Boy and vaccine syringe

Recently I was interviewed on both radio and TV about a case where a man had a severe reaction to a whooping cough vaccine. This is a dangerous area as virtually all discussions about immunisation generate lots of heat but very little light. The camps are highly polarised.

The case in question involved a previously fit and healthy man who was told that before he could visit his baby in hospital (the baby was eight weeks premature and was in the neonatal ward) that he had to have a booster shot. He initially protested on the basis of being up to date with all his immunisations. However he relented when it was put to him that he could not visit unless he had it.

Within 48 hours he was extremely unwell.

He spent the next ten months in hospital with Acute Disseminated Encephalomyelitis (AMED). This is an extremely rare condition, which affects the nerves leaving the person paralysed.

It is thought to be an overwhelming auto-immune response (where the person’s antibodies attack part of the body) triggered by an infection or vaccination. The frequency is between one in two million and one and eight million!

He spent a period of time on a ventilator and was told he would never walk again. His recovery has defied that prediction but he remains very weak and unable to work. The family has lost their car and was on the verge of losing their house.

Despite being harmed by a medical intervention they have been unable to get redress, as there was no “negligence”. Essentially nobody did anything “wrong” so there is nobody to sue.

The vaccination debate polarises into those who see vaccination as all good and deny any adverse effects. This group wants to silence those who suffer harm, as they believe it undermines the pro vaccine message. At the other end are those who see vaccination as some form of conspiracy and plot between doctors and the government. They see the small number of adverse effects as proof that they are right.

The truth is of course in the middle. Immunisation has contributed to the decline in various infectious diseases. However it is NOT the sole factor. Most of these infections were already in decline due to better housing, sanitation, nutrition and generally better living conditions before the advent of mass vaccination, which also helped.

The denial of harm actually feeds the anti vaccine lobby. The treatment of people who do suffer harm adds to this

In the same week as the above story, a settlement was reached in the case of a baby who suffered major permanent disability as a result of a flu vaccination. The settlement was reportedly worth multi millions – after a four-year battle.

It has also emerged that experiments for some vaccines were done on orphan babies in the 1930’s.

There is one other issue, which gets lost in the heat. Not all diseases for which we have vaccinations are of equal severity. Tetanus is almost always lethal whereas chicken pox is (with exceptions) just unpleasant. Yet on vaccination schedules there is an “all or none” approach.

And that schedule has more than doubled in the last 25 years. There are more infections covered and of course more injections. In Australia the government covers the cost. In the USA it is not. According to the New York Times the cost of the five vaccines recommended in 1986 was $215. Today the cost is $937. And eight more added since 1986 cost $1255.

Of greater concern is that costs seem to be “fluid”. On the Fierce Pharma site it was reported that the cost of one vaccine (Prevenar 13) went up from $80 to $120 the day after it was added to the government schedule.

It would be hard to argue that the cost of production went up 50% overnight.

Regardless of the benefit, there are harms associated with all medical interventions. In vaccination we have something which is all but mandated and which people do not just for themselves but also for the greater good. As a consequence, there needs to be recognition of and support of those who suffer considerable harm.

The two cases described above highlight this.

There also needs to be debate about whether we need an all or none approach, given that most of the vaccines added more recently are for generally non fatal illnesses. And there needs to be greater transparency about costs.

Immunisation has been of significant benefit but nothing should be above open discussion and questioning of how we go about it.

Time for more light and less heat.