02/25/04 00:00:00
At the risk of being labeled a pro-vaccination booster, allow me to correct some of the misinformation contained in the article by Dr. Colette Szalay, D.C. (Who's misleading who on flu shot's need, effectiveness, Feb. 11, 2004).
I am always skeptical of individuals who preface their name with a title such as Doctor, Professor or Councillor, as if the title somehow adds to the credibility of their message. To the average Peterborough This Week reader, I suspect the use of "doctor" by Ms Szalay could be interpreted that she is physician or surgeon rather than the broader meaning of that it can be anyone licensed to practise any of the healing arts.
There continues to be an anti-vaccination position by a minority of chiropractic practitioners in Canada but the majority no longer hold that position. According to Dr. Randy Ferrance , D.C., B.J. Palmer , the founder of the Palmer School of Chiropractic, published an article, in 1909, stating, "Chiropractors have found, in every disease that is supposed to be contagious, a cause in the spine."
He was a magnetic healer more influenced by ringmaster P.T. Barnum than by the germ theory of disease proposed by Louis Pasteur .
Today in Ontario, the College of Chiropractic Practitioners is reviewing the scope of practice of its members because its members don't have legislative authority and should advise the public that immunization is outside the scope of practice of the members.
Both the College and the Canadian Association of Chiropractic accept vaccination as a cost-effective public health prevention procedure for bacterial and viral diseases.
In the past, thimerosal was used as a preservative and concerns were raised by the anti-vaccination lobby. Today, however, thimerosal is not used in any vaccines given to infants under six months of age.
All vaccination is not compulsory but, according to the Immunization of School Pupils Act, it is recommended that children be immunized for diphtheria, tetanus, polio, measles, mumps and rubella, but also recognizes parents' right not to have their child immunized.
All that's required is for the parent to submit a completed Statement of Conscience or Religious Affidavit, or a medical exemption signed by a physician.
Parents must also accept that their non-immunized children would be a greater risk of infection and be willing to accept responsibility for any outcome of their decision.
So what is the record in favour of immunization?
By 2001, the actual incidence of polio cases had dropped in Canada from 20,000 to 0; for diphtheria, 9,000 to 0; for mumps, 52,000 to 73; for measles, 300,000 to 33; and for rubella, 69,000 to 23. Perhaps the most recent impact has been in cases of Haemophiles influenza type B (Him).
Prior to the introduction of this vaccine, this organism was a major cause of meningitis and epiglottitis and, even with appropriate antibiotic treatment, had a significant death rate. In 2001, the number of cases had fallen in Canada to 41 compared to 2,000 annually before immunization.
My concern is what could happen if young parents are influenced by anti-vaccination misinformation? One need only examine the experience of other countries.
The vaccination rate for pertussis (whooping cough) in England and Wales dropped from 75 per cent to 25 per cent as a result of news stories of concerns for the vaccine.
Subsequently, there was an epidemic of the disease in 1977 and 1979 with more than 100 deaths.
A similar event occurred in Japan where the vaccination rate fell from 90 per cent to 40 per cent in 1975 on the basis of two infants dying after receiving DPT. Later it was proven those deaths were not the result of vaccination.
In the four years prior to 1975, there were only 400 cases and two to three deaths per year but, from 1976 to 1979, there were 13,000 cases and deaths.
To address the issue of flu immunization in Peterborough and clarify the erroneous assumptions of Dr. Szalay, D.C., first, health care providers don't disclose personal information on individual cases, so the health unit's confidentiality is to be expected. However, reports presented publicly to the Board of Health in January 2004 contained the following facts.
The 20 long-term care facilities in the region have 1,884 residents and 1,772 staff.
Ninety-one per cent of residents, not 100 per cent as assumed by Dr. Szalay, were immunized as were 80 per cent of staff.
Three of the residences had a single death due to the flu, so the other three adults referred to in her article were community-acquired cases.
Of the 102 laboratory confirmed cases, 72 had not been immunized, 19 had been immunized, two didn't know if they had been immunized and nine couldn't be contacted.
The vaccine used for the past year's immunization program protected against the Panama and New Caladonia strains but not the Fujian strain of influenza A.
There have been seven outbreaks of influenza A involving senior residents, five of which have been confirmed as Fujian strain.
The vaccine used contained dead viruses and was preserved with 0.01 per cent thimerosal. The inoculation dose is 0.5 ml. Therefore, each dose contains 0.00005 ml of preservative -- hardly a risk factor of any great concern.
The primary weakness in the arguments put forward by Dr. Szalay lack scientific evidence, draw erroneous conclusions and are based upon her assumptions rather than facts.
For readers wishing to inform themselves regarding immunization, I recommend the book Your Child's Best Shot (2nd edition) authored by Dr. Ronald Gold M.D. from the Hospital for Sick Children. It can be ordered through the Canadian Paediatric Society or through its web site.
George Mitchell worked for 35 years as a medical laboratory technician, including time as chief technologist in Civic Hospital's microbiology division. Currently teaching microbiology to Trent/SSFC nursing students, he also served 12 years on the local Board of Health, twice as chairperson.
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