Over the past two weeks, almost a third of the patients in my hematology and oncology section for outpatients have asked whether they should get the swine flu vaccine, and over the last few days several friends have called me to ask the same thing.
When TV news showed footage of thousands of people attending the funeral of a seven-year-old boy surnamed Liu from Taichung who died after receiving the locally made vaccine, everyone was thinking about the possible side effects, while thoughts about the risk of getting swine flu were distant. I see people who are panicking and confused as to whether they should get the vaccination.
Why is this?
It implies the public do not trust the government because they think the government, experts and academics are endorsing the vaccine while ignoring scientific expertise and impartiality.
The policy to vaccinate everyone is sound and everyone should get the shot unless they are a special case. The special cases that should avoid getting the vaccination include those with overactive immune systems or patients with autoimmune disorders. They will have a stronger reaction to Cytokine than regular patients and this will worsen the symptoms of autoimmune disorders. It is very possible that this is what happened to Liu.
People with compromised immune systems, such as patients receiving chemotherapy, should make sure they get the vaccine because they are the real high-risk group for catching swine flu. Their vaccination shots should be scheduled approximately two weeks after chemotherapy.
I agree with comments made by Hsieh Yen-yao (謝炎堯), vice president of the Sun Yat-sen Cancer Center, in the Dec. 24 issue of the Chinese-language Apple Daily. He said the government cannot guarantee that the vaccine is 100 percent safe, but I also believe there is no need to question its efficacy. Comments about Taiwan’s vaccine being the worst in the world should not be made without adequate evidence to support them.
Next is the question of whether Liu’s death from septic shock a month after receiving the vaccination was related to the vaccine.
I believe the conclusion reached by the Department of Health (DOH) immediately after the child’s death that it was unrelated to the vaccine was hasty because the DOH had not obtained autopsy information at the time of the statement.
The boy’s autopsy is extremely important. His father is a doctor and therefore more capable of understanding the significance of an autopsy. Both parents accepted a mandatory autopsy. Obtaining compensation for an adverse reaction to the vaccine is a minor issue; much more important is the question of whether the autopsy results could provide information about the safety of the locally produced vaccine, which would be of immeasurable importance.
We sympathize with the pain and anger of the boy’s parents and thank them for transforming their love for their son into love for every citizen of Taiwan.
We must wait for the autopsy results to be released before we can ascertain whether the vaccine caused the child’s death or not.
There have also been many recent cases of prenatal death and cases involving deaths or psychoneurosis. If there is any reason to suspect that the deaths are connected to the vaccine, autopsies should be performed and other cases should be handed over to the DOH for further assessment.
In conclusion, I would like to stress again that it is a sound policy to encourage everyone to receive the swine flu vaccine and that the side effects are harmless. It seems, however, that the government is unable to prove that the domestically produced vaccine is absolutely safe and they cannot vouch for it without knowing for sure. If any recipient of the vaccine develops severe symptoms and if it is difficult to rule out that the vaccine caused the symptoms, the government should offer compensation for an adverse reaction to the vaccine.
Chen Yao-chang is a professor of medicine and forensic medicine at National Taiwan University Hospital.
TRANSLATED BY DREW CAMERON
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