Official attempts to reassure the public over the safety of the swine flu vaccine must battle rumour, speculation and fear, reports Reem Leila Experts and health officials expect an increase in incidents of swine flu as the cooler months approach, with possibly more severe symptoms. Yet doubts have been expressed over the safety of the swine flu vaccine, 150,000 courses of which arrived in Egypt days ago. An estimated 30,000 pilgrims have already been vaccinated and, in an attempt to reassure the public, both Minister of Health Hatem El-Gabali and the Grand Sheikh of Al-Azhar Mohamed Sayed Tantawi have received the shots. Housewife Rabab Harhash is far from atypical. "No member of my family, not my husband, my two children, or myself, will be taking the vaccine. Some doctors say it is perfectly safe, others say there are potential side-effects. I will not take the risk," she says. Dalia Nayer, a university professor, insists that she will wait until already inoculated pilgrims return from the hajj before she makes a decision: "The testing of the swine flu vaccine has been rushed and I feel there might be a danger. After watching the health minister taking it on TV I thought I might change my mind but I have decided to wait and see." Vaccination campaigns have long played an important role in protecting the health of individuals, says Abdel-Rahman Shahin, official spokesman at the Health Ministry. "But a group of factors around the swine flu vaccine, including confusion over how it is made and widespread speculation about whether it might be more dangerous than the virus itself has given the anti-vaccine movement a fresh airing." Rumour and misinformation, he says, are making it difficult to persuade an already wary public to line up for shots. "I wonder if the people disseminating this false information about this vaccine realise that what they are doing could result in people losing their lives." Websites, weblog feeds and even elevator chatter are replete with criticisms of the vaccine, often with no factual or scientific basis. The most common complaint is that the vaccine has been developed and distributed without adequate clinical trials. Nasr El-Sayed, deputy minister of health for preventive affairs, points out that the swine flu vaccine is made using the same techniques that have been employed for two decades to produce seasonal flu shots and that clinical trials were conducted earlier this year to determine dosage. The most pervasive fear, however, is that widespread vaccination may see an increase in the extremely rare Guillain-Barré syndrome, as happened in 1976 in the US following an immunisation campaign. "Flu vaccines are now much purer than they were, minimising the risk, and Guillain-Barré is far rarer," says El-Sayed. A press release issued by the World Health Organisation (WHO) points out that manufacturers had conducted advance studies using a "mock-up" vaccine to "expedite regulatory approval" and that potential long-term side effects, including cancer and other life threatening diseases, had yet to be determined. While questions remain around the vaccine, the public has been turning to other flu-related products, including vitamin supplements, in large numbers. Pharmacist Mustafa Mohamed reports that sales of such items tripled in September. Manal Masoud, the mother of two university students, argues that she prefers "to boost immunity rather than risk the vaccine as long as there are questions over its safety". Amid the controversy over the vaccine Prime Minister Ahmed Nazif announced on 7 November that the five-day Eid Al-Adha vacation, beginning on 26 November, would be extended until 5 December in an attempt to stem the spread of the virus at educational institutions. And in a press conference on 8 November Health Minister El-Gabali said that starting Saturday, 14 November, private and public hospitals will all be required to reserve five per cent of their beds for swine flu patients. The ministry will also issue a list of private laboratories licenced to test people for the H1N1 virus and is beginning training courses to help health workers identify swine flu patients. "Hospitals and private laboratories that do not abide by the ministry's decree will be closed down. To protect the public against exploitation the price of the swine flu test will be fixed by the ministry," said El-Gabali. During the press conference El-Gabali revealed that an additional 72 swine flu cases were reported on Friday, including 52 in schools; on Saturday 98 new cases were reported, including 60 among pupils and on Sunday 128 new cases, 69 of them children. By print time the health ministry announced Egypt's sixth swine flu fatality. The deceased is a pregnant woman who was suffering heart problems. The number of swine flu cases reached 2078 cases until Tuesday.
