Pneumococcal vaccination limits H1N1 death

Dear all,

Not all who gets H1N1 gets pneumonia BUT all who died of H1N1 gets pneumonia.

So, we should focus on how we can prevent pneumonia if we get H1N1…..
not how to prevent H1N1.

For those high risk group, getting pneumococcal vaccination is one of the defense mechanism we could use against dying from H1N1. You might still get H1N1 but at least you have a 30% lower risk of dying from H1N1.

Studies have shown here that 30% of H1N1 pneumonia related deaths are due to Streptococcus pneumoniae. Getting yourself vaccinated means you have eliminated 30% of the possible risk of dying from H1N1 pneumonia.

Of course, that does not mean you will not get H1N1 but at least you will not die of it… that’s what everyone would prefers. It’s really not about afraid of getting H1N1, it’s more about dying from it……..

So if the government is serious in preventing H1N1 deaths, all those in the high risk group should get pneumococcal vaccination. Also, please ensure that all clinics are able to administer this vaccination to adults as well and not only to the children….

Karen Lee

  1. #1 by OrangRojak on Tuesday, 18 August 2009 - 11:03 am

    Unless Karen Lee is a WHO doctor providing WHO-approved advice, I think publishing this letter is reckless at best. I realise (unless she really is a WHO doctor writing WHO-approved advice) that she’s doing it with the best of intentions, but I’m sure there are more appropriate forums to make her claims in.

    At very least, if you’re going to include this on your site, you should edit it to include some of the cautious language from the single article she refers to. Karen’s version makes promises where the single, journalistic article referred to suggests, infers or even cautions.

  2. #2 by tenaciousB on Tuesday, 18 August 2009 - 11:49 am

    I concur th “OrangRojak”. Karen lee’s letter has grave implications. Personall i’ve mentioned this to my doctor friend and the statement is inaccurately relayed and if the public were to heed such invalid and improper medical advice, there would be a national health debacle! Credible medical advice from qualified health professionals should only be allowed to be published next time for the naive citizen’s sake. Once again the danger of what little people know and their tendency to publish them and inconvinient the rest!

  3. #3 by OrangRojak on Tuesday, 18 August 2009 - 12:09 pm

    I also have young children. My personal point of view is that if there is a medical intervention that carries very little risk (all medical interventions carry a risk) that protects my children from a greater risk, then I will pay a doctor to jab away at them until they are like pin cushions.

    The Pneumovax vaccine is news to me. I hadn’t heard of it before, and I’m glad to have read about it. Karen is right to draw it to our attention.

    The problem lies in advocacy. I would never, ever recommend to a friend that they take their children to have an injection that was not also advocated by a very trustworthy source. I’m happy to bring to my friend’s attention the published best-practice of internationally respected medics, but I would always caution them to seek the advice of their family doctor first. There is an obvious “what if” scenario that should be so apparent as to not need describing in detail. I would rather those internationally respected medics explain “oh yes – sorry – that does happen in rare cases”, than my friend feel that I was somehow to blame because I recommended the treatment.

    Is Karen the mother who wrote about a child with asthmatic bronchitis recently? I sympathise if so. My own children show no signs of it, but I missed months of school every year when I was a child with chronic asthmatic bronchitis. It mysteriously vanished when I was about 20, around about the same time I stopped living with my parents. I had a Salbutamol inhaler with me when I came to Malaysia, but I threw it away after a few months. I think it was a decade out of date anyway, and I hadn’t used it in as long. I sometimes joke with my mother that I must have been allergic to her.

    Vaccinating against pneumonia is an interesting idea, but as ever, people must make their own minds up about what to do with their health and that of their children, and must consult a doctor first.

