Difference between revisions of "Talk:Assessment of the health impacts of H1N1 vaccination"

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{{discussion
 
{{discussion
 
|Statements= Pandemrix should not be used any more anywhere because its narcolepsy risk is too high.
 
|Statements= Pandemrix should not be used any more anywhere because its narcolepsy risk is too high.
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|Resolution=  
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|Resolution= Not accepted. Pandemrix is still an effective and safe vaccine. However, due to precautionary reasons, other alternatives should be used when available, because the occurrence of narcolepsy is not understood.
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|Resolved = Yes
 
|Argumentation =
 
|Argumentation =
 
{{attack|J5 |Pandemrix is a safe vaccine and narcolepsy risk is low. |--[[User:Jouni|Jouni]] 18:17, 6 April 2011 (EEST)}}
 
{{attack|J5 |Pandemrix is a safe vaccine and narcolepsy risk is low. |--[[User:Jouni|Jouni]] 18:17, 6 April 2011 (EEST)}}
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:{{defend|D5 |Compared to other vaccines, Pandemrix has a lower Hg content (2.5 vs 25 µg), which could cause neurological problems in children|--[[User:Carmen Gil|Carmen Gil]] 11:25, 1 April 2011 (EEST)}} <ref name="rokotusinfoswineflu">[http://www.rokotusinfo.fi/rokotteet/sikainfluenssa_html Rokotusinfo: Swine flu]</ref>
 
:{{defend|D5 |Compared to other vaccines, Pandemrix has a lower Hg content (2.5 vs 25 µg), which could cause neurological problems in children|--[[User:Carmen Gil|Carmen Gil]] 11:25, 1 April 2011 (EEST)}} <ref name="rokotusinfoswineflu">[http://www.rokotusinfo.fi/rokotteet/sikainfluenssa_html Rokotusinfo: Swine flu]</ref>
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:{{defend|B1 |All data compiled to date indicate that pandemic vaccines including Pandemrix match the excellent safety profile of seasonal influenza vaccines, which have been used for more than 60 years.The number of cases of side effects of H1N1 vaccines (including Pandemrix) is in line with normal background rates on a population basis.(European Medicines Agency.) |--[[User:Oluyemitoyinbo|Oluyemitoyinbo]] 11:12, 1 April 2011 (EEST)}} <ref name="ecdc_qa">[http://ecdc.europa.eu/en/healthtopics/H1N1/vaccines/Pages/QA_health_professionals_vaccines.aspx European Centre for Disease Prevention and Control (ECDC): Questions and answers]</ref>
 
:{{defend|B1 |All data compiled to date indicate that pandemic vaccines including Pandemrix match the excellent safety profile of seasonal influenza vaccines, which have been used for more than 60 years.The number of cases of side effects of H1N1 vaccines (including Pandemrix) is in line with normal background rates on a population basis.(European Medicines Agency.) |--[[User:Oluyemitoyinbo|Oluyemitoyinbo]] 11:12, 1 April 2011 (EEST)}} <ref name="ecdc_qa">[http://ecdc.europa.eu/en/healthtopics/H1N1/vaccines/Pages/QA_health_professionals_vaccines.aspx European Centre for Disease Prevention and Control (ECDC): Questions and answers]</ref>
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{{attack|J5 |Pandemrix is an effective vaccine with strong benefits.|--[[User:Jouni|Jouni]] 18:17, 6 April 2011 (EEST)}}
 
{{attack|J5 |Pandemrix is an effective vaccine with strong benefits.|--[[User:Jouni|Jouni]] 18:17, 6 April 2011 (EEST)}}
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{{attack invalid|J1 |Despite risks, Pandemrix is an effective vaccine and has clearly net positive effects in countries where emergency treatment is poorly available for severe swine flu cases.|--[[User:Jouni|Jouni]] 23:05, 31 March 2011 (EEST)}}
 
{{attack invalid|J1 |Despite risks, Pandemrix is an effective vaccine and has clearly net positive effects in countries where emergency treatment is poorly available for severe swine flu cases.|--[[User:Jouni|Jouni]] 23:05, 31 March 2011 (EEST)}}
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:{{attack|D2 |By September 2010 there was no conclusive prelimininary impact of the vaccine in other countries and research was ongoing in several countries to monitor the effect of the vaccine in preventing illness and death. Side effects are still there and will be treated poorly in these countries.|--[[User:Carmen Gil|Carmen Gil]] 11:25, 1 April 2011 (EEST)}} <ref name="thl20100825"/>
 
