23 October 2009
Dystonia after flu shot? Yes. Caused by it? No.
The video is of a news story about a young woman who seemed to develop a rare and strikingly unusual neurological disorder after receiving a seasonal flu shot (not swine flu shot). Her syndrome was one of dystonia (muscle spasms/contractions) that impaired ambulation (but not running) and disappeared when her ambulation was backwards. Most unusual - but not impossible.
A causal relationship to vaccination was raised because other neurological conditions such as Guillain-Barre syndrome have been documented in association with influenza vaccinations (and with influenza itself).
Addendum: One of the citations offered by Jacob in the comments section is from a thoughtful article in the Milwaukee Examiner which discusses the possibility that the dystonia is real, but that it is psychogenic in origin rather than vaccine-mediated. If you watch the video, you should also read this article.
Video via Arbroath.
Addendum: I received this comment from the author of the Milwaukee Examiner article: "Hi. I'm the author of the Examiner.com article you linked to. Thanks for the link. I think that this is very much up in the air, and I hope I made that clear by using "may" instead of "does", or other definitive words. Nonetheless, the risks from the flu outweigh the risks from the vaccine, and people should consult with their health care providers before blindly following the advice of starlets or other famous people."
Second addendum: More details were found re her case, and now she reports having been "cured" by a doctor known to use urine injection therapy and other nonconventional interventions. See the link at scienceblogs for an extensive discussion.
Third addendum: Additional followup and discussion at NeuroLogica blog.
Subscribe to:
Post Comments (Atom)
http://www.examiner.com/x-13791-Baltimore-Disease-Prevention-Examiner~y2009m10d16-Woman-claiming-she-acquired-dystonia-from-a-flu-shot-may-have-it-all-in-her-head
ReplyDeletehttp://www.newscientist.com/article/dn18014-is-the-swine-flu-vaccine-safe.html?DCMP=OTC-rss&nsref=online-news
ReplyDeleteJacob, thanks. Post modified.
ReplyDeleteThe New Scientist article does a good job of pointing out that concern about Guillain-Barre from flu vaccine is pretty silly, given that about 40 times more people (40 per million, pretty low odds) get G-B from the flu itself.
ReplyDeleteYou should also be careful when saying that GBS is "well documented to have been associated with influenza vaccine." This is often used by anti-vaccination proponents as a talking point. The truth is that GBS is only tenuously correlated with influenza vaccination. And it is a very low probability correlation. From a large study:
ReplyDelete"Although the incidence of GBS after influenza vaccination is low (the risk of GBS increases by one case per million person vaccinated)5, the swine influenza experience 8 suggests that continued monitoring of GBS occurrence after vaccination would be prudent.3,6,7,11"
and
"The incidence of GBS in the general population has been reported to be uniform between 0.6 and four cases per 100,000 person-year.8 Although the estimated incidence of postinfluenza vaccination is not different from the incidence in the general population, the occurrence of most cases within 6 weeks after vaccination support the common understanding that GBS is more strongly associated with vaccination for influenza than for vaccination for other diseases. However, it is also apparent that influenza vaccine is not the only one that presents a risk. We hypothesize that the GBS observed after vaccination may arise by either molecular mimicry or nonspecific activation of the immune system. Some vaccines may be more likely to trigger GBS because of high dose or high antigenicity of its endotoxin, antigenicity of other components of the vaccine (other than the endotoxin), and genetic predisposition of the vaccinated subjects to develop vaccine-induced autoimmunity.9,10"
(sorry I can't link to the full text but you can get it if you are at a university or similar place)
Basically there is some suggestion of correlation based on the timing of when people report GBS after getting vaccinated. This *does not* mean the vaccine is causing the disease. It does indicate that continued monitoring should be done.
The problem is that the incidence of GBS in general is very low and isn't really increased after vaccination. It is the timing of symptom onset that is suggestive but certainly not causal.
The other thing to consider is the scale. 1000 individuals reported GBS symptoms after receiving vaccination (not just flu but any vaccine) from 1990 to 2005, with 3% of that 1000 dying and 17% developing a disability. The number of people that die from flu in the US each year is estimated by the CDC to be somewhere between 17,000 and 52,000. That would be 255,000 to 780,000 over the 15 year period.
