Late last week the Washington Post reported that a number of U.S. doctors are following in the footsteps of many British
and European medical doctors and just saying “no” to the swine flu vaccine and swine flu vaccine sprays.
While the media has been reporting that the biggest frustration facing many doctors had been the apparent scarcity of
swine flu vaccines for their patients, in fact many are actually not even recommending the shots... nor the vaccine’s nasal
Understandably, many doctors remain skeptical about the government's unprecedented immunization campaign, citing
significant doubts about the actual risks presented by the H1N1 virus itself and the effectiveness and safety of the
"My feeling is that this is all being over-hyped," said Laurence J. Murphy, a pediatrician who will not inoculate his patients.
"Most people who get this virus do beautifully. I believe the vaccine hasn't been tested enough. I just think the benefit of it at
this point is not outweighed by the possible risk."
Such contrary voices, through the megaphone of cable news or in the quiet of exam rooms, have forced federal health
officials to play defense as well as offense in their campaign to encourage and even enforce immunizations.
Public health leaders are at a loss to explain the skeptics except to say that they mirror the chronically low percentage of
health-care workers who get the seasonal flu vaccine every year. Officials worry that these doubters could have a
disproportionate influence in an already frustrating and confusing situation.
"I am very disappointed, deeply puzzled and very disturbed by this," said William Schaffner, president-elect of the National
Foundation for Infectious Diseases. "The people for whom these doctors are not recommending this vaccine are clearly
high-priority patients who could have very adverse outcomes if they get infected with the virus."
'Not enough data'
Although no one has surveyed doctors' views on the vaccine, polls show that people look to their physicians when deciding whether to get the
shots or nasal spray. A nationally representative survey of 1,042 adults in September found that 68 percent said they trusted the advice of their
doctor or their child's pediatrician on this issue, far more than those who said they trusted top federal health officials and medical groups.
"People rely very heavily on their physician's judgments about whether or not they should take a vaccine," said Robert J. Blendon, a professor of
health policy at the Harvard School of Public Health who conducted the survey. "They are at the top of the charts."
As a result, the naysayers have left patients torn between a doctor's long-respected advice, their own judgment and official recommendations.
"It's like total confusion for me to try to figure out what to do," Soghomonian said as she lined up with her 3-year-old daughter, Ally, on a recent
morning at a District flu clinic.
"It's really been very frustrating and very scary," said Soghomonian, who eventually left after deciding to give her daughter only the seasonal flu
vaccine. "I just want someone to tell me what to do, you know?"
Cheryl F. Edmonds, founder of the practice where Soghomonian takes her children, declined to be interviewed. But a member of her staff, who
spoke on the condition of anonymity, characterized her concerns this way: "Her thing is there's just not enough data."
Murphy, the Burke pediatrician, said he has no reason to think the vaccine is unsafe -- he, like many of the skeptics, said he generally supports
vaccinations. But he wonders whether it was tested enough.
"They just didn't have the time to do that properly. They mean well and they are not doing anything to mislead people in any direct way. The reality
is no one knows. I'm not pretending to know. I don't think they should pretend to know," he said.
'Jumping on the bandwagon'
Murphy is not alone. Obstetricians, family practice doctors, internists and other physicians nationwide who harbor doubts about safety of the
vaccine or the danger the flu poses raise questions on blogs and during interviews, and counsel their patients not to get the immunization.
"What bothers me is pretty much every doctor in the country is jumping on the bandwagon and saying, 'This vaccine is completely safe' -- even for
the pregnant woman and the unborn baby," said Bob Sears, of Orange County, Calif. "But they can't give you a single study that backs up that
Officials repeatedly have stressed that while no vaccine is completely safe, there is no reason to believe the swine flu immunization would pose
any unusual risks, and so far no problems have emerged.
"I can understand the hesitancy and reluctance to take a vaccine that appears to be new and different. All we can do is provide the facts," said
Thomas R. Frieden, director of the federal Centers for Disease Control and Prevention. "The facts are that this is the same manufacturing
process, the same manufacturers, the same factories, the same safeguards as the seasonal flu vaccine that has been used for more than 100
million doses each year for many years and which has an excellent safety record."
But Meryl Nass, an internist in Bar Harbor, Maine, still has doubts, especially given that most people who become infected get only mildly ill.
"In this situation, when there's very little data, I don't think people -- and children in particular -- should be asked to bear the burden of being
experimental subjects," said Nass, who has been blogging about her doubts. Nass also questions the assertion that the vaccine is safe for
women in all stages of pregnancy.
"The CDC is telling women in all trimesters to go out and get vaccine. To my mind, this is reckless," said Nass, who is advising her patients to
consider receiving the vaccine only in their second or third trimesters.
'Behind the curve'
Some doctors hear echoes of politics in the reactions to their concerns.
"You come out and offer some caution about the safety of the vaccine, and it becomes very political: Are you with us or are you against us?" said
Kent Holtorf, whose Southern California practice specializes in treating chronic conditions. "It's almost like Republicans and Democrats, and no
one wants to toe the middle ground, because it could help the other side."
Giuseppe Lancellotti, a pediatrician from Ephrata, Pa., argues that the vaccine has arrived too late to make a difference anyway.
Let’s NOT continue to make this a political issue. Demand that the pharmaceutical companies provide PROOF – as they are legally required to
do through clinical trials, and studies. No drug should be allowed onto a market promising solutions to any ailment or threat without sufficient, well
To allow politics, fear campaign style marketing, business interests and unsupported and normally paid “expert” opinion to take the place of
scientific fact and clinical study is ludicrous and in many cases quite dangerous - even lethal.
Demand evidence and demand that the sources of information supply it or are otherwise held accountable.
All the best,
Rudi C. Loehwing
World Institute of Natural Health Sciences
The "Business" of Drugs: American Doctors Rejecting
H1N1 "Swine" Flu Vaccines & Sprays
Page created 8/9/09
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