Vanessa Gera – Drug Discovery & Development January 18, 2010
The decision seemed fraught with risk: a government refusing to import swine flu vaccines amid worldwide warnings of a spreading epidemic.
But Poland did just that, becoming the only country worldwide known to reject the vaccines over safety fears and distrust in the drug companies producing them - concerns international health experts reject as unfounded.
Now that the current outbreak appears to have peaked in much of Europe, many Poles feel their government has been vindicated: Countries with large stockpiles often saw low public interest in the vaccines and face financial loss from unused doses now set to expire. But Poland's government didn't spend a cent fighting the epidemic.
All along, the decision by Prime Minister Donald Tusk and Health Minister Ewa Kopacz met with broad support. Even with 145 swine flu deaths in Poland to date, many Poles view the rejection of the vaccines as a laudable gesture of defiance against pharmaceutical companies, sentiment shaped by a strengthening anti-vaccine movement and conspiracy theories about the vaccines circulating on the Internet.
"I had the impression that the information about swine flu was manipulated in order to create a panic," said Barbara Lazniewska, a 38-year-old architect who was among the many Poles to applaud the government's stance.
Poles take pride in having a strong independent streak and many respect the government for defying the EU, the World Health Organization and other international groups that urged countries to implement vaccination programs - advice that smacked to some of meddling in internal affairs.
The prime minister described Poland as a country with the rare "courage" to refuse a vaccine that he believes has not undergone sufficient testing.
"We are making this decision only in the interest of the Polish patient and the taxpayer," Tusk insisted in December. "We will not take part because it's not honest and it's not safe for the patient."
The anti-vaccine movement argues it is untested or contains risky ingredients, like the preservative thimerosal. However, there is little difference in the swine flu vaccine's formulation from the regular flu vaccine, which is available in Poland, and all evidence so far suggests it is safe and effective. The WHO says more than 150 million people have been vaccinated in more than 40 countries and that no unusual or dangerous side effects have been seen.
"The saving grace for Poland is that this swine flu pandemic is so far very mild. It would be a big scandal if this were a virus that would cause many deaths," said Andrew McMichael, an immunologist and the director of the Weatherall Institute of Molecular Medicine at Oxford.
Other conspiracy theories claim the drug companies making the vaccine secretly lobbied the WHO to declare swine flu a global epidemic to fatten their own pockets, a theory unproven but which some Europeans seem inclined to believe. Even the Parliamentary Assembly of the Council of Europe recently recommended that the EU investigate WHO's swine flu pandemic declaration to see if the body acted under undue influence.
In an e-mailed statement, WHO said its members "guard against the influence of any vested interests" but declined any other comment on the allegations, saying the group's flu chief, Dr. Keiji Fukuda, will address them during a news conference Thursday.
WHO spokeswoman Karen Mah said the organization has no reports of other countries rejecting the vaccine outright. Some countries, however, haven't launched vaccine programs because they lack the money.
Poland's approach contrasts sharply with steps taken by countries such as the United States - where President Barack Obama and his family got swine flu shots to set an example - and European countries like Austria and Sweden that stockpiled enough for their entire populations.
Other eastern EU members have also embraced inoculation, with Hungary and Romania even producing their own domestic vaccines against H1N1, the official name of the current swine flu strain. Romania has seen a burst of interest in vaccines in recent days following the death from swine flu of a well known TV actor, 37-year-old Toni Tecuceanu, on Jan. 5. Over the weekend, 13,000 people got vaccinated in Bucharest alone, the Health Ministry said Monday - vastly more than previous weekends that saw a few dozen at most ask for the jab.
But no well-known Pole has died, and flu fears failed to take root in the country of 38 million people.
Only one leading official, Janusz Kochanowski, the ombudsman for civil rights, has waged a prominent public fight against the government over vaccines, condemning its stance as irrational and irresponsible. He vowed to sue the health minister for a symbolic 1 zloty (35 U.S. cents/25 euro cents) for what he describes as a human rights offense: unnecessarily risking the health of the population by refusing to make vaccines available or take any other steps to fight the spread of swine flu.
Kochanowski came down with swine flu himself over the Christmas holidays, a turn of bad luck he viewed as deeply ironic. During a recent interview in his office he sneezed into a tissue from time to time, and his voice was raspy as he strongly denounced the government.
"In a normal country the media would attack a government that doesn't want to buy vaccines and which doesn't give citizens the right to choose. It's a basic right," Kochanowski told The Associated Press. "The constitution obliges the government to counteract and prevent epidemics. But rather than attacking the government, the media are attacking me."
Though there have been no recent opinion surveys on the matter, Kochanowski and several doctors say there is abundant anecdotal evidence showing that most Poles support the government's approach.
"Unfortunately most people are on the side of the government," Kochanowski said.
Kochanowski says he worries that the government's luck in dodging massive problems with swine flu will only encourage it to ignore future epidemics as well.
"This flu will pass, but there is a new flu every year and the government should prepare every year. However, this government is not only not preparing, but it's making a special point of not being prepared and then claims glory," he said.
In Poland, doctors are deeply divided on the matter, but some are clearly critical of the government.
"It should be the patient's rights to choose - that would be democracy in health care," said Maria Ciesielska, a family doctor whose disapproval only intensified when her 7-year-old son was laid up for a week with swine flu in November. "Even Hippocrates said it's not ethical to not offer a cure if you know that one exists."
www.dddmag.com/news-Poland-Refuses-Swine-Flu-Vaccine-11910.aspx
Last updated 19/04/2010
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