Hepatitis A - Creating a Market for Another Superfluous Vaccine
By Dr. Tim O'Shea

Part 1 of 2

They finally did it. After years of lobbying and angling, GlaxoSmithKline finally got their new vaccine for Hepatitis A tacked onto the mandated schedule as of Jan 2002, with no public fanfare. (www.aap.org) The vaccine is called Havrix, and is delineated on p.1544 of the 2002Physicians Desk Reference, which incidentally was printed much earlier lastyear. Merck also has a hepatitis A vaccine - Vaqta. The CDC's mandated schedule is the brass ring that all vaccine manufacturers are going for - approval of a vaccine can mean annual revenues of $1 billion or more, which is about what Merck pulls in for their current Hepatitis B vaccine. Hepatitis A vaccine appears in a brand new category on the mandated schedule called the 'high risk' category. The significance of this new category will soon become apparent. But before we get into that, let's take a look at Hepatitis A the disease and assess the necessity for a mandated vaccine.

What Is Hepatitis A?

As every doctor knows, Hepatitis A is an acute viral disease of the liver. Hepatitis A virus (HAV) has supposedly been isolated:  "a 27-nm RNA picornavirus (enterovirus) with only one serotype..."- American Academy of Pediatrics, Dec 1996 The infectious agent is passed from human to human either through the oral - fecal route, waterborne, often from raw shellfish or dirty water blood and body secretionsHepatitis A is a mild, self limiting disease, resolving on its own with no treatment in 4-8 weeks. Most infections are subclinical, meaning that most people who get the disease never even know it because they never manifest symptoms. (Merck Manual, p 377) The journal Pediatrics agrees:
"Most HAV infections in young children are asymptomatic... Clinical hepatitis occurs in fewer than 10% of infected children." This disease is so mild that 90%of kids who get hepatitis A never even know it. Even the National Institutes of Health states that:"Most people who have Hepatitis A get well on their own after a few weeks." - NIH Manual: What I Need To Know About Hepatitis A :Most cases of hepatitis A are found in Third World areas, outside the US.The question pops up: then why are we the only country in the world who recommends the vaccine on a mass scale?

That billion dollars hanging in the balance wouldn't be in the equation, now would it?

Diagnosis of hepatitis A is supposedly by IgM antibody. But more often, diagnosis is by symptoms alone. Symptoms Of Hepatitis A According to Merck Manual, the chief symptoms of hepatitis A are
 loss of appetite dark urine Hardly life-threatening situations. Jaundice may also occur, but it usually indicates the beginning of recovery. By the time these symptoms appear, the disease is no longer infectious. Unlike hepatitis B, Type A hepatitis disappears completely after acute infection, and does not contribute to chronic liver disease or to cirrhosis.  It is important to note that after the patient recovers, he has lifetime immunity. True immunity.

Hepatitis A is a disease of poor personal hygiene, bad sanitation, poverty, overcrowding - Third World scenario. Even well-groomed, well-fed junkies are not high risk for Hepatitis A. They're more apt to get Type B. Medline indicates the lack of sewers in Third World locales as the biggest contributor to Hepatitis A. Again from the journal Pediatrics we find that:
"The major method for prevention of HAV infections is improved sanitation and personal hygiene"

Bottom line here: Hepatitis A is not common in most of the United States.

Other Causes

It's shocking to discover that hepatitis can be caused by both hepatitis B and hepatitis C vaccines!

This fact is found in a disclaimer that GlaxoSmithKlein makes about Havrix,that it can't cure the hepatitis caused by these other 2 vaccines. So can we infer from this that Havrix itself also causes hepatitis? We don't need to infer it.

The manufacturer states it on p 1545 of the 2002 PDR: a possible side effect of Havrix is hepatitis!

Another source of hepatitis A for children is nososcomial infection. That means infants in hospital intensive care units pick it up there. We never hear about it because the new literature is leaving it out. (AAP Policy Statement, 1996)

So Then What's The Vaccine For?

The question arises - did we really need another vaccine beyond the 40 already mandated for school kids, and specifically did we need a vaccine for a rare disease that resolves by itself in a few weeks? To answer the first, we must ask were there any studies done which prove that the new vaccine is safe when Havrix is added to the other 40 mandated vaccines?