:{{attack|D2 |By September 2010 there was no conclusive prelimininary impact of the vaccine in other countries and research was ongoing in several countries to monitor the effect of the vaccine in preventing illness and death. Side effects are still there and will be treated poorly in these countries.|--[[User:Carmen Gil|Carmen Gil]] 11:25, 1 April 2011 (EEST)}} <ref name="thl20100825"/>
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:::{{attack|C5 |Arepanrix, a H1N1 influenza vaccine similar to Pandemrix and also made by GSK was used in Canada. There has been no increase in narcolepsy cases in Canada reported.|--[[User:Jpmannikko|Jpmannikko]] 17:15, 4 April 2011 (EEST)}}
 
:::{{attack|C5 |Arepanrix, a H1N1 influenza vaccine similar to Pandemrix and also made by GSK was used in Canada. There has been no increase in narcolepsy cases in Canada reported.|--[[User:Jpmannikko|Jpmannikko]] 17:15, 4 April 2011 (EEST)}}
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{{defend invalid|J2 |The reputation of Pandemrix is globally so poor that it is impossible to use it any more.|--[[User:Jouni|Jouni]] 23:05, 31 March 2011 (EEST)}}
 
{{defend invalid|J2 |The reputation of Pandemrix is globally so poor that it is impossible to use it any more.|--[[User:Jouni|Jouni]] 23:05, 31 March 2011 (EEST)}}
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:{{attack|B7 |Pandemrix vaccine was used in 38 countries worldwide during the 2009/2010 season. Increased cases of narcolepsy have been observed only in Finland, Iceland and Sweden (W.H.O). This I think makes its global reputation intact.|--[[User:Oluyemitoyinbo|Oluyemitoyinbo]] 12:27, 4 April 2011 (EEST)}} <ref>[http://www.euro.who.int/en/what-we-do/health-topics/disease-prevention/vaccines-and-immunization/news/news/2011/02/pandemrix-vaccine-and-increased-risk-of-narcolepsy WHO Europe]: Pandemrix® vaccine and increased risk of narcolepsy</ref>
 
:{{attack|B7 |Pandemrix vaccine was used in 38 countries worldwide during the 2009/2010 season. Increased cases of narcolepsy have been observed only in Finland, Iceland and Sweden (W.H.O). This I think makes its global reputation intact.|--[[User:Oluyemitoyinbo|Oluyemitoyinbo]] 12:27, 4 April 2011 (EEST)}} <ref>[http://www.euro.who.int/en/what-we-do/health-topics/disease-prevention/vaccines-and-immunization/news/news/2011/02/pandemrix-vaccine-and-increased-risk-of-narcolepsy WHO Europe]: Pandemrix® vaccine and increased risk of narcolepsy</ref>
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::{{defend|D7 |Although the causal relationship between the Pandemrix vaccine and increased narcolepsy cases is not yet confirmed, THL stopped the vaccinations as a safety measure until the matter can be fully investigated. A potential link between the Pandemrix vaccine and narcolepsy will be investigated in Finland by paedriatic neurologists and THL experts.|--[[User:Minna Ruokolainen|Minna Ruokolainen]] 21:51, 3 April 2011 (EEST)}} <ref name="thl20100825"/>
 
::{{defend|D7 |Although the causal relationship between the Pandemrix vaccine and increased narcolepsy cases is not yet confirmed, THL stopped the vaccinations as a safety measure until the matter can be fully investigated. A potential link between the Pandemrix vaccine and narcolepsy will be investigated in Finland by paedriatic neurologists and THL experts.|--[[User:Minna Ruokolainen|Minna Ruokolainen]] 21:51, 3 April 2011 (EEST)}} <ref name="thl20100825"/>
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{{defend|J6 |Pandemrix should not be used due to precautionary reasons and because there are alternatives.|--[[User:Jouni|Jouni]] 18:17, 6 April 2011 (EEST)}}
 
