Saturday, December 12, 2009

Over The Top With Swine Flu Vaccination?

Clameur de Haro was quite surprised last weekend when one of his close friends, a fellow-guest enjoying a relaxed informal supper with several other mutual friends, launched into a fairly trenchant criticism of the swine flu vaccination policy. CeH's friend is usually rather more inclined than is CdeH to give our politicos, their advisers, and those who do their bidding the benefit of the doubt, so this critique was doubly interesting to listen to, coming from the source it did.
Its substance was that the States in general, and the Medical Officer of Health in particular, have essentially gone over the top in the extent to which the swine flu scare has been talked up, almost to the point of causing a degree of anxiety among putatively vulnerable sections of the population which cannot be wholly justified, either by the incidence of infection, or its severity if actually contracted - and that there has of course been a considerable public expense incurred.
Not being in one of the allegedly-at-risk categories, Clameur de Haro hadn't previously given this too much thought, beyond a vague feeling of uneasiness that the whole thing seemed to be being promoted with the kind of almost evangelical zeal and "the nanny-state knows best" authoritarianism redolent of some of the more infamous scare campaigns of recent years which turned out eventually to be largely just that - a scare. Whatever happened to bird flu and SARS, which were similarly talked up as a serious threat?
So it was with more than a passing interest that CdeH read press reports this week to the effect that Roche, the manufacturer of oseltamivir (Tamiflu), has been accused by no less august a publication than the British Medical Journal of making it impossible for scientists to assess how well it works by withholding evidence the company has gained from trials.
Of particular significance, it seemed to Clameur de Haro, was this -
"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.
Tamiflu may shorten the bout of illness by a day or so, the investigators say, but it is impossible to know whether it prevents severe disease because the published data is insufficient. Roche has failed to make some of the studies carried out on the drug publicly available, the scientists say.
Freemantle (Professor Nick Freemantle, Birmingham University) said he saw "very little evidence to support the widespread use of oseltamivir in the otherwise healthy population who are developing signs of influenza-like illness." He added: "We have remarkably few resources in this country to spend on pharmaceuticals on health, and it is surprising to see such widespread use of oseltamivir".
Freemantle went on to suggest that the large stockpiles amassed by the UK health authorities may have had more than a little to do with the frequency and extent of distribution/vaccination, irrespective of the questionable effectiveness of the drug.
So, in the Jersey context, the questions arise - if there really has been precious little data on the effectiveness of oseltamivir/Tamiflu in preventing severe disease: if in many cases the swine flu infection itself really turns out to be either barely distinguishable from, or not much more onerous than, "normal" flu: and if there really is no conclusive evidence found that it prevents healthy people contracting flu from suffering complications: just what on earth have the Jersey health authorities been doing in playing up both the risks and the alleged benefits (including the constant flow of press releases suggesting dangers and remedials of almost epidemic proportions), and putting into action an vaccination programme compulsory in all but name across large swathes of the population? Is it also a case of a large stockpile having been amassed, and therefore having to be used to justify it?
Some answers from the Health Minister, please.
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