No, there are none.

This concept of the cumulative viral load is discussed at length in the 2002 edition of The Sanctity of Human Blood. Secondly, to substantiate the necessity for any vaccine, we must look at two
criteria: incidence of disease severity

How Many Cases Really Are There?

This is tricky - research roulette. In the 2002 Physicians Desk Reference, the manufacturer of Havrix cites 13-year old studies which supposedly show the incidence of hepatitis A and state that the case death rate is six-tenths of one per cent. (p 1545) This is claiming that about six out of a thousand who get hepatitis A die from hepatitis A. It seems like a rather high death rate until one realizes that these are not US figures, but global figures, meaning that they were taken primarily from Third World countries because that's where the majority of hepatitis A is found!

So that means that these patients are trying to recover from a disease of poverty, filth, and malnutrition in an environment of poverty, filth, and malnutrition. Hardly applies in the rare instance of a patient in most of America. But these are the studies and figures that the vaccine manufacturer has used to convince the FDA that Hepatitis A is such a serious disease in the US that a vaccine is necessary.

Numbers, numbers, numbers. Different sources, different stats. From the American Academy of Pediatricians website we see only half the death rate reported by the PDR: "Mortality is rare, especially in children. The case-fatality rate has been estimated as 3 per 1000 clinical cases in the United States.." - http://www.aap.org/policy/01207.html

Looking at the true incidence of the Hepatitis A in the US is an academic artifice, a daunting challenge indeed. A standard government reference for epidemiology is Statistical Abstracts. On p 137 of the most recent edition (2000), we find that the overall incidence of Hepatitis A has been declining for the past 2 decades:

1980 --- 29.1 cases per 100,000

1998 --- 23.2 cases per 100,000
This decline is good news, and of course has nothing to do with the vaccine. The vaccine just came out. But the figures still seem a little high, don't they? On closer inspection, getting out the magnifying glass and reading the microprint footnote on that same page, we read:

"Includes cases imported from outside the United States"

Huh? 'Cases imported from outside the United States'? We're not talking Pinot Noir here. No one doubts that the vast majority of hepatitis A cases are foreign. It's a disease of poverty, filth, and malnutrition. Unfortunately in a disease which only manifests symptoms less than 10% of the time, and with the immense amount of immigration and international travel going on, there is simply no way to separate foreign from domestic origin. To further illustrate the low credibility of government figures for hepatitis A cases, we need only look at a CDC report which claimed more than 10 times higher incidence: 30,000 cases, which is about 300 cases per 100,000. (Hepatitis Surveillance Report No. 55)

That's a little different from 23 cases per 100,000. So which study is right?
 
Who knows? Results depend on who funded it, who wrote it, and who was responsible for verification. The truth is no one can really say with authority how many cases of hepatitis A occur in the US annually.

The Real Number Of Deaths

In an earlier part of that same reference - Statistical Abstracts, p 90 - we find that the total number of annual US deaths from all 3 types of viral hepatitis put together (Types A, B, and C) in 1998 was only 4700. Remember this 4700 also includes complications of autoimmune diseases, terminal infectious diseases, and other serious illnesses, most in communities of poverty and malnutrition, alcoholics, drug addicts - individuals of this nature. This lowest common denominator of life
supposedly represents the necessity of a vaccine for all.

Looking at the PDR's global figures above - a mortality of 6 out of 100,000 - we see the usual attempt by the vaccine manufacturers to grab the credit for saving us from an already declining disease. As we learned from the Michael Alderson figures cited in The Sanctity of Human Blood (p 45), virtually every infectious disease of the past century had almost disappeared by the time vaccines came on the market. This is the perfect time to make the same claim for Hepatitis A, before it disappears completely on its own. Masterful PR in action, a la The Doors of Perception - www.thedoctorwithin.com

We may be sure that future studies on US hepatitis A incidence will show vast decreases, for which the vaccine will doubtless be given credit. Just remember the virtual impossibility of determining incidence at this time, when the vaccine is being introduced. Stats game aside, almost all sources agree that children are not the group dying from hepatitis A: "hepatitis with mortality occurs mostly in people with underlying conditions, such as chronic liver disease, and in older age groups" - http://www.aap.org/policy/01207.html

The Vaccine Itself

This is fun. Hepatitis A vaccine is made from infected human connective tissue cells.

