Issue: BCMJ, Vol. 55,
page(s) 201-202 Council on Health Promotion
Lloyd Oppel, MD, MHSc, FCFP(Em)
Vaccines stand out as one of the most cost-effective health interventions in modern medicine. It is estimated that immunizations have saved more Canadian lives over the last 50 years than any other health program.1 Vaccines are credited with reducing the death rate from infections in Canada to only 5%—a far cry from the situation 100 years ago when infectious diseases were the leading cause of death.
But there is a downside to the near eradication of vaccine-preventable illnesses. Most Canadians were born too recently to see the night-and-day difference in public health brought about by immunizations—individuals who witnessed the horrors of the polio epidemics of the 1950s first hand are now well into old age, and many have passed away. Good health can be taken for granted when the public does not properly understand the link between that same good health and the measures that made it possible, and unfortunately, history and science cannot always conquer misinformation, mistrust, and fear.
Much of the current antivaccine sentiment in public discourse results from widely publicized (and now discredited) pseudo-scientific reports of adverse outcomes. The 1998 claim by UK physician Dr Andrew Wakefield that the MMR vaccine caused autism contributed to a collapse in uptake of MMR vaccine in the UK and a subsequent surge in rubella cases in unimmunized children.
Experts estimate that herd immunity is achieved when 95% of a population has been immunized. Canadian immunization rates have fallen in recent years to levels well below this threshold. Canada’s Public Health Agency estimates that only 62% of 2-year-olds are up to date with their shots.
It is disheartening enough that misinformation about vaccines is spread by voices ranging from outspoken celebrities like Jennifer MacCarthy to various alternative medicine trades, but it is cause for urgent concern when public institutions entrusted with the health of Canadians enable misinformation about endemic communicable diseases to go forward with the imprimatur of science.
Health Canada is responsible for ensuring that remedies sold to the public are both safe and effective. In recent years, however, Health Canada has allowed various natural health products to enter the market without requiring rigorous proof of effectiveness. Indeed, there are many remedies and homeopathic preparations currently licensed for sale that do not contain any of the allegedly active ingredient. A number of these are homeopathic “nosodes.” These are ultradilute (typically diluted far beyond the point where anything is left except solvent) preparations of infectious agents or infected tissue, and are administered as an “oral vaccine.”
Although real vaccines use low doses of part of an infectious agent to prevent disease, homeopathic preparations typically are diluted beyond the point where a single molecule remains.
Remarkably, at the same time as Health Canada focuses on influenza education, flu shots, and other proven prevention measures, that same body has licensed 10 products with a homeopathic preparation called “influenzinum.” According to providers, influenzinum is for “preventing the flu and its related symptoms.”
Homeopathic vaccines are available for other infectious diseases as well. Health Canada licenses homeopathic preparations purported to prevent polio, measles, and pertussis.
Health Canada continues to assure Canadians that it tests products for safety and efficacy before allowing them to enter the market. All approved homeopathic products are given a DIN-HM number. The website states, “A NPN or DIN-HM means that the product has been authorized for sale in Canada and is safe and effective when used according the instructions on the label.”
Natural health products are big business, and the voice of providers is never far from the ear of government. While patients are free to make health decisions, government has a duty to ensure that false or misleading claims do not interfere with consumers’ ability to make an informed choice. Nowhere is the case more clear than in the realm of unproven vaccines for serious illnesses. When it comes to homeopathic vaccines, Health Canada needs to stop diluting its standards.
—Lloyd Oppel, MD
Chair, Council on Health Promotion
This article is the opinion of the Council on Health Promotion and has not been peer reviewed by the BCMJ Editorial Board.