The letter is a tacit acknowledgment of the risk of using an untested vaccine with novel ingredients. But it also indicates that the UK's health services are cognizant of the risks and are taking them seriously, setting up improved surveillance so that if the vaccine does cause Guillain-Barre, vaccinations can be stopped promptly. Bravo.
However, the risk does not begin and end with Guillain Barre Syndrome, as Dr. Tom Jefferson, head of the Cochrane Collaboration vaccine group pointed out in the article. Cochrane performs meta-analyses of the entire world literature on medical therapies. Unfortunately, Cochrane has not found any literature on the squalene-containing adjuvants set to be used in some (most?) swine flu vaccines:
‘New vaccines never behave in the way you expect them to. It may be that there is a link to GBS, which is certainly not something I would wish on anybody.That is the bigger problem: the potential variety of adverse reactions to the vaccine is very large, and it will be very difficult to sort out quickly (before tens or hundreds of millions have been vaccinated) which might be vaccine-related.
‘But it could end up being anything because one of the additives in one of the vaccines is a substance called squalene, and none of the studies we’ve extracted have any research on it at all.’
UPDATE:
Medscape reports, September 1, 2009 — "Neurologists should be vigilant in tracking any new cases of Guillain-Barré syndrome after patients have received the H1N1 flu vaccine, say officials. The American Academy of Neurology (AAN) is teaming up with the Centers for Disease Control and Prevention (CDC) to make sure doctors remain alert.
Guillain-Barré has been linked to several vaccines, including the preparation for the 1976 swine flu. In a statement issued by the AAN, experts said that although they do not expect the 2009 H1N1 vaccine to increase the risk for the autoimmune disease, this is a concern with any pandemic vaccine. "The active participation of neurologists is going to be critical for monitoring for any possible increase in Guillain-Barré following 2009 H1N1 influenza vaccination," AAN spokesperson Orly Avitzur, MD, said in a news release."
[Just an fyi: anthrax vaccine has been associated with GBS, and according to the anthrax vaccine label, the vaccine is contraindicated if you have ever had GBS.]
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