Not kidding.

Not from just one guy, but rather each batch of vaccine is made from an infected mass of cells which had 1000 donors. (Pediatrics) Imagine that party. They are infected with hepatitis A virus, the causative vector presumed to be present in every case of hepatitis A disease. The agents are filtered, and attenuated with aluminum, formaldehyde, and phenoxyethanol - a synonym for ethylene glycol - a component in antifreeze. Someday we're gonna pay for this.......

Aluminum And Formaldehyde

Just for the sake of argument, let's make the colossally irresponsible concession that the attenuated viral agent in this vaccine is necessary to stave off the "epidemic" of Hepatitis A about to sweep through our children's bloodstreams. All right, we'll concede that unlikely situation. So do the science wizards then want to explain the additional presence of one of the most potent of all human neurotoxins and also of a well known carcinogen in this supposed life-saving elixir?

Of course I am now referring to the aluminum and formaldehyde which GlaxoSmithKline thought so vital to the composition of Havrix. (PDR, p 1544)

As Drs. Russell Blaylock and Theo Colburn have well explained, it is not just the connection with Alzheimer's that makes aluminum such a danger to human physiology. It's that aluminum can interfere with the formation, development and survival of virtually any human nerve tissue in an
unpredictable fashion, beyond any timetables yet devised. (Excitotoxins, Our Stolen Future) We simply don't know.

As for formaldehyde, let's just ask how much danger of cancer is an acceptable risk in the pure, perfect blood of a newborn? Cancer occurs first in just one cell. So where are the studies that prove that this "trace" of formalin or antifreeze will not be sufficient to cause that first cell mutation that develops into cancer? Where are they? As long as we're talking about scientific probability here, let's take the discussion one step further. This single causative viral agent that has been identified for hepatitis A is a presumption. Remember - diagnosis is often by symptoms and by the presence of IgM in the blood. Viral infections are not cultured for diagnosis - it's largely theoretical. So then doesn't the isolation, concentration, and dissemination of an infectious viral agent seem at least a little presumptuous if not enormously reckless, especially when we're talking about the unformed immune systems of the newborn infant population?

That seems like a reasonable question, doesn't it?

Mass Dissemination Of An Unproven Agent

Here's the key point -- is it really necessary to introduce an attenuated infectious vector into our entire population of children in order to theoretically prevent a disease which is extremely rare in the vast majority of US communities, and getting rarer? And is self-limiting, does not contribute to chronic liver disease, and confers lifetime immunity to the ones who get it? What are we doing?

Even the manufacturer does not claim that the vaccine confers immunity, but only delay of the disease.

Thus the need for boosters.

Get the idea - if the vaccine worked, we wouldn't need boosters after 6 months or a year. Following this shaky logic, if the immunity only lasts a year, the child should get boosters every year for the rest of his life.

Now, the booster shot and the first vaccination shot are identical. So why does the first shot supposedly last for a year but the last one is going to be effective for the rest of the patient's life?? Anybody ever think of that??

The other big issue is that the Hepatitis A virus is supposedly a specific agent that has been photographed, sequenced, and catalogued, and occurs the same in every case of the disease. Classical diagnosis is by symptoms and the presence of the antibody, remember? IgM.

But acute viral liver infections can be of a variety of completely different agents and disease scenarios. To pretend that they can all be cured by the dissemination of one single type of attenuated viral agent is disingenuous at best and scientifically ludicrous, even criminal, at worst. Mass inoculat ion must be absolutely proven to be necessary, beneficial and free from side effects, or else it shouldn't even be considered. Havrix meets none of these criteria.

The New High Risk Category

The most disconcerting - make that horrifying - aspect of the new Mandated Vaccine Schedule that has just sneaked up on us will prove to be the creation of this new High Risk category, in my opinion.