{{defend|J6 |Pandemrix should not be used due to precautionary reasons and because there are alternatives.|--[[User:Jouni|Jouni]] 18:17, 6 April 2011 (EEST)}}
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:{{defend|D8 |The most of the narcolepsy cases in Finland are observed among the children. THL´s decision is far too late and THL should not have used Pandemrix at all or at least for the vaccination of children, because the WHO recommendations for not using the Pandemrix-vaccine for chilred were available before THL launched the vaccination campaing.  |--[[User:Minna Ruokolainen|Minna Ruokolainen]] 21:33, 3 April 2011 (EEST)}} <ref name="rokotusinfoswineflu"/>
 
:{{defend|D8 |The most of the narcolepsy cases in Finland are observed among the children. THL´s decision is far too late and THL should not have used Pandemrix at all or at least for the vaccination of children, because the WHO recommendations for not using the Pandemrix-vaccine for chilred were available before THL launched the vaccination campaing.  |--[[User:Minna Ruokolainen|Minna Ruokolainen]] 21:33, 3 April 2011 (EEST)}} <ref name="rokotusinfoswineflu"/>
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::::{{comment|# |Good usage of branches! However, branches do not affect the outcome of a discussion. You could use this branch also to defend J2 and then it would have an impact on this discussion.|--[[User:Jouni|Jouni]] 07:45, 2 April 2011 (EEST)}}
 
::::{{comment|# |Good usage of branches! However, branches do not affect the outcome of a discussion. You could use this branch also to defend J2 and then it would have an impact on this discussion.|--[[User:Jouni|Jouni]] 07:45, 2 April 2011 (EEST)}}
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{{defend invalid|B8 |There maybe a conflict of interest in the approval of Pandemrix for swine flu vaccination in Finland|--[[User:Oluyemitoyinbo|Oluyemitoyinbo]] 12:50, 4 April 2011 (EEST)}}
 
{{defend invalid|B8 |There maybe a conflict of interest in the approval of Pandemrix for swine flu vaccination in Finland|--[[User:Oluyemitoyinbo|Oluyemitoyinbo]] 12:50, 4 April 2011 (EEST)}}
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:{{attack|B11 |According to Chancellor of Justice, Jaakko Jonkka, there's no direct [ evidence to support ] suspicion of bribery but there is a risky situation because the seller funds the buyer.|--[[User:Oluyemitoyinbo|Oluyemitoyinbo]] 12:57, 4 April 2011 (EEST) <ref name="rokotusinfo">[http://www.rokotusinfo.fi/english_html Rokotusinfo]</ref>}}
 
:{{attack|B11 |According to Chancellor of Justice, Jaakko Jonkka, there's no direct [ evidence to support ] suspicion of bribery but there is a risky situation because the seller funds the buyer.|--[[User:Oluyemitoyinbo|Oluyemitoyinbo]] 12:57, 4 April 2011 (EEST) <ref name="rokotusinfo">[http://www.rokotusinfo.fi/english_html Rokotusinfo]</ref>}}
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:{{defend|C10 |There have been claims that THL would have had a conflict of interest, as it had received financing worth EUR 6 million from the vaccine producer GalaxoSmithKline (GSK)|--[[User:Jpmannikko|Jpmannikko]] 16:51, 4 April 2011 (EEST)}}
 
:{{defend|C10 |There have been claims that THL would have had a conflict of interest, as it had received financing worth EUR 6 million from the vaccine producer GalaxoSmithKline (GSK)|--[[User:Jpmannikko|Jpmannikko]] 16:51, 4 April 2011 (EEST)}}
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{{branch|C12 |The interesting question about Pandemrix is perhaps not if it should not be used because of narcolepsy threat, but whether if it was actually needed at all. Russian Federations chief doctor Gennady Onishchenko stated on June 2, 2009 that swine flu was not aggressive enough to cause worldwide pandemic. He noted that the mortality rate of confirmed cases was 1,6% in Mexico and only 0,1% in United States. He also noted that there was 16,000 cases so far when during any flu season some 10,000 people become ill in Moscow alone.|--[[User:Jpmannikko|Jpmannikko]] 19:25, 4 April 2011 (EEST)}}
 
