and there have even been instances where LEAs have put paedetricians under pressure to change a child's autism diagnosis so that they do not have to fund the help that you rightly say enables them to enjoy mainsream schooling. I used to hang out on Mumsnet and the stories on there about how obstructive and callous the State could be to these families were horrific. Once they get the care, of course, that is a different story.

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  • 81. At 12:03pm on 14 Dec 2009, dmcblue wrote:

    one of the most common cause of GBS is actual flu - you are 7 times more likely to get GBS after the flu, that association doesn't exist for the vaccine so despite the scare stories out there the vaccine is actually protective against GBS

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  • 82. At 3:15pm on 16 Dec 2009, DisgustedOfMitcham2 wrote:

    Firstly, Fergus, pleased to hear your boy is doing better.

    Secondly, while some of the sentiment remaining from the disgraceful junk science about MMR may well have played a part in diminishing uptake of the flu vaccine, I don't think it's as simple as that, for 2 reasons.

    First, although it seems to me a no-brainer that people in high risk groups should get vaccinated against flu, there is probably a bit of a grey area in deciding where you draw the dividing line between high risk and low risk. Although well-informed people know that the flu vaccine is safe (apart from the small risk of anaphylactic reactions in susceptible people), they also know that it has common side effects including a sore arm and mild flu-like symptoms, which, while medically unimportant, are still unpleasant. If you consider yourself to be at sufficiently low risk of the complications of swine flu and consider things like a sore arm to be important, then it may well be a rational decision not to be vaccinated, even if you never believed a word of the junk science about MMR or any of the scare stories about flu vaccine.

    Second, the junk science around MMR is nothing special. It's simply one manifestation of an anti-vaccination movement that has existed ever since the time of Jenner, and not something that's caused a significant change in attitudes in its own right. That anti-vaccination movement is still in full swing and will continue to peddle scare stories about flu vaccine and any other vaccines we might develop in the future.

    Having said that, of course, the exceptional prominence given to the MMR junk science in the mainstream media may well have fooled many well-meaning people who are not naturally part of the anti-vaccination movement and put them off vaccination. I trust the media have learned something from that sorry episode.

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  • 83. At 2:14pm on 17 Dec 2009, Dave Cheadle wrote:

    I'm appalled at the cynicism that the press showed over the whole jabs thing. As usual, there is no evidence of self-reflection - as recent coverage of the cervical cancer jab has shown (mentioning no names, but a certain frothingly right-wing sensationalist dishrag comes to mind)

    Is there any truth in the claim that there are fake flu jabs doing the rounds?

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  • 84. At 7:01pm on 17 Dec 2009, DisgustedOfMitcham2 wrote:

    #83, Carps:

    The story you linked to was about fake antivirals (ie counterfeit Tamiflu), not fake flu jabs. Fake medication is quite widespread, particularly if you buy things from dodgy internet sites. So I don't know whether the particular story you linked to is true, but it certainly could be.

    Flu vaccinations, on the other hand, are provided through a much more secure supply chain, so I'd be surprised if there were any fakes around.

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  • 85. At 00:55am on 09 Jan 2010, Ann Lewis wrote:

    What haven't you covered the story about the Cochrane Collaboration having found no evidence to support Roche's claim that Tamiflu reduces hospitalisation among swine flu patients by up to 60%? This was the main reason governments around the world bought millions of doses of the stuff and yet Cochrane supported by the British Medical Journal say this claim has not been backed up by any robust evidence. These independent researchers were commissioned by the NHS to review the evidence base for Tamiflu. This wasn't junk science Fergus, these are two very august bodies and the questions they raise are extremely important and in the public interest. (Anything to say on the BMJ/Cochrane Review of Tamiflu Skylineonfire?)

    The fact that you gave Tamiflu to your son, doesn't exempt you from examining the facts as a journalist. It may even be a spur to your professional curiosity. This is an extremely important issue and one the BMJ has dedicated a whole edition to.

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  • 86. At 12:39pm on 10 Apr 2010, Bojan Jop wrote:

    I was surprised to see Annabel's meals in a shop and to hear this years.
    I am, as should you be - using many articles that are thet not peer reviewed is both and have been much more well placed to helps parents by suggesting and tips a healthy nutritional daily.It is an uphill battle encouraging parents to cook, but then these parents aren when the local shop is stocked with disease like diabetes and part of educating our children to eat well is to teach many them.

    Best regards from Bojan M Jop

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