For an earlier fulmination on this topic see the post of 29 Oct ’09. Briefly, it was based on an article by Scott Gottlieb, a former deputy commissioner of the FDA, appearing the day before in the Wall Street Journal. Gottlieb gave 3 reasons why the vaccine against the H1N1 flu was so late. One had to do with the usage of single dose preparations rather than 100 dose vials. The reason given for this decision was that less preservative would be used for a single dose vials, and that there were people who believed that the mercury in the preservative caused autism. Knuckling under to this craziness delayed the vaccine because it takes longer to prepare 100 single doses than 1 one hundred dose vial. For a debunking of the idea that vaccines cause autism with actual data see Nature vol. 427 p. 765 ’04.
Gottlieb gave two more reasons for the delay, one of which was the decision not to use adjuvants. An adjuvant is an immune stimulant administered with the vaccine, which means that you have to use less inactivated virus in each dose to produce a protective immune response. Since one of the big bottlenecks in producing the vaccine is the speed at which viruses can produced, this produces yet another delay because more virus has to be put in each dose.
Today the NY Times reported on a Senate hearing concerning the delay in producing the vaccine. Some 250,000,000 million doses were ordered last spring (in a very timely and appropriate fashion). 120,000,000 doses were to be ready by October. Presently we’re in mid-November with only 42,000,000 doses available. A week or so ago it was noted by the CDC that 4,000 had died of the H1N1 flu including 560 children.
In testimony, Dr. Nicole Lurie (chief of preparedness and response for the Health and Human Services Department) said that one reason adjuvants were not used was because of vaccine activists, and they feared some people would avoid the shots. So the government (in the form of its experts) knuckled under to these cretins twice (once with single dose to avoid so much thiomersal, and once again with adjuvants). It is unlikely that more than a handful of the 250 less 42 million people eligible for the vaccine would have refused it, had it been available in a timely fashion. If the activists want to win a Darwin award by refusing the vaccine, let them — it would improve the general intelligence of the populace. As HL Mencken said about Prohibition — the humble swineherd will put us all in his pen.
In fairness, it should be noted that, at this point, we don’t have enough data to say that the vaccine is actually protective, but most think it will be. As always, in medicine, there is just no substitute for data.