Vaccine skepticism is in the air

The nation's political crosscurrents appear to have created vaccine skeptics of many stripes.

In a time when Americans are engaged in fierce debate over the federal government's role in their healthcare, many citizens are less inclined than ever to accept the warnings of the Department of Health and Human Services or the recommendations of its Centers for Disease Control and Prevention, says Sandra Quinn, a University of Pittsburgh public health professor who has just completed a national survey of attitudes about the flu vaccine.

Vaccine refusers have long decried vaccine mandates and campaigns as an unwarranted intrusion of parents' and local school boards' rights. And against the backdrop of charges that a "public healthcare option" would hijack patients' choices, such complaints have taken on new resonance for some.

Among racial and ethnic minorities, who are also believed to be at greater-than-average risk from H1N1 flu, concerns about vaccine spring from deeper roots. In the African American community, the Tuskegee syphilis experiments, uncovered in 1972, still stir fear and suspicion of many health initiatives. Over four decades, that Macon County, Ala., study left 400 poor black men with the sexually transmitted disease untreated long after penicillin's discovery.

In immigrant communities, where fear of government scrutiny or deportation has been heightened by new local initiatives and an acrimonious national debate, officials fear that many parents will not seek out vaccine for their children.

And for a new generation of vaccine skeptics, there are new objects of distrust. For some, it flows from a suspicion of the multinational corporations that develop and manufacture vaccines. For others, it comes from a belief that media outlets have hyped the pandemic flu story to secure the attention of readers and the revenue of advertisers. And many simply doubt the competency and independence of government agencies, which they believe are too inept, overwhelmed or co-opted by corporate interests to secure the safety of the nation's drugs and food supply.

Adding to the wariness toward the forthcoming H1N1 vaccine is the fact that the formulations used on patients in the United States might require the use of adjuvants -- special agents added to a vaccine mix that rev up the immune system and foster a stronger immune response. If clinical trials underway now find that subjects' immune responses to vaccines in development are weaker than had been hoped, U.S. officials are expected to debate whether to approve their addition to H1N1 vaccine formulations.

The addition of adjuvants to vaccines offered in the United States would mean, in FDA parlance, that the vaccines would have an "emergency use authorization" from the FDA. A more qualified FDA blessing than full approval, an "emergency use authorization" would likely spark additional reluctance among parents who are already leaning against vaccine, said experts.

While adjuvants have been used in vaccines in Europe for many years, the FDA has never approved them for widespread use in the United States. Some vaccine critics in Great Britain have charged that one adjuvant used in European formulations -- squalene -- is associated with a wide range of vague but persistent symptoms.

"My fear is that they've made this vaccine and that it's only a quick fix. I don't feel like they've taken enough time to develop it as far as they need to," says Susanne Stuart-Nystrom, a 37-year-old Venice resident and mother of a preschooler.

melissa.healy@latimes.com