There are multiple trials of swine flu vaccine in different countries and involving different subpopulations. Recent news strongly suggests that — surprisingly — a single dose of viral antigen (i.e., one injection) may be sufficient to raise antibody against swine flu to protective levels. There are a lot of uncertainties here, but the data have been fairly consistent. But that’s for adults (over 18 years old). Since children are also had high risk, there is much apprehension whether a single dose will also work for children. Now we’re getting some of the first results and the news is good and not quite so good. Here’s the short version. If you’re over ten years old, one shot might do it. If you’re under ten, it looks like you’ll need two (but if you’re under ten and sitting at computer, you’re probably playing video games and not reading this). Since this news is all over the wires you don’t need to read it here. So instead of talking about flu news, we’re going to discuss meta flu news, i.e., observations about how this news is disseminated. We use the word “observation” because it’s not a scholarly study, but just, well, an observation. We have a small, but significant, sample: stories written by excellent and knowledgeable science journalists.
First the news report that is certainly authoritative, the NIH Press Release upon which all the stories are based. Here’s the lede and a subsequent paragraph:
Early results from a trial testing a 2009 H1N1 influenza vaccine in children look promising, according to the trial sponsor, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Preliminary analysis of blood samples from a small group of trial participants shows that a single 15-microgram dose of a non-adjuvanted 2009 H1N1 influenza vaccine – the same dose that is in the seasonal flu vaccine – generates an immune response that is expected to be protective against 2009 H1N1 influenza virus in the majority of 10- to 17- year-olds eight to 10 days following vaccination. These results are similar to those recently reported in clinical trials of healthy adults. Younger children generally had a less robust early response to the vaccine.
“This is very encouraging news,” says NIAID Director Anthony S. Fauci, M.D.” As we had hoped, responses to the 2009 H1N1 influenza vaccine are very similar to what we see with routinely used seasonal influenza vaccines made in the same way. It seems likely that the H1N1 flu vaccine will require just one 15-microgram dose for children 10 to 17 years of age. The 2009 H1N1 influenza virus is causing widespread infections among children, so these are welcome results.” (NIH Press Release)
You have to read a couple of more paragraphs, almost halfway through before getting to this:
The immune responses in children nine years old and younger were not as strong. Among 25 volunteers aged 3 to 9 years old, a strong immune response was seen in 36 percent of those given 15 micrograms of vaccine. In the youngest group, 20 children between 6 months to 35 months old, a single 15-microgram dose of vaccine produced a strong immune response in 25 percent of recipients.
“These results are not unexpected and are both similar to what is seen with seasonal influenza vaccines and consistent with what we and our colleagues at the Food and Drug Administration anticipated,” notes Dr. Fauci.
Now here’s the lede from one of the world’s best flu reporters, the Canadian Press’s Helen Branswell:
The first clinical trial of swine flu vaccine in children suggests that those 10 and over will only need one shot of the vaccine, but children under 10 will need two doses for protection, U.S. officials said Monday as they released interim data from the study.
That dosing regime follows the pattern used for seasonal flu shots, where two doses are recommended for children nine and under if it is the first time they are getting a flu shot. (Helen Branswell, Canadian Press via Toronto Sun)
And Science Magazine’s Science Insider blogger, Jon Cohen:
Early results from clinical trials suggest that healthy children under the age of 9 will likely need two doses of the swine flu vaccine, but those between 10 and 17 can get by with a single shot, U.S. health officials announced today. (Jon Cohen, ScienceInsider)
Here’s Richard Knox, from NPR:
Ten days after the government announced the new pandemic flu vaccine works better than expected in adults, officials say it performs well in kids too.
But kids under 10 are not going to get away with just one shot or just one squirt in the nose, officials say. (NPR Health Blog)
And Maggie Fox (Reuters):
WASHINGTON, Sept 21 (Reuters) – Younger children will need two doses of the vaccine against the new pandemic of H1N1 influenza, U.S. officials said on Monday.
They said tests of Sanofi-Pasteur’s (SASY.PA) swine flu vaccine showed children respond to it just as they do to seasonal flu vaccines, with children over 10 needing only a single dose. (Reuters)
Here’s my point. Each of these experienced science journalists rewrote the NIH lede to emphasize the good news that one shot for the over tens was sufficient but that for their younger sibs it would take two. NIH portrayed that as meaning things are just like seasonal flu (where two shots for those first immunized under ten are also used), and that’s technically correct. But that wasn’t the real news buried halfway through the press release.
I’ve spent a lot of time here complaining how so much science reporting I see everyday is barely massaged press releases regurgitated by reporters acting as stenographers. So I wanted to make sure to say — again, because I’ve said it a lot here — that there are some really good science reporters out there that don’t do that. For the ones I didn’t mention I apologize. It’s one of the hazards of mentioning any. You inevitably leave out more just as deserving. But you know who you are and so do we. And we’re glad some of you are still around.
Addendum, 7 am, 9/22/09: Compare the above with the lede by “staff writers for Agence France Presse”:
US health officials announced “more good news” Monday in the fight against swine flu, saying clinical trials have shown that a single dose of H1N1 vaccine will be enough to immunize healthy older children.
“Preliminary data from our trials indicate that a single 15-microgram dose of vaccine is well tolerated and induces immune responses in most older children that is generally predictive of protection,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health (NIH), told a news conference.
“Among healthy children aged 10 – 17 years old, 76 percent had a robust immune response” eight to 10 days after being given a single shot of a vaccine made by French manufacturer Sanofi Pasteur, said Fauci.
The announcement came 10 days after US health officials announced that a single dose of swine flu vaccine could be enough to immunize healthy adults aged 18-64 (“One swine flu shot enough for pre-teens, teens: trials”, AFP)
AFP is a frequently unreliable wire service, but what we see here is all too typical of science and health reporting in general. It’s a rewrite of a press release, following the same emphases and little thought as to what was really news.