{{branch|C12 |The interesting question about Pandemrix is perhaps not if it should not be used because of narcolepsy threat, but whether if it was actually needed at all. Russian Federations chief doctor Gennady Onishchenko stated on June 2, 2009 that swine flu was not aggressive enough to cause worldwide pandemic. He noted that the mortality rate of confirmed cases was 1,6% in Mexico and only 0,1% in United States. He also noted that there was 16,000 cases so far when during any flu season some 10,000 people become ill in Moscow alone.|--[[User:Jpmannikko|Jpmannikko]] 19:25, 4 April 2011 (EEST)}}
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:{{defend|E8 |WHO recommended that H1N1 virus strain be included in the seasonal flu vaccines for the 2009/2010 season, because H1N1 is still in circulation, but behaving like a seasonal flu virus. |--[[User:Anna Kokkonen|Anna Kokkonen]] 11:10, 1 April 2011 (EEST)}} <ref name="emaswineflu"/>
 
:{{defend|E8 |WHO recommended that H1N1 virus strain be included in the seasonal flu vaccines for the 2009/2010 season, because H1N1 is still in circulation, but behaving like a seasonal flu virus. |--[[User:Anna Kokkonen|Anna Kokkonen]] 11:10, 1 April 2011 (EEST)}} <ref name="emaswineflu"/>
  
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{{attack|E5 |Nursing staff in hospitals should be vaccinated; it is their responsibility as medical professionals.|--[[User:Sallamari Tynkkynen|Sallamari Tynkkynen]] 10:54, 1 April 2011 (EEST)}} <ref name="hsarkkiatri"/>
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{{attack invalid|E5 |Nursing staff in hospitals should be vaccinated; it is their responsibility as medical professionals.|--[[User:Sallamari Tynkkynen|Sallamari Tynkkynen]] 10:54, 1 April 2011 (EEST)}} <ref name="hsarkkiatri"/>
  
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:{{comment|# |This may be true but what is the connection to the statement? Does this actually relate more to E4 than the main statement?|--[[User:Jouni|Jouni]] 08:15, 2 April 2011 (EEST)}}
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:{{attack|J7 |This may be true but what is the connection to the statement? Does this actually relate more to E4 than the main statement?|--[[User:Jouni|Jouni]] 08:15, 2 April 2011 (EEST)}}
  
 
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Revision as of 15:27, 6 April 2011

Darm exercise 4

Tasks:

  • Make pairs and select one group A-E (D and E have Finnish material).
  • Look at page Discussion for theoretical and practical advice. Also page op_fi:Keskustelun jälkijäsentäminen may be useful.
  • Look at the two or three links on your group's page.
  • Read the texts and try to identify arguments about the use of Pandemrix. Note that arguments can be (and most are) indirect arguments.
  • Rewrite the arguments in such a way that they can be understood outside the original context.
  • Place the arguments into a hierarchical tree of attacking and defending arguments pointing toward the main statement about Pandemrix use.
  • You can also make up your own arguments, or if you have extra time, read additional material (see end of the page).
  • When each group has done their own part, there will be a general discussion about all argumentations by the groups. All argumentations will be merged onto this page based on the discussion.
  • Think: How many readers do you need to make this extra effort of collecting, organising and synthesising information and opinions a worthwhile activity of social learning?


The group specific pages can be improved until Monday (4.4.) evening.
Evaluation of the exercise will be based on the contents of the group pages as of Monday evening.
The argumentation by different groups will be compiled on this page and discussed more on the lecture on Thursday 7.4.

Pandemrix should not be used because of narcolepsy risk

How to read discussions

Statements: Pandemrix should not be used any more anywhere because its narcolepsy risk is too high.

Resolution: Not accepted. Pandemrix is still an effective and safe vaccine. However, due to precautionary reasons, other alternatives should be used when available, because the occurrence of narcolepsy is not understood.

(Resolved, i.e., the resolution has been updated to the main page.)

Argumentation:

⇤J5 : Pandemrix is a safe vaccine and narcolepsy risk is low. --Jouni 18:17, 6 April 2011 (EEST)



⇤J5 : Pandemrix is an effective vaccine with strong benefits. --Jouni 18:17, 6 April 2011 (EEST)