I am not accusing anything here but stories like these often provide fodder to anti-vaccination proponents even if the risk of forgoing vaccination is much greater than the risk of real or imagined side effects (i.e. measles and mumps outbreaks because of non-vaccination due to fears of autism from the MMR vaccine, which there is no evidence of)
Surprised to see an otherwise reasonable blog jump on the paranoid anti-vax bandwagon. You may think you're being "fair and balanced" by saying, "Maybe. Maybe not", but by doing so you lending a false equivalence to the probabilities of both arguments.
ReplyDeleteHow many people have gotten the flu shot? How many of them got dystonia shortly afterward? How often do people get dystonia regardless of whether they're vaccinated or not? You can't build a case against an undeniably beneficial medicine by citing one dubious anecdote out of millions of uneventful vaccinations; it's disingenuous and dangerous, given what's at stake this flu season and the massive public benefit of vaccination.
@Swift Loris - "concern about Guillain-Barre from flu vaccine is pretty silly, given that about 40 times more people (40 per million, pretty low odds) get G-B from the flu itself."
ReplyDeleteIt's true that more people get G-B from the flu than from the vaccine, but that doesn't disprove a causal association with the vaccine. If some those who got the vaccine (and presumably didn't get the flu) wind up with G-B, then cause-and-effect is implied. The proper statistical rebuttal would be a comparison to how many people who have neither flu nor vaccine get G-B. I haven't seen those data.
As a former GBS patient, this woman's symptoms look very familiar to me, though my range of paralysis was much more subtle. Her's are incredibly distinct. Walking vs. running, forward vs. backward. Its clear she has a form of polyneuropathy but I don't think its Dystonia. She needs a good neurologist to do a deeper investigation of nerve conduction throughout her entire body to determine what the hell she has and why it exhibits the way that it does. My GBS resulted from an autoimmune response to food poisoning rather than a flu shot but both are rare. I still support people getting the flu shot as the benefits still outweigh the risks given the odds.
ReplyDeleteThat article linked to is not correct. They claim there is no link because "This is a scientific impossiblity. The flu virus in the injected vaccine is dead, inactive" The truth is, there is established evidence that vaccines can cause problems, not by infecting you with the flu, but by causing your body's own immune system to attack you. In these rare cases the immune system can actually attack the brain and cause brain damage. That could be what happened to this poor woman.
ReplyDeleteThat being said, this is a less then one in a million chance of happening. It's so rare that these vaccines are really no danger. They're a lot safer then the flu I'll tell you that!
I'll mention first off that I have not yet read the article that discusses the possibility of this woman having this in her head. I will, though, and thank you very much for the link!
ReplyDeleteThat being said, I suspect that it is very unlikely that there is a psychological aspect to this.
Based on my personal experience, I have tremendous respect for the power of the brain. It absolutely does have a powerful ability to contribute to or make someone quite ill. But as an RN, I'm struggling to believe that her symptoms are caused by a psychological component. If it were, why the ability to run? And her speech pattern, too.
Time will tell. Regardless, I ache for that woman and her family. It's heartbreaking to see someone suffer like that, regardless of the cause.
Hi. I'm the author of the Examiner.com article you linked to. Thanks for the link. I think that this is very much up in the air, and I hope I made that clear by using "may" instead of "does", or other definitive words. Nonetheless, the risks from the flu outweigh the risks from the vaccine, and people should consult with their health care providers before blindly following the advice of starlets or other famous people.
ReplyDeleteMy co-worker told me that her 14 yr old daughter received the flu shot and the H1N1 vaccine last Thursday. The next day her daughter began twitching on one side as she drove her to school appeared dazed, and had developed a fever. She took her back home and she began twitching more and more. She was told to call 9-1-1 and she was taken to the E.R. The dr's didn't do scans or xrays just sent her home with no explanation and a referral to a neurologist. She slowed down some but it has come back and today she had to get her from school because her entire body began twitching. I have not heard the results but she took her straight to the neurologist today.
ReplyDeleteDocumented evidence that Ms. Jennings' case was psychogenic: http://www.examiner.com/x-13791-Baltimore-Disease-Prevention-Examiner~y2009m11d4-Records-show-case-of-dystonia-is-psychogenic-and-not-related-to-flu-vaccine
ReplyDeleteAlso, she had the seasonal flu shot, not the swine flu vaccine, as the youtube video claims.