Oct. 2--TAMPA -- Swine flu arrived at the Berger home a few weeks ago.
David Berger's son came down with the classic symptoms, a fever and sore throat. Berger, a pediatrician, started treating the whole family right away with homeopathic remedies such as elderberry, vitamins A and C, and zinc. The boy started feeling better the next day, and no one else in the family has been sick yet.
Instead of convincing the Bergers they should get immunized to avoid another round of the highly contagious but usually mild virus, the experience affirmed their decision to pass on the vaccine.
"This is more of a nuisance than anything else," the Tampa holistic doctor said of the declared global swine flu pandemic.
Berger won't be the only one avoiding the swine flu vaccine. Though the federal government purchased an estimated 259 million doses, and public health officials are recommending the vaccine for nearly every American child and adult, a Consumer Reports survey released last week showed just 34 percent of American adults, and 35 percent of parents, have plans to get a shot or nasal spray vaccine for themselves or their children.
Swine flu vaccination has been a hot topic since the unique viral strain emerged on the world stage this past spring. It triggered memories of the 1976 nationwide flu vaccination program, which was halted for possible ties to Guillain-Barre syndrome, a nervous system disorder that causes muscle weakness and sometimes paralysis. The Centers for Disease Control and Prevention later reported that just one of several studies found any association between the 1976 vaccine and syndrome.
But now, with the new vaccine's arrival just a few weeks away, people are asking questions about the necessity and safety of this swine flu prevention remedy. Some critics claim that the government's massive vaccination effort is overblown and the research done on the vaccine's safety has been done too quickly to be trusted.
"We're not talking about ebola or smallpox," said Barbara LoeFisher, president of National Vaccine Information Center. "It's milder than some of the influenza strains that have gone around in the last few decades."
While most of the more than 1 million swine flu cases in the United States have mild symptoms, the strain has been responsible for 593 deaths nationwide through the summer, including 102 in Florida. The CDC is recommending widespread vaccination for all Americans 6 months and older because of the strain's ability to infect far more people than the traditional seasonal flu.
"If you have any regard for other people in your life, you should take it more seriously than you have in the past," said Hillsborough County Health Department Director Doug Holt.
Development of a vaccine for the flu, also called H1N1, began in April, and clinical tests on its efficacy launched in late summer. Results of safety tests for adults and children older than 10 are complete; the Food and Drug Administration is still waiting for the outcome of trials on young children and pregnant women.
Fisher, who founded her advocacy group when her son suffered adverse reactions to a vaccine, said this production schedule is simply too fast. And she believes plans to distribute much of the vaccine in schools and colleges take the voluntary program too far.
"Are you going to declare a public health emergency every flu season?" she asked.
Health and Human Services Secretary Kathleen Sebelius has said every step of H1N1 vaccine development followed long-established protocols used for seasonal flu vaccines. "We have a high degree of confidence in the vaccine's safety," she said.
More importantly, Sebelius said, the vaccine is voluntary for nearly everyone. (Some members of the military and health care workers in New York are being required to get the vaccination.)
A mandate would bother 75-year-old Tampa resident Daphne Carlson, who credits her health to a lot of exercise and not flu vaccines she's told to get. "I don't believe in medicine," she said. "I believe in walking."
For people who choose to skip the swine flu vaccine, some concerns resonate regardless of the vaccine type: It's inconvenient or too expensive, or the thought of needles makes them queasy. Others see the massive drug production as little more than government support of pharmaceutical giants.
And there are those bothered by the chemical mix within the vaccine, and its ability to trigger side effects and illness far worse than a bout of flu. People allergic to eggs, for example, can suffer serious side effects if exposed to some vaccines.
Of particular concern to swine flu vaccine critics is a preservative called thimerosal, an agent that contains approximately 49 percent ethylmercury, controversial for its debated link to autism and brain inflammation. The CDC states that low doses of thimerosal in vaccines triggers little more than "minor reactions like redness and swelling at the injection site." But it has caused enough fear that since 1999, the American Academy of Pediatrics, federal health services and vaccine makers agreed to reduce or eliminate the ingredient from future vaccines.
Thimerosal is included in multi-use vials of the swine flu vaccines being sent to the state of Florida, Department of Health Spokeswoman Susan Smith confirmed. There are however, several other H1N1 vaccines available without the preservative, including Flumist nasal spray.
CDC Assistant Surgeon General Anne Schuchat said it is critical that thimerosal-free vaccines are available. She added that the vaccines distributed to the states do not contain adjuvants, substances that are known to boost vaccine potency but suspected of triggering autoimmune diseases such as rheumatoid arthritis.
"We know some consumers have concerns," she said.
Tampa pediatrician Berger said he's not surprised that just five of the 1,400 patients at his Wholistic Pediatrics practice have requested swine flu vaccines. His practice specializes in alternative treatment for children with asthma, autism, ADHD and other disorders.
Because swine flu is relatively mild, Berger prefers patients treat flu symptoms with more natural remedies such as vitamins. He would, however, administer a thimerosal-free vaccine if asked, because he believes public health officials are offering a consistent message about options.
"Obviously there's been a huge push from the government, but you're not hearing gloom and doom scenarios," he said. "The government's done a good job not overselling the vaccine."
The options available in Florida aren't necessarily the same in New York, where state legislators have ordered health care workers to get both seasonal and swine flu vaccines. There, orders have been met with large protests.
Mayo Clinic researcher Greg Poland estimates 45 percent of American health care workers get a seasonal flu vaccine each year on their own. He said participation should be higher, considering the workers' exposure to the medically vulnerable.
"It's not about you. It's about the patients you care for," said Poland, an officer with the American College of Physicians.
A survey of Tampa Bay area hospitals found that most encourage, but do not require, employees to get vaccines for the swine or seasonal flu. Participation in past seasonal flu vaccine campaigns has varied from 77 percent at St. Petersburg's All Children's Hospital to 54 percent at the James A. Haley Veterans' Hospital to 55 percent at BayCare Health System's nine area medical centers.
Tampa General Hospital employee health director JoAnn Shea said swine flu vaccine will be offered as soon as it's available. "Our patients are more seriously ill and more susceptible to complications," she said.
Based on this fall's interest in seasonal flu vaccines, when more than 2,000 employees were vaccinated in the hospital's first week of immunization, participation should be high, she said.
There's no mandate to get seasonal flu vaccines at Tampa General, BayCare hospitals and Moffitt Cancer Center, but employees who skip a seasonal flu vaccine must sign a declaration saying why. A similar waiver will not be used for the swine flu vaccine, hospital officials said.
These disclosure forms and potential mandates create a slippery slope for the future, said Fisher, the vaccination watchdog.
Why risk the health of otherwise healthy individuals, she asked. "There is so much we don't know about the body and the way vaccines react."
Reporter Mary Shedden can be reached at (813) 259-7365.
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