As we would expect, this ingenious addition was tacked onto the program with no fanfare, no general public attention. Suddenly the most vaccinated children in the history of the world are still not getting sufficient injections, even at 40 vaccines now mandated.

So for further protection, the CDC has now created the new High Risk category that they'll christen with just 2 vaccines: Hepatitis A and influenza. Now folks, these extra shots aren't really part of the mandated schedule, but are intended for the child who needs that extra protection because he is what we doctors call 'high risk.'

Which according to the American Pediatrics Association means any child who seems to have a tendency to get colds, asthma, allergies, the flu, or is generally sick.

What percentage of kids does that include? Like, all of them?

Step right up. It's such a slick set-up. The script will go something like, well, little Johnny and little Suzie just got their regular shots, so they should be fine. By the way, Mrs. Jones, do these children have a tendency to get allergies, colds, or the flu?

Oh, they do?

Well, then the newest recommendations, just to be on the safe side, are that for extra protection for Johnny and Suzie we should add just two more shots today, while they're here. And that's the new Hepatitis A shot and the flu shot. Yes, and then they should be good for a year. Yes, all the other kids are getting the 2 extra shots. You can't be too careful these days, you know.

Who's going to argue with a rap like that? Only the most informed.
 

Source:Center For The Advancement Of Health
Date:11/25/2002
http://www.sciencedaily.com/releases/2002/11/021125071403.htm

Stressful Feelings May Influence Vaccine Effectiveness A person's state of mind may influence the body's response to a vaccine against meningitis C, suggests new research. The findings support previous research showing a link between psychological factors and antibody response to vaccines. Researchers at the School of Sport and Exercise Sciences and the School of Medicine at the University of Birmingham in England asked 60 first-year undergraduate students to answer a battery of questions about their life events, perceived stress, psychological well-being, coping styles, social support and health behaviors. The researchers also took blood samples to measure the concentration of protective meningitis C antibodies in the students. All of the students had previously received a meningitis C vaccine as part of a recently introduced national health program.

The results revealed that a high level of perceived life stress, but not actual stress, was associated with low antibody levels. A low level of psychological well being -- feeling anxious or under strain, for example -- was also linked to low antibody levels. The antibody concentrations did not appear to be associated with the amount of time between the meningitis C vaccination and the antibody tests, the students' demographics or the students' health behaviors, however. "These findings suggest that the feeling that one's life is stressful and the experience of high levels of distress were more detrimental than actual exposure to stressful life events," write Victoria E. Burns, Ph.D., and colleagues in the November/December issue of the journal Psychosomatic Medicine.

"The association between stress and vaccination response has potentially important clinical implications," the authors conclude. "In light of our findings, it may be important to monitor subsequent antibody status, particularly in those reporting high perceived stress and low levels of psychological well being." The authors note that their research supports other studies that have found associations between psychological influences and antibody response to hepatitis B, influenza, and rubella vaccines. However, theirs is the first  study to show that psychological factors are associated with antibody response to a conjugate vaccine, a vaccine type used to protect against meningitis C. Meningitis is an inflammation of the membranes covering the brain and spinal cord. Bacterial meningitis, including meningitis C, is less common than viral meningitis, but can be life-threatening. Bacterial meningitis often appears as single cases, but small outbreaks at institutions such as colleges or schools sometimes arise. In the United Kingdom, the meningitis C vaccine is routinely given to students before they enter a university, the study authors write.

 

Mexico more effective than U.S. at immunizing children Mexico's paternalistic approach has led to a 96% vaccination rate for children ages 1 to 4, compared with 79% of American 2-year-olds.
By EDWARD HEGSTROM
Houston Chronicle

MONTERREY, MEXICO - If parents here are late getting their child inoculated, a public-health nurse will come to their home, pull down the youngster's pants and give the vaccination right there in the living room.  If the parents are away at work, the nurse does not wait for them to come  home and give permission. Shots are given anyway, and the paperwork is left with the baby sitter.  In Monterrey, like Houston, an industrial city of more than a million with large pockets of underclass, the government divides its poor neighborhoods into sections of about four square blocks each, then puts a nurse in charge of supervising parents in each area to ensure all of the children are vaccinated on time.

