# 3826 (Updated)
From the Guardian tonight, a report on the feared low acceptance of the H1N1 swine flu vaccine by NHS (National Health Service) workers.
The vaccine, scheduled to be rolled out in the UK later this month, has been met with considerably less than universal acceptance by HCWs. Some polls show less than 25% intend to take the shot.
Unlike the US vaccine, the UK is using an antigen-sparing adjuvanted vaccine, which has prompted some additional concerns over its safety. Vaccine manufacturers, and the NHS, maintain that the adjuvants are proven and safe.
Their use allows less antigen to be required for each shot, extending the vaccine supply so that more people can be protected.
Still, recent polls have shown a growing erosion among NHS employee’s willingness to take the shot, with some hospitals reporting that they may see only 10% to 20% of their workers accept the vaccine.
NHS Chiefs worry that unvaccinated workers could infect vulnerable patients in their care, and that staff absenteeism due to the flu could seriously erode their ability to provide health services this winter.
From the guardian.co.uk . Follow the link to read it in its entirety.
Swine flu fears grow as NHS staff shun vaccine
• Health department urges frontline staff to get jab
• Inoculation vital in efforts to contain pandemic
- Denis Campbell, health correspondent
- guardian.co.uk, Sunday 11 October 2009 22.39 BST
The Department of Health has ordered NHS bosses across England to ensure that frontline staff get immunised against swine flu amid growing signs that many doctors and nurses intend to shun the vaccine.
Chief executives and boards who run hospitals, primary care trusts and strategic health authorities have been told to urgently maximise the number of workers having the jab. Leading DH figures including Sir Liam Donaldson, the chief medical officer, have written to them six times in the last five weeks stressing the need for action before the second wave of the pandemic causes major problems.
Ian Dalton, the NHS's national director of flu resilience, last week warned that vaccination of nurses, doctors and other frontline staff was "absolutely critical" and that widespread take-up of the jabs "will help us to save lives".
The DH's letters stress that patients' health could be put at risk and the NHS left seriously short-staffed through virus-related absenteeism if senior managers do not overcome "perceived obstacles" to the vaccination of workers. Swine flu's threat is so great that the NHS must avoid only small numbers of personnel getting immunised, as usually happens with seasonal flu every winter, the letters add.
Similar concerns have been raised by HCWs here in the US and in Canada, and polls indicate that half or more of HCWs in those two countries may forego the shot, as well.
In the past several months I’ve reported on several HCW related vaccine issues out of the US and the UK, including:
Americans Slow On The Uptake
UK: NHS Doctor Blogs Against Pandemic Vaccine
NHS officials have a lot riding on this winter’s pandemic vaccination campaign. The refusal of HCWs to take the vaccine over `safety concerns’, real or imagined, constitutes a serious public relations problem – one that may be difficult to overcome.
If the NHS can’t convince the majority of its employees that the vaccine is safe and necessary, they may find promoting acceptance of the jab by the general public to be equally difficult.
Which means that the virus is likely to find a `target rich’ environment, filled with susceptible hosts, for some time to come.
* * * * Addendum * * * * *
The issue of adjuvants in vaccines is one, thankfully, we don’t have to deal with right now in the United States.
All of the flu vaccines being used in the US are unadjuvanted.
The pandemic vaccine being used in the US is made using exactly the same process as the seasonal vaccines we’ve used for years.
The only change is the strain of virus being used.
There is no reason to suspect that it will have any greater incidence of adverse effects than does the seasonal flu shot.
Adjuvanted vaccines, such as are being used in Canada, the UK, and in Europe are a bit more controversial.
While I’m personally a bit more comfortable with an unadjuvanted vaccine, I am not aware of any convincing scientific data that shows that the use of an adjuvant endangers the recipient, and I don’t believe that governments are foolhardy enough to knowingly inflict a dangerous vaccine on the public.
The backlash would be enormous, and the political costs incalculable.
Of course, it is always possible for scientists to get something wrong, to miscalculate. They are not infallible. But I honestly believe they are working in good faith to produce a safe and effective vaccine.
There is no such thing as a zero-risk vaccine. Serious adverse effects, while extremely rare, are not unheard of. There are no absolute guarantees.
Going unvaccinated has its risks, as well. I believe the risks from the virus far outweigh any risks from the vaccine. But that’s an evaluation each one of us must make for ourselves.
If you’d like to compare the relative risks of taking the vaccine vs. going without, I would invite you to read Flu Math, where I attempt to compare the two.