←B4 : Adjuvanted vaccines commonly provide a stronger immune response than unadjuvanted vaccines and also provide a broader immune response allowing for some potential drift of the influenza virus (Pandemrix is an adjuvanted vaccine). --Oluyemitoyinbo 11:12, 1 April 2011 (EEST) [4]
←B5 : A positive effect of the vaccine can be felt from pregnant women, it gives immunization to the mother-to-be and the new born that is not eligible for vaccination until the age of six months. The adverse events reported so far have mainly been symptoms such as fever, nausea, headache, allergic reactions and injection site reactions, confirming the safety profile of the vaccine. The vaccine can even be given to breastfeeding mothers and this will reduce the chance that the infant will get influenza. --Oluyemitoyinbo 11:20, 1 April 2011 (EEST) [4]
←E7 : Vaccination is a very good method of preventing swine flu infections. --Sallamari Tynkkynen 10:59, 1 April 2011 (EEST) [5]

⇤D3b : The vaccine may still have been used where no other option was available and upon consideration in individual cases, for instance for people travelling to areas where an epidemic was in progress. --Carmen Gil 11:25, 1 April 2011 (EEST) [6]

⇤J1 Despite risks, Pandemrix is an effective vaccine and has clearly net positive effects in countries where emergency treatment is poorly available for severe swine flu cases. --Jouni 23:05, 31 March 2011 (EEST)



←J2 The reputation of Pandemrix is globally so poor that it is impossible to use it any more. --Jouni 23:05, 31 March 2011 (EEST)



←J6 : Pandemrix should not be used due to precautionary reasons and because there are alternatives. --Jouni 18:17, 6 April 2011 (EEST)



←B8 There maybe a conflict of interest in the approval of Pandemrix for swine flu vaccination in Finland --Oluyemitoyinbo 12:50, 4 April 2011 (EEST)



→C12 : The interesting question about Pandemrix is perhaps not if it should not be used because of narcolepsy threat, but whether if it was actually needed at all. Russian Federations chief doctor Gennady Onishchenko stated on June 2, 2009 that swine flu was not aggressive enough to cause worldwide pandemic. He noted that the mortality rate of confirmed cases was 1,6% in Mexico and only 0,1% in United States. He also noted that there was 16,000 cases so far when during any flu season some 10,000 people become ill in Moscow alone. --Jpmannikko 19:25, 4 April 2011 (EEST)

--# : Good usage of branch functionalities! However, this is also an attack, because it changes the resolution of the statement away from "accepted". --Jouni 06:55, 6 April 2011 (EEST)

⇤E6 The vaccination used last year will most likely protect also against the possible swine flu epidemic of this year, although the virus has changed a bit. --Sallamari Tynkkynen 10:57, 1 April 2011 (EEST) [5]

⇤J6 : This may be true but what is the connection to the statement? This is irrelevant. --Jouni 08:15, 2 April 2011 (EEST)
←E8 : WHO recommended that H1N1 virus strain be included in the seasonal flu vaccines for the 2009/2010 season, because H1N1 is still in circulation, but behaving like a seasonal flu virus. --Anna Kokkonen 11:10, 1 April 2011 (EEST) [10]

⇤E5 Nursing staff in hospitals should be vaccinated; it is their responsibility as medical professionals. --Sallamari Tynkkynen 10:54, 1 April 2011 (EEST) [7]

⇤J7 : This may be true but what is the connection to the statement? Does this actually relate more to E4 than the main statement? --Jouni 08:15, 2 April 2011 (EEST)


Discussion groups:

See also

Additional material:

References

  1. ↑ 1.0 1.1 1.2 1.3 Rokotusinfo: Swine flu
  2. ↑ YLE: EU agency does not find link between Pandemrix and narcolepsy
  3. ↑ 3.0 3.1 3.2 Rokotusinfo
  4. ↑ 4.0 4.1 4.2 European Centre for Disease Prevention and Control (ECDC): Questions and answers
  5. ↑ 5.0 5.1 THL press release 9 Dec 2010
  6. ↑ 6.0 6.1 6.2 6.3 THL press release 25 Aug 2010
  7. ↑ 7.0 7.1 Helsingin Sanomat: Arkkiatri moittii sikainfluenssarokotteen vastustajia (in Finnish)
  8. ↑ WHO Europe: Pandemrix® vaccine and increased risk of narcolepsy
  9. ↑ WHO Global Advisory Committee on Vaccine Safety: Statement on narcolepsy and vaccination
  10. ↑ 10.0 10.1 European Medicines Agency (EMA): Information page on Swine flu
  11. ↑ PreventDisease.com: Total of 2300 Reports of Adverse Reactions From Pandemrix Vaccine in Sweden
  12. ↑ THL recommends to stop the use of Pandemrix
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