It is a paternalistic approach almost impossible to imagine in the United States - where privacy rights and other freedoms are highly valued and immunizations are increasingly feared - but it has proved remarkably effective: Mexico has a 96 percent vaccination rate for children ages 1 to 4, compared with an immunization rate of 79 percent for 2-year-olds in the United States.

The disparity is even greater between Monterrey and Houston, which has one of the most stubbornly low vaccination rates in the United States. In Monterrey, 98 percent of the children ages 1 to 4 are fully immunized, a higher percentage than reached by any U.S. city. In Houston, barely 71 percent of 2-year-olds are caught up on their shots. Mexico's immunization success is something Americans - particularly Texans - can cheer. Epidemics of preventable disease used to go back and forth between the two countries. That no longer happens, thanks mostly to the remarkable but unheralded improvements in Mexico and other countries in the region.

"One of the main reasons there is no longer measles in the United States is because we no longer have measles in Latin America and the Caribbean," said Dr. Ciro de Quadros, the recently retired director of immunizations for the Pan American Health Organization. Mexico, he said, has done a "remarkable" job of vaccinating its children in the past decade. Conventional wisdom says it is harder to develop a public-health system in a poor country. But Quadros notes that a wealthy country like the United States has problems of its own.

"In the United States, there are so many obstacles to vaccinations," said Quadros, a native of Brazil. "People have so many forms to fill out, and there are so many more lobbies - anti-vaccine, anti-technology, anti-everything." The differences in culture and outlook between Mexico and the United States make it difficult to compare the two systems of administering vaccinations. But there are similarities, particularly between two cities that share so much trade and human traffic.

Both Houston and Monterrey suffered from a terrible resurgence of measles more than a decade ago, and leaders in both places promised to respond by bolstering vaccine programs to ensure such an epidemic never happened again. The goal - on both sides of the border - was a 100 percent vaccination rate.  But while Monterrey and Mexico as a whole have come close to keeping that promise, the improvement in Houston's vaccination program has not been so great. Vaccinations are clearly up from the winter of 1988-89, when 10 children died from measles in Houston and organizers of the Houston Livestock Show and Rodeo distributed letters warning that participants may have been exposed to the disease and risked taking it to other parts of the country.

Public and private groups responded by forming a number of programs, such as mobile health clinics, which are designed to better reach the most needy areas of Houston. But Houston still has no coordinated vaccine registry, which officials say is necessary to reach the people effectively.  And the effectiveness of the patchwork services now offered by so many different organizations is hampered by a lack of any central vision for running an immunization program, critics say.

"There's no real local leadership on the immunization issue," said Barbara Best, with the Children's Defense Fund. While no one predicts another measles resurgence, officials in Houston and the rest of Texas have already started to worry about a return of pertussis, also known as whooping cough.  Mexico, by contrast, has a sharply focused vision. After the measles pandemic reached Mexico in 1990 and killed 5,899 babies, the Mexican government established a central authority to oversee the national vaccination campaign, known as the National Immunization Program.

Immunization campaigns are run three times a year, done with great fanfare. In addition, uniformed brigades of nurses keep careful watch over vaccination rates, neighborhood by neighborhood.  U.S. health officials, who have seen the unsparing force of a Mexican immunization campaign, tend to remember it with both awe and dread. The public-health nurses of Monterrey begin tracking babies before they are born.

The nurse in charge of immunizations in a particular neighborhood keeps a census of the area, including maps detailing where women of child-bearing age live. Babies are given their first immunizations - against polio and tuberculosis - in the hospital right after birth. They also receive a government-issued National Vaccination Record, on which the vaccines they receive throughout their lives will be tallied. The vaccine record must be presented in order to enter school, to get passports or other identification papers and even to get some jobs and loans. Losing the record is not usually a problem, because the same information is recorded with the federal government and can be replaced.
 

HEALTH & SCIENCE

http://www.ama-assn.org/sci-pubs/amnews/pick_02/hlsb1209.htm

Pediatricians praise pentavalent vaccine, question cost Lowering the number of injections may increase the number of children vaccinated, but experts worry that inadequate reimbursement levels could stall widespread use. By Victoria Stagg Elliott, AMNews staff. Dec. 9, 2002. Additional information Kids can expect fewer vaccine shots in the future. With the promised, year-end introduction of a vaccine to include antigens for diphtheria, tetanus, pertussis, polio and hepatitis B, doctors will be able to reduce the number of injections their youngest patients must endure in a single visit.

