By: Rosemary Stephen, Elements: Environmental Health Intelligence
Articles:
“ Danger of swine flu is not what it is, but what it could become” by Bob Lamendola [1]
“ Swine flu shot: Intense tracking for side effects” by Lauran Neergaard [2]
“Public health surveillance: America the backward” by revere [3]
M ass immunization is a process where a large number of individuals are vaccinated in a relatively short time span. Aside from the small percentage of people who faint at the sight of a needle, or who have vaccine reactions, most mass immunizations run smoothly. Having been involved in mass immunization myself, I was intrigued by these three articles which discuss H1N1 immunization and subsequent monitoring. The first article, entitled “ Danger of swine flu is not what it is, but what it could become” by Bob Lamendola [available at: http://www.physorg.com/news173379230.html], tackles the question of H1N1 and its potential to become a serious threat to human health. The second article, entitled “ Swine flu shot: Intense tracking for side effects” by Lauran Neergaard [available at: http://www.physorg.com/news173281180.html], addresses what type of side-effects monitoring is being done and why. The third article, entitled “Public health surveillance: America the backward” by revere [available at: http://scienceblogs.com/effectmeasure/2009/09/public_health_surveillance_ame.php], is a ‘no-holds-barred’ response to Neergaard’s article.
In the first article, Bob Lamendola looks at the current, relatively mild H1N1 virus and discusses how, and why, it concerns infectious disease experts. Some of the fears include: the H1N1 virus affects a different demographic from seasonal flu, most commonly infecting people ages 4 to 25, and the worry that the H1N1 virus could mix with other viruses, for example the avian flu virus, and hence become more virulent. The article also provides data from the US on: the number of cases, the death toll, the hospitalization rates, the timing, estimates of who will get sick and estimates of who may die, giving readers an overview of the situation there to date.
In the second article “Swine flu shot: Intense tracking for side effects” Lauran Neergaard discusses the upcoming American, mass immunization program against the 2009 H1N1 virus. The main targets of the vaccination program are those considered to be most at risk from the virus; in the case of H1N1 this means not only the elderly, but also the young, including children and pregnant women. Due to fears of serious side-effects, the US government has developed “an unprecedented” system to track possible issues. Harvard Medical School, Johns Hopkins University and the Centers for Disease Control and Prevention will play key roles in gathering specific information about any vaccine side effects. They will also see if they can link Guillain-Barre syndrome to the vaccination. Guillain-Barre syndrome is a medical disorder of unknown origin that may be triggered by vaccinations. It causes the body’s immune system to attack part of the peripheral nervous system resulting in paralysis and even death.
The article clearly explains how this new monitoring will proceed; Harvard Medical School scientists will link large insurance databases with the US vaccination registries. What they hope to record is the number of vaccine recipients who see a doctor in the weeks after the flu shot and the reason for their visit. Johns Hopkins University will send e-mails to vaccine recipients asking for information about any possible vaccination side effects 
that did not require medical attention. The Centers for Disease Control and Prevention will give each recipient a take-home card asking that they report any side effects to the Vaccine Adverse Event Reporting system.
Lauran Neergaard also notes that the scientific community, via this intense monitoring, will also try to find ways to investigate the safety of medical products more quickly. This flu vaccination season is the perfect environment to do so.
The third article is a response to “ Swine flu shot: Intense tracking for side effects”. The author agrees with the importance of monitoring; it is the basis of public health and “would make assuring the safety and efficacy of vaccine programs and a myriad of other things possible”. The article goes on, however, to point out that in the States, it may actually be a case of too little, too late. According to the article “…every other industrialized country has a national health care system that makes keeping track of these elementary [medical] facts possible. The US doesn’t..” and the CDC is simply trying to “jury rig” a system to track the issues.
As for me, I hope the intense monitoring of the upcoming flu season will answer many questions…
Conclusion
These three articles are very interesting because they discuss different aspects of the fight against the H1N1 virus. Bob Lamendola gives a good overview of what is known about H1N1 in the US to date and Lauran Neergaard outlines what the scientific community is trying to learn from this flu through the use of new, intense monitoring methods. Linking large insurance databases with the US vaccination registries, sending e-mails to gather information about symptoms and using take-home cards to request recipients to report any side effects to the Vaccine Adverse Event Reporting system are all monitoring tools that will help the scientific community answer important questions and save more lives in the future. The third article by revere presents the view that the US monitoring program is needed, but more should, and could, have been done sooner.
References:
[1] Lamendola, B. Danger of swine flu is not what it is, but what it could become (2009) Science: Physic: Tech: Nano: News, Physorg.com. (On-line) Available: http://www.physorg.com/news173379230.html. Cited 2009 Sept 29
[2] Neergaard, L. Swine flu shot: Intense tracking for side effects (2009 ) Science: Physic: Tech: Nano: News, Physorg.com. (On-line) Available: http://www.physorg.com/news173281180.html. Cited 2009 Sept 29.
[3] revere, Public health surveillance: America the backward (2009), Scienceblogs.com, Effect Measure. (On-line) Available: http://scienceblogs.com/effectmeasure/2009/09/public_health_surveillance_ame.php. Cited 2009 Sept 30.
