Monday, October 05, 2009


Use vaccines with caution

By: (Thu, 01 Oct 2009)

RECENTLY, there has been some urgency by the Health Ministry to buy vaccines for the influenza A H1N1 pandemic, in view of the threat of a second phase.

While this move is with good intentions, it may be wise for the ministry to proceed with caution as this Influenza A H1N1 vaccine is not entirely harmless.

The treatment must not be worse than the disease itself. If the flu virus A H1N1 remains as such, is there a need to mass vaccinate? Is it not better to maintain good health and personal hygiene.

Furthermore, vaccines prepared in a hurry may not have been well tested to make sure that it is safe enough. There is also the issue of the target virus, which at the moment is still not obvious, so that at the end of the day, the vaccines may not protect against the offending virus and may in fact give a false sense of security.

So far, there are more than 20 reported cases of resistance to H1N1 vaccines and this number is rising, especially in Australia, Denmark, Canada, United States, China and even across our shores in Singapore.

Most of the cases have occurred in people who were given the drug either to prevent infection after exposure to the virus or as treatment.

There are also many documented accounts of side effects from flu vaccines. In 1976, Washington rushed in a mass immunisation programme against a similar swine flu outbreak that was confined to a military base.

Several hundred cases of a rare, lethal, paralysing neurological disease called Guillain-Barré syndrome (GBS) were reported afterwards from previous experience of mass vaccination as well as the Gulf War Syndrome.

Although the H1N1 vaccine now close to completion is different from the one used in 1976, the British Government’s Health Protection Agency said the earlier incident nevertheless highlighted a possible area of concern.

Similarly with the vaccine for cervical cancer. Though initial results with this vaccine are impressive in the reduction of pre-cancerous cervical lesions after three years of clinical trial, its long-term side effects are yet unknown. One has to only Google HPV vaccine deaths to know of the short-term risks present with mass immunisation programmes.

At the same time, vaccinating 13-year-olds in the prevention of a sexually transmitted disease has its social implications, not excluding promiscuity and a false sense of security, therefore indulging in more sex?

Is there a need to vaccinate 13-year-olds against pre-cervical cancer? Is it not better to improve cancer awareness and educate the females in the risk group to undergo the time-tried pap smear in the prevention of cancer of the cervix.

In any case, at the end of the day, it should the patient’s choice of how they wish to be treated or protected but as physicians, we must always remember, first do no harm.

Dr Ng Swee Choon
Medical Affairs Committee
Federation of Private Medical
Practitioners Associations of Malaysia

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