  4. #4 by drngsc on Tuesday, 18 August 2009 - 12:15 pm

    Yes Kit,
    There is some truth in this strategy.
    Almost all of the H1N1 death is bacterial pneumonia related. Pneumococcal is one of the bacterial involved. This recent spate of AH1N1 flu from Mexico however has an unusually high incidence of primary viral pneumonitis. We are not sure if the Mexican pathologists are correct.
    We did advise the MOH that antibiotics should be started early, if the high fever ( 38oC) does not resolve in 48hrs. Perhaps early use of antibiotics would reduce the incidence and severity of the secondary pneumonia. It also may be cheaper and safer.

  5. #5 by eusoon on Tuesday, 18 August 2009 - 12:31 pm

  6. #6 by AhPek on Tuesday, 18 August 2009 - 3:58 pm

    The idea behind this pneumococcal vaccination basically is to pre-empt pneumonia from setting in as complication to kill in the case of a person with underlying medical conditions getting infected with A(H1N1).
    Besides the vaccinations carry little side effects.
    I’ve a daughter who has an underlying condition.Recently I communicated with an associate professor Reda Girgis of the division of Pulmonary and Critical Health Care
    Medicine,John Hopkins University about giving pneomococcal vaccination,and here’s what he says:
    ‘ Pneumococcal vaccine certainly would be wise to administer.the risks are minimal.I would recommend it.’.
    With this I hope to clear some of your doubts if you have about the wisdom of administering pneumococcal vaccine into people with medical conditions such as diabetes,kidney problems,liver problems,
    pancreatic problems,heart problems,
    respiratory problems,low immune system to
    pre-empt pneumonia should they get infected.
    I think Karen has a huge heart in wanting to share her experience.She need not be a WHO doctor dispensing WHO approved advice.It’s a risk benefit type of decision to make for those with the above problem and that on balance it certainly will far more towards the benefit side for them.

  7. #7 by AhPek on Tuesday, 18 August 2009 - 4:02 pm

    correction:”It’s a risk benefit ……………………
    ..on balance it will tilt far more towards the
    benefit side for them.”.

  8. #8 by OrangRojak on Wednesday, 19 August 2009 - 1:49 am

    It would be interesting to hear what a Malaysian medical expert has to say about PneumoVax and simlar vaccines. The articles at wikipedia make for interesting reading. I didn’t know it was a standard jab for children in the UK. The articles do include a note that the pneumococcus vaccines target pneumococcus types that are common to the US and Europe and “only limited coverage of …types … in developing countries”.

    If there has been a local (since we’re told the targeted types vary from place to place) efficacy study, perhaps someone could bring it to light? The focus, as ever should be on high quality, relevant information. If Mahathir rushes out for his Yankee vaccine, only to be laid low by a monosexual Jewish bacterium, how bad would we feel about misleading him?

  9. #9 by tenaciousB on Wednesday, 19 August 2009 - 1:42 pm

    The Pneumococcal vaccine is suitable for the the very young and the elderly especially those above 65 and more so in those with preexisting lung problems such as COPD which encompasses chronic bronchitis, emphysema and also chronic asthma. In countries such as australia, it’s advocated especially during winter season in those above 65 more so in those with COPD. It does reduce the risk of getting bacterial pneumonia which is usually the cause of mortality in these groups. Now in the context of H1N1, pneumococcal vaccination would be beneficial in the aforementioned groups and the reasonings behind it is we should all know by now, H1N1 predisposes to a possibility of viral pneumonia as well as a superimposed bacterial pneumonia, therefore this reduces the risk of the latter. And in essence bacterial pneumonia carries a higher mortality than viral pneumonia and the important fact about it is, it can be treated with prompt antibiotic commencement.

    The above is advice from an australian doctor friend of mine.

  10. #10 by karenleehs on Thursday, 20 August 2009 - 9:38 pm

    YB…. please start a forum on H1N1 where constructive views and critisism could be given… i have been searching on the net for H1N1 forum in Malaysia, most comments are not useful.

    But you do have very good readers who contribute important leads but the comments are everywhere…..

    Have a one stop forum where it’s easier to track and many can follow up on the leads given.

    Ah Pek, Orang Rojak, tenacious B, drngsc, eusoon are usual readers of your blog and they usually post with good facts …..

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