Sun 10/25/09 2:40 PM
Dear Dr. Michael Lacombe,
While I truly admire your dedication to vaccination,
I fear you have been misinformed about those that oppose this particular swine flu vaccination. Your own colleagues at MGMC are not getting vaccinated. Take
a poll in the hallways, and I think you will find that, among your fellow doctors perhaps half will not be getting vaccinated.
In terms of the population as a whole, we are
seeing an increase in resistance to this vaccination. But even during the SARS
pandemic only 15% of pregnant women (Canadian study) received the vaccine. No
one would argue that wasn’t a horrible illness, but pregnant women are very skeptical of new vaccinations.
It is easy to pick on doctors who oppose your
point of view as the scapegoats of a resistance movement. Alternative physicians
make particularly easy targets, as our patient base is both more vocal and often fanatically opposed to vaccination. My own discussions with patients usually involve reassurances that the vaccination
will not harm them. But I cannot provide my patients will any studies that show
this particular vaccination will be effective (since it is too new to have studies done.)
The information that I have about previous flu
vaccination is not particularly convincing. While the CDC is publicly recommending
both the swine flu vaccine and the trivalent vaccination, on the CDC website the information is that 99% of the current flu
epidemic is the swine flu and the trivalent vaccine is ineffective. The Australian
study that you cited also clearly indicated that the trivalent had no effect on the swine flu.
Given that the new vaccination was prepared in
the same manner as previous flu vaccinations, I hope we can both agree that large scale, meta-analyses of all flu studies
like the Cochrane Database compilations would give us the most comprehensive view the vaccinations’ effect on the flu. In the Cochrane analyses of flu vaccination from 2004 (Cochrane Database
Syst Rev. 2004;(3):CD001269) I quote: “Universal immunisation of healthy
adults is not supported by the results of this review.” That review found
a 6% reduction in overall flu cases and no effect on complications. The more
updated Cochrane analysis is more positive with the addition of vaccination information from 1968-69. The effect of flu vaccination was as high as a 30% reduction in cases and might help with time off from
work but again I quote: “but there was insufficient evidence to draw conclusions
on hospital admissions or complication rates.” (Cochrane Database Syst Rev. 2007 Apr 18;(2):CD001269) In other words, we have no data that the vaccination that we’d both like to see work has any effect
on that list of terrible side effects you published in today’s paper.
Now we get to the facts I’d like you to
consider as you vaccinate infants and pregnant mothers as well as school children. I
quote: “In children under two, the efficacy of inactivated vaccine was
similar to placebo.” (Cochrane Database Syst Rev. 2008 Apr 16;(2):CD004879). In
my personal search of the VAERS data (on the CDC website) I looked at cases of mortality due to vaccinations of all types. Every year for the last ten years over half the deaths reported are associated with
children under two.
My own letter to my patients as well as med line
documentation of everything I say is on my website: www.maloneymedical.com under swine flu.
I am one of dozens of physicians providing their patients with information in Maine to let them make a choice based
on informed consent.
I would love to be convinced that this flu vaccination
is a great idea and I will pay for lunch if you’d like to sit down and talk about it.
Here is your opportunity to meet a genuine quack and convince him and his flock of your opinion.
I swear to you if you can provide me with convincing
evidence I will alter my view and broadcast it to parents. I am neither a fanatic
nor a charlatan, I am a man who lives and dies by the data available. Provide
me with the data, the studies, and I will make evidence based decisions.
If you do not wish to meet, please hear my voice
as you vaccinate infants “no better than placebo…half of all reported vaccine deaths.” This is the evidence I have.
Please call me if you’d like to meet (207)
623-1681. Let me know what a good time would be.
I usually have a break Monday mornings between 9-11 to work on paperwork but it would be wonderful to spend it talking
to a man who cares so much about his community. I work with dozens of families
locally and I think your time would be well spent.
Sincerely,
Christopher Maloney, N.D.
