Groundhog Day: the Flu Vaccine and Narcolepsy

Winter, with its wonderful festivals and awful weather is the time of year we are often physically closest to our fellow men, women and children.  For much of the day we are indoors breathing the same few cubic metres of air as those around us and one by one most of us will succumb to some kind of infection or another, most likely a cold or, for the more unlucky, the flu.

Fortunately, each year, when the season’s particular strain is identified, production of flu vaccine goes into overdrive. The panic caused by the 2009 outbreak of the H1N1 strain of swine flu, put a huge strain on health services around the world. Thankfully, it did not become a global tragedy thanks, in no small part, to vaccination. This year’s flu season has, according to the CDC,  brought with it at least 18 fatalities in the USA so far. Nevertheless, the fear mongering over the ‘flu vaccine continues in the usual quarters. It, once again, focusses on a supposed link between vaccine receipt and narcolepsy; the rare and debilitating condition the most obvious symptom of which is excessive sleepiness. Narcolepsy can be accompanied by a host of other problems such as cataplexy where one suddenly loses muscle tone as in sleep but while still awake, hallucinations and hypnagogia – dreaming while between sleep and wakefulness.

Just as the panic merchants have done in regurgitating this old story, I have to admit to recycling much of this piece from one I wrote for my Autismum blog around about this time last year bemoaning that year’s the resurrection of these fears.

The World Health Organisation (WHO), has confirmed that more than a dozen countries reported cases of narcolepsy following the administration of one brand of flu vaccine. In 2009, the vaccine in question, Pandemrix, produced by Glaxo Smith-Kline, was used in 47 countries world wide. More than 30 million shots were administered in Europe alone with six million of those going to UK recipients. The reported cases of narcolepsy following the administration of Pandemrix include 52 in Finland, fourteen in the Republic of Ireland and four as yet unconfirmed cases in the UK. “Further investigation [is] warranted,” says the WHO.

In February 2012, the Finns published their preliminary data. What they found certainly suggested a link between the vaccine and narcolepsy. The incidence of diagnosis in children aged five to nineteen had increased significantly compared to previous years’ data. Of those new cases, 90% were vaccinated with Pandemrix compared to a 70% vaccination coverage for that age group in general. Comparing one group with the other, the risk of narcolepsy is seen, in this study, to be nine times higher in those who received the vaccine than those who did not. In essence, the study showed there to be a probable link.

…But that’s not the end of the story.

The WHO’s Global Advisory Committee on Vaccine Safety (GACVS) stated in response to the Finnish study,

“it does not appear that narcolepsy following vaccination against pandemic influenza is a general worldwide phenomenon and this complicates interpretation of the findings in Finland.”

Indeed, there is no global pattern as one would expect if a vaccine so widely distributed were at fault. There has been no increase in the reports of numbers of people falling ill with narcolepsy in, for example, Canada, Germany or even Finland’s neighbour, Sweden. The four cases reported in the UK were flagged up only because of a temporal association to the vaccine being administered and onset of symptoms. In fact, the number lies well within expectations. To complicate the matter further, there has been observed a rise in cases of narcolepsy across both vaccinated and unvaccinated populations in Scandinavia.

So, could the vaccine have caused narcolepsy? The answer is an unsatisfying maybe. All of those who developed the condition post vaccine and have been tested, have been found to be of the (HLA) DQB1*0602 genotype. That narcolepsy is familial is not a matter of controversy. However, of those who fall within this group, only around 40% become symptomatic so it seems there must be an environmental trigger for an individual genotypically narcoleptic to become phenotypically narcoleptic. Among the candidates for that trigger are smoking, stress and infections including influenza.

Naturally, there has been an outcry from anti-vaccine groups – the one now repeated annually. The flu vaccine does not rely for its action on live virus and is one of vanishingly few vaccines routinely administered that contain the anti-microbial agent thimerosal. This chemical, which prevents microbial growth in vaccines, contains ethylmercury which, it has been proposed, can cause autism. This myth is still in wide circulation despite numerous studies that have proved it false and by the fact that the incidence of autism continues to rise years after thimerosal’s removal from most vaccines.

There are, of course, other reasons people choose not to get the flu vaccine – even those who really should, like pregnant women and health care workers. Some believe it just is not effective, citing either themselves or a friend who got the shot and then got flu, too. No vaccine offers 100% protection but significantly more for most people than relying on their immune system alone. Protection afforded by the vaccine can take weeks to fully develop and that’s one of the reasons some vaccinated individuals will still get the infection against which they are vaccinated. Perhaps the silliest excuse for not getting the shot is believing the vaccine can give you the flu. This is impossible. You may experience mild flu-like symptoms afterwards, but getting the infection from the jab won’t happen as it contains no live virus. What is so often lacking, amid the hysteria surrounding vaccines, is reporting of the very real and far more frequent complications of the infections which they prevent. In the case of influenza, this can include a consequence far more serious than narcolepsy: death.

