Public confidence in vaccinations against swine flu has been shaken after a private doctor suffered severe nervous system damage following a shot, the first such case reported in Hong Kong. Some patients booked for shots at private clinics did not show up yesterday, as the number of people receiving vaccinations plunged. The Centre for Health Protection said 8,872 people were vaccinated yesterday, the second lowest daily total since the programme was extended to private clinics on December 28. About 15 per cent fewer elderly people, children and chronically ill patients had shots than on Wednesday. A government expert panel on adverse reactions to the vaccine held an emergency meeting to investigate the case of the 58-year-old private doctor, a cardiologist practising in Jordan who has an underlying chronic illness. The panel said his condition was 'compatible' with Guillain-Barre syndrome, the most severe side effect of vaccination, which damages the nervous system and can result in muscle weakness and even paralysis. The doctor was vaccinated on Christmas Eve and admitted to Queen Mary Hospital on Saturday, a week after feeling weakness in his legs. More tests will be done to find out if the complications were caused by the vaccination. The head of microbiology at the University of Hong Kong, Professor Yuen Kwok-yung, said there was no definitive test available to confirm or rule out a correlation between vaccination and Guillain-Barre syndrome. Yuen called on people in high-risk groups to have the vaccine, but said those who were allergic to eggs should not be vaccinated. Secretary for Food and Health Dr York Chow Yat-ngok said the government would not conclude the vaccine was unsafe unless more severe complications were recorded. The government would check with the supplier whether complications had been reported overseas. Centre for Health Protection controller Dr Thomas Tsang Ho-fai said the incident would 'cast a shadow' on people considering vaccination. Tsang said Hong Kong had seen 42 to 65 cases of Guillain-Barre syndrome each year in the past few years. In the last quarter of 2009, there had been six to 10 cases a month. 'These cases are all not related to the swine flu vaccine,' he said. The government would only consider shelving the vaccination programme if cases of Guillain-Barre syndrome jumped to an abnormal level, such as four cases in every 500,000 shots, he said. The programme aims to inoculate two million high-risk people, among them children, the elderly, pregnant women and health workers. Doctors Union president Henry Yeung Chiu-fat said private doctors had seen a dramatic drop in the number of people getting swine flu jabs. 'No one who made a booking turned up in my clinic this morning,' he said. A private doctor in Western district, Cheng Chi-man, said only one of 10 patients booked for a swine flu shot showed up. 'We did not have any defaults before,' he said. A health professional familiar with the programme said the suspected case of Guillain-Barre presented the government with a difficult test: how to rebuild public confidence in the programme. 'The government believes this case will cause negative sentiment. If this patient can recover soon, the damage in public confidence will be less. What the government can do is let the public understand the risks and benefits and send a clear message that it is still beneficial for the high-risk groups to get the shots.' Another health professional involved in the programme said: 'We understand the public concerns. We hope that members of the public will be rational and look fairly at the risks and benefits of the vaccination.' Dr Tse Hung-hing, president of the Hong Kong Medical Association, said after a meeting with Tsang that the association would urge members to fully inform vaccine recipients of the man's case and the possibility his condition was a result of receiving swine flu shots. Former Medical Association president Dr Choi Kin said he would advise people not in high-risk groups to 'seriously think twice' before having a swine flu shot. 'I wouldn't recommend a shot for them,' he said. Choi also criticised the government for a delay in giving information to the public. The Centre for Health Protection did not inform the public when the private doctor was admitted to Queen Mary Hospital on Saturday. Choi said it was not until some inquiries were made to the centre on Wednesday that it issued a statement on the case. An insider on the investigation of the case said the centre had tried to play it down. 'The centre does not want to give the impression to the public that the case is serious,' the insider said. University of Hong Kong microbiologist Dr Ho Pak-leung said the incident would inevitably affect public confidence in the programme but that globally there was 'no unusual increase in the cases of Guillain-Barre syndrome'. Frontline Doctors' Union vice-president Dr Siu Yuk-leung warned that the vaccination programme would fail if another case of Guillain-Barre emerged in the next month or two. A spokeswoman for Sanofi-Aventis, the maker of the vaccine, said it had not received any reports about the vaccine causing Guillain-Barre syndrome. Meanwhile, the Macau Health Bureau said there were no reasons to believe the death of a 79-year-old after receiving swine flu vaccine was related to the shot. The man, who was chronically ill with hypertension and diabetes, died two days after receiving his second flu shot. Symptoms The symptoms of Guillain-Barre syndrome, which mainly affects the nervous system Limb and muscle paralysis Difficulty breathing Difficulty swallowing Slowing of nervous responses Source: Dr Patrick Li Chung-ki, a member of the government-appointed scientific committee