The pentavalent vaccine, which insiders expect to be approved by the Food and Drug Administration this month, will be manufactured by GlaxoSmithKline and is expected to be the first of an increasing number of vaccines that protect against five and even six diseases. "It's less painful for the child. It is less stressful for the medical staff that is administering the vaccine, and it's less stressful for the parent who's watching it," said Edgar Marcuse, MD, MPH, professor of pediatrics at the University of Washington, Seattle.

Experts say multivalent vaccines may increase vaccination rates and make parents more willing to let children get all the shots they need in one visit, rather than scheduling multiple appointments, which can lead to late vaccinations. "I'm excited about it," said Robert Yetman, MD, professor of pediatrics at the University of Texas Medical School at Houston. "If the number of vaccines we are currently giving patients is a reason for some parents to avoid getting their children immunized, then this will help eliminate this roadblock to improving our immunization rates." Reimbursement barrier

Vaccines with antigens for five or six diseases are already in widespread use around the world. But in the United States no currently available vaccine includes more than three. Still, as much as physicians say multivalent vaccines are a significant step in the right direction, there are many concerns that reimbursement issues may impact the number of doctors who administer the new vaccine. The cost of the vaccine may not be adequately covered by insurance.

In addition, physicians may receive less reimbursement for administering fewer injections in one visit despite the fact that the same number of antigens are being delivered to the patient. With the number of combination vaccines expected to increase significantly over the next few years, the issue is one of great concern and is expected to come up at this month's American Medical Association Interim Meeting in New Orleans. "Without reimbursement, this will not be adopted," said Gary L. Freed, MD, MPH, director of general pediatrics at the University of Michigan School of Public Health in Ann Arbor. There are also concerns that problems with record keeping combined with a mobile population may lead to overimmunization.

Children may shift from one doctor to another, both of whom may stock different combinations. Records may be incomplete or get lost. "As we get additional combinations licensed, and the combinations share common components but also have different components, it's going to increase the chance of confusion and miscommunication and make far more important the maintenance of very accurate records," Dr. Marcuse said. Children also may shift back and forth between public-sector vaccine sources and private physicians. Most believe that the public sector may be the slowest in adopting the multivalent vaccines, primarily because of cost issues. "The public sector may choose not to buy this vaccine if it costs a lot more than the individual vaccines themselves," Dr. Freed said. Also, not all vaccines included in the pentavalent vaccine are always delivered at the same time. Currently, hepatitis B is also frequently administered at birth, by itself, as well as additional doses during the visits at two and six months when it is given along with IPV, DTaP and several other vaccines not planned to be included in the five-valent mix.

"If a physician or hospital gives a child the newborn dose of hepatitis B yet wants to use this vaccine for at least a portion of the primary immunization series, they will have to be careful they don't give a child too many vaccines," Dr. Freed said. "There's no known harm to giving an extra vaccine, but we need to realize that that is a possibility." And despite recent anxieties expressed by certain vaccine awareness and parent advocacy groups over the combined measles, mumps and rubella vaccine, physicians say that most of their patients would prefer the reduction in needlesticks. "More than likely, parents will welcome the chance for the child to get fewer injections," Dr. Freed said.

The initial hope is that the multivalent vaccines will reduce the number of needlesticks kids must endure. In addition, though, many suspect it will simply make room in the schedule for new vaccines that are just around the corner. "We need to make room because there are more vaccines that will be coming, and you just can't keep giving more shots to children," said Mark Blatter, MD, medical director of Primary Physicians Research in Pittsburgh, the company that ran many of the trials on the new vaccine. "After years of increasing the number of shots, for the first time, we will be able to decrease the number of shots by as many as six."

