Sanofi’s vague medical advice

Elson Elizaga

DENGUE is a matter of life and death, but Sanofi Pasteur gives us information that seems to come from another planet. Its statement on November 29, 2017 is vague, evasive, and annoying.  Excerpt from mediaroom.sanofi.com:

“Based on up to six years of clinical data, the new analysis evaluated long-term safety and efficacy of Dengvaxia in people who had been infected with dengue prior to vaccination and those who had not. The analysis confirmed that Dengvaxia provides persistent protective benefit against dengue fever in those who had prior infection. For those not previously infected by dengue virus, however, the analysis found that in the longer term, more cases of severe disease could occur following vaccination upon a subsequent dengue infection.”

My understanding of the last sentence is if I have not been infected by dengue, and I get vaccinated, I’m fine. But after vaccination, if I get infected by dengue, I should kiss my ass goodbye.

But I’m not sure if my interpretation is correct. After all, why would I still get infected by dengue after I have been vaccinated?

The articles that I’ve read – news and opinion — do not interpret the Sanofi warning, possibly because the writers are as puzzled as anyone else. They just quote the statement, hoping the readers would get it. If we use Google Translate to decode the message, we get a headache:

“Base sa hangtod sa unom ka tuig nga clinical data, ang bag-ong pag-usisa nag-evaluate sa kaluwasan ug pagka-epektibo sa Dengvaxia sa mga tawo nga nataptan sa dengue sa wala pa ang pagbakuna ug niadtong wala pa. Ang pag-usisa nagpamatuod nga ang Dengvaxia Hinuon, ang pag-analisa nakit-an nga sa mas taas nga termino, dugang nga mga kaso sa grabe nga sakit ang mahitabo human sa pagbakuna sa sunod nga dengue infection.”

***

One article about the dengue vaccination program published by gmanetwork.com is confusing. Its headline says “No recommendation to use Dengvaxia, WHO clarifies”.

But the body of the article says the opposite. Here’s the statement of WHO (World Health Organization): “Use of the vaccine should only be considered in areas where a high proportion (preferably at least 70 percent) of the community had already been exposed to the virus; the vaccine should only be provided to people 9 years of age and above; and people being vaccinated should receive 3 doses.”

These statements are clearly recommendatory. Otherwise, they would contain negative words such as “do not”, or “avoid” or “refrain”.

It appears, though, that WHO doesn’t want to take responsibility for the vaccination if something goes wrong. WHO says use of the vaccine should only be CONSIDERED …”. WHO doesn’t say the vaccine should be used. So, it looks like WHO is washing its hands on Dengvaxia. It doesn’t give us clear instruction. It is simply telling us “Bahala na mo diha kung gamiton ba ninyo ang Dengvaxia o dili”. (You decide if you want to use Dengvaxia or not).

This wishy-washy advice is not what I normally would hear from a medical professional. A few months ago, I went to a doctor who told me in clear terms to buy and consume a specific medicine. He said I would be fine. And I was.

A few weeks later, I consulted another doctor for a different complaint. After looking at the ultrasound exam result, the doctor with the maiden surname of Emano said: “Look here. You have more than the usual amount of hydrocele in your right testicle, but it will disappear (the hydrocele, not the testicle) and you don’t need any medicine for it.”

And she was right. Thank you very much, doc.

(See also elson.elizaga.net.)