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When it comes to H1N1 vaccine, some doctors are just saying no

Nurse Terri Jackson administers the swine flu vaccine to Jimmie Jackson at the Utah County Health Department in Provo. A small group of health-care providers are choosing not to provide the vaccination.
Nurse Terri Jackson administers the swine flu vaccine to Jimmie Jackson at the Utah County Health Department in Provo. A small group of health-care providers are choosing not to provide the vaccination. (George Frey/bloomberg)

Cheryl F. Edmonds, founder of the practice where Soghomonian takes her children, declined to be interviewed. But a member of her staff, who spoke on the condition of anonymity, characterized her concerns this way: "Her thing is there's just not enough data."

Murphy, the Burke pediatrician, said he has no reason to think the vaccine is unsafe -- he, like many of the skeptics, said he generally supports vaccinations. But he wonders whether it was tested enough.

"They just didn't have the time to do that properly. They mean well and they are not doing anything to mislead people in any direct way. The reality is no one knows. I'm not pretending to know. I don't think they should pretend to know," he said.

'Jumping on the bandwagon'

Murphy is not alone. A smattering of obstetricians, family practice doctors, internists and other physicians nationwide who harbor doubts about safety of the vaccine or the danger the flu poses raise questions on blogs and during interviews, and counsel their patients not to get the immunization.

"What bothers me is pretty much every doctor in the country is jumping on the bandwagon and saying, 'This vaccine is completely safe' -- even for the pregnant woman and the unborn baby," said Bob Sears, of Orange County, Calif. "But they can't give you a single study that backs up that statement."

Officials repeatedly have stressed that while no vaccine is completely safe, there is no reason to believe the swine flu immunization would pose any unusual risks, and so far no problems have emerged.

"I can understand the hesitancy and reluctance to take a vaccine that appears to be new and different. All we can do is provide the facts," said Thomas R. Frieden, director of the federal Centers for Disease Control and Prevention. "The facts are that this is the same manufacturing process, the same manufacturers, the same factories, the same safeguards as the seasonal flu vaccine that has been used for more than 100 million doses each year for many years and which has an excellent safety record."

But Meryl Nass, an internist in Bar Harbor, Maine, still has doubts, especially given that most people who become infected get only mildly ill.

"In this situation, when there's very little data, I don't think people -- and children in particular -- should be asked to bear the burden of being experimental subjects," said Nass, who has been blogging about her doubts. Nass also questions the assertion that the vaccine is safe for women in all stages of pregnancy.

"The CDC is telling women in all trimesters to go out and get vaccine. To my mind, this is reckless," said Nass, who is advising her patients to consider receiving the vaccine only in their second or third trimesters.

'Behind the curve'

Some doctors hear echoes of politics in the reactions to their concerns.

"You come out and offer some caution about the safety of the vaccine, and it becomes very political: Are you with us or are you against us?" said Kent Holtorf, whose Southern California practice specializes in treating chronic conditions. "It's almost like Republicans and Democrats, and no one wants to toe the middle ground, because it could help the other side."

Giuseppe Lancellotti, a pediatrician from Ephrata, Pa., argues that the vaccine has arrived too late to make a difference anyway.

"We're just way behind the curve," he said.

Government officials counter that it remains far from clear whether the second wave of infections currently sweeping the country has peaked. Even if it has, people will continue to become infected for months and another wave could hit later.

"The risk of not getting the vaccine is much greater than the risk from getting it," said Anthony S. Fauci, who is leading the government's ongoing testing of the vaccine at the National Institutes of Health.

Soghomonian was finally forced to make a snap decision when her husband took her 5-year-old son to get a seasonal flu shot and discovered the swine flu vaccine was available, too.

"I called him and said, 'Just do both,' " she said. He did, but Soghomonian was still uneasy. "There was a moment of panic, like: What did I do?"

Nevertheless, Soghomonian was among the first few dozen people to line up last week at Wilson High School in the District to finally get her daughter vaccinated.

"It's your pediatrician. Your children have been there since Day One. You feel like they know and you should listen to their advice. And here I'm going against it," she said.

"Ultimately, you have to make your own decision."

Staff researcher Madonna Lebling contributed to this report.

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