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Whose job is it, anyway?

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Two important jobs it is hoped and expected that both health experts and the media will fulfill properly, are getting the facts, and getting them straight.  Unfortunately, time and time again, the public has been let down on both scores.  Perhaps no example illustrates this point better than recent events regarding the smallpox vaccine and cardiac events.

When the first of three smallpox vaccinees died, shortly after receiving smallpox vaccination, it was noted that "When administered in the past, the vaccine killed between one to two out of every million people inoculated and caused others to suffer brain damage. But it has never before been linked to heart problems." (my emphasis)

Other news reports have echoed that claim. 

In its "Guidance for Clinicians", however, the CDC stated: "Less frequently reported adverse events temporally associated with after smallpox vaccination include myocarditis, pericarditis", while issuing the predictable caveat that "Whether these conditions are caused by smallpox vaccination or represent coincidental occurrences after vaccination is unclear. Temporal association alone does not prove causation". They also noted in their March 25, 2003 Press Release that "Cases of heart inflammation following smallpox vaccination were reported in the 1960s and 1970s".

At best, the media's fact checking skills leave something to be desired.

While the media can be held accountable for the previous gaffe, the CDC can't blame the media for its own March 2003 statement  that "Other coronary events, including angina and myocardial infarction, have NOT been previously associated with smallpox vaccination."  (my emphasis)

These are their words and their words alone.  And they simply don't gibe with the fact that smallpox vaccination HAS been associated with myocardial infarction.  For instance, as long ago as 1957, in the book   "Coronary Heart Disease", the author Milton Plotz, MD stated, citing an earlier French article, that "Eight cases of infarction have been reported in men over 50 in the second week after vaccination for smallpox.  This, if confirmed, will be a matter of clinical importance."  Since then, at least one other report has been published.

While it appears to be true that there were few such reports, even one is more than none.  It may also turn out that on careful, thorough examination, the reported link doesn't prove to be a causal relationship.  Regardless, isn't it the CDC's and other health organizations' job to know about all reports?  Isn't it their job to know in this particular instance that smallpox vaccine HAS been associated with heart attacks, no matter how few times it has been reported? Doesn't the fact that they were either unaware of this fact, or chose to ignore it, undermine their credibility?

And enough with the excuses about temporal association not proving causation.  Given the provocative reports implicating smallpox vaccination in a variety of cardiac events, why has there not been a fair-minded, assiduous research effort aimed at getting to the bottom of this question?  And when will there be one?

Sandy Gottstein

Date: 4-25-2003              

"Eternal vigilance is the price of liberty." - Wendell Phillips (1811-1884), paraphrasing John Philpot Curran (1808)