Hot H1N1 Update from Miss Diagnosis

The proposed post-H1N1 makeout party.
The proposed post-H1N1 makeout party.

The Centers for Disease Control and Prevention (CDC) released a report on H1N1 vaccine safety based on all the information that has been collected since the vaccines have hit the market. The report’s take-home lesson? So far, so good.

This means that Miss Diagnosis feels pretty smart about telling you to get vaccinated in her column this week. And she continues to stand by the recommendation, given that the risks of vaccination remain marginal compared to the risks of contracting H1N1. Miss Diagnosis plans to celebrate her excellent judgment with plenty of hand washing. This way, her decontaminated hands will be perfectly poised to vaccinate anyone who asks.

Of course, if you’re not in one of these lucky priority groups—pregnant women, household members/caretakers of infants younger than 6 months old, children 6 to 59 months of age, children and adults 5 to 64 years of age with certain chronic health conditions, and healthcare workers—you’ll have to be patient and wait. But Miss Dx will be happy to poke ya when it’s your turn. The caring and compassionate medical staff (of one: me) here at the Alibi will let you know as soon as Uncle Sam says it’s okay to begin vaccinating everyone.

Unless you’re in an emergency without the time or resources to check the facts, it’s never a good idea to make a medical decision just because someone says, “trust me. It’s safe.” Since I want all of you lovely Alibi readers to be informed medical decision-makers, I’ve included a breakdown of the CDC report below in order to demonstrate how I reached the conclusion that risks associated with vaccination are small.

The report was released Friday, Dec. 4 in an early edition of the CDC’s Morbidity and Mortality Weekly Report. The publication posts the most current data from two vaccine safety monitoring programs, the national Vaccine Adverse Event Reporting System (VAERS) and the Vaccine Safety Datalink (VSD). The VAERS is a passive reporting system, and as such is unable to establish cause and effect between vaccination and adverse events, although it does provide nationwide surveillance for potential problems. The VSD, on the other hand, uses data collection techniques and comparison groups that enable the system to detect associations between adverse events and vaccination. This means the VSD is superior in terms of establishing cause and effect.

So far, people are reporting adverse events following H1N1 vaccination to the VAERS at a higher rate than that of seasonal flu reports, with 4.4 serious adverse events reported per 1 million H1N1 vaccines distributed, as compared with 2.9 serious adverse events per 1 million doses of seasonal flu vaccine. This contrasts with the VSD, which has followed over 438,000 people but has not seen the same relative increase in adverse events. The CDC postulates that increased reporting of H1N1 vaccine-associated adverse events to the VAERS is due to increased awareness and increased motivation to report events associated with a high-profile disease like H1N1 than with regular ol’ seasonal flu.

Over 46 million doses of H1N1 vaccine have been distributed in the U.S., and 13 deaths have been reported to the VAERS. Of these 13 deaths, 9 were found to occur in people with serious underlying illness, one occurred because of a motor vehicle accident, and three are still under investigation. To me, it looks as though two of the deaths could be vaccine-related, but I’m not a coroner with a complete autopsy report in my paws, so my opinion is purely conjecture.

The VSD, on the other hand, has received one report of anaphylaxis (or an acute, life-threatening allergic reaction) and no reports of Guillian-Barre syndrome, which is a serious neurological reaction seen in about 1 per 100,000 vaccinations during the infamous 1976 flu vaccination campaign. No increased rates were detected for other potential adverse events, like seizure or allergic reaction.

Taken together, the VAERS and the VSD show that there aren’t any unexpected or bizarre side effects cropping up. So let’s all celebrate with a big drunk make-out party once everyone’s vaccinated! Until then, though, keep your mucus membranes to yourself and continue washing those germy mitts!