ADDITIONAL INFORMATION:
Increased protection

The first pentavalent vaccine in the United States is expected to protect
against:

    * Diphtheria
    * Tetanus
    * Pertussis
    * Polio
    * Hepatitis B


Vaccine topics from the FDA's Center for Biologics Evaluation and Research
(http://www.fda.gov/cber/vaccines.htm)

CDC National Immunization Program (http://www.cdc.gov/nip/)
Comment from the web:
I'm not a medical person, but I am a person that can think.  It astounds me that the doctors can believe that injecting numerous antigens (pathogens, viruses) along with an assortment of adjuvants (poisons) that the tiny immune systems can actually begin manufacturing antibodies to all of these without a misstep.  It seems to me that doctors would realize how dangerous it is to do this to little babies. I think it is interesting also that so many newborns at birth have jaundice.  I read that Vitamin K can overwhelm the liver and cause this.  But the doctors don't know that?  It is a miracle that most babies live through all these assaults on their bodies, though we know many don't (SIDS). 

Again - there is NO safe vaccine.  But certainly DPT is a very bad one and
to keep DTaP a secret from UK people is immoral and criminal
Sheri

http://www.thescotsman.co.uk/health.cfm?id=151072003

Parents must ask to receive safer vaccine

FRASER NELSON

DOCTORS have been told to come clean about Infanrix, the safer whooping cough jab available on the NHS - but only if directly challenged about it by parents.  The compromise means that parents who ask no questions will have their children injected with the cheaper DTwP jab laced with ethyl mercury - a substance ordered out of US medicine on health grounds.

The deal was met with political outrage yesterday as Scotlandâ's opposition parties accused the Scottish Executive of skirting around its duty to give parents the full facts about vaccination options before going ahead. Dr Andrew Fraser, Scotlandâ's deputy chief medical officer, has written an "urgent message" to Scottish medical specialists alerting them to fears around thimerosal, a controversial vaccine preservative 50 per cent composed of mercury.

The substance is contained in DTwP, the £10-a-shot jab from France which protects against diphtheria, tetanus and pertussis, or whooping cough, routinely given to all babies aged two, three and four months. Its rival is Infanrix, a UK vaccine available on the NHS to the few parents who know to ask for it by name. It is almost twice the price because it comes without the so-called "junk cells" suspected of giving children fever after injection.

It is also made without thimerosal - and is the type of vaccine routinely used in the United States, Canada, Japan, Australia and South Korea. "Parents are entitled to know if thimerosal is contained in the vaccine available to them," Dr Fraserâ's letter said. "They should be aware of the reason for this - ethyl mercury is an essential component of the most effective vaccine available to protect children."

The Executive explained that this "entitlement" only extends to parents who ask if they have an alternative. Those who do not will be given the mercury vaccine. "The DTwP is recommended, because it is more effective. So that is the one which is given. If parents were to ask a question, for whatever reason, they would be told everything - about the choice, the side-effects, whatever they wanted to know."

The Scotsman revealed yesterday that babies injected with the cheaper DTwP vaccine are ten times as likely to suffer side effects ranging from fever to periods of unusual crying lasting more than an hour.

In a Holyrood debate yesterday, Frank McAveety, Scotlandâ's deputy health minister, admitted that Infanrix does have "lower levels of side effects" - but said it was less effective. "Our recommendation is that, on the balance of risk, DTwP offers the best protection against whooping cough. Each individual or family will have to make those choices in consultation with their medical practitioners."

Nicola Sturgeon, the SNP’s health spokeswoman, said this is meaningless if parents are not being told that Infanrix exists. "Choice can only be exercised if parents have the information to make that choice," she said. "There will be no consultation if doctors do not pro-actively lay out the options."

Mary Scanlon, the Tories’ health spokeswoman, asked Mr McAveety to publish the performance data for both vaccines - saying that only this could let parents decide which is best for their children. The thimerosal debate has swept the US, where parents are now suing drug companies. They are fast building evidence that the ethyl mercury induced autism in their children.

Lord Hodgson of Astley Abbotts, a Tory peer, raised the issue in the House of Lords on Wednesday night, calling for ministers "to follow a long list of developed countries and remove thimerosal from vaccines forthwith". Thimerosal has not survived any public debate in any country. The Scottish Executive has said it will soon publish the figures it uses to argue that the mercury vaccine is better.