The Daily Show (an often surprisingly level-headed source of news and commentary) had a little bit on the H1N1 vaccine last night which I recommend you give a quick watch (available online for Canadians at http://watch.thecomedynetwork.ca/the-daily-show-with-jon-stewart/full-episodes/the-daily-show-with-jon-stewart—october-15-2009/#clip223053 — Americans can watch Hulu, the bastards).
This reminded me of a question one of my cousins asked recently about the vaccine: what’s an adjuvant, “’cause I’m not able to find much positive about it.”
Indeed, if you just search the internet for information about the health effects of the various adjuvants used in vaccines, it looks like pretty scary stuff. That’s because an adjuvant is designed to trigger an immune response; to make your body’s immune system go into over-drive so that it will recognize the viral matter in the vaccine and produce antibodies against it. The risks include getting a fever or other flu-like symptoms, an allergic reaction, or even a very remote risk of developing certain autoimmune disorders like rheumatoid arthritis. If you just read up on the adjuvant alone, it sounds like something you’d never want to have in your body — but it’s only a small amount, and it’s necessary to make the vaccine effective (esp. in a single dose so you don’t have to keep going back for booster shots, which might work for hepatitis or tetanus vaccines, but doesn’t fly in the face of a potential pandemic).
“So if I don’t want those risks, don’t take the vaccines.”
Ah, well, there’s the tricky part. The risks are remote (aside from the mild cases of feeling unwell or having an acute allergic reaction), and the benefit is that you don’t get the virus you’re vaccinating against, or carry it to pass on to other people (such as seniors or those with compromised immune systems). On an individual level it can be a tricky mental calculation: on the one hand, psychologically it’s less desirable to subject yourself to something with risk before you have to, especially since it’s unknown and kinda scary. Whereas hey, you’ve had the flu before, how bad could it possibly be? Plus you can take steps to prevent yourself from getting the flu, such as wearing a space suit, or never leaving your basement, but once that shot is in your deltoid, that’s it cowboy, enjoy the ride. These psychological factors can really skew the perception of risk from the actual risks. It doesn’t help either that it’s new so there isn’t the years of testing that other vaccines have, or that there are people out there spreading the conspiracy theories that the government has put mind-control drugs in the vaccine (what, you think if they had those they wouldn’t have put it in your MMR vaccine as a kid??).
Of course, from a societal stand-point it’s a no-brainer for virtually every vaccine, including the one for the flu: society is better off when a large part of the population opts to be vaccinated. Even on the individual level the actual risk arithmetic (as opposed to the perceived risk) is also usually soundly in favour of getting vaccinated.
Update: LOL, Ben actually beat me to it with a post on the swine flu vaccine. He takes the opposite POV :)