Mon 11/09/09 11:08 PM
Dear Dr. Lacombe,
In reading your
recent column of replies, I was struck at how everyone was positive about vaccination and treated those who were concerned
about vaccination as idiots.
Since in previous columns you have discussed how alternative doctors come
out of the woodwork to shake their St. John's Wort and then slink back while you have to deal with the effects, I feel it
necessary to continue to attempt to contact you.
If you did not receive my previous letter, in short it
invited you out to lunch to convince me of your point of view. The deal was that if you convince me I will make every
effort to encourage all of my patients to get vaccinated.
By the way, I had to deal with a patient last
week who was so terrified by your and other media coverage of the swine flu that she is unable to leave her home. She
is also keeping her healthy children out of school and has cancelled her vacation plans. There are repercussions to
terrorizing our patients, Dr. Lacombe. Some of them will suffer nervous breakdowns. Someone needs to oppose the
terror, and I find myself in that position.
Please respond promptly. If I do not receive a response
within a few days, (a simple "I got it" will do) I will need to publically post my letters to you in order to show that I
am not slinking away back to my herbal den.
The best outcome for our patients is to have a pro and con
discussion of the flu vaccine. Nothing is black and white in medicine. I am attaching the stunning new cochrane
analysis of flu vaccine effects for patients with cystic fibrosis. No clinical benefit in terms of mortality or morbidity.
I still can't believe that even in this patient population we are not seeing the statistical benefits I would expect for a
vaccination.
Cochrane Database Syst Rev. 2009 Oct 7;(4):CD001753.
Vaccines for preventing influenza in people with cystic fibrosis.
Dharmaraj P, Smyth RL.
Diabetes & Endocrinology, Alder Hey Children's
Foundation Trust, Eaton Road, Liverpool, UK, L12 2AP.
BACKGROUND: Viral respiratory tract infections
in people with cystic fibrosis (CF) have a deteriorating effect on their lung function and disease progression. Annual influenza
vaccination is therefore commonly recommended for people with CF. OBJECTIVES: To assess the effectiveness of influenza vaccination
for people with CF. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register
which comprises of references identified from comprehensive electronic database searches and handsearching of relevant journals
and abstract books of conference proceedings. We also contacted the companies which market the influenza vaccines used in
the trials to obtain further information about randomised controlled trials.Date of the most recent search of the Cystic Fibrosis
Trials Register: 05 March 2009. SELECTION CRITERIA: All randomised and quasi-randomised trials (published or unpublished)
comparing any influenza vaccine with a placebo or with another type of influenza vaccine. DATA COLLECTION AND ANALYSIS: Two
authors independently assessed study quality and extracted data. Additional information was obtained by contacting the investigators
when it was indicated. MAIN RESULTS: Four studies enrolling a total of 179 participants with CF (143 (80%) were children aged
1 to 16 years) were included in this review. There was no study comparing a vaccine to a placebo or a whole virus vaccine
to a subunit or split virus vaccine. Two studies compared an intranasal applied live vaccine to an intramuscular inactivated
vaccine and the other two studies compared a split virus to a subunit vaccine and a virosome to a subunit vaccine (all intramuscular).
The incidence of all reported adverse events was high depending on the type of influenza vaccine. The total adverse event
rate ranged from 48 out of 201 participants (24%) for the intranasal live vaccine to 13 out of 30 participants (43%) for the
split virus vaccine. With the limitation of a statistical low power there was no significant difference between the study
vaccinations. None of the events were severe. All study influenza vaccinations generated a satisfactory serological antibody
response. No study reported other clinically important benefits. AUTHORS' CONCLUSIONS: There is currently no evidence from
randomised studies that influenza vaccine given to people with CF is of benefit to them. There remains a need for a well-constructed
clinical study, that assesses the effectiveness of influenza vaccination on important clinical outcome measures.
PMID: 19821281
