Nature Medicine | Spoonful of Medicine

The Oprah effect

Jenny McCarthy: vaccine expert

When it comes to swine flu vaccine, US health officials seem to be fearing fear itself.

Unlike most countries, the US is not using adjuvants in its swine flu vaccine. To do so, US health authorities must approve them in the vaccine on an ‘emergency’ basis. Why haven’t they?

One reason is that officials are concerned that people will reject the vaccine. That seems clear from recent congressional testimony by Anne Schuchat, head of immunization and respiratory diseases at the US Centers for Disease Control and Prevention.

Here is an exchange at a hearing last week between Schuchat and representative Bark Stupak:

Stupak: What is the problem with the adjuvant other than we haven’t done the test here in this country? [Referring to data obtained in Europe on the safety of the swine flu adjuvant]

Schuchat: Well, you know — as you know, the public’s confidence in our vaccine system and in vaccines in this country — very, very fragile.

Schuchat voiced similar concerns in an interview with Reuters. The decision surely was not easy for Shuchat and other health officials: if they had decided to use adjuvants, which reduce the dosage needed in a flu shot, the US would probably not be facing vaccine shortages—something I have blogged about before.

Other considerations, of course, factored into the decision. For instance, Jesse Goodman, an FDA official, told congress that the bulk of the safety data for the adjuvanted vaccine has been obtained in people over age 50, “So in terms of the kind of broad experience with millions of people that’s only in the elderly who were not a focus population of this vaccine…we don’t have enough data about those at this point or at the beginning of the pandemic for them to meet the standard of FDA licensure.”

Clearly, officials have the concerns and safety of the public in mind. It is also difficult to fault US agencies for considering the concerns of a public inundated with faulty information on vaccine safety, proliferating on the internet and aired by Don Imus, the Huffington Post and Oprah. Oprah, for instance, recently signed a deal with celebrity anti-vaccine activist Jenny McCarthy. The former playboy bunny is a regular guest on her show.

I wonder if Oprah has got her flu shot yet.


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