About M O'Callaghan

I work at home, in Wales and am the proud mother of the adorable Pwdin of my blog. My son is autistic and (let's get it out the way) fully vaccinated. When he's asleep or at school, I contribute to various websites such as Vaccines Today and Seek the Evidence among others. Here at Skeptoid, I intend to write about products, therapies and practices being marketed to parents and families. Give me a bit of wiggle room on this one, though, as I have found that parenting pages and mum magazines promote much woo targeted at women which may well get a good going over from time to time. Follow me @MLOCallaghan
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9 Responses to Groundhog Day: the Flu Vaccine and Narcolepsy

  1. Alex says:

    I didn’t have the flu vaccine when I was pregnant as I am a generaly healthy person and don’t suffer with colds etc. I don’t think it is neccessary for all pregnant women to have the flu vaccine, neither do I think all health care workers should have the vaccine. If you are healthy and lead a healthy lifestyle then why put another substance into your body when you may not need to. This however does stray somewhat from the original point of the article, sorry about that.

  2. Karolyn says:

    If people just kept their immune systems in good order, there would be no need for flue vaccines in the first place. But, then again, if everybody was healthy, Big Pharma would go out of business!

    • An immune system that has never been exposed to a given pathogen has a fighting chance at beating it, but only a fighting chance. There is no other way an immune system can develop the proper antigens to a pathogen it’s never seen before.

  3. lilady says:

    Excellent article and the reports of narcolepsy following influenza vaccination restricted mainly to Finland certainly is interesting.

    The CDC has a Flu Surveillance Network with weekly reports about flu activity and pediatric deaths. As of the last report on January 26, 2013, 45 pediatric deaths are attributed to influenza infections.

    As I “survey” those notorious anti-vaccine websites, the bloggers are cranking out posts about the cases of narcolepsy in the Finnish population…while totally ignoring the deaths of the 45 youngsters who succumbed to influenza.

  4. Krisque says:

    I have never gotten the flu vaccine but only because I have a huge phobia of needles. I know that is probably irrational at my age but it is true. I have recently been diagnosed with Narcolepsy and found this article while doing a search after reading a post someone wrote about ties to the shot and Narcolepsy which I thought was absurd! Thank you for writing this, it is well written and informative!

  5. I love the nonsense of “Well, a friend of mine got vaccinated and came down the Flu anyways! So OBVIOUSLY it doesn’t work and is just a plot by Big Pharma to make MONEY!” First off, MOST people that think they’ve had “Influenza” haven’t had “The Flu”. True influenza is hell on earth and most of the time, I hear people say “I got the sniffles and I was tired… I had the flu!” and as someone that has had the REAL THING, I can tell you that a little fatigue and some sniffles isn’t Influenza. I can’t describe how bad the joint pain and fever of true influenza was! Sniffles don’t cut it… You didn’t have the flu.

    Secondly, there are MANY strains of Influenza and the vaccinations don’t protect you from all of them. It’s like saying that it is the HPV vaccinations fault that you got one of the dozens of other strains of HPV that the vaccination doesn’t protect against. If the vaccination only covers 4 types of HPV and there are DOZENS of types of HPV why are you shocked?

    Third, I LOVE how every few days on my Facebook Landing Page I see a new post about thimerosal. When I mention that it’s been removed from most vaccines, they say “SEE! You said ‘MOST’, not ‘ALL’, so that means that it is still the reason for the autism pandemic, narcolepsy, cancer, etc. etc. etc.”

    While it seems as if most of these nutters have been diverted by a new increase in spreading myths about fluoride, the thimerosal/anti vaccination nonsense is still running rampant.

    It’s scary to see how many people just don’t fact check their beliefs.

    For Fluoride, the newest vague threat is “Why are there warnings about fluoride on toothpaste if it isn’t dangerous?” REALLY? 1 drop of bleach in a gallon of water makes it safe to drink, but one drop of water in a gallon of bleach is deadly. There are warnings on the sides of bleach bottles saying “Do not consume”, too.

    Sigh… I’m so frustrated by these people… It’s hard to not want to just shake them and scream “WHERE IS YOUR EVIDENCE????”

    • Dan says:

      Unfortunately there isn’t an anti-stupidity vaccine for these people (although the paradox is that they wouldn’t take it if there was…)

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